Table of Content

30 June 2025, Volume 30 Issue 6

Previous Issue    Next Issue

Liver Cancer

The prevalance and risk factors of early recurrence of primary liver cancer after resection and the establishment of a prediction model

LI Jiao, WANG Xin, WANG Huan, CHENG Jing-hua

2025, 30(6):  769-772. 

Asbtract ( 27 )   PDF (686KB) ( 2 )  

References | Related Articles | Metrics

Objective To investigate the prevalence and risk factors of early recurrence of primary liver cancer after resection, and to establish a predictive model. Methods From January 2019 to January 2021, 110 patients with primary liver cancer were treated in Beijing You'an Hospital affiliated to Capital Medical University. All patients were followed up for 2 year after operation. According to the followed up results, they were divided into the recurrence group (42 cases) and the non-recurrence group (68 cases). The clinical data were collected, the early recurrence were counted, and the risk factors of early recurrence of primary liver cancer after resection were analyzed by multivariate Cox regression. A nomograph prediction model was constructed to evaluate the predictive value of the model for early postoperative recurrence of primary liver cancer. Results Forty-two of 110 cases suffered from early recurrence of primary liver cancer after resection, the recurrence rate was 38.18%. The result of Cox regression model showed that poorly differentiated tumors, tumor diameter≥5 cm, tumor number≥2, extrahepatic invasion, compensatory stage of cirrhosis, MVI and AFP>400 μg/L were independent risk factors for early postoperative recurrence of primary liver cancer (P<0.05). The C-index of recurrence in patients with primary liver cancer after radical surgery was 0.794±0.054, with a median confidence level of 0.75-0.93, indicating that the accuracy of the model was good. The results of calibration curve show that the predicted probability was close to the actual probability, which indicates that the regression model has good discrimination, calibration and prediction ability. Conclusion There was early recurrence of primary liver cancer after resection, and the risk factors of recurrence include poorly differentiated tumor, tumor diameter ≥5 cm, tumor number ≥2, extrahepatic invasion, compensatory stage of cirrhosis, MVI and AFP>400μg/L, etc. The nomogram constructed based on this can accurately predict the risk of early recurrence of primary liver cancer after surgery, thus had high clinical application value.

An analysis on the relationship between GLUT-1, CDK4 and clinical pathological characteristics and prognosis of patients with primary liver cancer

FENG Shi-chuan, SHEN Yong

2025, 30(6):  773-776. 

Asbtract ( 37 )   PDF (508KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the relationship between GLUT-1, CDK4 and the clinical pathological characteristics and prognosis of patients with primary liver cancer. Methods Eighty-six patients with primary liver cancer admitted from December 2019 to June 2021 were included as the study subjects. All patients underwent surgical treatment and pathological examination, with a follow-up period of 3 years. The levels of GLUT-1 and CDK4 in cancer tissues and adjacent tissues were detected and compared. According to the prognosis, the patients were divided into a good prognosis group and a poor prognosis group. The relationship between the expression of GLUT-1 and CDK4 in primary liver cancer tissues and clinical pathological characteristics, as well as patient prognosis were analyzed. The patients were grouped based on their clinical stage and differentiation degree, and compare the levels of GLUT-1 and CDK4 in the two groups of patients. Kaplan Meier survival curves were used to evaluate the relationship between GLUT-1, CDK4, and prognosis of patients with primary liver cancer. Results The positive rates of GLUT-1 and CDK4 expression in cancer tissues of patients were 66.28% and 62.79%, respectively, which were significantly higher than those in adjacent tissues (22.09% and 18.60%, respectively) (P<0.05); There were significant differences (P<0.05) in lymphatic vessel metastasis and vascular invasion among liver cancer patients with positive expression of GLUT-1 and CDK4; The three-year cumulative survival rate of patients with GLUT-1 positive expression in liver cancer tissue was 42.11% (24/57), which was significantly lower than that of 79.31% (23/28) patients with GLUT-1 positive expression in liver cancer tissue (P<0.05); The three-year cumulative survival rate of patients with CDK4 positive expression in liver cancer tissue was 46.30% (25/54), which was significantly lower than that of 68.75% (22/32) patients with GLUT-1 negative expression in liver cancer tissue (P<0.05); Vascular invasion, and lymph node metastasis are independent risk factors affecting patient prognosis. Conclusion GLUT-1 and CDK4 are closely related to the clinical stage and differentiation degree of primary liver cancer patients, and can be used as important indicators to evaluate the patients' progression and poor prognosis.

An analysis on liver imaging and clinicopathological features of bimorphic hepatocellular carcinoma

GE Ju-yan, XU Xiu-juan

2025, 30(6):  777-780. 

Asbtract ( 30 )   PDF (426KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the liver imaging and clinicopathological features of bimorphic hepatocellular carcinoma (B-HCC). Methods 111 patients with HCC admitted to the hospital of Lianyungang City between May 2017 and December 2024 were divided into a B-HCC group and other HCC groups. The general data, imaging data and pathological manifestations of the two groups of patients were compared. Results Of the 111 patients, 17 had B-HCC (B-HCC group) and 94 had other HCC (other HCC group). There were significant differences in age and AFP level between B-HCC and other HCC groups (P<0.05). There were statistically significant differences between B-HCC group and other HCC groups in peritumoral enhancement in arterial phase, peritumoral hypointensity in hepatobiliary phase and unsmooth tumor margin (P<0.05). Microscopically, the tumor cells of B-HCC are polygonal, showing thick beams, pseudoadenoids and masses, with rich blood sinus cavities, obvious nucleoli and frequent mitosis. In all of the seventeen cases (100%) the tumor cells expressed CK19, of which 10 cases (58.8%) expressed CK7 at the same time. AFP and Hepatocyte-1 were positive in 8 cases (47.0%) and 7 cases (41.2%) respectively. Ki-67 index is 14% ~ 70%. Compared with other HCC groups, the incidence of vascular infiltration and MVI in B-HCC group increased significantly (P<0.05). Conclusion Compared with other types of HCC, B-HCC patients has younger onset age, higher AFP level and complicated imaging manifestations. At the same time, the cell proliferation of B-HCC is active, and it is more prone to vascular infiltration and MVI.

Liver Fibrosis&Cirrhosis

The effect of TIPS operation on peripheral blood T cell subsets of perioperative patients with portal hypertension

JING Chang-you, ZHU Tong, GAO Wen-feng, ZHANG Yong-hong, LI Jian-jun

2025, 30(6):  781-783. 

