Objective The purpose of this experiment was to investigate the effects of Notch inhibitor (DAPT) on cellular inflammatory factors and lipid related genes in L02 cells in vitro. Methods The steatosis of L02 cells was established by palmitic acid (PA) incubation in vitro, and also intervened by DAPT at 0μM, 1μM, 2μM, 5μM and 10 μM concentration. The cell survival rate was detected by CCK-8,the cell lipid droplets was observed by nile red staining, and the cellular TNF-α, IL-1 β and IL-6 mRNA and fat related factors [sterol regulatory element-binding protein 1c (SREBP1c), FASN and ACACA] mRNA loads were detected by RT-qPCR. The cell p65 and SREBP1c expression was detected by Western blot. Results The cell survival rates of L02 cell without PA intervention at 1μM, 2μM, 5μM and 10 μM DAPT incubation for 24 h were all decreased compared to in the control(85.2±5.3%, 84.6±2.9%, 84.4±6.0% and 84.5±3.2% vs. 100.0%, respectively, P<0.05); in 2 μM and 5 μM DAPT-intervened cells, the TNF-α mRNA levels were (0.6±0.01) and (0.5±0.09),significantly lower than in the control [(1.0±0.0), P<0.01], the IL-1 β mRNA levels were (0.7±0.2) and (0.4±0.0), significantly lower than [(1.1±0.1), P<0.01] in the control, and the IL-6 mRNA levels were (0.8±0.1) and (0.6±0.1), significantly lower than [(1.0±0.0), P<0. 05] in the control group; the p65 expression showed also remarkably decreased (P<0.05); the lipid droplets in 2 μM, 5 μM and 10 μM DAPT-intervened cells were significantly weaker than in the control group [(0.2±0.1), (0.3 ±0.0), (0.1 ±0.0) vs. (0.73±0.0), P<0.001], the FASN mRNA loads in 2 μM and 5 μM DAPT-intervened cells were (0.7±0.0) and (0.4±0.1), much lower than [(1.0±0.0), P<0.001] in the control group, and the ACACA mRNA load in 2 μM and 5 μM DAPT-intervened cells were (0.6±0.1) and (0.3±0.0), much lower than [(1.0±0.0), P<0.001] in the control group; the expression of SREBP1c protein at 5 μM and 10 μM DAPT-intervened cells was significantly weaker than in the control group (P<0.01). Conclusion The DAPT could effectively inhibit the expression of inflammatory factors and ameliorate the formation of intracellular lipid droplets in L02 cells with PA-induced steatosis in vitro, hinting the mechanism might be related to the regulation of fat-related factors. Our findings suggest that the inhibition of Notch signal pathway might have a potential to alleviate the occurrence and progression of cell steatosis.

Objective The aim of this study was to explore the evaluation of liver fibrosis by liver stiffness measurement (LSM) revealed by sound touch elastography (STE) and sound touch quantify (STQ) in patients with chronic hepatitis B (CHB). Methods 126 patients with CHB were enrolled in our hospital between January 2020 and December 2022, and all underwent routine liver biopsy. The non-significant liver fibrosis (NSLF) was defined as liver fibrosis at stages F0 and F1, and the significant liver fibrosis (SLF) was defined as liver fibrosis at stages F2, F3 and F4. The LSM was detected by STE and STQ. The blood routine and serum biochemical parameters were routinely obtained, and the fibrosis index based on the four factors (FIB-4) and aspartate aminotransferase /platelet ratio index (APRI) were calculated. The influencing factors of liver fibrosis severity were analyzed by multivariate Logistic regression analysis, and the diagnostic efficacy for the severity of liver fibrosis was evaluated by the area under receiver operating characteristic (ROC) curve (AUC). Results Out of the 126 patients with CHB, the liver histopathological examination showed liver fibrosis at stage F0 in 7 cases, F1 in 38 cases, F2 in 42 cases, F3 in 34 cases and F4 in 5 cases, e.g., the NSLF in 45 cases and SLF in 81 cases; the LSM_STE, LSM_STQ, FIB-4 and APRI in patients with SLF were (13.6±3.4)kPa,(16.8±4.5)kPa, (2.0±0.5) and (1.1±0.3), all significantly greater than [(9.2±2.3) kPa, (10.7±3.1)kPa, (1.4±0.3) and (0.7±0.2), respectively, P＜0.05] in patients with NSLF; the multivariate Logistic regression analysis showed that the LSM_STE, LSM_STQ, FIB-4 and APRI were all the independent risk factors impacting the existence of SLF in patients with CHB (P＜0.05); the ROC analysis demonstrated that the cut-off-value, the AUCs, the sensitivity (Se) and specificity(Sp) by LSM_STE and LSM_STQ in predicting the occurrence of SLF in patients with CHB were 11.6 kPa, 0.867, 76.5% and 86.7%, and 14.8 kPa, 0.856, 70.4% and 86.7%, all much superior to 1.8, 0.753, 60.5% and 80.0% (P＜0.05) by FIB-4 or 1.0, 0.736, 59.3% and 77.8% (P＜0.05) by APRI. Conclusion The detection of SLM obtained by STE and STQ might help evaluate the severity of liver fibrosis in patients with CHB, and warrants further clinical investigation.

Objective The aim of this study was to explore the correlation of liver Young's modulus by two-dimensional shear wave elastography (SWE) and alkaline phosphatase (ALP)/platelet (PLT) ratio to liver fibrosis in patients with chronic hepatitis B (CHB). Methods 120 patients with CHB were admitted to the Provincial People's Hospital, Inner Mongolia Autonomous Region between May 2019 and May 2022, and all patients underwent liver biopsy. The liver Young's modulus was obtained by ultrasonography, and serum ALP and whole blood PLT counts were detected routinely. The correlation of ALP / PLT ratio and Young's modulus to liver fibrosis was determined by Spearman correlation analysis. Results Out of the 120 patients with CHB, the liver histopathological examination showed F0/F1 stage in 38 cases(31.7%), F2 stage in 32 cases(26.7%), F3 stage in 32 cases(26.7%) and F4 stage in 18 cases (15.0%); serum ALP, blood PLT counts, ALP/PLT ratio and Young's modulus in patients with F4 were (197.1±39.7)U/L, (114.2±35.1)×10⁹/L, (1.7±0.3) and (11.7±1.7)kPa, all significantly different compared to [(180.9±43.8)U/L, (137.1±38.6)×10⁹/L, (1.3±0.4) and (8.6±1.5) kPa, respectively, all P＜0.05] in patients with F3 or [(162.7±41.1)U/L,(154.6±39.8)×10⁹/L,(0.9±0.2) and (6.4±1.0)kPa, respectively, all P＜0.05] in patients with F2 or [(150.5±36.4)U/L, (181.7±37.2)×10⁹/L, (0.7±0.2) and (5.3±1.1)kPa, respectively, all P＜0.05] in patients with F0/F1; the Spearman analysis showed that the Young's modulus and ALP/PLT ration in patients with CHB were positively correlated to liver fibrosis staging (r=0.79, P＜0.05; r=0.75, P＜0.05). Conclusion The Young's modulus and ALP / PLT ratio in patients with CHB are correlated to liver fibrosis, which might help predict the liver fibrosis staging and warrants further clinical investigation.

Objective The purpose of this study was to investigate the impact of hyperuricemia on virological response to sofosbuvir/daratavir therapy in patients with chronic hepatitis C (CHC). Methods 200 patients with CHC, including 38 patients with hyperuricemia, were recruited in our hospital between June 2018 and June 2023, and all received sofosbuvir/daratavir therapy for 24 weeks. The patients with CHC were followed-up for 24 weeks after discontinuation of the antiviral treatment. Results The body mass index, serum triglyceride level and the controlled attenuation parameter of liver in patients with hyperuricemia were (26.9±3.5)kg/m², (2.8±0.5)mmol/L and (273.5±15.3)dB/m, all significantly higher than (24.2±2.5)kg/m²,(1.9±0.6)mmol/L and (236.8±16.1)dB/m, respectively, P<0.05] in 162 patients with normal serum uric acid levels; the rapid virological response (RVR) and early virological response (EVR) in patients with hyperuricemia were 78.9% and 84.2%, both significantly lower than 96.9% and 100.0% (P<0.05) in patients with normal serum uric acid levels, while there were no significant differences as respect to the end of treatment virological response (94.7% vs. 100.0%) and the sustained virological response (97.4% vsl 100.0% (P>0.05) between the two groups; generally, serum uric acid levels in 16 male and 22 female patients with hyperuricemia at presentation decreased at the end of antiviral treatment, and the percentages of patients with decreased serum uric acid levels was 93.7% in male and 72.7% in female patients. Conclusion The hyperuricemia in patients with CHC might interfere with the early virological response to direct acting agent therapy, but do not impact the sustained virological response, and serum uric acid levels in most patients with hyperuricemia will return to normal.

