Objective The purpose of this experiment was to preliminarily explore the effects of small ubiquitin-like modifier specific protease 3 (SENP3) on lipid droplet regulation and hepatitis C virus (HCV) replication in HepG2 cells in vitro. Methods Human HepG2 cells were infected with infectious HCV particles, and SENP3 protein expression were detected by Western blot. The HepG2 cells were transfected by SENP3-siRNA and infected by HCV particles, then the HCV RNA level was detected by quantitative real-time PCR (qRT-PCR). The lipid droplets were observed by Oil red O staining. After SENP3 knocked down, the HepG2 cells were treated with free fatty acids, and the HCV RNA level was detected by qRT-PCR after HCV infection. Results The relative expression levels of HCV core protein were 0.01±0.00, 0.17±0.02 and 0.43±0.04 on the first, third and sixth days after HCV infection in HepG2 cells, and the relative expression levels of SENP3 protein were 0.23±0.04, 0.42±0.03 and 0.46±0.04, respectively, significantly different among them (P<0.05); the transfection of SENP3-siRNA in the cells effectively reduced the expression of SENP3 and HCV core protein after HCV infection; the relative level of HCV RNA in SENP3 knockdown cells was 54.2±11.4%, significantly lower than that in non-specific siRNA transfection cells (P<0.01); after SENP3 knockdown, the number of lipid droplets decreased significantly; the HCV RNA relative level in SENP3 knockdown HepG2 cells infected with HCV particles was 58.2±5.2%, significantly lower than that in non-specific siRNA transfection cells (P<0.01); the relative level of HCV RNA in HepG2 cells with SENP3 knockdown and co-cultured with palmitic acid was 74.6±6.4%, significantly higher than that in HepG2 cells with SENP3 knockdown (P<0.01). Conclusion The SENP3 could promote HCV replication by participating in regulation of lipid droplet metabolism in HCV-infected hepatocytes.

Objective The aim of this study was to investigate the effects of rosiglitazone (RGZ) on cell proliferation and peroxisome proliferator-activated receptor γ (PPARγ) and heme oxygenase 1 (HO-1) levels in HSC-T6 cells in vitro. Methods The HSC-T6 cells were divided into control, RGZ- and RGZ and ZnPP-IX ( a HO-1 antagonist) combination-intervened groups (n=8), and the cell viability was detected by methyl thiazolyl tetrazolium (MTT) and the cell apoptosis was detected by flow cytometry. The cell PPARγ and HO-1 mRNA levels were detected by Real-time PCR, and the cell fibrosis-related protein expressions were detected by Western blot. Results The proliferation activity (A value) of HSC-T6 cells in RGZ-intervened group was (0.6±0.1), 38.4% decreased compared with (1.0±0.1) in the control (P<0.05), while it was (0.8±0.1) in RGZ and ZnPP-IX combination-intervened group, 17.2% decreased compared with in control group (P<0.05), but significantly increased compared with RGZ-intervened group (P<0.05); the apoptosis rate in RGZ-intervened group significantly higher than that in the control group (P<0.05), and the apoptosis rate in RGZ and ZnPP-IX combination-intervened group was significantly lower than that in RGZ-treated group (P<0.05). Conclusion RGZ intervention could significantly inhibit the proliferation and promote apoptosis of HSC-T6 cells in vitro, which might be related to the down-regulation of PPARγ and HO-1 mRNA levels.

Objective The aim of this experiment was to construct p53 apoptosis stimulating protein 2 (ASPP2) gene liver conditional knockout mice by Cre-loxP system. Methods The ASPP2-flox mice were constructed by inserting loxP sequence at both ends of ASPP2 gene with designed sgRNA sequence. The F0 and F1 mice were genotyped by PCR amplification and gene sequencing. The ASPP2-flox F1 mice were mated with Alb-Cre expressing tool mice to obtain liver ASPP2 liver conditional knockout mice, and the genotypes were identified by PCR. The expression of ASPP2 protein in liver tissues of ASPP2 gene knockout mice was detected by Western blot and immunohistochemistry. Results The PCR and sequencing results of F0 and F1 generation mice showed that the ASPP2-flox mice were successfully constructed, and the genotype of F1 generation heterozygotes was ASPP2fl/-; after hybridization with Alb-Cre mice, the F1 generation heterozygotes were backcrossed with ASPP2fl/- mice, and the genotype was ASPP2fL/fLCreT, namely ASPP2 liver conditional knockout mice; the ASPP2 protein expression in liver tissues of ASPP2fL/fLCreT mice by Western blot and immunohistochemistry detection was significantly decreased. Conclusion The ASPP2 gene liver conditional knockout mice is successfully constructed based on Cre-loxP system, which might be beneficial to further experimental study.

Objective The aim of this experiment was to explore the effect of panax notoginsenosides (PNS) on liver steatosis and nitric oxide (NO)-induced nitrogen monoxide synthase (iNOS)-nuclear factor kappa-B (NF-κB) pathway protein expression in mice with high-fat-induced non-alcoholic fatty liver diseases(NAFLD). Methods 40 male BALB/c mice were randomly divided into normal, model, PNS-intervened and simvastatin-intervened group, with 10 mice in each group. The NAFLD model in mice was established by feeding high fat diet for 12 weeks. After the successful model completion, the mice were feed with normal saline, PNS solution or simvastatin solution for 12 weeks. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were detected. The protein expressions of NO-iNOS-NF-κB pathway in liver tissues were detected by Western bloting. Results The body mass, liver mass and visceral fat ratio in PNS-intervened group were (31.6±1.7) g, (6.3±0.9) g and (3.4±0.5)%, significantly lower than [(36.5±2.0) g, (8.1±1.2) g and (4.3±0.8)%, P<0.05] in the model group; serum TC, TG and LDL-C levels were (2.5±0.8) mmol/L, (0.9±0.3) mmol/L and (1.1±0.3) mmol/L, significantly lower than [(4.5±1.6) mmol/L, (2.7±1.1) mmol/L and (2.3±0.6) mmol/L, respectively, P<0.05], while serum HDL-C level was (0.4±0.2) mmol/L, significantly higher than (0.2±0.1) mmol/L in the model group (P<0.05); serum ALT and AST levels were (32.5±6.8)U/L and (41.3±6.8)U/L, significantly lower than [(65.2±8.7)U/L and (62.7±6.9)U/L, respectively, P<0.05] in the model group; the relative protein expressions of NO, iNOS and p-NF-κB were (1.2±0.2), (1.1±0.1) and (1.2±0.2), significantly lower than [(5.3±0.6), (4.8±0.5) and (5.6±0.5), respectively, P<0.05] in the model group. Conclusion PNS could effectively reduce blood lipids levels and alleviate liver steatosis in mice with NAFLD, which might be related to the inhibition NO/iNOS/NF-κB pathway protein expression.

