Objective This experiment aimed to investigate the mechanism by which dual specificity protein phosphatases 10(DUSP10) mediates lenvatinib resistance by through regulating stemness characteristics in hepatocellular carcinoma (HCC) in vitro. Methods Lenvatinib-resistant cell lines, e.g., Huh7-resistant and Hep3B-resistant, were established, and stable DUSP10-overexpressing (Huh7 and PLC/PRF/5) and knockdown (Huh7-resistant, Hep3B-resistant, Hep-12) cell models were constructed. Western blot was conducted to detect stemness markers (Nanog, BMI1, ABCG2) expression, and CCK-8 assay was performed to determine IC50 values and calculate the resistance index (RI). Results DUSP10 expression in resistant cell lines was up-regulated by 2.1 to 3.8 fold compared to in wild-type cells (P<0.01); overexpression of DUSP10 increased the IC50 of lenvatinib in Huh7 cells from 1.376 μM to 28.44 μM (RI=20.67) and in PLC/PRF/5 cells from 4.118 μM to 18.01 μM (RI=4.37), accompanied by a 1.5 to 2.3 fold up-regulation of stemness genes; conversely, DUSP10 knockdown reduced the IC50 in Huh7-resistant, Hep3B-resistant, and Hep-12 cells by 6.53 fold, 12.02 fold, and 3.29 fold, respectively (all P<0.001), with a 40% to 60% down-regulation of stemness genes. Conclusion DUSP10 significantly decreases the sensitivity of HCC cells to lenvatinib by probably up-regulating stemness-related genes, such as Nanog/BMI1/ABCG2, and targeting the DUSP10-stemness pathway might reverse drug resistance.

Objective The aim of this experiment was to investigate tumor-promoting elements, e.g., ectonucleotide pyrophosphatase/phosphodiesterase 2 (ENPP2) and enhancer of Zeste homolog 2 (EZH2) in HepG2 and HepG2.2.15 cells and their impact on cell proliferation and invasiveness. Methods For inhibition of ENPP2 and EZH2 expression, siRNAs were synthesized, and HepG2, HepG2.2.15, pSM2 plasmid-transfected HepG2(HepG2/pSM2) and siENPP2 or siEZH2-transfected HepG2.2.15 cells were harvested. ENPP2 and EZH2 mRNAs were detected by real-time PCR and their expression was detected by Western blot. Proliferation and invasion of cells were detected by CCK-8 and Trans-well movement. Results ENPP2 and EZH2 mRNA loads in transient HBV-plasmid transfected HepG2 cells or HepG2.2.15 cells with stable HBV infection increased greatly, compared to those in HepG2 cells (P<0.001), and ENPP2 and EZH2 protein expression also intensified (P<0.001); proliferation and invasiveness of HepG2.2.15 cells were obviously elevated compared to in HepG2 cells (P<0.01), while inhibition of ENPP2 or EZH2 expression in HepG2.2.15 cells greatly weakened proliferation and invasiveness of the cells (P<0.01). Conclusion The intensified expressions of ENPP2 and EZH2 in HepG2 cells and in HepG2.2.15 cells might play a pivotal role in carcinogenesis, which needs further investigation.

Objective The aim of this experiment was to investigate molecular mechanism of diethyldithiocarbamate (DDC) in improving metabolic dysfunction associated steatohepatitis (MASH) by regulating Insr/Akt signaling pathway. Methods 18 male C57BL/6 mice were randomly divided into control, MASH and DDC-intervened group (n=6 in each) and MASH model was established by feeding a choline-deficient, L-amino acid-defined (CDAA) diet, and the intervention was carried out by DDC gavage simultaneously. The expression of insulin receptor (Insr) and pro-apoptotic molecule, e.g., Bax in mouse liver tissue were detected by real-time PCR and Western blot. Model of lipotoxicity was established by induction of palmitic acid (PA) on AML12 cells, and was treated with DDC simultaneously. The expression of Insr, Akt, pAkt, Bax and Bcl2 were detected by Western blot. Results Insr mRNA level in liver tissue in MASH group was (0.38±0.13), significantly lower than [(1.03±0.27), P<0.05] in the control; the expression of Insr protein in liver tissues in MASH group was (0.61±0.11), significantly lower than [(1.68±0.58),P<0.05] in the control, while the expression of Insr protein in liver tissues in DDC-intervened group was (1.03±0.11), significantly higher than that in MASH group (P<0.05); the expression of Bax protein in liver tissue in MASH group was (1.14±0.39), significantly higher than [(0.47±0.26), P<0.05] in the control; the expression of Bax protein in liver tissues in DDC-intervened group was (0.66±0.19), significantly lower than that in MASH group (P<0.05); the expression of Insr protein in AML12 cells in PA group was (0.38±0.13), significantly lower than [(0.74±0.21), P<0.05] in the control, while the expression of Insr protein in AML12 cells in DDC-intervened group was (0.71±0.20), significantly higher than that in PA group (P<0.05); the ratio of pAkt/Akt protein in AML12 cells in PA group was (0.28±0.07), significantly lower than [(0.69±0.06), P<0.05] in the control, while the ratio of pAkt/Akt protein in AML12 cells in 25 μM or in 50 μM DDC-intervened groups were (0.85±0.02) and (0.97±0.04), both significantly increased than in PA group (P<0.05); the ratio of Bcl2/Bax in AML12 cells in PA group was (1.28±0.29), much lower than [(1.74±0.10),P<0.05] in the control, while the ratio of Bcl2/Bax in AML12 cells in DDC-intervened group was (2.30±0.78), much higher than that in PA group (P<0.05). Conclusion The Insr/Akt pathway is inhibited and apoptosis is increased in liver tissues in mice with CDAA diet-induced MASH, and DDC might inhibit hepatocyte apoptosis by stimulating Insr/Akt signaling pathway, thereby improving MASH progression.

Objective The purpose of this experiment was to investigate the protective effect of histone deacetylase (HDAC) inhibitor ACY1215 on acute liver failure (ALF) in mice and to explore its possible mechanism. Methods 18 mice were randomly divided into control, model and ACY1215-intervened group, with 6 in each. The ALF model was induced by intraperitoneal injection of lipopolysaccharide (LPS) and D-galactosamine (D-Gal). Liver tissue PANoptosis associated protein expression, such as receptor-interacting serine-threonine kinase 1(RIPK1), gas derivative D protein (GSDMD), Caspase-3, Caspase-8 and mixed lineage kinase domain protein (ML) were detected by Western blot. Results Liver histopathological examination showed that disordered intrahepatic parenchymal cell arrangement, with lamellar cell necrosis, a large number of blood cell exudation, and inflammatory cell infiltration in ALF group, while liver tissue damage alleviated in ACY1215-intervened group; serum ALT, AST and total bilirubin levels in ALF group were (3279.8±639.0)U/L,(2510.1±383.2)U/L and (85.5±6.8)μmol/L, while they all decreased to [(987.6±254.3)U/L, (426.3±105.6)U/L and (38.1±8.9)μmol/L, respectively, P<0.05] in ACY1215-intervened group; intrahepatic tissue PANoptosis-related protein, such as RIPK1, GSDMD, Caspase-3, Caspase-8 and MLKL intensified in ALF group, while they all obviously weakened in ACY1215-intervened group (P<0.05). Conclusion Histone deacetylase inhibitor ACY1215 could play a protective role in mice with ALF, probably by regulating PANoptosis-related protein expression.