Objective The aim of this study was to investigate the twenty-four month follow-up efficacy for patients with chronic hepatitis C (CHC) after sustained virological response (SVR) to different direct-acting antiviral agents (DAAs) treatment regimen. Methods 123 patients with CHC were enrolled in our hospital between January 2018 and December 2020, and were divided into three groups, receiving sofosbuvir/velpatasvir (SOF/VEL) in 52 cases, elbasvir/grazoprevir (EBR/GZR) in 43 cases, and ledipasvir/sofosbuvir (LDV/SOF) in 28 cases. The antiviral regimen lasted for 12 weeks and all patients were followed-up for 24 weeks. Serum HCV RNA loads were detected by real-time fluorescence quantitative RT-PCR. The rapid virological response (RVR), early virological response (EVR), end of treatment virological response (ETVR) and SVR were recorded in three groups. Results The RVR in SOF/VEL-, EBR/GZR- and LDV/SOF-treated patients were 96.2%, 93.0% and 92.9%, the EVR were 98.1%, 97.7% and 96.4%, the ETVR and SVR in all patients were 100.0%, not significantly different among the three groups ( all P＞0.05); during the treatment, the incidences of untoward effects, such as nausea, fatigue and dizziness, in the three groups were 13.5%, 11.6% and 21.4%, not significant different among them (P＞0.05); 7, 7 and 5 patients with SVR in the three groups lost, all other patients with SVR were followed-up for 24 months, and no relapse or liver cancer were found. Conclusion All the antiviral regimen, with different DAAs have good efficacy as HCV GT1b infection is common in China, and no relatively long-term relapse.

Objective The aim of this study was to observe the efficacy of liraglutide and atorvastatin calcium combination in the treatment of patients with nonalcoholic fatty liver diseases (NAFLD) with abnormal glucolipid metabolism. Methods 86 patients with NAFLD and abnormal glucolipid metabolism were enrolled in our hospital between January 2020 and December 2022, and were randomly divided into control (n=43) and observation group (n=43). The patients in both groups were given liraglutide treatment and those in the observation were treated by liraglutide and atorvastatin calcium combination for 12 weeks. The blood biochemical indicators, the liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) of liber were routinely detected. The visceral adiposity index (VAI) and the lipid accumulation product index (LAP) were calculated. Results At the end of 12 week of treatment, serum alanine aminotransferase, gamma-glutamyltransferase, LSM and CAP in the observation group were (32.8±4.9)U/L, (32.7±5.4)U/L, (5.0±0.9)kPa and (245.7±18.2)dB/m, all significantly lower than [(36.4±4.2)U/L,(39.0±5.1)U/L,(6.0±0.8)kPa and (268.9±19.1)dB/m, respectively, P<0.05] in the control; the VAI and LAP were (102.2±9.1) and (55.7±7.0), both significantly lower than [(118.3±10.5) and (62.0±6.7), respectively, P<0.05] in the control; serum total cholestero, triglyceride and low-density lipoprotein cholesterol levels were(4.8±0.8)mmol/L,(1.6±0.3)mmol/L and (2.7±0.4)mmol/L, all much lower than [(5.5±0.9)mmol/L, (2.8±0.3)mmol/L and (4.1±0.6)mmol/L, respectively, P<0.05], while serum high-density lipoprotein cholesterol level was (1.3±0.3)mmol/L, much higher than [(1.1±0.2)mmol/L, P<0.05] in the control group. Conclusion The administration of liraglutide and atorvastatin calcium combination in the treatment of patients with NAFLD with abnormal glucolipid metabolism could modulate the disordered glucolipid metabolism, alleviate the liver steatosis, and reduce the visceral fat accumulation, and the long-term efficacy needs further observation.

Objective This study was conducted to investigate the prevalence of non-alcoholic fatty liver diseases (NAFLD) and compensated advanced chronic liver disease (cACLD) in patients with type 2 diabetes mellitus (T2DM). Methods The patients with T2DM from 5 communities in Xingtai City were surveyed between July and September 2021, and an well-designed questionnaires were applied to record the height, body weight, blood pressure, blood glucose and blood lipids, and the liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were performed by using FibroScan© elastography. The binary Logistic regression analysis was applied to reveal the risk factors of severe NAFLD. Result This study included 946 patients with T2DM in five communities, and the female accounted for 64.5%, much higher than 35.5% in male (P<0.05); the concomitant NAFLD was found in 664 cases (70.2%), including severe in 334 cases (50.3%), moderate in 198 (29.8%) and mild in 132 cases (19.9%); the concomitant cACLD was found in 94 cases (9.9%), and the percentages of cACLD in normal body weight, overweight and obese individuals were 6.1%, 10.5% and 17.6%; the univariate Logistic regression analysis showed that the overweight, obesity, hyperlipidemia, coronary heart disease, and diabetic courses were different between persons with severe NAFLD and those without(P<0.05), and the overweight, obesity, hyperlipidemia, coronary heart disease were different in patients with cACLD and those without (P<0.05); the binary Logistic regression analysis showed that the body mass index was the independent risk factor impacting the concomitant existence of NAFLD in patients with T2DM (P<0.05). Conclusion The prevalence of NAFLD in our series of patients with T2DM is high, and the concomitant cACLD is also reached to 9.9%, which should be appropriately dealt with.

Objective This study was conducted to investigate the diagnostic performance of ultrasound attenuation parameter (UAP) combined with serum plasminogen activator inhibitor-1 (PAI-1) and alanine aminotransaminase (ALT) levels in evaluating severe hepatic steatosis in patients with metabolic associated fatty liver disease (MAFLD). Methods 112 patients with MAFLD were admitted to our hospital between March 2019 an December 2022, and all patients underwent liver biopsy and transient elastography for UAP detection. Serum PAI-1 level was measured by ELISA. The diagnostic efficacy was analyzed by using the receiver operating characteristic (ROC) curve. Results Out of the 112 patients with MAFLD, the liver histopathological examination showed mild liver steatosis in 45 cases, moderate in 42 cases and severe in 25 cases; the BMI, serum TC, TG and LDL-C levels in patients with severe liver steatosis were (32.6±2.4)kg/m², (6.6±0.9)mmol/L, (4.6±1.4)mmol/L and (4.0±0.9)mmol/L, significantly higher than [(27.6±1.9)kg/m², (5.8±0.8)mmol/L, (3.5±0.9)mmol/L and (3.5±0.7)mmol/L, respectively, P<0.05] in patients with moderate or [(24.1±0.9)kg/m², (5.1±0.7)mmol/L, (2.2±0.7)mmol/L and (3.0±0.5)mmol/L, respectively, P<0.05] in mild, while serum HDL-C level was (1.2±0.2)mmol/L, significantly lower than [(1.4±0.2) mmol/L, P<0.05] in moderate or [(1.4±0.2)mmol/L, P<0.05] in mild liver steatosis; the UAP, serum PAI-1 and ALT level in patients with severe steatosis were (312.7±32.6)dB/m, (36.5±4.2)mg/mL and (72.1±7.4)U/L, much higher than [(284.2±30.1)dB/m, (28.1±3.4)mg/mL and (36.3±4.1)U/L, P<0.05] in moderate or [(257.4±26.4)dB/m, (20.4±2.4)mg/mL and (23.7±2.5)U/L, P<0.05] in mild steatosis; the ROC analysis showed that the AUC, sensitivity (Se) and specificity (Sp) were 0.914(95%CI:0.883-0.990), 89.6% and 93.3%, with the Sp superior to any single parameter evaluation (P<0.05) by the combination of UAP and serum PAI-1 and ALT level in predicting severe liver steatosis. Conclusion We recommend the combination of UAP and serum PAI-1 and ALT level in predicting severe hepatic steatosis in patients with MAFLD, which might provide a scientific clue for clinical management.

