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Table of Content

    28 February 2026, Volume 31 Issue 2
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    Liver Failure
    The predictive value of different prognostic scoring models for the survival rate of patients with acute-on-chronic liver failure after liver transplantation
    LAI Man, XU Man-man, WANG Xin, LI Guang-ming, CHEN Yu
    2026, 31(2):  168-171. 
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    Objective To evaluate the efficacy of different prognostic scoring models in predicting the postoperative survival rates of patients with acute-on-chronic liver failure (ACLF) after liver transplantation, and to provide a basis for optimizing the decisions of liver transplantation. Methods A retrospective study was conducted on 131 ACLF patients who underwent liver transplantation from June 2018 to October 2023. The clinical data of all these patients were collected, and the following scoring models were calculated: model for end-stage liver disease (MELD) series (MELD, MELD-Na, MELD 3.0), chronic liver failure consortium organ failure (CLIF-C OF), chronic liver failure consortium acute on chronic liver failure (CLIF-C ACLF), transplantation for ACLF grade 3 model (TAM), and Sundaram ACLF-liver transplantation-mortality score (SALT-M) . The predictive efficacy of each scoring model for 90-day and 1-year postoperative survival was analyzed using receiver operating characteristic (ROC) curves method. DeLong tests were used to compare the areas under the ROC curves (AUROC). Kaplan-Meier analysis was performed to assess the prognostic differences stratified by SALT-M scores, and the correlation between SALT-M and CLIF-C ACLF was analyzed. Results Among the seven scoring models, the AUROC values of CLIF-C OF, CLIF-C ACLF, and SALT-M for predicting 1-year postoperative survival are 0.676, 0.695, and 0.680, respectively. However, there was no significant difference in the predictive efficacies among these three models (P>0.05). A weak to moderate positive correlation was found between SALT-M and CLIF-C ACLFs (R=0.319, P<0.001). After stratification by SALT-M tertiles, it was shown that the 1-year survival rate in the T3 group (≥9.34) was significantly lower than that in the T1 group (≤7.43) and T2 group (7.44~9.32) (P=0.015; P=0.028). Conclusion The CLIF-C OF, CLIF-C ACLFs, and SALT-M scores demonstrated a certain predictive value for postoperative survival in ACLF patients after liver transplantation. The SALT-M score is simple and practical but has limited stratification ability for patients with intermediate and low risks. It is recommended to combine with the dynamic changes when scoring to improve their predictive accuracy. Further large-scale studies are needed to validate the discriminative ability for extremely high-risk populations. This study provides theoretical support for individualized decision-making for liver transplantation and postoperative management.
    Liver Fibrosis & Cirrhosis
    The establishment of a predictive model for hepatic encephalopathy secondary to chronic hepatitis B-related cirrhosis based on LASSO regression
    YE Xiao-xin, LI Wei, GAO Yu-feng, XIAO An-ling, LIU Nan-nan
    2026, 31(2):  172-176. 
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    Objective This study aims to establish a predictive model for hepatic encephalopathy secondary to chronic hepatitis B-related cirrhosis using LASSO regression analysis. Methods The study population consisted of 189 patients with chronic hepatitis B-related cirrhosis admitted from January 2022 to January 2024. Patients with hepatic encephalopathy were designated as the observation group, while the others were served as the control group. The baseline data and biochemical indices of all patients were collected and compared between the two groups. LASSO-logistic regression analysis was employed to identify the predictive factors for hepatic encephalopathy and construct a predictive mode. The model′s fit was evaluated using the akaike information criterion (AIC) and bayesian information criterion (BIC), comparing the traditional logistic and LASSO-logistic regression models, and validated by calibration curves. Results Among the 189 patients with hepatitis B-related cirrhosis, 32.28% (61/189) developed hepatic encephalopathy. The baseline data of patients in the observation group were as the following: age (56.2±7.2) years, alanine aminotransferase (ALT) (32.15±4.51) U/L, aspartate aminotransferase (AST) (46.72±5.48) U/L, total bilirubin (TBil) (40.01±5.53) μmol/L, alkaline phosphatase (ALP) (95.67±10.28) U/L, blood ammonia (51.03±7.34) μmol/L, and model for end-stage liver disease (MELD) score (10.13±2.54), all of which were higher than those of (53.0±4.5) years, (28.83±4.10) U/L, (40.88±5.11) U/L, (28.78±5.11) μmol/L, (89.14±9.77) U/L, (30.28±5.93) μmol/L, and (7.23±8.205), respectively, in patients of the control group. Additionally, the levels of hemoglobin (Hb) and albumin (Alb) were lower than those of the observation group, with statistically significant differences (P<0.05). According to LASSO-logistic regression analysis, advanced age, high blood ammonia, high MELD score, and low albumin (Alb) were identified as independent risk factors for the development of hepatic encephalopathy. The AIC and BIC values for the LASSO-logistic regression model were 20.221 and 39.672, respectively, indicating a good fit of the model. Conclusion The LASSO-logistic regression model, based on the selected variables, shows good fit and predictive accuracy for assessing hepatic encephalopathy in patients with chronic hepatitis B-related cirrhosis.
    The clinical characteristics and influencing factors of recompensation in patients with first-time decompensated hepatitis B-related cirrhosis with esophageal and gastric fundus variceal rupture and bleeding
    LI Wen-ting, WANG Jing, DANG Tong, JIANG Zhen-yu
    2026, 31(2):  177-181. 
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    Objective To explore the clinical characteristics and influencing factors of patients with first-time decompensated hepatitis B-related cirrhosis accompanied by esophageal and gastric fundus variceal rupture and bleeding who have achieved recompensation. Methods A retrospective study was conducted on 69 inpatients with hepatitis B-related cirrhosis in the Second Affiliated Hospital of Baotou Medical College from January 2015 to January 2024. All patients were followed-up with the occurrence of the first recompensation or ≥2 decompensations (continuous decompensation) as the end-point. Based on their outcomes the patients were divided into a recompensation group and a continuous decompensation group. The independent influencing factors of re-compensation were analyzed. The differences in the cumulative occurrences of liver cancer were analyzed among patients with different compensatory states. Results Among the 69 patients with decompensated hepatitis B-related cirrhosis, 32 cases ultimately achieved re-compensation and 37 cases remained decompensation after antiviral treatment. Compared the data of patients in re-compensation group with those of persistent decompensation group, age (HR=0.94, 95%CI: 0.90~0.99, P=0.02), CTP scores (HR=0.63, 95%CI: 0.46~0.86, P<0.05), MELD scores (HR=0.90, 95%CI: 0.85~0.96, P<0.05) were identified to be independent influencing factors of re-compensation; When compared the clinical data of patients at re-compensation with those at first decompensation, there were significant statistical differences in CTP scores [(6.12±1.07) score vs. (7.91±1.59) score, OR=1.79, 95%CI: 1.01~3.16, P=0.05], Alb [(38.80±4.51)g/L vs. (30.98±4.98)g/L, OR=0.82, 95%CI: 0.68~0.97, P=0.02], Hb [(123.28±28.96)g/L vs. (89.69±23.49)g/L, OR=0.96, 95%CI: 0.93~0.99, P=0.01]; The incidence of tumors in patients with re-compensation was significantly lower than that in patients with continuous decompensation (HR=0.23, 95%CI: 0.37~0.57, P=0.02). Conclusion Compared with the baseline data of the patients with first decompensation, there were significant improvements in CTP score, Alb and Hb in the patients of re-decompensation group. Compared with the data of the continuous decompensation group, patients with younger age, lower CTP scores and MELD scores were more likely to achieve re-compensation, and the cumulative incidence of tumors in re-compensated patients was significantly lower than that in the continuous decompensation patients.