Objective The aim of this study was to investigate the clinical efficacy of tenofovir disoproxil fumarate (TDF) and Dangfei Liganning capsule, a herbal medicine compound, in the treatment of patients with chronic hepatitis B (CHB). Methods 97 consecutive patients with CHB were enrolled in our hospital between January 2021 and February 2024, and were randomly assigned to receive TDF in 48 cases in control, or to receive combination of TDF with the herbal medicine in 49 cases for 48 weeks. Serum HBeAg and HBsAg levels were detected by electrochemiluminescence and serum HBV DNA loads were quantitatively measured by real-time PCR. Serum hyaluronic acid (HA), laminin (LN), type III procollagen (PCIII) and type IV collagen (IV-C) levels were detected by chemiluminescence, serum interleukin(IL)-6, IL-8, tumor necrosis factor-α and transforming growth factor-β1 (TGF-β1) levels were assayed by ELISA, and serum superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO) levels were determined by xanthine oxidase, thiobarbituric acid and nitric acid reduction, respectively. Results By end of 48-week treatment, serum ALT and AST levels in combination group were (31.7±6.1)U/L and (39.5±7.3)U/L, both significantly lower than [(39.4±6.3)U/L and (45.3±6.1)U/L, respectively, P<0.05] in the control; serum HBV DNA in both groups transferred to negative, and there were no significant differences as respect to serum virologic and serologic markers in the two groups (P<0.05); serum HA, LN and PCⅢ levels in the combination group were (186.3±8.2)ng/mL, (171.2±10.4)ng/mL and (158.5±14.7)ng/mL, all much lower than [(292.4±16.7)ng/mL, (230.5±12.7)ng/mL and (181.2±18.6)ng/mL, respectively, P<0.05] in the control; serum IL-6, IL-8, TNF-α and TGF-β1 levels were (12.9±4.2)μg/L, (5.4±1.0)μg/L, (31.7±9.3)μg/L and (12.6±4.2)ng/L, all significantly lower than [(19.2±4.6)μg/L, (7.1±1.3)μg/L, (49.2±8.6)μg/L and (26.1±4.9)ng/L, respectively, P<0.05] in the control groups; serum SOD and NO levels were (116.3±17.2)U/mL and (44.2±6.5)μmol/L, both much higher than [(97.4±18.5)U/mL and (37.1±5.9)μmol/L, respectively, P<0.05], while serum MDA level was (7.1±1.8)nmol/L, much lower than [(9.3±1.5)nmol/L, P<0.05] in the control group. Conclusion Combination of TDF and Dangfei Liganning capsule has a better efficacy than TDF alone in the treatment of patients with CHB, which might be related to inhibition of liver fibrosis, body' s inflammatory reaction and oxidative stress.

Objective The aim of this study was to investigate immunological response of infants born to hepatitis B viral infected mothers to hepatitis B vaccination and its influencing factors. Methods 86 HBV-infected pregnant women and their 86 infants were encountered in our hospital between January 2019 and December 2020, and out of the 86 hepatitis B viral carriers, 64 women received oral tenofovir at 28 gestational week for blocking hepatitis B viral mother-to-infant transmission until delivering. All infants received hepatitis B immunoglobulin and hepatitis B vaccine routinely, and were followed-up for three years. Serum HBsAg and anti-hepatitis B surface antigen antibody (HBsAb) were detected by ELIS, and serum HBV DNA loads was assayed by PCR. Results By delivery, serum HBV DNA loads transferred to negative in tenofovir-treated women, and by end of three-year follow-up, serum HBsAb positive in 82 infants(95.3%), including weak positive in 16 cases (19.5%) and strong positive in 66 cases (80.5%), and negative in 4 infants (4.7%) in the 86 infants; concomitant diabetes percentage in mother with their infants positive response was much lower than in those with weak response (12.1% vs. 31.2%), while birth weights and gestational weeks were significantly heavier than(3442.7±333.1 g vs. 3385.4±370.6 g)or longer than(39.3±1.2 w vs. 37.4±1.2 w) in weak responders (P<0.05); multivariate Logistic regression analysis showed that concomitant diabetes, low infant birth weight and short gestational weeks at birth were all the risk factors impacting immunological response (P<0.05). Conclusion Hepatitis B vaccination might fails in infants who have a hepatitis B viral infection mothers, the surveillance is important and should re-vaccinates sometimes.

Objective The purpose of this study was to investigate efficacy and safety of solimbuvir combined with danorevir and ribavirin in the treatment of naïve patients with hepatitis C viral genotype 3 infection. Methods 104 patients with chronic hepatitis C (CHC) with genotype 3 infection were enrolled in our hospital between January 2019 and December 2023, and were randomly assigned to receive sorfosbuvir plus danorevir and ribavirin combination treatment (observation, n=52) for 12 weeks, or to receive pegylated interferon α-2a and ribavirin antiviral treatment for 24 weeks. All patients were followed-up for 24 weeks after discontinuation of antiviral therapy. Serum HCV RNA loads were assayed routinely and liver stiffness measurement (LSM) was detected by Fibroscan. Results The rapid virological response (RVR), early virological response (EVR), end of treatment virological response (ETVR) and sustained virological response rates (SVR) in the observation group were 67.3%, 88.5%,100.0% and 98.1%, all significantly higher than 15.4%, 19.2%,69.2% and 61.5% (P<0.05) in the control; by end of antiviral treatment, serum ALT, AST and LSM in the observation group were (36.2±8.5)U/L, (37.2±8.2)U/L and (7.1±1.3)kPa, all much lower than [(57.3±7.2)U/L, (49.6±6.2)U/L and (8.5±1.2)kPa, respectively, P<0.05] in the control group; during antiviral treatment, incidences of adverse effects, such as fever, granulocytopenia, thrombocytopenia and anorexia in the control group were 98.1%, 88.5%, 48.1% and 48.1%, all much higher than 0.0%, 20.3%, 13.3% and 9.6% (P<0.05) in the observation group. Conclusions The combination of soropovir plus danorevir and ribavirin in the treatment of naivepatients with CHC and hepatitis C viral genotype 3 infection could obtain a satisfactory clinical short-term efficacy, which is relatively safe and warrants further observation.

Objective The aim of this study was to investigate efficacy and safety of ritonavir (RTV)-boosted danoprevir (DNVr) with combination of sofosbuvir (SOF) and ribavirin (RBV) regimen in the treatment of patients with chronic hepatitis C (CHC) and viral genotype 3 infection. Methods 96 patients with HCV genotype 3 infected CHC were admitted to our hospital between January 2021 and December 2023, and were randomly assigned to receive SOF with combination of daclatasvir (DCV) and RBV in 48 cases in control group, and to receive DNVr with combination of SOF and RBV treatment in another 48 patients in the observation for 12 weeks. All patients were followed-up for 12 weeks after discontinuation of antiviral therapy. Serum HCV RNA loads was assayed by fluorescence quantitative PCR, and peripheral blood lymphocyte subsets were detected by flow cytometry. Results Rapid virological response, early virological response, end of treatment virological response and sustained virological response rates in the observation group were 89.6%, 95.8%, 100.0% and 91.7%, all significantly higher than 66.7%, 75.0%, 81.3% and 75.0% (P＜0.05) in the control; by end of 12-week treatment, serum ALT and AST normalization rates in the observation were 95.8% and 100.0%, both not much different as compared to 91.7% and 93.8% in the control (P＞0.05); percentages of peripheral blood CD4⁺ cells and CD4⁺/CD8⁺ cell ratios in the two groups elevated, while percentages of CD8⁺ cells decreased compared to those at presentation(P＜0.05), and there were no significant differences between the two groups (P＞0.05); during treatment, incidences of adverse effects, such as diarrhea, nausea, fever, lipsotrichia and rash in the two groups were not much different(27.1% vs. 31.3%, P＞0.05). Conclusion The DNVr with combination of SOF and RBV regimen in treatment of patients with CHC and HCV genotype 3 infection is short-termly efficacious and safe, which might be related to improve of immune functions besides suppression of viral replication.

Objective The aim of this study was to summarize etiology and prognosis of children with non-hepatophilic viral infection with liver injury. Method 102 children with non-hepatotropic virus infection-induced liver injury were encountered in our hospital between January 2022 and December 2023, serum viral RNA loads were assayed by RT-PCR, and liver-protecting procedures were given. Result Of 102 children with non-hepatotropic virus infection-induced liver injury, the etiologies included respiratory tract infection in 43 cases (41.7%), gut infections in 32 cases (31.1%), infectious mononucleosis in 10 cases (9.7%), drug-induced liver injury (DILI) in 9 cases (8.8%)and hand-foot-mouth disease in 8 cases(7.8%); fever in 58 cases (56.9%), diarrhea in 37 cases (36.3%), cough in 33 cases (32.4%), nausea and vomiting in 27 cases (26.5%), anorexia in 17 cases (16.7%), itching in 3 cases(2.9%); hepatomegaly in 26 cases (25.2%), lymphadenopathy in 21 cases (20.6%), tonsillitis in 19 cases (18.6%), splenomegaly in 13 cases (12.8%), rash in 8 cases (7.8%) and eyelid edema in 6 cases (5.9%); liver function tests recovered at 7 to 18 days, averaged in two weeks, in 73 cases (71.6%), and other 29 children (28.4%) got their liver function tests normal after 4 to 6 (average 5) week treatment. Conclusion The common causes of liver damage in children with non-hepatotropic virus infection are mainly respiratory tract, intestinal infection, and infectious mononucleosis. The overall prognosis of children with non-hepatotropic virus infection-induced liver injury is good as protecting liver function treatment is given.

