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Table of Content

    30 April 2026, Volume 31 Issue 4
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    Viral Hepatitis
    The impact of HBeAg status on HBV RNA in chronic hepatitis B patients undergoing treatment
    MU Huan, ZHANG Ying-yuan, XU Dan-qing, MOU Chun-yan, LI Wen-yan, CHANG Li-xian, LIU Li, LIU Chun-yun, HE Yu-xiao
    2026, 31(4):  482-485. 
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    Objective To explore the correlation between hepatitis B virus e antigen (HBeAg) status and hepatitis B viral (HBV) RNA in patients with chronic hepatitis B (CHB) whose HBV DNA is below the lower limit of monitoring. Methods From January 2023 to December 2023, one hundred and fifty CHB patients were admitted to the Third People′s Hospital of Kunming, including 110 males (73.33%) and 40 females (26.67%). These patients were all treated and achieved HBV DNA<100 IU/mL. They were divided into a positive and a negative groups based on the status of HBeAg, with 28 cases (18.67%) in the HBeAg positive group and 122 cases (81.33%) in the HBeAg negative group. The correlation of HBV RNA between the two groups.were compared. Results The results showed that there were statistically significant differences (P<0.05) in the levels of HBV RNA (Z=-6.095), HBsAg (Z=-4.169), and anti-HBe (Z=-3.995) between the two groups of patients. Whereas there was no statistically significant difference in the levels of aspartate transaminase (AST), alanine amintransferase (ALT), platelets count (PLT), anti-HBc, and liver hardness. Subsequently, Pearson and Spearman correlation analysis was performed and the result revealed that HBV RNA was associated with HBsAg (r=0.002, P<0.005) and HBeAg (r=0.000, P<0.005) in the HBeAg positive group. In the HBeAg negative group, HBV RNA was associated with HBsAg (r=0.000, P<0.005), and anti-HBc (r=0.024, P<0.005). Conclusion In the HBeAg positive group, HBV RNA is significantly positively correlated with HBsAg and HBeAg in patients with CHB who have undergone treatment, indicating there existed active viral transcription; In the HBeAg negative group, HBV RNA was positively correlated with HBsAg and anti-HBc, indicating that viral transcription was inhibited. For CHB patients undergoing treatment, the status of HBeAg can affect their HBV RNA levels. Patients in the HBeAg positive group have higher HBV RNA levels than those in the HBeAg negative group, indicating an higher viral transcriptional activity.
    A clinical outcome study on switching to interferon α-2b treatment in chronic hepatitis B patients poor responsiveness to nucleos(t)ide analogs (NAs)
    HUANG Fei, HE Shuang-mei, QIN Chun-jun, YANG Jing-yi, MAN Yin-xue
    2026, 31(4):  486-489. 
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    Objective To analyze the clinical efficacy and outcome differences of switching to interferon α-2b treatment in chronic hepatitis B (CHB) patients poor responsiveness to nucleos(t)ide analogs (NAs). Methods A total of 114 CHB patients poor responsiveness to NAs treatment were collected from January 2022 to June 2024 in our hospital. Based on their previous treatment response, the patients were divided into a drug-resistant group (n=58) and a partial responder group (n=56). All patients were switched to pegylated interferon α-2b treatment for 48 weeks. The clinical efficacy, HBV DNA negativity rate, HBsAg negativity rate, HBeAg negativity rate, anti-HBs positivity rate, anti-HBe positivity rate, alanine aminotransferase (ALT) normalization rate, liver function, blood routine, and safety were compared between the two groups of patients. Results After treatment, the overall clinical efficacy of the drug-resistant group and the partial responder group (48.28% vs. 58.93%) showed no significant statistical difference (P>0.05). After 12, 24, and 48 weeks of treatment, the HBV DNA negativity rate (12 w: 31.03% vs. 44.64%; 24 w: 43.10% vs. 58.93%; 48 w: 55.17% vs. 66.07%), HBsAg negativity rate (12 w: 3.45% vs. 5.36%; 24 w: 6.90% vs. 12.50%; 48 w: 10.34% vs. 17.86%), HBeAg negativity rate (12 w: 39.66% vs. 46.43%; 24 w: 44.83% vs. 51.78%; 48 w: 53.45% vs. 62.50%), anti-HBs positivity rate (12 w: 0% vs. 1.78%; 24 w: 3.45% vs. 10.71%; 48 w: 8.62% vs. 17.86%), anti-HBe positivity rate (12 w: 39.66% vs. 46.43%; 24 w: 43.10% vs. 50.00%; 48 w: 48.28% vs. 58.93%), and ALT normalization rate (12 w: 37.93% vs. 51.78%; 24 w: 60.34% vs. 71.43%; 48 w: 70.69% vs. 82.14%) showed significant improvement in relative to baseline, with no significant difference between the two groups (P>0.05). After 48 weeks of treatment, the ALT [(41.15±13.03) U/L vs. (38.12±12.17) U/L], aspartate aminotransferse (AST) [(38.67±10.92) U/L vs. (36.45±8.36) U/L], total bilirubin (TBil) [(15.42±3.73) μmol/L vs. (14.86±3.95) μmol/L], alkaline phosphatase (ALP) [(82.36±20.14) U/L vs. (78.63±22.47) U/L], γ-glutamyl transpeptidase (GGT) [(41.17±11.32) U/L vs. (38.25±10.64) U/L], white blood cells count (WBC) [(3.88±1.04)×109/L vs. (4.02±1.11)×109/L], platelet count (PLT) [(122.63±21.35)×109/L vs. (128.47±19.82)×109/L], and hemoglobin (Hb) [(122.37±12.45) g/L vs. (124.16±11.93) g/L] levels showed no significant difference between the two groups (P>0.05), but all were significantly lower than baseline (P<0.05). The total incidence of adverse events was not significantly different between the two groups (13.79% vs. 10.71%, P>0.05). Conclusion For CHB patients poor responsiveness to NAs treatment, switching to interferon α-2b treatment can significantly improve virological and biochemical markers. However, there was no significant difference in the treatment efficacy between the two groups, suggesting that interferon α-2b has similar effects on patients with different types of treatment response, although it has a certain degree of safety. The hematological toxicity related to interferon treatment needs close monitoring.
    Liver Fibrosis&Cirrhosis
    An analysis on the risk factors of nonalcoholic steatohepatitis-related cirrhosis
    JIANG Li-ping, WANG Hong-yan
    2026, 31(4):  490-493. 