Objective The aim of this study was to explore the protective mechanism of Danzhi Xiaoyao powder on hepatic damage in rats with D-galactosamine (D-GaIN)/lipopolysaccharide (LPS)-induced acute liver injury (ALI). Methods 110 SD male rats were randomly divided into control, model, low-dose, moderate dose and large-dose of herbal medicine-intervened groups, with 22 rats in each. The ALI model was built-up by D-GaIN/LPS injection intraperitoneally, and the herbal medicine was given by lavage. Serum MDA, SOD, GSH-PX, IL-6, IL-1β, TNF-α levels were detected by ELISA, and serum HA, LN and Ⅲ-PC levels were assayed by RIA. Results Serum AST, ALT, bilirubin and MDA levels in model group were (12081.3±587.7)U/L, (7658.7±742.2)U/L, (104.3±10.3)μmol/L and (8.9±1.1)mmol/mL, all significantly higher than [(171.9±17.2)U/L, (60.5±6.2)U/L, (2.4±0.2)μmol/L and (2.5±0.3)mmol/mL, respectively, P＜0.05] in the control; serum SOD and GSH-PX levels were (14.3±1.7)U/mL and (7.1±0.7)μmol/L, both significantly lower than [(38.6±4.4)U/mL and (21.9±2.2)μmol/L, P＜0.05] in the control, while serum SOD and GSH-PX levels in three herbal medicine-intervened groups significantly higher than those in the model (P＜0.05); serum IL-6, IL-1β and TNF-α levels in the model were (194.3±20.5)ng/mL, (24.7±2.5)ng/ml and (864.5±87.3)ng/mL, significantly higher than [(90.1±10.3)ng/mL, (5.2±1.0)ng/mL and (30.2±4.1)ng/mL in the control, while all significantly decreased compared to those in the model in three herbal medicine-intervened groups (P＜0.05); serum HA, LN and Ⅲ-PC levels were (286.3±29.1)ng/ml, (297.4±30.5)ng/ml and (257.1±26.7)ng/ml, all significantly higher than [(55.1±6.2)ng/mL, (75.1±7.6)ng/mL and (61.9±6.2)ng/mL] in the control, while all significantly decreased compared to those in the model in three-herbal medicine-intervened groups(P＜0.05). Conclusion Danzhi Xiaoyao powder could exert significant protective effect on liver functions in rats with D-GaIN/LPS-induced ALI, and the mechanism by which it works might be related to obvious inhibition of oxidative stress and inflammation response.

Objective The aim of this study was to investigate the noninvasive assessment of liver fibrosis (LF) via liver (LSM) and spleen stiffness measurement (SSM) using acoustic palpation elastography (APE) in patients with chronic hepatitis B (CHB). Methods A total of 392 patients with CHB were encountered in our hospital between January 2020 and October 2021, and all underwent liver biopsies. The LF was defined by METAVIR's score, and was divided into non-significant (less than F1) and significant (equal to or greater than F2). The LSM and SSM were obtained by using APE. The aspartate aminotransferase to platelet ratio index (APRI), FIB-4 and King's score were calculated. The diagnostic efficacy was evaluated by the the area under receiver operating characteristic curve (AUC). Results Out of the 392 patients with CHB, the histopathological examination showed F0 in 45 cases, F1 in 112 cases (non-significant LF in 157 cases), F2 in 105 cases, F3 in 70 cases and F4 (early cirrhosis) in 60 cases (significant LF in 235 cases); the LSM, SSM, APRI, FIB-4 and King's score in patients with significant LF were (13.4±2.0)kPa, (23.3±4.0)kPa,(2.2±0.4), (1.8±0.4) and (23.4±7.9), significantly greater than [(9.3±1.7)kPa, (15.0±3.6)kPa, (1.0±0.2), (0.9±0.2) and (10.4±6.9), respectively, P<0.05] in patients with non-significant LF; the multivariate Logistic regression analysis showed that the LSM, SSM, APRI, FIB-4 and King's score were all the independent factors impacting LF in patients with CHB (P<0.05); the sensitivity, specificity and accuracy of LSM and SSM combination in predicting significant LF were 79.6%, 83.0% and 81.6%, and in predicting early liver cirrhosis were 92.8%, 90.0% and 92.3%. Conclusion The application LSM and SSM by using APE in predicting the degree of liver fibrosis in patients with CHB is efficacious , which is worthy of further clinical investigation.

Objective The aim of this study was to explore the evaluation of significant liver fibrosis by hepatic vein waveform classification and ultrasound-based semi-quantitative scoring in patients with chronic hepatitis B(CHB). Methods 126 patients with CHB were admitted to our hospital between February 2018 and December 2020, and all patients with CHB underwent liver biopsies and were examined by ultrasound. The ultrasound semi-quantitative score of liver and the hepatic vein waveform typing were recorded. The diagnostic efficacy of sonographic parameters in predicting significant liver fibrosis (>=S2) was evaluated by the area under the receiver operating characteristic curve (AUC) by MedCal 15.2 software. Results The histopathological examination showed S0 in 20, S1 in 28, S2 in 31, S3 in 22 and S4 in 25 cases; the ultrasound semi-quantitative scores in patients with S0, S1, S2, S3, and S4 were(3.1±0.5), (5.4±0.9), (6.7±1.1), (8.3±1.5) and (9.9±1.8), significantly different among them(P<0.05); the percentages of HV type I and HV type II in patients with S3 and S4 were 40.9% and 56.0%, both significantly higher than 5.0%, 10.7%, 16.1% (P<0.05) in patients with S0, S1 and S2; the AUCs of hepatic venous waveform, ultrasound semi-quantitative scoring and the combination of the two in predicting significant liver fibrosis were 0.846(95%CI:0.753-0.938), 0.827(95%CI:0.729-0.924) and 0.919(95%CI:0.853-0.985), suggesting the combination of the two parameters was superior to any one of the parameter alone(P＜0.05), and its sensitivity and specificity were 85.1% and 97.5%, significantly higher than 87.2% and 83.5% by hepatic venous waveform or 85.1% and 86.1% by ultrasound semi-quantitative scoring. Conclusion The combination of hepatic vein waveform classification and ultrasonographic semi-quantitative scoring is efficacious in assessing the liver fibrosis staging in patients with CHB, which might provide an alternative imaging tool in clinical practice.

Objective The aim of this study was to explore the relationship between liver X receptor α (LXRα) and cytochrome P450 isoform 7A1 (CYP7A1) expression and liver histopathological inflammatory grading and fibrotic staging in patients with chronic hepatitis B (CHB). Methods 118 patients with CHB were enrolled in our hospital between January 2019 and October 2020, all patients underwent liver biopsies and histological activity >=G2 and liver fibrosis >=S2 were defined as significant inflammation or significant fibrosis. The expression and their mRNA levels of LXRα and CYP7A1 in liver tissues were detected by immunohistochemical staining and by RT-PCR. Results The positive rates of hepatic LXRα和CYP7A1mRNA and/or their proteins in 118 patients with CHB were 78.0% and 73.7%, respectively; the LXRα mRNA level and its protein expression in 38 patients with significant liver inflammation were (0.6±0.2) and (0.3±0.1)average optical density (AOD), significantly higher or stronger than [(0.4±0.1) and (0.1±0.0)AOD, respectively, P<0.05] in 80 patients without significant hepatic histopathological inflammation, and the CYP7A1 mRNA level and its protein expression were (0.8±0.2) and (0.4±0.1)AOD, significantly higher or stronger than [(0.3±0.1) and (0.1±0.0)AOD, respectively, P<0.05] in patients without significant hepatic inflammation; the LXRα mRNA and its protein expression in 48 patients with significant liver fibrosis were (0.7±0.2) and (0.3±0.1)AOD, significantly higher or stronger than [(0.3±0.1) and (0.1±0.1)AOD, P<0.05] in 70 patients without significant liver fibrosis, and the CYP7A1 mRNA level and its protein expression were (0.7±0.2)and (0.3±0.1)AOD, significantly higher or stronger than [(0.4±0.2) and (0.2±0.1)AOD, respectively, P<0.05] in patients without significant liver fibrosis. Conclusion The up-regulation of LXRα and CYP7A1 gene might be involved in the pathogenesis of liver inflammation and fibrosis, which needs further investigation.