Objective The aim of this study was to investigate short-term efficacy of Wuzhi capsule, a herbal medicine compound, and compound glycyrrhizin combination in the treatment of patients with non-alcoholic steatohepatitis(NASH). Methods 120 patients with NASH were encountered in our hospital between May 2021 and December 2024, and were randomly assigned to receive compound glycyrrhizin intravenously in 60 cases in the control or to receive oral herbal medicine plus compound glycyrrhizin in another 60 cases in the observation for 8 weeks. Serum procollagen-III (PC-III),laminin (LN),collage type Ⅳ(IV-C) and hyaluronidase (HA) levels were detected by RIA; serum(cortisol(COR),glutathione (GSH),superoxide dismutase(SOD) and malondialdehyde (MDA) levels were assayed by chemiluminescence; Serum interleukin-6 (IL-6),IL-1βand tumor necrosis factor-α(TNF-α) levels were determined by ELISA. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were determinedby Fibrotouch. Results By end of eight week treatment, serum alanine aminotransferase,aspartate aminotransferase and γ-glutamyl transpeptidase levels in the observation group were (38.9±2.7)U/L, (31.8±5.0)U/L and (46.7±3.8)U/L, all significantly lower than [(57.1±6.9)U/L, (43.7±6.9)U/L and (70.1±6.2)U/L, respectively, P＜0.05] in the control; serum HA, PC-III and IV-C levels were (132.3±21.8)ng/mL, (85.2±17.0)mg/L and (34.6±5.0)μg/L, all significantly lower than [(181.9±20.6)ng/mL, (122.4±15.3)mg/L and (65.8±7.2)μg/L, respectively, P＜0.05] in the control group; serum COR and MDA levels were (231.7±23.6)nmol/L and (1.9±0.7)μmol/L, both much lower than [(390.7±30.5)nmol/L and (5.0±1.2)μmol/L, respectively, P＜0.05], while serum GSH and SOD levels were (85.1±9.8)mg/L and (187.3±19.2)U/ml, both much higher than [(49.6±7.4)mg/L and (151.2±14.3)U/ml, respectively, P＜0.05] in the control; CAP was (271.9±17.6)db/m, much lower than [(287.2±25.1)db/m, P＜0.05], and serum cytokine levels were also much lower than in the control group (P＜0.05). Conclusion Combiantion ofWuzhi capsule and compound glycyrrhizin in treatment of patients with NASH is short-termly efficacious, which might relieve oxidative stress and cytokine reactions.

Objective The aim of this study was to explore changes of serum maresin-1, omentin-1 and microRNA-125b (miR-125b) levels, and their correlation to liver inflammation and liver fibrosis (LF) in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 103 patients with NAFLD and 67 healthy individuals were enrolled in our hospital between January and June 2024, serum maresin-1 and omentin-1 levels were detected by ELISA, and miR-125b level was assayed by RT-PCR. All patients with NAFLD underwent liver biopsy, and non-alcoholic steatohepatitis (NASH) and LF were diagnosed based on NAFLD activity scores (NAS). The diagnostic efficacy of serum maresin-1, omentin-1 and miR-125b levels for LF was evaluated by receiver operating characteristic (ROC) curves. Results Of 103 patients with NAFLD, liver histo-pathological examination proved liver cirrhosis (LC) in 15 cases, NASH in 57 cases (including significantLF in 36 cases and mild LF in 21 cases), and simple fatty liver (SFL) in 31 cases; serum maresin-1, omentin-1 and miR-125b levels in cirrhosis group were (43.7±5.2) pg/mL, (1.2±0.3) ng/mL and (0.6±0.1), all significantly lower than [(59.3±5.8) pg/mL, (2.4±0.5) ng/mL and (1.0±0.3), P<0.05]in NASH group, or [(67.2±6.6) pg/mL, (3.2±0.7) ng/mL and (1.6±0.4), P<0.05] in SFL group or [(78.5±7.3) pg/mL, (4.3±0.9) ng/mL and (2.3±0.5) ng/ml, respectively, P<0.05] in control group; serum maresin-1, omentin-1 and miR-125b levels in NASH patients with significant LF were (56.9±5.6) pg/mL, (2.1±0.6) ng/mL and (0.8±0.2), all significantly lower than [(63.4±5.3) pg/mL, (2.9±0.8) ng/mL and (1.3±0.3), respectively, P<0.05] in those with mild LF; ROC analysis showed that area under the curve (ACU) of serum maresin-1, omentin-1 and miR-125b level combination in the diagnosis of NASH with significant LF was 0.912, with sensitivity of 97.2% and specificity of 71.4%, much superior to any parameter did alone (P<0.05). Conclusion Serum maresin-1, omentin-1 and miR-125b levels in patients with NAFLD reduce, and very low of them might indicate the existence of NASH and LF, which warrants further interventions.

Objective The aim of this study was to investigate the clinical efficacy of silymarin and diammonium glycyrrhizinate combination in the treatment of patients with non-alcoholic steatohepatitis(NASH). Methods 97 patients with NASH were encountered in our hospital between October 2022 and June 2024, and were randomly assigned to receive oral diammonium glycyrrhizinate in control (n=48), or to receive diammonium glycyrrhizinate with combination of silymarin in observation (n=49) at base of sport exercise and food guidance for six months. Serum hyaluronic acid (HA), laminin (LN), IV collagen (Ⅳ-C) and III procollagen (PCⅢ) levels were assayed by RIA, and serum interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and IL-6 levels were detected by ELIS. Liver stiffness measurements (LSM) and controlled attenuation parameter (CAP) were measured by Fibrotouch. Results By end of six month treatment, serum ALT, AST, GGT levels, and LSM and CAP in the observation group were (49.4±4.2)U/L, (41.1±3.9)U/L, (60.1±5.5)U/L, (7.3±1.2)kPa and (272.3±10.6)dB/m, all significantly lower than [(57.2±6.3)U/L, (49.5±5.2)U/L, (81.5±7.3)U/L, (8.8±2.5)kPa and (289.5±13.8)dB/m, respectively, P<0.05] in the control; serum HA, Ⅳ-C and PCⅢ levels were (62.1±5.7)μg/L, (60.5±6.2)μg/L and (90.3±10.4)μg/L, all much lower than [(73.2±7.4)μg/L, (68.2±8.7)μg/L and (148.5±13.7)μg/L, respectively, P<0.05] in the control; serum IL-10 level was (30.5±7.6)mg/L, much higher than [(25.2±6.3)mg/L, P<0.05], while serum TNF-α and IL-6 levels were (13.1±3.8)mg/L and (13.6±4.0)ng/L, both much lower than [(26.2±5.7)mg/L and (20.1±6.4)ng/L, respectively, P<0.05] in the control group. Conclusion Combination of oral silymarin and diammonium glycyrrhizinate at base of sport and diet guidance in patients with NASH is short-termly efficacious, which needs further clinical investigation.

Objective The aim of this study was to investigate the efficacy of ezetimibe (EZM) and polyene phosphatidylcholine (PPC) combination in the treatment of patients with non-alcoholic steatohepatitis (NASH). Methods 94 patients with NASH were admitted to our hospital between February 2021 and February 2024, and were randomly divided into observation group (n=47) andcontrol group (n=47), receiving EZM and PPCcombination treatment or PPC treatment alone for six months.Serum adiponectin (APN) and resistin levels were assayed by ELISA. Liver stiffness measurement(LSM) and controlled attenuation parameter(CAP) were detected by Fibroscan. Results By end of six month observation, serum ALTand AST levels in the observation group were (42.3±5.9)U/L and (45.1±5.5)U/L, both significantly lower than [(58.2±6.0)U/L and (59.3±5.2)U/L, respectively, P<0.05] in the control; serum TC, TG and fasting blood glucoselevels were (4.8±0.4)mmo/L, (2.1±0.4)mmo/Land (5.8±1.2)mmo/L, all significantly lower than [(5.8±0.8)mmo/L, (3.4±0.6)mmo/L and (6.4±1.5)mmo/L, respectively, P<0.05] in the control; serum APN level was (15.6±2.8)mg/mL, much higher than [(10.8±2.0)mg/mL, P<0.05], while serum resistin level was (5.2±0.6)mg/mL, much lower than [(7.2±0.9)mg/mL, P<0.05] in the control, and the CAP was (252.5±26.3)dB/m, also much lower than [(286.3±30.6)dB/m, P<0.05]in the control group. Conclusion Combination of EZM and PPCin treatment of patients with NASH could effectively ameliorate liver function tests, and promote glucose and lipid metabolism, which might be related to regulation of adipokines.

