Table of Content

31 March 2026, Volume 31 Issue 3

Previous Issue   

Frontier, Exploration and Controversy Liver Failure

The relationship between nutritional risk screening scores and 90-day prognosis in patients with acute-on-chronic liver failure

TANG Rui, XUE Hong, BIAN Zhao-lian

2026, 31(3):  326-330. 

Asbtract ( 5 )   PDF (614KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the prognostic value of nutritional risk screening (NRS) scores in patients with acute-on-chronic liver failure (ACLF), and to guide nutritional interventions for ACLF patients. Methods The clinical data of 228 ACLF patients treated at the Third People′s Hospital of Nantong from August 2021 to August 2023 were collected. Patients were divided into a survival and a death groups based on 90-day survival status post-admission. The correlation between NRS scores and Child-Turcotte-Pugh (CTP) scores, Model for End-Stage Liver Disease (MELD) series scores was analyzed; receiver operating characteristic (ROC) curves were used to assess the diagnostic efficacy of NRS scores compared to CTP and MELD series scores; Kaplan-Meier method was employed to plot survival curves. Results There were no statistically significant differences in age, gender, complications, ALT, AST, renal function, and blood routine between the two groups (P>0.05). The BMI, Alb, and prothrombin activity in the survival group were 21.30(20.90,22.23) kg/m², (30.6±4.02)g/L, and 28.21(23.96,32.35)%, respectively. The BMI, Alb, and prothrombin activity in the death group were 19.27(18.59, 19.94)kg/m², (27.18±3.26)g/L, and 21.85 (17.60,25.73)%, respectively. There were significant differences between the two groups (P<0.05). The TBil, NRS score, CTP score, MELD score, MELD-Na score, and iMELD score in the death group were 335.55 (246.25, 431.08)μmol/L, 4.00 (4.00, 5.00), 10.00 (9.00,11.00), 23.02 (20.85, 25.86), 27.02 (22.71, 34.05), and 49.83±7.25, respectively. The TBIL, NRS score, CTP score, MELD score, MELD-Na score, and iMELD score in the improvement group were 225.20 (185.68, 288.45)μmol/L, 2.00 (2.00,3.00), 9.00 (8.00,10.00), 19.67(17.62,22.88), 21.42 (18.16, 27.43), and 43.66 ±7.52, respectively. There were significant differences between the two groups (P<0.05). Pearson correlation analysis revealed a positive correlation between NRS scores and CTP scores(r=0.399,P<0.05), MELD scores(r=0.301,P<0.05), MELD-Na scores(r=0.234,P<0.05), and iMELD scores(r=0.302,P<0.05). ROC curve analysis showed that the area under the curve (AUC) for NRS scores(0.896)was superior to that of MELD scores(0.707), MELD-Na scores(0.688), iMELD scores(0.735), and CTP scores(0.669)(all P<0.05). Kaplan-Meier analysis indicated that ACLF patients with NRS scores≥3 [37.01% (47/127)] had significantly lower cumulative survival rates than those with NRS scores＜3[91.09％(92/101)](P<0.0001). Conclusion NRS scores are correlated with the prognosis of ACLF patients, and patients with NRS scores ≥ 3 (high nutritional risk group) have poorer outcomes. Early nutritional risk assessment and appropriate interventions can help to improve patients′ prognosis.

An observation study on the effect of dual plasma molecular adsorption system combined with plasma exchange to improve the treatment outcome of patients at early stage of acute-on-chronic liver failure

ZHAO Xiao-chun, AN Xuan, WANG Yong, ZHU Hong-xu, YU Hai-yan, HAO Li-juan

2026, 31(3):  331-335. 

Asbtract ( 4 )   PDF (574KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the effect of dual plasma molecular adsorption system (DPMAS) model of artificial liver combined with plasma exchange (PE) as an auxiliary medical treatment to improve the treatment outcome of patients at early stage of acute-on-chronic liver failure (pre-ACLF). Methods The clinical data of 146 patients with pre-ACLF were retrospectively analyzed, all of whom were treated from April 2020 to December 2023. The subjects were divided into a control group and a treatment group according to different treatment methods. Sixty-four cases in the control group received comprehensive medical treatment (including medicines to remove the etiology, protect liver function, promote liver cell growth, and relieve symptoms, etc.). In the 82 cases of the treatment group, DPMAS combined with PE artificial liver therapy was given on the basis of comprehensive medical treatment. Liver function indexes, data of electrolytes, coagulation function, alpha-fetoprotein (AFP) and model of end-stage liver disease (MELD-Na) were collected at before treatment, 1 week and 4 weeks after treatment. The occurrence of adverse reactions in the two groups was analyzed. Results The total effective rate in the treatment group was 79.27%, which was higher than that of 53.13% in the control group (P<0.05). Compared to before treatment, the levels of total bilirubin (TBil), direct bilirubin (DBil), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and total bile acid (TBA) in both groups were lower after 1 week and 4 weeks of treatment (P<0.05). The levels of TBil[(152.09±77.19)μmol/L, (49.29±6.74)μmol/L], DBil[(130.14±69.73)μmol/L, (38.56±6.75)μmol/L] and AST[(192.84±54.82)U/L, (45.37±6.18)U/L], ALT[(256.83±119.27)U/L, (42.88±6.58)U/L], GGT[(152.47±35.25)U/L, (84.69±10.69)U/L], ALP[(143.83±34.15)U/L, (108.12±11.74)U/L], LDH[(199.54±56.73)U/L, (180.81±20.75)U/L], TBA[(187.01±42.38)μmol/L, (71.78±6.83)μmol/L] in the treatment group after 1 week and 4 weeks of treatment, respectively, were lower than those of the control group (P<0.05). Compared with before treatment, the levels of Na⁺, K⁺, Cl^- and prothrombin activity (PTA) were increased after 1 week and 4 weeks of treatment in both groups (P<0.05), whereas the levels of prothrombin time (PT) were decreased (P<0.05). Compared with the control group, Na⁺, K⁺, Cl, PTA levels in the treatment group were higher (P<0.05), and PT levels were lower (P<0.05) after 1 week of treatment. Compared with before treatment, white blood cell count (WBC), neutrophil count, neutrophil/lymphocyte ratio (NLR), AFP and MELD-Na levels were decreased after 1 week and 4 weeks of treatment in both groups (P<0.05), whereas lymphocyte count levels were increased (P<0.05). In the treatment group, the levels of WBC count [(5.72±0.82) ×10⁹/L, (5.12±0.54)×10⁹/L], neutrophil count [(3.21±0.53)×10⁹/L, (2.61±0.39)×10⁹/L], NLR[(2.93±0.58), (2.12±0.35)], AFP[(68.32±8.47) ng/mL, (24.18±4.12) ng/mL], MELD-Na[(14.13±3.08) min, (6.72±2.15) min] after 1 week and 4 weeks of treatment, respectively, were lower when compared to those of the control group (P<0.05), whereas the lymphocyte count level was higher [(1.89±0.31)×10⁹/L, (2.14±0.29)×10⁹/L, respectively] (P<0.05). After 1 week of treatment, the levels of the Hb, platelet count and Alb levels in both groups were decreased (P<0.05), but the above indexes in the treatment group were decreased more significantly (P<0.05). There were no differences in the incidence of adverse reactions and mortality between the two groups (P>0.05). Conclusion DPMAS model of artificial liver combined with PE assisted medical comprehensive treatment for pre-ACLF patients is more conducive in improving clinical efficacy, improving liver function, maintaining water and electrolyte balance, reducing the degree of inflammation in the body, delaying the progression of the disease, and with high safety.