    The clinical value of spleen stiffness in the diagnosis of esophageal varices in patients with hepatitis B-related cirrhosis
    YANG Xue-ping, WANG Xue-mei, HE Nan, PAN Guo-dong, ZHANG Yao, YU Jing
    2026, 31(2):  182-186. 
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    Objective To explore the non-invasive parameters that can be used to evaluate esophageal varices (EV) from ultrasound, liver and spleen stiffness measurement and laboratory data of patients with hepatitis B-related cirrhosis. Methods A total of 202 patients with hepatitis B-related cirrhosis admitted to Beijing Ditan Hospital Affiliated to Capital Medical University from March 2019 to March 2022 were enrolled in this study. The patients′ endoscopies, abdominal ultrasounds, liver stiffness measurements, spleen stiffness measurements (SSM), and laboratory data were collected. According to the endoscopic results, they were divided into an EV group and a non- EV group. The values of platelet count to spleen diameter ratio (PC/SD) and liver stiffness measurement-spleen diameter to platelet ratio (LSPS) were calculated. Univariate and multivariate logistic regression analyses were conducted to identify the independent influencing factors of EV. The effectiveness of these factors in diagnosing EV was evaluated with receiver operating characteristic (ROC) curve analysis. The accuracy of them in diagnosing EV was compared with those of PC/SD and LSPS. Results Among the 202 patients, there were 136 in the EV group and 66 in the non-EV group. LSM, SSM, portal vein diameter, splenic vein diameter, splenic index, INR and Child Pugh score in patients with EV were 19.69 (13.86, 27.01) kPa, 48.78 (40.89, 54.67) kPa, 13.20 (12.00, 14.50) mm, 10.95 (8.63, 13.00) mm, 47.01 (36.81, 58.28) cm2, 1.30 (1.18, 1.45) and 6 (5,8) respectively, which were significantly higher than those of 13.37 (8.08, 22.30) kPa, 24.51 (20.90, 33.34) kPa, 11.60 (1.80, 12.50) mm, 6.60 (5.58, 8.00) mm, 24.69 (18.96, 32.92) cm2, 1.17 (1.06,1.31), and 5 (5,7) in patients without EV (P<0.05). The PLT of the EV group was 57.85 (44.18,82.75)×109/L, which was lower than that of 112.50 (72.50,150.50)×109/L in the non-EV group. Multivariate analysis showed that SSM was an independent influencing factor of EV (HR=1.234, 95%CI:1.137~1.339, P<0.001). The area under the curve (AUC) for diagnosing EV with SSM was 0.947 (95%CI: 0.906-0.973, P<0.001) with the optimal cutoff value of 35.2 kPa. The diagnostic accuracy of SSM was better than that of PC/SD (Z=4.162, P<0.001) and LSPS (Z=4.356, P<0.001). Conclusion SSM can be used as a primary screening method to evaluate EV in patients with hepatitis B-related cirrhosis. SSM can be used as a reference for diagnosing EV.
    A study on the diagnostic value of portal hemodynamics combined with red blood cell distribution width to lymphocyte ratio (RLR) in evaluating esophageal varices in hepatitis B-related liver cirrhosis
    WANG Hai-yu, ZHANG Mei-xi, ZHANG Zhi-bo, LI-Jing, WANG Qian
    2026, 31(2):  187-190. 
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    Objective To explore the diagnostic value of hemodynamic parameters of portal vein combined with red blood cell distribution width to lymphocyte ratio (RLR) in hepatitis B-related liver cirrhosis complicated by esophageal varices (EV). Methods A total of 126 patients with hepatitis B-related liver cirrhosis admitted to Qinhuangdao Traditional Chinese Medicine Hospital from January 2021 to January 2024 were selected. All patients underwent endoscopic examination. Patients with EV were designated as the observation group, and patients without the condition was referred as the control group. The clinical data of all patients were collected, and the portal vein blood flow was assessed using color Doppler ultrasound. The RLR was then compared between the two groups. Logistic regression analysis was conducted to explore the relationship between portal hemodynamic parameters and RLR and the occurrence of esophageal varices. The diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves method. Results Among the 126 patients with hepatitis B-related liver cirrhosis, 77 (61.11%) developed EV. The portal vein blood flow velocity in the observation group was significantly lower than those in the control group [(9.51 ± 1.68) cm/s vs. (12.97 ± 2.21) cm/s]. The portal vein diameter, blood flow volume, and RLR in the observation group were significantly greater than those in the control group [(15.02 ± 2.71) mm vs. (13.56 ± 2.52) mm; (1 099.84 ± 296.75) mL/min vs. (792.32 ± 180.92) mL/min; (18.12 ± 2.94) vs. (13.86 ± 2.53)], respectively. Logistic regression analysis showed that an increased portal vein diameter, blood flow volume, RLR, and reduced blood flow velocity were associated with a higher risk of developing EV. ROC curve analysis indicated that the combined use of portal hemodynamic parameters and RLR had a diagnostic accuracy of 0.981 (0.963~0.999), sensitivity of 90.9%, and specificity of 95.9%. Conclusion The combined evaluation of portal hemodynamic parameters and RLR has a high diagnostic value for EV in hepatitis B-related liver cirrhosis.
    The prognostic value of serum sCD163 and MMP-9 in patients with esophageal and gastric variceal bleeding
    CHANG Yun-li, YE Jing, CHEN Guo-yu, FENG Ling-mei, MA Rong, LUO Hao
    2026, 31(2):  191-194. 
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    Objective To evaluate the prognostic value of serum soluble hemoglobin scavenger receptor (sCD163) and matrix metalloproteinase-9 (MMP-9) in cases with esophageal and gastric varices bleeding (EGVB). Methods A total of 178 patients with EGVB admitted to our hospital from January 2018 to November 2023 were selected. They were divided into a death group (n=11) and a survival group (n=167) according to their prognosis. Serum levels of sCD163 and MMP-9 were detected in all subjects after admission and compared among all groups. The prognostic value of serum sCD163 and MMP-9 in patients with EGVB were evaluated by receiver operating characteristic curve (ROC) method , and the related factors affecting the prognosis of cases with EGVB were explored by multi-factor logistics regression. Results The serum levels of sCD163 and MMP-9 in patients with EGVB in the death group were higher than those in the survival group [(98.96±16.69) pg/mL vs. (157.54±18.46) pg/mL, (88.69±15.66) ng/mL vs. (345.43±35.74) ng/mL, respectively] (P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of serum sCD163 and MMP-9, and their combination in predicting the death of patients with EGVB were 0.854 (95%CI: 0.804~0.904) and 0.867 (95%CI: 0.817~0.917), and 0.905 (95%CI: 0.855~0.955), respectively. Serum sCD163 (OR=3.762, 95%CI: 1.978~7.155) and MMP-9 (OR=3.469, 95%CI: 1.977~6.089) levels and MELD score (OR=2.423, 95%CI: 1.628~3.607) and GBS score (OR=2.779, 95%CI: 1.750~4.413) were risk factors associated with motality in patients with EGVB (P<0.05). Conclusion The increments of serum sCD163 and MMP-9 levels are closely related to the prognosis of patients with EGVB, and has good prognostic predicting value, which may to be used as biomarkers to evaluate the patients’ prognosis.