Asbtract ( 29 )   PDF (301KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the effect of transjugular intrahepatic portosystemic shunt (TIPS) on peripheral blood T cell subsets of perioperative patients with portal hypertension. Methods A retrospective analysis was conducted on patients with portal hypertension who underwent TIPS from May 2023 to August 2023. The changes in peripheral blood T cell subsets before and after TIPS was analyzed. Results The study included a total of 22 patients, with a preoperative pressure gradient (PPG) of 23.64 ± 6.8 mmHg and a postoperative PPG of 9.27 ± 4.7 mmHg (P<0.05); Preoperative blood ammonia levels were 74.38±31.30 μg/dL, and postoperative blood ammonia levels were 88.43+42.20 μg/dL. There was no statistically significant difference in postoperative blood ammonia levels. The changes in postoperative lymphocytes, CD8⁺ T cell/lymphocyte ratio, and T cell/lymphocyte ratio showed statistical differences (P<0.05). Postoperative follow-up revealed that 2 patients died and 6 (27%) had obvious hepatic encephalopathy. Through comparison, it was found that patients with hepatic encephalopathy had a significantly reduced number of lymphocytes after surgery compared to patients without hepatic encephalopathy (431.9±493.8 vs. 65.5±247.2, P=0.031). Conclusion The T cell subpopulations in patients after TIPS operation may change and this may be associated with the occurrence of hepatic encephalopathy in these patients.

The diagnosis of liver fibrosis in chronic hepatitis B patients based on a transient elastography and serological model

LIANG Kuo-peng, ZHANG Lei, LI Li-ping, ZHANG Dai-hui, WANG Xiao-juan, LI Jin-long, WANG Wen-chuan, MIAO Jie

2025, 30(6):  784-788. 

Asbtract ( 25 )   PDF (463KB) ( 2 )  

References | Related Articles | Metrics

Objective To explore the feasibility of using liver stiffness measurement (LSM) based on transient elastography and serological model to diagnose the severity of liver fibrosis in chronic hepatitis B (CHB) patients, and to provide a reliable method for noninvasive assessment of liver fibrosis. Methods The study enrolled 153 hepatitis B patients who underwent liver biopsies between January 2019 to January 2021. All patients had data on transient elastography and serological tests. Serum aspartate aminotransferase and platelet ratio index (APRI), AST/ALT ratio (AAR), liver fibrosis factor 4 index (FIB-4) of all patients were calculated. The Correlation between liver stiffness based on transient elastography, APRT, AAR, FIB-4 factor and the degree of liver fibrosis was analyzed using Spearman correlation method. The area under the curve (AUROC) was used to evaluate the efficacy of each index to diagnose liver fibrosis in CHB patients. Results 153 participants were included in the study. As confirmed by the pathological findings, The numbers of patients with fibrosis stages S1, S2, S3, and S4 were 32, 35, 10, and 76, respectively. Patients with stages≥S2 had significant fibrosis. The LSM, APRI, AAR, and FIB-4 factors were associated with the degree of liver fibrosis. The correlation coefficients were 0.737, 0.473, 0.516, and 0.720, respectively. As shown by the AUROC analysis, APRI had higher diagnostic efficacy in S2 than LSM, AAR, and FIB-4 factors. The diagnostic efficacy of LSM for S3 and S4 was higher than those of the other serological models; The specificity of the combination of LSM and FIB-4 factors for diagnosing fibrosis stages ≥ S2 was up to 96.8%. Conclusion Transient elastography is of certain clinical value in the diagnosis of liver fibrosis in CHB patients, and its combination with FIB-4 factor can exempt some of the patients from the necessity of liver puncture biopsy.

The efficacy of liver and spleen stiffness measurement combined with APRI and FIB-4 in the evaluation of liver fibrosis in chronic hepatitis B patients

DUAN Liang-liang, BAI Bao-yan, WANG Sheng-li, FENG Xiao

2025, 30(6):  789-792. 

Asbtract ( 41 )   PDF (384KB) ( 2 )  

References | Related Articles | Metrics

Objective To evaluate the diagnostic efficacy of liver and spleen stiffness measurement (LSM, SSM) combined with common liver fibrosis indexes APRI and FIB-4 in chronic hepatitis B (CHB). Methods 117 patients with CHB diagnosed and treated in our hospital between May 2021 and May 2024 were collected. LSM and SSM were examined by acoustic palpation elastography (STE), and serum aspartate aminotransferase and platelet ratio index (APRI) and liver fibrosis factor 4 index (FIB-4) were calculated through the detection of blood biochemical indexes. Liver fibrosis was evaluated according to METAVIR scoring system. The CHB patients were divided into a non-significant and a significant liver fibrosis groups, The clinical data, LSM, SSM, APRI and FIB-4 data of these two groups of patients were compared. The risk factors of significant liver fibrosis were analyzed, and the efficacy of each index in diagnosing different stages of liver fibrosis was evaluated by ROC curve analysis. Results Among 117 patients with CHB, there were 13 cases, 32 cases, 36 cases, 24 cases and 12 cases in F0 to F4 stages, respectively. The clinical data of patients with non-significant (≤F1 stage, N=45) and significant (≥F2 stage, N=72) liver fibrosis were compared. The PLT, ALT, AST, LSM, SSM, APRI and FIB-4 in the liver fibrosis group were (106.1±34.0) ×10⁹/L, (66.1±10.4) U/L, (61.4±12.5) U/L, (13.1±1.7) kPa, (23.1±3.7) kPa, (2.3±0.5), and (1.8±0.4), respectively, compared with those of (160.5±23.4) ×10⁹/L, (51.4±9.8) U/L, (46.8±10.1) U/L, (9.2±1.5) kPa, (15.4±3.2) kPa, (1.1±0.3), (1.0±0.3) in the non-significant hepatic fibrosis group, the difference was statistically significant (P<0.05). Taking these differences as independent variables and significant hepatic fibrosis as dependent variables, the results showed that LSM, SSM, APRI and FIB-4 were significantly associated with the occurrence of significant hepatic fibrosis in CHB patients (P<0.05). The diagnostic AUC values of LSM+SSM, LSM+SSM+APRI+FIB-4 were significantly higher than those of LSM, SSM, APRI and FIB-4 individually (P<0.05), and the diagnostic AUC value of LSM+SSM+APRI+FIB-4 was also significantly higher than that of LSM+SSM (P<0.05). The diagnostic AUC value, the sensitivity and specificity of LSM+SSM were 0.85, 88.9% and 90.3%, respectively. The diagnostic AUC value, the sensitivity and specificity of LSM+SSM+APRI+FIB-4 were 0.93, 93.3% and 91.7%, respectively. Conclusion Using STE to detect LSM and SSM in patients with CHB can effectively evaluate the status of liver fibrosis, and it is more effective when combined with APRI and FIB-4, which is worth of further study as a non-invasive diagnostic method.

Liver Failure

The correlation between immune inflammatory markers and the prognosis of patients with acute-on-chronic liver failure associated with HBV infection

WEI Li, SHI Wen-juan, ZHOU Xiao-li, YANG Xue-fang, MA Hai-wen, WAN Hong

2025, 30(6):  793-795. 