Objective The aim of this study was to explore the diagnostic efficacy of real-time tissue elastography (RTE) in evaluating the liver fibrosis in patients with non-alcoholic steatohepatitis (NASH). Methods 159 patients with non-alcoholic fatty liver diseases (NAFLD), including simple fatty liver (SFL) in 89 cases, NASH in 47 cases and liver cirrhosis (LC) in 23 cases, and 53 healthy persons at physical examination were enrolled in our hospital between June 2021 and June 2022, and all underwent RTE examination. All patients with NAFLD received liver biopsies. The area under the receiver operating characteristic curve (AUROC) was applied to predict the diagnostic performance. Results The relative strain value in patients with LC was (94.3±13.5), significantly lower than [(105.2±20.6), P<0.05] in patients with NASH or [(115.1±9.8), P<0.05] in patients with SFL or [(121.3±17.1), P<0.05] in healthy control, but the percentage of blue area, complexity, measure skewness, contrast and clutter were(25.9±4.3)%, (38.5±4.2), (0.6±0.1), (241.0±30.5) and (0.4±0.1), all significantly higher than [(21.2±4.1)%, (31.9±3.7), (0.4±0.1), (191.3±27.9) and (0.2±0.1), P<0.05] in patients with NASH or [(16.2±1.9)%, (25.1±3.5), (0.3±0.1), (153.0±19.8) and (0.1±0.1), P<0.05] in patients with SFL or [(9.2±1.5)%, (19.5±2.4), (0.2±0.0), (113.5±20.3) and (0.1±0.0), P<0.05] in healthy persons; out the 47 patients with NASH, the histopathological examination showed liver fibrosis S0/S1 in 16 cases, S2 in 19 cases and S3 in 12 cases; the relative strain value in patients with S3 and with S2 were (101.2±7.9) and (106.7±10.3), significantly lower than [(112.5±9.8), P<0.05] in patients with S0/S1, while the percentage of blue area, complexity, measure skewness, contrast and clutter in patients with S3 were(23.1±3.4)%, (34.6±3.7), (0.4±0.1), (202.5±23.7) and (0.2±0.0), all significantly greater than [(19.8±2.5)%, (29.3±2.9), (0.3±0.1), (179.1±25.9) and (0.2±0.0), P<0.05] in patients with S2 or [(16.2±3.8)%, (25.9±3.5), (0.3±0.1), (152.8±21.1) and (0.1±0.1), respectively, P<0.05] in patients with S0/S1; the ROC analysis showed that the AUC was 0.977, with the sensitivity of 84.2%, the specificity of 66.7% and the accuracy of 77.4%, when the RTE parameters were synthetically applied to predict the significant and advanced liver fibrosis in patients with NASH. Conclusion The RTE parameters in deed has to some extent a diagnostic efficacy in predicting the significant and advanced liver fibrosis in patients with NASH, and needs further clinical investigation.

Objective The study was conducted to analyze the changes of thyroid functions and their impact on response to standardized therapy in patients with autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Methods 30 patients with AIH, 28 patients with PBC and 32 volunteers were recruited in our hospital between January 2020 and January 2022, and the patients with AIH or with PBC were treated by standardized immunosuppression or ursodeoxycholic acid therapy. Serum total-triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine T4 (FT4) and thyroid-stimulating hormone (TSH) levels were routinely detected. Serum anti-thyroglobulin antibodies (TRAb), thyroid-peroxidase antibody (TPO-Ab), anti-thyroglobulin antibodies (TGAb), thyroxine-binding globulin (TBG) and thyroglobulin (TG) were also determined by radioimmunoassay. Results Serum FT3 and FT4 levels in patients with AIH were (4.2±0.2)pmol/L and (13.8±1.9)pmol/L, and in patients with PBC were (4.3±0.3)pmol/L and (13.9±1.3)pmol/L, significantly lower than [(4.9±0.6)pmol/L and (15.9±4.2)pmol/L, respectively, P＜0.05], while serum TSH levels in patients with AIH and in with PBC were (3.8±1.2)mIU/L and (3.7±0.5)mIU/L, significantly higher than [(2.6±0.5)mIU/L, P＜0.05] in healthy volunteers; serum TPO-Ab and TG positive rates in patients with AIH were 33.3% and 26.7%, and in patients with PBC were 39.3% and 25.0%, all significantly higher than 9.4% and 3.1%(P＜0.05) in healthy individuals; at the end of one-year treatment, the response rates to treatment in patients with AIH was 66.7% and in patients with PBC was 75.0%; serum FT3 and FT4 levels in responders no matter in AIH or PBC were significantly higher than, while serum TSH levels as well as serum TPO-Ab and TG positive rates were much lower than in non-responders(P＜0.05). Conclusion The hypothyroidism could occur in patients with autoimmune liver diseases, which might influence the response to standardized therapy, and warrants clinical careful surveillance.

Objective This study was to observe the Kuhuang, a herbal injection compound, in preventing anti-tuberculosis drugs (ATD)-induced liver injury(DILI) for avoiding unreasonable anti-tuberculosis treatment interruption. Methods A total of 97 patients with naïve pulmonary tuberculosis were encountered in our hospital between March 2022 and November 2022, and were randomly divided into control (n=47) and observation (n=50) groups, receiving standardized 2HREZ/4HR anti-tuberculosis therapy, or intravenous injection of Kuhuang compound at base of anti-tuberculosis for 8 weeks. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected by ELISA, and serum heme oxygenase (HO-1) and superoxide dismutase (SOD) levels were detected by radioimmunoassay. Results At the end of 4 week anti-tuberculosis treatment, the incidences of adaptive liver injury (ALI) and DILI in the observation group were 6.0% and 2.0%, much lower than 17.0% and 8.5%(P＜0.05) in the control, and at the end of 8 week treatment, the incidences of ALI and DILI were 6.0% and 4.0%, much lower than 21.3% and 17.0%(P＜0.05) in the control group; at the end of 8 week treatment, serum ALT, AST and total bilirubin levels in the observation group were (28.4±23.4)U/L, (30.8±18.7)U/L and (12.9±7.3)μmol/L, all significantly lower than [(53.1±33.1)U/L, (52.5±37.7)U/L and (20.1±10.9)μmol/L, respectively, P＜0.05] in the control; serum HO-1 and SOD levels were (200.3±14.0)U/L and (418.0±18.7)U/L, both significantly higher than [(128.8±21.4)U/L and (318.0±15.1)U/L, P＜0.05], while serum IL-6 and TNF-α levels were (11.4±1.9)ng/L and (9.3±1.8)ng/L, both significantly lower than [(17.5±4.0)ng/L and (14.5±3.0)ng/L, respectively, P＜0.05] in the control. Conclusion The administration of Kuhuang injection compound could prevent the occurrence of anti-tuberculosis DILI, and guarantee the standardized anti-tuberculosis treatment completing.