    The application of ultrasound SWE and TE techniques combined with APRI in assessing the severity of esophagogastric varices in liver cirrhosis
    LI Wen-zhou, GUO Jun-xian, BAO Qi-de
    2026, 31(2):  195-199. 
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    Objective To investigate the clinical value of shear wave elastography (SWE), transient elastography (TE), and the aspartate aminotransferase-to-platelet ratio index (APRI) in assessing the severity of esophagogastric varices (EGV) in patients with liver cirrhosis. Methods A total of 128 patients diagnosed with liver cirrhosis and confirmed to have EGV by endoscopy in Anyang District Hospital of Puyang City between January 2022 and December 2024 were enrolled in this study. Based on the finding of endoscopic examination, the patients were divided into a mild group (n=61) and a moderate-to-severe group (n=67). All patients underwent SWE, TE, and serological tests within one week prior to endoscopic examination. Liver and spleen elasticity parameters and APRI values were recorded. The correlations of them with EGV severity were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the combined model. Results The liver mean values of elasticity (liver Emean) [(28.03±10.15) kPa], liver maximum values of elasticity (liver Emax) [(49.78±11.65) kPa], spleen Emean [(55.15±8.77) kPa], spleen Emax [(80.45±10.54) kPa], liver fibrosis index (LF) Index[(3.02±0.23)], spleen LF index [(3.32±0.71)], spleen stiffness [(16.55±3.21) kPa], and APRI index [(3.51±0.56)] levels in the moderate-to-severe group were significantly higher than those of (20.66±5.68) kPa, (37.15±8.77) kPa, (33.46±9.41) kPa, (49.78±12.69) kPa, (2.92±0.24), (2.91±0.88), (11.12±2.65) kPa, (2.02±0.55),in the mild group [P<0.05]. Spearman correlation analysis showed that these indicators were positively correlated with EGV severity. ROC analysis demonstrated that a combined diagnostic model incorporating indicators with AUC>0.750 (including liver Emax, spleen Emean, spleen Emax, spleen stiffness, and APRI) yielded an AUC of 0.930. Conclusion The diagnostic model constructed using SWE, TE, and APRI can effectively assess the severity of EGV in patients with liver cirrhosis with high diagnostic performances, which may provide a noninvasive reference for pre-endoscopic stratification.
    The application value of point shear wave elastography combined with contrast-enhanced ultrasound quantitative parameters in detecting the curative effect of TIPS in liver cirrhotic patients complicated with portal hypertension
    CHEN Jin-jin, HU Xin, QIN Fei, JIANG Jun-lin, LI Lin
    2026, 31(2):  200-203. 
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    Objective Investigate the application value of point shear wave elastography (pSWE) combined with quantitative parameters of contrast-enhanced ultrasound (CEUS) in evaluating the curative effect of transjugular intrahepatic portosystemic shunt (TIPS) for liver cirrhotic patients complicated with portal hypertension (LC-PHT). Methods 108 patients with LC-PHT undergoing TIPS were enrolled in Jiangnan University Affiliated Wuxi Fifth Hospital between July 2022 and December 2024. Before treatment and at 3 months after treatment, pSWE and CEUS were performed to compare quantitative parameters [shear wave velocity (SWV) of liver and spleen, arrival time (AT), time to peak (TTP), peak intensity (PI), ascending branch slope (AS)] and Freiburg index of post-TIPS survival (FIPS). The relationship between pSWE, CEUS quantitative parameters and FIPS score was analyzed by Pearson correlation analysis. Results After TIPS, spleen SWV and FIPS score were (2.4±0.7) m/s and (-0.86±0.21) points, which were lower than those of (3.8±0.8) m/s, and (-0.56±0.14) points before treatment [P<0.05], TTP was shorter than that before treatment [(29.5±2.9) s vs. (35.6±3.8) s, P<0.05], PI and AS were (18.6±2.5) dB and (1.3±0.4) dB/s, which were higher than those of (13.4±2.0) dB and (1.0±0.3) dB/s before treatment [P<0.05]. In LC-PHT patients after TIPS, spleen SWV and TTP were positively correlated with FIPS score (r=0.47, P<0.05; r=0.51, P<0.05), while PI and AS were negatively correlated with it (r=-0.38, P<0.05; r=-0.41, P<0.05); However, liver SWV and AT was not correlated with FIPS score (r=0.08, P>0.05; r=0.14, P>0.05). Conclusion The clinical application value of pSWE combined with CEUS quantitative parameters is high in evaluating the curative effect of TIPS in LC-PHT patients.
    Liver Tumor
    Feasibility study of ultrasound-guided radiofrequency ablation for hepatocellular carcinoma in special locations
    ZHENG Bing, LI Xiao-he, GUO Xing-chun, MO Peng
    2026, 31(2):  204-206. 
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    Objective To evaluate the safety and efficacy of ultrasound-guided radiofrequency ablation (MWA) for hepatocellular carcinoma (HCC) in special locations, thereby improving the feasibility and clinical application value of this technique. Methods 92 HCC patients treated in our hospital between January 2019 and January 2023 were involved in our study. Among them, 45 patients had HCC in special locations were the observation group. The remaining patients served as the control group. Both groups underwent a treatment regimen of transarterial chemoembolization (TACE) combined with MWA. Clinical efficacy, tumor markers, and survival rates were compared between the two groups. Results At the 1-month follow-up, there was no statistically significant difference in disease control rates between the two groups (P>0.05). Compared with baseline levels, both the observation and control groups showed significant increases in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) after treatment (P<0.05). Additionally, alpha-fetoprotein (AFP), cancer antigen 125 (CA-125), and cancer antigen 199 (CA-199) levels decreased significantly at 1 and 12 months post-treatment in both groups (P<0.05). Regarding long-term survival outcomes, no statistically significant difference was observed in cumulative survival rates between the two groups at 6, 12, 18, and 24 months (Log-rank test: χ2=0.167, 0.875, 1.452, and 2.639; P=0.862, 0.801, 0.651, and 0.208). Conclusion TACE combined with MWA for HCC in special locations demonstrates good feasibility and safety, with comparable disease control rates, changes in tumor marker reductions, and long-term survival rates to those of HCC in common locations.