The impact of platelet aggregation function on the prognosis of patients with acute-on-chronic liver failure

ZHANG Yu-li, HUANG Yan, CHENG Si

2026, 31(3):  336-340. 

Asbtract ( 5 )   PDF (652KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the impact of platelet aggregation function on the prognosis of patients with acute-on-chronic liver failure (ACLF). Methods A retrospective case cohort study was conducted in 120 ACLF patients admitted to Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from July 2022 to July 2024. Based on their 28 day survival status after admission, they were divided into a mortality group (n=60) and a survival group (n=60). All patients were tested for platelet aggregation function upon admission, and other baseline data were collected at the same time. Univariate and multivariate logistic regression models were used to analyze the factors affecting the prognosis of these ACLF patients, and receiver operating characteristic (ROC) curves were drawn to analyze the predictive power of platelet aggregation function for the prognosis of ACLF patients. Results The neutrophil to lymphocyte ratio (NLR), direct bilirubin (DBil), and total bilirubin (TBil) levels in the mortality group were (3.42±0.21), (179.62±11.05) μmol/L, and (320.02±20.14) μmol/L, respectively, which were higher than those of (3.21±0.17), (169.33±8.61) μmol/L, and (304.25±18.66) μmol/L in the survival group. The levels of platelet aggregation rate (PAR)-adrenaline (A), PAR collagen (COL), and PAR adenosine diphosphate (ADP) were (40.9±3.91)%, (28.64±3.27)%, and (30.22±3.75)%, respectively, which were lower than those of [(46.50±4.83)%, (33.52±3.41)%, and (35.30±3.15)% in the survival group, and the difference was statistically significant (P<0.05). The comparison of other baseline data showed no statistical significant difference (P>0.05). By multivariate logistic regression analysis it was shown that PAR-A, PAR-COL, PAR-ADP, and DBil were prognostic factors for ACLF patients [OR (95% CI)=0.704 (0.555~0.894), 0.523 (0.367~0.745), 0.595 (0.440~0.805), and 1.120 (1.011~1.241), P<0.05]. The ROC curve analysis showed that PAR-A, PAR-COL, and PAR-ADP had moderate predictive value for the prognosis of ACLF patients, with areas under the curve (AUC) of 0.816, 0.842, and 0.848, respectively. The combination of these three factors had high predictive value for the prognosis of ACLF patients, with AUC of 0.968. Conclusion The levels of PAR-A, PAR-COL, and PAR-ADP are influencing factors for the prognosis of ACLF patients, and the detection of platelet aggregation function is helpful in predicting patients′ prognosis, which has certain clinical guiding significance.

Liver Fibrosis&Cirrhosis

The evaluation value of ultrasound shear wave elastography and portal vein hemodynamic parameters for the severity of liver cirrhosis

LIU Ting, YANG Wan-ying, CHEN Jia-rui, TU Jiao, QIAN Rong

2026, 31(3):  341-344. 