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    Objective To investigate the influencing factors of nonalcoholic steatohepatitis (NASH) progression to cirrhosis in order to prevent the development of NASH-related cirrhosis (NASLC) at an early stage. Methods A case-control study was conducted in patients enrolled from Mengchao Hepatobiliary Hospital of Fujian Medical University between December 2017 and December 2019. Within them, 45 hospitalized patients with NASH-related cirrhosis were selected as the case group, and 180 age- and sex-matched NASH patients without cirrhosis that were admitted during the same period of time was selected as the control group. The study aimed to analyze the risk factors associated with NASLC. Results In the case group, the levels of prothrombin time (PT), prothrombin time and international normalised ratio (PT-INR), thrombin time (TT), and total bilirubin (TBil) were (13.98±3.88)s, 1.01(0.92,1.10), (17.57±1.57)s, and 17.5(9.4,26.5)μmol/L, respectively, which were significantly higher than those of (12.91±2.16)s, 0.95(0.88,1.03), (16.99±1.69)s and 14.1(6.3,21.0)μmol/L in the control group. Conversely, the prothrombin time activity (PTA), uric acid (UA), total glycerol (TG) platelet count (PLT) and white blood cells count (WBC) in the case group were (95.62±18.78)% (286.84±84.77)μmol/L, 1.54(0.95,2.20)mmol/L, (5.56±2.12)×109/L, and (167.71±70.24)×109/L, respectively, which were significantly lower than those of (105.78 ± 15.17)%, (342.57 ± 108.37) μmol/L, 1.91(1.20,2.7) mmol/L, (6.97±3.87)× 109/L, and (232.06±81.61)×109/L in the control group (all P<0.05). By multifactorial logistic regression analysis it was revealed that the variables associated with NASH-related cirrhosis risk with statistical significance were UA (OR=0.994, 95% CI: 0.990~0.998) and PLT (OR=0.989, 95%CI: 0.984~0.994). Conclusion Decreased UA and PLT are independent risk factors for NASLC.
    The predictive value of prognostic nutritional index combined with systemic inflammatory response index for the short-term prognosis of patients with acute decompensated cirrhosis
    ZENG Xue-li, LIU Pei, ZHANG Shun-ling, LI Xin-yi, YANG Juan, ZHENG Sheng
    2026, 31(4):  494-498. 
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    Objective To investigate the predictive value of prognostic nutritional index (PNI) combined with systemic inflammatory response index (SIRI) for the short-term prognosis of patients with acute decompensated cirrhosis. Methods One hundred and twelve patients with acute decompensated cirrhosis admitted to the Second Affiliated Hospital of Dali University from January 2020 to November 2024 were collected as the study subjects. The patients were followed up for 3 months to observe their survival status and categorized into a survival group (n=82) and a death group (n=30). The baseline data of these two groups of patients were compared and the independent risk factors affecting short-term mortality of patients with acute decompensated cirrhosis and the predictive value of PNI combined with SIRI for the short-term prognosis of patients with acute decompensated cirrhosis were analyzed. Results In the death group, the Child-Turcotte-Pugh (CTP) score, percentage of CTP grade C, Model for end-stage liver disease (MELD) score, CLIF Consortium Acute Decompensation (CLIF-C AD) score, white blood cells count (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and SIRI were (10.53±2.01) points, 63.3% (19/30), (17.33±8.76)points, (56.75±12.20) points, 6.55 (4.01, 12.33)×109/L, 33.15 (18.68, 59.48) U/L, 69.50 (37.40, 118.68) U/L, 63.85 (37.35, 137.15) μmol/L, and 31.08±7.15, respectively, which were higher than those of (7.80±1.56) points, 14.2% (12/82), (8.19±4.78) points, (46.16±7.62) points, 4.33 (2.96, 6.15)×109/L,19.35 (13.45, 32.08) U/L, 28.55 (21.85, 58.20) U/L, 24.00 (16.08, 47.8) μmol/L, and 37.56±4.13 in the survival group, and the difference was statistically significant (P<0.05). The red blood cells count (RBC) and PNI were (2.82±0.83)×1012/L and 31.08±7.15 in the death group, which were lower than those of (3.20±0.76)×1012/L and 37.56±4.13 in the survival group, and the differences were statistically significant (P<0.05). By one-way logistic regression analysis it was shown that RBC, ALT, TBil, SCr, PNI, SIRI, CTP score, MELD score, and CLIF-C AD score were the influencing factors of the short-term poor prognosis in patients with acute decompensated cirrhosis (P<0.05). By multifactorial logistic regression analysis it was shown that SCr, PNI, SIRI, and CTP score were still the independent risk factors of short-term poor prognosis in patients with acute decompensated cirrhosis (P<0.05). By ROC curves analysis it was shown that the AUC of SIRI, PNI alone and SIRI combined with PNI for predicting short-term poor prognosis in patients with acute decompensated cirrhosis were 0.652(95%CI=0.522~0.782), 0.782(95% CI=0.674~0.889), and 0.846(95%CI=0.753~0.939), respectively (P<0.05). Conclusion PNI and SIRI, as two simple and readily available serologic indices, have better efficacy in combination for predicting short-term mortality risk in patients with acute decompensated cirrhosis.
    The occurrence and clinical characteristics of spontaneous splenorenal shunt in chronic hepatitis B-related liver cirrhotic patients
    HAN Min, ZHANG Dong-bang, CAI Xin
    2026, 31(4):  499-502. 