Objective This study was conducted to investigate the clinical feature and gene mutation in patients with hepatolenticular degeneration (HLD). Methods 79 consecutive patients with HLD were encountered in our hospital between January 2017 and December 2022, and the basic clinical materials were retrieved. TheATP7B gene mutation was assayed by high throughput gene sequencing. Results There were 55 patients with hepatic, 12 with cerebral and 12 with mixed phonotypes in our series; the disease onset age of patients with hepatic phonotype was much younger than those with cerebral or mixed phonotypes(P<0.05), while the percentage of K-F ring in patients with cerebral phonotype was 100.0%, greatly higher than 45.5% in patients with hepatic or 66.7% in patients with cerebral phonotype(P<0.05); serum AST, ALT and ceruloplasmin levels in patients with hepatic phonotype were 83.7(52.8, 137.5)U/L, 83.6(33.2, 163.6)U/L and 0.12(0.083, 0.22)g/L, significantly higher than [29.6(21.3, 46.1)U/L, 27.5(18.9, 38.8)U/L and 0.031(0.011, 0.058)g/L, respectively, P<0.05] in patients with cerebral phonotype or [37.2(27.8, 56.4)U/L, 23.2(18.4, 45.0)U/L and 0.057(0.040, 0.096)g/L, respectively, P<0.05] in patients with mixed phonotype; the ATP7B gene mutation was found in 11 sites in our series, and the incidences of EX11, EX13/CDS13, EX16 and EX18 mutation in patients with mixed phonotype were 41.7%, 25.0%, 25.0% and 16.7%, significantly higher than 7.3%, 5.5%, 3.6% and 3.6%(P<0.05) in patients with hepatic or 8.3%, 8.3%, 8.3% and 0.0%(P<0.05) in patients with cerebral phonotype, while the incidences of EX13 and EX8 mutation in patients with hepatic phonotype were 34.5% and 7.3%, much higher than 16.7% and 0.0%(P<0.05) in patients with cerebral or 16.7% and 0.0%(P<0.05) in those with mixed phonotype. Conclusion The clinical features of patients with HLD varies, and the ATP7B gene mutation differs, which needs further foundational verification.

Objective The aim of this study was to investigate the pathogenic bacteria distribution and serum interferon-gamma (IFN-γ) and interleukin-6 (IL-6) level changes in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) complicated by bacterial infections. Methods 86 patients with HBV-ACLF were admitted to our hospital between December 2019 and January 2023, and the bacteria were isolated and identified routinely. Serum procalcitonin (PCT) level was detected by electrochemiluminescence immunoassay, and serum IFN-γ and IL-6 levels were assayed by ELISA. The diagnostic performance was evaluated by the area under the receiver operating characteristic (ROC) curve. Results 37 patients in our series were found having bacterial infection, and out of them, 68 pathogenic bacteria strains were characterized with Gram-negative bacteria infection in 41 strains and Gram-positive bacterial infection in 27 strains(39.7%); serum PCT, IFN-γ and IL-6 levels in patients with bacterial infection were (10.9±3.1)μg/L, (46.5±1.9)pg/mL and (16.9±1.6)pg/mL, all significantly higher [(0.9±0.1)μg/L, (20.1±2.4)pg/mL and (4.8±0.9)pg/mL, respectively, P＜0.05], and 28-day and 90-day fatality rates were 67.6% and 75.7%, both significantly higher than 8.2% and 12.2% (P＜0.05) in patients without bacterial infection; the ROC analysis showed that the AUC was 0.874, with the sensitivity of 93.6% and the specificity of 84.1%, when the combination of serum parameters was applied to predict bacterial infection as serum PCT＞3.3μg/L, serum IFN-γ＞45.5 pg/mL and IL-6＞15.4 pg/mL was set as the cut-off-value. Conclusion The distribution of pathogenic bacteria in patients with HBV-ACLF complicated by bacterial infections is characteristic, and the Gram-negative bacteria is the main common pathogenic bacteria. Besides serum PCT level, the surveillance of serum IFN-γ and IL-6 levels is helpful for early diagnosis of bacterial infection in this setting.

Objective This study was conducted to investigate the assessment of liver reserve functions by intra-voxel incoherent motion-diffusion weighted imaging (IVIM-DWI) and T1 mapping of Gd-EOB-DTPA enhanced MR scan in patients with hepatitis B-induced liver cirrhosis (LC). Methods Sixty patients with hepatitis B-induced LC were encountered in our hospital between March 2020 and March 2022, and all underwent indocyanine green 15 min retention detection and Gd-EOB-DTPA enhanced MR scan. The T1 relaxation times 20 minutes before and after enhancement were measured, and the hepatocyte enhancement fraction was calculated. The apparent diffusion coefficient (ADC) and the true water molecule diffusion coefficient (D) was automatically obtained by software Mltalytics 1.0.1. The diagnostic performance was evaluated by the receiver operating characteristic curve (ROC) analysis. Results Out of the 60 patient with hepatitis B-induced LC, the indocyanine green 15 min retention rates was found <10% in 30 case(group A), ≥10% but <30% in 16 case(group B) and ≥30% in 14 case (group C); the T1 relaxation times 20 minutes before and after enhancement in group C were (700.5±71.2) ms and (324.1±99.6)ms, much longer than [(612.2±28.3)ms and (148.3±51.9)ms, respectively, P＜0.05] in group A or [(682.5±73.1)ms and (256.2±88.1)ms, respectively, P＜0.05] in group B, while the ADC, the D and the hepatocyte enhancement fraction were (0.5±0.1)×10³, (0.5±0.1)×10³ and (50.2±11.6)%, all significantly lower than [(1.2±0.1)×10³, (1.0±0.4)×10³ and (80.8±10.9)%, P＜0.05] in group A or [(0.8±0.2)×10³, (0.7±0.2)×10³ and (59.4±19.7)%, P＜0.05] in group B; the ROC analysis showed that the T1 relaxation times 20 minutes before and after enhancement, ADC, D and hepatocyte enhancement fraction all had a promising diagnostic efficacy in assessing the liver reserve functions of patients with LC, with the sensitivities greater than 70.0% and the specificities greater than 76.7%. Conclusion The IVIM-DWI and T1 mapping parameters of MR is helpful in assessment of liver reserve functions in patients with LC, which might provide evidences for clinical decision-making.

Objective This study was conducted to explore the evaluation of esophageal varices (EV) by semi quantitative ultrasound scoring (SQUS) and elastography in patients with hepatitis B viral infection-induced liver cirrhosis (LC). Methods 116 patients with hepatitis B-induced LC were encountered in our hospital between April 2020 and April 2023, and all patients underwent esophagogastroscopy as the gold standard for the diagnosis of EV. Simultaneously, the SQUS was evaluated by ultrasonography, and the liver stiffness measurement (LSM) was detected by transient elastography. The multivariate Logistic regression analysis was applied to reveal the risk factors and the area under the receiver operating characteristic curve was applied to evaluate the diagnostic performance. Results Out of our series, the esophagogastroscopy found patients with EV in 72 cases (62.1%), including mild EV in 30 cases (41.7%), moderate in 24 cases (33.3%) and severe in 18 cases (25.0%); the SQUS in 42 patients with moderate/severe EV was (13.2±1.6), much higher than [(11.7±1.3), P＜0.05] in patients with mild EV or [(10.4±1.2), P＜0.05] in individuals without EV; the LSM in patients with moderate/severe EV was (23.9±4.2)kPa, significantly greater than [(18.1±3.7)kPa, P＜0.05] in patients with mild EV or [(13.6±2.1)kPa, P＜0.05] in individuals without EV; the Logistic regression analysis showed that the SQUS and LSM were both the independent risk factors for the occurrence of moderate/severe EV (P＜0.05); the ROC analysis demonstrated the sensitivity and specificity were 78.6% and 83.8%, respectively, when the SQUS and LSM was combined in predicting the moderate/severe EV, much superior to any parameter did alone(P＜0.05). Conclusion The diagnostic efficacy of SQUS and LSM combination in predicting the severity of EV in patients with LC is promising, and warrants further clinical investigation.