Asbtract ( 5 )   PDF (2983KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the evaluation value of shear wave elastography (SWE) and portal venous hemodynamic parameters for the severity of liver fibrosis. Methods Sixty-six patients with liver cirrhosis admitted between October 2024 and August 2025 were enrolled in this study. Among them, 27 cases were of Child-Pugh grade A, 21 cases of grade B, and 18 cases of grade C. Additionally, 24 healthy individuals who underwent physical examinations at our hospital were selected as the control group. The average liver SWE (Emean) was measured using SWE technology, and the portal vein diameter (PVD) and resting portal vein velocity (PVV) were detected using ultrasound CDFI technology. By comparing PVD, PVV, and Emean parameters, the correlation between Emean, PVD, PVV, and Child-Pugh score in liver cirrhosis were evaluated, and the application value of these parameters in assessing the degree of liver fibrosis were analyzed. Results The Emean values of the Child-Pugh grade A. B and C groups of patients were (9.90 ± 1.64) kPa, (16.84 ± 3.2) kPa, and (19.62 ± 6.89) kPa, respectively. The PVD values were (11.96 ± 3.6) mm, (13.37 ± 1.2) mm, and (13.90 ± 2.81) mm, respectively. The PVV values were (14.15 ± 2.12) cm/s, (12.25 ± 1.75) cm/s, and (11.07 ± 1.49) cm/s, respectively. There were statistically significant differences in liver Emean, PVV, and PVD between the patients′ groups and the control group (P<0.05), and there were statistically significant differences in liver Emean, PVD, and PVV between patients with different grades of liver function (P<0.05) (F value=29.988, 4.371, 14.078, respectively). PVD, PVV, and liver Emean in patients with cirrhosis are correlated with Child-Pugh grading (correlation coefficients rates=0.269, -0.701, 0.741, respectively). Conclusion Liver SWE and portal vein hemodynamics are closely related to the degree of liver fibrosis in patients with chronic liver diseases. Color doppler ultrasound combined with shear wave elastic imaging technology has a good evaluation efficacy for the severity of liver cirrhosis.

An analysis on the incidence and prognosis of liver cirrhotic patients with chronic hepatitis B

YUAN Xuan, YANG Xiao-yu, CHEN Ying

2026, 31(3):  345-350. 

Asbtract ( 4 )   PDF (874KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the incidence of cirrhosis and its relationship with the prognosis of patients with chronic hepatitis B (CHB). Methods This retrospective cohort study included 89 CHB patients admitted to the Second People′s Hospital of Taizhou City from May 2021 to May 2023. The levels of total bilirubin (TBil) and serum creatinine (Scr) were detected in all patients after admission by automatic biochemical analyzer. The prothrombin normalized ratio (INR) was measured by automatic coagulation analyzer. The patients were given antiviral, immunomodulatory, anti-inflammatory, antioxidant and liver protective treatment, and divided into a progression group and a non-progression group based on whether they developed into cirrhosis or not. The factors affecting the development of cirrhosis in CHB patients were analyzed and the evaluation value of ROC curve was analyzed. The patients were followed up for 1 year and divided into a good prognosis group and a poor prognosis group (death) according to the prognosis status of the patients. The factors affecting the poor prognosis of CHB patients were analyzed and their evaluation value was analyzed by ROC curve method. Results Among 89 patients with CHB, 19 patients (21.35%) developed cirrhosis. The level of PLT in the progression group was lower than that of the non-progression group (P<0.05) and the liver function of the progression group was grade C. By binary logistic regression analysis it was shown that the duration of disease (OR=2.169, 95%CI=1.349~3.489) and liver function grade of C (OR=4.350, 95%CI=1.456~12.993) were risk factors for cirrhosis in CHB patients, whereas the PLT level (OR=0.927, 95%CI=0.890~0.965) was a protective factor for cirrhosis in CHB patients (P<0.05). According to ROC curve analysis, the sensitivity of disease duration, PLT and liver function grade C to predict the cirrhosis progression in CHB patients were 78.90%, 73.70%, 47.40% and 89.50%, respectively; the specificity was 71.40%, 67.10%, 82.90% and 90.00%, respectively. Moreover, the combination of disease duration, PLT, and liver function grade C had a high value in predicting cirrhosis progression in CHB patients (AUC=0.899). Of the 89 patients with CHB, 15 had a poor prognosis (16.85%). Liver function grade C, TBil, INR and Scr levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). By Binary Logistic regression analysis, it was shown that TBil level (OR=1.032, 95%CI=1.013~1.052), INR level (OR=60.167, 95%CI=6.894~525.068), Scr level (OR=2.032, 95%CI:1.332~3.101), grade C liver function (OR=5.905, 95%CI=1.800~19.368) were the influential factors for poor prognosis in CHB patients (P<0.05). According to ROC curve analysis, the sensitivity of TBil, INR, Scr and liver function grade C to predict poor prognosis in CHB patients was 73.30%, 66.70%, 80.00%, 53.30% and 93.30%, respectively. The specificity was 74.30%, 77.00%, 71.60%, 83.80% and 89.20%, respectively. Moreover, the combination of TBil, INR, Scr and liver function grade C had a high value in predicting poor prognosis of CHB patients (AUC=0.894). Conclusion Long duration of disease, grade C liver function and PLT are the influencing factors for cirrhosis in CHB patients, and TBil, INR, Scr and liver function grade C are the influencing factors for poor prognosis in CHB patients. Early identification and correction of reversible factors are helpful to reduce the progression of cirrhosis and improve the prognosis of CHB patients.

The electrocardiographic features, imaging manifestations and prognostic influencing factors of hepatitis B-related cirrhotic cardiomyopathy

ZHU Ying, NIU Jing, XU Yuan-ping, TIE Jun

2026, 31(3):  351-355. 

