Objective The aim of this study was to explore the effects of britanin on cell proliferation and apoptosis and impact on mammalian target of rapamycin complex (mTORC1) signal pathway in HepG2 cells in vitro. Methods The Hep G2 cells were cultured with britanin at 0 μmol/L (control), 5 μmol/L, 10 μmol/L and 20 μmol/L for 48 hours. The cell proliferation was detected by MTT, the cell apoptosis was evaluated by flow cytometry, and the apoptosis-related protein expressions, such as Bax, Bcl2 and Caspase3 and mTORC1 signaling pathway were detected by Western bloting. Results The cell proliferation rates in 5 μmol/L, 10 μmol/L and 20 μmol/L britanin-intervened groups were (89.56±8.11)%, (66.40±6.61)% and (41.78±5.79)%, all significantly lower than [(100.00±10.01)%, P<0.05] in the control; the apoptosis rate were (14.75±1.34)%, (19.11±1.87) % and (27.45±1.99)%, significantly higher than [(7.01±0.89)%, P<0.05] in the control; the expressions of pro-apoptotic proteins, Bax and Caspase3, were (1.36±0.15) and (1.63±0.32), (3.57±0.33) and (3.92±0.47), and (7.33±0.52) and (6.94±0.53), all significantly higher than [(0.98±0.11) and (0.87±0.15), P<0.05] in the control, while the expression of anti-apoptotic protein, Bcl2, were (4.71±0.52), (2.36±0.36) and (0.89±0.14), significantly lower than [(8.05±0.65), P<0.05] in the control; the protein expressions of mTORC1 and 70S6K were (0.82±0.08) and (0.79±0.08), (0.63±0.06) and (0.58±0.05) and (0.51±0.05) and ( 0.43±0.04), all significantly lower than [(0.96±0.11) and (0.99±0.09), P<0.05] in the control. Conclusion Britanin could inhibit cell proliferation and induce cell apoptosis, which might exert a certain anti-tumor effects by down-regulation of mTORC1 signaling pathway.

Objective The aim of this study was to investigate the effect of long non-coding RNA (lncRNA) HOXD cluster antisense RNA 1 (HOXD-AS1) on proliferation and motion of HepG2,Hep3B and Huh7 cells in zebrafish patient derived xenograft (zPDX). Methods The HOXD-AS1 and miR-130A-3P were knocked down in HepG2,Hep3B and Huh7 cells, and the HOXD-AS1 mRNA was detected. The cell proliferation was detected by CCK-8 and the cell migration was by Transwell. The zPDX was established. Results The HOXD-AS1 mRNA levels in HepG2, Hep3B and Huh7 cells were 65.6±5.7(P<0.01), 4.6±0.5(P<0.01) and 23.4±1.0(P<0.001) times than in LO2 cells; the cell counts per field in Hep3B cells with knock-down of HOXD-AS1 was 49.6±3.9, significantly decreased than 221.8±63.3(P<0.01) in the control; in zPDX, the proliferation of cells was 56.0±12.0%(P<0.01) and the migration was 49.0±8.9%(P<0.05) of control; the cell counts per field in Huh7 cells with HOXD-AS1 knock-down was 54.2±15.2, significantly decreased than 226.8±26.3(P<0.01) in the control; in zPDX, the proliferation was 46.5±16.8%(P<0.01), and the migration was 41.9±10.2%(P<0.01) of control; the cell counts per field in Huh7 cells with down-regulated miR-130a-3p was 39.0±9.2, significantly increased than 24.4±7.2(P<0.001) in the control; in zPDX, the cell migration increased greatly; the cell counts per field in Huh7 cells with si1-HOXD-AS1 and miR-130a-3p co-tranfection, si1-HOXD-AS1-transfected and control were 78.2±15.3, 39.3±9.5 and 79.4±18.3, significantly different among them (P<0.01); in zPDX, the CM-DII positive cells in si1-HOXD-AS1-transfected cells and in co-transfected cells were 48.9±13.5% (P<0.05) and 109.4±24.9% (P> 0.05) of control. Conclusion This study demonstrates the effects of HOXD-AS1 / miR-130a-3p ceRNA network on HCC cells in vitro and in vivo, and the zebrafish might be used for tumor metastasis study.

Objective The aim of this experiment was to explore the mechanism by which saxagliptin on adenosine 5-monophosphate (AMP)-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)-transcription factor EB (TFEB) autophagy signaling pathway in rats with high-fat diet feed non-alcoholic fatty liver disease (NAFLD) and concomitant type 2 diabetes mellitus (T2DM). Methods 42 SD rats were randomly divided into control, model and saxagliptin-intervened group, with 14 rats in each group. The NAFLD and T2DM models in rats was established by high-fat diet feeding and intraperitoneal injection of streptozotocin. After two rats sacrificed in each groups for successful modeling proven, the left 12 rats in saxagliptin-intervened group were given saxagliptin gavage for 8 weeks, and the rats in other two groups were treated with the same amount of normal saline for gavage for 8 weeks. The body mass and liver mass were obtained and the liver index was calculated. Serum fasting insulin (INS) level was assayed by radioimmunoassay, fasting plasma glucose (FPG) levels were detected, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The hepatic expressions of p-AMPK, mTOR, TFEB and autophagy marker, LC3B-II, were detected by Western blotting. Results The body mass, liver mass and liver index were (341.53±5.15) g, (11.06±0.49) g and (3.32±0.25) % in saxagliptin-intervened group, significantly lower than [(353.27±8.74) g, (12.77±0.84) g and (3.67±0.18)%, P<0.05] in the model group; the FPG, INS and HOMA-IR were (9.45±0.71) mmol/L, (7.92±0.34) mIU/L and (3.44±0.36), significantly lower than [(13.97±0.92) mmol/L, (14.57±0.84) mIU/L and (9.03±0.91), P<0.05] in the model group; serum TC, TG, ALT and AST levels were (3.79±0.17) mmol/L, (0.81±0.13) mmol/L, (68.76±4.11) IU/L and (54.49±5.21) IU/L, significantly lower than [(4.05±0.20) mmol/L, (2.04±0.15) mmol/L, (119.73±3.94) IU/L and (83.27±7.68) IU/L, P<0.05] in the model group; the hepatic expressions of p-AMPK, TFEB and LC3B-II were (1.13±0.11), (1.23±0.13) and (1.17±0.12), significantly stronger higher than (0.62±0.07), (0.48±0.05) and (0.37±0.04), while the expression of mTOR was (0.89±0.08), significantly weaker than [(1.53±0.16), P<0.05] in the model group. Conclusion Saxagliptin could significantly reduce blood glucose and blood lipids levels and ameliorate liver steatosis in rats with NAFLD and T2DM, which might be achieved by regulation of AMPK/mTOR-TFEB autophagy signaling pathway.

Objective The aim of this study was to investigate the diagnostic performance of FibroTouch scan in predicting liver fibrosis in chronic hepatitis B virus (HBV) carriers. Methods 66 HBV carriers were encountered in Longgang Central Hospital, Shenzhen, between July 2017 and December 2019, and all underwent liver biopsy. The liver fibrosis based on four factors (FIB-4) was calculated routinely, and the liver stiffness measurement (LSM) was detected by FibroTouch. The ROC was drawn by MedCalc software. Results The liver histopathological examination showed S₀-S₁ in 24 cases, S₂-S₃ in 27 cases and liver cirrhosis (S₄) in 15 cases in our series; the LSM in carriers with S_0-1 was (7.8±1.8) kPa, significantly lower than [(11.4±3.1)kPa, P＜0.01] in those with progressive liver fibrosis or [(18.2±6.2)kPa, P＜0.01] in patients with liver cirrhosis, and the FBI-4 in carriers with S_0-1 was (1.0±0.5), in those with S_2-3 was (1.2±0.5), not significantly different between them (P>0.05), while both significantly lower than [(2.0±1.0, P<0.01] in patients with liver cirrhosis; the AUCs by LSM in predicting S₂, S₃ and S₄ were 0.856 [with sensitivity (Se) of 83.7% and specificity (Sp) of 52.6%, 0.938( Se of 92.3% and Sp of 90.0%, and 0.963(Se of 100.0% and Sp of 90.2%), all significantly higher than by FBI-4 (P<0.05), while the combination of LSM and FIB-4 didn’t improve the diagnostic performance (P>0.05). Conclusion The non-invasive diagnosis of liver fibrosis by FibroTouch detection in chronic HBV carriers is efficacious, and warrants further clinical investigation.