Objective The aim of this clinical trial was to compare the virologic response (VR) to elbavir/glarevir therapy in naïve and re-treated patients with chronic hepatitis C (CHC) with HCV genotype 1b infection. Methods 59 naïve and 56 re-treated patients with HCV gene type 1b infected CHC, the latter had failed to response to peg-interferon-α2b treatment, were recruited in our hospital between January 2019 and March 2020, and all patients with CHC were treated by orally elbavir/glarevir for 12 weeks. All the patients were followed-up for 24 weeks. Serum HCV RNA loads were detected by real-time fluorescent quantitative RT-PCR. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TSB), and serum laminin (LN), hyaluronidase (HA), type Ⅲ procollagen N-terminal peptide (PC-Ⅲ) and type Ⅳ collagen (Ⅳ-C) were routinely detected. The rapid virologic response (RVR), end treatment virologic response (ETVR) and sustained virologic response (SVR) were evaluated. Results After treatment, there were no statistical differences as respect to serum ALT, AST and total bilirubin levels between the two groups (P>0.05), and there were also no statistical differences in serum LN, HA, PC-Ⅲ and Ⅳ-C levels between the two groups (P＞0.05); the serum ALT normalization rate and serum HCV RNA loss rate in naïve patients with CHC were 96.6% and 98.3%, both not significantly different as compared to 98.2% and 100.0% in re-treated patients with CHC (P＞0.05); the RVR, ETVR and SVR were 89.8%, 94.9% and 93.2%, not significantly different compared to 91.1%, 98.2% and 98.2%, respectively, in re-treated patients (P＞0.05); there were some cases with headache, dizziness, nausea, vomiting and diarrhoea, which disappeared gradually or after appropriate management, without untoward reactions in our series during the regimen. Conclusion The therapeutic efficacy of elbavir/glarevir is promising in patients with naïve or re-treated CHC, without obvious adverse reactions, and warrants further clinical investigation.

Objective The aim of this study was to explore the clinical implications of hepatic interleukin-35 (IL-35) and the peripheral blood myeloid-derived suppressor cell (MDSCs) count changes in patients with autoimmune hepatitis (AIH). Methods 35 patients with AIH were enrolled in our hospital between May 2017 and February 2020, and all patients underwent liver biopises. The p35 and the Epstein-Barr virus-induced gene 3 (Ebi3) expressions in liver tissues were detected by Western blot. The percentages of peripheral blood MDSCs were detected by LX flow cytometry. According to interface inflammation and cell infiltration depth, the liver damage were divided into mild, moderate and severe degree. Results The hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 6 patients with severe liver injury were(0.9±0.1),(0.9±0.1) and (1.5±0.3)%, significantly higher than [(0.5±0.1),(0.6±0.1) and (0.9±0.2)%, respectively, P<0.05] in 18 patients with mild or [(0.6±0.1), (0.7±0.1) and (1.2±0.2)%, respectively, P<0.05] in 11 patients with moderate liver injury; the hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 16 patients with liver fibrosis S3-S4 were (0.7±0.2), (0.8±0.1) and (1.3±0.2)%, significantly higher than [(0.5±0.1),(0.6±0.1) and (0.9±0.2)%, respectively, P<0.05] in 19 patients with S1～S2, and those in 17 patients with G3-G4 were (0.7±0.1), (0.8±0.2) and (1.2±0.2)%, significantly higher than [(0.5±0.1), (0.6±0.1) and (1.0±0.1)%, respectively, P<0.05]in 18 patients with G1-G2; the hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 19 patients who responded to immunosuppressive agent therapy less than 3 month were (0.4±0.1), (0.5±0.1) and (1.0±0.2)%, the former two were significantly weaker than [(0.7±0.1) and (0.8±0.2), P<0.05] in 10 patients who responded to therapy 3 to 6 months or [(1.1±0.1),(1.1±0.2) and (1.4±0.2)%, respectively, P<0.05] in 6 patients who responded to therapy longer than 6 month. Conclusion The hepatic IL-35 expression and the peripheral blood MDSCs counts are related to liver injuries in patients with AIH, which needs further investigation.

Objective The purpose of this study was to investigate the prevalence of serum anti-mitochondrial antibody-M2 (AMA-M2) antibody in physical examination individuals. Methods 18515 serum samples were collected from the Physical Examination Center, Shanghai General Hospital between May 2012 and December 2014. Serum AMA-M2 was quantitatively detected by ELISA, and blood biochemical parameters were assayed. Results Among 18515 screened people, 245 persons (1.3%) were serum AMA-M2 positive, of which 97 were men and 148 were women, with the ratio of men to women of about 1∶1.5, and the highest positive rate (28.6%) was found in 46 to 55 year old age group(n=70); serum alkaline phosphatase levels increased in 12 persons with serum AMA-M2 positive, who met the diagnostic criteria of primary biliary cholangitis (PBC); serum ALP level in 54 persons with higher serum AMA-M2 (＞150U/ml) was (92.8±85.6 U/L), and serum GGT level was (84.3±118.5 U/L, significantly higher than [(67.7±38.3U/L) and (39.1±61.8U/L), respectively, P<0.05] in 191 individuals with low serum AMA-M2. Conclusion It is not uncommon that serum AMA-M2 antibody is positive in healthy people, and early screening serum AMA-M2 antibody is helpful for early diagnosis of PBC.

Objective The aim of this study was to summarize the clinical features of patients with familial primary biliary cirrhosis (PBC). Methods The clinical manifestations, imaging features, pathological findings, and clinical outcomes of 17 patients with PBC were collected from 9 different pedigrees, and were summarized by retrospective analysis. Results Out of the 17 patients with PBC, 12 were females and 5 males with the mean age of 54.35±11.94 years at presentation; the common clinical manifestations included fatigue (64.7%) , itching (47.1%), jaundice (41.2%) and gastrointestinal bleeding (17.6%), with 5 (29.4%) diagnosed without any obvious manifestations; the laboratory tests showed the elevation of serum ALP and GGT levels (76.4%), and serum AMA/AMA-M2 positive in 88.2%; the 8 diagnosed patients with PBC were the first-degree relatives of 9 probands, and among them, sister-sister pairs (including a pair of twins) and sister-brother pairs were 37.5% respectively, father-daughter, and mother-daughter were 12.5%; the mean age was 57.75±10.38 years in the probands, older than 47.63±7.19 years in the relative patients; in probands, the clinical stage included asymptomatic patient in 1 (11.1%), symptomatic patient in 1 (11.1%) and decompensated cirrhosis in 7 (77.8%), while in the diagnosed relatives included preclinical stage in 1 (12.5%), asymptomatic in 2 (25%), symptomatic in 3 (37.5%) and decompensated cirrhosis in 2 (25.0%); except for 1 patient in preclinical stage, 16 patients with PBC were treated with ursodeoxycholic acid, and during follow-up of 5.2 years, 3 patients including a pair of twin sisters progressed to death of liver failure, including 2 probands and 1 diagnosed relative. Conclusion The patients with PBC have some tendency of family clustering, mainly involved the first-degree relatives of the probands, with the most frequent probability of sister-sister pairs and sister-brother pairs. Since the clinical features of patients with familial PBC are similar to scattered PBC, it is convenient to recognize them. The clinicians should pay high attention to the early screening of the relatives of probands with PBC and give them early treatment once diagnosed.

