Objective The present paper aimed to inhibit the expression of tumor suppressor p53-binding protein 2 (TP53BP2) in liver cancer by short hairpin RNAs(shRNAs) with lentiviral vector. Methods Two pairs of RNA interference sequences targeting to TP53BP52 gene were designed, and their corresponding shRNA sequences were synthesized. After annealing of shRNA to form double-stranded oligo sequences, the recombinant plasmid was constructed by gene recombination technique. The correct recombinant plasmid was used after PCR and sequencing identification of the colony for lentivirus packaging and titer determination. The interference effect of lentivirus lenti-shTP53BP2 on TP53BP2 gene in HepG2 cells was observed by Western Blot, qRT-PCR and laser confocal technique. Results The sequencing alignment results showed that each recombinant lentiviral vector was consistent with the designed reference sequence, indicating that each recombinant lentiviral vector was successfully constructed; the titers of pHS-ASR-LW429, pHS-ASR-LW512 and pHS-ASR-LW513 were 9.7×10⁸ TU/mL, 6.1×10⁸ TU/mL and 6.4×10⁸ TU/mL, respectively; the HepG2 cells were infected with lentivirus lenti-shTP53BP2 (pHS-ASR-LW512 and pHS-ASR-LW513), and the results of Western blot, qRT-PCR and laser confocal technique showed that the two lenti-shTP53BP2 significantly down-regulated the TP53BP2 RNA level and its protein expression in HepG2 cells as compared with the control lentivirus (PHS-ASR-LW429). Conclusion In this study, we successfully construct the shRNA lentiviral vector targeting to TP53BP2 gene with the capacity of effectively down-regulation of TP53BP2 expression in HepG2 cells, which might lay a foundation for further research on the mechanism of TP53BP2 in the hepatocarcinogenesis.

Objective The aim of this study was to explore the screening of occult hepatitis B viral infection (OBI) in unpaid blood donors with low-level viremia (LLV) by serum HBV DNA precise detection technology. Methods 11352 unpaid blood samples with negative serum hepatitis B surface antigen (HBsAg) were collected between February 2017 and December 2021. Serum hepatitis B e antigen (HBeAg), anti-hepatitis B e antibody (HBeAb), anti-hepatitis B core antibody (HBcAb) and serum anti-hepatitis B surface antibody (HBsAb) were qualitatively or quantitatively detected by CL-2000i automatic chemiluminescence immunoassay. Serum biochemical parameters were detected by AU5800 automatic biochemical analyzer. Serum HBV DNA loads were assayed by ABI ViiA7 fluorescence quantitative PCR amplifier by means of high-sensitivity PCR assay. All individuals with positive seru HBV DNA by high-sensitivity PCR assay were checked-up by Cobas AmpliPrep/Cobas TaqMan automatic nucleic acid quantitative detection system. Results The high-sensitivity PCR detection found 67 blood donors (0.59%) were serum HBV DNA positive with LLV from the 11352 blood samples, which were completely coincided with the gold method of automatic nucleic acid quantitative detection system, with the sensitivity and specificity of 100.0% (67/67) and 100.0% (67/67), respectively; there was no statistical significance as respect to serum HBV DNA loads detected by gold standard method and high-sensitivity PCR [(110.7±20.2) IU/ml vs. (108.2±19.6) IU/ml, P>0.05]; the high-sensitivity PCR detection found serum HBV DNA loads were 100-200 IU/ml in 41 cases (61.2%), 20-100 IU/ml in 15 cases (22.4%) and <20 IU/ml in 11 cases (16.4%); serum HBV DNA loads in 5 blood samples with serum HBsAb/ HBeAb/ HBcAb positive were (162.4±18.3) IU/ml, significantly higher than [(82.3±14.1)IU/ml, P<0.05] in 9 blood samples with serum HBcAb positive or [(136.9±15.7)IU/ml, P<0.05] in 16 blood samples with serum HBeAb/ HBcAb positive or [(99.3±15.5)IU/ml, P<0.05] in 32 blood samples with serum HBsAb/ HBcAb positive or [(71.5±12.9)IU/ml, P<0.05] in 3 blood samples with serum HBsAb positive or [55.0 IU/ml和56.1 IU/ml, respectively] in 2 blood samples with all serum HBV markers negative. Conclusion The screening of serum HBV DNA by high-sensitivity PCR in unpaid blood donors could reveal OBI with LLV, which might be more safe in clinical blood use.

Objective The aim of this study was to explore the short-term efficacy of oxymatrine capsule and entecavir combination in the treatment of patients with serum HBeAg-positive chronic hepatitis B (CHB). Methods 96 patients with HBeAg-positive CHB were enrolled in our hospital between March 2019 and March 2021, and were randomly divided into control (n=48) and observation group (n=48), receiving entecavir or entecavir and oxymatrine capsule combination treatment for 48 weeks. Serum HBV DNA loads were detected by polymerase chain reaction, serum HBeAg was determined by ELISA, the peripheral blood T lymphocyte subsets were measured by flow cytometry, and serum interleukin 10 (IL-10), IL-17 and IL-23 levels were assayed by ELISA. Results At the end of 48 week treatment, serum AST and ALT levels in the observation group were (31.2±4.7)U/L and (38.7±9.4)UL, both significantly lower than [(46.3±6.8)U/L and (66.1±13.6)U/L, respectively, P<0.05] in the control; serum ALT normalization rate in the observation was 83.3%, much higher than 64.6% (P<0.05) in the control; the percentages of peripheral blood CD3⁺ and CD4⁺ cells, and the ratio of CD4⁺/CD8⁺ cells were (73.4±8.1)%, (47.2±6.1)% and (1.9±0.6), all significantly higher than [(66.7±8.8)%, (38.7±4.8)% and (1.6±0.6), respectively, P<0.05] in the control; serum IL-17 and IL-23 levels were (156.8±29.4)ng/L and (22.9±4.2)ng/L, both significantly lower than [(181.7±24.3)ng/L and (26.5±4.6)ng/L, respectively, P<0.05], while serum IL-10 levels was (84.2±5.6)ng/L, significantly higher than [(60.4±6.2)ng/L, P<0.05] in the control group. Conclusion The combination of oxymatrine and entecavir in the treatment of patients with serum HBeAg-positive CHB could effectively improve the short-term serum ALT normalization, which might be related to the improvement of immune functions, and its long-term impact on serum HBeAg loss needs further investigation.

Objective The aim of this study was to observe the blocking effect of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high serum HBV loads by oral tenofovir, and human hepatitis B immunoglobulin (HBIG)and hepatitis B vaccine (HBVac) combination immunization in fetus. Methods A total of 109 pregnant women with high serum viral load of hepatitis B virus were encountered in the Fourth People's Hospital, Huai'an City, Jiangsu Province between April 2019 and February 2022, and were divided into control (n=55) and observation group (n=54). The fetus in the control group were treated with HBIG and HBVac immunization immediately after birth, and those in the observation group got the same immunization, and their mothers took tenofovir orally at gestation of 28 weeks until delivery. The mothers and fetuses were carefully followed-up for 7 months. Serum biochemical parameters, HBV markers and HBV DNA loads were routinelymonitored. The untoward pregnancy outcomes of neonates were recorded. Results At inclusion, there were no significant differences as respect to ages, gestation, pregnancy times and birth times in the two groups(P>0.05); at birth, serum HBV DNA load in the observation women was (0.8±0.8)lgIU/mL, significantly lower than [(7.8±1.1)lgIU/mL, P＜0.05] in the control, while there was no significant difference respect to serum ALT levels in the two groups [(41.5±6.4)U/L vs. (43.6±7.0)U/L, P>0.05); at the end of seven month follow-up, serum HBsAg, HBeAg and HBV DNA load in all fetuses in the observation group were negative, while they were positive in 5 cases, 4 cases and 4 cases in the control, with the blocking failure of 12.7%, much higher than 0.0% in the observation (P＜0.05). Conclusion The oral administration of tenofovir with HBIG and HBVac combination immunization could successfully block the mother-to-infant transmission of HBV, without severe untoward effects or pregnancy outcomes, which warrants further clinical investigation.