Asbtract ( 31 )   PDF (513KB) ( 3 )  

References | Related Articles | Metrics

Objective To investigate the relationship between immune inflammatory markers and the prognosis of patients with acute-on-chronic liver failure associated with hepatitis B viral infection (HBV-ACLF). Methods A total of 98 HBV-ACLF patients with complete clinical data admitted to the Second People’s Hospital of Lanzhou from January 2020 to December 2022 were collected. The patients were divided into an improvement group (N=65 cases) and a death group(N=33 cases)based on their clinical outcomes. The differences in age, gender, blood cell count, infection indicators, systemic immune inflammation index (SII), and Model for End-Stage Liver Disease (MELD) scores were analyzed among the two groups of patients. Correlation analysis was conducted between blood cell count, infection indicators, SII, and MELD scores of the two groups of patients. Results In the improvement group,platelet count (PLT), interleukin-6 (IL-6), and MELD scores are 122.2±50.5,17.9 (8.6, 23.1), and 8.8±5.2, respectively, which were significantly different with those of 91.7±38.1,16.1 (11.5, 43.3), and 21.9±4.8 in the death group (t=2.186, P=0.034; Z=0.748, P=0.045; t=2.048, P=0.046). The correlation analysis between blood cell count, infection indicators, SII and MELD score showed that white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT) were positively correlated with MELD score (r=0.312, P=0.027; r=0.419, P=0.002; r_s=0.507, P<0.001), PLT was negatively correlated with MELD score (r=-0.350, P=0.013), and other indicators were not correlated with MELD score (P>0.05). Conclusion Elevated levels of WBC, NEU, PCT, and decreased levels of PLT are associated with short-term prognosis in HBV-ACLF patients upon admission.

The clinical predictive value of short-term dynamic changes of new COSSH scores in patients with hepatitis B virus-related acute-on-chronic liver failure

LIU Yu-he, ZHANG Ying, LI Bin-hua, XIE Qing, CHEN Xiao-yong, YAN Xue-hua

2025, 30(6):  796-800. 

Asbtract ( 26 )   PDF (843KB) ( 2 )  

References | Related Articles | Metrics

Objective To investigate the clinical significance of the short-term dynamic changes of the new COSSH score (COSSH-ACLFⅡs) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods This is a retrospective cohort study with 99 HBV-ACLF patients who were admitted in Lanzhou Second People's Hospital., The general characteristics, 48hr, 3~7 d laboratory examination index, 28 d and 90 d prognosis were recorded, and the prognosis score at admission, 48 hr and 3~7 d COSSH-ACLFⅡs score were calculated, respectively. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive value of each scoring model on the short-term prognosis of the studied patients. The clinical predictive value of the short-term dynamic changes of COSSH-ACLFⅡs in HBV-ACLF was analyzed by classified variables. Results The largest AUC of COSSH-ACLFIIs to predict the 28d and 90d deaths of patients had the highest sensitivity and specificity (75% vs. 84% and 86.8% vs. 80.9%, respectively). The COSSH-ACLFIIs resolved or improved in 35.86% of patients, had a steady or fluctuating course in 42.4% and worsened in 21.7% of patients. In the improvement group, 87.8% of patients survived, while in the deterioration group, 85.0% of patients died. Conclusion In comparison with MELD, MELD-Na, CLIF-COFs, and CLIF-CACLFs, COSSH-ACLFIIs has higher sensitivity and specificity for predicting HBV-ACLF. The Survival of 3~7d can be accurately predicted after evaluation with COSSH-ACLFIIs.

Metabolic Associated Fatty Liver Disease

Mechanism of Mertk overexpression in liver sinusoidal endothelial cells in promoting lipotoxic hepatocyte injury

GAO Yu-xuan, XU Ming-yi, WANG Jia-yi

2025, 30(6):  801-807. 

Asbtract ( 29 )   PDF (921KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the mechanism of myeloid-epithelial-reproductive tyrosine kinase (Mertk) expression in liver sinusoidal endothelial cells (LSECs) on non-alcoholic steatohepatitis (NASH) under a lipotoxic environment using plasmid transfection. Methods In the human liver sinusoidal endothelial cell line (TMNK-1), overexpression of Mertk (ov-Mertk) or knockdown of Mertk (sh-Mertk) was achieved through plasmid transfection. LSECs were treated with PA to simulate a high-fat environment, and were divided into 6 groups: palmitic acid (PA), bovine serum albumin (BSA, high-fat control group), ov-Mertk+PA, vector+PA (high-fat Mertk overexpression control group), sh-Mertk+PA, and sh-NC+PA (high-fat Mertk knockdown control group). Subsequently, LSECs from these 6 groups were co-cultured with the human hepatocellular carcinoma cell line (HepG2) using the Transwell method. The impact of co-culture on hepatocellular lipid metabolism, inflammatory response, and proliferation-related factors was assessed using quantitative polymerase chain reaction (qPCR) and Western Blot. Proliferation activity of HepG2 cells under co-culture conditions was evaluated using EdU assay. Independent sample t-tests were employed for data comparison between the two groups. Results (1) When LSECs of PA or PA+ov-Mertk were co-cultured with hepatocytes, the expression of fatty acid synthase (FAS), which promotes lipogenesis in hepatocytes, increased, while the expression of peroxisome proliferator activated receptor alpha (PPAR-α), which promotes lipolysis in hepatocytes, decreased. This condition was reversed when LSECs of PA+sh-Mertk co-cultured with hepatocytes (BSA vs. PA,FAS: 1.00±0.16 vs. 1.91±0.16, P=0.002,PPAR-α: 1.07±0.10 vs. 0.74±0.14, P=0.028;PA+vector vs. PA+ov-Mertk, FAS: 1.79±0.28 vs. 2.57±0.39, P=0.049,PPAR-α: 0.70±0.04 vs. 0.48±0.13, P=0.049;PA+sh-NC vs. PA+sh-Mertk, FAS: 1.93±0.29 vs. 1.37±0.16, P=0.045,PPAR-α: 0.70±0.12 vs. 0.95±0.06, P=0.035). (2) When LSECs of PA or PA+ov-Mertk were co-cultured with hepatocytes, the expression of interleukin-1β (IL-1β), which promotes inflammatory responses in hepatocytes, increased. However, the expression of IL-1β was reduced when LSECs of PA+sh-Mertk co-cultured with hepatocytes (BSA vs. PA, 1.17±0.16 vs. 2.51±0.23, P=0.001; PA+vector vs. PA+ov-Mertk, 2.37±0.15 vs. 3.81±0.33, P=0.002; PA+sh-NC vs. PA+sh-Mertk, 2.41±0.28 vs. 1.62±0.12, P=0.011). (3) When LSECs of PA or PA+ov-Mertk were co-cultured with hepatocytes, the expression of cyclin D1 and proliferating cell nuclear antigen (PCNA), which promote cell proliferation in hepatocytes, increased. However, the expression of CyclinD1 and PCNA was downregulated when LSECs of PA+sh-Mertk co-cultured with hepatocytes (BSA vs. PA, PCNA: 1.02±0.03 vs. 1.55±0.27, P=0.026,CyclinD1: 1.13±0.13 vs. 1.47±0.09, P=0.019;PA+vector vs. PA+ov-Mertk, PCNA: 1.57±0.20 vs. 2.04±0.16, P=0.032,CyclinD1: 1.29±0.44 vs. 2.32±0.35, P=0.034;PA+sh-NC vs. PA+sh-Mertk, PCNA: 1.51±0.30 vs. 0.98±0.13, P=0.048,CyclinD1: 1.42±0.09 vs. 1.11±0.16, P=0.045). (4) The EdU assay showed that the number of proliferating hepatocytes increased when hepatocytes were co-cultured with LSECs of PA or PA+ov-Mertk, while the number of proliferating hepatocytes decreased when they were co-cultured with LSECs of sh-Mertk [BSA: (12.86 ± 3.38) % vs. PA: (49.15 ± 4.5) %, P=0.0004;PA+vector: (42.15 ± 8.43) % vs. PA+ov-Mertk: (65.41 ± 0.66) %, P=0.009;PA+sh-NC: (48.19 ± 3.11) % vs. PA+sh-Mertk: (28.44 ± 1.96) %, P=0.001]. Conclusion In summary, our study found that overexpression of Mertk in LSECs could promote lipotoxic hepatocyte lipogenesis, inflammatory responses, and cell proliferation, thereby promoting NASH. Knockdown of Mertk in LSECs could serve as a target for NASH therapy.