Objective The aim of this study was to summarize the efficacy of ursodeoxycholic acid (UDCA) in the treatment of patients with primary biliary cholangitis (PBC) and cirrhosis and its effect on serum nuclear factor-related factor 2 (Nrf2) and hemeoxygenase-1 (HO-1) levels. Methods 31 patients with PBC and 34 patients with primary biliary cirrhosis (Child A in 15, Child B in 12 and Child C in 7 cases) were recruited in our hospital between January 2017 and January 2020, and 43 healthy persons were selected as control group. The patients with cholangitis and cirrhosis were all treated with UDCA for 12 months. Serum malondialdehyde (MDA), superoxide dismutase (SOD), Nrf2 and HO-1 levels were detected. Results At presentation, serum GGT and ALP levels in patients with primary biliary cirrhosis were (389.4±29.7)U/L and (457.9±73.8)U/L, both significantly higher than [(173.5±16.4)U/L and (298.3±52.1)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; at the end of 12 month treatment, serum GGT and ALP levels in patients with primary biliary cirrhosis were(174.1±10.4)U/L and (144.6±24.5)U/L, still significantly higher than [(72.6±7.1)U/L and (95.7±11.6)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; serum Nrf2, HO-1, MDA and SOD levels in healthy individuals were (182.3±30.6)U/L, (12.2±2.1)U/L, (4.1±0.7)mol/L and (102.3±17.8)U/mL; at 12 month observation, serum Nrf2, HO-1 and MDA levels in patients with primary biliary cirrhosis were (712.6±100.1)U/L, (25.1±4.3)U/L and (7.6±1.3)mol/L, all significantly higher than [(665.3±90.5)U/L, (21.3±3.8)U/L and (6.5±1.1)mol/L, respectively, P<0.05], while serum SOD level was (80.6±14.5)U/mL, significantly lower than [(90.8±15.6)U/mL, P<0.05] in patients with primary biliary cholangitis; there were no significant differences as respect to serum Nrf2, HO-1, MDA and SOD levels in cirrhotics with Child class A, B and C(P＞0.05). Conclusion The continuous administration of UDCA could improve the liver function test normalization in patients with PCB and cirrhosis, which might be related to the amelioration of cholestasis, inhibition of oxidative stress, and increase serum Nrf2 and HO-1 levels.

Objective The aim of this study was to analyze serum lipidomics of patients with non-alcoholic simple fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Methods 107 patients with NAFL and 92 patients with NASH were enrolled in our hospital between May 2015 and May 2020. The basic data were collected, and serum lipidomics were analyzed by ultra-high performance liquid chromatography-tandem mass spectrometry. Results Compared with in NAFL group, the levels of 3 kinds of free fatty acids (FFA, 12:0, 18:1 and 20:0), 2 kinds of diacylglycerols (DAG, 36:3 and 36:4), 16 kinds of triacylglycerols (TAG, 52:4, 52: 5, 54: 4, 54: 5, 54: 8, 56: 5, 56: 7, 56: 8, 56: 9, 58: 4, 58: 8, 58: 9, 58: 10, 58 : 11, 60: 6 and 60: 12), 2 kinds of phosphatidylcholines (PC, 36:5 and 38:6), 1 phosphatidylserine (PS, 33:0), 2 kinds of lysophosphatidyl ethanolamines (LPE, 36:2 and 39:1), 2 kinds of cholesterol esters (CE, 20:4 and 22:6, 4 kinds of sphingomyelins (SM, 36:3, 38:2, 40:1 and 42:1) and 3 kinds of ceramides (Cer, 40:1, 41:1 and 42:1) increased in NASH group, while 3 kinds of FFA (16: 1, 22: 4 and 22: 5), 1 TAG (54: 2), 3 types of PC (32:1, 35:4 and 38:3), 5 types of phosphatidylinositols (PI, 32:1, 34:1, 34:2, 36:4 and 40:4), 5 kinds of phosphatidalcholines (PlsCho, 34:2, 36:2, 36:4, 40:5 and 42:5) and 7 kinds of phosphatidal ethanolamines (PlsEtn, 36:6, 38:5, 38:6, 38:7, 40:7, 40:8 and 42:7) levels decreased (P<0.05). Conclusion There is a significant difference in serum lipid metabolism between patients with NAFL and patients with NASH, which might be help clarify the pathogenesis of patients with non-alcoholic simple fatty liver diseases.

Objective The purpose of this study was to investigate the efficacy of polyene phosphatidylcholine and Fuzheng Huayu capsule, a herbal medicine, combination in the treatment of patients with non-alcoholic fatty liver diseases (NAFLD) and its effect on hepatic steatosis score (HSSu) by ultrasonography. Methods A total of 132 patients with NAFLD were recruited in our hospital between January 2018 and January 2020, and were randomly divided into control (n=66) and observation group (n=66), receiving orally polyene phosphatidylcholine or polyene phosphatidylcholine and Fuzheng Huayu combination therapy for 24 weeks. Serum tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP) and interleukin-10 (IL-10) levels were assayed. The hepatic steatosis scores was evaluated by ultrasonography. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamine transferase (GGT), serum alkaline phosphatase (ALP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL - C) and low density lipoprotein cholesterol (LDL-c) levels were detected routinely. Results At the end of 24 week observation, serum ALT, AST and GGT levels in the observationgroup were (39.4±4.1)U/L, (35.8±6.6)U/L and (81.4±10.1)U/L, significantly lower than [(54.3±5.2)U/L, (50.9±7.4)U/L and (108.8±12.6)U/L, respectively, P＜0.05] in the control; blood TC, TG and LDL-C levels were (3.5±1.0)mmol/L, (2.2±0.6)mmol/L and (2.7±0.6)mmol/L, significantly lower than [(4.2±1.2)mmol/L, (2.9±0.8)mmol/L and (3.4±0.8)mmol/L, respectively, P＜0.05], while blood HDL-C level was (1.7±0.6)mmol/L, significantly higher than [(1.3±0.5)mmol/L, P＜0.05] in the control group; the hepatic steatosis score and serum TNF-α level were (0.9±0.2) and (3.5±0.8)ng/L, significantly lower than [(1.7±0.3) and (4.2±1.0)ng/L, while serum IL-10 level was (28.9±7.4)ng/L, significantly higher than (24.1±6.7)ng/L, P＜0.05] in the control. Conclusion The oral administration of polyene phosphatidylcholine and Fuzheng Huayu combination in the treatment of patients with NAFLD could improve liver function test normal and decrease blood lipids, which might be related to the intrahepatic steatosis and inflammatory reactions.

Objective The aim of this study was to investigate the prevalence of non-alcoholic fatty liver diseases (NAFLD) and other metabolic diseases among whole adults of Blang ethnicity in Menghai county in Yunnan province. Methods A cross-sectional study with the census method was performed in this study. All residents of Blang ethnicity aged 18 or over from 5 administrative villages were recruited between February and March 2017. A total of 3365 individuals participated in this survey and eligible 3258 individuals with complete data were included. The data was obtained by questionnaires, physical examinations, blood assays and ultrasonography. The standardized prevalence was adjusted according to the sixth Chinese national census data in 2010. The multivariable Logistic regression was applied to reveal the risk factors for NAFLD. Results The overall standardized prevalence of NAFLD in our series was 16.7%, and of which, the prevalence of NAFLD in women was 19.9%, significantly higher than 13.6% in men (x²=4.896, P<0.05); the prevalence of NAFLD increased as the age increased among the overall population in among women (Ptrend<0.001); the multivariable Logistic regression analysis showed that when the age, gender, education, smoking, and drinking status adjusted, the likelihood of NAFLD in patients with overweight/obesity (OR: 21.6, 95% CI 16.8-27.9, P<0.05), central obesity (OR: 14.2, 95% CI 10.9-18.6, P<0.05), hypertension (OR: 3.7, 95% CI 2.8-4.9, P<0.05), hypertriglyceridemia (OR: 3.6, 95% CI 3.0-4.4, P<0.05), and diabetes (OR: 3.3, 95% CI 2.4-4.4, P<0.05)was significantly higher than that in their control group. Conclusion NAFLD is prevalent in Blang ethnic adults and the strongest association is found between obesity and NAFLD. The strict management of weight is a key measure to prevent NAFLD and other metabolic diseases in Blang ethnic adults.