Asbtract ( 4 )   PDF (454KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the electrocardiographic characteristics, imaging manifestations and prognostic influencing factors of hepatitis B-related cirrhotic cardiomyopathy, and to provide a basis for improving the prognosis of patients. Methods Sixty-five patients with hepatitis B-related liver cirrhosis admitted to First Affiliated Hospital of Air Force Medical University from April 2021 to April 2023 were enrolled in this study. According to whether they developed hepatitis B-related cirrhotic cardiomyopathy, they were divided into an occurrence group (n=40) and a control group (n=25). The occurrence group was further classified into a good prognosis group (25 cases, 1 case of lossing follow-up) and a poor prognosis group (13 cases , 1 case of lossing follow-up). Blood creatinine (Scr) and hemoglobin (Hb) were detected using a fully automated biochemical immunoassay analyzer; prothrombin time (PT) was detected using a fully automated coagulation analyzer; imaging features were detected using a color Doppler ultrasound diagnostic machine; and electrocardiography was performed using an electrocardiograph. The imaging and electrocardiogram examination indexes in the occurrence group and control group were compared. The influencing factors for the prognosis of hepatitis B-related cirrhotic cardiomyopathy were analyzed using multifactorial logistics. Results The left atrial inner diameter (LAD), diastolic ventricular septal thickness (IVSD), Q-T interval prolongation, ST-T changes, and the percentage of low voltage in the occurrence group were (39.2±4.6) mm, (12.8±1.5) mm, 75.0%, 70.0%, and 30.0% in the occurrence group, respectively, which were higher than those of [(34.2±2.8) mm, (10.5±1.1) mm, 36.0%, 28.0%, and 8.0%] in the control group. The E/A ratio was (0.7±0.1) in the occurrence group, which was lower than that of (1.4±0.3) in the control group (P<0.05). The percentages of Child-Pugh classification C, Q-T interval prolongation, ST-T changes, and low voltage in the adverse group were 69.2%, 61.5%, 53.9%, and 61.5%, respectively, which were significantly higher than those of 20.0%, 16.0%, 8.0%, and 12.0% in the survival group (P<0.05). The results of multifactorial logistic regression analysis showed that Child-Pugh classification, Q-T interval prolongation, ST-T changes, and low voltage were factors affecting the prognosis of patients with hepatitis B-related cirrhotic cardiomyopathy (OR=3.490, 3.842, 3.466, 3.684, respectively, P<0.05). Conclusion Child-Pugh classification, Q-T interval prolongation, ST-T changes, and low voltage are factors affecting the prognosis of patients with hepatitis B-related cirrhotic cardiomyopathy.

The efficacy of left gastric vein shunt index, spleen stiffness value and GPR in the assessment of high-risk esophageal varices in cirrhotic patients

ZHU Hong-mei, ZHONG Ji-feng, HUANG Yong

2026, 31(3):  356-360. 

Asbtract ( 5 )   PDF (494KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the clinical predictive efficacy of the left gastric vein shunt index (LGVSI), spleen stiffness value (SSM), and gamma-glutamyl transpeptidase to platelet ratio (GPR) for the occurrence of high-risk esophageal varices (EGV) in patients with liver cirrhosis (LC). Methods A total of 115 patients with LC combined with EGV who were diagnosed and treated from January 2022 to December 2024 were selected. According to the results of electronic gastroscopy, they were divided into a mild variceal group (n=30), a moderate variceal group (n=48), and a severe variceal group (n=37). Additionally, 68 cases were in the non-EGV group and 47 cases were in the EGV group. The LGVSI, SSM, and GPR scores of each group were detected and compared. Pearson analysis was conducted to explore the correlations between LGVSI, SSM, GPR scores and albumin-bilirubin score (ALBI), FIB-4 index, and Child-Pugh modified grading scores. The receiver operating characteristic curve (ROC) was drawn to analyze the efficacy of combined detection of LGVSI, SSM, and GPR in evaluating EGV. Results The LGVSI, SSM and GPR scores in the severe EGV subgroup were 0.43, 23.29 kPa and 1.28 respectively, which were higher than those of 0.32, 21.06 kPa and 0.69 in the moderate subgroup and 0.21, 17.54 kPa and 0.45 in the mild subgroup, the differences were statistically significant (H=11.439, F=9.185, H=15.627, all P<0.05). The LGVSI, SSM, GPR, ALBI, FIB-4 and Child-Pugh scores in the EGVB subgroup were 0.47, 24.72 kPa, 1.37, -1.15, 5.94 and 2.06 respectively, which were higher than those of 0.28, 19.36 kPa, 0.61, -1.41, 4.51 and 2.43 in the non-EGVB subgroup, and the differences were also statistically significant (Z=7.416, t=7.639, Z=8.264, Z=7.529, t=9.162 and Z=7.284, all P<0.05). Pearson analysis showed that the LGVSI, SSM and GPR scores of patients with HREV in LC were positively correlated with the ALBI, FIB-4 index and Child-Pugh modified grading scores (P<0.01). The ROC curve showed that the AUC, sensitivity and specificity of the combined assessment of LGVSI, SSM and GPR for the occurrence of HREV in LC patients were higher than the efficacy of any single item (P<0.01). Conclusion The combined detection of LGVSI, SSM and GPR score can effectively reflect the degree of liver fibrosis and the bleeding risk of EGV in LC patients, which has high clinical diagnosis efficacy.

Viral Hepatitis

Association between M-CSF, GGT/Alb and the degree of liver fibrosis in patients with chronic HBV infection

CUI Li-wei, DU Yan-ming, MA Li-li

2026, 31(3):  361-364. 

Asbtract ( 3 )   PDF (516KB) ( 1 )  