Objective The aim of this study was to investigate the impact of nonalcoholic fatty liver diseases (NAFLD) on antiviral response to entecavir in patients with chronic hepatitis B (CHB). Methods 125 patients with CHB and concomitant NAFLD and 120 patients with CHB at the same time were recruited in our hospital between January 2016 and June 2020, and all received entecavir therapy for 48 weeks. The controlled attenuation parameter (CAP) of the liver was determined by FibroScan 502, and serum HBV DNA and HBeAg were detected routinely. The COX proportional risk regression model was applied to multivariate correlation analysis. Results The blood platelet (PLT) counts, alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL) and CAP in patients with CHB and NAFLD were 189.0(156.0,212.0)×10⁹/L, 78.0(40.0, 138.0)U/L, 72.0(26.0, 98.0)U/L, 4.4(3.0, 5.8)mmol/L, 5.9(4.9,7.3)mmol/L, 3.8(2.7, 4.5)mmol/L and 290.0(245.0, 315.0)dB/m, all significantly different compared to [154.0(127.0, 184.0)×10⁹/L, 198.0(43.0, 160.0)U/L, 121.0(29.0, 105.0)U/L, 1.7(1.2, 3.2)mmol/L, 4.9(4.4, 5.4)mmol/L, 2.9(2.5, 3.6)mmol/L and 194.0(170.0, 232.0)dB/m, respectively, P<0.05] in patients with CHB; at the end of 24 week and 48 week treatment, almost all patients in the two groups had their serum HBV DNA transferred to negative and few patients in the two groups had their serum HBeAg transferred to negative (P>0.05), but serum ALT normalization rates in patients with CHB and NAFLD were 44.8% and 66.4%, both significantly lower than 95.8% and 100.0%(P<0.05) in patients with CHB; the multivariate COX analysis showed that the CAP was the independent risk factor for serum ALT normalization (HR:0.996, 95%CI:0.994-0.999, P<0.05), suggesting that the more high the CAP, the more lower the ALT normalization rates. Conclusion The concomitant NAFLD might frustrate the biochemical response to entecavir antiviral therapy in patients with CHB, which warrants simultaneously appropriate management of hepatic steatosis.

Objective The aim of this study was to explore the implication of serum retinol-binding protein 4 (RBP4) and sterol regulatory element-binding protein-1c (SREBP-1c) in patients with chronic hepatitis C (CHC) and non-alcoholic fatty liver diseases (NAFLD). Methods A total of 94 patients with CHC were admitted to our hospital between February 2019 and February 2022, and all underwent liver biopsy and were treated with recombinant human interferon-α 2a and ribavirin for 24 weeks. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum RBP4 and SREBP-1c levels were detected by ELISA. Results The liver histopathological examination revealed NAFLD in 50 cases (53.2%), including 22 (44.0%) with mild and 28 (56.0%) with moderate-severe (M/S) steatosis in our series; serum AST, ALT, ALP and GGT levels in patients with M/S steatosis were(62.2±12.8)U/L, (87.2±11.5)U/L, (99.0±14.4)U/L and (69.4±10.3)U/L, much higher than [(53.6±10.1)U/L, (75.7±12.5)U/L, (83.8±12.7)U/L and (58.5±7.7)U/L, respectively, P<0.05] in patients with mild steatosis or [(51.7±8.5)U/L,(73.5±13.8)U/L,(81.6±10.9)U/L and (56.2±8.1)U/L, respectively, P<0.05] in patients with CHC; serum RBP4 and SREBP-1c levels in patients with M/S steatosis were (55.9±8.2) mg/L and (40.1±7.4)μg/L, significantly higher than [(36.7±5.8)mg/L and (29.3±5.1)μg/L, respectively, P<0.05] in patients with mild steatosis or [(28.4±6.3)mg/L and (21.8±5.5)μg/L, P<0.05] in patients with CHC; serum HbA1c and HOMA-IR in patients with M/S steatosis were (5.7±0.5)% and (3.2±0.5), both significantly higher than [(5.3±0.5)% and (2.5±0.4), P<0.05] in patients with mild steatosis or [(5.1±0.3)% and (1.9±0.3), P<0.05] in patients with CHC; serum RBP4 and SREBP-1c levels in 41 patients who responded to interferon-α 2a therapy were (25.7±6.0)mg/L and (20.6±5.0)μg/L, much lower than [(48.5±7.4)mg/L and (35.5±6.3)μg/L, P<0.05] in 53 patients who didn’t. Conclusion Serum RBP4 and SREBP-1c levels in patients with CHC and NAFLD increase, which might interferes with antiviral therapy, and warrants further investigation.

Objective The aim of this study was to explore the implication of serum adiponectin (APN), 25-hydroxyvitamin D [25-(OH)D] and apolipoprotein B (ApoB) level changes in patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 117 patients with NAFLD and 51 healthy individuals were enrolled in our hospital between August 2018 and May 2021, and all underwent liver stiffness measurement (LSM) by Fibroscan. Serum 25-(OH)D level was detected by chemiluminescence, and serum APN and ApoB levels were detected by ELISA. Results Based on the controlled attenuated parameters (CAP), the simple fatty liver (SFL) was found in 37 cases, the non-alcoholic steatohepatitis (NASH) was found in 58 cases and the fatty liver-induced cirrhosis was found in 22 cases, and out of them, no liver fibrosis was determined in 81 patients with NAFLD and progressive liver fibrosis in 36 cases; serum APN and 25-(OH)D levels in patients with NAFLD were (9.7±1.9)μg/mL and (30.8±6.4)nmol/L, both significantly lower than [(12.9±2.7)μg/mL and (57.9±8.1)nmol/L, respectively, P<0.05], while serum ApoB level was (1.2±0.2)g/L, significantly higher than [(0.7±0.1)g/L, P<0.05] in healthy persons; serum APN and 25-(OH)D levels in patients with cirrhosis were (7.9±1.3)μg/mL and (24.3±6.9)nmol/L, both significantly lower than [(9.2±2.1)μg/mL and (30.5±7.4)nmol/L, respectively, P<0.05] in patients with NASH or [(11.5±2.5)μg/mL and (35.1±7.1)nmol/L, respectively, P<0.05] in patients with SFL, while serum ApoB level was (1.5±0.2)g/L, significantly higher than [((1.3±0.3)g/L, P<0.05] in patients with NASH or [(0.9±0.1)g/L, P<0.05] in patients with SFL; serum APN and 25-(OH)D levels in patients with progressive liver fibrosis were (8.1±1.4)μg/mL and (25.3±6.7)nmol/L, both significantly lower than [(10.4±2.2)μg/mL and (33.2±7.5)nmol/L, P<0.05], while serum ApoB level was (1.6±0.3)g/L, significantly higher than [(1.0±0.2)g/L, P<0.05] in patients without liver fibrosis. Conclusion Serum APN, 25-(OH)D and ApoB levels are abnormal in patients with NAFLD, which might help predict the disease severity and the progression of liver fibrosis.

Objective The aim of this study was to investigate the impact of COVID-19 pandemic on emotions and liver function tests in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 28 patients with NAFLD were encountered in our hospital between January to Jun 2022, and the BMI, liver function tests, blood glucose and blood lipids were obtained and the psychological state was evaluated by using 9-item depression scale of patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). Results At the end of the episode of pandemic in Shanghai, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in 28 patients with NAFLD were (88.6±9.2)U/L and(49.2±3.9)U/L, significantly higher than [(52.3±4.9)U/L and (31.0±2.7)U/L, P<0.01] before the pandemic, while there were no significant differences as respect to total serum bilirubin, serum γ-glutamyltransferase (GGT), blood glucose and blood lipids levels (P>0.05); the GAD-7 score in patients with NAFLD after the pandemic was (7.9±0.6), significantly higher than [(5.9±0.5), P<0.05] before pandemic, and the PHQ-9 score was (6.9±0.7), also significantly higher than [(5.3±0.5), P<0.05] before pandemic; after adjusting for gender and age, the change of GAD-7 score was positively correlated with the elevated serum ALT level in patients with NAFLD[β=0.033(CI:0.005-0.061),P=0.021], but not with serum AST level [β=0.037(CI:-0.015-0.09),P=0.165]. Conclusion The pandemic of COVID-19 could result in the anxiety of patients with NAFLD, which might lead to the liver injury. More mental attention, psychological counseling and social support should be paid to them at the time of hardship.