Objective The aim of this study was to analyze the correlation of rs738409 gene polymorphism of patatin like phospholipase domain containing protein 3 (PNPLA3) to genetic susceptibility of patients with nonalcoholic fatty liver diseases (NAFLD). Methods 162 patients with NAFLD and 100 healthy persons were recruited in our hospital between November 2017 and November 2019. The peripheral blood PNPLA3 rs738409 locus polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism. Results The frequencies of GG genotypes and the frequencies of G alleles at rs738409 locus of PNPLA3 gene in patients with NAFLD were 37.0% and 58.3%, both significantly higher than 11.0% and 34.0% (P<0.05) in healthy individuals, while the frequencies of GC and CC genotypes were 42.6% and 20.4%, the frequency of C allele was 41.7%, all not significantly different compared to 46.0%, 43.0% and 66.0% in the control (P>0.05); serum alanine aminotransferase and aspartate aminotransferase levels in 73 NAFLD patients with GG genotype were (118.5±20.3)U/L and (85.2±14.7)U/L, both significantly higher than [(93.3±16.4)U/L and (59.6±10.3)U/L, respectively, P<0.05] in 65 patients with GC genotype or [(65.9±11.8)U/L and (31.9±5.5)U/L, respectively, P<0.05] in 24 patients with CC genotype; serum triglyceride levels in patients with GG and GC genotypes were (2.0±0.5)mmol/L and (1.6±0.4)mmol/L, both significantly higher than [(1.1±0.2)mmol/L, P<0.05] in NAFLD patients with CC genotype. Conclusion Our findings suggest that the PNPLA3 rs738409 gene polymorphism might be related to genetic susceptibility of individuals to NAFLD, and the mechanism involved needs further studied.

Objective The aim of this study was to explore the implication of serum resistin and retinol-binding protein 4 (RBP4) in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods 106 patients with NAFLD and T2DM and 106 patients with NAFLD were enrolled in our hospital between October 2017 and January 2021,and blood lipid and fasting blood glucose (FBG) levels were detected by full-automatic biochemical analyzer. Serum fasting insulin (FINS) level was detected by chemiluminescence, and the pancreatic β-cell function was assessed by HOMA-β. The insulin resistance (IR) was assessed by homeostasis model assessment (HOMA-IR). Serum resistin, RBP4, tumor necrosis factor (TNF-α) and interleukin (IL-6) levels were detected by ELISA. Results Total serum cholesterol and high-density lipoprotein cholesterol levels in patients with NAFLD and T2DM were (4.7±0.5)mmol/L and (1.1±0.2)mmol/L, significantly lower than [(5.6±0.6)mmol/L and (1.4±0.3)mmol/L, respectively, P<0.05] in patients with NAFLD; serum gamma-glutamyl transferase level in patients with NAFLD and T2DM were (102.3±15.5)U/L, significantly higher than [(71.6±4.6), P<0.05] in patients with NAFLD, while there were no significant differences as respect to serum alanine aminotransferase, aspartate aminotransferase and aLkaline phosphatase levels between the two groups (P>0.05); the FBG, FINS and HOMA-IR in patients with NAFLD and T2DM were (7.7±0.8)mmol/L, (6.7±1.2)mU/L and (2.3±0.5), significantly higher than [(5.7±0.7)mmol/L, (5.5±2.3)mU/L and (1.4±0.2), respectively, P<0.05], while the HOMA-β was (3.7±0.4), significantly lower than [(5.0±0.5), P<0.05] in patients with NAFLD; serum resistin, RBP4, TNF-α and IL-6 levels in patients with NAFLD and T2DM were(3.2±0.4)ng/mL, (57.3±12.3)mg/L, (376.2±36.7)pg/mL and (76.3±8.2) ng/L, significantly higher than [(1.2±0.2)ng/mL, (32.7±7.1)mg/L,(340.3±38.2)pg/mL and (68.4±7.6)ng/L, respectively, P<0.05] in patients with NAFLD. Conclusion There are differences in liver function indexes, glucose metabolism indexes, resistin , RBP4 and cytokine levels between patients with NAFLD and T2D and those with NAFLD alone, which might help distinguish the two entity in clinical practice.

Objective The aim of this study was to investigate the short-term efficacy of Huanglian Jiedu decoction, a herbal medicine, and probiotics supplement in intervention of patients with non-alcoholic steatohepatitis (NASH). Methods 72 patients with NASH were enrolled in our hospital between December 2018 and June 2020, and we guided 35 patients in the control for appropriate sports and diet control and taking bifidobacterium triple viable, and other 37 patients received Huanglian Jiedu decoction at base of what in the control. The intervention in the two groups lasted for 12 weeks. The traditional Chinese medicine (TCM) symptoms scores were evaluated and blood biochemical indicators were routinely detected, including fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC ), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB). The controlled attenuation parameters was detected by Fibroscan, the body mass index (BMI) and fatty liver index (FLI) were calculated, and intestinal flora examination was performed. Results At the end of week 12 of treatment, the scores of TCM syndromes of distending pain in hypochondrium, abdominal fullness and distention, uncomfortable body and sleepiness, and dry mouth and bitter taste in the observation group were(1.4±0.6),(0.7±0.4), (1.2±0.6) and (1.0±0.5), all significantly lower than [(1.8±0.8),(1.3±0.6),(1.8±0.9) and (1.5±0.6), respectively, P<0.05] in the control; the FBF, HOMA-IR, serum TC and LDL-C levels were (5.4±0.7)mmol/L, (4.1±0.7),(4.7±1.1)mmol/L and (2.6±0.8)mmol/L, all significantly lower than [(5.8±0.9)mmol/L, (4.9±0.8), (5.6±1.3)mmol/L and (3.1±0.9)mmol/L, respectively, P<0.05] in the control; serum ALT and AST levels were (47.2±7.4)U/L and (43.5±6.2)U/L, both significantly lower than [(62.3±8.1)U/L and (57.9±8.4)U/L, respectively, P<0.05] in the control; the BMI, CAP and FLI were (25.1±2.0)kg/m2, (252.6±12.7)db/m and (19.8±4.7), significantly lower than [(28.1±2.0)kg/m2, (261.1±15.2)db/m and (22.9±4.2), respectively, P<0.05] in the control; the fecal Enterobacter counts was (7.4±0.9)CFU/g, significantly lower than [(8.1±1.0)CFU/g, P<0.05], while the fecal Bacteroides and Bifidobacterium counts were (8.3±1.1)CFU/g and (8.9±1.0)CFU/g, both significantly higher than [(7.6±1.2)CFU/g and (8.0±0.9)CFU/g, respectively, P<0.05] in the control. Conclusion The application of Huanglian Jiedu decoction and probiotics supplement for patients with NASH could efficiently improve the TCM syndrome evaluation, which might be related to the regulation of glucolipid metabolism and improvement of intestinal flora balance.

Objective The aim of this study was to investigate the implication of serum free triiodothyronine (FT3) in patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). Methods 122 patients with HBV-ACLF were admitted in Beijing You'an Hospital between September 2018 and February 2020, and serum FT3 levels were detected. The area under the receiver operating characteristic curve (AUROC) was applied to analyze the efficacy of serum FT3 for predicting the model for end-stage liver disease (MELD) score. Result Serum FT3 levels in 45 patients with HBV-ACLF early stage, in 46 patients with middle stage and in 31 patients with late stage were (2.73±0.57)pmol/L,(2.55±0.49)pmol/L and (2.29±0.42)pmol/L, significantly different among them(P < 0.001); serum FT3 levels in patients with MELD<30, 30≤MELD<40 and MELD≥40 were (2.77±0.14)pmol/L, (2.32±0.13)pmol/L and (2.08±0.09)pmol/L(P < 0.001), suggesting the tends of increased MELD score as serum FT3 levels gradually decreased; the ROC analysis showed that the 1-AUROC of serum FT3 was 0.739(0.686-0.792), while the 1-AUROCs of total serum bilirubin (TSB) levels, of serum creatinine and international normalized ratio (INR) of prothrombin time were [0.748(0.696-0.800), 0.632(0.562-0.702) and 0.933(0.903-0.963), respectively, P<0.001], suggesting that the efficacy of serum FT3 levels was equal to TSB. Conclusion Serum FT3 levels decrease in patients with HBV-ACLF, which might be a new indicator to judge the severity of the disease.