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    Objective To analyze the incidence and clinical characteristics of spontaneous splenorenal shunts (SSRS) in patients with hepatitis B-related liver cirrhosis, aiming to provide insight into improving patients′ prognosis. Methods A retrospective study was conducted on 126 patients with hepatitis B-relate cirrhosis who were admitted and treated between February 2021 and February 2025. The patients were divided into a shunt group (n=40) and a non-shunt group (n=86) based on the presence or absence of SSRS. The clinical data of the patients in both groups were collected. SSRS were classified based on ultrasonographic features, and clinical data were compared across different shunt types. Multivariate logistic regression analysis was used to identify factors associated with the occurrence of SSRS. Results Among the 126 patients, 40 (31.7%) developed SSRS. Compared to the non-shunt group, patients in the shunt group had significantly higher levels of serum total bilirubin[(40.2±5.3) μmol/L vs. (34.6±4.5)μmol/L], larger portal vein diameter [(15.8±3.2) mm vs. (13.2±2.1) mm], larger splenic vein diameter (14.7±3.3 mm vs. 12.5±1.4 mm), and higher incidences of hepatic encephalopathy (45.0% vs. 19.8%) and ascites (52.5% vs. 16.3%), with all differences being statistically significant (P<0.05). Serum albumin levels were significantly lower in the shunt group[(26.2±5.6)g/L]compared to the non-shunt group [(35.3±5.2)g/L, P<0.05]. Ultrasound imaging revealed prominent collateral circulation between the splenic vein and the left renal vein in the form of tubular or serpentine vessels, including: direct type, splenic vein directly draining into the left renal vein (25 cases); indirect type, splenic vein draining into the left renal vein via multiple collateral branches (11 cases); complex type, associated with gastrorenal shunt or esophagogastric varices forming a complex network (4 cases). Significant differences in portal vein diameter, splenic vein diameter, incidence of hepatic encephalopathy, and ascites were observed among the different shunt types (P<0.05). Multivariate logistic regression analysis identified serum total bilirubin, serum albumin level, portal vein diameter, splenic vein diameter, hepatic encephalopathy, and ascites as independent risk factors for the development of SSRS in hepatitis B-related cirrhosis patients (OR=3.442, 3.677, 3.540, 3.710, 3.582, 3.732; P<0.05). Conclusion The incidence of SSRS is relatively high in patients with hepatitis B cirrhosis. Serum total bilirubin, albumin levels, portal and splenic vein diameters, hepatic encephalopathy, and ascites are significant influencing factors. These clinical characteristics may help predict the risk of SSRS and improve patients’ prognosis.
    The predictive value of albumin-to-globulin ratio combined with FIB-4 for assessing the degree of liver fibrosis in patients with chronic HBV infection
    LING Fang-peng, CHEN Xue-mei, FAN Bing-ling, LAN Shi-yu, LI Xiao-ting, WEI Mei-liao, WEI Lai-an, JIANG Jian-ning, SU Ming-hua
    2026, 31(4):  503-507. 
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    Objective To explore the predictive value of albumin-to-globulin ratio for assessing liver fibrosis in patients with chronic HBV infection and to determine clinical diagnostic thresholds. Methods A total of 297 patients with chronic HBV infection who underwent liver puncture at the First Affiliated Hospital of Guangxi Medical University from February 2004 to December 2024 were included. Baseline demographic characteristics (gender, age), pathological examination results, and biochemical indicators [total bilirubin(TBil), albumin(Alb), globulin(Glo), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT)] were collected, and the albumin-to-globulin ratio, fibrosis 4 index (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) were calculated. A combined model of albumin-to-globulin ratio with FIB-4 was constructed. Based on the METAVIR score, patients were divided into a non-significant liver fibrosis group (stages S0~2) and a significant liver fibrosis group (stage S≥3). Univariate and multivariate logistic regression was used to identify the independent predictive factors that significantly associated with liver fibrosis in HBV-infected patients. The predictive value of these indicators for liver fibrosis was assessed using receiver operating characteristic (ROC) curves, and the area under the curve (AUC), optimal thresholds, sensitivity, and specificity were calculated. Mann-Whitney U tests were used to compare non-normally distributed quantitative data between the two groups, while the χ2 test was used for comparisons of categorical data between groups. Results In the 297 chronic HBV infection patients, there were 79 patients with significant liver fibrosis (S3~S4) and 218 patients with non-significant liver fibrosis (S0~S2). The levels of Glo, ALT, and AST, as well as FIB-4 and APRI in patients with significant liver fibrosis were higher than those in the non-significant fibrosis group [32.2 (27.7, 35.1) g/L vs. 27.5 (25.4, 30.7) g/L, 49 (27, 85.5) U/L vs. 32 (22, 49) U/L, 44 (30, 79) U/L vs. 27 (21, 37) U/L, 1.546 (1.0205, 2.5972) vs. 0.9492 (0.6998, 1.4103), 0.6439 (0.4206, 1.2075) vs. 0.3555 (0.2451, 0.5708), Z=-5.418, -3.658, -5.332, -5.369, -5.696, respectively, P<0.05], while Alb, albumin/globulin ratio, and PLT were significantly lower in the non-significant fibrosis group [41.5 (36.9-43.8) g/L vs. 42.6 (39.8, 45.5) g/L, 1.2707 (1.1138, 1.4765) vs. 1.5295 (1.3742, 1.6873), 172 (138, 231)×109/L vs. 199 (165, 239)×109/L, Z=-2.758, -6.349, -2.645, P<0.05]. Multivariate logistic regression analysis indicated that the albumin-to-globulin ratio is an independent predictor of significant liver fibrosis in chronic HBV infection patients (OR=0.091, P<0.05). The optimal cutoff values, AUC, sensitivity, specificity, and accuracy of albumin-to-globulin ratio in predicting the degree of liver fibrosis in patients with chronic HBV infection are 1.3601, 0.741, 64.6%, 76.6%, and 73.4%, respectively; for APRI, they were 0.4744, 0.716, 70.9%, 67.4%, and 68.35%; for FIB-4, they were 1.5911, 0.704, 49.4%, 83.9%, and 74.75%; for the combined model, they were 0.2424, 0.767, 74.7%, 72.9%, and 73.4%. Pairwise comparisons of the AUCs of the four diagnostic models showed no statistically significant differences. The differences in sensitivities among the four diagnostic methods were statistically significant (χ2=21.321, P<0.001), with the sensitivities of the combined model and the APRI method being significantly higher than that of FIB-4 (P<0.0083), while there were no statistically significant differences in pairwise comparisons among the combined model, APRI, and the albumin-to-globulin ratio. The comparison of the specificities of the four diagnostic methods revealed statistically significant differences (χ2=29.739, P<0.001), with the specificity of FIB-4 being significantly higher than that of the other three methods (P<0.0083), and the specificity of the albumin-to-globulin ratio being significantly higher than that of APRI (P<0.0083), whereas the difference in specificity between the combined diagnosis and the albumin-to-globulin ratio was not statistically significant. Conclusion The albumin-to-globulin ratio can serve as an indicator for predicting the degree of liver fibrosis in patients with HBV infection, and the combined diagnostic model of the albumin-to-globulin ratio and FIB-4 performs best in diagnosing patients with significant fibrosis.