Predictive value of triglyceride-glucose-body mass index in nonalcoholic fatty liver disease among lean populations

GONG Hong, ZHANG Yan, ZHANG Chun-yan, DENG Jie, WU Hao-yu, HAN Tuo

2025, 30(6):  808-812. 

Asbtract ( 36 )   PDF (635KB) ( 2 )  

References | Related Articles | Metrics

Objective To explore the association between triglyceride-glucose-body mass index (TyG-BMI) and nonalcoholic fatty liver disease (NAFLD) in lean population and its predictive value. Methods 2553 healthy subjects from the Second Affiliated Hospital of Xi′an Jiaotong University from June 2020 to May 2021 were randomly included and divided into Q1-Q4 groups according to the TyG-BMI quartiles. The correlation between TyG-BMI and lean NAFLD was analyzed with restricted cubic spline (RCS), and its predictive value was explored by logistic regression and receiver operating characteristic (ROC) curve. Results There were 209 patients with lean NAFLD (8.2%), and the prevalence of NAFLD in Q1-Q4 groups were 0.3%, 1.1%, 7.1% and 24.3%, respectively (P<0.001). RCS showed that the risk of NAFLD in lean population upraised significantly with the increase of TyG-BMI (P<0.001), and there was a nonlinear relationship between them (P for nonlinear < 0.001). Logistic regression showed that after adjusting confounding factors, increased TyG-BMI was significantly associated with the increased risk of lean NAFLD (odds ratio [OR] 1.076, 95% CI: 1.066~1.086), and the risk of lean NAFLD in Q3 (177.85, 194.28) and Q4 (194.28, 269.07) groups was still 5.545 times (95% CI: 1.137~27.039) and 9.853 times (95% CI: 1.788~54.279) than Q1 (115.92, 162.43) group. ROC curve showed that TyG-BMI had a good predictive value for lean NAFLD, with area under the curve of 0.858, critical value of 187.95, the sensitivity and specificity were 89.5% and 70.8%, respectively, which were better than TyG, BMI and waist circumference (WC). Conclusion The TyG-BMI is significantly associated with the risk of NAFLD in lean population, and has a good predictive value, which can be used for early screening and diagnosis of lean NAFLD.

Prognostic role of neutrophil to lymphocyte ratio in nonalcoholic fatty liver disease: a Meta-analysis

YU Yuan, ZHANG Dan-dan, BAO Wei-ping, CHU Xiao-qiu, DOU Ying-lei, ZHANG Mei-yun

2025, 30(6):  813-819. 

Asbtract ( 22 )   PDF (3076KB) ( 1 )  

References | Related Articles | Metrics

Objective To systematically evaluate the correlation between neutrophil to lymphocyte ratio (NLR) and the prognosis of nonalcoholic fatty liver disease (NAFLD). Methods Studies about the correlation between NLR and the prognosis of NAFLD were searched in PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform from the establishment of the database to December 2023. Two researchers independently screened the literature, extracted data, and performed quality assessment. Meta-analysis was performed using Stata software (Version 15.0). Results A total of 11 articles were included, including 6 prospective studies and 5 retrospective studies, with a total of 2,044 NAFLD patients. The results of meta-analysis showed that the NLR level of patients with NASH was higher than that of patients without NASH (SMD=0.82, 95%CI 0.33-1.30, P<0.001), the diagnostic sensitivity of NLR was 0.77 (95%CI 0.70-0.83), the diagnostic specificity was 0.65 (95%CI 0.53-0.76), and the area under the receiver operating characteristic curve (AUC) was 0.79 (95%CI 0.75-0.83); the NLR level of patients with fibrosis was higher than that of patients without fibrosis (SMD=1.17, 95%CI 0.51-1.83, P<0.001), the diagnostic sensitivity of NLR was 0.80 (95%CI 0.70-0.87), the diagnostic specificity was 0.77 (95%CI 0.65-0.86), and the AUC was 0.85 (95%CI 0.82-0.88). The results of sensitivity analysis showed that the research results were stable and reliable. Egger test showed that there was no publication bias in the diagnosis of NASH by NLR (P=0.823), and there was a publication bias in the diagnosis of fibrosis (P=0.004). Conclusion NLR can be used as a new indicator for predicting NASH and liver fibrosis in patients with NAFLD.

Clinical features and risk factors of liver fibrosis in children with non-alcoholic fatty liver disease

CHEN Lei, GONG Qian, LIU Jin-guang, SHEN Huai-yun

2025, 30(6):  820-824. 