Objective The aim of this study was to evaluate the safety of tenofovir disoproxil fumarate (TDF) therapy in pregnant women. Methods 120 pregnant female HBV carriers delivered in Beijing You'an Hospital, Capital Medical University,between July 1, 2018 and June 30, 2019. 40 carriers (group A) started taking TDF within one year before pregnancy until the delivery, 40 carriers (group B) taking at 24 to 28 weeks of pregnancy, and 40 carriers (group C) did not taking antiviral medicine. All pregnant women took blood and urine routine examination at the 12th and 36th weeks of pregnancy to evaluate the renal functions, such as serum phosphorus (P), glomerular filtration rate (GFR), creatinine (sCr), creatine kinase (CK) and urinary protein (uPRO). We also record the physical development indexes of newborns at birth, such as head circumference, body length and body mass. The adverse events of newborns recorded such as neonatal clavicle fracture, birth defect and neonatal death. Results At 36th week of gestation, serum P, GFR, sCr, CK and uPRO in group A were(1.2±0.1)mmol/L,(120.9±7.9)mL/(min·1.73 m²),(52.1±7.9)μmol/L, (57.7±21.8)U/L and 6 cases (15.0%) positive, in group B were (1.2±0.1)mmol/L, (119.5±9.4)mL/(min·1.73 m²), (50.6±7.7)μmol/L, (56.6±18.8)U/L and 5 cases (12.5%), and in group C were (1.2±0.1)mmol/L, (125.7±8.7)mL/(min·1.73 m²), (48.9±7.2)μmol/L, (53.9±16.1)U/L and 4 cases(10.0%), not significantly different among them (P>0.05); the height, head circumference and birth weight of newborns in group A were (50.0±1.1)cm, (333.6±5.1)cm and(3383±319)g, in group B were (49.9±1.2)cm, (333.9±5.1)cm and 3215±327)g, and in group C were (50.1±1.1) cm, (332.9±5.7)cm and(3284±328)g, not significantly different among them (P>0.05); only one neonatal had clavicular fracture in group C in our series. Conclusion TDF has no untoward effects on renal function tests and fetal growth in pregnant women with HBV infection. It might be administered safely during pregnancy.

Objective The aim of this study was to explore the antiviral efficacy of entecavir (ETV) and pegylated interferon α-2b (PEG-IFNα-2b) combination in treatment of patients with low serum level HBsAg-positive chronic hepatitis B (CHB). Methods A total of 96 patients with low serum level HBsAg-positive CHB were enrolled in our hospital between January 2018 and January 2020, and were randomly divided into control and observation group, with 48 cases in each group. The patients in the control group were treated with orally ETV and those in the observation were treated with ETV and PEG-IFNα-2b combination for 48 weeks. Serum HBV DNA loads were detected by fluorescence quantitative polymerase chain reaction, and serum HBsAg and HBeAg levels were detected by electrochemiluminescence. The percentages of CD3⁺, CD4⁺ and CD8⁺ cells were detected by flow cytometry, and ratio of CD4⁺/CD8⁺ cells was calculated. Results At the end of 48 week observation, serum HBsAg and HBeAg levels in the observation group were (809.8±101.5)IU/mL and (193.4±24.5)IU/mL, both significantly lower than [(1201.7±204.9)IU/mL and (244.2±5.7)IU/mL, respectively, P<0.05] in the control; serum HBeAg negative rate was 29.2%, significantly higher than 4.2%(P<0.05) in the control, and the HBeAg seroconversion rate was 12.5% and serum HBsAg loss was 8.3%; serum ALT and AST levels were (52.5±4.6)U/L and (45.1±5.2)U/L, both significantly lower than [(63.4±5.2)U/L and (68.2±5.4)U/L, respectively, P<0.05] in the control; the percentages of peripheral blood CD3⁺ and CD4⁺ cells and the ratio of CD4⁺/CD8⁺ cells were (68.5±4.2)%, (38.1±3.6)% and (1.8±0.5), all significantly higher than [(57.4±3.8)%, (32.6±3.1)% and (1.1±0.4), respectively, P<0.05], while the percentage of CD8⁺ cells was(21.3±1.8)%, significantly lower than [(28.7±2.0)%, P<0.05] in the control group. Conclusion The regimen with ETV and PEG-IFNα-2b combination in treating CHB patients with low serum HBsAg positive could gain a good antiviral efficacy, with serologic response in some cases, which might be related to the improved immune functions.

Objective The aim of this study was to investigate the response to tenofovir antiviral therapy in chronic hepatitis B (CHB) patients with different HBV genotype infection. Methods A total of 119 patients with CHB were enrolled in our hospital between January 2017 and November 2020, and all received tenofovir therapy. The HBV genotypes were detected. Serum metallothionein (MT) and interleukin-29 (IL-29) levels were assayed by ELISA. The programmed cell death-1 (PD-1) expression on peripheral blood lymphocytes was detected by FCM. Results Out of the 119 patients with CHB, the HBV genotype B infection was found in 31 cases(26.1%), genotype C infection was found in 77 cases (64.7%) and genotype B/C mixed infection in 11 patients (9.2%); at baseline, serum ALT and AST levels in CHB patients with genotype B infection were (154.1±46.7)U/L and (83.3±26.8)U/L, significantly higher than [(135.8±40.3)U/L and (68.5±20.6)U/L, P＜0.05] in patients with C infection or[(138.9±50.2)U/L and (71.6±23.9)U/L, P＜0.05] in B/C mixed infection, while serum HBV DNA load was (6.7±1.1)lg copies/ml, significantly lower than [(7.8±1.4)lg copies/ml, P＜0.05] in C or[(7.4±1.0)lg copies/ml, P＜0.05] in B/C infection; at the end of 24 week and 48 week treatment, there were no significant differences as respect to serum ALT normalization rates in the three groups (P>0.05), while serum HBV DNA loss in patients with B and C infection were 96.8% and 96.8%, and 88.3% and 93.5%, all significantly higher than 63.6% and 81.8% (P<0.05) in patients with B/C mixed infection; at the end of 48 week treatment, serum MT level in patients with B infection was significantly higher than in patients with C or B/C infection (P＜0.05), serum IL-29 level was significantly higher than in patients with C infection (P＜0.05), while the PD-1 expression on peripheral blood CD4⁺ and CD8⁺T cell surfaces was significantly lower than in patients with C or B/C infection (P＜0.05). Conclusion The antiviral response to tenofovir treatment in CHB patients with different HBV genotype infection could be different, and further investigation on this might help deal with them appropriately in clinical practice and improve the outcomes of them.

Objective The aim of this study was to investigate the prevalence of occult hepatitis B viral infections (OBI) in blood donors (BD). Methods 107397 blood samples were collected in our Blood Station between January and December 2021. The initial serum screening of HBsAg was conducted by two ELISA kits, and serum HBV DNA loads was assayed by NAT. For serum HBV DNA positive samples, serum HBV markers were repeatedly detected and HBV genotype was determined by real-time fluorescence quantitative polymerase chain reaction (PCR). Results Out of the 107397 blood samples, the OBI was found in 29 cases (0.27‰) as defined by serum HBV DNA positive; the re-testing of the positive blood showed that serum anti-HBc positive in 12 cases (35.3%), anti-HBe/anti-HBc positive in 8 cases (23.5%), anti-HBs/anti-HBc positive in 6 cases (17.7%) and anti-HBs/anti-HBe/anti-HBc positive in 3 cases (8.8%); the prevalence of OBI in individuals at 19-29 year old was 0.09‰, in those at 30-39 was 0.32‰, in at 40-49 was 0.39‰ and in at 50-55 was 0.41‰, and in persons at age of 50-55 with more than one time blood donor, the prevalence of OBI was 0.31‰; the percentages of serum HBV DNA loads greater than 1000 IU/mL in OBI individuals with serum anti-HBs/anti-HBc positive and with serum anti-HBs/anti-HBe/anti-HBc positive were 33.3% and 66.7%, significantly higher than 0.0% in those with serum anti-HBc positive (P<0.05) or with serum anti-HBe/anti-HBc positive (0.0%, P<0.05); out of the 29 OBI persons, the genotype C infection accounted for 62.1% and genotype B infection for 27.6%. Conclusion The prevalence of OBI in blood donors is a challenge for public health security, and the cost-efficacy of all-scale detection of serum HBV DNA loads in this setting needs further investigation. The quality and sensitivity of conventional ELISA kits should be improved.