    Predictors of bleeding in patients with esophageal and gastric varices: a systematic review and meta-analysis based on risk prediction models
    SU Cheng-de, ZHU Qian-qian, LI Ming-dan, XU Ya-li, LIU Qian, ZHANG Ying, ZHANG Xin-yi, WANG Hua-jun, LI Qiu-xiang, YANG Ping
    2026, 31(4):  508-516. 
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    Objective Systematic evaluation of predictors of esophageal and gastric variceal bleeding risk prediction models for clinical construction of relevant models and clinical practice. Methods A comprehensive search for studies related to predictive models of esophageal and gastric variceal bleeding (EGVB) risk was conducted in Chinese and English databases, including PubMed, EMbase, Web of Science, the Cochrane Library, SinoMed, China Knowledge, Wanfang, Wipro, and Chinese Medical Journal Full Text Databases, with a timeframe of the construction of the library to January 6, 2025, for the search. The information of the included literature was extracted by two researchers, and the risk of literature bias and applicability were evaluated using the PROBAST tool. The meta-analysis of the model was performed using the R program (version 4.4.2), MedCalc software. Results A total of 12 studies were included, including 4 English literature and 8 Chinese literature. The area under the curve (AUC) of the subjects in the predictive model was 0.802~0.994. Meta-analysis was conducted on the AUC of the model using MedCalc software, and the combined AUC was 0.888 (95%CI: 0.857~0.919). The results of the meta-analysis showed that platelet (OR=0.98, 95%CI: 0.97~0.99), spleen thickness (OR=1.11, 95%CI:1.09~1.14), liver rough surface (OR=6.54, 95%CI:4.65~9.24), ascites (OR=3.83, 95%CI:1.55~9.50), and red color sign (OR=4.48, 95%CI: 2.81~7.13) were effective predictors in the predictive model for the risk of esophageal and gastric variceal bleeding (P<0.05). Conclusion Predictive models for the risk of EGVB are still in the exploratory stage. In the future, prospective clinical studies with multicenter and expanded sample sizes can be carried out to improve the methodology of model construction and to develop a risk prediction model for EGVB with a higher degree of identification accuracy as early as possible.
    Liver Tumor
    Analysis of risk factors for the satisfaction of percutaneous puncture biopsy of hepatic space occupying lesions
    WANG Chen, HU Chun-feng
    2026, 31(4):  517-520. 
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    Objective To investigate the risk factors of material satisfaction in percutaneous needle biopsy. Methods The risk factors of ultrasound-guided percutaneous liver biopsy cases of Jiawang District People′s Hospital, Xuzhou city from January 2022 to June 2023, were retrospectively analyzed. The following factors, age, size and site of lesion, number of puncture, and presence of necrosis in the lesion, were analyzed. Biopsy satisfaction was analyzed by the diagnosis. Safety was analyzed by the percentage of complications classified as serious and minor complications. Results 80 patients had 87 biopsies taken. 91.3% (73/80) of the biopsies were malignant, and 62.5% (50/80) of the lesions were located in the right lobe of the liver. The median number of tissue columns obtained from biopsy was 3 (range 1 to 6); 91.3% (73/80) had satisfactory biopsy material with low lesion necrosis. Complications were noted in 7 (8.8%) patients, including 3 (3.8%) patients of major complication (2 bleeding and 1 infection), and 4 (5.0%) patients of minor complications. Patients with lesion necrosis, malignant lesions, left-lobe lesions, and multiple punctures had a higher incidence of complications (P<0.05). Conclusion Ultrasound-guided percutaneous liver biopsy is a safe and effective technique for histological diagnosis of liver lesions, including necrosis, malignant lesions and increased incidence of complications. Lesion diameter and necrosis affected biopsy satisfaction.
    Observation on the effect of CT-guided thermal ablation combined with metal stent implantation in the treatment of unresectable cholangiocarcinoma patients
    LANG Wei-wei, LU Ze-hua, GENG Cheng-jun
    2026, 31(4):  521-524. 
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    Objective This study aimed to evaluate the therapeutic effect of combining percutaneous CT-guided thermal ablation with biliary metal stent placement for patients with non-operable cholangiocarcinoma. Methods From March 2017 to December 2021, 106 patients in the 904th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army with unresectable cholangiocarcinoma were involved and randomly divided into control group (metal stent implantation) and observation group (radiofrequency ablation+metal stent implantation), with 53 cases in each group. The operation conditions of the two groups were compared, and serum levels of aspartate aminotransferase (AST), total bilirubin (TBil) and other indicators were measured. The incidence of complications, biliary tract patency time, survival time and survival rate of the two groups were recorded, and the survival curve was made. Results The operative time in the observation group was (98.2 ± 13.7) min, which was longer than that in the control group (49.6 ± 5.8) min, with a statistically significant difference (P< 0.05). After treatment, the serum levels of TBil, AST, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (γ-GT) in the observation group were (48.7±12.6) μmol/L, (33.5±6.8) U/L, (54.7±11.4) U/L, (226.3±37.8) U/L, and (241.7±36.2) U/L, respectively, significantly lower than those in the control group: (91.6±20.5) μmol/L, (57.8±14.2) U/L, (72.5±9.3) U/L, (285.6±53.9) U/L, and (342.8±49.5) U/L, with statistically significant differences (P<0.05). The complication rates in the observation group and the control group were 26.4% and 20.8%, respectively, showing no significant difference (P>0.05). After 18 months of follow-up, the biliary patency duration, survival time, and 18-month survival rate in the observation group were (8.7±1.4) months, (13.6±1.9) months, and 52.8%, respectively, which were significantly higher than those in the control group: (5.9±1.1) months, (9.7±1.4) months, and 32.1% (P<0.05). Conclusion The combination of CT-guided thermal ablation and metal stent implantation is effective in the treatment of patients with unresectable cholangiocarcinoma, which is conducive to improving the liver function, prolonging the biliary patency duration and survival time of stents and improving the survival rate of patients within 18 months, but the incidence of postoperative complications has not been significantly improved.
    Value of CT dynamic contrast-enhanced imaging combined with ultrasound-guided liver biopsy in diagnosing hepatic space-occupying lesions
    LI Jia-shan, DU Yun-song, MA Meng, SONG Yan
    2026, 31(4):  525-527. 