Objective The aim of this study was to explore the implications of microRNA(miR)-183-5p and miR-96-5p level changes in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 62 patients with NAFLD and 80 healthy individuals with matched gender and age and without history of excessive drinking were enrolled in our hospital between November 2019 and January 2022. Serum miR-183-5p and miR-96-5p levels were detected by real-time fluorescent quantitative RT-PCR, and the factors impacting the occurrence of severe NAFLD was analyzed by multivariate Logistic regression analysis. The diagnostic performance of miR-183-5p and miR-96-5p in predicting the severity of NAFLD was evaluated by the area under the receiver operating characteristic curves(AUC). Results The body mass index, HOMA-IR, fasting plasma glucose and blood fat levels in patients with NAFLD were significantly higher than in healthy persons (P＜0.05), while serum miR-183-5p and miR-96-5p levels were (0.8±0.2) and (1.2±0.3), much lower than [(1.4±0.4) and (2.3±0.6), respectively, P＜0.05] in healthy control; serum miR-183-5p and miR-96-5p levels in 17 patients with severe NAFLD were (0.4±0.1) and (0.8±0.2), significantly lower than [(0.8±0.2) and (1.2±0.3), respectively, P＜0.05] in 21 patients with moderate NAFLD or [(1.1±0.3) and (1.5±0.4), respectively, P＜0.05] in 24 patients with mild NAFLD; the multivariate Logistic regression analysis revealed that the BMI, HOMA-IR, FPG, triglyceride and low-density lipoprotein cholesterol as well as serum miR-183-5p and miR-96-5p levels were the independent risk factors for the existence of severe NAFLD(P＜0.05); the AUC was 0.821, with the accuracy, sensitivity and specificity of 77.4%, 76.5% and 77.8% when the combination of serum miR-183-5p and miR-96-5p levels was applied to predict the severe NAFLD, much superior to anyone of the two parameters alone (with the AUC of 0.713 or 0.718, respectively, P＜0.05). Conclusion Serum miR-183-5p and miR-96-5p levels are down-regulated in patients with NAFLD, and the lowest the serum levels of them, the more severe of the NAFLD, which hints the more severe intrahepatic steatosis, and warrants further clinical investigation.

Objective The aim of this study was to explore the implication of serum homocystein (HCY), fibroblast growth factor-21 (FGF21) and nuclear factor-κB (NF-κB) levels in patients with non-alcoholic fatty liver diseases (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 192 patients with NAFLD and 106 patients with NAFLD and T2DM were enrolled in our hospital between May 2020 and March 2022. Serum HCY, FGF-21 and NF-κB levels were detected by ELISA. The fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were detected by glucose oxidase and high performance liquid chromatography, respectivley. The patients with NAFLD and T2DM were divided into simple fatty liver (SFL) in 76 cases, nonalcoholic steatohepatitis (NASH) in 21 cases and cirrhosis in 9 cases. All patients underwent liver stiffness measurement (LSM) by FibroTouch, and the liver fibrosis stage S0-S1 was found in 75 cases and stage S2-S4 in 31 cases. Results Serum LDL-C, FPG and HbA1c levels in patients with NAFLD and T2DM were (3.9±0.7)mmol/L, (8.6±1.3)mmol/L and (8.1±1.7)%, all significantly higher than [(3.1±0.6) mmol/L, (5.2±1.1)mmol/L and (5.7±1.0)%, P<0.05], while serum HDL-C level was (1.0±0.2)mmol/L, significantly lower than [(1.4±0.2)mmol/L, P<0.05] in patients with NAFLD; serum HCY, FGF21 and NF-κB levels in patients with NAFLD and T2DM were (17.8±2.3)μmol/L, (315.2±32.5) pg/ml and (4.1±0.8)pg/mL, significantly higher than [(14.1±1.9)μmol/L, (278.9±30.7)pg/ml and (2.8±0.5)pg/mL, respectively, P<0.05] in patients with NAFLD; serum HCY and NF-κB levels in patients with cirrhosis were (20.3±2.1)μmol/L and (5.0±1.0)pg/mL, both significantly higher than [(18.9±1.9)μmol/L and (4.5±0.7)pg/mL, P<0.05] in patients with NASH or [(16.2±1.6)μmol/L and (3.9±0.6)pg/mL, P<0.05] in patients with SFL, while serum FGF21 level was (284.7±30.5)pg/ml, significantly lower than [(337.8±25.1)pg/ml, P<0.05] in patients with NASH or [(312.5±28.3)pg/ml, P<0.05] in patients with SFL; serum HCY and NF-κB levels in patients with liver fibrosis staging S2-S4 were (20.9±1.8)μmol/L and (5.1±1.1)pg/mL, both significantly higher than [(17.2±2.1)μmol/L and (3.9±0.8)pg/mL, P<0.05] in patients with staging S0-S1, while serum FGF21 level was (291.1±26.7) pg/ml, significantly lower than [(319.8±28.3)pg/ml, P<0.05] in patients with staging S0-S1. Conclusion Serum HCY, FGF21 and NF-κB levels significantly increase in patients with NAFLD and T2DM, which might be related to clinical catalogues of NAFLD and the severity of liver fibrosis.

Objective The aim of this study was to explore the gene polymorphisms of solute carrier organic anion transporter family member 1B1 (SLCO1B1) and apolipoprotein E (APOE) to lipid metabolism in patients with metabolism-associated fatty liver diseases (MAFLD). Methods 121 patients with MAFLD and 150 healthy persons were encountered in our hospital between August 2018 and August 2021. Peripheral blood total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were detected, and SLCO1B1 and APOE gene phenotypes in the two groups were determined. Results Serum TC, TG and LDL-C levels in patients with MAFLD were (5.8±2.3)mmol/L,(2.9±1.4)mmol/L and (3.3±1.5)mmol/L, all significantly higher than [(4.8±1.2)mmol/L, (1.5±1.3)mmol/L and (2.6±1.1)mmol/L, respectively, P<0.05]; the frequency of SLCO1B1 genotyp *1a/*1a and *1a/*1b in patients with MAFLD were 8.3% and 35.5%, both significantly higher than 2.7% and 23.3%(P<0.05), while the frequency of phenotype *1b/*1b were 32.2%, significantly lower than 46.0%(P<0.05) in the healthy persons; the frequency of APOE genotype ε3/3 and the frequency of E3 phenotype in patients with MAFLD were 69.4% and 71.9%, both significantly higher than 56.7% and 58.7%(P<0.05), while the frequencies of genotypeε 3/4 and phenotype E4 were 17.4% and 18.2%, both significantly lower than 29.3% and 30.7%(P<0.05) in healthy individuals; serum TC, TG and LDL-C levels in 26 MAFLD patients with SLCO1B1genotype B were (6.4±1.2)mmol/L, (3.5±2.2)mmol/L and (3.8±0.8)mmol/L, all significantly higher than [(5.5±1.3)mmol/L, (2.6±3.3)mmol/L and (3.0±1.2)mmol/L, respectively, P<0.05] in 92 patients with genotype A or [(4.6±0.3)mmol/L,(2.6±0.9)mmol/L and (2.5±0.2)mmol/L, respectively, P<0.05] in 3 patients with genotype C; serum TG and LDL-C levels in 87 patients with APOE genotype E3 were (3.2±1.6)mmol/L and (3.4±1.1)mmol/L, both significantly higher than [(2.7±1.8)mmol/L and (2.8±0.8)mmol/L, respectively, P<0.05] in 12 patients with genotype E2 or [(2.3±0.7)mmol/L and (3.0±1.2)mmol/L, respectively, P<0.05] in 22 patients with genotype E4. Conclusion The gene polymorphisms of SLCO1B1 and APOE in patients with MAFLD are closely related to lipid metabolism disorders, and needs further investigation.