Objective The aim of this study was to investigate the efficacy of standardized pegylated interferon α-2a (Peg-IFNα-2a) and ribavirin (RBV) combination in treatment of patients with chronic hepatitis C (CHC). Methods 102 patients with CHC were enrolled in our hospital between February 2017 and April 2020, and were divided randomly into control (n=50) and observation (n=52). The patients in the control received RBV and interferonα-2a therapy, and those in the observation were treated by RBV and Peg-IFNα-2a therapy. The regimen in both groups lasted for 6 months. The peripheral blood T lymphocyte subsets was detected by Flow cytometry. Results The end treatment virological response (ETVR) and the sustained virological response in the observation group were 88.5% and 82.7%, both significantly higher than 62.0% and 62.0%(P＜0.05) in the control group; at the end of treatment, serum ALT and AST levels in the observation were (36.8±4.1)U/L and (38.4±3.4)U/L, both significantly lower than [(61.5±4.3)U/L and(51.6±3.6)U/L, respectively, P＜0.05] in the control group; at week 4, 12 and 24, serum HCV RNA loads in the observation group were (4.6±1.2)Ig IU/mL, (4.1±1.1)Ig IU/mL and (3.6±0.9)Ig IU/mL, all significantly lower than [(5.1±1.1)Ig IU/mL, (4.7±1.2)Ig IU/mL and (4.2±1.0)Ig IU/mL, respectively, P＜0.05] in the control; at the end of the regimen, the percentage of peripheral blood CD3⁺ cells in the observation group was (73.8±7.5)%, significantly higher than [(65.6±6.9)%, P＜0.05], that of CD4⁺ cells was (49.5±6.3)%, significantly higher than [(34.8±5.8)%, P＜0.05], while that of CD8⁺ cells was (17.6±3.8)%, significantly lower than [(25.9±4.6)%, P＜0.05] and the ratio of CD4⁺/CD8⁺ cells was (1.0±0.2), significantly lower than [(1.4±0.3), P＜0.05] in the control group. Conclusion The standardized Peg-IFNα-2a and RBV antiviral therapy is still efficacious in treating patients with CHC, which might be carried out alternatively in case no direct antiviral agents is available.

Objective The aim of this study was to explore the clinical evaluation of liver fibrosis (LF) by serum N-oligosaccharide and total bile acid (TBA) levels and liver stiffness measurement (LSM) combination in patients with chronic hepatitis C (CHC). Methods A total of 84 patients with CHC and 51 healthy individuals were enrolled in our hospital between June 2018 and June 2021. Serum TBA levels were detected by full-automatic biochemical analyzer. The relative content of serum N-oligosaccharide was detected and calculated with data analysis software. The LSM was detected by Fibroscan-502. The diagnostic value of combined parameters was evaluated by area under the receiver operating characteristic (ROC) curve (AUC). Results Serum N-oligosaccharide and TBA levels in patients with CHC were(4.1±0.8) and (20.0±3.1)μmol/L, significantly higher than [(1.6±0.3) and (8.6±1.5)μmol/L, and the LSM was (16.7±2.9)kPa, significantly higher than [(6.3±0.4)kPa, P<0.05] in the control; the liver histopathological examination showed LF S₁ in 19 cases, S₂ in 21 cases, S₃ in 26 cases and S₄ in 18 cases; serum N-oligosaccharide levels in patients with S₁, S₂, S₃ and S₄ were (2.5±0.6), (3.8±0.7), (4.3±0.7) and (5.7±1.0), serum TBA levels were (11.3±2.5)μmol/L, (18.5±3.1)μmol/L, (21.4±3.7)μmol/L and (28.7±4.1)μmol/L, and the LSM were (6.3±1.7)kPa, (13.8±2.1)kPa, (17.9±3.2)kPa and (29.4±4.6)kPa, suggesting they increased as the LF severer (P<0.05); the AUC by the three parameter combination in predicting LF was 0.918(95%CI:0.862-0.973, with Se of 90.9%, Sp of 77.5% and Ac of 84.5%), significantly higher than [0.785(95%CI:0.675-0.894), with Se of 93.2%, Sp of 67.5% and Ac of 81.0%] by serum N-oligosaccharide levels, or [0.769(95%CI:0.668-0.870), with Se of 68.2%, Sp of 77.5% and Ac of 72.6%] by serum TBA levels or [0.802(95%CI:0.708-0.895), with Se of 75.0%, Sp of 80.0% and Ac of 77.4%] by LSM alone(P<0.05). Conclusion The combination of serum N-oligosaccharides and TBA levels as well as LSM is of evaluation value for severity of liver fibrosis in patients with CHC, which needs further investigation.

Objective The aim of this study was to summarize the clinicopathological features and serum cytokine levels in patients with drug-induced liver injury (DILI). Methods 60 patients with DILI were admitted to the Department of Gastroenterology and Hepatology in our hospital between May 2019 and May 2021,and all underwent liver biopsies. The suspected medicines were discontinued and liver function-protecting medicines were given. Serum tumor necrosis factor-ɑ (TNF-ɑ), interleukin-6 (IL-6),IL-17, IL-10 and fibroblast growth factor (FGF-1)levels were detected by ELISA. Results In our series, the drugs suspected for DILI included the anti- tuberculosis medicines accounted in 23.3%, the Chinese herbal medicines in 15.0%, the chemical medicines in 11.7%, the healthcare products in 11.7%, and some other uncommon drugs included non-steroidal anti-inflammatory medicines in 5.0%, antipsychotic drugs in 5.0%, bee venom in 6.7% and antibiotics in 6.7%; at presentation, serum ALT, AST and total bilirubin levels in the 60 patients with DILI were(198.5±33.1)U/L,(221.7±55.8)U/L and (42.3±12.8)μmol/L, all backed to normal at about two week treatment; the liver histopathologic examination showed that the eosinophil (36.7%), lymphocyte (18.3%) and neutrophil (15.0%) infiltration, and other manifestations included plasma cell infiltration (10.0%), steatosis (8.3%), cholestasis (5.0%), apoptosis(3.3%) and granulomatosis(3.3%); at admission, serum TNF-ɑ, IL-17, IL-6, IL-10 and FGF-1 levels were (16.5±3.3)pg/ml, (38.8±6.7)pg/ml, (122.9±15.2)pg/ml, (2.0±1.2)pg/ml and (15.3±5.1)pg/ml, and they changed to [(2.1±0.8)pg/ml, (15.2±5.4)pg/ml, (45.3±8.4)pg/ml, (5.9±1.4)pg/ml and (26.8±7.6)pg/ml, P<0.05] when the disease recovered, significantly different. Conclusion The recognition of common medicines, liver function test and histopathologic changes in patients with DILI will help dealing with them in this circumstance, and discontinue the suspected medicines in time. The prognosis of patients tends to be good.