Objective The purpose of this study was to explore the clinical implication of serum aquaporin-8 (AQP8) and aquaporin-9 (AQP9) in patients with hepatitis B-induced liver cirrhosis (LC) receiving long-term entecavir therapy. Methods A total of 83 patients with hepatitis B-induced LC who received long-term entecavir therapy were enrolled in our hospital between January 2019 and June 2020. Serum AQP8 and AQP9 levels were detected by full-automatic electrochemiluminescence analyzer. The Logistic regression model was applied to analyze the risk factors for disease deterioration. Results There were significant differences as respect to the courses of disease longer than 10 yr(63.0% vs. 33.9%), antiviral therapy longer than 5 yrs (25.9% vs. 62.5%), serum albumin levels(31.4±1.9 g/L vs. 37.9±2.3 g/L)platelet counts (73.8±7.5×109/L vs. 109.6±6.8×109/L), serum AQP8 levels(20.5±2.8 μg/L vs. 12.6±2.1μg/L), serum AQP9 levels (10.1±1.7 μg/L vs. 6.0±1.0 μg/L) and MELD scores (21.5±3.5对13.6±2.9) between 27 patients with decompensated and 56 patients with compensated LC(P<0.05); the multivariate Logistic regression analysis showed that the short antiviral therapy, serum AQP8≥15.2 μg/L and MELD score ≥19.5 were the independent risk factors for disease deterioration of LC(P<0.05); serum AQP8 and AQP9 levels in 19 patients with ascites were (19.5±2.8)μg/L and (10.7±1.3)μg/L, both significantly higher than [(13.9±2.1)μg/L and (6.3±0.9)μg/L, respectively, P<0.05] in 64 patients without ascites; serum AQP8 and AQP9 levels in 13 patients with hepatic encephalopathy (HE) were (20.3±2.6)μg/L and (9.7±1.3)μg/L, significantly higher than [(14.2±2.4)μg/L and (6.9±1.1)μg/L, respectively, P<0.05] in 70 patients without HE. Conclusion Serum AQP8 level elevation might hint disease deterioration in patients with hepatitis B-induced LC receiving long-term entecavir therapy, which warrants further clinical investigation.

Objective This study aimed to investigate the cell-free and concentrated ascites reinfusion therapy (CFCART) for treatment of patients withdecompensated liver cirrhosis (DLC). Methods 140 patients with hepatitis B-induced DLC were enrolled in our hospitalbetween October 2018 and October 2020, and they were randomly divided into control and observation group, with 70 cases in each group. The patients in the control group wasintravenously given cefoperazone sodium and sulbactam sodium, and those in the observation group received CFCART therapy.The regimen lasted for two weeks. Serum urea nitrogen (BUN), creatinine (sCr), plasma renin activity (PRA) , endothelin-1(ET-1) and angiotensinogen II (Ang II),aldosterone (ALD), interleukin-6 (IL-6), IL-8 and IL-10, endotoxin (LPS) and nitric oxide (NO) levels were assayed. Results At the end of two week treatment, the total efficient rate in the observation group was 95.7%, significantly higher than 82.9%(P＜0.05) in the control; serumBUN and sCr levels in the observation were (5.7±1.6)mmol/L and (115.1±27.7)μmol/L, significantly lower than [(7.1±2.1)mmol/L and (132.6±31.3)μmol/L, P＜0.05] in the control; serum PRA, AngⅡ and ALD levels were (2.9±0.9)ng/mL/h, (290.5±64.3)ng/L and (258.1±74.2)pg/mL, all significantly lower than [(3.8±1.0)ng/mL/h, (320.9±75.4)ng/L and (276.5±68.4)pg/mL, respectively, P＜0.05] in the control; serum LPS and ET-1 levels were(0.07±0.01)EU/mL and (75.5±2.6)ng/L, significantly lower than [(0.10±0.03)EU/mL and (89.6±5.2)ng/L, P＜0.05], while serum NO level was(69.4±4.3)μmol/L, significantly higher than [(55.7±3.6)μmol/L, P＜0.05] in the control group. Conclusion The CFCART therapy in dealing with patients with DLC could effectively improve kidney functions, which might be related to the inhibition of renin angiotensin aldosterone system.

Objective The aim of this study was to summarize the clinical features of patients with primary hepatic neuroendocrine neoplasm (PHNEN). Methods The clinical manifestations, laboratory tests, imaging, pathological examination and clinical outcomes in four patients with PHNEN encountered in our hospital were summarized by retrospective analysis. Results The age of the four female patients was 56 (40-73) years; there were no symptoms in 2 cases and abdominal pain in 2 cases; serum ALT levels were 28.3(18.0-49.8)U/L, bilirubin levels were 11.5(9.5-16.3)μmol/L, neuron-specific enolase levels were 44.1(20.2-77.1) ng/ml; the abdominal CT scan showed multiple lesions in all cases, and in contrast-enhanced scan, different degrees of ring or uneven enhancement in the arterial phases, and decreased enhancement in the venous phase; all diagnoses were confirmed by pathological examination, and surgical operation, interventional therapy and chemotherapy were given in 3 cases, and one case did not receive any treatment; during the follow-up period of 11 to 81 months, 2 cases died and 2 cases still survived. Conclusion The PHNEN is a rare tumor in clinic, and lacks of specific laboratory and pathological markers. It should be considered after excluding other liver tumors. Early detection and several therapy combination are recommended to improve the prognosis.

Objective The aim of this study was to investigate the implication of peripheral CD4+T, CD8+T, Tc17, Th17 and Treg lymphocyte changes in patients with primary liver cancer (PLC). Methods 83 patients with PLC (BCLC stage A in 25, stage B in 23, stage C in 18, and stage D in 17) and 35 healthy individuals were recruited in our hospital between June 2018 and December 2019, and the percentages of peripheral blood CD4+T, CD8+T, Tc17 (CD8+ IL-17), Th17(CD4+ IL-17) and CD4+CD25+CD45RA+ Treg lymphocytes were detected by flow cytometry. Results The percentage of peripheral blood CD4+ T lymphocytes in patients with PLC was (32.8±8.5)%, significantly lower than [(43.3±7.4)%, P ＜0.05], and the ratio of CD4+/CD8 + cells were (0.9±0.3), also significantly lower than [(1.2±0.1), P ＜0.05] in healthy control; the percentages of peripheral blood Treg cell[(6.4±0.9)% vs. (3.0±0.1)%], Th17 cell [(5.0±1.1)% vs. (3.1±1.5)%] and Tc17 cell [(2.3±0.4)% vs. (1.0±0.2)%] were all significantly increased as compared to those in the control (all P＜0.05); the percentage of CD4+CD25+CD45RA+ Treg cell in patients with BCLC stage C/D increased greatly compared to that in patients with stage A/B [(7.6±0.4) % vs.(5.3±0.5)%, P＜0.001], the percentages of Th17(CD4+ IL-17) cell and Tc17(CD8+ IL-17) cell also increased greatly compared to in patients with stage A/B[(6.9±1.1)% vs. (5.4±0.6)%, P ＜0.01 and (2.8±0.6)% vs. (1.6±0.4)%, P＜0.01]. Conclusion There is an immune imbalance of peripheral blood lymphocyte subsets in patients with PLC, which might hint the immunotherapy targeting at regulating T lymphocyte imbalance necessary in this setting.