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    Objective To investigate the diagnostic value of CT dynamic contrast-enhanced imaging combined with ultrasound-guided liver biopsy in diagnosing hepatic space-occupying lesions. Methods Between November 2020 and November 2024, 95 patients with malignant hepatic space-occupying lesions were encountered in Jieshou People′s Hospital. All patients underwent ultrasound-guided liver biopsy. Based on whether they received CT dynamic contrast-enhanced scanning, tissue strip lengths and test results were compared between the two groups. Results Among the 95 patients with malignant hepatic space-occupying lesions in this group, 55 patients received CT dynamic contrast-enhanced scanning (the observation group), and 40 patients did not (the control group). In the control group, 5 patients had bleeding, all of which were exudative. After compression for self-hemostasis, they returned to normal. No bleeding was observed in the observation group (χ2=7.257, P=0.007). The lengths of effective pathological tissue strips in the control group and the observation group were (15.84±2.02) mm and (17.62±2.31) mm respectively. The length in the observation group was longer than that in the control group (t=3.975, P<0.001). The positive rate of diagnosis by ultrasound-guided biopsy in the control group was 75.00% (30/40). The positive rate of diagnosis by CT dynamic contrast-enhanced scanning combined with ultrasound-guided biopsy in the observation group was 92.73% (51/55). The detection accuracy of the observation group was higher than that of the control group, and the difference was statistically significant (χ2=5.792, P=0.016). Conclusion CT dynamic contrast-enhanced scanning combined with ultrasound-guided liver biopsy for the diagnosis of hepatic space-occupying lesions can reduce the patient′s bleeding risk and improve the diagnostic accuracy.
    Study on the application of multimodal MRI findings in the diagnosis of fatty liver with focal nodular lesions
    ZHANG He-yi, LI Xin-ran, LIU Xiao-xiao
    2026, 31(4):  528-531. 
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    Objective To compare the differences between focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC) in terms of MRI proton density fat fraction (PDFF), diffusion parameters, and dynamic contrast-enhanced perfusion characteristics, and to evaluate their diagnostic performance. Methods A total of 92 patients who underwent liver MRI between December 2022 and September 2025 and were pathologically confirmed to have fatty liver with focal nodular lesions were retrospectively enrolled. According to pathological diagnosis, 55 cases were classified as FNH and 37 cases as HCC. Fat quantification parameters, diffusion parameters, and dynamic enhancement characteristics were compared between the two groups, and their diagnostic performance was evaluated. Results In FNH group, the PDFF in the lesion and the surrounding liver parenchyma were significantly lower than those in HCC group [(9.3±2.1)% vs. (16.7±2.9)%, (18.6±6.2)% vs. (24.9±7.8)%, all P<0.05). In terms of diffusion parameters, ADC and pure diffusion coefficient D in FNH group were significantly higher than those in HCC group [(1.45±0.18) × 10-3 mm2/s vs. (1.12±0.21) × 10-3 m2/s; (1.18±0.14) vs. (0.89±0.16), all P<0.05), while the micro-perfusion fraction F was significantly lower than that in HCC group [(18.2±4.1)% vs. (25.7±5.4)%, P<0.05). In the aspect of dynamic enhancement, the enhancement amplitude of FNH group in arterial phase was significantly lower than that of HCC group [(78.6±22.4)% vs. (112.3±28.5)%, P<0.05], while the relative enhancement ratio of portal vein phase and delayed phase was higher [(0.92±0.15) vs. (0.68±0.14), (0.88±0.13) vs. (0.56±0.12), all P<0.05]. ROC analysis showed that the AUC of ADC, enhancement ratio of delay period, elution rate and enhancement mode were 0.90, 0.91, 0.93 and 0.94, respectively, and the AUC of multi-parameter joint model reached 0.97, with sensitivity of 94.5% and specificity of 91.9%. Conclusion Multimodal MRI can effectively distinguish FNH from HCC in the background of fatty liver by assessing fat deposition, tissue structure, cellular density, and perfusion characteristics. Its comprehensive diagnostic performance is significantly superior to any single sequence or parameter.
    Clinical efficacy of camrelizumab combined with TACE in the treatment of unresectable hepatocellular carcinoma
    LI Chun-ling, ZHANG Xiao-juan, SONG Yan-qi, CHENG LI, NIU Bo-yu
    2026, 31(4):  532-535. 
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    Objective To investigate the clinical efficacy, survival prognosis, and safety of camrelizumab combined with transarterial chemoembolization (TACE) in patients with primary hepatocellular carcinoma (HCC). Methods A total of 90 patients with HCC admitted to our hospital from September 2021 to September 2022 were selected and divided into two groups by random number table method. There were 45 cases in each of the control group (treated with TACE alone) and the study group (treated with camrelizumab combined with TACE). The two groups underwent comparison regarding clinical efficacy, variations in serum PEG10, CA15-3 and AFP concentrations, survival results, and the incidence of adverse events. Results After 6 months of treatment, the objective response rate (ORR) and disease control rate (DCR) in the study group were 73.3% and 93.3%, respectively, significantly higher than those in the control group (46.7% and 80.0%, P<0.05). Post-treatment serum levels of PEG10, CA15-3, and AFP in the study group were (519.4±65.1) ng/L, (7.6±1.0) U/mL, and (313.2±22.2) μg/L, respectively, significantly lower than those in the control group [(550.6±69.3) ng/L, (10.1±1.2) U/mL, and (327.0±27.2) μg/L; P<0.05]. During a 30-month follow-up, the median overall survival (OS) and median progression-free survival (PFS) were significantly longer in the study group (26.7 months and 21.0 months) than in the control group (21.4 months and 15.9 months) (P<0.05). The incidence rates of grade 1、2 (57.8% vs. 66.7%) and grade 3、4 (26.7% vs. 20.0%) adverse events did not differ significantly between the two groups (P>0.05). Conclusion Camrelizumab combined with TACE significantly improves clinical efficacy and prolongs survival in patients with primary HCC, with an acceptable safety profile.
    Efficacy of ultrasound-guided anhydrous ethanol and lauromacrogol sclerotherapy in the treatment of giant simple hepatic cysts
    LV Hui, LIU Shuai, LIU Ji-long, LV Ping-ping
    2026, 31(4):  536-538. 