Asbtract ( 31 )   PDF (664KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the clinical features of non-alcoholic fatty liver disease (NAFLD) in children and explore the risk factors of liver fibrosis, providing a basis for early diagnosis and intervention. Methods A total of 83 pediatric patients with NAFLD, who were treated at the First People's Hospital of Mengcheng County from May 2022 to May 2024, were enrolled. Based on the degree of liver fibrosis, patients were divided into a non-significant liver fibrosis group (n=48) and a significant liver fibrosis group (n=35). The clinical characteristics and laboratory results between the two groups were compared. Logistic regression analysis was used to identify independent risk factors for liver fibrosis. The diagnostic performance of key indicators in predicting significant liver fibrosis was assessed using receiver operating characteristic (ROC) curves. Results Compared to the mild fibrosis group, the severe fibrosis group showed the significantly higher levels of body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and glycated haemoglobin A1c (HbA1c) (P<0.05). Specifically, after treatment, the BMI in the mild fibrosis group was (18.62±1.95) kg/m², ALT was (40.28±13.80) U/L, AST was (31.18±8.45) U/L, and HbA1c was (5.46±0.35)%, while in the severe fibrosis group, the BMI was (25.14±2.23) kg/m², ALT was (56.32±17.90) U/L, AST was (38.66±9.22) U/L, and HbA1c was (7.05±0.74)%. Multivariate analysis further revealed that the higher levels of BMI, ALT, AST, and HbA1c were closely associated with the occurrence of hepatic fibrosis. ROC curve analysis indicated that the combination of BMI, ALT, AST, and HbA1c effectively predicted significant hepatic fibrosis with an area under the curve (AUC) of 0.968, which demonstrating high sensitivity (85.7%) and specificity (97.9%). The model showed good fit, with no significant deviation indicating by the Hosmer-Lemeshow test (χ²=4.138, P=0.844). Conclusion BMI, ALT, AST, and HbA1c can serve as effective indicators for predicting liver fibrosis in children with NAFLD. The combined model of the four factors improves the accuracy of early diagnosis and provides reference for clinical intervention.

Effect of probiotics assisted compound glycyrrhizin on liver function and intestinal flora in obese children with non-alcoholic fatty liver disease

SUN Zhi-wei, ZHU Wei-jie, ZHANG Hai-ying, MEI Zhen-ru, LI Xiao-yun

2025, 30(6):  825-828. 

Asbtract ( 20 )   PDF (397KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the effects of probiotics and compound glycyrrhizin on liver function and intestinal flora in the treatment of obese children with non-alcoholic fatty liver disease (NAFLD). Methods A total of 120 obese children with NAFLD were enrolled from May 2019 to May 2024, and were divided into control group and observation group. The control group was treated with compound glycyrrhizin, and the observation group was treated with compound glycyrrhizin and probiotics. Serum aspartate aminotransferase (AST), alanase aminotransferase (ALT), γ-glutamyltranspeptidase (γ-GT), intestinal flora, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared, and the efficacy and adverse reactions were evaluated between the two groups. Results After treatment, AST, ALT, γ-GT, TNF-α, and IL-6 in observation group [(38.72±9.15) U/L, (42.44±8.17) U/L, (95.48±28.19) U/L, (24.73±5.28) μg/L, (16.71±3.14) μg/L] were lower than those in control group [(56.16±10.31) U/L, (57.48±9.35) U/L, (129.21±33.75) U/L, (37.15±6.52) μg/L, (20.45±3.56) μg/L] (P<0.05). After treatment, the number of bifidobacterium and lactobacillus in observation group [(8.63±0.44) lg/g, (8.87±0.54) lg/g] was higher than those in control group [(8.11±0.52) lg/g, (8.41±0.73) lg/g], and the number of E. coli [(6.55±0.47) lg/g] was lower than that in control group [(6.88±0.59) lg/g] (P<0.05). After treatment, the total effective rate of observation group was higher than that in control group (91.67% vs. 76.67%, P<0.05). The two groups had comparable adverse reactions (P>0.05). Conclusion Probiotic-assisted compound glycyrrhizin can significantly improve liver function, alleviate intestinal flora disorder and inflammation in obese-NAFLD children, with good efficacy and safety.

Autoimmune Liver Diseases

Occurrence and clinical characteristics of Hashimoto′s thyroiditis with primary biliary cholangitis and its clinical regression

DU Li-chuan, GAO Ru, GAO Yan

2025, 30(6):  829-832. 

Asbtract ( 22 )   PDF (405KB) ( 2 )  

References | Related Articles | Metrics

Objective To analyze the occurrence, clinical characteristics, and clinical outcomes of Hashimoto′s thyroiditis in patients with primary biliary cholangitis. Methods Sixty patients who were diagnosed with primary biliary cholangitis and underwent thyroid examination in Beijing Chaoyang Hospital, Capital Medical University between February 2020 and February 2022 were selected. They were divided into the occurrence group (n=35) and the non-occurrence group (n=25) according to whether Hashimoto′s thyroiditis occurred. The clinical characteristics and prognosis of the occurrence and non-occurrence groups were compared. Results In the occurrence group, the Child-Pugh grade, the proportion of cirrhosis and other symptoms such as malaise, dyspepsia, abdominal distension, edema, and the levels of immunoglobulin A (IgA), thyroglobulin antibody, and thyroid peroxidase antibody were (8.3±1.2), 85.7%, 91.4%, 85.7%, 91.4%, 85.7%, (2.9±1.2) g/L, (217.5± 102.3) IU/mL, and (192.6±62.4) IU/mL, which were higher than those in the non-occurrence group [(5.2±1.1), 48.0%, 60.0%, 40.0%, 48.0%, 48.0%, 48.0%, (2.0±0.5) g/L, (10.2±3.6) IU/mL, and (11.4±4.6) IU/mL, respectively]. The levels of total cholesterol, triglycerides, low-density lipoprotein (LDL), and complement C3 in the occurrence group were (4.3±1.2)μmol/L, (1.2±0.2) μmol/L, (2.5±0.2) mmol/L, (0.5±0.2) g/L, respectively, which were lower than those in the non-occurrence group [(5.8±2.3) μmol/L, (1.6±0.8)μmol/L, (3.0±1.2) mmol/L, and (0.8±0.2) g/L, P<0.05]. Thirty-five patients were followed up until February 2023. Ten (28.6%) patients developed peritoneal effusion (n=5), hepatic insufficiency (n=4), and hepatic encephalopathy (n=1), and 2 (5.7%) patients died due to postoperative cerebral hemorrhage. Five (14.3%) patients developed recurrent postoperative hemorrhage, 2 died within one year, and the survival rate was 94.3%. Conclusion Patients with primary biliary cholangitis have a high probability of developing Hashimoto′s thyroiditis, and their prognosis is poor. Child-Pugh grade of liver function, thyroglobulin antibody and thyroid peroxidase antibody are the risk factors that affect the prognosis of the above cases.

The impact of standard immunosuppressive therapy combined with magnesium isoglycyrrhizinate on the efficacy and immunoglobulins in patients with autoimmune hepatitis

WU An-ni, DU De-hui, WU Rui, XING Jing, WU Shuo-jun

2025, 30(6):  833-836. 