Objective The aim of this study was to meta analyze the clinical efficacy of granulocyte colony stimulating factor (G-GSF) in treatment of patients with severe alcoholic hepatitis (SAH). Methods The PubMed, Embase, Chinese Journal Full-text Database, Wanfang Database, Chinese Science and Technology Journal Database, Chinese Medical Association digital Journal Database in Chinese and English were searched from the establishment of databases to May 2022. At the same time, we handed check related journals and conference proceedings. The randomized controlled trials (RCT) on the administration of G-CSF in the treatment of patients with SAH were analyzed to evaluate the 90-day survival rate in both G-CSF-treated and control groups, and the data were analyzed by RevMan 5.4. Results A total of 198 patients were included in 5 RCT studies obtained; at the base of conventional medical support therapy, 98 patients received G-CSF and another 100 patients received placebo; by the Meta-analysis, the 90-day survival in the G-CSF-treated group was 76.5%, much higher than 28.0% in the control group, and the difference was statistically significant (RR=2.74,95% CI: 1.96-3.83, P＜0.01); there was no significant heterogeneity among the five studies (P=0.61, I²=0%). Conclusion In patients with SAH, the 90-day survival rate is significantly improved when the G-CSF treatment is given, which needs further clinical investigation.

Objective The purpose of this study was to investigate the efficacy of magnesium isoglycyrrhizinate in the treatment of patients with autoimmune hepatitis (AIH) and the effects on serum cytokine changes. Methods 46 patients with AIH were admitted to the Nantong Cancer Hospital between August 2019 and August 2021, and were randomly divided into two groups, with 23 cases in each. The prednisone was routinely given to all the patients in the two groups, and the dose was gradually tapered to maintaining. The magnesium isoglycyrrhizinate was intravenously administered in patients in observation group for 8 weeks. Serum interleukin 18 (IL-18), IL-2 and tumor necrosis factor alpha (TNF-α) levels were assayed by enzyme-linked immunosorbent assay, serum nitric oxide (NO) level was detected by nitrate reductase method, and serum laminin (LN), hyaluronic acid (HA), type III procollagen (PCIII) and type IV collagen (IV-C) levels were determined by radioimmunoassay. Results At the end of eight week treatment, serum ALT, AST and bilirubin levels in the observation group were (44.3±7.3)U/L, (38.5±6.4)U/L and (25.2±5.2)μmmol/L, all significantly lower than [(69.8±11.3)U/L, (46.5±7.3)U/L and (31.6±6.4)μmmol/L, respectively, P<0.05] in the control; serum IL-18 and TNF-α levels were (36.3±6.3)pg/mL and (27.1±4.4)pg/mL, both significantly lower than [(42.5±7.4)pg/mL and (35.5±5.9)pg/mL, respectively, P<0.05], while serum NO and IL-2 levels were (47.3±7.1)μmmol/L and (464.3±65.2)pg/mL, both significantly higher than [(41.8±8.1)μmmol/L and (419.8±74.1)pg/mL, respectively, P<0.05] in the control; serum HA, PCⅢ and Ⅳ-C levels were (131.7±22.5)μg/L, (133.9±22.6)μg/L and (126.9±19.8)μg/L, all significantly lower than [(184.4±28.4)μg/L, (167.4±28.1)μg/L and (158.6±24.6)μg/L, respectively, P<0.05] in the control. Conclusion The administration of magnesium isoglycyrrhizinate in the treatment of patients with AIH could short-termly improve liver function test normalization and relieve liver fibrosis, which needs further clinical investigation.

Objective The aim of this study was to compare the clinicopathological features between patients with autoimmune hepatitis (AIH) and drug-induced liver injury (DILI). Methods 62 patients with AIH and 104 patients with DILI were encountered in our hospital between January 2018 and March 2022, and all underwent liver biopsies. The hepatic inflammation and fibrosis was evaluated by Ishak scores. Results The percentage of female cases in patients with AIH was 75.8%, much higher than 53.8% in patients with DILI (P<0.05); serum AST and immunoglobulin G levels in patients with AIH were 134(58, 312)U/L and 17.4(12.8, 20.4)mg/dL, significantly higher than [57(32, 135)U/L and 13.6(10.9, 15.7)mg/dL, respectively, P<0.05], while serum albumin level was 37.0(32.4, 40.6)g/L, significantly lower than [(42.2(36.8, 44.3)g/L, P<0.05] in patients with DILI; the incidence of interfacial hepatitis, plasma cell infiltration, rosette formation and lymphocyte infiltration in patients with AIH were 91.9%, 71.0%, 62.9% and 51.6%, all significantly higher than 16.3%, 29.8%, 21.1% and 17.3%, respectively, in patients with DILI (P<0.05); the incidences of fibrosis score 0, 1, 2, 3, 4, 5 and 6 in patients with AIH were 6.4%, 6.4%, 9.7%, 50.0%, 14.5%, 8.1% and 4.8%, significantly different compared to 25.0%, 35.6%, 29.8%, 7.7%, 1.9%, 0.0% and 0.0% in patients with DILI (P<0.05), suggesting more severe fibrosis in patients with AIH. Conclusion There are differences as respect to blood biochemistry, plasma immunoglobulin, and liver histopathology between patients with AIH and DILI, and among them, the liver tissue changes in patients with AIH is characterized by interfacial hepatitis, portal inflammation and liver fibrosis, which might help differentiate them.

Objective The aim of this study was to analyze the clinical and liver histopathological features of patients with autoimmune hepatitis (AIH) with serum normal alanine aminotransferase (ALT) and low immunoglobulin G (IgG) levels. Methods 61 patients with AIH were admitted to Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University between January 2015 and December 2021, and the clinical and liver biopsy materials were retrospectively collected, including demographic information, medical history, blood routine, liver function tests, immunoglobulin G(IgG), antinuclear antibody (ANA). Results Serum alkaline phosphatase (ALP) levels were 93.7(71.0, 161.0)U/L and 193.6(41.0, 320.4)U/L, GGT levels were 27.9(18.3, 104.2)U/L and 158.8(62.2, 293.2)U/L, total serum bilirubin levels were 18.7(12.8, 26.0)μmol/L and 28.4(16.5, 45.9)μmol/L, aspartate aminotransferase-to-platelet ratio index (APRI) were 0.5(0.3, 1.7) and 3.1(1.1, 5.1), GGT/platelet ratio were 0.2(0.1, 1.4) and 0.8(0.4, 1.9), significantly different between patients with normal and elevated serum ALT levels(P＜0.01); the percentages of histological activity index greater than G2 were 45.0% and 56.1%, liver fibrosis greater than S2 were 55.0% and 41.5%, interfacial inflammation accounted for 90.0% and 100.0%, plasma cell infiltration accounted for 80.0% and 90.2%, and rose-rosette changes accounted for 25.0% and 19.5%, not significantly different between the two groups (P＞0.05); there was no significant difference as respect to liver histopathological changes between patients with low serum IgG level and those with elevated serum IgG level (P＞0.05); there were significant differences respect to serum ALP, GGT, TBIL, APRI and GGT/PLT ratio (P＜0.01)between patients with normal serum ALT and low IgG level and those with elevated serum ALT and IgG levels, while there was no significant difference as respect to liver histopathological changes between them (P＞0.05). Conclusions Serum biochemical and serological indexes could not accurately reflect the disease severity in patients with AIH, and we recommend liver biopsy in AIH patients with low serum IgG and normal ALT.

