Objective The aim of this study was to investigate serum vitamin D deficiency in patients with autoimmune hepatitis (AIH). Methods A total of 74 patients with AIH were admitted to our hospital between January 2015 and November 2020, and all patients went liver biopsies. Serum 25-hydroxyvitamin D levels were detected. Severe vitamin D deficiency was defined as serum 25-hydroxyvitamin D level <25 nmol/L, life support D deficiency (deficiency) was defined as serum 25-hydroxyvitamin D level between 25nmol/L and 75nmol/L, and normal serum vitamin D level as >75nmol/L. Results Out of the 74 patients with AIH, severe vitamin D deficiency, deficiency and normal vitamin D levels were found in 20 cases, 28 cases and 26 cases; the age when diagnosed in patients with severe vitamin D deficiency was (34.2±14.8) year-old, significantly younger than [(40.2±11.4) year-old] in patients with vitamin D deficiency or [(47.2±10.8) year-old] in AIH patients with normal vitamin D levels (P<0.05), the percentage of males was 45.0%, significantly higher than 21.4% in deficiency patients or 11.5% in patients with normal vitamin D level (P<0.05), serum albumin level was (28.4±4.0) g/l, significantly lower than (32.0±3.8) g/l in patients with serum vitamin D deficiency or (38.3±3.7) g/l in patients with normal serum vitamin D level (P<0.05), the percentage of liver cirrhosis was 40.0%, which was significantly higher than (21.4%) in patients with serum vitamin D deficiency or (15.4%) in patients with normal serum vitamin D level (P < 0.05), the complete response to immunosuppressive therapy was 30.0%, which was significantly lower than 46.4% in patients with serum vitamin D deficiency or 73.1% in patients with normal serum vitamin D level (P < 0.05), the incidence of liver related events was 65.0%, which was significantly higher than 39.3% in patients with serum vitamin D deficiency or 19.2% in patients with normal serum vitamin D level (P<0.05), and there were significant differences as respect to ages at diagnosis, gender percentage, serum albumin levels, liver cirrhosis percentages and liver related events between patients with vitamin D deficiency and those with normal vitamin D levels (P < 0.05); serum 25-hydroxyvitamin D level in patients with G4 hepatic histological activity was (19.3±6.2)nmol/L, significantly lower than (45.1±17.6)nmol/L in patients with G3, or (63.9±21.5)nmol/L in with G2, or (74.0±26.8)nmol/L in with G1 or (83.8±30.2)nmol/L in with G0 (all P<0.05】, and serum 25-hydroxyvitamin D level in patients with F4 liver fibrosis was(23.1±7.8)nmol/L, significantly lower than (42.9±18.8)nmol/L in patients with F3, or (68.0±20.4)nmol/L in with F2, or (82.7±28.6)nmol/L in with F1 or (94.4±33.0)nmol/L in with F0 (all P<0.05). Conclusion Severe vitamin D deficiency is found in patients with AIH, which might be related to a severe disease and poor response to immunosuppressive treatment, and warrants further clinical investigation.

Objective The aim of this study was to investigate the impact of inhibition of tumor necrosis factor receptor associated factor 6 (TRAF6) gene expression on hepatic nuclear factor kappa-B (NF-κB)-related protein expression in rats with autoimmune hepatitis (AIH). Methods 40 rats were randomly divided into four groups, with 10 in each. The model of AIH was established in SD rats by specific antigen S-100, and the model rats were transfected with empty vector or TRAF6 shRNA vector. The expression of TRAF6-related proteins were detected by immunohistochemistry. The level of TRAF6 mRNA was detected by qRT-PCR. The IL-1β and IL-6 levels in liver homogenates were detected by ELISA. The expression of NF-κB signaling pathway related proteins in liver tissues was detected by Western blot. Results The hepatic TRAF6 mRNA level in model was (6.2±0.4), significantly higher than (1.0±0.2, P＜0.05) in control, while that in TRAF6 shRNA-intervened group decreased greatly as compared to in the model [(1.5±0.2), P＜0.05]; the liver homogenate IL-1βand IL-6 levels in the model were (60.3±8.1)pg/mL and (41.5±5.9)pg/mL, both significantly higher than [(8.9±0.6)pg/mL and (15.6±0.6)pg/mL, respectively, P＜0.05] in the control; the relative hepatic expression of IκBα, NF-κB p65, NF-κB p50, p-NF-κB p65 and p-NF-κB p50 in the model were (1.3±0.1), (1.6±0.1), (1.3±0.1), (1.3±0.1) and (1.1±0.1), all significantly higher than [(0.3±0.03), (0.3±0.02), (0.3±0.03), (0.3±0.03) and (0.3±0.03), P＜0.05] in the control, while they all significantly decreased in TRAF6-intervened group [(1.0±0.1),(0.9±0.05),(0.7±0.1),(0.8±0.1) and (0.5±0.05), P＜0.05] as compared to those in the model. Conclusion Inhibition TRAF6 gene expression could down-regulate the NF-κB signaling pathway, which might reduce liver inflammation of rats with AIH.

Objective This paper aimed to establish a cell model with luciferase as reporter gene for screening human EFTUD2 gene-targeting compounds. Methods After double-digestion of LV6 lentivirus vector by restrictive enzymes, the target fragment was recombined into the LV6 lentivirus vector.The HepG2 cells were further infected with the recombinant lentivirus, and the Epro-LUC-HepG2 cell line was obtained by puromycin screening and limited dilution. By using the luciferase reporter gene system, we select the best single clone cell lines and expand the culture. Results The LV6-Epro0.5-LUC lentivirus vector was successfully constructed, and the Epro-LUC-HepG2 monoclonal cell lines expressing luciferase was successfully screened by lentivirus transfection and puromycin selection. According to the results of luciferase reporter gene detection, the best monoclonal cells were selected and named as Epro-LUC-HepG2 cells. Conclusion The Epro-LUC-HepG2 cells, a compounds screening model of targeting human EFTUD2 gene, is successfully constructed, which laid a hope for further screening of new targeted immunoregulatory agents.

Objective The aim of this experimental study was to implore the regulation of intestinal floras and their metabolism functions by ganoderma lucidum plysaceharide (GLP) in mice with HepG2 cell-induced implanted cancer. Methods The subcutaneous cancer in mice was established by HepG2 cell implantation, and 21 mice with successful implanted cancer were randomly divided into model, GLP-intervened and probiotics-intervened groups, with 7 in each. 7 normal mice were selected as control. The GLP and probiotics were administered intragastrically, while normal saline were given by gavage in model and control for 2 weeks. The diversity of intestinal floras, and fatty acid metabolites were detected by microscopy and denaturing gradient gel electrophoresis (DGGE). Results The number of Bifidobacterium, Lactobacillus, Escherichia Coli and Enterococcus in model group were(2.3±0.5)×10¹⁰ CFU/g, (12.2±2.2)×10⁹ CFU/g, (3.9±1.5)×10⁷ CFU/g and(5.0±1.2)×10¹⁰ CFU/g, all significantly higher than [(0.94±0.18)×10¹⁰ CFU/g,(3.49±0.66)×10⁹ CFU/g, (1.12±0.11)×10⁷ CFU/g and (0.57±0.06)×10¹⁰ CFU/g, respectively,P<0.05] in the control,ylajj@163.com while they were(1.1±0.1)×10¹⁰ CFU/g, (6.5±1.1)×10⁹ CFU/g, (1.8±0.2)×10⁷ CFU/g and (1.5±0.1)×10¹⁰ CFU/g in GLP-intervened group (P<0.05); the abundance, the diversity index and uniformity of intestinal floras in GLP-intervened group were (7.2±1.1)S,(4.8±1.1)H and (1.0±0.2)E, all significantly higher than [(5.7±1.2)S, (3.4±0.5)H and (0.7±0.1)E, respectively, P<0.05] in the model; the intestinal flora acetic acid, propionic acid and n-butyric acid in GLP-intervened group were (37.9±3.3)mmol/L,(3.9±0.2)mmol/L and (2.3±0.3)mmol/L, all significantly higher than [(26.8±3.2)mmol/L,(1.8±0.4)mmol/L and (1.8±0.2)mmol/L, respectively, P<0.05], while the D-lactic acid was (0.2±0.0)g/L, much lower than (0.5±0.1)g/L in the model (P<0.05). Conclusion The imbalance of intestinal floras is closely related to the carcinogenesis in mice, and the GLP administration might correct the intestinal microecological disorders, which warrants further investigation.