    Value of diffusion-weighted MRI combined with dual-source CT in evaluating the efficacy of TACE in patients with primary liver cancer
    WANG Wan-ting, LUO Wei
    2026, 31(2):  207-210. 
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    Objective To evaluate the efficacy of magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) combined with dual-source CT in patients with primary liver cancer after transcatheter arterial chemoembolization (TACE). Methods A total of 117 patients with primary liver cancer (PLC) admitted to our hospital between June 2022 and December 2024 were selected. The apparent diffusion coefficient (ADC), start time (TTS), hepatic artery perfusion volume (ALP), blood volume (RV), hepatic perfusion index (HPI) and portal vein perfusion volume (PVP) were detected by MRI-DWI and dual-source CT. Receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was used to evaluate the value of dual-source CT perfusion imaging parameters combined with CT in predicting residual lesion area after TACE. Results Before operation, 46 cases had non-uniform hyperperfusion and 71 cases had uniform ALP perfusion. PVP showed low perfusion. One month after operation, the results showed that 85 cases of ALP showed high perfusion, site defect or iodol deposition in the lesion. 32 cases of ALP showed no perfusion and intrafocal perfusion fluid was uniformly deposited. One month after surgery, ADC value and PVP in residual lesion were (1.3±0.1) ×10-3 mm2/s and (8.0±1.6) [mL/ (100 mL·min-1)], respectively, significantly lower than the values before operation [(1.5±0.2) ×10-3 mm2/s, (10.2±2.6) [mL/ (100mL·min-1)], P<0.05]. ALP and HPI were (48.3±6.8) [mL/ (100 mL·min-1)] and (82.3±6.5) %, respectively, which was significantly higher than that those before operation [(37.4±5.9) [mL/ (100 mL·min-1)] and (74.1±5.8) %, respectively, P<0.05]. One month after surgery, ADC, TTS and PVP in the completely embolized zone were (1.8±0.4) ×10-3 mm2/s, (12.1±2.9) s, (46.3±5.9) [mL/ (100 mL·min-1)], respectively, significantly higher than preoperative values of (1.5±0.2) ×10-3 mm2/s, (6.2±1.4) s, (10.3±2.7) [mL/ (100 mL·min-1) (P<0.05). ALP, RV and HPI were (16.3±3.2) [mL/ (100 mL·min-1)], (4.9±1.5) mL/100 mL, (20.3±3.1) %, respectively, which was significantly lower than that before operation [(37.9±5.4) [mL/ (100 mL·min-1)], (12.3±2.7) mL/100 mL, (73.6±5.3) %, P<0.05]. ROC analysis showed that the specificity and sensitivity of residual area after TACE were 93.8%, 90.6% and 0.909 respectively. Conclusion ADC value, PVP and ALP combined with HPI have important value in predicting the postoperative efficacy of TACE in patients with primary liver cancer.
    Serum levels of ADAMTS13, GDF-15, and ANGPTL6 in patients with HBV-related hepatocellular carcinoma and their correlation with hepatocellular carcinoma
    ZHAO Wei, MA Min, XU Qiao-yun, ZHANG Jian
    2026, 31(2):  211-214. 
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    Objective To investigate the serum levels of a disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS13), growth differentiation factor-15 (GDF-15), and angiopoietin-like protein 6 (ANGPTL6) in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) and their correlation with HCC. Methods Eighty patients with HBV-related HCC admitted to Nanjing Lishui People's Hospital and Nanjing Gaochun People's Hospital between June 2020 and December 2023 were selected as the observation group, and 80 patients with chronic HBV infection during the same period were selected as the control group. General data, and serum levels of ADAMTS13, GDF-15, and ANGPTL6 of the two groups were compared. Multivariate logistic analysis was used to identify the risk factors associated with the HBV-related HCC, and the diagnostic value of each factor in predicting HCC occurrence was assessed by receiver operating characteristic (ROC) curves. Results The serum levels of ADAMTS13, GDF-15, and ANGPTL6 in the observation group were (975.15±191.60) ng/mL, (1.61±0.29) ng/mL, and (163.66±47.40) ng/mL, respectively, lower than those in the control group [(1 140.63±158.34) ng/mL, (2.03±0.43) ng/mL, and (199.58±44.86) ng/mL]. Logistic regression analysis showed that low levels of ADAMTS13, GDF-15, and ANGPTL6, and high levels of HBV DNA, were independent risk factors for the occurrence of HBV-related HCC (P<0.05). ROC curve analysis indicated that the sensitivity of ADAMTS13, GDF-15, and ANGPTL6 in predicting HCC occurrence in chronic HBV-infected patients was 52.5%, 73.8%, and 65.0%, respectively. The specificity was 88.7%, 71.3%, and 71.3%, respectively, with are under the curve (AUC) of 0.745, 0.787, and 0.711. When ADAMTS13, GDF-15, and ANGPTL6 were combined for prediction, the sensitivity and specificity increased to 70.0% and 88.7%, respectively, with an AUC of 0.878. Conclusion Serum levels of ADAMTS13, GDF-15, and ANGPTL6 are significantly reduced in patients with HBV-related HCC, and the expression levels of these biomarkers are closely related to the occurrence of HCC. Dynamic monitoring of these markers may contribute to the early warning and prognosis of HCC.
    Analysis of the efficacy of hepatic artery chemoembolization combined with ultrasound-guided microwave ablation in the treatment of solitary caudate lobe hepatocellular carcinoma
    LI Ying-jie, DING Bin, CHEN Shan-shan, DONG Cheng
    2026, 31(2):  215-219. 
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    Objective To evaluate the efficacy of transcatheter hepatic arterial chemoembolization (TACE) combined with ultrasound-guided microwave ablation (MWA) in the treatment of isolated caudate lobe hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on 70 patients with isolated caudate lobe HCC who were treated at Leshan People's Hospital between January 2015 and January 2022. The patients were divided into an observation group (34 patients treated with TACE combined with MWA) and a control group (36 patients treated with TACE alone). Preoperative clinical data, one-month postoperative serum tumor markers, liver function indicators, clinical efficacy, incidence of postoperative adverse reactions, and 2-year overall survival (OS) rate were recorded and compared between the two groups. Results There was no statistically significant difference in preoperative clinical data such as age, gender, tumor diameter, Child-Pugh grade, presence of hepatitis, and cirrhosis between the two groups (all P>0.05). One month after surgery, the levels of serum tumor markers alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and vascular endothelial growth factor (VEGF) in the observation group were (124.04±13.41) ng/mL,(3.69±1.47) ng/mL, and (237.64±26.86) ng/L, respectively, which were lower than those in the control group [(144.68±13.82) ng/mL, (3.48±1.44) ng/mL, and (263.93±27.17) ng/L], respectively. Among them, the differences in AFP and VEGF levels between the two groups were statistically significant (t=6.338, 4.068, respectively, both P<0.05). One month after surgery, the liver function indicators of total bilirubin (TBil), albumin (Alb), and alanine aminotransferase (ALT) in the observation group were (18.55±1.93) μmol/L, (37.68±4.13) g/L, and (44.36±4.19) U/L, respectively, which were lower than those in the control group [(21.07±2.02) μmol/L, (36.39±5.90) g/L, and (51.40±4.10)U/L, respectively. Among them, the differences in TBil and ALT levels between the two groups were statistically significant (t=5.309, 7.092, respectively, both P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05). One month after surgery, the objective response rate in the observation group was 79.4%, significantly higher than that in the control group (55.6%) (χ2=4.511, P<0.05). Two years after surgery, the OS rate in the observation group was 70.6%, significantly higher than that in the control group (44.4%) (χ2=4.880, P<0.05). Conclusion Compared with TACE alone, TACE combined with MWA for the treatment of isolated caudate lobe HCC can effectively improve early clinical efficacy and two-year OS.