Objective The aim of this study was to explore the clinical efficacy of obeticholic acid (OCA) and fibrates rescue therapy in patients with primary biliary cholangitis (PBC) who didn’t response to ursodeoxycholic acid (UDCA) treatment. Methods 41 PBC patients without complete response to UDCA therapy were encountered in our hospital between January 2019 and December 2020, and were randomly divided into control (n=20) and observation group (n=21), receiving OCA or OCA and fenofibrate combination at base of UDCA maintaining treatment in both group for 24 weeks. Serum type IV collagen (IV-C), hyaluronic acid (HA), type III procollagen (PIIIP) and laminin (LN) were detected by radioimmunoassay, serum immunoglobulins (IgG, IgA and IgM) were detected by immunoturbidimetry, and serum interleukin-2 (IL-2), IL-6, IL-10 and tumor necrosis factor-α (TNF-α) were detected by ELISA. Results At the end of 24 week treatment, serum ALT, bilirubin, GGT and ALP levels in the observation group were (29.1±5.3)U/L, (24.8±4.1)μmol/L, (86.4±15.7)U/L and (100.6±26.3)U/L, all significantly lower than [(42.8±7.6)U/L, (30.2±6.5)μmol/L, (121.7±18.6)U/L and (131.8±33.7)U/L, respectively, P＜0.05] in the control; serum IV-C, HA and P Ⅲ P levels were (125.1±19.5)μg/L, (118.5±28.9)μg/L and (136.8±31.5)μg/L, all significantly lower than [(149.3±30.1)μg/L, (165.3±40.2)μg/L and (167.9±42.8)μg/L, respectively, P＜0.05] in the control; serum IgG, IgA and IgM levels were (11.7±1.6)g/L, (2.9±0.5)g/L and (2.2±0.3)g/L, all significantly lower than [(15.9±2.2)g/L, (3.6±0.7)g/L and (3.0±0.8)g/L, respectively, P＜0.05] in the control group; serum IL-2 level was (84.6±18.4)pg/ml, significantly higher than [(63.2±12.9)pg/ml, P＜0.05], while serum IL-6 and TNF-α levels were (3.3±1.4)pg/ml and (5.1±1.9)pg/ml, both significantly lower than [(6.6±1.8)pg/ml and (7.4±2.3)pg/ml, P＜0.05] in the control. Conclusion The rescue treatment of OCA and fibrate combination in dealing with PBC patients without complete response to UDCA therapy could improve liver function tests and alleviate liver fibrosis, which might be related to inhibition of immunoglobulins secretion and regulation of serum cytokine metabolism.

Objective This paper aimed too summarize the clinical characteristics of patients with systemic sclerosis (SSc) complicated with primary biliary cholangitis (PBC) and portal hypertension. Methods Twelve patients with SSc complicated with PBC and portal hypertension were hospitalized in Beijing You'an Hospital Affiliated to Capital Medical University between January 2010 and March 2022, and the clinical symptoms, laboratory tests, abdominal imaging and gastroscopy data were analyzed. Results Among the 12 patients, 5 patients went to see doctors for hematemesis and/or melena as the first symptom; 8 patients were diagnosed with SSc earlier than PBC; 10 patients had decreased peripheral blood hemoglobin (HGB) levels, and 9 patients had decreased blood PLT counts; 8 patients had elevated serum GGT and ALP levels, showing cholestasis; 10 patients had electronic gastroscopic findings, suggesting esophageal varices, 12 patients had splenomegaly by CT/ultrasonography, and 9 patients had varying degrees of ascites, 8 patients had formation of collateral circulation. Conclusion The clinical manifestations of patients with SSc, PBC and portal hypertension are similar to patients with PBC alone. The clinical manifestations of portal hypertension are more obvious, and the cholestasis is more obvious than the increase of serum transaminases levles. It might be necessary to actively find PBC, when the SSc is diagnosed. Early diagnosis and early intervention might improve the outcome of patients with those entities.

Objective The aim of this study was to observe the clinical efficacy of magnesium isoglycyrrhizinate in preventing and treating liver and kidney injuries in patients with advanced gastric cancer (AGC) undergoing chemotherapy. Methods A total of 105 patients with AGC were encountered in our hospital between April 2020 and April 2022, and all received taxotere, cisplatin and 5-fluorouracil combination chemotherapy. During the chemotherapy, the patients were randomly assigned to control (n=52) and observation group (n=53), receiving glutathione or magnesium isoglycyrrhizinate for preventing drug-induced liver injury (DILI) and kidney injury. Serum carbohydrate antigen 199 (CA199), CA125, CA724 and carcinoembryonic antigen (CEA) levels wereassayed by electrochemical luminescence, and serum interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α(TNF-α) levels were detected by ELISA. Results At the end of chemotherapy, the incidence of DILI in the observation group was 3.8%, much lower than 15.4% (P<0.05) in the control, and no kidney injury occurred in the two groups; serum ALT, AST and ALP levels in the observation group were (44.3±10.5)U/L, (27.4±2.8)U/L and (70.6±14.5)U/L, all significantly lower than [(56.6±15.3)U/L,(49.1±2.9)U/L and (82.5±8.7)U/L, respectively, P<0.05] in the control; at the end of one month after chemotherapy, serum ALT and AST levels in the observation group were (33.5±5.8)U/L and (23.4±2.5)U/L, both significantly lower than [(42.6±7.7)U/L and (37.7±3.2)U/L, respectively,P<0.05] in the control; after treatment, serum CA199, CA125, CA724 and CEA levels in the two groups were not significantly different(P>0.05), while serum IL-6, IL-8 and TNF-α levels in the observation group were (3.9±0.5)ng/L,(57.3±5.8)ng/L and (3.4±0.4)ng/L, all significantly lower than [(5.7±0.6)ng/L, (84.2±8.5)ng/L and (6.7±0.8)ng/L, respectively, P<0.05] in the control group. Conclusion The application of magnesium isoglycyrrhizinate in preventing and treating patients with AGC undergoing chemotherapy is efficacious, which might be related to the inhibition of body inflammatory reactions.

Objective This study aimed at summarizing the clinical features and risk factors of liver injuries in patients with hyperthyroidism (HT). Methods 216 patients with HT were encountered in our hospital between January 2018 and May 2022, and all took methimazole orally. The patients with drug-induced liver injuries (DILI) were treated by liver-protecting medicines. Serum free triiodothyronine (FT3), free thyroxine (FT4), alanine aminotransferase (ALT) and aspartate transaminase (AST) levels were routinely obtained. Results During the process of clinical management, the DILI was found in 102 cases (47.2%); the age, percentage of alcohol-taking, concomitant diabetes, large dose of methimazole administration, high serum FT3 and FT4 levels in patients with HT and DILI were (49.5±10.7)yr, 44.1%, 31.4%, 62.8%,(19.0±5.8)pmol/L and (60.4±18.4)pmol/L, significantly older or higher than[(44.0±14.5)yr, 30.7%, 6.1%, 21.0%, (16.6±4.2)pmol/L and (32.3±9.8)pmol/L, respectively, P<0.05] in 114 patients without DILI; the multivariate Logistic analysis showed that the concomitant diabetes[OR:1.8(95%CI:1.1-2.8)], large dose of methimazole administration [OR:1.6(95%CI:1.0-2.4)] and high serum FT4 level[OR:1.6(95%CI:1.2-2.1)] were all the independent risk factors for the occurrence of DILI (P<0.05); after treatment, serum FT3 and FT4 levels in patients with HT and DILI were (15.9±4.7)pmol/L and (40.1±12.5)pmol/L, both much lower than[(20.6±7.3)pmol/L and (70.5±23.3)pmol/L, respectively, P<0.05] before treatment, and serum ALT and AST levels were (23.5±4.8)U/L and (29.1±6.2)U/L, both much lower than[(88.9±26.4)U/L and (64.6±18.7)U/L, P<0.05] at the time of DILI diagnosed. Conclusion The clinicians should take the precipitating factors of DILI into consideration in patients with HT, and prescribe carefully medicines for them to decrease the incidence of DILI.