Objective The aim of this study was to investigate clinical efficacy of rosiglitazone and metformin combination in the treatment of patients with non-alcoholic fatty liver disease (NAFLD)and type 2 diabetes mellitus(T2DM). Methods A total of 98 patients with NAFLD and T2DMwere enrolled in our hospital between January 2023 and March 2024, and were randomly assigned to receive oral metformin (control, n=49) or combination of metformin and rosiglitazone (observation, n=49) for six months. Serum high density lipoprotein cholesterol(HDL-C), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) levels were routinely detected. Fasting insulin level was detected by radioimmunoassay. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were detected by Fibroscan. Results By end of six-month treatment, serum HDL-C level in the observation group was(1.3±0.3)mmol/L, much higher than [(1.1±0.2)mmol/L, P＜0.05], while serum TG level was(2.0±0.3)mmol/L, much lower than [(2.9±0.5)mmol/L, P＜0.05] in the control; fasting insulin level in the observation was (6.5±1.3)μU/ml, much lower than [(7.4±1.6)μU/ml, P＜0.05] in the control, while there were no significant differences as respect to HbA1c and FBG between the two groups(P>0.05); serum AST and CAP were (38.9±4.3)U/L and (266.1±10.7)dB/m, both much lower than [(45.4±4.8)U/L and (286.0±11.9)dB/m, respectively, P＜0.05]in the control group. Conclusion Rosiglitazone and metformin combination in the treatment of patients with NAFLD and T2DM could improve lipid metabolism disorder, which is worthy of further clinical study.

Objective This study aimed to investigate iron metabolism index changes in patients with nonalcoholic fatty liver disease (NAFLD). Methods Ninety-eight patients with NAFLD and ninety-eight healthy individuals for physical examination were encountered in Yizheng People's Hospital between January 2022 to March 2024, and all underwent abdominal CT scan and total adipose area (TAA), total skeletal muscle area (SMA), liver-to-spleen CT value ratio (CT_L/S) and visceral adipose volume/subcutaneous adipose volume (VAV/SAV)ratio were measured and calculated by Reformate software. Serum ferritin light chain (FTL)was detected by ELISA, serum iron (SI)and unsaturated iron binding capacity (UIBC) were detected by colorimetry, and transferrin receptor (TRF) were assayed by turbidimetry. Fatty liver degree was determined by ultrasonography. Result Ultrasonography found mild, moderate and severe fatty liver in 31 cases, 33 cases and 34 cases in our series; serum ALT, AST, TG and TC levels in patients with moderate fatty liver were much higher than in those with mild fatty liver or healthy persons (P<0.05), and they were much higher in patients with severe fatty liver than in those with moderate (P<0.05);serumSI, FTLand UIBC levels in patients with moderate fatty liver were (29.6±3.3)μmol/L,(439.5±15.6)μg/L and (73.1±5.7)μmol/L, all much higher than [(20.9±3.9)μmol/L, (417.5±16.6)μg/Land (62.6±6.6)μmol/L, respectively, P<0.05] in patients with mild fatty liver or [(14.3±3.0)μmol/L, (303.6±18.5)μg/L and (50.5±7.5)μmol/L, respectively, P<0.05] in healthy persons, while serum TRF level was (2.6±0.3)g/L, much lower than [(3.0±0.4)g/L, P<0.05] in patients with mild fatty liver or [(3.5±0.6)g/L, P<0.05] in healthy individuals; TAA,SMA and VAV/SAV ratio in patients with moderate fatty liver were much greater (P<0.05), while CT_L/S was much less than in patients with mild fatty liver (P<0.05);TAA, SMA and VAV/SAV ratio in patients with severe fatty liver were much greater (P<0.05), while CT_L/S was much less than in patients with moderate fatty liver(P<0.05). Conclusion Iron metabolism is unstable in patients with NAFLD, which might be related to liver steatosis and inflammation and needs further investigation.

Objective The purpose of this study was to investigate diagnostic performance of ultrasound-derived fat fraction (UDFF) in patients with metabolic associated fatty liver disease (MAFLD). Methods 54 allegedpatients with fatty liver were encountered in our hospital between October and December 2023, and all received MRI proton density fat fraction sequence (MRI-PDFF) and UDFF examination simultaneously. Intragroup correlation coefficient (ICC) was conducted to compare the consistency, and area underreceiver operating characteristic curve (AUC) was applied to assess the diagnostic efficacy. Results Based onMRI-PDFF results, non-fatty liver was found in 16 cases, mild fatty liver in 28 cases, moderate fatty liver in 3 cases and severe fatty liver in 7 cases; UDFF in 10 patients with moderate/severe fatty liver was 20.5(15.8, 28.0) %, much higher than [13.0(11.0,17.0)%, P＜0.01] in 28 patients with mild fatty liver or [5.5(4.0,7.0)%, P＜0.01] in 16 persons without fatty liver; ICC between MRI-PDFF and UDFF was 0.808,presenting as satisfactory diagnostic consistency; AUC in diagnosing MAFLD by UDFF was 0.987 (P<0.001), when the cut-off value was set as 8.0%,with the sensitivity (Se) of 97.4%, and the specificity (Sp) of 93.8%, and the AUC in diagnosing moderate/severe fatty liver was 0.908(P<0.001), when the cut-off value was set as 14.0%, with Se of 91.7% and Sp of 79.6%; our study didn't found difference of point shear wave elastography (pSWE) among individuals with or without fatty liver(P>0.05). Conclusion We recommendUDFF for diagnosis of metabolic associated fatty liver disease as its excellent efficacy, while the application of pSWE still needs multiple center validation.

Objective The aim of this study was to explore clinical implications of serum interferon (IFN)-α and IFN-β levels in patients with type 2 diabetes mellitus (T2DM)and metabolic dysfunction-associated fatty liver disease (MAFLD). Methods 87 patients with T2DM and 63 patients with T2DM and MAFLD were encountered in our hospital between September 2021 and August 2024. Serum IFN-α and IFN-β levels were assayed by ELISA, multivariate Logistic regression analysis was conducted to find risk factors forMAFLD in patients with T2DM, and receiver operating characteristic (ROC) curve was applied to analyze predictive performance. Results BMI, concomitant blood hypertension, serum total cholesterol, total triglyceride, low density lipoprotein-cholesterol, uric acid (UA), IFN-α and IFN-β levels in patients with T2DM and MAFLD were (26.9±2.6)kg/m², 74.6%, (6.8±1.4)mmol/L, (4.3±1.7)mmol/L, (3.7±0.6)μmol/L, (477.1±31.2)μmol/L, (27.9±8.5)pg/mL and (260.1±59.2)pg/mL, all significantly higher than [(24.9±2.2)kg/m², 24.1%, (5.6±1.1)mmol/L, (2.2±0.6)mmol/L, (3.2±0.8)mmol/L, (329.7±30.1)μmol/L, (21.9±4.1)pg/mLand (205.7±51.8)pg/mL, respectively, P＜0.05] in patients with T2DM; multivariate Logistic regression analysis showed that BMI, serum UA, IFN-α and IFN-β levels were all the independent risk factors for patients with T2DM and MAFLD (P＜0.05); ROC analysis demonstrated that the AUC was 0.832, with sensitivity of 73.0% and specificity of 87.4% when serum IFN-α and IFN=β level combination was applied to predict MAFLD in patients with T2DM (P＜0.05). Conclusion Serum IFN-α and IFN-β levelsare significantlyelevated in patients with T2DM and MAFLD, and surveillance of them might help clinicians evaluate the progress of the entity.