Objective To investigate the shear wave elastography (SWE, or E imaging) and serological markers in the evaluation of significant liver fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 76 patients with CHB were enrolled in our hospital between January 2017 and January 2020, and all of them received liver biopsies and hepatic SWE examination. The APRI and FIB-4 scores were calculated. Multivariate Logistic regression analysis was applied to analyze the independent risk factors of liver fibrosis, and the area under receiver operating characteristic curve (AUROC) was used to evaluate the accuracy of each index in the diagnosis of liver fibrosis. Results Among the 76 patients with CHB, there were 8 cases of F0 stage, 22 cases of F1 stage, and 25 cases of F2 stage, 12 cases of F3 stage and 9 cases of F4 stage by histopathological examination; We combined F0 and F1 stages of liver fibrosis as non-significant liver fibrosis group (n = 30),and defined F2, F3 and F4 stages as significantly group (n = 46); the Young's modulus of patients in non-significant group was (6.6±1.2) kpa, significantly lower than that in significant group [(12.7±2.1) kpa, P<0.05]; serum HA level in patients with non-significant group was 36.4 (23.1-70.6) g/L, significantly lower than that in significant group [92.3 (67.2-192.5) g/L, P <0.05], serum LN level was 42.9(26.4-58.4)μg/L, significantly lower than [75.8(36.8-142.0)μg/L, P<0.05], serum Ⅳ-C level was 36.6(24.0-75.3)μg/L, significantly lower than [102.2(47.2-245.8)μg/L, P<0.05], and serum PⅢP level was 8.2(7.2-10.5)μg/L, significantly lower than [17.0(7.7-26.8)μg/L, P<0.05] in patients with significant liver fibrosis; the APRI score in patients without significant fibrosis was (0.5±0.2) , significantly lower than that in those with significant fibrosis [(1.0±0.4), P<0.05], and the FIB-4 score was (1.2±0.9), significantly lower than that in with significant group [(2.1±1.3), P<0.05]; multivariate Logistic regression analysis showed that Young’s modulus, APRI and FIB-4 were the independent predictors of significant liver fibrosis in CHB patients (P<0.05); the AUC of Young's modulus was 0.89, significantly higher than 0.80 (P<0.05) by APRI or 0.77 (P<0.05) by FIB-4, in diagnosing significant liver fibrosis, with the diagnostic cut-off value, sensitivity and specificity being of 7.5 kPa, 84.5% and 88.4%, respectively. Conclusion The detection of Young's modulus of liver by ultrasound E-imaging might effectively diagnose significant hepatic fibrosis in patients with CHB, which is of great clinical value.

Objective The aim of this study was to investigate the change of serum endoplasmic reticulum stress parameters in patients with chronic hepatitis B (CHB). Methods 109 patients with CHB, 91 patients with hepatitis B cirrhosis and 76 patients with primary liver cancer (PLC)], and 120 healthyvolunteers were recruited in this study between May 2017 and May 2020, and serum hyaluronic acid (HA) , laminin (LN), type Ⅲ collagen peptide (P Ⅲ P), and collagen type Ⅳ (Ⅳ - C) were assayed by RIA. Serum glucose-regulating protein 78 (GRP78), endoplasmic reticulum stress transcription factor CCAAT/enhancer binding protein homologous protein (CHOP) and aspartic cysteine-specific protease 12 (Caspase-12) were determined by ELISA. Results Serum ALT, AST, GGT and ALP levels in patients with CHB were (83.4±21.7)U/L, (63.7±20.5)U/L, (82.2±20.4)U/L and (95.7±20.8)U/L, they were (74.3±18.5)U/L,(51.5±18.9)U/L,(84.9±22.5)U/L and (94.8±19.8)U/L in patients with liver cirrhosis, and were (70.2±17.7)U/L, (52.6±18.8)U/L, (93.8±24.8)U/L and (106.8±22.4)U/L in patients with PLC, all significantly higher than those in healthy control (P＜0.05); serum HA,LN,Ⅳ-C and PⅢP levels in patients with CHB were (84.5±78.9)ng/mL, (52.8±24.1)ng/mL,(61.4±33.0)ng/mL and (10.9±7.4)ng/mL, in patients with liver cirrhosis were (155.2±75.6)ng/mL,(63.1±22.8)ng/mL, (82.2±30.1)ng/mL and (15.4±5.2)ng/mL, and in patients with PLC were (153.3±73.2)ng/mL, (64.6±20.4)ng/mL, (80.9±28.4)ng/mL and (15.4±3.1)ng/mL, all significantly higher than [(38.6±14.2)ng/mL,(34.2±13.3)ng/mL, (33.9±10.9)ng/mL and (6.8±1.6)ng/mL, respectively,P＜0.05] in healthy control; serum GRP78, CHOP and caspase-12 levels in patients with CHB were (44.0±12.4)μg/L, (2485.5±1200.0)μg/L and (699.8±204.2)pmol/L, in patients with liver cirrhosis were (51.7±15.9)μg/L, (2873.1±1314.2)μg/L and (752.2±241.5)pmol/L, and in patients with PLC were (62.7±17.1)μg/L, (3040.9±1440.3)μg/L and (842.8±289.4)pmol/L, all significantly higher than [(7.3±2.1)μg/L,(833.4±333.5)μg/L and (85.3±13.7)pmol/L,P＜0.05] in healthy persons. Conclusion Endoplasmic reticulum stress is activated in patients with CHB, and its implications warrants further investigation.

Objective The aim of this study was to investigate the liver stiffness measurement (LSM) in patients with chronic hepatitis B viral infection and different alanineaminotransferase (ALT) levels. Methods 68 patients with chronic hepatitis B viral infections (HBV carriers in 21 and CHB in 47) were enrolled in this study between April 2018 and April 2020,and the patients were divided based on serum ALT levels into group A ( serum ALT level <40 U/L, n=21), group B (40 U/L≤ALT<80 U/L, n=24) and group C (ALT≥80 U/L, n=23). All patients underwent liver biopsies and LSM by Fibroscan. Serum hyaluronic acid (HA), laminin (LN), typeⅣ collagen (ⅣC) and type Ⅲ procollagen (PcⅢ) in the three groups were detected. The efficacy of serum ALT and LSM in predicting theexistence of significant liver fibrosis (≥S2 stage) was determined by the area under receiver operating characteristic (AUC) by MedCalc1 5.1 software. Results There were no significant differences asrespect to serum fibrosis indexes among the three groups (P>0.05); the histopathological examination showed that S₀ liver fibrosis in 24, S₁ in 13, S₂ in 13, S₃ in 10 and S₄ in 8, and there were no significant differences as respect to the distribution of different liver fibrosis among the three groups(P>0.05); the LSM in 24 individuals with S₀ liver fibrosis was (10.9±2.8)kPa, was (11.3±3.0)kPa in 13 patients with S₁, and was (12.8±3.3)kPa in 31 patients with equal to or greater than S2 liver fibrosis (P<0.05), while there were still no significant differences as respect to serum liver fibrosis indexes among thethree different liver fibrosis individuals (P>0.05); the ROC analysis demonstrated that the AUC was 0.400(SE=0.070, 95%CI=0.262-0.538, P=0.185) when serum ALT level equal to 63.8 U/L was set as the cut-off-value in predicting equal to or greater than S₂ liver fibrosis, with the sensitivity (Se) and specificity (Sp) of 0.364 and 0.370, while when the LSM equal to 12.3 kPa was set as the cut-off-value in predicting equal to or greater than S₂ liver fibrosis, the AUC was 0.868(SE=0.042, 95%CI=0.785-0.950,P=0.000), with the Se and Sp of 0.955 and 0.717. Conclusion The individuals with chronic hepatitis B viral infections might have different stage of liver fibrosis no matter how high serum ALT level, and either serum ALT levels or serum so-called liver fibrosis index, such as HA, LN,ⅣC and PcⅢ, couldn’t early warn liver fibrosis, but the LSM might do.