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    Objective To compare the therapeutic efficacy of ultrasound-guided percutaneous aspiration combined with anhydrous ethanol or lauromacrogol sclerotherapy in patients with giant simple hepatic cysts (GSHC). Methods A total of 94 patients with GSHC treated between January 2022 and December 2024 in Lingbi People′s Hospital were enrolled. According to the sclerosing agent used, patients were assigned to the absolute ethanol group (n=52) or the lauromacrogol group (n=42). The cyst volume reduction rate, systemic stress response indicators, and adverse events were compared between the two groups. Results At 1, 3, and 6 months after treatment, the cyst volume reduction rates in the lauromacrogol group were (67.0±8.6)%, (82.6±7.8)%, and (93.8±7.0)%, respectively, all significantly higher than those in the absolute ethanol group [(55.4±7.1) %, (74.5±6.3) %, and (84.3±6.5) %, P<0.05]. One week after treatment, NE, glu, and lactate levels in the absolute ethanol group increased to (405.8±54.5) pg/mL, (6.2±0.8) mmol/L, and (2.1±0.5) mmol/L, respectively, with greater elevations than those observed in the lauromacrogol group [(366.5±46.2) pg/mL, (5.5±0.6) mmol/L, and (1.8±0.4) mmol/L, P<0.05]. The incidence of adverse reactions in the absolute ethanol group was 30.8% (15/52), significantly higher than that in the lauromacrogol group [9.5% (4/42), P<0.05]. Conclusion Ultrasound-guided lauromacrogol sclerotherapy for GSHC provides superior cyst volume reduction, milder systemic and local inflammatory stress responses, and better safety compared with anhydrous ethanol, making it a preferred option in clinical practice, particularly for high-risk patients.
    The effect of GINS1 on glycolysis, epithelial-mesenchymal transition and angiogenesis in hepatocellular carcinoma
    LV Yu-qing, CHEN Si
    2026, 31(4):  539-544. 
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    Objective To investigate the effects of GINS1 on glycolysis, epithelial-mesenchymal transition (EMT), and angiogenesis in hepatocellular carcinoma (HCC). Methods GINS1 knockdown was performed in HCC cell lines MHCC97H and Hep3B cells (shGINS1-NC, shGINS1), and the expression levels of glycolysis-related proteins and EMT-related proteins were detected by Western blot. Cell proliferation activity was detected by EDU assay and colony formation assay, and cell metastasis activity was detected by scratch assay and Transwell assay. HUVEC cells were co-cultured to detect tumor angiogenesis ability. Twelve nude mice HCC xenograft models were constructed and divided into shGINS1-NC-nude and shGINS1-nude groups, with 6 mice in each group. The tumor volume of the two groups of nude mice were observed, and the expression level of glycolysis-related proteins and EMT-related proteins were detected. Results Compared with the shGINS1-NC group, the protein levels of GLUT1, HK2, LDHA, Vimentin, and N-cadherin were decreased, and the protein levels of E-cadherin and ZO-1 were increased in the shGINS1 group, and the cell proliferation, metastasis, and angiogenesis abilities were significantly inhibited (all P<0.05). Compared with the shGINS1-NC-nude group, the tumor volume and weight were reduced, and the protein levels of GLUT1, HK2, LDHA, Vimentin, and N-cadherin were decreased, and the protein levels of E-cadherin and ZO-1 were increased in the shGINS1-nude group (all P<0.05). Conclusion Downregulation of GINS1 expression level can inhibit HCC cell glycolysis, EMT, angiogenesis and metastasis.
    Drug Induced Liver Injury
    Clinical characteristics of 84 cases of drug-induced liver injury caused by Chinese patent medicines
    NIE Hong, SONG Jie, ZHANG Hui, WANG Rui, LOU Ting-ting, WU Jian-jun
    2026, 31(4):  545-548. 
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    Objective To analyze the medication usage, laboratory test results, types of liver injury, and clinical outcomes in patients with drug-induced liver injury (DILI) caused by Chinese patent medicines, and to provide robust data support for safe clinical medication practices and pharmaceutical supervision. Methods Patients diagnosed with primarily or secondarily as “drug-induced liver injury” or “drug-induced hepatitis” between January 2022 and December 2024 were sellected. A total of 84 DILI cases caused by Chinese patent medicines were included, comprising 41 cases of hepatocellular injury type, 29 cases of cholestatic type, and 14 cases of mixed type. The suspected ingredients of the Chinese patent medicines and patient prognoses were analyzed. Clinical symptoms and biochemical parameters were compared across different clinical types of DILI. Results The most common suspected ingredients in Chinese patent medicines associated with DILI were Polygonum multiflorum (He Shou Wu) and its related preparations, tripterygium glycosides tablets, and Zhuanggu Guanjie Pills. Among the 84 cases, there were 41 cases of hepatocellular injury type, 29 cases of cholestatic type, and 14 cases of mixed type. The most common clinical symptoms included fatigue, loss of appetite, and jaundice. Comparisons showed no statistically significant differences in the main clinical symptoms among the three types of DILI (P>0.05). However, the incidence of pruritus was significantly higher in patients with cholestatic and mixed types than in those with hepatocellular injury type (P<0.05). Before treatment, ALT and AST levels were significantly higher in the hepatocellular and mixed types compared to the cholestatic type (P<0.05), while ALP and TBil levels were significantly elevated in the cholestatic and mixed types compared to the hepatocellular type (P<0.05). After treatment, liver function indices in all types significantly improved from baseline (P<0.05). All patients recovered and were discharged following the withdrawal of suspected causative agents and standard hepatoprotective therapy. No cases of liver failure or death occurred. Conclusion DILI caused by Chinese patent medicines primarily manifests as hepatocellular and cholestatic types. Clinical symptoms are often non-specific, and diagnosis relies on detailed medication history and dynamic monitoring of liver function indicators. With timely withdrawal of the offending drug and proper hepatoprotective treatment, patients generally have favorable outcomes.
    Efficacy of polyene phosphatidylcholine combined with diammonium glycyrrhizinate in the treatment of anti-tuberculosis drug-induced liver injury
    DU De-hui, WU An-ni, XING Jing, WANG Yue-kun, LIU Chang
    2026, 31(4):  549-552. 