Objective The aim of this study was to investigate combination of prednisolone and magnesium isoglycyrrhizinate in treatment of patients with autoimmune hepatitis(AIH). Methods 91 patients with AIH were encountered in our hospital between April 2021 and April 2024, and were randomly assigned to receive prednisolone in control (n=45), or prednisolone with combination of magnesium isoglycyrrhizinate in observation (n=46) group. The regimen lasted for 6 months. Aspartate aminotransferase (AST)/platelet ratio index (APRI) and fibrosis based on four factors (FIB-4) were obtained. Serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) levels were assayed by ELISA, and serum immunoglobulin IgA, IgM and IgG levels were also detected by ELISA. Liver stiffness measurement (LSM) was performed by using transient elastography. Results By end of six month treatment, serum ALT and AST levels in combination group were (46.4±5.2)U/L and (38.4±5.8)U/L, both significantly lower than [(80.8±8.0)U/L and (75.0±7.7)U/L, respectively, P<0.05] in the control; LSM, APRI and FIB-4 scores were (6.4±0.6)kPa,(1.7±0.2) and (2.8±0.3), all not significantly different as compared to [(6.4±0.6)kPa,(1.7±0.2) and (3.0±0.3), respectively, P>0.05] in the control group; serum IgA, IgM and IgG levels were(3.2±0.3)g/L, (14.3±1.5)g/L and (3.5±0.5)g/L, all significantly lower than [(4.8±0.5)g/L,(17.6±1.8)g/L and (5.0±0.6)g/L, respectively, P<0.05] in the control; serum SOD and GSH-Px levels were (83.5±8.3)U/L and (118.7±12.1)ng/L, both much higher than [(77.5±7.8)U/L and (105.6±10.2)ng/L, P<0.05], while serum MDA level was (3.3±0.3)ng/L, much lower than [(4.7±0.3)ng/L, P<0.05]in the control group. Conclusion The combination of prednisolone and magnesium isoglycyrrhizinate is a satisfactory alteration in treatment of patients with AIH, which needs further clinical observation.

Objective The aim of this study was to investigate impacting factors of poor response to immunosuppressive therapy in patients with autoimmune hepatitis (AIH). Methods 57 patients with AIH were enrolled in this study between January 2022 and June 2023, and all received liver biopsies. All patients were treated by prednisone or prednisone with combination of azathioprine. Blood biochemical indexes and immunoglobulin levels were routinely detected. Serum autoimmune antibodies were assayed by Western blot. Impacting factors of response was analyzed by multivariate Logistic regression. Results By end of one-year treatment, the complete response (CR) rate to immunosuppressive therapy in the 57 patients with AIH was 75.4%; ages, percentages of liver cirrhosis, ascites and Child-Pugh score in patients with partial response (PR) were 57(44, 62)yr, 64.3%, 42.8% and 10(8, 12)points, all significantly greater or higher than [53(41, 60)yr, 18.6%, 11.6% and 6(5, 8)points, respectively, P<0.05] in those with CR; PLT counts and serum albumin level in patients with PR were 81(67,105)×10⁹/L and 32.3(30.0, 36.7)g/L, both significantly lower than [131(96, 210)×10⁹/L and 36.8(34.5, 39.5)g/L, respectively, P<0.05], while total serum bilirubin (TSB) level, international normalized ratio of prothrombin time, serum IgM and IgG levels in patients with PR were 56.9(30.1, 132.5)μmol/L,1.3(1.1, 1.6),14.0(12.3, 16.7)g/L and 17.7(14.5, 19.4)g/L, all much higher than [34.3(16.7, 67.9)μmol/L, 1.1(1.0, 1.2),11.2(9.4, 13.2)g/L and 12.5(10.7, 14.6)g/L, respectively, P<0.05] in those with CR; there were no significant differences as respect to interfacial hepatitis, Rosette-like manifestations, plasma cell infiltration and bile duct damages between the two groups (P>0.05);multivariate Logistic regression analysis showed that liver cirrhosis (OR=6.283, 95%CI:1.728-10.769,P=0.002), TSB (OR=11.158, 95%CI:2.200-18.758, P=0.001) and serum IgG level (OR=16.894, 95%CI:4.118-30.018, P<0.001) were the independent factors impacting response to immunosuppressive therapy. Conclusion Clinicians should take some impacting factors into consideration when immunosuppressive therapy is administered in patients with AIH, and optimization of treatment might carry out as necessary as possible.

Objective The aim of this study was to investigate the clinical implication of peripheral blood dendritic cells (DC) and their subsets in patients with primary biliary cholangitis (PBC) and PBC-autoimmune hepatitis overlap syndrome (PBC-AIH OS) . Methods 56 patients with PBC and 20 patients with PBC-AIH OS were encountered in Nantong Third People's Hospital between January 2020 and January 2024, receiving ursodeoxycholic acid (UDCA) or UDCA with immunosuppressant combination treatment for 12 months. Percentages of peripheral blood dendritic cell subpopulations, including plasmacytoid dendritic cells (pDC), conventional dendritic cells (cDC), conventional type 1 dendritic cells (cDC1) and conventional type 2 dendritic cells (cDC2) were detected by flow cytometry. Results Serum ALT, AST, bilirubin, albumin, globulin, bile acid, IgG and IgA levels in patients with PBC-AIH OS were significantly higher than those in patients with PBC (P<0.05); percentages of peripheral blood cDC, pdc, cDC1and cDC2 cells in patients with PBC were 1.1 (0.6, 1.9) %, 0.2 (0.1, 0.4) %, 0.004 (0.003, 0.010) % and 0.2 (0.1, 0.4) %, is significantly higher than [0.7 (0.4, 1.0) %, 0.1 (0.1, 0.2) %, 0.004 (0.0004, 0.007) % and 0.2 (0.1, 0.2) %, P< 0.05)] in patients with PBC- AIH OS; by end of 12-month treatment, complete response (CR) by Paris's criteria was found in 12 cases 60.0%)in patients with PBC-AIH OS, and in 47 cases (83.9%) in patients with PBC; percentages of cDC and cDC2 cells in CR patients with PBC were (1.4±1.0)% and 0.3(0.2,0.4)%, both significantly higher than [(0.6±0.4)% and 0.2(0.1,0.2)%, respectively P<0.05] in non-responders; percentages of cDC and cDC1 cells in CR patients with PBC-AIH OS were 0.7(0.5, 1.0)% and (0.01±0.002)%, both much higher than [0.4(0.2, 0.5)% and(0.0003±0.001)%, respectively, P<0.05] in non-responders. Conclusion DCs and their subpopulations change greatly, which might impact response of UDCA and/or immunosuppressant combination treatment, and needs further investigation.

Objective The purpose of this study was to explore implication of serum matrix metalloproteinase 1 (MMP-1) and interleukin-6 (IL-6) level changes in patients with primary biliary cholangitis (PBC)during ursodeoxycholic acid (UDCA) treatment. Methods 52 patients with PBCand 50 healthyindividuals were enrolled in our hospital between January 2022 and January 2024, and all patients received UDCA treatment for six months. Serum MMP-1 and IL-6 levels were detected by ELISA,multivariate Logistic regression analysis was applied to reveal impacting factors, and receiver operating characteristic (ROC) curve was used to evaluate predicting efficacy. Results At presentation, serum MMP-1 level in patients with PBC was (8.6±1.9)ng/mL, much lower than [(12.1±2.8)ng/mL, P<0.05], while serum IL-6 level was (9.8±2.4)pg/mL, much higher than [(6.1±1.5)pg/mL, P<0.05] in the healthy individuals; by end of six month treatment, serum MMP-1 level increased and serum IL-6 level decreased (P<0.05)in patients with PBC; baseline serum MMP-1 level in 17 patients with Ludwig phase Ⅲ/Ⅳ was much lower, while serum IL-6 level was much higher than in 35 patients with Ludwig phase Ⅰ/Ⅱ (P<0.05); complete response (CR) rate in our series was 59.6%(31/52) by end of six month observation; percentages of Ludwig phase Ⅲ/Ⅳ(76.2% vs. 3.2%), concomitant fatty liver (47.6% vs. 9.7%) and serum anti-mitochondrial antibody negative (38.1% vs. 12.9%), as well as total serum bilirubin (TSB) levels [(37.6±11.4)μmol/Lvs. (19.1±1.6)μmol/L], MMP-1[(7.6±1.5)ng/mL vs. (9.3±1.7)ng/mL] and IL-6 levels [(11.4±2.8)pg/mL vs. (9.0±1.8)pg/mL] in patients with incomplete response (ICR) were significantly different compared to in those with CR (P<0.05); multivariate Logistic regression analysis showed that Ludwig phase Ⅲ/Ⅳ, elevated TSB and IL-6 and decreased serum MMP-1 levels were all the independent risk factors impacting response to UDCA treatment(P<0.05);ROC analysis demonstrated that serum MMP-1 level lower than 8.0 ng/mL or serum IL-6 level higher than 10.6pg/mL hinted poor response to UDCA treatment (P<0.05). Conclusion Surveillance of serum MMP-1 and IL-6 level changes might help predict response to UDCA treatment in patients with PBC, which warrants further clinical investigation.