Objective The aim of this study was to predict liver fibrosis by liver stiffness measurement (LSM) and aspartate aminotransferase/platelet ratio (APRI) in patients with chronic hepatitis C (CHC). Methods A total of 133 patients with CHC and 133 volunteers were enrolled in this study in our hospital between May 2016 and May 2020, and all of them underwent LSM by FibroScan check-up and got APRI in clinic assessment. All CHC patients received liver biopsies for liver fibrosis evaluation. Results The LSM and APRI in patients with CHC were (10.3±4.2) and (0.8±0.3), both significantly higher than [(4.3±2.0) and (0.3±0.1), respectively, P＜0.05] in healthy persons; the LSM and APRI in 52 patients with liver fibrosis stage 1 (S₁) were (6.5±2.4) and (0.6±0.2), in 37 with S₂ were (10.3±2.9) and (0.9±0.3), in 28 with S₃ were (14.5±4.1) and (1.2±0.5), in 16 with S₄ were (18.4±5.7) and (1.8±0.6), significantly different among them (P＜0.05); the ROC analysis showed that the AUC of LSM was 0.891 in predicting significant liver fibrosis defined as equal to or greater than S2, with the standard error (SE) of 0.033 (P=0.000, 95% confidence interval (CI) of 0.826-0.956), the primal cut-off-value of 11.200, the sensitivity (Se) of 0.625 and the specificity (Sp) of 0.925, while the AUC of APRI was 0.776, with the SE of 0.050 (P=0.000, 95% CI of 0.678-0.875, the cut-off-value of 0.795, the Se of 0.643 and Sp of 0.887; both the LSM and APRI were positively correlated to liver fibrosis in patients with CHC(P＜0.05). Conclusion Both LSM and APRI could be applied to the diagnosis and staging assessment of liver fibrosis in patients with CHC, which warrants further multi-central clinical investigation.

Objective The aim of this study was to investigate the predictive value of liver cirrhosis by serum microRNA-1273g-3p levels in patients with chronic hepatitis C (CHC). Methods 125 patients with CHC were admitted to our hospital between March 2018 and August 2020, and serum microRNA-1273g-3p levels were detected by real-time fluorescent quantitative RT-polymerase chain reaction (qRT-PCR). The Logistic regression analysis was applied to reveal the influencing factors for liver cirrhosis occurrence. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of serum microRNA-1273g-3p for liver cirrhosis. Results Out of our series in this study, 42 patients with CHC were found to have liver cirrhosis based on the clinical, blood biochemical and imaging examination; the BMI, blood transfusion history, dyslipidemia, failure to adhere to antiviral treatment and serum microRNA-1273g-3p levels in patients with liver cirrhosis were significantly different compared to those without (all P < 0.05), the disease course in patients with liver cirrhosis was (12.4±2.7) yr, significantly longer than [(8.2±2.1) yr, P < 0.01] in patients without, and serum microRNA-1273g-3p level in the cirrhotics was (2.1±0.5), significantly higher than t [(1.3±0.3), P < 0.01] in patients without liver cirrhosis; the Logistic regression analysis showed that all the parameters mentioned above were the independent risk factors for CHC patients having liver cirrhosis; the ROC analysis showed that the optimal cut-off value of serum microRNA-1273g-3p level was 1.56, and its AUC was 0.844(95%CI:0.768-0.902), with the sensitivity of 78.6%(33/42, 95%CI:73.1%-83.2%), the specificity of 86.8%(72/83, 95%CI:82.5%-90.6%) and the accuracy of 90.4%(113/125, 95%CI:73.1%-83.2%) in predicting the concomitant liver cirrhosis. Conclusion Serum microrna-1273g-3p levels in CHC patients with liver cirrhosis increase, and regular surveillance might help manage the patients and give them an appropriate treatment.

Objective The aim of this study was to investigate serum cytokine changes in patients with nonalcoholic fatty liver diseases (NAFLD) and helicobacter pylori (HP)infection after clearance therapy. Methods 84 patients with NAFLD and HP infection were enrolled in our hospital between October 2018 and October 2020, and were randomly divided into observation and control group with 42 cases in each group. All patients received diet-control and exercise guidance, and those in the observationgroup received conventional four medicine combination for Hp eradication. Serum IL-6, IL-18 and TNF-α levels were detected by ELISA, and the homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Results The Hp infection was eradicated in all patients in the observation group; after treatment, serum IL-6,IL-18 and TNF-α levels in the observation group were (23.4±8.0)pg/ml, (43.7±8.2)pg/ml and (1.5±0.4)ng/L, all significantly lower than [(30.6±6.8)pg/ml, (49.5±10.1)pg/ml and (1.7±0.5)ng/L, respectively, P<0.05] in the control; there were no significantly differences as respect to serum AST levels [(50.8±10.9)U/L vs. (48.1±9.9)U/L], serum ALT levels [(69.3±13.5)U/L vs. (71.8±8.7)U/L] and serum GGT levels [(84.8±16.7)U/L vs. (86.2±20.3)U/L] between the two groups (P>0.05); the HOMA-IR in the observation group was (2.3±1.1), significantly lower than [(3.3±1.2), P <0.05] in the control, while there were no significant differences respect to fasting blood glucose levels [(6.3±1.0)mmol/L vs. (6.5±0.8)mmol/L] and blood glucose level at two hour after meal [7.3±0.9)mmol/L vs. (7.9±1.1)mmol/L] between the two groups(P >0.05); there was no significant difference in blood ester between the two groups(P >0.05). Conclusion The eradication of HP infection could inhibit inflammatory reaction in patients with NAFLD and HPinfection, which warrants further investigation for its impact on hepatic steatosis.

Objective To explore the relationship between the expression of transmembrane 6 superfamily member 2 (TM6SF2) gene and cardiovascular disease (CVD) in patients with non-alcoholic steatohepatitis (NASH). Methods A total of 93 NASH patients who were admitted to the hospital from September 2018 to September 2020 were enrolled. According to presence or absence of CVD, they were divided into NASH group and CVD group. The polymorphism of TM6SF2 gene at rs58542936 locus was detected by TaqMan probe method. The influencing factors of CVD were analyzed by Logistic multivariate regression analysis. The predictive value of TM6SF2 gene polymorphism at rs58542936 locus for CVD was analyzed by ROC curves. According to the polymorphism of TM6SF2 gene at rs58542936 locus in CVD patients, they were divided into homozygous group and heterozygous group. The levels of blood lipid and cardiac function indexes were compared betweenthe two groups. Results The proportions of cases with BMI not lower than 28kg/m², TC not lower than 5.2 mmol/L, smoking history, family history of CVD and heterozygous TM6SF2 gene at rs58542936 locus in CVD group were 51.4%, 82.9%, 57.1%, 51.4% and 40.0%, higher than those in NASH group (29.3%, 63.8%, 31.0%, 27.6%, 20.7%, P<0.05). The multivariate Logistics regression analysis showed that BMI not lower than 28 kg/m² [OR(95%CI): 1.7 (1.0-2.8)], TC not lower than 5.2 mmol/L [OR(95%CI): 1.8 (1.1-3.1)], family history of CVD [OR (95%CI): 1.8 (1.1-2.9)] and CT type TM6SF2 gene at rs58542936 locus [OR (95%CI): 1.8 (1.1-3.0)] were risk factors of CVD (P<0.05). AUC of TM6SF2 gene polymorphism at rs58542936 locus for predicting CVD was 0.7. TC, TG, LVEF and IMT in heterozygous TM6SF2 gene at rs58542936 locus were (6.3±1.0) mmol/L, (2.0±0.4) mmol/L, (56.1±2.9) % and (1.3±0.2) mm, higher or greater than those in homozygous type [(5.0±0.9) mmol/L, (1.6±0.3) mmol/L,(57.9±2.9) %, (0.9±0.2) mm] (P<0.05). Conclusion The polymorphism of TM6SF2 gene at rs58542936 locus is a risk factor of CVD, which is of predictive value for the occurrence of CVD. The cardiac function is worse in patients with heterozygous TM6SF2 gene at rs58542936 locus.