    Effect of sindilizumab combined with sorafenib in the treatment of advanced primary liver cancer
    ZHOU Xiao-qiu, KONG Li-xia, XU Yan
    2026, 31(2):  220-223. 
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    Objective To observe the efficacy and safety of sintilimab combined with sorafenib in the treatment of advanced primary liver carcinoma (PLC). Methods Using the prospective study method, 198 patients with advanced PLC admitted to Wuxi 904 Hospital from July 2019 to January 2022 were divided into the experimental group and control group. The anti-tumor efficacy, tumor markers, immune function, liver function, drug safety and survival within 1 year of continuous treatment were compared between the two groups after 3 cycles of continuous treatment. Results The anti-tumor efficacy [objective remission rate (41.41% vs. 26.26) and clinical control rate (76.77% vs. 60.61%)] of the test group was better than that of the control group (P<0.05), and there was no difference in safety (31.31% vs. 28.28%) and survival (P>0.05). After treatment, carcinoembryonic antigen [(15.24±3.01) ng/mL], alpha-fetoprotein [(119.84±20.19) ng/mL], glycan antigen 199 [(98.32±16.38) U/mL], Th1/Th2 [(4.98±0.64)], and Th17/Treg [(1.03±0.16)], and CD4+/CD8+ [(1.41±0.21)] levels in the study group were better than those in the control group [(19.87±3.25) ng/mL, (152.31±28.69) ng/mL, (128.65±20.34) U/mL, (5.39±0.72), (1.21±0.18), (1.23±0.19)] (P< 0.05). Conclusion The combination of sintilimab and sorafenib can effectively reduce the level of tumor markers in patients with advanced PLC, improve the immune function of patients, and have a high safety profile.
    The diagnostic value of dual energy CT quantitative parameters for different tissue types in patients with hepatocellular carcinoma after arterial chemoembolization
    ZHANG Xiu-juan, ZANG Chuan-cheng, ZOU Hong-mei
    2026, 31(2):  224-227. 
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    Objective To explore the role of dual energy CT quantitative parameters in evaluating patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Methods A retrospective analysis was conducted on the clinical and dual energy CT imaging data of 72 HCC patients who received TACE treatment in Qingdao Third People's Hospital from June 2021 to June 2024. Digital subtraction angiography (DSA) was used as a reference standard, the arterial phase standardized iodine concentration (NICAP), portal vein phase standardized iodine concentration (NICPP), iodine concentration difference (ICD), arterial iodine fraction (AIF), and Hounsfield unit curve slope (λHu) of region of interest (ROI) measurements in tumor active areas, normal liver tissue adjacent to cancer, and tumor necrosis areas were analyzed in dual energy CT iodine maps. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of dual energy CT quantitative parameters for different tissue types. Results In a total of 72 patients, 401 ROIs were measured, including 175 in the tumor active area, 175 in the peritumor normal liver tissue, and 51 in the tumor necrosis area. The λHu, NICAP, and NICPP of the tumor active area were 3.34±0.97, (16.33±6.77)%, and (46.56±12.37)%, respectively, which were all higher than those of the peritumor normal liver tissue [0.69±0.21, (2.56±0.61)%, (39.49±9.77)%] and the tumor necrosis area [0.36±0.18, (2.40±0.61)%, (9.14±2.53)%], with statistically significant differences (P<0.05). The ICD of the tumor active area was (0.52±0.18) mg/mL, which was lower than that of the peritumor normal liver tissue (1.32±0.37) mg/mL and higher than that of the tumor necrosis area (0.31±0.12) mg/mL (P values were all <0.05). The AIF of the tumor active area was 0.97±0.26, which was higher than that of the peritumor normal liver tissue (0.13±0.03) and lower than that of the tumor necrosis area (1.08±0.35) (P values were all <0.05). Conclusion Dual energy CT quantitative parameters can effectively distinguish between tumor active areas, normal liver tissue adjacent to cancer, and tumor necrotic areas in the liver after TACE.
    Construction and comparison of hepatocellular carcinoma prediction models based on serum AFP, AFP-L3 and PIVKA-Ⅱ
    LI Bo, WANG Hai-yu, JIANG Wen, YU Jin-hong, ZHANG Yong-chen
    2026, 31(2):  228-233. 
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    Objective To construct a prediction model for hepatocellular carcinoma (HCC) based on serum alpha fetoprotein (AFP), alpha fetoprotein isoform (AFP-L3), and protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ), and to compare its value with previously published predictive models, exploring its clinical application significance. Methods A total of 106 patients with HCC and 60 patients with liver cirrhosis were collected from the Second Hospital of Nanjing between January and May 2023 as the training set. An additional 40 cases of HCC and 46 cases of liver cirrhosis were collected from May to July 2024 as the validation set. A risk prediction model for HCC was established using stepwise backward logistic regression, and its efficacy was validated in the validation set. The diagnostic value of the model was evaluated by comparing the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy with two previously reported HCC predictive models. Results The levels of AFP [596.85 (60.71, 16 338.00)(ng/mL)], AFP-L3 [58.07 (7.05,2730.50)(ng/mL)]and PIVKA-Ⅱ [1 934.50 (59.42, 19 036.25)(ng/mL)] in HCC group were significantly higher than those in cirrhosis group, and the differences were statistically significant (P<0.01). Through multivariate logistic regression analysis, AFP [OR(95%CI): 1.030(1.008~1.052), P=0.007], AFP-L3 [OR(95%CI): 0.971(0.950~0.992), P=0.007] and PIVKA-Ⅱ [OR(95%CI): 1.002(1.000~1.004), P=0.031] were identified as predictive variables for HCC diagnosis. A model was constructed based on these variables. The AUC for the ROC curve in the training set was 0.979 (95%CI: 0.943~0.995), with sensitivity and specificity of 94.30% and 91.70%, respectively. In the validation set, the AUC was 0.939 (95%CI: 0.866~0.979), with sensitivity and specificity of 100% and 76.10%, respectively. Our constructed model demonstrated good diagnostic performance compared to the ASAP and GALAD models. Conclusion The developed predictive model effectively assesses the risk of HCC in high-risk patients, providing important clinical evidence for early diagnosis of hepatocellular carcinoma.