Objective The aim of this study was to compare discrepancy of platelet and coagulation functions between patients with liver cirrhosis (LC) and patients with primary liver cancer (PLC) and underlying LC. Methods A total of 80 patients with LC and another 80 patients with PLC and underlying LC were encountered in Department of Infectious Diseases, Second Affiliated Hospital, Xi 'an Jiaotong University between October 2022 and December 2023, and thromboelastography (TEG) was conducted to record maximum amplitude (MA), react time (R),kinetic time (K),alpha angle (Angle) and clot index (CI). Results There were no significant differences as respect to platelet counts and MA between patients with PLC and LC, although the parameters decreased greatly in both patients of PLC and LC(P>0.05); serum fibrinogen degradation products (FDP) and d-dimer (D-D) levels in patients with PLC were significantly higher than in those with LC (P<0.05); in patients with liver function Child class B/C, MA and CI in 64 patients with PLC were 49.0(40.8, 54.2) and -1.5(-3.7, 0.2), both much greater than [42.5(31.0, 50.2) and -3.2(-7.3,-0.2), respectively, P<0.05], and serum FDP and D-D levels were 5.3(2.9,12.0) μg/mLand 1750.0(870.0, 5285.0)ng/mL, both much higher than [2.1(1.5, 4.0) μg/mLand 740.0(527.5, 1522.5) ng/mL, respectively, P<0.05], while serum fibrinogen level was 1.5(1.1, 2.4) g/L, much lower than [2.1(1.7, 2.7) g/L,P<0.05] in 33 patients with LC. Conclusions Patients with PLC and underlying LC could have even more sophisticated coagulation function disorders, which might involve platelet functionchanges and warrants further investigation.

Objective The aim of this study was to investigate prediction of re-bleeding by platelet-to-albumin ratio (PAR) and Charlson comorbidity indexin cirrhotics with esophageal variceal bleeding (EVB) after first hemostasis. Methods 119 patients with EVB arisen from liver cirrhosiswere encountered in our hospital between May 2021 and June 2024, all received somatostatin and omeprazole therapy for emergent hemostasis at base of comprehensive supporting measurement and oral carvedilol maintenance thereafter, and were followed-up for six months. PAR and Charlson index were routinely obtained clinically, and hepatic vein pressure gradient (HVPG) was detected and calculated by Siremuller special equipment. Multivariate Logistic regression analysis was conducted to screen risk factors for re-bleeding, and receiver operating characteristic curve (ROC) was applied to analyze predicting performance. Results By end of 6 months, re-bleeding occurred in 41cases (34.5%) out of the 119 patients; platelet count and PAR in the re-bleeding group were (53.4±5.6)×10⁹/L and (1.8±0.2), both much lower than [(68.9±7.3)×10⁹/L and (2.3±0.4),P<0.05], while serum D-dimer, Charlson index, HVPG, portal vein diameter, splenic vein diameter and percentage of G3 EV were (2.7±0.3)g/L, (2.6±0.3),(20.3±2.6)mmHg, (16.3±1.7)mm,(10.5±1.4)mm and 78.0%, all significantly higher than [(1.4±0.2)g/L, (2.0±0.4),(16.2±1.8)mmHg, (14.6±1.8)mm, (8.8±0.9)mm and 42.3%, respectively, P<0.05] in non-re-bleeding group; Logistic regression analysis showed that PAR was protecting factor (OR=0.562, 95%CI:0.397-0.797,P<0.05), while Charlson index (OR=1.587, 95%CI: 1.064-2.368),HVPG(OR=1.464, 95%CI:1.072-1.999)and EV grading (OR=1.647, 95%CI:1.041-2.606, P<0.05) were all the independent risk factors;ROC analysis demonstrated that the AUC was 0.889(95%CI:0.838-0.939) when PAR was combined Charlson index in predicting re-bleeding, much superior to PAR[AUC=0.804(95%CI:0.747-0.861) by PAR or Charlson index [AUC=0.790(95%CI:0.725-0.855), P<0.05] alone. Conclusion The combination of PAR and Charlson index has to some extent predicting performance of re-bleeding in patients with EVB after first hemostasis.

Objective The aim of this study was to investigate the clinical efficacy of sofosbuvir and velpatasvir combination regimen in the treatment of patients with hepatitis C-induced liver cirrhosisand its influence on ultrasonic indexes of portal vain. Methods 54 patients with hepatitis C-induced liver cirrhosis, including compensated in 31 cases and decompensated in 23 cases, were enrolled in our hospital between June 2021 and June 2024, patients with compensated liver cirrhosis received sofosbuvir and velpatasvir combination, and those with decompensated liver cirrhosis received ribavirin at base of sofosbuvir and velpatasvir combination. Antiviral therapy lasted for 12 weeks. Serum HCV RNA loads were detected by fluorescenct quantitative RT-PCR, and serum hyaluronic acid (HA), type III procollagen (PCIII), type IV collagen (IV-C) and laminin (LN) levels were assayed immunoradiometric assay. Liver stiffness measurement (LSM), portal vein diameter (PVD) and spleen thickness (ST) were measured by Fibrotouch or ultrasonic diagnostic instrument. Results The sustained viral response (SVR) rate in our series was 94.4%, all but one with HCV genotype 1 and two with HCV genotype 3 responded completely to the antiviral therapy; virological response rate in patients with compensated cirrhosis at month one, month three and three months after discontinuation of antiviral therapy were all 100.0%, while in those with decompensated cirrhosis were 78.3%, 82.6% and 87.0%, respectively; after treatment, serum HA, PCⅢ and Ⅳ-C levels in patients with compensated cirrhosis were (92.6±21.4)μg/L, (127.2±28.4)μg/Land (105.6±26.8)μg/L, all significantly lower than [(139.4±35.8)μg/L, (197.6±34.8)μg/Land (166.2±32.9)μg/L, respectively, P<0.05] in those with decompensated cirrhosis; LSM and PVD were (18.2±2.1) kPa and (13.4±1.3)mm, both much less than [(20.7±2.3)kPa and (15.8±1.1)mm, respectively, P<0.05] in those with decompensated cirrhosis. Conclusion Sofosbuvir and velpatasvir combination with or without ribavirin in the treatment of patients with hepatitis C-induced liver cirrhosis is efficacious, which warrants further clinical observation.

Objective The aim of this study was to compare conventional ultrasonography and contrast-enhanced ultrasonography(CEUS) in assessing stent function in patients with cirrhotics with portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS) treatment. Methods 80 patients with hepatitis B-induced liver cirrhosis (LC) with PH were encountered in our hospital between November 2021 and October 2024, and all underwent TIPS routinely. Patients received digital subtraction angiography (DSA), conventional ultrasonography and CEUS examinations after surgery. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate diagnostic efficacy, and diagnostic consistency was assessed by Kappa analysis. Results By end of six months after TIPS, DSA found stent function normal in 73 cases(91.3%) and disabled stent function in 7 cases (8.7%) in the 80 patients with LC; conventional ultrasound found disabled stent function in 5 cases and CEUS found in 6 cases; the AUC was 0.857(95%CI:0.761-0.925)by conventional ultrasound in judging stent function disable, with sensitivity(Se), specificity(Sp), accuracy(Ac), positive predictive value (PPV) and negative predictive value (NPV) of 57.1%, 98.6%, 95.0%, 80.0% and 96.0%, and the AUC was 0.929(95%CI:0.848-0.974)by CEUS, with Se, Sp, Ac, PPV and NPV of 71.4%, 98.6%, 96.3%, 83.3% and 97.3%, respectively, with the consistence satisfactory (Kappa>0.640). Conclusion We recommend conventional ultrasonography for assessing stent function in patients with cirrhotic portal hypertension after TIPS, and CEUS could be done unless necessary.