Objective The aim of this study was to investigate the liver pathological features of patients with drug-induced liver injury(DILI). Methods Thirty-eight patients with DILI was encountered in our hospital between January 2017 and December 2020, and all were evaluated by structured expert opinion process(SEPO)and underwent liber biopsies. The diagnostic performance of DILI-pathological scroring system (DILI-PSS) was verified by the area under the receiver operating characteristic curve (AUROC). Results Out of the 38 patients with DILI, 14 patients (36.8%) had taken chemical medicines and biological products, 12 patients (31.6%) had taken Chinese herbal medicines, 9 patients (23.7%) had taken Chinese herbal, chemical medicines and biological products, and 3 patients (7.9%) had taken dietary supplements; the pathological examination showed that hepatic steatosis in 20 cases(52.6%), hepatic cholestasis in 22 cases(57.9%), bile duct damage in 15 cases(39.4%), eosinophil immersion in 11 cases(28.9%), hepatocellular wreaths in 9 cases (23.7%), and granuloma in 6 cases (15.8%); the AUROC was 0.775 with 95% confidence interval of 0.669-0.880 (P<0.05), and the sensitivity of 81.6% and the specificity of 65.8% when the DILI-pathological scroring system (DILI-PSS) was applied to predict the diagnosis. Conclusion The application of DILI-PSS might help diagnose patients with DILI, which needs further clinical investigation.

Objective The aim of this study was to explore the clinical implications of peripheral blood mononuclear cell (PBMC) hypoxia-inducible factor 1a-antisense RNA 1 (HIF1a-AS1)and serum autophagy gene beclin1 in patients with non-alcoholic steatohepatitis (NASH). Methods 118 patients with NASH (early stage in 43 cases, with liver fibrosis in 46 cases and with cirrhosis in 29 cases ) and 118 healthy individuals were enrolled in our hospital between January 2019 and April 2021. The fasting blood glucose (FBG), serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were detected by full-automatic biochemical analyzer. The PBMC HIF1a-AS1 level was detected by real-time fluorescent quantitative PCR. Serum beclin1 level was detected by ELISA. Results The FBG, serum TC, TG, LDL-C, PBMC HIF1a-AS1 and serum beclin1 levels in patients with NASH were (5.9±1.6)mmol/L, (6.2±0.5)mmol/L,(2.4±0.6)mmol/L, (3.7±0.9)mmol/L, (1.9±0.2) and (5.7±1.9)ng/mL, all significantly higher [(4.8±0.7)mmol/L, (5.3±0.3)mmol/L, (1.3±0.3)mmol/L, (2.3±0.6)mmol/L, (1.0±0.1) and (4.1±1.5)ng/mL, respectively, P＜0.05], while serum HDL-C level was (1.2±0.2)mmol/L, significantly lower than [(1.4±0.3)mmol/L, P＜0.05] in healthy persons; the FBG, serum TC, TG, LDL-C, PBMC HIF1a-AS1 and serum beclin1 levels in patients with cirrhotic NASH were(6.8±2.0)mmol/L, (6.8±0.8)mmol/L, (2.8±0.7)mmol/L, (4.4±1.2)mmol/L, (2.5±0.3) and (6.4±2.1)ng/mL, all significantly higher than [(5.2±1.1)mmol/L, (5.7±0.4)mmol/L, (1.9±0.5)mmol/L, (3.1±1.0)mmol/L, (1.4±0.1) and (5.1±1.3)ng/mL, respectively, P＜0.05] in patients with early NASH; the FBG, serum TC, TG, LDL-C, PBMC HIF1a-AS1 and serum beclin1 levels in 49 patients with concomitant hypertension, diabetes and/or hyperlipidemia were (6.5±1.9) mmol/L, (6.9±0.8)mmol/L, (2.7±0.8)mmol/L, (4.0±1.1)mmol/L,(2.2±0.3) and (6.3±2.0)ng/mL, all significantly higher than [(5.5±1.3)mmol/L, (5.7±0.4)mmol/L, (2.2±0.5)mmol/L, (3.5±0.7)mmol/L, (1.7±0.2) and (5.3±1.6)ng/mL, respectively, P＜0.05], while serum HDL-C level was (1.1±0.2)mmol/L, significantly lower than [(1.3±0.4)mmol/L, P＜0.05] in 69 patients without. Conclusion The PBMC HIF1a-AS1 and serum beclin1 levels abnormally increase in patients with NASH, and the surveillance of them might help the disease assessment.

Objective The aim of this study was to screen plasma exosome differential proteins in patients with non-alcoholic fatty liver diseases (NAFLD) and analyze their roles in biological processes. Methods Three patients with NAFLD and three healthy individuals were encountered in You'an Hospital, Capital Medical University between July and October 2020. The plasma exosome proteins were identified and quantitatively characterized by tandem mass tag (TMT) labeled quantitative proteomics. The differential proteins and their functional enrichment were screened, and the biological processes involved were analyzed. Results A total of 387 proteins were identified by exosome proteomic analysis, and out of them, 34 differentially expressed proteins were screened out according to the criteria of up-regulation > 1.2 folds or down-regulation > 1.2 folds and P<0.05; 25 up-regulation proteins and 9 down-regulation proteins were found in patients with NAFLD compared with healthy persons; the bioinformatics analysis showed that these proteins were mainly involved in lipid storage and metabolism, immune response, cellulose formation and other biological processes, and were closely related to insulin resistance, inflammatory response, cell damage and other signaling pathways. Conclusion The differential proteins screened by TMT marker quantitative proteomics might be used as serological markers for the study of NAFLD.

Objective The aim of this study was to observe the clinical efficacy of Huatan Qushi Shugan decoction, herbal medicines, and simvastatin combination in the treatment of patients with non-alcoholic fatty liver disease (NAFLD). Methods 68 patients with NAFLD with a special traditional Chinese medicine (TCM) type were encountered in our hospital between February 2020 and January 2022, and among them, 33 cases in control group received simvastatin therapy at base of routine diet and exercise guidance, and the other 35 patients received Huatan Qushi Shugan decoction at the base of above management in the control. The regimen lasted for 12 weeks. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) levels were detected by thiobarbituric acid and oxidase method, and the liver fat content (LFC) was measured by color Doppler ultrasonography. Results The clinical effective rate as defined by comprehensive TCM judgement in patients with simvastatin and herbal medicine combination therapy was 94.3%, significantly higher than 75.8% in the control (P<0.05); the scores of TCM symptoms, such as distension in right hypochondrium, heavy feeling the whole body, sticky stool, lassitude and weakness and abdominal distention were (1.4±0.5), (0.9±0.2), (0.8±0.2), (1.2±0.4) and (1.5±0.3), significantly lower than [(2.8±0.7), (2.1±0.3), (1.5±0.4), (2.1±0.6) and (2.4±0.6), respectively, P<0.05] in the control group; the improvement of liver function tests and blood fat were greatly superior to in the control; serum MDA and LFC were (7.5±1.3) μmol/L and (6.5±0.9)%, significantly lower than [(11.4±1.8) μmol/L and (7.9±1.3)%, P<0.05], while serum SOD level was (80.4±7.8) U/L, significantly higher than [(66.3±7.2) U/L, P<0.05] in the control group. Conclusion The combination of herbal medicine and simvastatin has an obvious short-term efficacy in the treatment of patients with NAFLD with special TCM syndrome, which could improve the liver function tests and lipid metabolism, and needs further investigation.

Objective The aim of this study was to summarize the experience about endoscopic management of cirrhotics with superior esophageal variceal bleeding(SEVB). Methods 25539 patients with gastroesophageal varices (GEV) were encountered in our hospital between January 2010 and January 2020, out of them, 12 patients(0.4‰)had SEVB and all underwent endoscopic management (urgent in 5 cases and non-urgent in 7 cases). Results The etiology of the 12 patients with SEVB included hepatitis B cirrhosis in 5 cases, hepatitis C cirrhosis in 4 cases, alcoholic liver cirrhosis in 2 cases and unknown cause cirrhosis in 1 case; 11 patients had obvious clinical manifestations, such as hematemesis, melena, hematochezia or peripheral circulation disorder; 5 cases had successful hemostasis immediately with urgent endoscopic management, and 6 of 7 had with non-urgent management(P>0.05); the endoscopic variceal ligation(EVL) therapy was done in 9 cases, sclerotherapy in 1 case, EVL combined with tissue glue injection in 1 case and EVL combined with sclerotherapy and tissue glue injection in 1 case; the adverse reactions occurred after endoscopic management in 7 cases; 8 patients were followed-up for (31.0±28.5)m, and 1 patient had recent rebleeding and 5 patients had long-term rebleeding; out of 7 patients followed-up after treatment, 1 patient had splenectomy and 2 patients had splenectomy and pericardial devascularization; the all-cause mortality in our series was 42.9%. Conclusion The EVL is the first choice for patients with SEVB with high immediate hemostasis, but a poor long-term prognosis. It is necessary to reduce portal hypertension in combination with other treatments to decrease the risk of long-term rebleeding and death.