Asbtract ( 23 )   PDF (391KB) ( 2 )  

References | Related Articles | Metrics

Objective To explore the effects of standard immunosuppressive therapy combined with magnesium isoglycyrrhizinate on the efficacy and immunoglobulins in patients with autoimmune hepatitis (AIH). Methods A total of 90 patients with AIH admitted to our hospital from March 2021 to March 2024 were selected. They were randomly divided into the immunosuppressive group (n=45) and the magnesium isoglycyrrhizinate group (n=45) by the envelope lottery method. The immunosuppressive group was treated with standard immunosuppressive therapy, and the magnesium isoglycyrrhizinate group was treated with magnesium isoglycyrrhizinate and standard immunosuppressive therapy. Compare the therapeutic effects, liver function [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)], liver fibrosis indexes [hyaluronic acid (HA), laminin (LN), type III procollagen (PCⅢ)], immunoglobulin [IgA, IgG, IgM] and adverse reactions between the two groups. Results After treatment, the effective rate of the magnesium isoglycyrrhizinate group [93.3% (42/45)] was higher than that of the immunosuppressive group [77.8% (35/45)] (P<0.05); the levels of TBil (15.38 ± 1.41 μmol/L), ALT (56.35 ± 5.21 U/L), AST (48.44 ± 5.82 U/L), and ALP (69.44 ± 7.67 U/L) in the magnesium isoglycyrrhizinate group were lower than those in the immunosuppressive group (17.85 ± 1.78 μmol/L, 80.82 ± 8.03 U/L, 75.03 ± 7.71 U/L, 82.03 ± 9.32 U/L) (P<0.05); the levels of HA (136.43 ± 16.58 μg/L), LN (147.65 ± 16.65 μg/L), and PCⅢ (126.42 ± 13.77 μg/L) in the magnesium isoglycyrrhizinate group were all lower than those in the immunosuppressive group (174.41 ± 19.56, 188.67 ± 21.17, 168.85 ± 17.09 μg/L) (P<0.05); the levels of IgA (0.85 ± 0.29 g/L), IgM (14.73 ± 1.56 g/L), and IgG (1.42 ± 0.22 g/L) in the magnesium isoglycyrrhizinate group were all lower than those in the immunosuppressive group (1.09 ± 0.32, 16.10 ± 1.73, 1.57 ± 0.31 g/L) (P<0.05); there was no significant difference in the incidence of adverse reactions between the magnesium isoglycyrrhizinate group [8.9% (4/45)] and the immunosuppressive group [4.4% (2/45)] (P>0.05). Conclusion The combination of immunosuppressive therapy and magnesium isoglycyrrhizinate can significantly improve the treatment effect of patients with AIH and have a positive regulatory effect on their immunoglobulin levels.    

Other Liver Diseases

Diagnostic path and etiology of non-viral chronic liver injury

FENG Yan-fei, SU Ming-hua, YIN Qian-bing, LI Qing-mei, SU Tu-mei, JIANG Jian-ning

2025, 30(6):  837-840. 

Asbtract ( 24 )   PDF (860KB) ( 3 )  

References | Related Articles | Metrics

Objective To analyze the etiology and diagnostic methods of non-viral chronic liver injury and explore the clinical diagnostic pathways. Methods Clinical data of 356 patients with non-viral chronic liver injury admitted to the First Affiliated Hospital of Guangxi Medical University from June 2020 to December 2022 were collected in this study. Results The common causes of non-viral chronic liver injury were autoimmune liver disease (AILD) in 71 cases (19.9%), non-alcoholic fatty liver disease (NAFLD) in 64 cases (18.0%), and alcoholic liver disease (ALD) in 57 cases (16.0%); the main diagnostic methods were medical history (26.5%), liver biopsy (25.5%), and imaging examinations (15.5%). Based on the common types of diseases and the operability of examination, the following clinical diagnosis path were summarized: first-line screening: ① medical history collection and physical examination; ② liver function; ③ liver tropic and non-liver tropic virus screening; ④ autoimmune antibody; ⑤ immunoglobulin; ⑥ blood lipid; ⑦ abdominal ultrasound; second-line screening: ① rare etiology; ② thyroid function; ③ blood ceruloplasmin and K-F ring; ④ liver CT / MRI; third-line screening: ① genetic test; ② liver biopsy. For patients with weak second-line or third-line screening intention, we can follow up first and observe whether the liver function can be improved after taking special drugs, drinking abstinence, diet control, deworming or treatment of the primary disease. If improved, it will be related to the above situation. Conclusion AILD, NAFLD and ALD are common causes of non-viral chronic liver injury. The diagnostic pathway for non-viral chronic liver injury shows high diagnostic efficacy, is simple to implement, and is worthy of clinical promotion on a trial basis.

Review of safety and indications of percutaneous liver biopsy

CHEN Ri-run, SUN Xin, CHEN Gao-feng, LIU Kun, XING Feng, LIU Cheng-hai

2025, 30(6):  841-846. 

Asbtract ( 24 )   PDF (547KB) ( 2 )  

References | Related Articles | Metrics

Objective To investigate the safety and application value of percutaneous liver biopsy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent percutaneous liver biopsy in the Liver Cirrhosis Department of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 2014 to June 2023. The data included patient demographics (sex, age), blood routine tests, coagulation function, biochemical indicators of liver and kidney function, liver stiffness measurement,clinical diagnosis, and pathological diagnosis. The indications, complications and their management, and diagnostic value of percutaneous liver biopsy were analyzed and evaluated. Results Among the 727 patients who underwent percutaneous liver biopsy, aged between 19 and 86 years, liver biopsy was performed on the left lobe in 6 patients due to right liver atrophy (3 cases), excessive obesity (2 cases), and situs inversus (1 case), while the remaining patients underwent biopsy on the right lobe. 5 patients experienced post-biopsy hemorrhage complications (4 in the abdominal cavity and 1 in the pleural cavity), all of them with an INR less than 1.5 and platelet counts above 50×10⁹/L; no hemorrhage complications occurred in the 14 cases with platelet counts below 50×10⁹/L. In terms of diagnostic distribution, over 50% of the cases involved chronic hepatitis B, either with or without cirrhosis , primarily used in clinical trials to evaluate the efficacy of treatments for hepatitis B-related liver fibrosis. There were 200 patients (27.5%) who exhibited discrepancies between pre-biopsy clinical diagnosis and pathological diagnosis. Beyond differences in the assessment of cirrhosis severity, these discrepancies also included inconsistent etiological diagnoses, particularly in differentiating primary biliary cholangitis, autoimmune hepatitis, drug-induced liver injury, non-alcoholic steatohepatitis, and overlap syndromes. Conclusion Percutaneous liver biopsy is frequently used in diagnosing the etiology of unexplained liver injury and cirrhosis, differentiating autoimmune liver diseases, and assessing the severity of liver fibrosis and treatment efficacy. A platelet count below 50×10⁹/L is not the primary cause of post-biopsy complications such as hemorrhage, but caution should be exercised and a thorough assessment should be conducted before performing the biopsy.

Clinical study of infectious mononucleosis complicated with liver damage in children

ZHANG Yi, ZHU Xin-xin

2025, 30(6):  847-849. 