Objective The aim of this study was to observe the efficacy of terlipressin treatment after endoscopic variceal ligation (EVL) in the treatment of patients with liver cirrhosis (LC) complicated by esophageal and gastric variceal bleeding (EGVB). Methods 89 patients with LC and complicated EGVB were enrolled in our hospital between December 2018 and July 2022, and were divided into control (n=45) and observation group (n=44 cases). All patients underwent EVL, and those in the observation group were treated with intravenous terlipressin for three days after EVL. The cardiac output (CO), cardiac index (CI), portal venous flow (PVF) and esophageal variceal diameter (EVD) were detected by color Doppler ultrasonography. Serum motilin, gastrin and somatostatin levels were determined by ELISA and serum malondialdehyde (MDA), lipid hydrogen peroxide (LHP) and glutathione peroxidase (GSH-Px) levels were detected by radioimmunoassay. Results During the treatment period, three patients (6.8%) in the observation and nine patients (20.0%) died of hemorrhagic shock; at day three after admission, the CI, EVD and PVF in 41 patients in the observation were (3.0±0.6)L/(min.m²),(3.3±0.6)mm and (3.4±0.6)L/min, all significantly smaller than [(3.5±0.6)L/(min.m²), (4.5±0.9)mm and (4.1±0.6)L/min, respectively, P<0.05] in 36 patients in the control; serum motilin, gastrin and somatostatin levels in the observation group were (207.5±25.1)ng/L,(82.4±8.6)ng/L and (11.9±1.5)ng/L, much lower than [(241.1±24.8)ng/L, (98.0±8.2)ng/L and (16.8±1.3)ng/L, P<0.05] in the control; serum MDA and LHP levels were (22.0±4.3)μmol/L and (9.7±2.4)μmol/L, both significantly lower than [(31.8±4.2)μmol/L and (14.4±2.6)μmol/L, P<0.05], while serum GSH-Px level was (29.7±3.6)U/ml, much higher than [(20.8±4.0)U/ml, P<0.05] in the control; at the end of six month follow-up, the re-bleeding occurred in one case (2.4%) in the observation, much lower than 7 cases (19.4%, P<0.05) in the control, while there was no significant difference as respect to relapse of varies between the two groups (4.9% vs. 19.4%, P>0.05). Conclusion The administration of terlipressin after EVL in the treatment of patients with LC and EGVB could reduce the rebleeding rate and recurrence of varies, which might be related to the improvement of hemodynamics, inhibition of gastrointestinal hormone secretions and relief of oxidative stress response.

Objective The purpose of this study was to investigate the risk factors of spontaneous bacterial peritonitis (SBP) and peripheral blood mononuclear cell (PBMC) cluster of differentiation (CD) 36/mammalian target of rapamycin 1 (mTORC1) signal pathway expression in patients with decompensated cirrhosis. Methods 82 patients with decompensated liver cirrhosis were encountered in our hospital between July 2020 and December 2023. Ascites bacteria was cultured and characterized routinely. The PBMCs were separated and the CD36/mTORC1 mRNA was detected by real-time fluorescent quantitative PCR. The multivariate Logistic regression analysis was applied to screen the risk factors for SBP occurrence in patients with decompensated cirrhosis. Results The complications of SBP was found in 43 cases out of our patients with decompensated liver cirrhosis and eight strains (9.8%)of bacteria were successfully isolated, including one strain of Staphylococcus coriolis, one strain of Hemolytic Staphylococcus, two strains of Escherichia coli, two strains of Klebsiella pneumonia and two strains of Enterobacter cloacae; the incidence of past SBP, serum total bilirubin, albumin, international normalized ratio, the model of end-stage liver disease score, the PBMC CD36 mRNA and mTORC1 mRNA in patients with SBP were 51.2%, (45.7±5.2)μmol/L, (21.7±3.1)g/L, (1.5±0.5), (24.9±7.5), (3.2±0.8) and (2.4±0.7), all significantly different compared to [18.0%,(12.3±1.4)μmol/L, (35.3±5.4)g/L, (1.2±0.3), (12.8±3.7), (1.4±0.5) and (1.1±0.4), respectively, P<0.05] in patients with liver cirrhosis; the multivariate Logistic regression analysis showed that the past SBP, serum bilirubin, albumin, MELD score as well as PBMC CD36 and mTORC1 levels were all the independent risk factors for the occurrence of SBP in patients with decompensated liver cirrhosis (P＜0.05). Conclusion The PBMC CD36/mTORC1 signal pathway is up-regulated in patients with decompensated cirrhosis and complicated SBP, and the mechanism involved in the pathogenesis needs further investigation.

Objective The aim of this study was to explore the implications of hepatic homeobox gene C9 (HOXC9) and kinesin family member 4A (KIF4A) protein expression in patients with hepatocellular carcinoma (HCC). Methods 86 patients with HCC were enrolled in our hospital between January 2018 and January 2021, and all underwent hepatectomy. The patients with HCC were all followed-up for two years after operation. The cancerous and the adjacent non-cancerous tissues were collected, and the protein expressions of HOXC9 and KIF4A in tissues were detected by immunohistochemical staining. Results The intensified expression rates of HOXC9 and KIF4A in cancerous tissues were 69.8% and 51.2%, both significantly higher than 15.1% and 16.3% in adjacent liver tissues (P<0.05); the intensified expression rates of HOXC9 in 56 patients with low/moderate tumor cell differentiation, in 40 patients withⅡb/Ⅲb stages, in 38 patients with tumor capsule invasion and 37 patients with microvascular invasion were 78.6%, 85.0%, 71.1% and 83.8%, all significantly higher than 53.3%, 56.5%, 47.9% and 59.2% (P<0.05) in 30 patients with high tumor cell differentiation, in 46 patients with Ⅰa/Ⅱa stages, in 48 patients without tumor capsule invasion and in 49 patients without microvascular invasion; the intensified expression rates of KIF4A in low/moderate tumor cell differentiation, Ⅱb/Ⅲb stages, with tumor capsule invasion and microvascular invasion were 60.7%, 80.0%, 60.5% and 89.2%, also significantly higher than 33.3%, 26.1%, 43.8% and 22.4% (P<0.05) in their parallel adjacent non-cancerous tissues; at the end of two-year follow-up, 38 patients(44.2%)survived and 48 patients (55.8%) died; the overall survivals (OS) in 60 patients with intensified cancerous HOXC9 expression was 14.0(7.8, 26.7)mon, much shorter than [27.0(18.8, 30.5)mon, P<0.05] in 26 patients with weak HOXC9 expression; the OS in 44 patients with intensified cancerous KIF4A expression was 9.0(7.0, 26.3)mon, also significantly shorter than [15.3(26.0, 28.8) mon, P<0.05] in 42 patients with weak HOXC9 expression. Conclusion The upregulation of cancerous HOXC9 and KIF4A in patients with HCC might be correlated to the malignant quality of tumor cells, and to the poor prognosis.

Objective The aim of this study was to compare the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) and enhanced CT scan in patients with small hepatocellular carcinoma (sHCC). Methods 104 patients with intrahepatic nodules with diameter of less than 3.0 cm were encountered in our hospital between January 2020 and June 2022, and all underwent CEUS and enhanced CT scan. The gold diagnostic criteria was based on fine needle aspiration biopsies and/or histopathological examination after operation. The 2018 edition Liver Imaging Reporting and Data System (LI-RADS) was applied to classify the hepatic nodules, and the diagnostic efficacy of CEUS and enhanced CT scan was compared by Kappa coefficient. The differences in CEUS quantitative parameters including initial enhancement time, peak time and initial clearance time was compared too. Results The classification of CEUS and enhanced CT scan was consistent in 93 cases (89.4%) in patients with intrahepatic nodules, showing a good consistency (Kappa coefficient=0.749, P<0.05); there were 42 cases with sHCC (including highly differentiated in 29 cases and poorly differentiated in 13 cases) and 62 cases with small benign hepatic nodules among our 104 patients finally confirmed by pathological examination; the Kappa consistency test showed that both the CEUS and enhanced CT scan had good diagnostic efficacy in diagnosing sHCC (P<0.05), and the diagnostic consistencies of CEUS and enhanced CT scan with gold criteria were good when the LR-4/LR-5 was defined as HCC(Kappa=0.861 and Kappa=0.803),suggesting the CEUS was relatively superior to CT scan; the peak time and initial clearance time in patients with highly-differentiated sHCC were(29.4±4.8)s and (62.4±5.7)s, both significantly longer than [(25.0±4.3)s and (51.8±5.2)s, respectively, P<0.05] in those with poorly-differentiated patients. Conclusion Both the CEUS and enhanced CT scan have a good diagnostic efficacy in diagnosing sHCC, and the CEUS might be superior under certain circumstance, which provide more information for tumor classification.