Objective The aim of this study was to explore the diagnostic efficacy of magnetic resonance imaging (MRI) iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence (IDEAL-IQ) in the evaluation of hepatic steatosis in patients with non-alcoholic fatty liver diseases(NAFLD). Methods A total of 120 patients with NAFLD and 65 healthy individuals were enrolled in our hospital between February 2018 and February 2020, and all underwent MRI scan. The magnetic resonance spectroscopy (MRS) of hydrogen proton and IDEAL-IQ quantitative indexes, e.g. relative lipid content (RLC) and fat fraction (FF) were obtained. The patients with NAFLD received liver biopsies. The diagnostic efficacy of IDEAL-IQ for hepatic steatosis was analyzed by ROC. Results Serum ALT, GGT, TC, TG, and the RLC and FF in patients with NAFLD were (54.8±10.6)U/L, (103.1±5.6)U/L, (6.2±0.7)mmol/L, (2.7±0.6)mmol/L, (17.4±9.2)% and (18.0±6.5)%, all significantly higher than [(25.7±11.4)U/L,(59.7±2.7)U/L,(4.6±0.4)mmol/L, (1.6±0.2)mmol/L, (3.5±1.3)% and (6.2±2.1)%, respectively, P＜0.05] in healthy persons; the RLC and FF in 15 patients with severe hepatic steatosis were(32.5±4.8)% and (28.6±4.0)%, both significantly higher than [(23.1±6.2)% and (20.8±5.1)%, P＜0.05] in 39 NAFLD patients with moderate liver steatosis or [(10.6±3.0)% and (13.9±4.2)%, P＜0.05] in 66 patients with mild liver steatosis; the AUC was 0.894, with the sensitivity (Se) of 88.7%, the specificity (Sp) of 70.8% as the RLC＞23.7 % was set as the cut-off-value, and the AUC was 0.870, with the Se of 97.0%, the Sp of 90.0% when the FF＞20.4 % was set as the cut-off-value in diagnosing moderate to severe liver steatosis, the latter superior to the former (Z=3.025,P＜0.05). Conclusion The qualitative and quantitative diagnosis of hepatic steatosis as an non-invasive approach in patients with NAFLD by MRI IDEAL-IQ is promising, and warrants further investigation.

Objective The aim of this study was to investigate the prevalence of fatty liver on physical healthy examination in 800 faculty in Chongqing. Methods 800 faculty members underwent physical examinations in our hospital between 2016 and 2017. All the individuals received sonography and blood analysis. The Logistic analysis was applied to reveal the risk factors. Results The prevalence of fatty liver was 28.4%(227/800) in our series, and out of which, the prevalence of fatty liver in male personnel was 39.1%, significantly higher than 20.2% in female (P<0.05), the positive detection as high risk population in individuals greater than 40 year old was 74.0% (169/227), and the prevalence of fatty liver in uneducated population was 42.8%, significantly higher than 27.7% in educated or 23.1% in well-educated persons(P<0.05); in individuals with fatty liver, the systolic blood pressure was(132.3±5.6)mmHg, the diastolic blood pressure was(83.2±10.9) mmHg, the body mass index (BMI) was (26.9±3.2)kg/m², the fasting blood glucose was (6.1±1.5)mmol/L, total blood cholesterol was (5.3±0.9)mmol/L, the triglycerides was (4.2±2.1)mmol/L, the uric acid was (361.9±85.9)μmol/L and serum alanine aminotransferase levels was (51.5±5.5)U/L, all significantly higher than [(116.9±23.2)mmHg, (71.9±9.9)mmHg, (22.7±2.7)kg/m²,(5.2±1.1)mmol/L,(2.2±1.7)mmol/L,(1.3±0.9)mmol/L,(328.9±213.4)μmol/L and (19.5±4.9)U/L, respectively, P<0.05] in persons without fatty liver; the multivariate Logistic analysis showed than the male, older than 40 years, uneducated, with hypertension and the BMI>24 kg/m² were the independent risk factors for occurrence of fatty liver. Conclusion The prevalence of fatty liver in faculty personnel is high, and the physical examination in time might diagnose the entity early and help give them healthy consultation as early as possible.

Objective The aim of this study was to investigate the implication of interleukin-6 (IL-6) gene polymorphism in short-term prognosis of patients with hepatitis B-inducedacute-on-chronic liver failure (HBV-ACLF). Methods 134 patients with HBV-ACLF were admitted to our hospital between April 2017 and April 2020. The single nucleotide polymorphisms (SNPs) of rs1524107, rs2069837, rs2069840 and rs2069845 of IL-6 gene were detected by imLDRTM multiple SNP typing kit. Results Out of the 134 patients with HBV-ACLF, the 90 day survivalrate was 73.9% with 35 dead; the peak total serum bilirubin level and prothrombin time international standardized ratio in dead patients were(399.3±168.8)μmol/L and (2.3±0.8), both significantly higher than[(285.9±121.5)μmol/L and (1.7±0.4), respectively, P＜0.05] in survived patients, while there were no significant differences as respect toserum albumin, creatinine, procalcitonin, white blood cell counts and platelet counts (P＞0.05); the distributions of rs1524107, rs2069837, rs2069840 and rs2069845 conform to Hardy-Weinberg genetic equilibrium law (P>0.05), and possess population representative; the genotype frequency distribution of rs1524107, rs2069837, rs2069840 and rs2069845 in the two groups showed no statistically significant difference (P>0.05), and the allele frequency distribution of rs1524107, rs2069837, rs2069840 and rs2069845 in the two groups also showed no statistical significance (P>0.05). Conclusion The SNPs of IL-6 rs1524107, RS2069837, rs2069840 and RS2069845 in survived and dead patients with HBV-ACLF have no significant differences, so the detection could not predict the prognosis of patients in this setting and might deal with them routinely.

Objective This paper aimed to investigate the clinical features and influencing factors of invasive fungal infections (IFI) in patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF). Methods The clinical data of 130 patients with HBV-ACLF admitted in our hospital between January 2017 and January 2020 were collected and analyzed retrospectively. The incidence, location and species of IFI in patients with ACLF were documented. The multivariate Logistic regression analysis was applied analyze the risk factors for IFI in patients with ACLF. Results Out of the 130 patients with HBV-ACLF in our series, the incidence of IFI was 38.5%, and the common infection sites were in upper respiratory tract and lung infection in 24 cases(48.0%), gut infection in 14 cases(28.0%), urinary tract infection in 7 cases(14.0%), blood infection in 4 cases (8.0%) and peritoneal infection in 1 case(2.0%); the most common pathogenic bacteria was the Candida albicans in 26 cases(52.0%); the percentages of age older than 40 year and long-term administration of antibiotics in patients with IFI were significantly higher than in patients without (P<0.05), total serum bilirubin and prothrombin time were significantly higher or longer than, while serum albumin level was much lower than in patients without IFI(P<0.05); multivariate Logistic regression analysis showed that older than 40 year (OR=3.332), incredible hyperbilirubinemia (OR=4.525) and long-term intravenous administration of antibiotics(OR=1.576) were the independent risk factors for IFI in patients with ACLF(P<0.05). Conclusion The main sites of invasive fungal infection in patients with HBV-ACLF are upper respiratory tract and lung, and the main common pathogenic bacteria is Candida albicans. The peripheral blood white blood cell counts, serum bilirubin levels, and PT increase or elongated. The patients’ age older than 40 year, intravenous infusion of antibiotics longer than 4 weeks and excessive high serum bilirubin levels are the risk factors for invasive fungal infection in patients with HBV-ACLF. Therefore, targeted preventive measures should be taken to deal with them, which might reduce the complications and improve the prognosis.