Asbtract ( 27 )   PDF (412KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the clinical features of children with infectious mononucleosis (IM) complicated with liver damage. Methods Hospitalized children diagnosed with infectious mononucleosis in the Department of Infectious Diseases, Children′s Hospital of Xi′an Jiaotong University from January 1 to December 31, 2023 were collected as research subjects. According to the results of liver function examination, patients were divided into liver damage group (n=126) and non-liver damage group (n=105), and the clinical features and related laboratory tests were compared between the two groups. Results A total of 231 IM cases were collected, of which 126 cases (54.54%) developed liver damage, among them, 50 cases (39.68%) were male and 76 cases (60.32%) were female. There were 0 infants, 11 early childhood (8.73%), 67 pre-school-age patients (53.17%), 47 school-age patients (37.30%), and 1 pre-youth patient (0.79%).The proportion of female children in liver damage group was higher than that in male children (60.32% vs 39.68%, P=0.000).The median age of onset was 70 (47,104) months, and the incidence of IM in preschool age (53.17%) and school-age children (37.3%) , higher than that in other age groups (P=0.001). The hospital stay days in the liver injury group was longer than that in the non-liver injury group [7 (6,8)] (P<0.05).The percentage of abnormal lymphocytes[15.50(11.00,22.00)], EB virus quantification[812.50(0.00,2400.00)], immunoglobulin (IgM) [1.64 (1.29,2.20)] and the percentage of Ts cells (inhibitory T cells) [64.00 (57.00,71.00)] in the liver injury group were higher than those in the non-liver injury group [13.00 (9.00,20.00)], EB virus quantification [0.00 (0.00, 1240.00)], immunoglobulin (IgM) [1.36 (1.08,1.88)] and the proportion of Ts cells (inhibitory T cells) [59.00 (52.00, 67.00)];The proportion of Th cells (helper T cells) [13.50 (10.00,19.00)] and B cells [4.00 (3.00,6.00)] in the liver injury group were lower than those in the non-liver injury group [16.00 (12.00, 21.00)] and B cells [6.00 (4.00, 8.00)].There were statistically significant differences in the percentage of atypical lymphocytes, quantitative EB virus DNA, immunoglobulin (IgM) and lymphocyte subsets (proportion of Th cells, proportion of Ts cells and proportion of B cells) in 2 groups (P<0.05).There was no statistical significance in the number of immunoglobulin (IgA, IgG) and NK cells in 2 groups (P>0.05). Conclusion Liver damage is more frequently observed in IM children, with higher incidence in female children and early school age children. The percentage of abnormal lymphocytes, EB Epstein-Barr virus load and cellular immunity were correlated with liver damage in IM. Children with liver damage are prone to immune dysfunction.

Retrospective analysis of measles combined with liver dysfunction

DONG Xiao-feng, LIANG Dong

2025, 30(6):  850-851. 

Asbtract ( 30 )   PDF (411KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the clinical characteristics and prognosis of patients with measles combined with liver dysfunction, and to improve diagnostic and treatment capabilities. Methods A total of 182 patients diagnosed with measles admitted to our hospital from January 2013 to June 2023 were selected as the study subjects, divided into an adult group and a children′s group, and all case data were statistically analyzed. Results There were a total of 27 cases with abnormal liver function, accounting for 14.8%. There were 21 cases in the adult group and 6 cases in the children′s group, with no significant difference (P>0.05); Abnormal liver function was found during the rash period, with most cases showing no obvious discomfort symptoms; All 27 patients had elevated ALT levels, with an average of 106.6 ± 42.8 U/L, compared to 109.3 ± 58.5 U/L in the adult group and 98.5 ± 44.2 U/L in the children group, with no significant difference (P>0.05). 14 patients had elevated AST levels, but no patients had elevated bilirubin levels; Liver injury was classified as mild in 25 cases, moderate in 1 case, and severe in 1 case. After appropriate liver protection treatment, 22 cases were cured, 5 cases improved, and 0 cases were ineffective. The effective rate was 100%. Conclusion Abnormal liver function is a common complication of measles observed in adults and children. It is more likely to occur during the rash period, and the clinical symptoms are not obvious. It is mostly mild to moderate damage, with elevated ALT as the main symptom. It can be cured through appropriate liver protection treatment.

Study on the etiology, clinical manifestations, and pregnancy outcomes of drug-induced liver injury in pregnancy

WANG Feng-mei, YANG Yue, HE Ya-jie

2025, 30(6):  852-856. 

Asbtract ( 21 )   PDF (515KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the etiology, clinical manifestations, and pregnancy outcomes of drug-induced liver injury (DILI) during pregnancy. Methods A total of 98 pregnant female patients diagnosed with drug-induced liver injury hospitalized at our institution from January 2020 to October 2024 were included in the observation group. Meanwhile, 102 pregnant female patients with normal liver function during pregnancy, who underwent examination at our hospital during the same period were chosen as the control group. Clinical data were collected from both groups to analyze the etiology of DILI in the observation group and to compare liver function indicators and pregnancy outcomes between the two groups. Results The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), total bile acid (TBA), and albumin (Alb) in the observation group were (152.11±20.47) U/L, (138.48±14.58) U/L, (30.45±4.26) μmol/L, (20.68±3.17) μmol/L, respectively, higher than those in the control group, while ALB was lower than the control group [(30.15±4.18) vs (39.41±4.56) g/L], with statistical significance (P<0.05). Among the 98 patients in the observation group, 36 cases (36.73%) had concomitant viral hepatitis, including 6 cases of hepatitis A, 20 cases of hepatitis B, 4 cases of hepatitis C, 3 cases of cytomegalovirus infection, and 3 cases of Epstein-Barr virus infection. Additionally, 16 cases (16.33%) had gestational hypertension; 24 cases (24.49%) had intrahepatic cholestasis of pregnancy; 12 cases (12.24%) had hyperthyroidism and were treated with propylthiouracil; 19 cases (19.39%) had depression and were treated with sertraline; 18 cases (18.37%) self-administered herbal medicines or related health supplements; and 10 cases (10.20%) used antibiotics. The proportions of patients with viral hepatitis, gestational hypertension, intrahepatic cholestasis of pregnancy, hyperthyroidism, depression, use of herbal medicines, use of antibiotics, and adverse pregnancy outcomes were higher in the observation group than that in the control group (P<0.05). Conclusion Drug-induced liver injury during pregnancy is strongly linked to various causes, resulting in liver dysfunction and a higher risk of adverse pregnancy outcomes.

Establishment and validation of a risk factor model for intrahepatic cholestasis of pregnancy in patients with chronic hepatitis B

LIU Li, ZHANG Rui, WANG Xiao-wei

2025, 30(6):  857-861. 