Objective The aim of the present study was attempted to screen out risk factors in cirrhotic patients with nosocomial infections (Nis) and thereby establish an objective and user-friendly risk prediction model. Methods A retrospective analysis of the clinical data of inpatients with liver cirrhosis in our tertiary hospital between January 2016 and December 2020. The univariate and multivariate Logistic regression analyses were applied to screen the possible risk factors and build up a prediction model, which was further developed into a prediction nomogram. The performance of the nomogram model was evaluated by the area under the receiver operating characteristic curve (AUC), calibration diagram and Hosmer-Lemeshow test. The clinical benefit was assessed by using decision curve analysis. Results The nomograms were developed based on the materials of 503 patients with liver cirrhosis, among them, 131 (26.0%) acquired at least one episode of Nis during the hospitalization; the predictive variables screened out by multivariate Logistic regression were the presence of ascites, invasive procedures, platelet/lymphocyte ratio and MELD score; by incorporating these factors, the validation tests showed that the final model had a well-fitted calibration and good discrimination capability with the AUC of 0845, and the Hosmer-Lemeshow test showed that the model calibration curve fitted well with the ideal curve (P=0.999, P=0.688); the analysis of the decision curve demonstrated that the model had a higher net benefit within a larger threshold. Conclusion Our nomogram could accurately predict the risk of Nis in cirrhotic patients, which might help clinicians identify high-risk patients early and provide clinical decision-making basis for intervention and optimization.

Objective The aim of this study was to explore the factors impacting liver fibrosis progress in patients with chronic hepatitis B (CHB). Methods A total of 135 patients with CHB were encountered in our Department of Infectious Diseases, Second Affiliated Hospital, Anhui Medical University, between 2010 and 2016, and all patients underwent liver biopsy, and followed-up for 5(7,11)years. The multivariate Logistic regression analysis was carried out, the prediction model was established and the area under the receiver operating characteristic (ROC) curve (AUC) was calculated to evaluate the diagnostic performance of the model. Results At the presentation, the histopatholotical examination showed non-fibrosis in 81 cases and significant liver fibrosis in 54 cases in our series; at the end of follow-up, we found non-cirrhosis in 111 cases and liver cirrhosis in 24 cases(from non-fibrosis in 7 cases and from significant fibrosis in 17 cases) based on clinical diagnosis; there were significant differences respect to age, antiviral treatment, serum HBV DNA loads, platelet counts (PLT), plasma prothrombin time international normalized ratio (INR), activated partial thromboplastin time (APTT) and erythrocyte distribution width (RDW) between patients with non-cirrhosis and cirrhosis (all P < 0.05); the Logistic regression analysis showed that INR (P = 0.010, OR = 369.352), APTT(P = 0.001,OR = 1.169), RDW (P = 0.035, OR = 1.402), PLT (P = 0.018, OR = 0.989), age (P = 0.024, OR =1.052), platelet to lymphocyte ratio (P/L, P = 0.044, OR = 0.983) and antiviral or not (P = 0.000, OR = 7.600) were the independent risk factors for liver cirrhosis; thereby, we established a prediction model as follows: Logit (P) = - 17.407 + 0.528×INR+0.161×APTT+0.079×Age + 2.401×Antiviral or not (no = 0, yes = 1); the AUC of the model in predicting liver cirrhosis was 0.872, with the sensitivity of 91.7% and the specificity of 75.7%. Conclusion The age and antiviral therapy could be the important factors impacting liver cirrhosis occurrence, and early intervention might prevent the disease progression.

Objective The aim of this study was to explore the diagnostic performance of liver parenchymal texture feature quantification by high-frequency ultrasonography (HFU) and serum alpha-fetoprotein-L3 (AFP-L3) levels in the evaluation of liver function classification in patients with hepatitis B cirrhosis. Methods 87 patients with liver cirrhosis induced by hepatitis B viral infection and 80 healthy volunteers who underwent physical examination were enrolled in our hospital between June 2019 and May 2021. According to the liver function class, the patients with liver cirrhosis were divided into Child-Pugh class A (n=34), Child-Pugh class B (n=29) and Child-Pugh class C (n=24). All the individuals underwent HFU check-up to obtain automaticallyxD, mean D and εD by software. Serum AFP-L3 was assayed by ELISA. The area under receiver operating characteristic curve (AUC) was applied to predict liver function class. Results ThexD, mean D, εD and serum AFP-L3 levels in patients with liver cirrhosis were (6.1±1.8), (4.8±1.2), (3.2±1.1) and (7.5±2.1)%, significantly higher than [(2.5±0.9), (1.9±0.6),(1.3±0.4) and (5.6±1.3)%, respectively, P<0.05] in healthy persons; the xD, mean D, εD and serum AFP-L3 levels in patients with liver cirrhosis class C were (6.9±2.2), (7.0±2.2), (4.3±1.3) and (9.0±2.4)%, significantly higher than [(6.5±1.7), (5.4±1.5), (3.8±1.1) and (7.9±2.1)%, respectively, P<0.05] in patients with class B or [(5.3±1.3), (3.2±1.0), (2.1±0.6) and (6.1±1.5)%, respectively, P<0.05] in patients with class A; the AUC was 0.910, with the specificity of 91.4% in predicting liver function class B when the mean D, ε D and serum AFP-L3 levels were combined, significantly higher than 70.7%, 77.6% and 75.9% (P<0.05) by any one alone. Conclusion The diagnostic efficacy of liver parenchymal texture feature quantification by high-frequency ultrasonography and serum AFP-L3 level combination in predicting liver function class B is promising, and warrants further clinical investigation.

Objective The aim of this study was to explore the diagnostic efficacy of shear wave elastography (SWE) by ultrasonography in predicting esophageal varices (EV) in patients with hepatitis B cirrhosis. Methods 89 patients with hepatitis B-induced liver cirrhosis were enrolled in our hospital between March 2018 and March 2021, and all patients underwent gastroscopy to find the occurrence of EV. SWE by ultrasonography was applied to detect the spleen maximum Young’ s modulus (Emax) and mean Young’ s modulus (Emean). The portal vein diameter (PVD), spleen thickness diameter (ST), spleen long diameter (SD) and spleen vein diameter (SVD) were obtained by Color Doppler ultrasound. The diagnostic efficacy was evaluated by the area under receiver operating characteristic curve(AUC). Results The gastroscopy found 53 cases with EV among the 89 cirrhotics in our series; there were significant differences respect to Child-Pugh class, serum albumin, prothrombin time international normalized rati, platelet counts and ascites between patients with and without EV(P<0.05); the Emax and Emean in patients with EV were (55.9±10.5)kPa and (38.9±9.2)kPa, significantly higher than [(45.2±7.3)kPa and (29.3±6.7)kPa, respectively, P<0.05], the PVD, ST, SD and SVD were 13.6±2.1)mm, (48.0±9.4)mm,(149.1±27.1)mm and (10.1±1.9)mm, significantly higher than [(11.5±1.8)mm,(36.9±8.7)mm, (119.8±24.9)mm and (7.8±1.7)mm, respectively, P<0.05] in patients without EV; the AUCs were 0.84 and 0.83 in predicting EV in patients with liver cirrhosis as the Emax and Emean equal to 53.2 kPa and 33.6 kPa were set as the cut-off-value, with the sensitivities and specificities of 66.0% and 88.9%, and 75.5% and 77.8%. Conclusion The spleen Emax and Emean measured by SWE could be used to diagnose the EV in patients with liver cirrhosis, which needs further clinical investigations.