Objective The aim of this study was to analyze the clinical features and risk factors of acute kidney injury (AKI) in patients with viral hepatitis B-induced liver cirrhosis (LC). Methods A total of 223 patients with hepatitis B cirrhosis were admitted to our hospital between April 2015 and February 2020, and the AKI incidence was found. Serum hydroxybutyrate-dehydrogenase (HBDH) and indocyanine green (ICG) were detected. The estimated glomerular filtration rate (eGFR) was calculated. The independent risk factors for occurrence AKI were analyzed by multivariate Logistic regression analysis. Results Out of the 223 patients with LC, 41 patients(18.4%) were found having AKI, and we selected 82 patients without AKI based on age and gender pair for control; the results showed that the percentages of aged≥50 yr, with diabetes, hyperuricemia, ascites, infection and Child-Pugh class C in patients with AKI were 39.0%,26.8%,29.3%,80.5%,36.6% and 53.7%, all significantly higher than (20.7%, 12.2%, 13.4%, 59.8%, 17.1% and 17.1%, respectively, P<0.05); serum HBDH and ICG levels in patients with AKI were (184.2±21.3)U/L and (31.4±3.6)%, both significantly higher than [(141.0±13.8)U/L and (15.6±1.9)%, respectively, P<0.05], while the eGFR was (71.6±11.3)mL/min·(1.73 m²)^-1, significantly lower than [(113.8±13.4)mL/min·(1.73 m²)^-1, P<0.05] in patients without AKI; the multivariate Logistic regression analysis demonstrated that aged ≥50 yr[OR(95%CI):3.0(1.1-8.6)], complicated by diabetes [OR(95%CI):1.9(1.1-3.3)], with hyperuricemia [OR(95%CI):2.8(1.1-7.3)], with ascites [OR(95%CI):2.6(1.0-6.6)], with infection [OR(95%CI):5.1(1.2-22.6)], Child-Pugh class C [OR(95%CI):3.6(1.5-8.9)], high serum HBDH level [OR(95%CI):2.8(1.2-6.3)] and lower eGFR [OR(95%CI):2.4(1.3-4.4)] were all the independent risk factors for occurrence of AKI in patients with LC induced by CHB(P<0.05). Conclusion AKI is more prone to patients with hepatitis B-induced liver cirrhosis, and some risk factors, such as eldly patients, with concomitant diabetes, hyperuricemia, ascites, infection, and poor liver functions, should be taken into consideration clinically, which means early diagnosis and appropriate management might improve the prognosis.

Objective The aim of this study was to explore the value of serum pro-adrenomedullin (pro-ADM) levels in the diagnosis of bacterial infection and the prediction of short-term prognosis in patients with decompensated cirrhosis(DC). Methods 229 patients with DC were prospectively enrolled between January 2016 and December 2017 in Hwamei Hospital, University of Chinese Academy of Sciences. Serum pro-ADM levels were detected, ,and the value of serum pro-ADM in the diagnosis of infection and the prediction of 28-day mortality in patients with DC was analyzed. Results Out of the 229 DC patients, the bacterial infections occurred in 60 cases (26.2%), with the 28-day mortality of 6.1% and 90-day mortality of 12.2%; serum pro-ADM level in patients with bacterial infection was 13.0(12.3, 13.7) nmol/L, significantly higher than (8.8(7.5, 11.0)nmol/L, P<0.001) in patients without; the multivariate Logistic regression analysis showed that serum pro-ADM, peripheral white blood cell(WBC) counts, C-reactive protein (CRP) and MELD score were the independent risk factors for bacterial infection (P<0.05), and serum pro-ADM, WBC counts and MELD score were the independent risk factors for 28-day mortality (P<0.05); the AUC of serum pro-ADM level in predicting bacterial infection in patients with DC was 0.674(95% CI:0.609-0.734), and the AUC of combination of it with WBC counts and CRP was 0.787(95% CI:0.729-0.839). Conclusions The detection of serum pro-ADM levels might help diagnose the bacterial infection in patients with DC, and those with extremely increased serum pro-ADM levels hints poor prognosis.

Objective The aim of this study was to summarize the clinical features of patients with hepatitis B liver cirrhosis (LC) complicated by esophagogastric variceal bleeding (EVB), and to explore the risk factors of EVB. Methods The clinical data of 108 patients with hepatitis B LC complicated with gastroesophageal varices (GOV) were collected in our hospital between June 2018 and June 2020, and internal medicine was given when the EVB occurred. The clinical features of patients were summarized and the independent risk factors of EVB were evaluated by univariate and multivariate Logistic regression analysis. Results Among the 108 patients with hepatitis B LC and GOV, the EVB occurred in 38 cases (35.2%) , and out of which, 5 patients (13.2%) died within 72 hours after onset of bleeding; the univariate analysis indicated that overwork was not significantly related with EVB in patients with hepatitis B LC and GOV (P>0.05), while improper diet, taking non-steroidal anti-inflammatory agents, platelet (PLT) count, prothrombin time (PT), serum albumin (ALB), diameter of portal vein and splenic vein, red-color sign, Child-Pugh class of liver functions and GOV degrees were significantly correlated with EVB happening (P<0.05); the multivariate Logistic regression analysis showed that improper diet [OR(95%CI) : 2.2 (1.3-3.7)], increased portal vein diameter [OR(95% CI:1.4(1.1-1.7)], prolonged PT [OR(95% CI:1.3(1.1-1.6)], red-color sign [OR(95% CI:3.3(1.6-7.1)], Child-Pugh class C [OR(95% CI:3.9(1.7-9.0)] and severe GOV [OR(95% CI:3.5(1.9-6.5)] were the independent risk factors of EVB in patients with LC. Conclusion The EVB is the improper cause of gastrointestinal bleeding in patients with hepatitis B-induced LC,and the common intriguing events should be dealt with early and appropriately in clinical practice to decrease the EVB occurrence.

Objective The aim of this study was to investigate the changes of serum leptin level in patients with hepatitis B liver cirrhosis and concomitant metabolic associated fatty liver diseases (MAFLD). Methods The specimen from 186 patients with hepatitis B liver cirrhosis (including 95 cases of Child-Pugh class A, 51 cases of Child-Pugh class B and 40 cases of Child-Pugh class C) as the Sino-French Hepatocellular Carcinoma Project in our hospital were selected, and out of the patients with Child-Pugh class A, 49 patients had, and 46 had not concomitant MAFLD.Serum LP levels were determined by ELISA. The multivariate Logistic analysis was applied to reveal the risk factors for MAFLD occurrence. Results Serum AFP and LP levels in cirrhotics with MAFLD were (2.1±1.3)ln ng/ml and (0.9±1.2)ng/ml, significantly higher than [(1.5±1.1)ln ng/ml and (0.5±1.1)ng/ml, respectively, P＜0.05] in cirrhotics without; the multivariate Logistic regression analysis was performed with the concomitant MAFLD as the dependent variable, the final factors found included serum LP and AFP levels, the risk for MAFLD occurrence increased 2.3 times for every increased 1 unit of serum LP level (P＜0.05, OR=2.3), and the risk for MAFLD increased 1.8 times for every increased 1 unit of serum LP level (P＜0.05, OR=1.8); there was no significant difference respect to serum LP level (P＞0.05), while there was significant differences respect to serum AFP level among cirrhotics with Child-Pugh class A, class B and class C (P<0.05). Conclusion Serum LP levels in patients with hepatitis B liver cirrhosis and concomitant MAFLD increase, but no correlation is found between serum LP levels and the severity of liver cirrhosis, suggesting that the elevated serum LP levels in patients with hepatitis B cirrhosis might be related to the combined metabolic factors.

Objective The aim of this study was to investigate summarize the ultrasonographic features of cavernous transformation of the portal vein (CTPV) in patients with chronic liver diseases (CLD). Methods Abdominal ultrasonography was conducted in 101 patients with CLD, who was diagnosed with CTPV by CT or MRI in Beijing Ditan Hospital affiliated to Capital Medical University between June 2017 and June 2020. The ultrasonic image features of CTPV and its related complications were summarized, and the causes of ultrasonic missed diagnosis were analyzed with the solutions proposed. Results Out of the 101 patients with CTPV proven by CT and/or MRI, the ultrasonic diagnosis was correct in 82 cases (82.2%), with 19 cases (17.8%) missed; among the cases correctly diagnosed by ultrasonography, 82 patients (100.0%) showed extensive or local cellular vascular structures around the portal vein trunk and its branches, the wall of portal vein was thickened in 70 cases (85.4%), the tortuously dilated cellular vascular structure showed red and blue interlaced rich blood flow signals in 76 patients (92.7%), the low-speed blood flow spectrum of portal vein was measured by pulse Doppler, the tortuously dilated honeycomb vessels around the portal vein compressed the bile duct, resulting in bile duct dilatation in ten cases (12.2%), the gallbladder enlargement occurred in 8 patients (9.6%), the cholecystolithiasis was present in 6 patients (7.4%), the bile duct stones were found in 5 cases (6.1%) and the portal shunt occurred in 5 cases (6.1%). Conclusion Ultrasonography is an important imaging method for the diagnosis of cavernous transformation of portal vein. The main reasons for ultrasonic missed diagnosis are small vascular lumen, small lesion scope, abdominal distension, pseudotumor of bile duct, narrow intercostal space and substernal angle. The enhanced CT or MRI examinations need to perform for correct diagnosis. The liver is scanned at acoustic windows of abdominal effusion or gallbladder and the contrast-enhanced ultrasonography might help reduce the missed diagnosis.