Asbtract ( 21 )   PDF (877KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the risk factors for intrahepatic cholestasis of pregnancy (ICP) patients with chronic hepatitis B (CHB) during pregnancy, and to establish a corresponding risk prediction model, to furnish a basis for early clinical intervention and management. Methods A total of 149 pregnant patients with chronic hepatitis B (CHB) treated at Shangqiu Maternal and Child Health Hospital from March 2021 to March 2024 were selected. They were grouped by the presence or absence of ICP. Significant variables were screened via univariate analysis, followed by multivariate Logistic regression analysis. A nomogram model was constructed and validated. Results A total of 149 pregnant patients with CHB were included, among which 21 patients were in the ICP group (14.09%), and 128 patients were in the non- ICP group (85.91%). Univariate analysis revealed that the ICP group had a higher prevalence of cholelithiasis [42.86% (9/21) vs. 21.88% (28/128)], gestational hypertension [23.81% (5/21) vs. 7.81% (10/128)], elevated TBA (15.51 ± 2.31 μmol/L vs. 11.19 ± 3.24 μmol/L), elevated ALT (115.72 ± 12.29 U/L vs. 85.62 ± 8.81 U/L), and elevated HBV pgRNA (5.40 ± 0.69 lg copies/mL vs. 4.28 ± 0.51 lg copies/mL) compared to the non-ICP group (P<0.05). Multivariate logistic regression analysis showed that cholelithiasis [OR=15.340 (95% CI: 1.124~209.390)], pregnancy-induced hypertension [OR=15.618 (95% CI: 1.310~186.220)], high TBA [OR=1.438 (95% CI: 1.074~1.924)], high ALT [OR=1.233 (95% CI: 1.107~1.373)], and high HBV pgRNA [OR=40.620 (95% CI: 2.253~732.301)] were risk factors for ICP patients with CHB. Receiver operating characteristic (ROC) curve analysis indicated that the combined prediction of all items had a high value, with an area under the curve (AUC) value of 0.988, a sensitivity of 95.2%, and a specificity of 96.1%. A nomogram and a calibration curve were constructed, which showed a good fit. Conclusion Cholelithiasis, pregnancy - induced hypertension, TBA, ALT, and HBV pgRNA are the main risk factors for ICP in pregnant patients with CHB, providing valuable prediction basis for clinicians.

The predictive value of C-reactive protein/albumin ratio combined with platelet-to-lymphocyte ratio for the prognosis of patients with malignant obstructive jaundice after interventional therapy

LI Guang-lin, LI Heng, CHENG Xun, YANG Gui-bin, LUO Da-yong

2025, 30(6):  862-867. 

Asbtract ( 32 )   PDF (939KB) ( 2 )  

References | Related Articles | Metrics

Objective To analyze the prognostic value of C-reactive protein/albumin ratio (CAR) combined with platelet to lymphocyte ratio (PLR) in malignant obstructive jaundice (MOJ) after interventional therapy. Methods A total of 87 MOJ patients who underwent interventional therapy in the No.2 People’s Hospital of Fuyang City from May 2020 to February 2023 were retrospectively selected in the study. The patients were divided into good prognosis group and poor prognosis group according to the survival status within 1 year after interventional therapy. CAR and PLR were measured before treatment, and other clinical data were collected to analyze the prognostic factors of patients. The predictive value of CAR and PLR for the prognosis of patients was analyzed by the area under the receiver operating characteristic (ROC) curve (AUC). The survival curve was analyzed by Kaplan-Meier method. Results In the poor prognosis group, age [(66.27±7.22) years vs (62.35±6.91) years], obstruction time > 20 days accounted for [62.50% vs 38.46%], CAR[(1.76±0.34) vs (1.15±0.23)], PLR[(0.77±0.19) vs (0.51±0.13)] and Child-Pugh grade C [31.25% vs 7.69%] were higher than those in good prognosis group, the proportion of anti-tumor after operation [20.83% vs 58.97%] was lower than that in the group with good prognosis (P<0.05). Multivariate stepwise Logistic regression analysis showed that CAR level (OR=6.241, 95%CI: 2.310~16.858), PLR level (OR=4.937, 95%CI: 1.919~12.698), Child-Pugh classification (OR=2.388, 95%CI: 1.174~4.854) were independent risk factors for the prognosis of patients, and postoperative antineoplastic therapy (OR=0.252, 95%CI: 0.112~0.566) was an independent protective factor (P<0.05). ROC curve showed that the sensitivity of CAR, PLR and the combination of the two to predict the prognosis of patients was 70.80%, 75.00%, 89.60%, respectively, the specificity was 74.40%, 71.80%, 87.20%, respectively, and the AUC was 0.794, 0.807, 0.890, respectively (P<0.05). The survival curves of patients with high and low expressions of CAR and PLR were statistically different (P<0.05). Conclusion CAR, PLR are independent risk factors of postoperative outcomes in MOJ patients, through joint determination CAR and PLR level can effectively predict the patients′ prognosis.

TLR4 monoclonal antibody combined with stem cell therapy improves liver injury in heat stroke mice

LI Ping, YAO Chuan-xia, XING Ji-cheng, YANG Zhi-hui, CAO Xiao-hui, WANG Jun-yi

2025, 30(6):  868-871. 

Asbtract ( 26 )   PDF (2786KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the protective effect of mesenchymal stem cells combined with TLR4 monoclonal antibody as the treatment of liver injury in heatstroke mice. Methods Mesenchymal stem cells were obtained from inguinal fat tissue separated from living mice. Mice were randomly divided into four groups: blank control group (control), heat stroke group (HS), stem cell intervention group (MSC), and stem cell+TLR4 antibody intervention group (MT). After the successful modeling of heat stroke in the experimental mice, 1 mL of 0.9% sodium chloride injection was injected intraperitoneally in the HS group. The MSC group was injected with 2×10⁶ MSCs. In the MT group, 2×10⁶ MSCs and 100 μg TLR4 monoclonal antibody were injected. After 7 days of refeeding, 1ml of orbital venous blood was collected, serum ALT and AST were detected by biochemical instrument, and inflammatory factors IL-1β, IL-6 and TNF-α were detected by Elisa method. At the same time, the mice were sacrificed to collect liver tissue, and the sections were fixed and stained with HE. SPSS 19.0 was used for the analysis of experimental data. Results The liver histopathology of HS group mice showed that the hepatocyte cord arrangement was disordered, the hepatocytes were moderately to severely turbid with vacuolar degeneration, some hepatocytes were necrosis, and a small amount of scattered lymphocyte infiltration. Mild to moderate turbidity of hepatocytes and moderate vacuolar structures were observed in the liver tissues of mice in the MSC group. The liver tissue damage of mice in the MT group was mild. The ALT and AST levels in the HS group mice were significantly increased, reaching 347.3 ± 130.5 U/L and 345.0 ± 229.3 U/L, respectively, with significant statistical differences compared to the other groups (P<0.01); Serum inflammatory cytokine IL-1 β, IL-6, TNF- α The levels were 185.44 ± 143.64 pg/mL, 51.42 ± 34.41 pg/mL, and 83.94 ± 54.24 pg/mL, respectively. There was a significant statistical difference compared to the other three groups, with P values of 0.003, 0.011, and 0.016, respectively. Conclusion Stem cell combined with TLR4 monoclonal antibody therapy improves liver injury in heat stroke mice through NF- κ B inflammatory signaling pathway; And the combination therapy has a synergistic effect.