References | Related Articles | Metrics

Objective To evaluate the association between macrophage colony-stimulating factor (M-CSF), the ratio of γ-glutamyl transpeptidase to albumin (GGT/Alb), and the progression of liver fibrosis in patients with chronic HBV infection. Methods A cohort of 110 chronic HBV patients treated between March 2020 and April 2021 constituted the HBV infection group. Based on liver biopsy pathology and the Metavir scoring system, patients were stratified into non-fibrosis (F0, n=47), mild-moderate fibrosis (F1-F3, n=34), and severe fibrosis (F4, n=29) subgroups. Ninety-eight contemporaneous healthy individuals served as the control group. Levels of M-CSF, GGT/Alb, and established liver fibrosis markers [hyaluronic acid (HA), type Ⅳ collagen (Ⅳ-C), type III procollagen (PC-Ⅲ), laminin (LN)] were measured and compared amomg groups. Pearson correlation analysis was employed to examine the relationships between M-CSF, GGT/Alb, fibrosis severity, and other markers. Results M-CSF and GGT/Alb levels were significantly elevated in the HBV group compared to controls [(305.16±45.87) pg/mL vs (237.39±33.02) pg/mL,0.53 (0.38,0.77) vs 0.30 (0.22,0.61)] (P<0.05). Within the HBV group, levels of M-CSF, GGT/Alb, HA, Ⅳ-C, PC-Ⅲ, and LN were significantly higher in both mild-moderate and severe fibrosis subgroups than those in the non-fibrosis subgroup (P<0.05), and further elevated in the severe versus mild-moderate subgroup (P<0.05). Pearson analysis revealed significant positive correlations between both M-CSF and GGT/Alb and the levels of HA, Ⅳ-C, PC-Ⅲ, and LN (all P<0.05) among chronic HBV patients. A significant positive correlation was also found between M-CSF and GGT/Alb (P<0.05). Conclusion Elevated levels of M-CSF and GGT/Alb are closely associated with the severity of liver fibrosis in chronic HBV infection, and there is a positive correlation between the two markers. Their combined assessment may offer valuable serological insights for evaluating liver fibrosis.

Impact of chronic HBV infection combined with gestational diabetes mellitus on adverse pregnancy outcomes

ZHANG Yan-wei, JIANG Yong-li, YUE Xin

2026, 31(3):  365-368. 

Asbtract ( 4 )   PDF (544KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the key risk predictors for the development of gestational diabetes mellitus (GDM) in pregnant women with chronic hepatitis B virus (HBV), as well as its impact on adverse pregnancy outcomes, in order to provide a basis for early identification of high-risk populations and improvement of maternal and fetal outcomes. Methods A retrospective analysis was conducted on 80 pregnant women with chronic HBV infection and GDM (HBV+GDM group) who delivered in our hospital between January 2022 and December 2024, serving as the case group. A control group (pure HBV group) of 80 pregnant women with chronic HBV infection but without GDM during the same period was matched at 1∶1 ratio. Baseline characteristics, liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin (Alb), prealbumin (PAB), cholinesterase (ChE)], bilirubin metabolism indicators [total bilirubin (TBil), direct bilirubin (DBil)], glucose metabolism, and renal function [fasting blood glucose, uric acid (UA), creatinine (Cr)] were compared between the two groups. Independent predictors of GDM in HBV-infected pregnant women were determined through multivariate logistic regression, with receiver operating characteristic (ROC) curve analysis evaluating their predictive efficacy. Follow-up was conducted until postpartum discharge to compare adverse pregnancy outcomes between the two groups. Results No significant difference was observed between groups regarding age, gravidity and parity, pre-pregnancy BMI, family history of diabetes, AST, ALP, GGT, Alb, ChE, TBil, DBil, or Cr levels (P<0.05). Levels of fasting blood glucose [(5.14±0.64) mmol/L], ALT [(19.90±4.46) U/L], LDH [(178.45±30.58) U/L], PAB [(258.33±42.19) mg/L], and UA [(275.70±48.43) μmol/L] in the HBV+GDM group were higher than those in the HBV group [(4.72±0.48) mmol/L, (18.21±3.56) U/L, (165.60±28.18) U/L, (235.70±45.28) mg/L, (248.16±39.31) μmol/L] (P<0.05). Multivariate logistic regression analysis showed that elevated fasting blood glucose (OR=4.334), ALT (OR=1.136), LDH (OR=1.014), PAB (OR=1.014), and UA (OR=1.018) were independent risk factors for GDM in pregnant women with chronic HBV infection (P<0.05). All five independent risk factors demonstrated some predictive ability for GDM occurrence (AUC<0.50 for all). Among them, fasting blood glucose had the highest predictive efficacy (AUC=0.691), followed by UA (AUC=0.676) and PAB (AUC=0.640). The combined prediction model using these five factors had an AUC of 0.825, with a sensitivity of 66.2% and specificity of 88.7%, indicating relatively high predictive efficacy. The overall incidence of adverse pregnancy outcomes was higher in the HBV+GDM group than in the HBV group (P<0.05). Conclusion In pregnant women with chronic HBV infection, early pregnancy fasting blood glucose, ALT, LDH, PAB, and UA are independent risk factors for GDM. The combined prediction model constructed from these factors exhibited excellent discriminative ability. Once GDM is superimposed on HBV infection, it significantly increases the risk of adverse pregnancy outcomes. It is recommended to implement early intensive monitoring and intervention for HBV-infected pregnant women who exhibit these risk factors.

Liver Tumor

Study on the relationship between prognosis in primary liver cancer patients and the infiltration levels of CD8⁺ cytotoxic T lymphocytes in the tumor microenvironment

FAN Bin, HUANG Sheng-li, YI Gang-feng, ZHOU Yu

2026, 31(3):  369-374. 