Objective The aim of this study was to explore the evaluation of bacterial infection by common hematological indexes in patients with acute-on-chronic liver failure (ACLF). Methods 208 patients with ACLF were admitted to our hospital between July 2015 and July 2022, and were given conventional supporting therapy. The clinical materials of all patients were retrospectively analyzed. The factors impacting bacterial infection was evaluated by binary multivariate Logistic analysis. The judging performance of infection by each index was evaluated by receiver operating characteristic (ROC) curves, and the Cox regression analysis was applied to predict the prognosis. Results Out of the 208 patients with ACLF in our series,the incidence of bacterial infection was 68.8%, and the common infection sites were abdominal infection in 87 cases(51.5%), pulmonary infection in 38 cases (22.5%), urinary tract infection in 4 cases (2.4%), blood infection in 1 case (0.6%) and other site infection in 39 cases (23.0%), and there were 119 cases with single site infection and 24 cases with multi-site infection; 108 patients (51.9%) were discharged recovered, and 100 patients (48.1%) died during hospitalization or after discharge; the average age in patients with bacterial infection was (48.4±12.6) years, significantly greater than in those without infection [(43.9±12.4) years, P<0.05]; the white blood cells (WBC) count, neutrophil count and serum procalcitonin (PCT) level in patients with infection were 7.0 (4.8, 8.9)×10⁹/L, 5.0 (3.3,6.7)×10⁹/L and 0.9 (0.4,1.2) ng/ml, all significantly higher than [6.0 (4.6, 7.3)×10⁹/L, 4.1 (2.9, 5.1)×10⁹/L and 0.5 (0.3, 0.9) ng/ml, respectively, P＜0.05] in those without infection, while there were no significant differences as respect to serum C-reaction protein (CRP) and hypersensitive C-reactive protein (hsCRP) levels in the two groups (P > 0.05); serum total bilirubin (TBIL), international standardization ratio (INR) and D-dimer levels were significantly higher than those in patients without infection (P<0.05), while blood red blood cell (RBC) count, hemoglobin (Hb), albumin, ALT, AST, cholinesterase, Na⁺, PTA and alpha fetoprotein (AFP) in patients with infection were significantly lower than those in patients without infection (P<0.05); the Logistic analysis showed that Hb, neutrophil count, TBIL, Na⁺ and PTA were the independent influencing factors for bacterial infection in patients with ACLF; the ROC curves analysis showed that the AUCs were 0.645, 0.627, 0.724, 0.658 and 0.645 by Hb, neutrophil count, TBIL, Na⁺ and PTA, predicting bacterial infection in patients with ACLF, when the cut-off-value were set as 117.5 g/L, 5.1×10⁹/L, 261.0 μmol/L, 137.5 mmol/L and 34.5%, while the combination of the above indicators had the largest AUC of 0.810, with the sensitivity and specificity of 70.6% and 79.4%, respectively; the Cox multivariate analysis showed that TBIL and PTA were the independent risk factors for the poor prognosis of patients with ACLF. Conclusion Under the circumstance of ACLF, some common blood parameters might help judge infection, and warrants emphasis in clinical practice.

Objective The aim of this study was to investigate the distribution of pathogens and serum Th1/Th2 cytokine changes in patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) and nosocomial infections (NI). Methods 63 patients with HBV-ACLF were admitted to our hospital between December 2019 and December 2021, and out of them, 35 patients were found having NI. Serum Th1 cytokines, such as interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), and Th2 cytokines, including IL-4, IL -6 and IL-10 levels were detected by ELISA. Serum C-reactive protein (CRP) and procalcitonin (PCT) levels were detected by immunofluorescence, and serum lipopolysaccharide (LPS) level was detected by limulus test. The isolation and identification of pathogens were conducted by microbiological analyzer. Results In the 35 HBV-ACLF patients with NI, 72 strains of pathogens, including 44 strains of Gram-negative and 28 strains of Gram-positive bacteria were found; serum CRP, PCT and LPS levels in patients with NI were (78.7±12.9)mg/L,(6.2±0.2)ng/mL and (0.9±0.1)EU/ml, significantly higher than [(15.9±1.7)mg/L, (0.9±0.1)ng/mL and (0.2±0.1)EU/ml, respectively, P<0.05] in patients without NI; serum TNF-α, IFN-γ and IL-6 levels in patients with NI were (16.5±1.7)pg/mL, (27.8±2.3)pg/mL and (12.5±1.3)pg/mL, all significantly higher than [(11.7±1.2)pg/mL, (20.2±2.1)pg/mL and (4.2±0.4)pg/mL, respectively, P<0.05], while serum IL-2, IL-4 and IL-10 levels were (3.3±0.3)pg/mL, (11.8±1.1)pg/mL and (10.2±1.0)pg/mL, respectively, P<0.05] in patients without NI; the 28 d and 90 d survivals in patients with NI were 28.6% and 20.0%, both significantly lower than 71.4%(x²=8.239, P=0.022) and 57.1%(x²=7.014, P=0.025) in patients without NI. Conclusion The mortality of HBV-ACLF patients with NI is high, and the main pathogens of bacterial infection is Gram-negative bacteria, which might have the Th1/Th2 cytokine imbalance.

Objective The aim of this study was to explore the changes of interferon-inducible protein -10 (IP-10) and cyclooxygenase-2 (COX-2) in peripheral blood mononuclear cells (PBMCs) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods 73 patients with HBV-ACLF and 95 patients with chronic hepatitis B (CHB) were enrolled in our hospital between January 2019 and March 2021. The PBMCs were separated from peripheral blood, and the IP-10 and COX-2 mRNA levels were assayed by RT-PCR. Serum HBsAg level was detected by chemiluminescence, and serum IFN-γ level was measured by ELISA. Results Serum IFN-γ, PBMC IP-10 mRNA and COX-2 mRNA levels in patients with HBV-ACLF were (59.3±7.9)ng/L,(0.9±0.1) and (1.6±0.2), all significantly higher than [(35.8±6.2)ng/L, (0.6±0.1) and (0.5±0.1), respectively, P<0.05] in patients with CHB; the PBMC IP-10 and COX-2 levels in patients with HBV-ACLF were negatively correlated to serum HBsAg levels (r=-0.828, P<0.05; r=-0.795, P<0.05); serum IFN-γ, PBMC IP-10 mRNA and COX-2 mRNA in 29 dead patients with ACLF were (67.5±8.1)ng/L, (1.2±0.2) and (1.9±0.4), much higher than [(53.9±7.4)ng/L, (0.7±0.1) and (1.4±0.2), respectively, P<0.05] in 44 survivals; the AUCs were 0.835 and 0.828, as the PBMC IP-10 and COX-2 levels were applied to predict the prognosis of patients with HBV-ACLF, not significantly different (P>0.05); the 90-day survival was 46.9% in 32 patients with PBMC IP-10 mRNA≥0.9, much lower than 70.7%(P<0.05) in 41 patients with IP-10 mRNA＜0.9, and the 90-day survival was 47.4% in 38 patients with COX-2 mRNA≥1.7, much lower than 74.3%(P<0.05) in 35 patients with COX-2 mRNA<1.7. Conclusion The PBMC IP-10 and COX-2 mRNA levels in patients with HBV-ACLF are greatly increased, which might hint a poor prognosis, and needs further investigation.

Objective The purpose of this study was to compare the clinical efficacy of carvedilol and propranolol in preventing esophagogastric varices bleeding (EVB) in patients with liver cirrhosis. Methods 312 cirrhotics eligible for inclusion were encountered in our hospital between April 2013 and September 2020, and out of them, carvedilol were given in 190 cases and propranolol were given in 122 cases. All patients were followed-up until December 2020. The wedged hepatic venous pressure (WHVP) and free hepatic venous pressure (FHVP) were routinely determined and the hepatic venous pressure gradient (HVPG) was calculated. Results During the follow-up period, the incidence of EVB in propranolol-treated patients was 34.4%, significantly higher than 13.2%(P＜0.05) in carvedilol-treated patients; the fatality rates in the two groups were 5.7% and 1.6%(P＞0.05); after treatment, the WHVP, FHVP and HVPG in 66 propranolol-treated patients were (22.7±5.1)mmHg, 9.0(6.0-11.0)mmHg and (13.7±3.5)mmHg, not significantly different compared to[(22.5±4.5)mmHg, 8.0(6.0~10.0) mmHg and (14.5±3.8)mmHg] in 32 carvedilol-treated patients (P>0.05). Conclusion The efficacy of carvedilol in preventing EVB in patients with liver cirrhosis and esophagogastric varices is superior to propranolol, although there is no significant difference as respect to the reduction of HVPG by the two medicines.