    Effects of preoperative serum IL-34 and MMP-9 levels on the clinical stage and prognosis of primary liver cancer based on mediation analysis
    HU Gang-feng, WANG Jun, ZHANG Bo, WANG Lu-bing, HUANG Lei
    2026, 31(2):  234-241. 
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    Objective To predict the effects of preoperative serum interleukin-34 (IL-34) and matrix metalloproteinase-9 (MMP-9) levels on the clinical stage and prognosis of primary liver cancer (PLC) based on mediation effect analysis. Methods 186 patients with PLC were selected as subjects, all of whom were treated in Shanghai Health Medical College Affiliated Chongming Hospital from June 2017 to June 2021. The subjects were divided into stage I group, stage II group and stage III group according to clinical stage. The subjects were followed up after the operation. Those who died from all causes during the follow-up period were included in the poor prognosis group, and the remaining were assigned to the good prognosis group. The clinical data of the subjects were collected and the levels of serum IL-34 and MMP-9 were detected before operation. Univariate and ordered Logistic regression were used to analyze the independent factors affecting the clinical stage of patients. Univariate and multivariate Cox regression were used to analyze the independent risk factors for poor prognosis. The mediating effect was analyzed by screening out variables that affect both clinical analysis and prognosis of patients as covariables. Results Among the 186 patients included in this study, 12 patients were lost to follow up, with a loss rate of 6.45% (12/186). Among the other 174 patients, 45 patients were in stage I, 70 patients in stage II, 59 patients in stage III, and 52 patients died of all causes, with an adverse prognosis rate of 29.89% (52/174). Univariate and multivariate Logistic regression analysis showed that lymph node metastasis, tumor size (>5 cm), Barcelona Clinic Liver Cancer stage (BCLC stage C), low albumin, IL-34 and MMP-9 were all independent risk factors affecting the clinical stage progression of patients with PLC (P<0.05). Univariate and multivariate Cox regression analysis showed that lymph node metastasis, tumor size (>5 cm), BCLC stage (grade C), Child-Pugh grade (grade B), low albumin, IL-34 and MMP-9 were independent risk factors for poor prognosis in patients with PLC (P<0.05). Lymph node metastasis, tumor size, BCLC stage, and low albumin were included in the mediation effect model as covariables. The results showed that preoperative serum IL-34 and MMP-9 had a positive predictive effect on the poor prognosis of patients with primary liver cancer (β=1.853, 2.214, both P<0.001). They also had positive predictive effect on clinical stage (β=0.264, 0.478, P<0.001). After the clinical stage was included in the model, preoperative serum IL-34 and MMP-9 levels had a positive predictive effect on the poor prognosis of patients with primary liver cancer (β=2.436, 3.108, both P<0.001). Direct effect accounted for 78.45% and 82.36% respectively, indirect effect accounted for 21.55% and 17.64% respectively. Conclusion The higher the levels of serum IL-34 and MMP-9 before operation, the higher the risk of poor prognosis in patients with primary liver cancer. The higher the level of serum IL-34 and MMP-9 before operation can directly affect the prognosis of patients, and also indirectly affect the prognosis of patients through affecting the clinical stage.
    Clinical diagnostic value of multi-slice spiral CT combined with serum miR-574-5p and miR-876-5p for primary liver cancer
    CHEN Wen-zhuo, LIU Bin, JIANG Yun-guang, HUANG Li-ming, LI Miao
    2026, 31(2):  242-247. 
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    Objective To explore the clinical diagnostic value of multi-slice spiral CT combined with serum miR-574-5p and miR-876-5p for primary liver cancer, and analyze the levels of the two factors in the serum of primary liver cancer patients. Methods From June 2023 to June 2024, 120 patients with primary liver cancer admitted to Tieling Central Hospital Affiliated to China Medical University were included as the liver cancer group. During the same period, 60 patients with benign liver lesions were included in the benign liver disease group; 60 healthy individuals who underwent physical examinations in our hospital were classified as the healthy group. Serum samples and clinical data were collected from the research subjects . Multi-slice spiral CT scan was performed. The quantitative polymerase chain reaction (qPCR) method was applied to detect serum miR-574-5p and miR-876-5p. The influencing factors of primary liver cancer were analyzed using logistic regression. ROC curve was applied to analyze and evaluate the diagnostic value of individual and combined detection of various indicators for primary liver cancer. Results The blood flow, hepatic artery perfusion, and average transit time in the liver cancer group were increased compared to the healthy group and the benign liver disease group, while the arrival time of the contrast agent was reduced compared to the healthy group and the benign liver disease group (P<0.05). The serum miR-574-5p level in the liver cancer group was higher than that in other groups, with liver cancer group(3.89±1.03)>benign liver disease group(2.09±0.60)>healthy group(1.03±0.32)(F=277.433,P<0.001), while the miR-876-5p level decreased, with the liver cancer group(0.51±0.14)<benign liver disease group(0.72±0.23)<healthy group(0.98±0.22)(F=127.840,P<0.001), and both pairwise comparisons were meaningful, with obvious differences (P<0.05). The differentiation degree, TNM stage, hepatitis B surface antigen and vascular invasion were different in patients with primary liver cancer (P<0.05). Low differentiation, TNM stage III, positive hepatitis B surface antigen, vascular invasion, large blood flow, long average transit time, and high level of miR-574-5p(ORmiR-574-5p=1.307,PmiR-574-5p=0.001) were risk factors for primary liver cancer, and high level of miR-876-5p(ORmiR-876-5p=0.547,PmiR-876-5p<0.001) was a protective factor for primary liver cancer. The AUC for combined diagnosis was 0.923, with sensitivity and specificity of 86.67% and 81.67%, respectively. The combined diagnosis was superior to individual diagnosis (Zcombination-blood flow=2.896, Z combination - average transit time=2.425, Zcombination-miR-574-5p=2.910, Zcombination-miR-876-5p=4.958, P<0.05). Conclusion Serum miR-574-5p level is elevated in patients with primary liver cancer, while miR-876-5p level is decreased. The combination of multi-slice spiral CT and serum levels of miR-574-5p and miR-876-5p is of great significance and value for the clinical diagnosis of primary liver cancer patients.
    Effects of incadronate disodium combined with local single radiotherapy on bone metabolism, liver function and quality of life in patients with hepatocellular carcinoma with bone metastasis
    LIU Hui, XU Xiao-mei, LIU Xiao-gang, HU Ya-fang, ZHANG Yan
    2026, 31(2):  248-252. 