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    Objective To evaluate the clinical efficacy, safety, and effects on oxidative stress-related biochemical indicators of polyene phosphatidylcholine combined with diammonium glycyrrhizinate in patients with anti-tuberculosis drug-induced liver injury (DILI). Methods A total of 86 patients who diagnosed with DILI during anti-tuberculosis therapy and were hospitalized in our institution between January 2022 and June 2025 were enrolled. According to the hepatoprotective regimen, patients were divided into an observation group (polyene phosphatidylcholine injection + diammonium glycyrrhizinate injection, n=42) and a control group (diammonium glycyrrhizinate injection alone, n=44). The clinical efficacy, safety, and changes in oxidative stress-related biochemical markers were compared between the two groups. Results After 4 weeks of treatment, the levels of ALT, AST, and TBil in the observation group significantly decreased to 38 (28, 50) U/L, 34 (27, 44) U/L, and (18.9±7.6) μmol/L, respectively. The reductions in the observation group were significantly greater than those in the control group [51 (33, 70) U/L, 52 (40, 67) U/L, and (25.1±8.4) μmol/L, all P<0.05]. The average time for ALT to return to normal in the observation group was (12.3±4.1) days, significantly shorter than that in the control group [(18.7±5.6) days, P<0.05]. The overall incidence of adverse events during treatment was 16.7% (7/42) in the observation group and 29.5% (13/44) in the control group, with no statistically significant difference (P>0.05). The proportion of patients progressing to severe DILI in the observation group (2.4%) was significantly lower than that in the control group (13.6%, P<0.05), and the median hospital stay was shorter [7 (5, 9) days vs. 10 (8, 13) days, P<0.05]. After treatment, the reduction in serum MDA in the observation group [(-1.8±0.6) μmol/L] was significantly greater than that in the control group [(-0.9±0.4) μmol/L, P<0.05], and the increase in SOD [(12.5±4.2) μmol/L vs. (6.1±2.8) μmol/L, P<0.05] was also more significant. The 3-month recurrence rates were 4.8% (2/42) in the observation group and 15.9% (7/44) in the control group, with no statistically significant difference (P>0.05). Conclusion Polyene phosphatidylcholine combined with diammonium glycyrrhizinate significantly improves liver function, accelerates liver enzyme recovery, and reduces the incidence of severe liver injury in patients with anti-tuberculosis DILI, with good safety and tolerability.
    Metabolic Associated Fatty Liver Disease
    Relationship between dietary active microbiota intake and non-alcoholic fatty liver disease: based on NHANES 2015-2023
    ZHANG Wei
    2026, 31(4):  553-559. 
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    Objective To explore the correlation between dietary active microbiota intake and non-alcoholic fatty liver disease (NAFLD). Methods Data from the NHANES cross-sectional survey conducted from 2015 to 2023 were selected, including 2 903 participants. Participants were divided into the NAFLD group (≥248 dB/m) and the control group (<248 dB/m) based on liver ultrasonography transient elastography and controlled attenuation parameter (CAP). Dietary active microbiota intake was assessed using the Sanders dietary active microbiota classification system, and the MedHi index was calculated. Multivariate logistic regression was used to examine the independent association between dietary active microbiota intake and NAFLD. Restricted cubic splines (RCS) were used to detect the dose-response relationship. Results A total of 2 903 adult participants were included, of whom 1 235 were diagnosed with NAFLD, yielding an NAFLD prevalence of 42.54%. Compared with the control group, the NAFLD group had a lower proportion of high dietary active microbiota intake (52.71%) and higher proportions of low (30.61%) and moderate (16.68%) intake. The MedHi index in the NAFLD group was lower than that in the control group, with a statistically significant difference (P<0.05). Multivariate logistic regression analysis, after adjusting for all covariates, showed that compared to the low intake group, the high intake group of dietary active microbiota had a lower risk of NAFLD (OR=0.763). The increase in MedHi index was independently associated with a reduced risk of NAFLD (OR=0.784). Dose-response analysis revealed a clear nonlinear dose-dependent relationship between MedHi and the prevalence of NAFLD (nonlinear P<0.001). Conclusion Dietary active microbiota intake is significantly associated with NAFLD, and maintaining a certain level of dietary active microbiota intake plays an important role in improving liver health.
    Efficacy of entecavir combined with polyene phosphatidylcholine in the treatment of patients with chronic hepatitis B complicated by nonalcoholic steatohepatitis
    YANG Min, SUN Shu
    2026, 31(4):  560-564. 
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    Objective To evaluate the therapeutic efficacy of entecavir combined with polyene phosphatidylcholine (PPC) in patients with chronic hepatitis B (CHB) complicated by nonalcoholic steatohepatitis (NASH). Methods A total of 102 patients with CHB complicated by NASH who were treated in the 904th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Anny from January 2022 to January 2025 were enrolled. According to the treatment regimen, patients were divided into two groups: the monotherapy group (entecavir alone, n=52) and the combination group (entecavir plus PPC, n=50). Virological indicators, liver function, metabolic and inflammatory parameters, as well as histological improvements were compared between the two groups. Results After 48 weeks of treatment, the HBV DNA level in the combination group (2.1±0.7) lg U/mL was significantly lower than that in the monotherapy group [(2.7±0.8) lg U/mL, P<0.05). The ALT level in the combination group (28.4±13.2) U/L was also significantly lower than that in the monotherapy group [(36.2±17.5) U/L, P<0.05]. The rate of ALT normalization was 88.0% (44/50) in the combination group, higher than 65.4% (34/52) in the monotherapy group (P<0.05). Regarding hepatic fibrosis and steatosis indices, the combination group showed APRI, FIB-4, LSM, CAP, and MRI-PDFF values of (0.7±0.3) kPa, (1.8±0.7) kPa, (6.8±2.1) kPa, (243.2±28.4) dB/m and (11.8±3.7) %, respectively, which were all significantly lower than those in the monotherapy group [(1.0±0.4) kPa, (2.2±0.8) kPa, (7.8±2.3) kPa, (273.0±30.8) dB/m and (14.6±4.2) %, P<0.05]. For metabolic and inflammatory parameters, HOMA-IR, TG, hs-CRP, and IL-6 levels in the combination group were (2.3±0.9) mmol/L, (1.7±0.5) mmol/L, (2.5±1.1) mg/L and (5.9±2.1) pg/mL, respectively, lower than those in the monotherapy group [(2.8±1.0) mmol/L, (1.9±0.5) mmol/L, (3.3±1.2) mmol/L and (6.9±2.3) pg/mL, P<0.05]. Histological results showed that the NAS total score, Ishak fibrosis score, and CPA in the combination group were (3.1±1.0) points, (2.4±0.8) points and (4.9±1.8)%, respectively, which were significantly lower than those in the monotherapy group [(4.2±1.1) points, (3.1±0.9) points and (6.8±2.1)%, P<0.05]. Conclusion Entecavir combined with polyene phosphatidylcholine can significantly improve virological, hepatic, metabolic, and inflammatory indicators in patients with CHB complicated by NASH, alleviates hepatic steatosis and fibrosis, and promotes structural repair of liver tissue.