Objective This study was conducted to investigate targeted and immunotherapy plus transarterial chemoembolization (TACE) in the treatment of patient with primary liver cancer (PLC). Methods A total of 100 PLC patients were encountered in our hospital between May 2021 and April 2023, randomly divided into control (n=50) and observation (n=50) groups, and all patients in the two groups underwent TACE for two to five times. Patients in the observation group received target medicine, including apatinib or cangvatinib, and immunomodulators, including carilizumab or trelizumab, etc., combination therapy for three months. Peripheral blood lymphocyte subsets were detected by FCM, serum AFP level were routinely obtained, and serum macrophage metastasis inhibitor (MIF) and vascular endothelial growth factor (VEGF) levels were determined by ELISA. Results By end of three month treatment, Objective response rate (ORR) in the observation group was 62.0%, much higher than 42.0% in the control group (P<0.05); after treatment, percentage of peripheral blood CD4⁺ cells and ratio of CD4⁺/CD8⁺cells in the observation group were (46.8±4.6)% and (1.8±0.3), both much higher than [(37.3±4.2)% and (1.3±0.3), respectively, P＜0.05], while percentage of CD8⁺ cells was (25.1±2.4)%, much lower than [(28.5±2.5)%, P＜0.05] in the control; serum AFP, MIF and VEGF levels were (110.2±27.5)μg/L, (55.8±10.1)ng/mL and (180.1±48.7)pg/mL, all significantly lower than [(288.1±31.5)μg/L, (80.1±11.3)ng/mL and (261.1±54.3)pg/mL, respectively, P＜0.05] in the control; by end of one-year follow-up, survival rate in the observation group was 66.0%, not statistically significantly different as compared to 46.7% in the control group (Log-Rank=2.643, P=0.104). Conclusin Targeted and immunotherapy with combination of TACE in dealing with patients with advanced PLC could get a satisfactory short-term clinical efficacy, which might be related to improvement of body immune functions, but the long-term efficacy should be investigated further.

Objective The aim of this study was to compare conventional and contrast-enhanced ultrasonography (CEUS) features of hepatocellular carcinoma (HCC0 and intrahepatic cholangiocarcinoma(ICC) for differentiation of the two entities. Methods 86 patients with HCC and 16 patients with ICC were encountered in our hospital between March 2019 and May 2024, and all underwent conventional and contrast-enhanced ultrasonography. The imaging features were compared between the two malignant tumors. Results There were no significant differences as respect to numbers of intrahepatic space-occupying lesions, shapes, diameters, intratumor echos, echo features and portal thrombosis between the two groups (P＞0.05), while the percentage of bile duct dilatation in patients with ICC was 37.5%, much higher than 2.3%(P＜0.05)in those with HCC; CEUS demonstrated that percentages of arterial-phase ring enhancement, arterial-phase hypo-enhancement, portal-phase hypo-enhancement andclearing time at delayed phase in ICC group were 37.5%, 18.8%, 93.8% and (45.2±8.1)s, all significantly higher or shorter than 10.5%, 2.3%,59.3% and (66.7±11.8)s in HCC group (P＜0.05). Conclusion The imaging features, such as bile duct dilation, arterial phase enhancement mode, arterial phase enhancement characteristics, and significant differences in clearance time in patients with ICC and HCC are obvious different, which might help clinicians differentiate the two liver cancers.

Objective The aim of this study was to investigate contrast-enhanced ultrasound (CEUS) in the diagnosis of hepatic hemangioma (HH and in evaluation of efficacy after transcatheter arterial embolization (TAE). Methods 86 patients with HH were encountered in our hospital between January 2021 and January 2024, and all underwent routine ultrasonography (US) and CEUS. TAE was performed in all patients with HH, and efficacy was evaluated three months after. Results Diameter of HH in our series was 5-10cm, with average of (7.4±1.1)cm; routine US found HH lesion regular in 65 cases (75.6%), clean margins in75 cases (87.2%),homogeneous echo in 67 cases (77.9%),high echo in 9 cases (10.5%) and rich blood supply in 19 cases (22.1%);CEUS demonstrated lesions with arterial phase high enhancement in 38 cases (44.2%), with overall enhancement in 33 cases (38.4%) and with centripetal enhancement in 15 cases (17.4%), with portal phase centrifugal enhancement in 4 cases (4.7%), with continuous high enhancement in 46 cases (53.5%) and with equal enhancement in 36 cases (41.9%), and with delayed phase high enhancement in 3 cases (3.5%), equal enhancement in 37 cases (43.0%) and with low enhancement in 46 cases (53.5%); three months after TAE, complete and partial remission rate was found in 73.7%% in 38 patients with HH lesion of overall enhancement, much higher than 45.8%(P<0.05) in 48 patients with lesions of centripetal /centrifugal enhancement. Conclusion TAE is efficacious in treatment of patients with HH, and those with CEUS overall enhancement might be even more satisfactory.

Objective The aim of this study was to summarize magnetic resonance imaging (MRI) manifestation of atypical focal nodular hyperplasia (FNH) of the liver. Methods 116 patients with liver FNH were encountered in our hospital between January 2022 and July 2024, all underwent plain, enhanced MRIscan, including diffusion weighted imaging (DWI), and the diagnosis was confirmed by biopsies or post-operational histo-pathological examinations. Results Of the 116 patients with liver FNHA, all had solitary intrahepatic nodule, located at right and/or left lobe, with diameters of 1.0to 11.2 cm, averaged with (6.1±1.3)cm, including≤2.0 cm in 31 cases, 2.0-5.0 cm in 51 cases and ＞5.0 cm in 34 cases; equal or slightly lower signals on T1WI, equal or slightly higher signals on T2WI, slightly higher signals on DWI, high signals at arterial phase, slightly high or equal signals at portal phase, equal or low signals at delayed phase, and high or equal signals at hepatobiliary phase; without central scar in 49lesions(42.2%),with pseudocapsule in 69lesions(59.5%),with internal bleeding or necrosis in 43lesions (37.1%),with fat infiltration in 37lesions (31.9%) and without significant enhancement at arterial phase in 56lesions(48.3%); percentages of without central scar, pseudocapsule, internal bleeding or necrosis, fat infiltration and non-significant enhancement at arterial phase in lesions >5.0cm were 64.7%, 88.2%, 61.8%, 52.9%and 73.5%, all significantly higher than 41.2%, 56.9%, 35.3%,31.4% and 47.1%(P＜0.05)in lesions of 2.0 to 5.0 cm or 19.4%, 32.3%, 12.9%, 9.7%and 22.6%(P＜0.05)in ≤2.0 cm of lesions. Conclusion Liver FNH, including atypical ones could have specific MRI feature, which might help clinicians make an appropriate measures to deal with.

Objective The aim of this study was to assess diagnostic performance of ultrasound fine vascular imaging technology (UFVIT) and contrast-enhanced ultrasound (CEUS) in patients with focal liver lesions (FLL). Method This study was conducted on clinical data of 95 patients with FLL who admitted to our hospital between May 2021 and April 2024, and all patients underwent UFVIT and intravenous CEUS examinations. Pathological diagnosis was made on tissues from fine needle aspiration biopsy or from post-operational specimens. Area under receiver operating characteristic curve was applied to evaluate diagnostic efficacy. Result Of 95 patients with FLL, postoperative pathological examination found benign lesions in 51 cases, including focal nodular hyperplasia in 20 cases, hepatic hemangiomas in 31 cases, and malignant lesions in 44 cases, including Cholangiocarcinoma in5 cases and hepatocellular carcinoma in 39 cases; the sensitivity, specificity and accuracy by UFVIT were 81.8%, 78.4% and 80.0%, by CEUS were 68.2%, 76.5% and 72.6%, while by combination of the two methods were 97.7%, 96.1% and 和96.8%, much superior to any one method alone (P<0.05). Conclusion Microvascular imaging technology and intravenous contrast-enhanced ultrasonography has a high accuracy and reliability in distinguishing intrahepatic benign and malignant lesions in patients with FLL, which might help clinicians make a correct interventional measurement.

Objective Theaim of this study was to compare clinical efficacy of lauromacrogol or anhydrous alcohol sclerotherapyin the treatment of patients with simple hepatic cysts(SHC) under ultrasound (US) guidance. Methods An consecutive 58 patients with SHC were encountered in the First Hospital of Yulin between June 2022 and January 2024, and were randomly divided into lauromacrogolgroup (n=28) and ethanol group (n=30). Patients received percutaneous transhepatic puncture under US guidance for cyst fluid extraction, then the sclerotherapy was carried out. Serum Golgi protein 73 (GP73), protein disulfide isomerase A3 (PDIA3) and chitosinase 3-like protein 1 (CHI3L1) levels were detected by ELISA, and post-operational pain was evaluated by visual analogue scale (VAS) score. Results At three days post-operationally, serumGP73, PDIA3 and CHI3L1 levels in patients with lauromacrogol sclerotherapy were (24.0±4.7)pg/L, (73.2±6.6)ng/ml and (41.7±4.5)ng/L, all much lower than [(36.7±6.1)pg/L, (92.8±7.9)ng/ml and (65.8±6.3)ng/L, respectively, P<0.05] in patients with ethanol sclerotherapy; at 2hour and 24hour, the resting and motion VAS scores in lauromacrogol group were all much lower than in ethanol group (P<0.05); incidence of adverse effects in lauromacrogol group was 14.3%, much lower than 36.7%(P<0.05) in ethanol group; by end of six months after treatment, disappearance rate of cysts in lauromacrogol group was 78.6%, much higher than 53.3%(P<0.05), and reduction of cyst volume was (93.7±9.7)%, much higher than [(83.0±9.2)%, P<0.05] in ethanol group. Conclusion Our results suggest that US-guided liver cyst puncture and fluid drainage with lauromacrogol sclerotherapy in dealing with patients with SHC has a satisfactory efficacy with less adverse effects.