Objective The aim of this study was to summarize the clinical features of patients with portal hypertension and gastroesophageal varices (GOV) under 30 year old of age.Methods The clinical data of 61 inpatients with GOV aged under 30 year old encountered between January 2015 and December 2020 were retrospectively summarized. Results Out of the 61 patients with GOV, the cirrhotic portal hypertension were found in 27 patients (44.3%), including cryptogenic cirrhosis in 11 patients (40.7%), and hepatitis B cirrhosis in 9 patients (33.3%), and noncirrhotic portal hypertension (NCPH) were found in 34 cases (55.7%), including cavernous transformation of portal vein in 21 patients (61.8%); as for the LDRf classification, the varices in our series were mainly Le/ g type, accounting for 77.1%, in terms of diameter, D1.0 for 41.0%, and in terms of bleeding risk factor, the Rf grade 1 were more common (77.1%); the secondary prevention was the main treatment (85.7%), and tissue glue and sclerosing agent injection or band ligation combination was commonly administered (66.1%) in our series; the incidence of rebleeding in patient with NCPH was 11.8%, significantly lower than 29.6% in patients with liver cirrhosis (P＜0.01). Conclusion The majority of young patients with GOV have portal hypertension caused by non-cirrhotic factors, and portal cavernous transformation is the main cause of NCPH. The rebleeding of esophageal and gastric varices in patients with NCPH is relatively lower than that in patients with liver cirrhosis.

Objective The aim of this study was to investigate the diagnostic efficacy of GD-EOB-DTPA enhanced magnetic resonance imaging (MRI) in differentiation of primary liver cancer (PLC) fromnodular regenerative hyperplasia of liver (NRH) in patients with hepatitis B cirrhosis. Methods 147 patients with hepatic focal lesions (HFL) in the background of hepatitis B cirrhosis were encountered in our hospital between December 2018 and December 2020, and all patients underwent GD-Eob-DTPA enhanced MRI scan. The foci enhancement characteristics and signal intensity in each sequence were observed, including T1-weighted image (T1WI), T2-weighted image (T2WI), and signal intensity of arterial phase, portal vein phase, hepatobiliary specific phase, and magnetic resonance diffusion weighted imaging (DWI). The area under receiver operating characteristic (ROC) curve (AUC) was applied to analyze the diagnostic efficacy of signal feature. Results Out of our 147 patients with HFL, the contrast-enhanced MRI scan made diagnosis of PLC in 102 cases, with the lesion size of 0.9-2.9 cm (average of 1.8±0.6 cm), and NRH in 45 cases, with lesion size of 0.8-2.5 cm (average of 1.4±0.2 cm); the enhanced MRI scan showed that low or equal enhancement in arterial phase, low enhancement in portal vein phase or in delayed phase in 84 cases, and significant enhancement in arterial stage, without clearance in portal or delayed stage in 63 cases; the proportions of low signal in T₁WI, high signal in T₂WI, high signal in DWI, increased enhancement in arterial phase, and low signal in hepatobiliary phase in patients with PLC were 50.0%, 79.4%, 82.4%, 52.9%, and 94.1%, significantly higher than 20.0%, 20.0%, 26.7%, 20.0% and 20.0% (P<0.05) in patients with NRH; the ROC analysis showed that the low signal in T₁WI (AUC=0.670, sensitivity=0.451), high signal in T₂WI (AUC=0.817, sensitivity=0.745), high signal in DWI (AUC=0.754, sensitivity=0.863), high enhancement in arterial phase (AUC=0.693, sensitivity=0.520) and low signal in hepatobiliary phase (AUC=0.891, sensitivity=0.892) had certain diagnostic efficacy for PLC (P<0.05). Conclusion The enhanced MRI scan plays an important role in the diagnosis of PLC under the background of hepatitis B-induced liver cirrhosis.

Objective The purpose of this study was to investigate the prognosis of patients with hepatocellular carcinoma (HCC) by a prognostic risk model we constructed based on the cyber-arisen materials on ferroptosis-related long non-coding RNAs (lncRNAs). Methods The RNA sequencing data from patients with HCC were downloaded from the Cancer Genome Atlas TCGA database. A prognostic risk model was constructed based on differentially expressed iron death-associated lncRNAs in HCC tissues. Results Five differentially expressed lncRNAs associated with HCC prognosis were identified, and the Kaplan-Meier analysis showed that the high-risk lncRNAs were associated with poor prognosis in patients with HCC, with an area under the ROC curve (AUC) of 0.873 for 3-year survival;the single sample gene set enrichment analysis (ssGSEA) revealed immuno- and tumor-related pathways in low-risk populations; the differential analysis of immune functions showed that there were significant differences in cytolytic activity, type I INF response and type II INF response between patients with low and high risk; the immune checkpoint showed that there were also significant differences in the expression of CD44, TNFRSF4 and CD276 between the two groups. Conclusion Five ferroptosis-related lncRNAs impacting the prognosis of patients with HCC are selected by bioinformatics, and we thereby construct a prognostic risk model, which might lay the foundation for the further prevention and therapeutic study on HCC.

Objective The aim of this study was to investigate the clinical value of three-dimensional reconstruction based on cone-beam CT (CBCT) for the identification of supplying arteries in patients with primary liver cancer (PLC) underwent hepatic arterial chemoembolization (TACE) . Methods A total of 103 patients with PLC were encountered in our hospital between January 2018 and January 2021, and all patients with PLC underwent TACE. During TACE process, 54 patients received DSA examination and 49 patients received CBCT-based three-dimensional reconstruction examination to find blood-supplying arteries. All patients were followed-up for 3 months after TACE. Results The operative time, the amount of radiation, and the success rate of superselective intubation rate in patients underwent CBCT-bade 3D reconstruction were(42.3±5.1)min,(209.4±27.6)mGy and 93.9%, significantly different compared to (35.2±3.0)min, (142.3±15.2)mGy and 66.7% in patients underwent DSA check-up (P＜0.05); the identification of supplying arteries meeting the diagnostic requirements in CBCT-based 3D reconstruction was 100.0%, the detection of lesions was 93.9%, and the complete deposition of lipiopine was 91.8%, all significantly superior to 74.1%, 70.4% and 72.2% in patients underwent DSA (P＜0.05); at the end of three month after operation, the effective rate and disease control rate in patients underwent CBCT-based 3D reconstruction were 83.7% and 89.8%, both significantly higher than 57.4% and 68.5%(P＜0.05)in patients underwent DSA. Conclusion As compared with DSA examination during TACE, the CBCT-based three-dimensional reconstruction for identify tumor supplying blood arteries in patients with PLC could obtain better short-term outcomes, however, the implementation of CBCT-based three-dimensional reconstruction might also prolong the operative time and increase the radiation exposure, which should take into consideration in clinical practice.