Asbtract ( 4 )   PDF (667KB) ( 1 )  

References | Related Articles | Metrics

Objective This study aims to explore the relationship between the degree of infiltration of CD8⁺ cytotoxic T lymphocytes in the tumor microenvironment of patients with primary liver cancer and their prognosis, with the hope of providing a new immunological basis for the treatment of liver cancer. Methods This study was retrospective, selecting 68 patients who underwent surgery for primary liver cancer between January 2018 and January 2020 as research subjects. Fresh liver tissues (including tumor and adjacent non-tumor tissues) were obtained during the surgery. Flow cytometry was used to assess the infiltration levels (IL) of CD8⁺ T cells in tumor tissues, adjacent non-tumor tissues. Patients were divided into recurrence (25 patients) and non-recurrence groups (43 patients) based on postoperative recurrence, and into survival (50 patients) and death groups (18 patients) based on final survival status. Clinical and pathological characteristics were statistically compared. All the above study subjects were followed up, with the follow-up period from January 2020 to January 2024. Cox regression analysis was utilized to examine factors affecting survival post-hepatectomy. Survival curves based on CD8⁺ T IL quantities were plotted using the Kaplan-Meier method, and differences were analyzed using the log-rank test. Results The recurrence group had 17 patients with ≤100 CD8⁺ T cells, fewer than the non-recurrence group′s 12 patients (P<0.05). The death group included 14 patients with tumors ≥5 cm, significantly more than the survival group (P<0.05), and 13 patients with ≥2 tumors, fewer than the 21 in the survival group (P<0.05). The death group also had 11 patients with encapsulated tumors, fewer than the survival group′s 13 patients (P<0.05), and 9 with tumor thrombi, the same number as the survival group but with statistical significance (P<0.05). Ten patients in the death group had postoperative alpha-fetoprotein (AFP) levels <400 ng/mL, fewer than the 31 in the survival group (P<0.05). Univariate and multivariate Cox regression analyses identified alpha-fetoprotein levels (P=0.041) and CD8⁺ T cell counts (P=0.009) as factors influencing recurrence post-surgery. Tumor size (P=0.001), capsule presence (P=0.037), serum AFP levels one month post-surgery (P=0.034), Edmondson-Steiner grading (P=0.013), and alpha-fetoprotein levels (P=0.013) were factors affecting mortality in univariate analysis, while AFP levels (P=0.009) and CD8⁺ T cell counts (P=0.006) were identified in multivariate analysis. Conclusion The level of CD8⁺ T cell infiltration in the tumor microenvironment of primary liver cancer patients is closely related to their prognosis. Higher levels of CD8⁺ T cell infiltration correlate with a better clinical outcome, suggesting that CD8⁺ T cells may be an important immunological target in liver cancer treatment.

Efficacy of CT-guided microwave ablation combined with lenvatinib in primary liver cancer

PANG Cheng, MO Chao-yan, HUANG Chang-fa, WANG You-hua

2026, 31(3):  375-379. 

Asbtract ( 4 )   PDF (538KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the clinical efficacy of CT-guided microwave ablation (MWA) combined with lenvatinib in patients with primary liver cancer (PLC) and its impact on patients′ quality of life and prognosis. Methods A total of 96 patients with PLC who were treated at Yulin Red Cross Hospital from January 2024 to December 2024 were randomly divided into an observation group (48 patients) and a control group (48 patients). The observation group received CT-guided MWA combined with lenvatinib treatment, while the control group received MWA alone. Tumor size, liver function, serum tumor markers were compared between two groups. Recurrence was assessed after 3 months of treatment, and the long-term survival and adverse event rates were observed after a 1-year follow-up. Results After treatment, the levels of alpha-fetoprotein (AFP), prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) in the observation group were (74.50±33.84) ng/mL, (128.84±47.69) mAU/mL, (93.22±40.83) U/L, (84.62±36.15) U/L, and (23.58±3.65) μmol/L, respectively, which were lower than control group, which were (116.25±46.52) ng/mL, (191.01±42.84) mAU/mL, (145.69±57.60) U/L, (138.96±40.56) U/L, and (34.36±4.18) μmol/L (P<0.05). The albumin (Alb) level in the observation group was (37.63±4.69) g/L, which was higher than control group, which was (33.75±4.36) g/L (P<0.05). Fourweek post-treatment, the observation group had a higher total effective rate (P<0.05). After 12 months, the recurrence rate was lower, and the 1-year survival rate higher in the observation group (P<0.05). Conclusion CT-guided MWA combined with lenvatinib demonstrates significant clinical advantages in the treatment of PLC. Compared with the control group who received MWA alone, the combined therapy not only effectively reduced tumor marker levels and improved liver function but also increased the total effective rate and quality of life of patients. After 12 months of follow-up, the observation group showed a lower tumor recurrence rate and a higher 1-year survival rate, further proving the long-term effectiveness and superiority of this treatment regimen. Therefore, MWA combined with lenvatinib may become a new and effective option for the treatment of PLC.

Analysis of influencing factors of cancer recurrence after indocyanine green guided laparoscopic partial hepatectomy

CHEN Chen, ZHU Yun, LI Yong-bo, WANG Lei

2026, 31(3):  380-384. 