Objective The purpose of this study was to investigate the expression of nucleotide-binding oligomerization domain leucine rich repeats containing pyrin domain 3 (NLRP3) inflammasome in cancerous tissues of patients with primary liver cancer (PLC). Methods The tumorous specimens from 34 patients with PLC and 30 normal liver tissues from patients with cholelithiasis were obtained in our hospital between January 2017 and January 2018, and the expression of NLRP3 inflammasome were detected by immunohistochemistry. The NLRP3 mRNA levels were detected by RT-PCR. Serum IL-1β, IL-6 and TNF-α levels were assayed by ELISA. The NLRP3 inflammasome, E-cadherin, Vimentin and cysteine protease 1 (Caspase-1) expression were detected by Western blot. Results The positive rate of NLRP3 in cancerous tissues was 76.5%, significantly higher than 23.3%(P<0.05) in normal liver tissues; the NLRP3 mRNA level in cancerous tissues was (-2.58±0.35), much higher than [(0.00±0.24), P<0.05] in normal liver tissues; serum IL-1β, IL-6 and TNF-α levels in patients with PLC were (17.25±3.36) pg/ml, (60.32±8.14) pg/ml and (24.68±3.58) pg/ml, significantly higher than [(10.35±1.25) pg/ml, (33.21±4.20) pg/ml and (10.36±2.54) pg/ml, respectively, P<0.05] in patients with cholelithiasis; the expression of E-cadherin in normal liver was (1.2±0.15), significantly higher than [(0.41±0.04), P<0.05], while the hepatic expression of caspase-1 and vimentin were (0.21±0.03) and (0.42±0.06), significantly lower than [(1.49±0.12) and (1.51±0.14), respectively, P<0.05] in normal liver tissues. Conclusion NLRP3 inflammasome is highly expressed in patients with PLC, and the up-regulation might lead to inflammatory reactions and promote migration of cancer cells.

Objective The aim of this study was to explore the value of serum heat shock protein 90α (HSP90α) and protein-induced by vitamin K antagonist-II (PIVKA-II) in prognosis of patients with hepatocellular carcinoma (HCC). Methods A total of 112 patients with HCC, 96 patients with hepatitis B liver cirrhosis, 82 patients with chronic hepatitis B, and 84 healthy persons were enrolled in our hospital between January 2014 and June 2016, and all patients with HCC underwent transcatheter arterial chemoembolization (TACE). Serum HSP90α and PIVKA-II levels were detected by ELISA. The ROC was applied to evaluate the efficacy of serum parameters for the prognosis of patients with HCC after TACE. Results Serum Hsp90 α and PIVKA-II levels in HCC group were (61.6±5.0) ng / mL and (832.6±66.7) mAU / mL, significantly higher than [13.2±1.6] ng/mL and (29.4±2.9) mAU / mL, P < 0.05] in patients with cirrhosis, or [4.3±0.4) ng / mL and (29.1±3.0) mAU / mL, P<0.05] in patients with hepatitis B or [(3.2±0.4) ng / mL and (26.7±3.2) mAU / mL, P<0.05] in healthy persons; serum Hsp90 α and PIVKA-Ⅱ levels in 55 survivals were (44.4±4.4) ng / mL and (701.3±62.3) mAU / mL, respectively, which were significantly lower than [(78.3±5.2) ng / mL and (959.2±92.2) mAU / mL, P < 0.05] in 57 dead; univariate analysis showed that extrahepatic metastasis, tumor cell differentiation, Child-Pugh classification, TNM staging, and serum HSP90α and PIVKA-II levels were significantly different in survivals and dead, and the multivariate Logistic regression analysis showed that extrahepatic metastasis, low tumor differentiation, Child-Pugh class C, TNM III-IV staging, as well as serum high HSP90α and PIVKA-II levels were the independent risk factors for poor three-year survival rate (P<0.05); the results of ROC curve analysis showed that the AUC of serum HSP90α and PIVKA-II combination for predicting three-year survival were 0.929, significantly higher by anyone alone (the AUC were 0.814 and 0.836, respectively, P<0.05). Conclusion Serum HSP90α and PIVKA-II levels are closely related to the outcomes of patients with HCC after TACE therapy, and the increased serum levels of the two parameters hints poor prognosis of patients with HCC, which should deal with appropriately in clinical practice.

Objective The aim of this study was to detect the expression of chromobox protein homolog 7 (CBX7) and phosphorylated extracellular signal-regulated kinase (PERK) in cancerous tissues in patients with hepatocellular carcinoma (HCC) and explore their implications of prognosis after hepatectomy. Methods A total of 68 patients with HCC were treated with hepatectomy in our hospital between January 2016 and January 2017, and the cancerous and adjacent non-cancerous liver tissues were collected. The CBX7 mRNA and PERK mRNA were detected by RT-PCR, and the expression of CBX7 and PERK proteins in cancerous tissues were detected by immunohistochemistry. Results The CBX7 mRNA level in cancerous tissue was significantly lower than that in adjacent liver tissues [(0.51±0.10) vs. (4.11±0.91), P<0.05], while the PERK mRNA level was significantly higher than that in adjacent liver tissues [(4.87±0.99) vs. (0.58±0.15, P<0.05]; the positive rate of intensified expression of CBX7 in 38 patients with tumor diameter >3 cm was 33.3%, significantly lower than 66.7% in 30 patients with tumor size ≤3 cm, while the positive rate of intensified expression of PERK was 73.3%, much higher than 26.7% in patients with tumor size ≤3 cm; the positive rate of intensified expression of CBXY in 28 patients with AJCC stage Ⅲ/Ⅳ was 8.3%, significantly lower than 91.7% in 40 patients with AJCC stage Ⅰ/Ⅱ, while the positive rate of intensified expression of PERK was 70.0%, significantly higher than 30.0%(P<0.05) in the control; the 1 a, 2 a and 3 a survival rates in 32 patients with cancerous intensified expression of CBX7 were 78.1%, 65.6% and 53.1%, significantly higher than 52.7%, 38.9% and 30.6% (P<0.05) in 36 patients with weak or negative expression, and the 1 a, 2 a and 3 a survival rates in 38 patients with cancerous intensified expression of PERK were 55.3%, 44.7% and 31.6%, significantly lower than 80.0%,63.6% and 53.3% (P<0.05) in 30 patients with weak or negative expression. Conclusion The HCC patients with decreased cancerous expression of CBX7 and intensified expression of PERK might have a poor prognosis after hepatectomy, which should take into consideration in dealing with them in clinical practice.

Objective The aim of this paper was to discover key genes that affect the prognosis of patients with hepatocellular carcinoma (HCC) by bioinformatics. Methods We searched the key genes in peripheral blood mononuclear cells (PBMCs) and tumor tissues in GEO and TCGA databases by using STRING to construct a protein-protein interaction (PPI) network, by using GEPIA to obtain the survival information, and by using Cytoscape to filter key gene modules for the analysis of differentially expressed genes (DEGs). The Cox proportional hazards regression model was applied for prognostic analysis. Results We obtained 225 DEGs in PBMC, of which 105 were up-regulated and 120 were down-regulated genes; out of which, six key genes were screened and verified by through key modules, e.g. GPSM2, PPIL1, POLR2H, CRNKL1, U2SURP and TRA2B; the high levels of these genes in tumor tissues was significantly related to the overall survival rate of patients; the clinical data of TCGA database were analyzed for prognosis, which showed that the GPSM2 level (HR=1.556,95%CI:1.153-2.100) was independently related to overall survival in patients with HCC stage III, and the trends of GPSM2, TRA2B and U2SURP in PBMCs were the same as in tumor tissues. Conclusion The high level of GPSM2 in HCC tumor tissues and PBMCs is independently associated with the poor prognosis of patients with HCC stage III, and it is expected this gene might become a new marker for screening and prognostic judgment of patients with HCC.