Objective The purpose of this study was o evaluate magnetic resonance imaging (MRI)and 4-d computed tomography (4DCT) images in the delineation of target area in patients with primary liver cancer (PLC) undergoingfirst radiotherapy. Methods 56 patients with PLC were admitted to our hospital between May 2019 and May 2021, and all patients tended to receive radiotherapy. Before treatment, the patients underwent MRI and 4DCT examinations respectively, and the images were up-loaded to the workstation. After the automatic registration,the Reg Reveal and Reg Refine were applied for further preciseregistration, the image quality was assessed and local regionof interest (ROI) was locked. The tumor target volume and large body target volume in differentstage of 4DCT images were compared before and after registration. The registration accuracy of T2 weighted image (MR-T2) and 4DCT image was observed. Results After 4DCT registration, the tumor target volume atCT₀₀, CT₁₀, CT₂₀, CT₃₀, CT₄₀, CT₅₀, CT₆₀, CT₇₀, CT₈₀ and CT₉₀ were (389.8±52.5)cm³,(393.4±59.7)cm³,(390.7±50.3)cm³,(388.5±47.8)cm³,(380.4±40.5)cm³,(379.2±40.6)cm³,(383.7±43.3)cm³,(380.2±41.7)cm³,(371.0±38.9)cm³ and (381.7±36.6)cm³, all significantly larger than [(365.7±29.0)cm³,(360.5±29.2)cm³,(347.4±24.9)cm³,(350.2±27.2)cm³,(351.4±28.5)cm³,(358.4±29.3)cm³,(361.5±34.7)cm³,(357.5±28.8)cm³,(350.3±36.6)cm³ and (355.0±34.9)cm³, P＜0.05] before registration; after registration, the large body target volume in the 56 patients with PLC was (468.7±226.2)cm³, significantly larger than [(410.5±192.5)cm³, P＜0.05] before registration; after Reg Refine registration by portal vain or byceliac trunk, the shift at X, Y, Z axis were (0.3±0.1)mm, (0.6±0.2)mm and (0.5±0.2)mm, or (0.7±0.2)mm, (0.7±0.3)mm and (0.6±0.2)mm, all significantly smaller than [(3.3±0.4)mm, (4.9±0.5)mm and (4.2±0.4)mm or (3.4±0.3)mm, (3.7±0.4)mm and (3.2±0.4)mm, respectively, P＜0.05] by automatic registration; the liver volume in MR-T2 image was (2002.4±843.7) cm³, the liver volume in 4DCT image was (2048.7±937.2) cm³, and the overlap of liver volume was (110.2±22.7)%. Conclusion Thecombination of MT-T2 and 4DCT for precise delineation of tumor target in patients withPLC before first radiotherapy could help get accurate tumor targets, which might improve the therapy efficacy.

Objective The aim of this study was to investigate the clinical efficacy of percutaneous cather drainage (PCD) under ultrasound (US) guidance with lauromacrogol replacement for sclerotherapy in patients with huge hepatic cysts. Methods A total of 73 patients with huge hepatic cysts were enrolled in our hospital between January 2018 and December 2020, and were randomly divided into control (n=36 and observation group (n=37). The patients in both groups underwent PCD under US guidance, and the patients in the control were given anhydrous ethanol for sclerotherapy, while those in the observation group were given lauromacrogol replacement for sclerotherapy. All patients were followed-up for 6 months after surgery. Serum C-reactive protein (CRP) and serum amyloid A (SAA) levels were detected by chemiluminescence, and serum cortisol (Cor) level was detected by magnetic particle chemiluminescence. Results At the end of 6 month followed-up, the total clinical effectiveness, the disappearance, or largely disappearance, of the cysts, in the observation group was 97.3%, significantly higher than 80.6%(P＜0.05) in the control; there were no significant differences respect to liver function tests between the two groups before and after the surgery (P＞0.05); one week after the operation, serum CRP, Cor and SAA levels in the observation group were (15.7±3.6)mg/L, (283.6±10.3)nmol/L and (13.5±2.4)ng/mL, significantly lower than [(21.1±4.5)mg/L, (312.3±10.7)nmol/L and (19.8±3.7)ng/mL, respectively, P＜0.05] in the control. Conclusion The clinical efficacy of PCD under US guidance with lauromacrogol replacement for sclerotherapy in dealing with patients with huge hepatic cysts is good, with little adverse reactions.

Objective The aim of this study was to evaluate the value of contrast ultrasonography (CEUS) and virtual touch tissue quantification (VTQ) in differentiating hepatic hemangioma from hepatocellular carcinoma (HCC). Methods 93 patients with intrahepatic space-occupying lesions were encountered in our hospital between April 2018 and April 2021, and all underwent CEUS and VTQ check-up. The CEUS parameters including start enhancement time, peak enhancement time and peak intensity, and the shear wave velocity (SWV) of intrahepatic foci, surrounding tissues and SWV ratio of foci/surrounding tissue obtained by VTQ were recorded. Thediagnostic efficacy was determined by ROC analysis. Results Out of our series, the hepatic hemangioma was found in 40 cases, and HCC in 53 cases based on CT/MRI scan or post-operational histopathological examination; the onset enhancement time and peak enhancement time in patients with HCC were (8.2±1.2) s and (16.7±3.3) s, significantly shorter than [(15.9±5.0) s and (45.7±15.4) s, respectively, P < 0.05] in patients with hepatic hemangioma; the SWV of hepatic foci, the SWV of surrounding tissues and SWV ratio in patients with HCC were (2.7±0.9), (2.0±0.8) and (1.8±0.7), significantly greater than [(1.5±0.4), (1.4±0.6) and (1.1±0.3), respectively, P＜0.05] in patients with hepatic hemangioma; the ROC analysis showed that the onset enhancement time, peak enhancement time, the SWV of hepatic foci, the SWV of surrounding tissues and SWV ratio all had some diagnostic efficacy with the AUC of 0.754, 0.818, 0.758, 0.802 and 0.809, respectively; we set the onset enhancement time ≤12.080 s, the peak enhancement time≤26.530 s, the SWV of hepatic foci≥2.015 m/s, the SWV of surrounding tissues ≥1.920 m/s and SWV ratio ≥1.280 as the optimal cut-off-value, the HCC was diagnosed in 48 cases when any one of the five parameter meeting, with sensitivity of 0.906, specificity of 0.950, accuracy of 0.925, positive predictive value of 0.960 and negative predictive value of 0.884. Conclusion There are significant differences in CEUS and VTQ results between HCC and hepatic hemangioma, by which the clinicians could make differentiation of benign and malignant intrahepatic lesions.

Objective The aim of this study was to analyze the differential diagnosis of enhanced multi-slice spiral CT scanning in patients with hepatic hemangioma (HH) and malignant liver metastasis. Methods A total of 133 patients with space occupying lesions inside livers were encountered in our hospital between January 2018 and January 2020, and the comprehensive diagnosis based on imaging and histopathological examination revealed HH in 102 cases and malignant liver metastasis in 31 cases. All patients underwent enhanced multi-slice spiral CT scanning. Results In patients with HH, the blood flow passing time was (14.3±1.7) s, the liver blood volume was (25.4±2.6) ml/100 g, and the capillary surface permeability was (33.1±4.6), significantly higher than [(9.4±1.0)s, (13.7±1.6)ml/100 g and (27.1±3.1), respectively, P＜0.05], while the proportion of hepatic artery perfusion was (0.3±0.1)%, and the hepatic blood flow was (151.3±15.9)ml/100g/min, significantly lower than [(0.5±0.2)% and (189.3±19.6)ml/100g/min, respectively, P＜0.05] in patients with malignant liver metastasis; the incidences of lesion fusion was 60.8%, the distribution under liver capsules was 74.5%, and the target ring sign was 33.3%, significantly higher than 3.2%, 0.0% and 0.0%, respectively (P＜0.05), while the quasi circular central low-density mass was 2.0%, and the bovine eye sign was 1.0%, significantly lower than 61.3% and 48.4%(P＜0.05)in patients with malignant liver metastasis; based on the golden criteria, the sensitivity, specificity and accuracy by CT scan in diagnosing HH were 89.2%, 77.4% and 86.5%, with the Kappa of 0.638 consistent with histopathological diagnosis. Conclusion The diagnostic performance of enhanced multi slice spiral CT scanning in patients with HH is efficacious, which might guide the clinicians to make suitable plans for the patients with HH.

Objective The aim of this study was to investigate the computed tomography angiography (CTA) and ultrasonography in evaluation of vascular anatomic variation and lumen patency in patients undergoing liver transplantation(LT). Methods 138 patients receiving LT were admitted to our hospital between May 2014 and May 2020, and before operation, all patients underwent three-stage CT enhancement scan, CTA post-processing vascular reconstruction and ultrasonography. The hepatic artery, portal vein, hepatic vein and inferior vena cava, as well as collateral circulation were observed. Results Among 138 patients, CTA showed that 107 (77.5%) had hepatic artery of Michels type I and 31 (22.5%) had hepatic artery anatomic variation; there was no stenosis or abnormal dilatation of the hepatic artery lumen, and only one case (0.7%) had splenic aneurysm; the intraoperative observation of hepatic artery was consistent with preoperative CTA assessment in 136 patients; the sensitivity and accuracy by CTA in the diagnosis of portal thrombus and tumor thrombus were 83.3% and 68.6%, while those by ultrasonography were 58.3% (P<0.05)and 60.0%; both the accuracy by ultrasonography and CTA in diagnosing the patency of hepatic vein and inferior vena cava was 99.3%. Conclusion As compared with ultrasonography, the CTA could accurately evaluate the anatomic variation of hepatic artery and portal vein thrombosis, and could clearly show the opening of collateral circulation of portal vein before LT.