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    Objective To investigate the efficacy and safety of cadronic acid disodium combined with local single radiotherapy in patients with hepatocellular carcinoma(HCC) with bone metastasis. Methods 68 HCC patients with bone metastasis admitted from January 2022 to March 2024 in Hai′an City People′s Hospital were randomly divided into an observation group and a control group. Based on routine intervention and single radiotherapy, the control group were treated with zoledronic acid, while the observation group were treated with infadronate disodium. The course of treatment was 2 months. The changes of bone metabolism, liver function, physiological indexes, efficacy and safety were observed. Results After 2 months of treatment, the serum 25-hydroxyvitamin D level in the observation group was (45.08±6.13) ng/mL, which was higher than that in the control group (40.27±5.26) ng/mL, the level of type I collagen crosslinked amino terminal peptide and serum bone-specific alkaline phosphatase were (22.93±2.75) ng/mL and( 92.76±7.81) U/L. Lower than (26.76±3.08) ng/mL and (98.54±8.36)U/L in control group, the differences were statistically significant (t=6.914, 6.237, 6.873, P<0.05). The levels of alanine aminotransferase, alkaline phosphatase and total bilirubin in the observation group were (68.42±6.18) U/L, (91.37±7.65) U/L and (17.35±2.07) μmol/L,lower than (74.29±6.84) U/L, (98.63±8.04) U/L, (18.47±2.13) μmol/L in control group, the differences were statistically significant (t=6.417, 6.527, 6.165, P<0.05). The scores of the pain scale and the bone metastases-specific subscale of the European Cancer Research and Treatment tissue in the observation group were (4.51±0.75) and (17.46±3.08) points, which were lower than those of the control group (4.97±0.84) and (19.38±3.25) points, and the core score of the quality of life scale for cancer patients was (66.59±5.71) points. It was higher than 61.84±5.47 points in the control group, and the differences were statistically significant (t=5.672, 6.385, 6.473, P<0.05). The objective remission rate of observation group was 67.65%, which was higher than that of control group (47.06%). The incidence of adverse reactions was 11.76%, which was lower than 26.47% in the control group, with statistical significance (χ2=3.296, 3.514, P<0.05). Conclusion Cadronic acid disodium combined with local single radiotherapy can improve the metabolism and liver function of HCC patients with bone metastasis and the quality of life.
    Metabolic Associated Fatty Liver Disease
    Polymorphism of methylenetetrahydrofolate reductase gene in patients with T2DM combined with NAFLD and the relationship with hepatic fat content and insulin resistance
    CHENG Xiao-he, ZHAI Chun-ying, KE Xiao-li, TIAN Nan
    2026, 31(2):  253-256. 
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    Objective To analyze the polymorphism of methylenetetrahydrofolate reductase gene and the relationship with hepatic fat content and insulin resistance in patients with type 2 diabetes mellitus (T2DM) combined with nonalcoholic fatty liver disease (NAFLD). Methods A total of 120 patients with T2DM complicated by NAFLD admitted to our hospital from January 2021 to December 2022 were selected. Patients carrying the CC genotype at the C677T locus were classified as the wild-type group, while those with the CT or TT genotype were assigned to the mutation group. The clinical characteristics of the two groups were compared, and multivariate logistic regression analysis was performed to identify independent risk factors influencing methylenetetrahydrofolate reductase (MTHFR) gene polymorphism in T2DM patients with NAFLD. Results Among the 120 patients, 50 were in the mutation group and 70 in the wild-type group. Compared to the wild-type group, the mutation group exhibited significantly higher serum homocysteine levels (P<0.05). No statistically significant differences were observed in fasting blood glucose, fasting insulin, or HOMA-IR between the two groups (P>0.05). The mutation group showed significantly lower HDL levels (P<0.05). In terms of liver fat content, the mutation group had 30 cases with <240 dB/m and 20 cases with >240 dB/m, while the wild-type group had 25 cases and 45 cases, respectively, with a statistically significant difference (P<0.05). Elevated serum homocysteine, reduced HDL, and liver fat content >240 dB/m were identified as independent risk factors for MTHFR gene polymorphism in these patients (OR=5.078, 4.918, 4.963; P<0.05). Conclusion Serum Hcy, high-density lipoprotein cholesterol, and hepatic fat content above 240 dB/m were independent risk factors affecting methylenetetrahydrofolate reductase gene polymorphisms in patients with T2DM combined with NAFLD, and mutations in the C677T locus of the methylenetetrahydrofolate reductase gene usually resulted in abnormal lipid metabolism but had no effect on hepatic fat content.
    Expression of ITGBL1 in metabolic dysfunction-associated steatohepatitis and its correlation with patient prognosis
    DAI Wen, CHEN Hui, LI Zi-qiang, JI Yi-fei, LU Cui-hua, HUANG Wei
    2026, 31(2):  257-263. 
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    Objective To investigate the dynamic expression of ITGBL1 in metabolic dysfunction-associated steatohepatitis (MASH)-related hepatic fibrosis and elucidate its correlation with fibrosis staging and clinical prognosis. Methods Transcriptomic data from MASH patient liver tissues were retrieved from the GEO database. Dimensionality reduction analysis was performed to visualize sample distribution patterns. Differentially expressed genes (DEGs) across fibrosis stages were identified, and common intersecting genes were screened using Venn diagrams. Correlation analysis was used to evaluate the association between ITGBL1 expression and fibrosis severity. Receiver operating characteristic (ROC) curves were constructed to assess diagnostic efficacy. Immune cell infiltration profiles were analyzed, and fluorescence in situ hybridization (FISH) was used to determine the subcellular localization of ITGBL1 mRNA. Results Venn analysis identified ITGBL1 as a core intersection gene across all DEG groups. ITGBL1 expression exhibited a fibrosis stage-dependent escalation, with optimal diagnostic performance at F4 stage (AUC=0.958, 95% CI: 3.118~34.769; sensitivity=88.9%, specificity=95.7%). ITGBL1 expression was positively correlated with M1 macrophage infiltration (R=0.468, P<0.0001) but negatively correlated with M2 polarization (R=-0.188, P=0.032). FISH confirmed nuclear-specific enrichment of ITGBL1 mRNA in F2-stage hepatocytes (3.8-fold fluorescence intensity increase vs. controls, P=0.0021). Conclusion ITGBL1 serves as a novel molecular biomarker for MASH-related hepatic fibrosis progression, shows high diagnostic accuracy for advanced fibrosis stages.
    Application of ultrasound FibroTouch quantitative technology in screening for fatty liver disease and evaluation of liver fibrosis in middle and young people undergoing physical examination
    GUO Kai, ZHOU Xiao-jun, GAO Hong-ying, ZHANG Zhi-jian, LI Ting
    2026, 31(2):  264-266. 