Objective The aim of this study was to investigate ultrasound-guided polidocanol sclerotherapy in patients with hepatic cysts (HC). Methods Ninety-one patients with HC were recruited in Henan Provincial Children's Hospital between March 2022 and March 2024, and were randomly divided into control group (n=45) and observation group (n=46), receiving ethanol sclerotherapy, or polidocanol sclerotherapy under ultrasound-guidance. Serum Golgi protein 73 (GP73), protein disulfide isomerase A3 (PDIA3) and chitinase 3-like protein 1 (CHI3L1) levels were detected by using automatic immunoassay analyzer, and serum superoxide dismutase (SOD), nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) levels were measured by ELISA. Results After treatment, serum ALT and AST levels in the observation group were 48.4±9.2U/L and 38.4±7.3U/L, both significantly lower than [59.8±11.3U/L and 62.0±14.3U/L, P<0.05] in the control; serum GP73, PDIA3 and CHI3L1 levels were 24.4±3.6pg/L, 67.7±5.2ng/mL and 46.4±5.8ng/L, all much lower than [36.4±5.1pg/L, 92.7±5.4ng/mL and 65.8±6.4ng/L, respectively, P<0.05] in the control group; serum SOD, Nrf2 and HO-1 levels were 83.5±8.3 U/L, 713.3±82.3 U/L and 27.7±3.1U/L, all much higher than [77.5±7.8U/L, 664.7±75.3U/L and 23.7±2.5U/L, respectively, P<0.05] in the control; post-operationally, incidence of adverse effects in the observation group was 6.5%, much lower than 24.4%(P<0.05)in the control; six months after sclerotherapy, disappearance rate of HC in the observation group was 87.0%, much higher than 66.7%(P<0.05)in the control group. Conclusion Our observation backs up lauromacrogol sclerotherapy under ultrasound-guidance in patients with HC, which is efficacious and safe.

Objective The aim of this study was to analyze failure reasons of endoscopic retrograde cholangiopancreatography (ERCP)and rescue therapy in patients with common bile duct stones(CBDS). Methods A total of 254 patients with CBDS were encountered in our hospitalbetween January 2020 and June 2023, and all underwent ERCP therapy. The operation was finished by attending surgeons in 102 cases, and by proficient surgeons in other 152 cases. Failure reasons was recorded, and remedial management measures included laparoscopic or open cholecystectomy, percutaneous transhepatic biliary drainage (PTCD), ERCP once again by proficient surgeions, or comprehensive internal therapy. Results There were no statistically significant differences as respect to ages, gender, common bile duct diameters, stone sizes and concomitant gallbladder stones between patients treated by attending or proficient surgeons (P>0.05); in patients with selective operation, successful rate of ERCP by proficient surgeons was 82.2%, much higher than 72.5%(P<0.05) by attending surgeons, while there was no significant difference as respect to successful rate of ERCP in patients with emergent operation by the two group surgeons (8.6% vs. 8.8%, P>0.05);ERCP failed in 33 cases (13.0%) in our series, the main reasons arising from invisible duodenal papilla, including pyloric stenosis and duodenal stenosis, and from visible duodenal papilla, including juxtapapillary diverticulum, small papilla, edema of papilla, space-occupying lesions in papilla and bile duct stenosis, and there was no significant difference respect to ERCP failure reasons between attending and proficient surgeons(P>0.05); of 33 patients with failed ERCP, ERCP was tried again by proficient surgeons and successful in 7 patients (21.2%),laparoscopic or open cholecystectomy performed in 9 cases (27.3%), including palliative operation in 6 cases (66.7%)and radical surgery in 3 cases(33.3%), 2 patients (6.1%) with chronic pancreatitis and pseudocyst of the pancreas recovered, PTCD was carried out in 11 cases (33.3%), clinical symptoms relieved, and one of them recovered after open surgery, and comprehensive internal supporting therapy was administered in 4 cases (12.1%), and jaundice and abdominal pain disappeared in two (50.0%)of them. Conclusion ERCP is a complicated operation, and should be performed by proficient surgeons. We vigorously recommend preparation of rescue plans for failed patients for improvement of clinical outcomes.

Objective The aim of this study was to investigate magnetic resonance cholangiopancreatography (MRCP) and abdominal CT scan in preoperative evaluation of surgical difficulty in patients with gallstones and cholecystitis. Methods A total of consecutive 102 patients with gallstones and cholecystitis were encountered in our hospital between January 2022 and June 2024, and all underwent laparoscopic cholecystectomy (LC). Prior to operation, all patients received MRCP and abdominal CT scan. Operation difficulty was evaluated according to literature report, and readability of cystic arteries and cystic ducts were assessed based on imaging. Results Of the 102 patients with gallstones and cholecystitis, the imaging showed types of cystic arteries weretypeⅠa in 81 cases, type Ⅰb in 9 cases, type Ⅱa in 5 cases and type Ⅱb in 7 cases, with normal shape in 81 cases (79.4%), and abnormal in 21 cases (20.6%); the imaging also showed normal cystic duct shape in 85 cases (83.3%) and abnormal in 17 cases (16.7%);the scores of gallbladder artery display and gallbladder duct display in24 patients with surgical difficulty as assessed pre-operationally were (1.3±0.3) points and (1.4±0.3)points, both significantly lower than [(1.6±0.3) points and (1.7±0.3)points, respectively, P＜0.05] in 78 patients with operation easily, while the gallbladder wall thickness, gallbladder volume and stone diameter were (10.1±2.3)mm, (53.2±8.3)mm³ and (18.2±3.3)mm, all significantly greater than [(7.5±2.1)mm, (46.4±7.1)mm³ and (14.4±5.1)mm, respectively, P＜0.05] in easy operation group. Conclusion MRCP and abdominal CT scan could clearly display anatomic structure around gallbladder artery and cystic duct, which might help evaluate pre-operationally LCdifficulty in patients with gallstones and cholecystitis.

Objective The aim of this study was to investigate influencing factors on postoperative stone residual and recurrence in patients with intrahepatic bile duct stones (IHBDS) after partial hepatectomy (ph) and cholangioenterostomy. Methods 50 patients with IHBDS were encountered in our hospital between January 2019 and January 2022, all underwent PH and choledochojejunostomy and were followed-up for one year. Serum C-reactive protein (CRP) and interleukin- 6 (IL-6) levels were detected by ELISA. Multivariate Logistic regression analysis was applied to predict impacting factors of stone residual or recurrence. Results By end of one-year follow-up, stoneresidual was found by imaging in 10 cases (20.0%) among our 50 patients with IHBDS; at baseline, percentages of bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture in patients with residual stone or recurrence were 60.0%, 60.0% and 80.0%, all much higher than 20.0%, 20.0% and 35.0% (P<0.05) in patients without; at presentation, white blood cell count, serum CRP, GGT and IL-6 levels in patients with stone residual were (7.9±0.9)×10⁹/L, (52.7±4.6)mg/L, (252.7±27.4)U/L and (92.5±14.3)μg/L, all significantly higher than [(4.6±0.8)×10⁹/L, (25.6±3.0)mg/L, (143.5±26.0)U/L and (65.3±15.2)μg/L, respectively, P<0.05] in patients without; multivariate Logistic regression analysis showed that bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture were all the independent risk factors for stone residual or recurrence(OR=3.536, OR=3.695,OR=3.404, respectively, P<0.05). Conclusion The main problem after PH and cholangioenterostomy in patients with IHBDS is stone residual or recurrence, and how to tackle it still need further clinical investigation.

Primary liver cancer ( PLC ) is one of the most common cancers in the world and is also the third most common cause of death from malignant tumors. It increases family and social economic burden. In recent years, hepatic artery infusion chemotherapy ( HAIC ) has gained more and more favor in the treatment of patients with PLC due to its excellent efficacy and safety. The raltitrexed and oxaliplatin (RALOX)-HAIC regimen has emerged in this field as the active exploration of domestic scholars get a satisfactory efficacy. In this article, we reviewed the application and prospect of RALOX-HAIC and its combination therapy in dealing with patients with PLC.