Objective The aim of this study was to investigate the risk factors for microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Methods 206 patients with HCC were encountered in our hospital between March 2018 and March 2022, and all underwent MRI and hepatectomy. The MVI was diagnosed by histopathology. The univariate and multivariate Logistic regression analysis were applied to predict the existence of MVI in patients with HCC. Results Out of the 206 patients with HCC, the MVI was found in 50 cases (24.3%); there were no significant differences as respect to serum AFP levels, Child-Pugh classes and the tumor envelope intact or not between patients with and without MVI(P>0.05), while the percentages of tumor diameter ≥5 cm and low tumor cell differentiation in patients with MVI were 56.0% and 58.0%, both much higher than 32.7% and 35.3% (P<0.05) in patients without MVI; the multivariate Logistic regression analysis showed that the tumor diameter ≥5 cm and low tumor cell differentiation were the independent risk factors for the existence of MVI in patients with HCC (OR=1.166, OR=1.141, bot P<0.05). Conclusion The large tumor and low differentiation of tumor cells are the independent risk factors of MVI happening in patients with HCC, and the preoperative imaging could help determine the size of tumors, and thus make the therapeutic strategy.

Objective This clinical trial was conducted to investigate the efficacy of camrelizumab and apatinib combination in the treatment of patients with advanced hepatocellular carcinoma (HCC). Methods A total of 117 patients with advanced HCC were admitted to the first affiliated Hospital of Xinjiang Medical University between June 2019 and October 2021, and 65 patients were treated with camrelizumab and apatinib combination, and 52 patients were treated by apatinib alone. All patients were followed-up for one year. The therapeutic efficacy was evaluated according to mRECIST, the progression-free survival (PFS) and its influencing factors were analyzed by Kaplan-Meier method, and the prognostic factors of PFS were analyzed by multivariate COX regression. Results The objective remission rate (ORR) and the disease control rate (DCR) in patients with combination treatment were 44.7% and 66.2%, both significantly greater than 15.4% and 42.3% in the apatinib-treated patients (P<0.05); at the end of three-month treatment, the blood platelet count in patients with combination treatment was 81.0(51.5, 145.5)×10⁹/L, much lower than [107.0(69.5, 191.0)×10⁹/L P<0.05] in patients with apatinib treatment alone; the PFS in patients with combination treatment was 10.6 (95%CI:9.986-11.16) months, significantly longer than 7.9 (95%CI:6.84-8.944) months in the apatinib-treated group (Log-rank=12.807,P<0.05); the performance status (PS), Child-Pugh score, CNLC stage, liver cirrhosis, portal vein tumor thrombus and transarterial chemoembolization (TACE) were the prognostic factors impacting PFS, and the multivariate COX regression analysis showed that the Child-Pugh grade B (HR=2.379,P=0.021) and portal vein tumor thrombus (HR=3.481,P=0.003) were the independent risk factors for PFS, while the TACE (HR=0.528, P=0.034) was an independent protective factor for PFS in patients with advanced HCC. Conclusion The combination of camrelizumab and apatinib in treating patients with advanced HCC could effectively improve the clinical efficacy, with an obvious prolonged survival period. For patients with high tumor load, the auxiliary TACE might help raise better clinical benefits.

Objective The aim of this study was to investigate different hepatic inflow occlusion techniques during laparoscopic hepatectomy (LH) in treatment of patients with primary liver cancer (PLC). Methods A total of 132 patients with PLC were encountered in our hospital between February 2021 and November 2022, and all underwent LH. They were divided into observation (n=69), and control group (n=63), received regional hepatic inflow occlusion or intermittent total hepatic inflow occlusion during LH. The heart rate (HR) and mean arterial pressure (MAP) were routinely measured, and the portal vein peak velocity (VPV) was detected by ultrasonography. Results There was no significant differences as respect to blood transfusion rate, operation time and hospitalization stay [15.9%, (240.3±42.9) min and (14.7±2.3) d vs. 19.1%, (231.7±39.5) min and (15.0±2.9) d, P>0.05] between the observation and control group, while the hepatic flow occlusion time in the observation group was significantly shorter than that in the control group [(0.0±0.0) min vs. (26.8±7.1) min, P<0.05], and the intraoperative blood loss was significantly less than that in the control group [(301.2±52.5) mL vs. (369.8±59.4) mL, P<0.05]; there was no significant differences between the two groups respect to the HR, MAP and PVV [(79.1±7.2) beats/min, (80.7±3.6) mmHg and (21.3±2.0) cm/s vs. (78.9±6.8) beats/min, (81.9±4.1) mmHg and (20.9±1.9) cm/s, P>0.05] at day seven after surgery; serum total bilirubin level in the observation group was significantly lower than that in the control group [(18.4±3.5) μmol/L vs, (24.9±5.7) μmol/L, P<0.05], while serum albumin level was significantly higher than that in the control group [(35.3±5.4) g/L vs. (32.0±4.6) g/L, P<0.05]; all patients were followed-up for 1 month after surgery, and there was no significant difference between the two groups as respect to the incidence of ascites, incision infection, bile leakage, pulmonary infection and abdominal bleeding(2.9% vs. 3.2%, P＞0.05). Conclusion The two hepatic inflow occlusion techniques are both safe and effective during the LH operation, but the measure by regional hepatic inflow occlusion could shorten occlusion time and reduce intraoperative blood loss, and decrease the postoperative liver function injury.

Objective The aim of this study was to investigate the short-term efficacy of three-dimensional conformal radiotherapy (3DCRT) in patients with primary liver cancer (PLC) and to analyze the influencing factors for radiation-induced liver injury (RILI) occurrence. Methods 85 patients with PLC were encountered in our hospital between April 2019 and April 2022, and all received 3DCRT therapy. The short-term efficacy was evaluated by RECIST, and the RILI was diagnosed based on liver function tests. The multivariate Logistic regression analysis was applied to reveal the factors impacting the efficacy and the occurrence of RILI. Results After the 3D-CRT treatment, the objective remission rate (ORR) was 58.8% in our series; the percentages of TNM stage Ⅳ and Child-Pugh class B in 50 patients with objective remission were 36.0% and 14.0%, both significantly lower than 60.0% and 48.6%(P<0.05), while the percentages of single dose of 3-4 Gy and total dose of 50-60 Gy were 52.0% and 68.0%, both significantly higher than 28.6% and 45.7%(P<0.05) in those without objective remission; the prevalence of RILI was 17.7% during the 3D-CRT therapy; the percentages of TNM stage Ⅳ, Child-Pugh class B, single dose of 3-4 Gy and total dose of 50-60 Gy in 15 patients with RILI were 80.0%, 93.0%, 73.3% and 86.7%, all significantly higher than 38.6%, 14.3%, 35.7% and 52.9% (P<0.05) in 70 patients without RILI; the multivariate Logistic regression analysis showed that the TNM stage, Child-Pugh classification, single dose and total dose were all the independent risk factors impacting the efficacy and the occurrence of RILI(OR=5.078, 4.988, 4.600, 4.850, 4.963, 5.043, 5.150, 4.740, respectively, P<0.05). Conclusion The efficacy of 3DCRT treatment in patients with PLC and the occurrence of RILI are influenced by TNM staging, Child-Pugh class, single dose and total dose, so the clinicians should fully consider the above sensitive factors when making the radiotherapy plans to ensure the improved efficacy and less incidence of RILI.

Objective The aim of this study was to investigate the dynamic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of microvascular invasion (MVI) in patients with primary liver cancer (PLC). Methods 50 patients with PLC were admitted to our hospital between January 2020 and January 2023, and all underwent plain and dynamic contrast-enhanced CT and MRI scan before operation. The blurry tumor margins, such as locally convex nodules, locally incomplete capsule, multi-nodule fusion, intra-tumor crescent sign, two-trait predictor of venous invasion (TTPVI), portal vein tumor thrombosis (PVTT) and apparent diffusion coefficient (ADC) were recorded. All patients underwent hepatectomy and the post-operational examination was conducted for the diagnosis of MVI. Results The postoperative histopathological examination found that among the 50 patients with PLC, there were 32 patients with hepatocellular carcinoma (HCC) and 18 patients with cholangiocellular carcinoma, with MVI positive in 29 cases and without MVI in 21 cases; the CT scan found that the proportions of the blurry tumor margins, locally convex nodules, locally incomplete capsule, multi-nodule fusion, intra-tumor crescent sign, TTPVI and PVTT among patients with MVI were 82.8%, 17.2%, 31.0%, 17.2%, 13.8%, 65.5% and 17.2%, all significantly higher than 14.3%, 4.8%, 4.8%, 4.8%, 0.0%, 9.5% and 0.0% (P<0.05) in patients without MVI; the MRI found that the proportions of the blurry tumor margins, locally convex nodules, locally incomplete capsule, multi-nodule fusion, intra-tumor crescent sign, TTPVI and PVTT among patients with MVI were 89.7%, 24.1%, 37.9%, 27.6%, 13.8%, 72.4% and 24.1%, all significantly higher than 23.8%, 9.5%, 9.5%, 9.5%, 0.0%, 14.3% and 0.0% (P<0.05) in patients without MVI; the Logistic regression analysis showed that the blurry tumor margins, TTPVI and PVTT were the independent risk factors for the existence of MVI in patients with PLC (P<0.05). Conclusion The special signs of dynamic contrast-enhanced CT and MRI scan could hint the existence of MVI, which might help the gastroenterologists make an appropriate management strategy.