Objective The aim of this study was to investigate the efficacy and safety of epirubicin drug-eluting beads-transcatheter arterial chemoembolization (DEB-TACE) in the treatment of patients with unresectable primary liver cancer (PLC). Methods 78 patients with unresectable PLC were enrolled in our hospital between January 2016 and June 2019, and 42 patients received TACE and 36 patients underwent epirubicin DEB-TACE. The clinical efficacy was evaluated based on RECIST 3 months after treatment and the treatment-related adverse events were recorded. All patients were followed-up for two years, and the survival rate was compared by Log-Rank test. Results The complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD) in DEB-TAC-treated patients were 16.7%, 66.7%, 13.9% and 2.8% with the objective remission (OR) rate of 83.3%, significantly different compared to 2.4%, 52.4%, 33.3% and 11.9% with OR of 54.8% in TACE-treated patients (P<0.05); after treatment, the grade one and grade two abdominal pain in DEB-TACE-treated patients were 11.1% and 33.3%, significantly different compared to 30.9% and 14.3% in TACE-treated patients (P<0.05), and grade one nausea and vomiting was 27.8%, significantly higher than 9.5% in patients receiving TACE treatment (P<0.05); at the end of two-year follow-up, the 1 year survival rates in TACE-treated and DEB-TACE-treated patients were 71.4% and 80.5% (P>0.05), while the 2 year survival rates were 42.9% and 69.4%, significantly different (P<0.05). Conclusion DEB-TACE is efficacious in the treatment of patients with unresectab PLC without increased side effect, which might be related to the increased local drug concentration.

Objective The aim of this study was to investigate the influencing factors of disease control after ultrasound-guided 125I radioactive seed implantation for patients with hepatocellular carcinoma (HCC). Methods 84 patients with HCC were admitted to our hospital betweenJuly 2017 and August 2021, and all patients received ultrasound-guided intrahepatic 125I radioactive seed implantation with particle activity of 0.6-0.8 mCi and the tumor matched peripheral dose (MPD) of 110-160 Gy. The CT or MRI scan was performed 2 months after the operation and the short-term efficacy was evaluated according to RECIST standard version 1.1. The multivariate Logistic regression analysis was applied to screen for independent factors impacting disease control (the sum of complete response, partial response and disease stable). Results The intratumorous implantation of radioactive125I seeds was successfully finished in our 84 patients with HCC; at the end of two months after surgery, the imaging showed disease control in 69 cases (82.1%), including complete remission in 15 cases (17.9%), partial remission in 47 cases (56.0%) and disease stable in 7 cases (8.3%), with disease progression in 15 cases (17.9%); the univariate Logistic regression analysis showed that the proportions of Child-Pugh class B, BCLC stage C, tumor diameter > 5 cm and the received irradiation dose of 90% target volume (D90 dose) < 110 Gy in thedisease control group were 40.0%, 43.5%, 40.9% and 28.6%, all significantly lower than 60.0%, 56.5%, 59.1% and 71.4% in the disease progression group (P<0.05); the multivariate Logistic regression analysis showed that the D90 dose was an independent factor impacting disease control in patients with HCC after ultrasound-guided radioactive125I seed implantation (OR=344.350, P<0.05). Conclusion The sufficient irradiation dose is necessary in patients with unresectable HCC receiving intratumorous radioactive125I seed implantation in order to gain therapeutic efficacy, which needs further clinical investigation.

Objective The aim of this study was to explore the clinical value of perfusion phase analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of patients with hyperplastic nodules with underlying liver cirrhosis. Methods 100 patients with cirrhosis were encountered in our hospital between June 2017 and June 2020, and all underwent CEUS check-up. The region of interest was drawn, and the peak, time to peak (TTP) and mean transit time (MTT) as well as the regional blood volume (RBV) and the regional blood flow (RBF) were recorded. Results Out of our 100 cirrhotics, the dysplastic nodule (DN) in liver was proven in 54 cases, and small hepatocellular carcinoma (sHCC) was confirmed in 46 cases by histopathological examination; no significant blood flow signals of lesions in DN was 53.9%, while the lesions of sHCC were mainly with low blood flow signals in 48.5%; the lesions in both groups were mainly with low echoes (79.6% vs. 74.2%), with clear boundaries (91.1% vs. 77.3%) and regular morphology (65.4% vs.74.2%); the enhancement features on CEUS images in DN were mainly on low (52.3%), equal (85.9%) and equal enhancement echoes (91.0%) in arterial phase, portal phase and delayed phase, while those in sHCC were mainly with high (86.4%), equal (63.6%) and low enhancement echoes (60.6%), respectively; the peak, TTP and MTT in DN were (46.4±13.5) %, (26.8±3.5) s and (53.3±7.8) s, all significantly different compared with those in sHCC [(58.8±11.3) %, (24.2±4.3) s and (42.5±9.7) s, respectively, P<0.05]; the RBV and RBF in DN in arterial phase were (1562.8±618.3) mL and (1562.8±618.3) mL/s, while in delayed phase were (612.3±95.3) mL and (25.7±6.9) mL/s, significantly different compared with [(3428.6±562.8) mL, (62.5±13.5) mL/s and (385.5±89.6) mL, (18.3±4.7) mL/s, P<0.05] in sHCC; the accuracy, sensitivity, specificity, positive predictive value and negative predictive value by CEUS in diagnosis of DN under cirrhosis background were 87.0%, 87.0%, 87.0%, 88.7% and 85.1%, respectively (Kappa value=0.739). Conclusion The perfusion phase analysis of CEUS could provide objective basis for the diagnosis of DN in patients with underlying liver cirrhosis, which might be of high clinical applicatione.

Objective The ultrasonographic feature and prognosis of patients with hepatocellular carcinoma (HCC) and cardiac metastasis were summarized. Methods A total of 19 patients with HCC and cardiac metastasis were admitted to our hospital between January 2013 and May 2019, and all patients underwent ultrasonography and followed-up for 12 months. The diagnosis was confirmed by histopathological examination. Results The solid echo was observed in adjacent hepatic veins and extended to inferior vena cava and right atrium in 16 cases (84%), the solid echogenicity was observed in adjacent inferior vena cava and extended to right atrium in 3 cases (16%), the mixed echo was found in 13 cases (68%) and the hypoechoic in 6 cases (32%); the clear boundaries was found in 15 cases (79%) and the irregular morphology was found in 16 cases (89%); there was no blood flow signal of tumor thrombus in the right atrial in 19 cases (100%); no relationship with cardiac cycle was found in 12 cases 63%, and no significant relationship with cardiac cycle was found in 7 cases (37%); the right ventricular inflow tract was involved in 3 cases (16%); the survival time after right atrial metastasis was found was 25 to 412 days, and acute pulmonary embolism was found in 2 patients. Conclusion The continuous cancerous thrombus extending from hepatic vena to inferior vena cava to right atrium or to inferior vena cava to right atrium is the most important ultrasonographic manifestations in patients with HCC and cardiac metastasis. The patients at this circumstance have a very short survival time and might have acute pulmonary embolism at any time.

Objective The aim of this study was to compare the efficacy and safety of laparoscopic (LLR) and open liver resection (OLR) in the treatment of patients with intrahepatic cholangiocarcinoma (ICC). Methods 74 patients with ICC were enrolled in our hospital between January 2015 and June 2018, and 32 patients received LLR and 42 underwent OLR. All patients in the two groups were followed-up for 3 years. Results There was no significant differences as respect to ages, gender, abdominal operation history, serum carbohydrate antigen 199 and carcinoembryonic antigen levels, nerve invasion, microvascular invasion, tumor low differentiation, tumor diameters and lymph node enlargement between the two groups (P>0.05); the intraoperative blood loss, surgical incision length, hepatic portal occlusion, postoperative hospital stay, percentages of blood transfusion and post-operational gastrointestinal function recovery in patients receiving LLR were 325(250, 475)ml, 5(3.5, 6.5)cm, 9 cases(28.1%), 7(5, 12)d, 2 cases(6.2%)and 2(2, 4)d, significantly different as compared to [500(375, 750)ml, 20.5(17.0, 25.0)cm, 31 cases(73.8%), 10(7, 15)d, 7 cases (16.7%) and 4(3, 6)d] in patients receiving OLR (P<0.05), while there were no significant differences in one-year (81.2% vs. 76.2%) and three year (46.8% vs. 33.3%) survivals between the two groups (P>0.05); no severe untoward effects post-operationally occurred in our series. Conclusion At present, the LLR might be an alternative option for patients with ICC, although the OLR is still underwent in some circumstances, so the surgeon could make choice based on the patients' conditions and the technical requirement.