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    Objective To explore the application of ultrasound FibroTouch quantitative technology in screening for fatty liver disease and evaluating liver fibrosis in middle-aged and young patients undergoing physical examinations. Methods 296 young patients who underwent physical examinations in our hospital from January 2023 to September 2023 were selected as the research subjects, all patients underwent quantitative ultrasound FibroTouch examination. Detection of fatty liver disease and liver fibrosis were recorded by physical examination population. Gender and BMI of fatty liver diesease and liver fibrosis patients were recorded. Changes in hardness, elasticity, and fat attenuation were conpared among healthy individuals, fatty liver groups, and liver fibrosis groups. ROC curve analysis of hardness, elasticity, and fat attenuation were used to explore the predictive value for fatty liver and liver fibrosis. Results Among the 296 middle-aged and young patinets undergoing physical examination, 137 cases of fatty liver were detected, accounting for 46.28%. Among them, 39 cases of liver fibrosis were detected, accounting for 13.18%. The detection rate of fatty liver in males higher than females (P<0.05); the detection rate of liver fibrosis between different genders showed no significant difference (P>0.05). The detection rates of fatty liver with BMI of 18.5-23.9 kg/m2, 24.0-27.9 kg/m2, and ≥28.0 kg/m2 higher BMI<18.5 kg/m2 (P<0.05). The detection rate of fatty liver with a BMI of 24.0~27.9 kg/m2 and ≥28.0 kg/m2 higher BMI of 18.5~23.9 kg/m2 (P<0.05). The detection rate of fatty liver with BMI≥28.0 kg/m2 was higher than BMI 24.0~27.9 kg/m2 (P<0.05); The detection rate of liver fibrosis among different BMI groupsshowed no significant difference (P>0.05). The fatty liver group and liver fibrosis group hardness, elasticity, and fat attenuation were higher than healthy population (P<0.05). The liver fibrosis group hardness, elasticity, and fat attenuation were higher compared to fatty liver group (P<0.05). The ROC curve analysis showed that the combination of hardness and elasticity values with fat attenuation had higher sensitivity and specificity in predicting fatty liver and liver fibrosis than hardness and elasticity values with fat attenuation (P<0.05). Conclusion Ultrasound FibroTouch quantitative technology has important predictive value in screening fatty liver disease and evaluating liver fibrosis in middle-aged and young physical examination patients, with good sensitivity and specificity, and is worth clinical reference.
    Other Liver Diseases
    Levels of thiopurine metabolites in patients with autoimmune hepatitis and their predictive value for therapeutic effect
    WU Ben-juan, CHEN Fu-xi, KONG Chun-yu
    2026, 31(2):  267-270. 
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    Objective To analyze the levels of thiopurine metabolites in autoimmune hepatitis (AIH) patients and their predictive value for treatment efficacy. Methods Fifty-two AIH patients were enrolled between January 2022 and December 2024 and treated with prednisone combined with azathioprine. Fifty healthy individuals undergoing routine physical examinations during the same period were enrolled as control group. Clinical parameters of AIH group and control group were compared before and after treatment. Changes in 6-thioguanine nucleotides (6-TGNs) and 6-methylmercaptopurine nucleotides (6-MMPNs) levels were analyzed across different treatment response groups, and their predictive efficacy for AIH treatment response was evaluated. Results Before treatment, AIH patients showed significantly higher levels of ALT, AST, IgG, IgM, and gamma-globulin than controls (P<0.05). After treatment, these parameters decreased significantly in AIH patients (P<0.05). At the end of treatment, 31 patients achieved complete response, while 21 had incomplete response. The 6-TGN level in the complete response group [225 (74-717) pmol/8×108 RBC] was significantly higher than in the incomplete response group [150 (53,370) pmol/8×108 RBC, P<0.05], whereas 6-MMPN levels did not differ significantly between groups (P>0.05). Among complete responders, 12, 10, and 9 patients achieved response within <3 months, 3~6 months, and >6 months, respectively. Rapid responders (<6 months) had significantly higher 6-TGN levels than delayed responders (>6 months) (P<0.05), while 6-MMPN levels showed no significant differences across response timelines (P>0.05). 6-TGN demonstrated strong predictive value for treatment response (AUC=0.79; diagnostic cutoff: 174 pmol/8×108 RBC). Conclusion 6-TGN is a core predictor of thiopurine treatment response in AIH. A concentration >174 pmol/8×108 RBCs may serve as a biomarker for complete response.
    Hexavalent phospholipids ameliorate alcoholic liver disease by modulating lipid metabolism via the p38 MAPK/CD36 axis
    GENG Wen-qian, WANG Yang, LI Jia-xi, YUAN Xiao-xue, YANG Song
    2026, 31(2):  271-278. 
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    Objective To investigate the hepatoprotective effects of HexaV in ALD and elucidate its underlying molecular mechanisms, with particular focus on its regulatory pathways in lipid metabolic dysregulation. Methods 30 male SPF-grade C57BL/6 mice were randomly divided into three groups: the control group (normal saline, 5 g/kg, once daily for 8 weeks), the ALD model group (32.5% absolute ethanol, 5 g/kg, once daily for 8 weeks), and the ALD + HexaV group (32.5% absolute ethanol (5 g/kg) + HexaV (0.8 mg/g), once daily for 8 weeks). Mouse serum and liver tissues were collected, and biochemical indicators in mouse serum were detected. Pathological changes in mouse liver tissues were observed through HE and Oil Red O staining. Transcriptome sequencing, q-PCR and Western Blot were performed on mouse liver tissues to detect the mRNA and protein expression of related genes. Results Compared to the control group, alcohol treatment increased plasma ALT (U/L) levels (430.90±150.56 vs. 228.80 ±115.87, t=2.450, P=0.036). After HexaV treatment, plasma ALT (U/L) (ALD+HexaV group vs. control group: 34.15±19.79 vs. 228.80±115.87, t=4.766, P=0.001; ALD+HexaV group vs. ALD group: 34.15±19.79 vs. 430.90±150.56, t=7.470,P<0.001) and AST (U/L) (ALD+HexaV group vs. control group: 246.00±95.40 vs. 690.80±148.28, t=6.667, P<0.001; ALD+HexaV group vs. ALD group: 246.00±95.40 vs. 639.40±160.57, t=5.764, P<0.001) levels were reduced compared to both the control group and the ALD model group. Compared to the control group, the ALD model group showed a significant increase in TC (mmol/L) content (3.61±0.20 vs. 1.80±0.34, t=8.529,P<0.001). In the ALD+HexaV group, plasma TC (mmol/L) (ALD+HexaV group vs. ALD group: 3.27±0.12 vs. 3.61±0.20, t=2.894, P=0.034) and TG (mmol/L) (ALD+HexaV group vs. ALD group: 0.53±0.03 vs. 0.67±0.06, t=3.575, P=0.011) levels were significantly reduced compared to the ALD group. Histological assessment (H&E and Oil Red O staining) confirmed HexaV-mediated attenuation of liver injury and steatosis in ALD mice. RNA-seq analysis identified 66 consensus DEGs, with 51 showing reversal of ALD-induced upregulation and 15 exhibiting rescure of ALD-suppressed expression following HexaV treatment. KEGG pathway analysis identified significant enrichment of DEGs in lipid metabolic and pro-inflammatory cascades. GSEA confirmed marked activation of atherogenic pathways (Fat digestion and absorption Lipid and atherosclerosis, PPAR signaling pathway) in ALD mice, with complete reversal following HexaV intervention. Ranscriptomic enrichment analysis revealed significant involvement of the MAPK signaling pathway. Western Blot confirmed p38 hyperphosphorylation in ALD mice, which was attenuated by HexaV treatment. Conclusion Our study demonstrates that HexaV attenuates alcoholic steatosis through selective inhibition of the p38 MAPK-CD36 axis, revealing both a druggable pathway in ALD pathogenesis and a clinically actionable therapeutic strategy.