Objective The aim of this study was to summarize the feature of MRI dynamic enhancement and diffusion weighted imaging in patients with small hepatic hemangioma (sHH). Methods A total of 113 patients with ≤2 cm sHH were enrolled in the hospital between January 2022 and March 2023, and all underwent MRI dynamic enhancement and diffusion weighted imaging (DWI) scans. The feature of MRI dynamic enhancement and DWI were summarized. The apparent diffusion coefficient (ADC), maximum slop of increase (MSI), positive enhancement integral (PEI) and mean time to enhancement (MET) were recorded. Results Out of the 113 patients with sHH, 158 lesions were found by MRI scan, and the proportion of single lesions accounted for 78.8%; the lesion size were (1.7±0.4) cm; according to the distribution of curve types by dynamic contrast enhancement, there were 27 lesions of type I, 29 lesions of type II and 102 lesions of type III; there were 71 lesions in the left lobe and 87 lesions in the right lobe; on dynamic contrast-enhanced MRI, sHH were not significantly enhanced at arterial phase and portal venous phase; compared with liver parenchyma, the lesions generally showed continuous relatively low signal, and slight high signal in delayed phase, presenting with mainly mild to moderate delayed enhancement; the MRI dynamic enhancement scan showed that the MSI, PEI and MET in patients with sHH were(321.0±33.6), (256.6±30.7) and (535.9±61.3)s; the DWI scan showed that ADC in patients with sHH was (2.4±0.4) ×10^-3mm²/s. Conclusion The dynamic contrast-enhanced MRI and DWI scan could provide an important tool for clinical diagnosis of patients with sHH.

Objective The purpose of this study was to compare the efficacy of microwave ablation (MWA) and laparoscopic hepatectomy (LH) in the treatment of patients with hepatic hemangiomas (HH). Methods 94 patients with HH were admitted to our hospital between January 2018 and March 2022, and were divided into two groups, receiving MWA in 46 cases and LH in 48 cases. All patients were followed-up for 1 year after operation. Serum tumor necrosis factor -α (TNF-α) and interleukin-6 (IL-6) levels were determined by ELISA. Results The intraoperative blood loss, blood flow blocking time, operation time and hospital stay in MWA-treated patients were (17.2±3.5)mL, (22.8±4.4)min, (158.0±31.8)min and (6.3±1.9)d, all significantly less or shorter than [(208.4±39.7) mL, (26.3±5.1)min, (228.5±43.2)min and (8.1±2.4)d, respectively, P<0.05] in patients receiving LH treatment; there were no significant differences as respect to liver function tests between the two groups before and after operation (P>0.05); five days after operation, serum TNF-α and IL-6 levels in patients with MWA treatment were (51.3±7.5)pg/ml and (18.3±3.5)pg/ml, both significantly lower than [(65.9±10.4)pg/ml and (26.8±4.9)pg/ml, respectively, P<0.05] in LH-treated patients; the incidences of post-operational complications, such as infections and bile leakage, in MWA- and LH-treated patients were 4.4% and 8.3% (P>0.05); at the end of one-year follow-up, no intrahepatic tumors relapsed in LH-treated patients, and the tumors shrank to 25% in 43 cases (93.5%) in MWA-treated patients. Conclusion The patients with HH could be managed by both MWA or LH, but we recommend the former because of the less body inflammatory reactions and rapid recovery.

Objective The purpose of this study was to summarize the clinical features of Klebsiella Pneumonia (KP)-induced bacterial liver abscess (PLA). Methods 110 patients with PLA were encountered in our hospital between January 2017 and May 2022, and all patients were treated by needle puncture and drainage under US guidance at base of intravenous administration of antibiotics. Serum high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and fibrinogen (Fib) levels were detected. Results Out of the 110 patients with PLA, the bacteria culture found positive in 70 (63.6%) patients, including KP in 48 cases (68.6%), Escherichia Coli in 7 cases (10.0%), Streptococcus in 4 cases (5.7%), Staphylococcus in 3 cases (4.3%), Enterococcus Faecalis in 3 cases (4.3%), Enterococcus Faecalis in 2 cases (2.8%) and others in 3 cases (4.3%); the KP-induced PLA (KPLA) accounted for 68.6% (48/70), and non-KP-induced PLA (N-KPLA) for 31.4% (22/70); the age of patients with KPLA was 58(49,66)yr, much younger than [65(61, 74)yr, P<0.05] in patients with N-KPLA; there were significant differences as respect to the incidences of concomitant diabetes, biliary operation histories and biliary infections between the two groups (56.2%, 8.3% and 14.6% vs. 22.7%, 27.3% and 45.4%, P<0.05); the sCr, serum hs-CRP, PCT and Fib levels in patients with KPLA were 88.7(60.8, 115.4)μmol/L, 170.5(86.3, 240.5)mg/L, 20.2(9.8, 31.5)ng/L and 6.4(5.0, 7.8)g/L, all significant different compared to [100.3(62.3, 145.0)μmol/L, 132.6(60.6, 181.2)mg/L, 26.8(13.4, 40.6)ng/L and 5.3(4.3, 7.1)g/L] in patients with N-KPLA(P<0.05); the imaging scan found that the incidences of thin wall of intrahepatic abscess, separated abscess and liquidation of abscess in patients with KPLA were 83.3%, 62.5% and 97.9%, all much higher than 54.5%, 31.8% and 72.7%(P<0.05) in patients with N-KPLA; the short-term recovery rate in the 48 patients with KPLA was 70.8%, a little bit higher than 59.1% in patients with N-KPLA, and the hospital stay were 20(15, 28)d and 22(16, 28)d(P>0.05) between the two groups. Conclusion The common pathogen of PLA is KP, followed by Escherichia Coli. The clinicians should take the clinical features of PLA, especially those with KP infections, might help making an appropriate measures to deal with it.

Objective The aim of this study was to compare the efficacy of ultrasound-guided injection of absolute ethanol (AE) or lauromacrogol in the treatment of patients with hepatic cysts (HC). Methods 62 patients with HC were enrolled in our hospital between June 2020 and October 2022, and 30 patients out of them were treated with ultrasound-guided injection of AE, and another 32 patients were given ultrasound-guided injection of lauromacrogol. All patients were followed-up for 6 months. Serum amyloid A (SAA) and C-reactive protein (CRP) levels were detected by chemiluminescence, and serum cortisol (Cor) and epinephrine (E) levels were measured by radioimmunoassay. Results The successful disappearance rate of HC in AE-treated patients was 96.7%, significantly higher than 75.0% in lauromacrogol-injected patients (P<0.05); 3 days after injection, serum SAA, CRP, Cor and E levels in AE-treated patients were (20.7±2.3)mg/L, (35.8±3.8)mg/L, (336.4±24.9)nmol/L and (49.4±6.0)ng/L, all significantly higher [(16.5±2.2)mg/L, (21.9±3.2)mg/L, (282.0±25.9)nmol/L and (39.1±5.3)ng/L, respectively, P<0.05] in lauromacrogol-treated patients; the incidence of adverse reactions, such as alcohol-drunken-like reaction, abdominal pain, fever and anorexia in AE-injected patients was 43.3%, much higher than 12.5%(P<0.05) in lauromacrogol-injected patients. Conclusion The intra-cyst injection of AE or lauromacrogol under ultrasound guidance in the treatment of patients with HC is efficacious, and we recommend the AE injection although the AE has a relatively more untoward effects.