Objective The aim of this study was to investigate the application of indocyanine green fluorescence navigation technology and three-dimensional visualization in laparoscopic precision surgery for patients with primary liver cancer (PLC). Methods A total of 114 patients with PLC were admitted to our hospital between January 2015 and December 2019, and were randomly divided into observation (n=57) and control group (n=57). The patients in the control received indocyanine green fluorescence navigation and laparoscopic hepatectomy and those in the combination received indocyanine green fluorescence navigation and laparoscopic hepatectomy under three-dimensional visualization. Serum cortisol (COR) and interleukin 6 (IL-6) were detected. Results The hospital stay were(6.9±2.3)d and (7.5±2.5)d (P>0.05) in the combination and control group, the satisfaction rates of fluorescent staining in the two groups were 91.2% and 91.2%(P>0.05), while the operation time and blood loss in the combination were (181.0±59.6)min and (96.9±21.7)ml, both significantly shorter or less than [(210.4±86.5)min and (106.3±25.0)ml, respectively,P<0.05] in the control; there was no significant differences as respect to the liver function tests between the two groups (P<0.05); after operation, serum COR and IL-6 levels in the combination were (264.3±33.8)mmol/L and (108.0±13.8)pg/ml, both significantly lower than [(288.0±34.5)mmol/L and (116.1±15.8)pg/ml, respectively, P<0.05] in the control; after operation, the incidences of bile leakage, pleural effusion and ascites, and fever in the two groups were 24.6% vs. 36.8%, without significant differences (P>0.05). Conclusion The application of indocyanine green fluorescence navigation technology and laparoscopic hepatectomy under three-dimensional visualization might help remove the tumors precisely and shorten operational times, which warrants more clinical observations.

Objective The aim of this study was to investigate the target delineation accuracy of tumors for radiotherapy based on MR-T2 image in patients with hepatocellular carcinoma (HCC). Methods 36 patients with HCC were enrolled in this study between May 2019 and May 2020, and all patients underwent CT and MRI scan before radiotherapy. The gross tumor volume (GTV), internal gross tumor target volume (IGTV) and planning target volume (PTV) as well as 2%, 50%, 95% and 98% exposure dose of PTV(D2, D50, D95 and D98) were recorded. Results The x, y and z axial displacements of portal vein after Reg refine registration were(0.5±0.2)mm, (0.8±0.3)mm and (0.7±0.3)mm, significantly smaller than [(2.9±0.4)mm,(4.8±0.5)mm and (3.9±0.6)mm, respectively, P<0.05] by automatic deformation registration, and the x, y and z axial displacements of celiac trunk were (0.8±0.4)mm, (0.7±0.3)mm and (0.6±0.3)mm, significantly smaller than [(3.2±0.5)mm, (3.0±0.7)mm and (2.4±0.4)mm, respectively, P<0.05] by automatic deformation registration; the GTV and IGTV after deformation registration were (379.8±103.9)cm³ and (430.1±120.6)cm³, significantly larger than [(330.4±92.8)cm³ and (375.2±95.5)cm³, P<0.05] before deformation registration, while the PTV was (542.7±130.2)cm³, significantly smaller than [(690.2±150.3)cm³, P<0.05] before deformation registration; the exposure doses of D2, D50, D95 and D98 target tumors after deformation registration were (56.0±12.9)Gy, (53.0±6.8)Gy, (49.8±5.3)Gy and (52.9±8.1)Gy, not significantly different compared to [(55.7±13.2)Gy, (52.8±7.3)Gy, (50.1±4.6)Gy and (53.3±7.7)Gy] before deformation registration(P>0.05); the V5, V10, V20, V30 and V40 exposure doses of liver after deformation registration were (52.7±9.4)%, (32.0±5.6)%, (20.1±4.6)%, (13.5±5.2)% and (7.4±3.8)%, significantly lower than [(58.2±10.1)%, (39.3±7.5)%, (24.8±5.8)%, (17.2±4.4)% and (10.1±3.9)%, P<0.05] before deformation registration. Conclusion The target delineation based on MR-T2 imaging for radiotherapy in patients with HCC could help expand the target area and trajectory, and improve the accuracy of target delineation, which might improve the radiotherapy efficacy.

Objective The aim of this study was to evaluate the clinical application of contrast-enhanced ultrasonography (CEUS) in guiding liver biopsy in patients with space-occupying lesions (SOL). Methods The clinical data of 80 patients with SOL encounted in our Department of Ultrasound were retrospectively analyzed, and all underwent liver biopsy under US guidance. Before the liver biopsies, the CEUS was done in 50 cases, and the routine gray-scale US examination was performed in 30 cases. The diagnostic efficacy was compared between the two groups. Results The proportion of demonstrated necrotic areas in lesions in patients receiving CEUS was significantly increased (56.0% vs. 30.0%, P = 0.024), and the successful puncture rate in obtaining sampling was significantly higher (100.0% vs. 90.0%, P=0.022) as compared with those having gray-scale ultrasound scan; there was no significant difference in puncture times between the two groups (3.0±0.8 vs. 2.9±0.8, P=0.590); the sensitivity, specificity and accuracy by CEUS guidance were 97.8%, 100%, and 98.0%, significantly higher than in gray-scale ultrasound guidance (80.8%, 75.0% and 80.0%, respectively, all P< 0.05); no severe bleeding, pneumothorax, bile leakage and other complications occurred in all patients in the two groups. Conclusion The liver biopsies under CEUS guidance in patients with SOL could improve the puncture success and diagnostic efficacy, which warrants further clinical investigation.

Objective The aim of this study was to analyze the clinical application of ultrasound-guided percutaneous aspiration (PA) and percutaneous catheter drainage (PCD) for treatment of liver abscess patients with or without acquired immune deficiency syndrome (AIDS). Methods The clinical data of 74 patients (with underlying AIDS in 39) with liver abscess were admitted to our hospital between June 2013 and December 2019, and all patients underwent PA or/ and PCD for treatment at base of supporting management. Results The main clinical manifestations in the two groups were fever, and the incidence of abdominal pain or abdominal discomfort in AIDS group was 56.4%, significantly higher than that in non-AIDS group (31.4%, P< 0.05); in AIDS group and non-AIDS group, the white blood cell count was 7.2×10⁹/L and 10.6×10⁹/L, and the percentage of neutrophil was 73.7% to 78.8% (P< 0.05); serum C-reactive protein (CRP) levels were 62.8 mg /L and 120.9 mg/L (P< 0.05), while serum procalcitonin levels were 0.3 g/L and 0.4 g/L (P﹥0.05) ; the incidence of extrahepatic infection in AIDS group was 71.8%, significantly higher than 48.6% in non-AIDS group (P< 0.05) ; it was difficult to culture out pathogens from pus from AIDS patients, and the pathogens varied, while the lebsiella pneumoniae was the main pathogen in patients without AIDS; in AIDS group and non- AIDS groups, the size of abscess were 9.4 ± 3.6 cm and 9.0 ± 3.1 cm (P>0.05), the postoperative complications were 17.9% and 8.6%, and the cure rate was 87.2% and 94.3% (P>0.05). Conclusion The patients with AIDS and liver abscess have their unique clinical features, and the interventional therapy under ultrasound guidance is safe, reliable and efficacy.

Objective The aim of this study was to explore the clinical value of 256-slice CT scan in differentiating hepatic echinococcosis from hepatic cysts. Methods 77 patients with hepatic echinococcosis and 34 patients with hepatic cysts were enrolled in our hospital between April 2017 and November 2020, and all underwent CT scan. Serum anti-cystic fluid antigen antibody (anti-EgCF antibody), anti-cephalomere antigen antibody (anti-EgP antibody), anti-cyst fluid semi-purified antigen antibody (anti-EgB antibody) and anti-echinococcus multilocularis antibody (anti-Em2 antibody) were detected by ELISA. Results Before surgery, the blood eosinophil count in patients with hepatic echinococcosis was (0.3±0.1)×10⁹/L, significantly higher than [(0.1±0.1)×10⁹/L, P<0.05] in patients with hepatic cysts; serum anti-EgCF and anti-EgB positive rates in patients with hepatic echinococcosis were 85.3% and 61.8%, significantly higher than (31.2% and 0.0%, respectively, P<0.05) in patients with hepatic cysts; the CT scan showed hepatic round, round-like or lobulated cysts with calcified cyst walls in patients with hepatic echinococcosis, significantly different to that in patients with hepatic cysts; out of the 111 patients, the CT scan misdiagnosed hepatic echinococcosis as hepatic cysts in 3 cases(2.7%), as hepatic metastasis in 1 case (1.0%), and misdiagnosed hepatic cysts as hepatic echinococcosis in 2 cases (1.8%). Conclusion The 256-slice CT examination can display the characteristic imaging of hepatic echinococcosis lesions, which can help differentiating hepatic echinococcosis from hepatic cysts, and provide a reliable imaging evidence for management of patients with hepatic cysts.