Objective The aim of this study was to analyze the efficacy of hemangioma stripping and hepatectomy in the treatment of patients with hepatic hemangioma and to evaluate the infleunce of the two surgical treatment on perioperative indicators, postoperative complications and prognosis. Methods A total of 58 patients with hepatic hemangioma were recruited in our hospital between January 2019 and June 2020, out of them, 31 patients were treated with hemangioma stripping and 27 patients were treated with hepatectomy. All patients were followed-up for 6 months. The perioperative indicators, postoperative complications and postoperative recurrence of tumor were recorded in the two groups. Results The surgical time, intraoperative blood loss, postoperative abdominal drainage volume and postoperative hospital stay in hemangioma stripping-treated patients were (120.6±25.4)min, (389.3±53.8)mL, (264.5±55.7)mL and (13.9±2.4)d, all significantly shorter or less than [(148.1±28.9)min, (468.2±59.2)mL,(321.8±63.4)mL and (15.8±3.3)d, respectively, P<0.05] in patients receiving hepatectomy; the post-operational complications, such as intraperitoneal hemorrhage, bile leakage and pleural effusion in hemangioma stripping-treated patients was significantly lower than in patients receiving hepatectomy (6.5% vs. 35.0%, P<0.05); six months after operation, all hepatic hemangioma in the two groups disappeared without recurrence; five days after surgery, serum alanine aminotransferase and aspartate aminotransferase levels in hemangioma stripping-treated patients were (71.3±15.3)U/L and ((49.1±9.3)U/L, both significantly lower than [(82.9±16.8)U/L and (57.3±11.2)U/L, respectively, P<0.05] in hepatectomy-treated patients. Conclusion Hemangioma stripping and hepatectomy are both effective and safe in treating patients with hepatic hemangioma, However, hemangioma stripping has some advantages in reducing trauma and shortening postoperative recovery time. The two surgical approaches have their own indications, and the surgeons might choose the appropriate surgery for the optimal efficacy.

Objective The aim of this study was to compare the clinical efficacy of laparoscopic puncture drainage (LPD) and laparoscopic incision drainage (LID) in treatment of patients with bacterial liver abscess (BLA). Methods 63 patients with BLA were admitted to our hospital between January 2019 and December 2020, and were divided into observation (n=32), underwent LPD, and control group (n=31), underwent LID. They were all followed-up for 3 months after surgery. Serum interleukin 6 (IL-6), C-reactive protein (CRP)and procalcitonin (PCT) levels were detected. Results All but one patients in the observation group who died from concomitant diabetes and pulmonary infection recovered in the two groups; the hospitalization stay and medical cost in the observation group were (14.2±2.3)d and (13.0±2.0) thousand yuan, both significantly shorter or lower than [(16.1±2.5)d and (16.0±3.0)thousand yuan, respectively, P＜0.05], while the body temperature normal and hepatic abscess disappearance time were (2.3±0.4)d and (10.3±1.5)d, both significantly longer than [(1.7±0.4)d and (8.4±1.2)d, respectively, P＜0.05] in the control; there were no significant differences respect to serum ALT, AST, GGT and albumin levels, as well as serum CRP, PCT, IL-6 levels or white blood cell counts between the two groups at presentation or after surgery (P＞0.05). Conclusion The clinical efficacy of laparoscopic puncture drainage and laparoscopic incision drainage in dealing with patients with BLA is comparable, but the former is more beneficial to accelerate recovery of patients.

Objective The aim of this study was to investigate the short-term efficacy of three-dimensional visualization system and fiber choledochoscope in guiding hepatectomy in the treatment of patients with hepatolithiasis. Methods 117 patients with hepatolithiasis were encountered in our hospital between September 2015 and September 2020, and 61 patients in observation group received hepatectomy after mimics under the guidance of three-dimensional visualization system, and 56 patients in control received hepatectomy routinely. The changes in peripheral blood T lymphocyte subsets was detected by flow cytometry. Results The surgical time, intraoperative blood loss, postoperative drainage volume, first feeding and postoperative hospital stay in the observation were (159.8±37.4) min, (172.7±56.4) mL, (141.1±34.8) mL, (2.1±0.6) d and (8.1±2.3) d, significantly shorter or less than [(201.5±52.7) min, (241.6±79.5) mL, (195.2±87.4) mL, (2.7±0.8) d and (10.5±2.9) d, respectivelyy, P<0.05)] in the control; the stone clearance rate was significantly higher than that in the control group (95.7% vs. 85.7%, P<0.05); the incidence of postoperative complications was significantly lower than that in the control (6.6% vs. 19.6%, P<0.05) ; the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells were (38.8±5.3)% and (1.9±0.4), which were significantly higher than those in the control group [(34.2±5.5)% and (1.5±0.3), respectively, P<0.05]. Conclusion The hepatectomy under the guidance of three-dimensional visualization system for the treatment of patients with hepatolithiasis could relieve surgical trauma, promote early recovery, elevate stone removal with less incidence of postoperative complications, which warrants further clinical investigation.

Objective The aim of this study was to investigate the modified endoscopic nosal biliary drainage (ENBD) through gallbladder approach in the treatment of patients with small-diameter common bile duct stones (CBDS). Methods A retrospective analysis was conducted, including 54 patients with small-diameter CBDS encountered in the hospital between December 2015 and June 2018 (control group) and other 54 cases presented between July 2018 and December 2020 (observation group). All patients underwent laparoscopic cholecystectomy (LC), followed by common bile duct exploration and ENBD, and the difference was the common nasal biliary drainage (NBD) was applied in the control and the modified NBD in the observation. Serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected routinely. Results The postoperative drainage volume of bile and extubation time of nasobiliary ducts in the observation were (281.6±52.5)mL and (5.9±1.3)d, significantly greater or longer than [(228.7±53.2)mL and (4.0±1.4)d, respectively, P＜0.05], while the hospital stay was (6.1±1.1)d, significantly shorter than [(8.1±1.3)d, P＜0.05] in the control group; the incidences of post-operational complications, such as pancreatitis, bile leakage and slippage of nasobiliary ducts in the observation was 7.4%, significantly lower than 25.9%(P＜0.05) in the control; one week after operation, serum CRP, IL-6 and TNF-α levels in the observation were (42.8±11.1)mg/L, (3.2±0.8)ng/L and (1.0±0.8)ng/L, significantly lower than [(73.7±17.4)mg/L, (4.9±1.2)ng/L and (1.8±0.9)ng/L, respectively, P＜0.05] in the control group. Conclusion Compared with the ordinary NBD tube, the application of modified NBD tube could reduce the risk of slippage, improve the drainage of bile and shorten the postoperative recovery in patients with small-diameter CBDS.

Objective Non-alcoholic fatty liver diseases (NAFLD) is the most prevalent chronic liver disease worldwide at present, and the main mechanisms involved in the pathogenesis include insulin resistance, oxidative stress and so on. Different serum markers are closely related to the pathogenesis of NAFLD, but there is no clear conclusion yet. This article reviewed the important role of different serum markers in patients with NAFLD.

Objective Sarcopenia is defined as loss of systemic skeletal muscle mass and functions. It may affect the physiological functions and leads to the declined quality of life, and even death. Sarcopenia occurs in up to 70% of patients with advanced liver diseases, which is associated with untoward clinical outcomes and poor prognosis. At present, most treatments are based on nutrition and exercise, however, there is still a lack of effective targeted molecular therapy. This review summarizes the pathogenesis of sarcopenia in liver diseases, in order to identify potential biomarkers for treatment and improve the clinical prognosis.