Asbtract ( 4 )   PDF (846KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the influencing factors of cancer recurrence after indocyanine green guided laparoscopic partial hepatectomy. Methods The clinical data of 97 patients with indocyanine green-guided laparoscopic partial hepatectomy admitted to Suqian Hospital of Jiangsu Provincial People′s Hospital from January 2021 to December 2022 were retrospectively analyzed. All patients were followed up until October 2024, and were divided into recurrence group and non-recurrence group according to the recurrence of cancer. The cancer recurrence and relapse-free survival (RFS) of the patients were statistically analyzed. The influencing factors of cancer recurrence in patients with hepatocellular carcinoma (HCC) after indocyanine green guided laparoscopic partial hepatectomy, and the value of significant factors in predicting cancer recurrence in patients with HCC were further explored. Results Among 97 patients, 3 cases were lost ,so the total number of cases in this study was 94, including 36 patients with cancer recurrence and 58 patients without cancer recurrence. The mean RFS of 36 patients with recurrent cancer was 28.00 months (95%CI: 25.391 ~ 30.609). The serum AFP level (164.85±34.28) ng/mL, the rate of tumor number 2~3 (69.44%), low differentiation rate (55.56%) and microvascular infiltration rate (69.44%) in the relapsed group were higher than those in the non-relapsed group [(94.69±16.27) ng/mL, (29.31%), (27.59%), (46.55%)], the tumor diameter [(7.52±1.35) cm] was higher than that of the non-recurrence group [(5.31±1.06)cm] (P<0.05). Multivariate logistic regression analysis showed that high AFP levels [OR:1.152 (95%CI: 1.082 ~ 1.228)], large tumors [OR:5.046 (95%CI:2.672 ~ 9.527)], and numerous tumor [OR:5.481 (95%CI:2.213 ~ 13.576)], low differentiation degree [OR:3.281 (95%CI:1.369~7.863)], microvascular infiltration [OR:2.609 (95%CI:1.086~6.272)] were the risk factors for cancer recurrence in indocyanine green-guided laparoscopic partial hepatectomy (P<0.05). The ROC curve showed that the AUC value of the combination of these five factors to predict cancer recurrence was 0.973, which had high predictive value. Conclusion High AFP level, large and numerous tumors,low differentiation degree,and microvascular infiltration are all independent risk factors for cancer recurrence in patients undergoing indocyanine green-guided laparoscopic partial hepatectomy. The combination of the five factors can better predict cancer recurrence in patients and assist doctors to develop personalized postoperative management plans.

Application of serum DKK1, TAP combined with abnormal prothrombin in preoperative prediction of microvascular invasion in hepatocellular carcinoma

ZHU Hong-yu, HU Qing-chao, SONG Qing-jie, SONG Hui, ZHU Zhong-hui

2026, 31(3):  385-389. 

Asbtract ( 5 )   PDF (677KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the value of serum Dickkopf-1 related protein (DKK1), tumor abnormal protein (TAP) combined with protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Methods A total of 270 HCC patients diagnosed and treated in Qidong People′s Hospital from September 2021 to August 2024 were regarded as the HCC group, and 247 patients with benign liver lesions and 283 physical examination volunteers were selected as the benign group and control group. HCC patients were assigned into non-MVI group (n=176) and MVI group (n=94) based on whether MVI occurred. Quantitative hepatitis B virus (HBV) DNA, prothrombin time (PT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alpha-fetoprotein (AFP), DKK1, PIVKA-Ⅱ and TAP levels were determined. Multivariate logistic regression was applied to analyze the influencing factors of MVI occurrence. The ROC curve was applied to analyze the diagnostic value of DKK1, TAP, and PIVKA-II for the occurrence of MVI. The Z-test was applied to compare the difference in AUC. Results The levels of serum DKK1, TAP and PIVKA-Ⅱ in HCC group were (147.95±45.36) pg/L, (184.90±58.72) μm² and (124.47±38.31) ng/mL, respectively higher than the benign group [(115.32±34.31) pg/L, (126.37±38.32) μm², (75.28±24.74) ng/mL] and the control group [(96.45±28.44) pg/L, (86.21±25.34) μm², (32.71±8.43) ng/mL]. Compared with the non-MVI group, the MVI group had tumors with a diameter of ≥ 5 cm, multiple tumors, low tumor differentiation, HBV DNA quantification >10⁴ copies/mL, a higher proportion of Child Pugh grade B, and higher levels of serum AFP, DKK1, TAP, and PIVKA Ⅱ (P<0.05). Tumor diameter ≥ 5 cm, multiple tumors, low tumor differentiation, and elevated levels of AFP, DKK1, TAP, and PIVKA-Ⅱ were independent risk factors for MVI in HCC patients (P<0.05). The AUC values of DKK1, TAP, and PIVKA-Ⅱ for diagnosing MVI in HCC patients were 0.773, 0.788, and 0.777, respectively. The AUC of the combined diagnosis of the three was 0.934, which was better than the individual diagnosis. Conclusion The levels of serum DKK1, TAP, and PIVKA Ⅱ in patients with MVI are higher than those in non-MVI patients, and these three are independent risk factors for the occurrence of MVI. The combined diagnosis of MVI has certain clinical significance and provides reference for clinical diagnosis.

The efficacy of TACE and TACE in combination with lenvatinib mesylate in the treatment of intermediate and advanced primary liver cancer and its impact on safety

YIN Hong-ling, YUAN Yue, ZHANG Hai-li

2026, 31(3):  390-393. 

Asbtract ( 6 )   PDF (464KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the efficacy of transarterial chemoembolization (TACE) and TACE combined with lenvatinib mesylate in the treatment of advanced primary liver cancer (PLC) and its impact on safety. Methods A total of 125 patients with advanced PLC admitted to Baoji Central Hospital (February 2020-April 2024) were selected and divided into two groups according to the treatment methods. 61 cases in the control group were treated with TACE, and 64 cases in the observation group were treated with lenvatinib mesylate in addition. The therapeutic effects of the two groups were compared. Results The DCR rate of the observation group was 84.38% (54/64), and the ORR rate was 62.50% (40/64), which were 65.57% (40/61) /31.15% (19/61) higher than those of the control group (χ² values=5.920, 12.319; all P values＜0.05). Three weeks of treatment The AST level (35.62±6.14) U/L, ALT level (62.01±4.28) U/L, and TBil level (20.02±3.47) μmol/L in the observation group were lower than those in the control group [43.52±7.63) U/L, (67.17±5.32) U/L, (21.82±3.08) μmol/L] (P<0.05). After 3 weeks of treatment, the levels of CD3⁺ (66.22±8.19)/μL and CD4⁺ (33.69±3.74)/μL in the observation group were higher than those in the control group (62.04±7.60)/μL and (30.05±3.47)/μL, while the level of CD8⁺ (26.23±2.84)/μL was lower than that in the control group (29.96±3.17)/μL (P<0.05). After 3 weeks of treatment, the AFP level (79.62±6.47) ng/mL and CEA level (13.66±2.34) U/mL in the observation group were lower than those in the control group [(150.39±10.46) ng/mL and (14.85±2.47) U/mL]. The level of CA199 (31.04±5.07) ng/mL was higher than that of the control group (28.03±4.92) ng/mL (P<0.05). The incidence of fever in the observation group was 3.13% (2/64), which was lower than 13.11% (8/61) in the control group (χ² value=4.235, P value=0.040). Patients were followed up for one year. The survival rate of the observation group was 92.19% (59/64), which was higher than that of the control group at 83.61% (51/61). χ²=0.285, P=0.594. Conclusion The treatment of advanced PLC patients with TACE combined with lenvatinib mesylate has a significant effect. It can significantly improve immune function and liver function, effectively reduce tumor markers, and has a low mortality rate.