Objective The purpose of this study was to analyze the factors impacting duration of percutaneous transhepatic biliary drainage (PTBD) in patients with choledocholithiasis. Methods A total of 112 patients with common bile duct stones (CBDS) were encountered in our hospital between April 2019 and March 2021, and all patients were treated with PTBD. The patients were divided post-operationally into normal biliary drainage group with mean plus deviation drainage time and prolonged drainage group with longer drainage time. The factors impacting the duration of PTBD in patients with CBDS were analyzed by multivariate Logistic regression. Results Out of the 112 patients with CBDS, the biliary stones were successfully removed in 109 patients(97.3%), with prolonged biliary drainage time in 28 cases; there were significant differences as respect to serum bilirubin levels [(38.1±7.3)μmol/L vs. (24.2±6.2)μmol/L], serum amylase levels [(403.7±15.6)U/L vs.(92.7±13.2)U/L], serum ALP levels [(302.3±52.1)U/L vs. (180.7±50.2)U/L], serum GGT levels [(176.6±16.7)U/L vs. (93.3±15.6)U/L], serum C-reactive proteins [(75.1±12.2)mg/L vs. (56.9±10.3)mg/L] and the diameters of stones [(16.9±2.5)mm vs. (11.3±2.1)mm] between the two groups(P＜0.05); the multivariate Logistic analysis showed that serum bilirubin levels (OR:4.092, 95%CI:1.684-9.944), serum amylase levels (OR:3.277, 95%CI: 1.348-7.965) and the diameter of stones (OR:3.651, 95%CI:1.502-8.873) were the risk factors impacting the duration of biliary drainage(P＜0.05). Conclusion The treatment of patients with CBDS by PTBD is successful, and our findings suggest the clinicians should take influencing factors of biliary drainage time into consideration in clinical practice in order to manage appropriately pre-operationally.

Objective The aim of this study was to investigate the clinical efficacy of partial hepatectomy and choledochojejunostomy combination in the treatment of patients with hepatolithiasis, and to analyze the risk factors for postoperative stone recurrence. Methods 62 patients with hepatolithiasis were enrolled in our hospital between January 2018 and January 2021, and among them, 29 patients in the control were treated with partial hepatectomy and 33 patients in the observation were treated with partial hepatectomy and choledochojejunostomy combination. All patients were followed-up for 1 year after operation. The risk factors for postoperative recurrence was analyzed by multivariate Logistic regression. Results After the operation in both group, serum ALT and AST levels decreased greatly, and total serum bilirubin levels turned back to normal; there was no significant differences as respect to the post-operational complications(9.1% vs. 13.8%, P＞0.05); at the end of one-year follow-up, the ultrasonography showed the stone recurrence rate in the observation was 15.2%, significantly lower than 41.4%(P＜0.05) in the control; out of the 62 patients with hepatolithiasis, 17 cases (27.4%)had intrahepatic stone recurrence after operation; the univariate Logistic regression analysis showed that the residual stone, biliary stricture and the operation itself were different between patients with and without stone recurrence, and the multivariate Logistic regression analysis demonstrated that residual stone [OR(95%CI):3.5(1.3-9.6)] and biliary stricture [OR(95%CI):2.7(1.1-6.6)] were the risk factors for post-operational stone recurrence, while the partial hepatectomy and choledochojejunostomy [OR (95%CI) :0.3 (0.1-0.9)] was the good choice for patients with hepatolithiasis. Conclusion The partial hepatectomy and choledochojejunostomy combination in the treatment of patients with hepatolithiasis could reduce the risk of postoperative stone recurrence, which warrants further clinical investigation.

Objective The aim of this study was to investigate the efficacy of percutaneous transhepatic puncture choledochoscopic lithotomy (PTCSL) under CT three-dimensional reconstruction (3D) guidance in the treatment of patients with complex hepatolithiasis. Methods A total of 136 patients with complicated hepatobiliary stones were admitted to our hospital between June 2018 and June 2020, and 74 patients in observation group were treated by PTCSL under 3D guidance and 62 patients received PTCSL routinely. All patients were followed-up for 12 months. Results The operative time, intraoperative blood loss and hospital stay in the observation group were (98.1±30.2) min, (32.5±10.5) mL and (8.9±1.6) d, significantly shorter or less than [(129.7±36.7) min, (36.9±14.3) mL and (10.8±2.8) d, P< 0.05] in the control group; there were no significant differences as respect to blood biochemical parameters between the two groups (P>0.05); after operation, the incidence of complications in the observation was 4.1%, significantly lower than 14.5%(P＜0.05) in the control; one month after operation, the CT scan showed that the clearance of stone in the observation was 97.3%, significantly higher than 85.5%(P<0.05) in the control; at the end of 12 month followed-up, 5 patients in the observation and 2 patients in the control lost, with the relapse of hepatobiliary stone as demonstrated by CT scan of 2.9%(2/69) and 15.0%(9/60, x²=6.026, P=0.014) in the two groups. Conclusion The PTCSL operation as guided under 3D technology in the treatment of patients with complex hepatolithiasis could improve the stone clearance rate, with reduction of operation time, intraoperative blood loss and hospital stay, which might have a promising efficacy with less residual of stone.

Objective The aim of this study was to summarize the long-term survival of patients with stage T1b gallbladder cancer (GC) after cholecystectomy and wedge resection of liver tissues and regional lymph node dissection (LND) combination therapy. Methods A total of 98 patients with stage T1b GC were encountered in our hospital between August 2011 and August 2016, and 53 in observation group received cholecystectomy and wedge resection of liver tissues and LND therapy and another 45 patients received cholecystectomy only therapy. All patients were followed-up for five years or to death. The postoperative pain was assessed by visual analogue scale (VAS). Results The intraoperative blood loss in the observation group was greater than that in the control group [(208.3±20.2) mL vs. (185.7±19.4) mL], the postoperative recovery time of gastrointestinal functions and hospitalization stay were longer than those in the control group [(27.5±5.8) h and (11.7±2.6) d vs. (19.9±4.2) h and (9.4±2.1) d, respectively, P<0.05]; at 24 h and 72 h post-operationally, the VAS score in the observation group was (4.5±0.8) and (2.1±0.7), not significantly different compared to (4.4±0.9) and (2.0±0.6) in the control (P>0.05); post-operationally, the complications such as cystic fossa effusion, gastric retention, intraperitoneal hemorrhage, bile leakage and peritoneal infections in the observation group was 15.1%, not significantly different as compared to 9.3% in the control (P>0.05); the one-year, three-year and five-year survival rates in the observation group were 96.2%, 81.1% and 67.9%, while in the control group were 91.1%, 73.3% and 55.6%, with the five-year survivals significantly different (Log-Rank x²=4.521, P=0.034). Conclusion The combination of cholecystectomy and wedge resection of liver tissues and regional LND is efficacious in dealing with patients with stage T1b GC, which could improve long-term prognosis.

Objective Hepatocellar carcinoma (HCC) is still a heavy health burden in China. Hepatitis B and C infection is the main cause for it. Most patients with HCC are diagnosed at advanced stage with poor prognosis, owing to the lack of early symptoms. The present available monitoring approaches seem to unable to find liver cancer early. It is urgent to explore more sensitive markers to facilitate the early screening of liver cancer. The current research confirms that protein induced by vitamin K absence (PIVKA-II) is conducive to solving the problem. In this paper, we reviewed the progress on PIVKA-II as a new biological marker in this field.