Objective The aim of this study was to select a relatively good biliary drainage for patients with cholecystolithiasis and choledocholithiasis undergoing surgical operation. Methods 85 patients with gallbladder and common bile duct stones were encountered in our hospital between March 2018 and May 2022, and all received laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBD) combination operation. After removal of the gallbladders and the stones, the nasobiliary drainage was conducted in the observation group (n=42) and the T-tube drainage was completed in the control group (n=43). The gastrointestinal quality of life index (GIQLI) was evaluated by questionnaire. Results The drainage tube removal time and medical cost in the observation group were (5.6 ± 1.8) days and (35.0±5.0)thousand yuan, both significantly shorter or less than [(50.5±6.8)days and (39.0±7.0)thousand yuan, P＜0.05]; at day 7 after operation, serum ALT and AST levels in the observation group were (37.1±14.6)U/L and (36.7±16.8)U/L, both much lower than [(79.7±13.8)U/L and (53.5±14.7)U/L, respectively, P<0.05] in the control; one month after operation, the GIQLI score in the observation group was (98.5±3.3), significantly higher than [(81.4±3.9), P＜0.05] in the control; post-operationally, the incidence of abnormal liver function tests in the observation group was 40.5%, much lower than 65.1%(P＜0.05) in the control, while there were no significant differences as respect to the bile leakage, pancreatitis, residual bile duct stones and bleeding occurrence between the two groups (P>0.05). Conclusion The placement of nasobiliary drainage during the LC and LCBDE operation in the treatment of patients with gallbladder and common bile duct stones might be a technical innovation, which could improve the quality of life after operation.

Objective The aim of this study was to investigate the evaluation of surgical risk in patients with liver cirrhosis and acute cholecystitis (AC) by cholecystitis severity grading and model for end-stage liver disease (MELD) scores. Methods 92 patients with LC and AC were enrolled in our hospital between February 2021 and December 2022, and all patients underwent laparoscopic cholecystectomy (LC). Before operation, the AC severity was evaluated according to Tokyo Guidelines (2018), including grade I in 55 cases and grade II/III in 37 cases, and the MELD scores were calculated, including low risk (≤14) in 64 cases and moderately/high risk (＞15) in 28 cases. The surgical risk was evaluated by multivariate Logistic regression analysis. Results The rates of conversion to laparotomy during LC were not significantly different among groups(P＞0.05); the operation time in patients with cholecystitis grade Ⅱ/Ⅲ was (88.8±11.8)min, much longer than [(77.1±10.4)min, P＜0.05], and intra-operational blood loss and peritoneal drainage were (91.4±18.7)mL and (339.7±40.7)mL, both significantly greater than [(79.5±12.2)mL and (285.9±36.4)mL, respectively, P＜0.05] in patients with grade Ⅰ, while there were no significant differences as respect to these surgical parameters between patients grouped on MELD scores(P>0.05); the incidence of post-operational complications, such as infection, bleeding and bile leakage in patients with grade Ⅱ/Ⅲ was 27.0%, much higher than 7.3%(P＜0.05) in patients with grade Ⅰ, and that was 28.6% in patients with high risk MELD scores, much higher than 9.4%(P＜0.05) in patients with low risk MELD scores; the patients were then further divided into with (n=18)and without (n=74) surgical risk groups based on surgical complications, and the percentages of cholecystitis grade Ⅱ/Ⅲ and the high MELD scores in patients with surgical risk were 61.1% and 55.6%, both significantly higher than 35.1% and 24.3%(P＜0.05) in those without surgical risk; the multivariate Logistic regression analysis showed that the cholecystitis grading and poor MELD scores were the independent risk factors for LC operation in cirrhotics with AC (P＜0.05). Conclusion The surgeons should take the cholecystitis severity grading and MELD scores into consideration before LC operation in patients with liver cirrhosis and AC, and deal with appropriately.

Objective The purpose of this study was to analyze the diagnostic efficacy of color Doppler ultrasonography and magnetic resonance cholangiopancreatography (MRCP) in patients with cholecystolithiasis. Methods A retrospective analysis was performed on the clinical data of 78 patients with suspected cholecystolithiasis who were admitted to our hospital between June 2018 and March 2022. All patients underwent color Doppler ultrasonography and MRCP, and thereafter received cholecystectomy. Results Out of the 78 patients with suspected cholecystolithiasis, the histopathological examination after operation showed gallbladder stones in 71 cases (91.0%), including typical gallbladder stones in 51 cases(65.4%), full gallbladder stone in 13 cases (16.7%), multiple stones in 4 cases (5.1%) and silt-like stones in 3 cases (3.8%), and without stones in 7 cases (9.0%); the diagnostic rate of gallbladder stones by MRCP was 83.3%, much higher than 64.1%(P＜0.05) by ultrasonography; the diagnostic sensitivity and specificity by MRCP were 90.1% and 85.7%, both significantly higher than 67.6% and 71.4% (P<0.05) by color Doppler ultrasonography; the detection rates of stones at 0.5-1.0 cm by MRCP was 43.6%, much higher than 32.1%(P＜0.05) by ultrasonography. Conclusion The MRCP could detect smaller gallstones effectively, which might help clinicians to deal with appropriately at some special circumstances.

Objective The aim of this study was to investigate the application of laparoscopic cholecystectomy (LC) under guidance of indocyanine green (ICG) near infrared fluorescence in treatment of patients with gallstones. Methods 172 patients with gallstones were consecutively encountered in our hospital between March 2019 and August 2022, and were randomly divided into two control and observation groups, with 86 cases in each group. The patients in the control group received routine LC, and those in the observation underwent LC under the guidance of ICG cholangiography. All patients after operation were followed-up and univariate and multivariate Logistic regression analysis was applied to reveal the impacting factors for complications after operation. Results The operation time, blood loss and hospitalization stay in the observation group were(38.4±3.8)min,(65.1±6.4)mL and (4.6±0.4)day, all significantly shorter or less than [(49.7±4.7)min,(85.3±8.4)mL and (6.5±0.7)day, respectively, P<0.05] in the control; the rate of post-operational complication, such as biliary injury, rupture of ductus cysticus, biliary infection, peritoneal infection and stone residue, in the observation group was 4.6%, much lower than 15.1% in the control (P<0.05); out the 172 patients with gallstone in our series, the post-operational complications occurred in 17 cases, and the elderly patients, obviously increased body mass index, concomitant diabetes mellitus, chronic cholecystitis history, relatively large amount of blood loss and no ICG radiography in the patients with complications were 70.6%, 52.9%, 64.7%, 94.1%, 76.5% and 0.0%, significantly different compared to 34.8%, 27.7%, 37.4%, 62.6%, 47.1% and 72.9% in patients without complications (P<0.05); the multivariate Logistic regression analysis showed that the ages, concomitant diabetes, blood loss and ICG radiography were the independent factors related to the occurrence of post-operational complications(all P<0.05). Conclusion The application of LC under the guidance of ICG near infrared fluorescence cholangiography in the treatment of patients with gallstone could reduce the amount of intraoperative blood loss and the incidence of postoperative complications, which warrants further clinical multi-central validation.

The nonalcoholic fatty liver disease (NAFLD) is the most common liver diseases worldwide. Currently, due to the lack of effective drugs for treatment of NAFLD, the scholars recommend reducing body weight and improving metabolism through dietary interventions. In this paper, we summarize the research progress of NAFLD-related dietary interventions and the mechanisms by which they play roles in therapeutic effects in order to better guide clinical practice.

Nonalcoholic steatohepatitis (NASH),with pathological characteristics of hepatic steatosis, ballooning, and lobular inflammation, reflects the chronic liver disases induced by metabolic stress. Here, we summarize the regulatory effect of gut microbia-derived butyrate on the docosahexaenoic acid (DHA) metabolic phenotype of hepatic mononuclear phagocyte system through HDAC/12/15-LOX/maresin signaling. Its role in NASH amelioration is further reviewed on the basis of proinflammatory mediators/maresins rebalancing and spontaneous resolution of inflammation.