    Analysis of risk factors for fatty liver disease in a single-center study
    DENG Fei-die, WANG Guang-fu, YANG Yang, WANG Zi-ming
    2026, 31(4):  565-568. 
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    Objective To investigate the epidemiological characteristics and risk factors of fatty liver disease(FLD) using cross-sectional data. Methods A total of 18 921 examinees at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2024 to December 2024 were enrolled. Participants were divided into a FLD group (n=5 083) and a non-FLD group (n=13 838) based on imaging findings. Clinical baseline data, laboratory results, and auxiliary examination results were collected and analyzed. Logistic regression was used to identify risk factors for fatty liver disease. Results The detection rate of FLD was 26.86%, with a higher prevalence in females (n=2 728, 27.24%) than males (n=2 355, 26.45%). Compared to the non-FLD group, the FLD group showed statistically significant differences (P<0.05) in TG, HDL-C, WBC, RBC, PLT, ALC, AMC, TyG, SIRI and AISI. Binary logistic regression analysis identified TyG (OR=1.07,95%CI:1.02~1.122,P<0.001) and AISI (OR=1.003,95%CI:1.002~1.004,P<0.001) as independent risk factors for FLD. Conversely, systemic immune-inflammation index SII (OR=0.998,95%CI:0.998~0.999) and SIRI (OR=0.618,95%CI:0.525~0.727) were protective factors. For every 1-unit increase in TyG, the detection rate of fatty liver increases by 7.0%. For every 1-unit increase in AISI, the detection rate of fatty liver increases by 0.3%. Conclusion TyG and AISI are risk factors for the development of fatty liver, while SII and SIRI are protective factors.
    Other Liver Diseases
    Analysis of risk factors for 90-day mortality in patients with acute-on-chronic liver failure and machine learning application
    GUO He-bing, LIU Jing-yuan, WAN Gang, LI Ang
    2026, 31(4):  569-577. 
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    Objective To explore the risk factors for 90-day mortality in patients with acute-on-chronic liver failure (ACLF) and construct a machine learning-based prediction model. Methods A single-center retrospective cohort study was conducted, including 534 ACLF patients admitted to Beijing Ditan Hospital from June 1, 2020, to May 31, 2024. The dataset was divided into training and test sets at a 7∶3 ratio. Variables were screened via Lasso regression and 10-fold cross-validation, and a random forest algorithm was used to build the model, which was validated by Kaplan-Meier curves, time-dependent ROC curves, and SHAP value analysis. Results Prothrombin activity (PTA), neutrophils, serum phosphorus, blood ammonia, and neutrophil-to-lymphocyte ratio (NLR) were identified as independent risk factors. The area under the curve (AUC) of the random forest time-dependent ROC curve model for predicting 28-day and 90-day prognosis was 0.89 and 0.88, respectively, with the AUC of the validation set being 0.88 and 0.82, respectively. Determined by the maximum goodness-of-fit method via the surv_cutpoint function, the optimal cut-off value for the model score was 10.32. Patients were divided into high-risk and low-risk groups based on this value, and the survival difference between the two groups was statistically significant (P<0.001). Compared with other scoring systems, the forest plot model showed better AUC values (0.89, 0.83) in predicting 28-day and 90-day prognosis. SHAP value visualization indicated that the weight of each factor was in the order of: NLR > blood ammonia > PTA > neutrophils > serum phosphorus; in the high-risk group, the SHAP weight values of NLR, blood ammonia, neutrophil count, and serum phosphorus increased by 6.56, 3.73, 1.42, and 0.32, respectively, while the SHAP weight value of PTA decreased by 1.37, all of which were associated with an increased risk of death. Conclusion The study confirms that PTA, neutrophils, serum phosphorus, blood ammonia, and NLR are core factors affecting the short-term prognosis of ACLF patients. It also verifies the advantages of machine learning in prognostic prediction, providing a new means for precise clinical intervention.
    The expression and clinical significance of serum lncRNA-H19 and FOXO1 levels in children with infantile cholestatic hepatopathy
    FANG Wen-zheng, LI Dao-xing, ZUO Li
    2026, 31(4):  578-582. 
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    Objective To investigate the expression and clinical significance of serum lncRNA-H19 and forkhead transcription factor O1 (FOXO1) levels in children with infantile cholestatic hepatopathy (ICH). Methods 100 children with ICH who received treatment at our institute from April 2017 to April 2022 were included as the study subjects (ICH group). According to the score of clinical symptoms and signs, they were further divided into mild group (<10 points, 79 cases) and moderate and severe group (≥10 points, 21 cases). Another 100 infants who developed jaundice in the same period without liver disease were included as control group. The serum levels of lncRNA-H19 and FOXO1 in children were measured by fluorescence quantitative real time PCR; logistic multiple factor regression was applied to analyze the influencing factors of patients with ICH; the serum levels of lncRNA-H19, FOXO1 and their combined diagnostic value for ICH were evaluated by the subject working characteristic (ROC) curve. Results Compared with the control group, the levels of lncRNA-H19 (1.39±0.43 vs. 1.00±0.33) in ICH group were obviously higher, the levels of FOXO1 (0.74±0.24 vs. 1.01±0.32) were obviously lower, and the difference were statistically significant (t=7.195, 6.750, P<0.05). Compared with the mild group, lncRNA-H19 (1.78±0.47 vs. 1.29±0.32) levels in the moderate and severe group were significantly higher , FOXO1 (0.48±0.13 vs. 0.81±0.22) levels were significantly lower (t=5.610, 6.561, P<0.05). Logistic analysis showed that lncRNA-H19 (OR: 1.715, 95%CI:1.212~2.426) were independent risk factors for ICH, and high levels of FOXO1 (OR: 0.593, 95%CI:0.374~0.940) were independent protective factors for ICH (P<0.05). ROC results showed that the AUC of the severity of the levels of lncRNA-H19 and FOXO1 in serum and their combination for ICH was 0.758, 0.750 and 0.829, respectively, the AUC of combined prediction was obviously higher than the two independent prediction (Z=1.589, 1.738, P<0.05). Conclusion The level of serum lncRNA-H19 is increased and the level of FOXO1 is decreased in children with ICH, they are closely related to the severity of ICH and are expected to become predictors of ICH.