Objective The aim of this study was to investigate the long-term curative effects of transarterial embolization with pingyangmycin-lipiodol suspension (PLS) in the treatment of patients with hepatic hemangioma (HH). Methods A total of 56 patients with HH were enrolled in our hospital between February 2012 and December 2016, and were divided into two groups. 28 patients with HH were treated by transarterial embolization with PLS, and another 28 were with bleomycin-lipiodol suspension (BLS), and all patients were followed-up for 36 months. The clinical curative effects, incidences of postoperative complications and reduction of maximum tumor diameter were recorded in the two groups. Results At the end of six month after treatment, the total effective rate in PLS-treated patients was significantly higher than that in BLS-treated patients (89.3% vs. 64.3%, P<0.05), and at the end of thirty-six month after treatment, there was no significant difference as respect to the effective rates in the two groups (96.4% vs. 92.9%, P＞0.05); there was no significant difference in total complications after operation in the two groups (25.0% vs. 14.3%, P＞0.05); at the end of six month, twelve month and twenty-four month after treatment, the tumor diameters in PLS-treated patients were (7.3±0.5)cm,(5.6±0.7)cm and (3.4±1.4)cm, all significantly smaller than [(8.1±0.7)cm,(7.3±1.2)cm and (4.5±0.7), respectively, P<0.05] in BLS-treated patients, while at the end of thirty-six month, the tumor diameters in the two groups were not significantly different [(1.9±0.3)cm vs. (2.4±0.5)cm, P＞0.05]. Conclusion PLS and BLS by transarterial embolization both have comparable long-term effects in treatment of patients with HH, and the PLS seems work early, which needs further clinical observation.

Objective The aim of this study was to observe the short-term efficacy of regular hepatic lobectomy in patients with complicated hepatolithiasis. Methods 298 patients with complicated hepatolithiasis were admitted to our hospital between January 2019 and June 2020, and 139 patients underwent regular (observation) and another 159 patients underwent irregular (control) hepatic lobectomy. All patients were followed up for 6 months after surgery. Serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP)] levels were detected by enzyme-linked immunosorbent assay or double antibody sandwich immunoluminescence. Results The operation time in observation group was significantly longer than that in control group [(121.3±25.2) min vs. (116.7±22.8) min, P<0.05], while intraoperative blood loss, anal exhaust time and hospital stay were significantly less or shorter than those in the control group [(252.3±60.0) mL, (18.9±3.2) h and (11.2±2.3) d vs. (301.7±70.2) mL, (20.1±4.1) h and (14.5±3.5) d, respectively, P<0.05]; at the end of seven days after surgery, serum CRP, IL-6 and PCT levels in the observation group were (23.8±6.0) mg/L, (80.8±10.1) μg/L and (1.4±0.5) ng/mL, all significantly lower than those in the control group [(27.9±6.8) mg/L, (96.7±11.3) μg/L and (1.8±0.4) ng/mL, respectively, P<0.05]; serum albumin level was significantly higher than that in the control group [(34.1±2.9) g/L vs. (32.5±2.7) g/L, P<0.05]; at the end of six month follow-up, the incidence rate of complications, such as incision infection, bile leakage, biliary hemorrhage and pleural effusion in observation group was 7.9%, significantly lower than 15.7% in the control group (P＜0.05), and the recurrence rate of intrahepatic stone was 11.5%, significantly lower than 23.9%(P＜0.05) in the control. Conclusion The application of regular hepatic lobectomy isefficacious in treating patients with complicated hepatolithiasis, which might lead to less inflammatory reactions, and needs further and long-term observation.

Objective The aim of this study was to explore the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) combination in the treatment of patients with cholecystolithiasis and choledocholithiasis. Methods A total of 85 patients with cholecystolithiasis and choledocholithiasis were enrolled in this study between May 2016 and July 2020, 41 patients received LCBDE and LC combination, and another 44 patients received endoscopic sphincterotony (EST) under endoscopic retrograde cholangiopancreatography (ERCP) and LC. All patients were followed-up for 12 months. The visual analogue scales (VAS) score was applied to evaluate post-operational pain, and peripheral blood lymphocyte subsets was assayed by FCM. Results There were no significant differences respect to the surgical success rates and stone residual rates between the two groups (97.6% vs.93.2% and 2.4% vs. 6.8%, P>0.05), the usage rate of analgesic pumps and VAS score were 36.6% and (2.5±0.5), both significantly lower than 59.1% and (3.1±0.6) in the control (P<0.05), and the stone recurrence rate as confirmed by sonography one year after operation in the observation group was 2.4%,significantly lower than 15.9% in the control (P<0.05); there were no significant differences respect to biochemical parameters between the two groups two weeks after operation (P>0.05); the percentages of peripheral blood CD3⁺, CD4⁺ and CD8⁺ cells as well as the ratio of D4⁺/CD8⁺ cells in the observation group were (52.8±7.1)%, (40.3±7.5)%, (21.0±5.2)% and (1.9±0.3), not significantly different as compared to [(54.7±6.9)%, (41.0±7.2)%, (22.5±5.6)% and (1.8±0.3), respectively, P>0.05] in the control; there was no significant difference in the incidence of post-operational complications between the two groups (2.4% vs. 9.1%, P>0.05). Conclusion The surgical success rate of LCBDE and LC combination in the treatment of patients with cholecystolithiasis and choledocholithiasis is high, and is still a good approach for the management of patients with this kind of entity.

Objective This study aimed to explore the implication of ubiquitinase E2T (UBE2T) expression in cancerous tissues in patients with gallbladder cancer. Methods 50 patients with gallbladder cancer were included in this study between January 2015 and December 2017. The cancerous and adjacent noncancerous tissues as well as 50 normal gallbladder tissues were collected, and the relative expression of UBE2T was detected by Western bloting. All patients with gallbladder cancer underwent radical tumor resection and followed-up for up to 36 months. The multivariate Logistic regression analysis was applied to predict the risk factors for poor prognosis of patients with gallbladder cancer after operation. Results The relative expression ofUBE2T in cancerous tissue was (2.9±0.4), much higher than (1.5±0.3, P<0.05) in noncancerous or (1.7±0.3, P<0.05) in normal tissues; there were a significant differences as respect to the expression of UBE2T gallbladder between differentTNM stages, invasions, lymph node metastasis, remote metastasis and pathological classification (P<0.05); after 21.0 month follow-up, the Logrank analysis showed that there was a significant difference between 12.0 month survival in 31 patients with high cancerous UBE2T expression and 25.0 month (P<0.05) in 19 patients with low cancerous UBE2T expression; the multivariate Logistic analysis demonstrated that the poor TNM stage [OR(95%CI):1.9(1.5-2.4)], strong cancerous UBE2T expression [OR(95%CI):2.5(2.1-2.9)], tumor invasion [OR(95%CI):2.3(1.8-3.0)], lymph node metastasis [OR(95%CI):1.2(1.0-1.8)], remote metastasis [OR(95%CI):2.1(1.7-2.8)] and poor pathological classification [OR(95%CI): 1.6(1.3-2.2)] were the risk factors for poor prognosis of patients with gallbladder cancer after operation (P<0.05). Conclusion The expression of UBE2T protein in gallbladder tissues of patients with gallbladder cancer is significantly intensified, which might be related to the poor prognosis.

Objective Besides its lipid-lowering function, the simvastatin also exhibits multiple pleiotropic effects, such as antioxidative, antiproliferative and antiinflammatory properties, as well as the capacity to improve endothelial function and to stimulate neoangiogenesis. It rarely lead to apparent clinical acute liver injury, and might be a new choice for the treatment of patients with chronic liver diseases. In this article, we briefly introduce the basic and clinical researches of simvastatin in the treatment of patients with chronic liver diseases.

Objective Esophageal and gastric varices bleeding (EGVB) is a common complications of liver cirrhosis, with a high mortality rate. Therefore, the prevention and treatment of EGVB is very important for patients with liver cirrhosis. Internal medicine, endoscopic management, interventional and surgical operation are all important approaches for the prevention and treatment of EGVB, which greatly improves the survival rate of cirrhotic patients. In this paper, we reviewed the current progress of primary prevention, emergent hemostasis and secondary prevention of patients with different types of esophageal and gastric varices.