Objective The aim of this study was to compare the laparoscopic and open splenectomy and pericardial devascularization in treatment of cirrhotics with esophageal varice (EV) and its impact on portal hemodynamics. Methods 45 cirrhotic patients with EV were enrolled in our hospital between March 2016 and March 2021, and 20 patients received open and another 25 patients received laparoscopic splenectomy and pericardial devascularization. Plasma endothelin (ET), angiotensin II (ATII) and plasma renin activity (PRA) were detected by radioimmunoassay. The portal vein flow (PVF), portal vein velocity (PVV), portal vein diameter (PVD) and hepatic arterial flow (HAF) were measured by Doppler ultrasonography. Results The operation time, intraoperative blood loss, blood transfusion volume, removal of drainage tube, postoperative exhaust and suture removal in patients receiving laparoscopic surgery were (213.5±20.7)min, (362.8±56.9)ml, (312.5±20.7)ml, (3.8±0.6)d, (2.7±0.4)d and (7.9±1.5)d, significantly different as compared to [(188.4±16.9)min,(415.2±50.7)ml, (349.4±23.6)ml, (5.1±0.9)d,(3.2±0.5)d and (11.3±2.1)d, respectively, P<0.05] in patients receiving open operation; at the end of one month after operation, the PVF, PVV, PVD and HAF in laparoscopic surgery-treated patients were (871.3±91.5)ml/min, (41.5±3.8)cm/s, (1.0±0.2)cm and (872.2±29.7) ml/min, not significantly different compared to [(904.7±87.3)ml/min, (39.7±3.4)cm/s, (1.1±0.2)cm and (881.6±30.5)ml/min, P>0.05] in open operation-treated patients; at the end of six months after surgery, there were no significant differences respect to liver function tests between the two groups (P>0.05); plasma ET, ATⅡ and PRA in laparoscopic surgery-treated patients were (74.7±5.1)ng/L, (143.3±7.6)ng/L and (71.5±7.9)ng/L, not significantly different compared to [(76.5±6.3)ng/L, (146.7±9.6)ng/L and (73.4±7.6)ng/L, respectively, P>0.05] in open operation-treated patients. Conclusion The laparoscopic splenectomy and pericardial devascularization might obtain the same efficacy of open operation in cirrhotics with EV, and the portal hemodynamics after operation is getting smooth.

Objective The purpose of this study was to investigate the efficacy of human umbilical cord blood mononuclear cells (hUCB-MNCs) and human umbilical cord mesenchymal stem cell (hUC-MSCs) transfusion in patients with hepatitis B liver cirrhosis and its impact on peripheral blood CD4⁺, CD8⁺, CD34⁺ and CD38^- cells. Methods 116 patients with decompensated hepatitis B liver cirrhosis were admitted to our hospital between March 2018 and March 2022, and were divided into control and observation group, with 58 cases in each. The patients in the control group were treated with routine liver-protecting medicines, nutritional support, entecavir for antiviral therapy, and β-blocker, and those in the observation group were treated with intravenous hUCB-MNCs and hUC-MSCs transfusion, once a week, for two to eight weeks, at base of treatment in the control. The percentages of peripheral blood CD4⁺, CD8⁺, CD34⁺ and CD38^- cells were detected by flow cytometry and serum tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interleukin-6 (IL-6) and IL-10 levels were detected by ELISA. The liver stiffness measurement (LSM) was detected by FibroScan. Results At the end of eight week treatment, serum albumin level in the observation group was (30.9±3.2)g/L, much higher than [(28.4±2.7)g/L, P＜0.05], while serum bilirubin level was (23.5±5.9)μmol/L, much lower than [(28.4±6.8)μmol/L, P＜0.05] in the control; the percentages of peripheral blood CD4⁺, CD34⁺ and CD38^- cells were (39.8±3.1)%, (7.3±1.9)% and (5.7±1.4)%, all significantly higher than [(36.1±3.9)%, (4.2±1.5)% and (4.6±1.2)%, respectively, P＜0.05], while the percentage of blood CD8⁺ cells was (22.2±2.1)%. significantly lower than [(28.5±2.5)%, P＜0.05] in the control; serum TNF-α and IL-6 levels were (189.3±58.4)ng/L and (102.5±28.6)ng/L, both significantly lower than [(237.9±62.5)ng/L and (135.8±36.2)ng/L, P＜0.05], while serum TGF-β and IL-10 levels were (47.3±7.9)pg/L and (48.6±14.9)pg/L, both significantly higher than [(35.6±5.8)pg/L and (36.9±11.7)pg/L, respectively, P＜0.05] in the control; the Child-Pugh score and LSM were (7.6±1.8) and (8.0±0.2)kPa, both significantly lower than [(8.5±1.7) and (8.8±0.3)kPa, P＜0.05] in the control group. Conclusion The combination transfusion of hUCB-MNCs and hUC-MSCs in the treatment of patients with hepatitis B cirrhosis could improve liver functions, evidenced by increased serum albumin levels, which might be related to the inhibited bogy inflammatory reactions and modulation of immune functions.

Objective The purpose of this study was to observe the efficacy of transjugular intrahepatic portal shunt (TIPS) and partial splenic artery embolization (PSE) in the treatment of patients with hepatitis B cirrhosis complicated by hypersplenism. Methods A total of 72 patients with hepatitis B cirrhosis complicated by hypersplenism were encountered in our hospital between January 2018 and January 2021, and were randomly divided into control (n = 36) and combination group (n = 36), receiving PSE or PSE and TIPS combination treatment. All patients were followed-up for one year. Results One week after treatment, the platelet (PLT) and white blood cell (WBC) counts in the combination group were (76.1±25.8) ×10⁹/L and (4.2±1.2) ×10⁹/L, both significantly higher than [(45.8±13.7) ×10⁹/L and (2.4±0.5) ×10⁹/L, respectively, P < 0.05] in PSE-treated patients; at the end of 12 months after operation, the PLT and WBC counts in the combination group were (59.3±18.7) ×10⁹/L and (2.8±0.9) ×10⁹/L, both significantly higher than [(45.6±14.2) ×10⁹/L and (2.0±0.6) ×10⁹/L, respectively, P<0.05] in the PSE-treated patients; serum albumin level in the combination group were (37.9±3.4) g/L, significantly higher than [(35.9±3.5) g/L, P < 0.05] in PSE-treated patients; the incidences of stent stenosis and hepatic encephalophathy after TIPS and PSE were 22.2% and 33.3%. Conclusion The TIPS and PSE is beneficial to alleviate short-term postoperative hypersplenism in patients with hepatitis B liver cirrhosis, which might help improve the compromised functions of immune system.

Objective The aim of this study was to investigate the effect of single high dose of hepatic irradiation on amelioration of hepatic pain in patients with primary liver cancer (PLC). Methods 76 patients with PLC and hepatic pain were encountered in our hospital between June 2018 and June 2021, and were divided randomly into observation and control group, with 38 cases in each group. All the patients received supporting treatment, and those in the observation group received a single dose of large dose of liver irradiation. The brief pain inventory (BPI) and the European organization for research and treatment of cancer (EORTCQLQ-C30) score were evaluated. Results One month after enrollment, the BPI score in irradiation-treated patients was (1.7±0.8), significantly lower than [(3.4±1.3), P＜0.05] in the control; the functional and overall health status/quality of life aspects by the EORTCQLQ-C30 were(47.2±7.0) and (12.7±1.2), both significantly higher than [(35.6±6.0) and (8.6±0.8), respectively, P＜0.05], while the symptom and single measurement item scores were (10.2±2.2) and (15.4±3.1), significantly lower than [(18.1±5.0) and (19.6±4.2), respectively, P＜0.05] in the control group; the common symptoms after irradiation were nausea and vomiting, fatigue and anorexia in 24 cases(63.2%), fever in 8 cases (21.1%), upper gastrointestinal bleeding in 9 cases (23.7%) and leucopenia in 3 cases(7.0%), which were ameliorated gradually after in time management; at the end of 60 day followed-up, the fatality rate in the irradiation-treated group was 44.7%, and that in the control was 55.3%, not significantly different by Kaplan-Meier analysis (Log-Rank=0.497, P=0.481). Conclusion A single high-dose of hepatic irradiation in patients with PLC and liver pain could gain a good therapeutic relieve pain effect and relatively improve the quality of life in this circumstance.

Objective The purpose of this study was to compare the two-year survivals in primary liver cancer (PLC) patients with spontaneous tumor rupture underwent hepatectomy at early or late operation time windows. Methods A total of 74 PLC patients with spontaneous tumor rupture were admitted to our hospital between January 2014 and January 2019, and all received hepatectomy, greater omentum resection and abdominal heat perfusion. 31 patients (early surgery) received theoperation within two weeks, and 43 patients (late surgery) received the operation two weeks after onset of the disease. All patients were followed-up for two years. Results Within two year follow-up period, the incidence of greater omentum invasion in patients receiving early operation was 3.2%, much lower than 20.9%(P＜0.05) in patients receiving late operation, while there were no significant differences as respect to the incidences of intrahepatic tumor recurrence, pulmonary metastasis and intraperitoneal metastasis (P＞0.05) between the two groups; post-operationally, there were no significant differences as respect to the incidences of complications, such as bleeding, ascites, liver failure and peritoneal infections(25.8% vs. 32.6%,P＞0.05); during two-year follow-up period, 5 patients died and 26 patients (83.9%) survived in patients receiving early operation, and 8 patients died and 35 patients (81.4%,P＞0.05) survived in patients receiving late surgery; the median disease-free survival in patients receiving early operation was 17(10, 23) months, significantly longer than 11(4,14) months(Z=3.865, P＜0.05) in patients receiving late operation; the overall survival in patients receiving early operation was 22(16, 24) months, not significantly different as compared to 20(14, 24) months in patients receiving late operation (P＞0.05). Conclusion The hepatectomy could rescue the PLC patients’ life when tumor rupture occurs, so the clinicians should actively prepare for the operation no mater early or late times.

Objective The aim of this clinical trial was to investigate the preoperative doxorubicin magnetic fluid targeted chemotherapy before microwave ablation (MWA) in the treatment of patients with primary liver cancer (PLC). Methods 65 patients with PLC were encountered in our hospital between January 2018 and January 2021, and were randomly divided into observation (n=33) and control group (n=32). The patients in the control group was treated with percutaneous MWA, and those in the observation group was treated with preoperative doxorubicin magnetic fluid targeted chemotherapy before MWA. The clinical efficacy was evaluated by mRECIST. Serum carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), fucosidase (AFU) and alpha-fetoprotein (AFP) levels were detected by ELISA. The percentages of peripheral blood of CD3⁺, CD4⁺ and CD8⁺ cells were detected by flow cytometry. Results The total effective rate in the observation group at one-month evaluation was 87.9%, much higher than 65.6%(P＜0.05) in the control; at the end of one month after MWA, serum CA19-9, CEA, AFU and AFP levels in the observation group were (23.5±4.7)U/L,(9.3±2.1)μg/mL, (36.4±6.9)U/L and (78.5±10.2)ng/mL, all significantly lower than [(31.2±5.1)U/L, (12.6±3.5)μg/mL,(45.1±10.2)U/L and (103.6±17.1)ng/mL, respectively, P＜0.05] in the control; the percentages of peripheral blood CD3⁺ and CD4⁺ cells as well as the ratio of CD4⁺/CD8⁺ cells in the observation group were (70.5±9.1)%, (39.8±4.7)% and (1.6±0.2), all significantly higher than [(61.1±8.8)%, (31.9±4.4)% and (1.4±0.1), respectively, P＜0.05] in the control. Conclusion The procedure of adriamycin magnetic fluid targeted chemotherapy before MWA in dealing with patients with PLC could promote the short-term efficacy, which might be related to the regulation of immune functions.

Objective The aim of this study was to compare the clinical efficacy of complete laparoscopic left hemihepatectomy and traditional open laparotomy with left hepatic pedicle occlusion in treatment of patients with intrahepatic and extrahepatic bile duct stones. Methods A total of 78 patients with intrahepatic and extrahepatic bile duct stones were admitted to our hospital between January 2016 and December 2021, and out of them, 45 patients underwent laparoscopic left hemihepatectomy with left hepatic pedicle occlusion and 33 patients received open laparotomy with left hepatic pedicle occlusion. Results In patients receiving laparoscopic operation, the operation time was (4.6±0.9) h, significantly longer than [(3.6±0.6) h, P<0.05], the postoperative exhaust time and hospitalization time were (22.8±8.4) h and (9.4±2.5) d, significantly shorter than [(44.6±10.5) h and (12.3±3.1) d, P<0.05] in patients with open operation, while the intraoperative blood loss in the two groups was not significantly different [(190.6±45.7)ml vs. (212.5±50.4)ml, P＞0.05]; one week after operation, serum ALT, AST and GGT levels in patients receiving laparoscopic operation were (33.5±6.8)U/L, (43.1±7.4)U/L and (56.0±8.4)U/L, much lower than [(39.7±5.2)U/L, (50.8±8.2)U/L and (64.2±8.8)U/L, respectively, P<0.05] in patients receiving open operation; the incidence of postoperative complications, such as incision or abdominal infection, biliary leakage, ascites and pneumonia between the two groups was not statistically significantly different (4.4% vs. 12.1%, P>0.05). Conclusion The application of complete laparoscopic left hemihepatectomy with left hepatic pedicle occlusion is a safe and feasible operation in the treatment of patients with intrahepatic and extrahepatic bile duct stones.

Objective The aim of this study was to analyze the diagnostic performance of high-frequency and color Doppler ultrasonography in judging the benign and malignant gallbladder polyps. Methods 71 patients with polypoid lesions of gallbladder (PLG) were encountered in our hospital between April 2019 and April 2022, and all patients underwent HD11-type high-frequency and SONOLINE Premier color Doppler ultrasonography. All patients received laparoscopic cholecystectomy (LC) and histopathological examination was performed after operation. Results Out of the 71 patients with PLG, the histopathological examination showed that the benign lesions were found in 67 cases and the adenocarcinoma was found in 4 cases; the high-frequency and color Doppler ultrasonography demonstrated the benign gallbladder polyps in 66 cases(98.5%), and that was 64 cases (95.5%) by high-frequency ultrasonography or 63 cases (94.0%) by color Doppler ultrasonography(P>0.05); the sensitivity, specificity and accuracy were 98.5%, 100.0% and 98.6% by the high-frequency and color Doppler ultrasonography combination detection with the Kappa of 0.881, much excellent compared to 95.5%, 75.0% and 94.4% by high-frequency ultrasonography (Kappa=0.571) or 94.0%, 75.0% and 93.0% by color Doppler ultrasonography (Kappa=0.510). Conclusion The combination of high-frequency and color Doppler ultrasonography in diagnosing gallbladder polyps is efficacious, which could guide the clinicians to make an appropriate decisions.

Objective At present, the artificial intelligence (AI) has been widely used in many fields, and it also applied in medical diagnosis and treatment. In this paper, we mainly reviewed the AI research on the diagnosis, management and prognosis of patients with in liver diseases, in order to provide more effective measures. Finally, the future development of AI in the field of liver disease study is prospected.

Objective With the wide application of biologics, the hepatitis B virus (HBV) reactivation have been increasingly become a problem. The patients with HBV reactivation may suffer from liver failure, which might lead to death. The screening, prophylactic antiviral therapy and surveillance for the patients at a risk of HBV reactivation have become the consensus of major related guidelines. In this article, we reviewed the population risk stratification, mechanism by which the HBV reactivated, and the prophylactic antiviral agents.

Objective Primary biliary cholangitis(PBC)is characterized by a chronic autoimmune intrahepatic cholestasis,and autoimmune hepatitis (AIH) is a liver parenchymal inflammation mediated by autoimmune reaction. When the two entities coexist in a given patient, we call it "PBC-AIH overlap syndrome (PBC-AIH OS)". The prevalence of PBC-AIH OS is low, but it progresses faster and has a poorer prognosis. The clinical diagnosis and the choice of treatment are still challenging. Therefore, in this article, we reviewed the latest progress in the definition, epidemiology, clinical features, diagnosis, treatment and prognosis of patients with PBC-AIH OS, in order to help the appropriate diagnosis and treatment of the disease.

In order to standardize the diagnosis, treatment and management of esophagogastric variceal bleeding (EVB) in cirrhotic portal hypertension, the Chinese Society of Hepatology, Chinese Society of Gastroenterology, and Chinese Society of Digestive Endoscopology of Chinese Medical Association organized relevant experts, revieweddomestic and international latest progress in clinical research on EVB in cirrhotic portal hypertension, and followed the evidence of evidence-based medicine toupdate the Guidelines on the Management of EVB in Cirrhotic Portal Hypertension. The guidelineprovides recommendations for the diagnosis, treatment and management of EVB in cirrhotic portal hypertension and aims to improve the level of clinical treatment of EVB in cirrhotic portal hypertension.