Drug-Induced Liver Injury

Comparative study on clinical and serological characteristics of patients with different pathological types of chronic drug-induced liver injury

LI Jian, ZHANG Ya-nan, HUANG Xiao-yu, WANG Zhi-hua, QIE Lan-xia, NIU Hong-yao

2026, 31(3):  394-400. 

Asbtract ( 5 )   PDF (625KB) ( 1 )  

References | Related Articles | Metrics

Objective To compare and analyze the clinical and serological characteristics and differences of patients with different pathological types of chronic drug-induced liver injury (DILI). Methods 86 patients with chronic DILI by histopathology were retrospectively observed at the Fifth Hospital of Shijiazhuang. Patients were divided into chronic lobular hepatitis group and chronic cholestasis group according to different pathological injury targets. The general data, medication history, allergy history, course of disease, clinical severity grading, combined with other underlying diseases, recurrent attacks, and previous serological indicators during the course of the disease were compared between the two groups. Results Middle-aged and elderly female patients aged 45 years and above were more common in both groups, and there was no statistical difference in gender composition ratio and average age between the two groups (P>0.05). The number of recurrent episodes in chronic hepatitis group was higher than that in chronic cholestasis group (P<0.05). Overall, there was significant difference in clinical severity between the two groups (P<0.05). There was no significant difference in the mean course of disease between the two groups (P>0.05). The most common drugs used in the two groups were traditional Chinese medicine or proprietary Chinese medicine with a total of 44 cases (51.2%). There were 45 cases (52.3%) of combined drug use, 27 cases (31.4%) of single drug use, and 14 cases (16.3%) of chemical contact history. There was no significant difference in the proportion of detailed drug use between the two groups (P>0.05). Hypertension, diabetes and hyperlipidemia accounted for the top three comorbidities in both groups. A total of 16 patients (18.6%) had allergic history in the two groups. Serum ALP, GGT, TC, PA, HDL and LDL in chronic cholestasis group were higher than those in chronic hepatitis group (P<0.05). LY% in chronic hepatitis group was higher than that in chronic cholestasis group (P<0.05). The most common autoantibody in both groups was antinuclear antibody (ANA), with 36 cases (41.9%). AMA in chronic cholestasis group was significantly higher than that in chronic hepatitis group (P<0.05). There was no significant difference in other autoantibody indexes between the two groups (P>0.05). Conclusion Patients with different pathological types of chronic DILI have different clinical and serological characteristics. It is of great significance for clinicians to understand the of patients with different pathological types in understanding chronic DILI.

Analysis of MRI features of drug-induced liver injury type and disease severity

ZHANG Qian, LIU Yan

2026, 31(3):  401-404. 

Asbtract ( 4 )   PDF (423KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the magnetic resonance imaging (MRI) characteristics of the injury type and severity of drug-induced liver injury. Methods The clinical data of 120 patients with drug-induced liver injury who were diagnosed and treated in our hospital from January 2020 to December 2024and received MRI examination were retrospectively analyzed, and the MRI characteristics of patients with different injury types and disease severity were analyzed. Results The main MRI features observed in DILI patients included irregular liver surface, intrahepatic bile duct dilatation, gallbladder wall thickening, and splenomegaly. Among different injury types, the ADC values of the hepatocellular and mixed injury types [824.5 (526.5~1 114.6) ×10^-6 mm²/s and 890.2 (621.5~1 268.1) ×10^-6 mm²/s, respectively] were significantly lower than those of the cholestatic type [1 126.3 (818.6~1 268.4) ×10^-6 mm²/s, P<0.05]. Comparison among patients with varying disease severity showed that the incidence of intrahepatic bile duct dilatation in patients with grade ≥3 was 32.5%, significantly higher than that in patients with grade ≤2 (22.5%, P<0.05). The incidence of gallbladder wall thickening was also higher in grade ≥3 patients (52.5%) than in grade ≤2 patients (30.0%, P<0.05), while ADC values were markedly reduced [846.2 (621.5~1 150.8) ×10^-6 mm²/s vs. 1 058.6 (856.4~1 268.4) ×10^-6 mm²/s, P<0.05]. According to the causative drug categories, the incidence of intrahepatic bile duct dilatation was the highest in the traditional Chinese medicine and Chinese patent medicine group (55.2%), significantly higher than that in the antibacterial (20.0%), antineoplastic (18.7%), and cardiovascular drug groups (23.5%, P<0.05). The incidence of gallbladder wall thickening was also the highest in the traditional Chinese medicine and Chinese patent medicine group (58.6%), followed by the antineoplastic drug group (50.0%, P<0.05). The ADC value was the lowest in the antineoplastic drug group [812.3 (554.6~986.4) ×10^-6 mm²/s], followed by the traditional Chinese medicine and Chinese patent medicine group [826.7 (526.5~936.8) ×10^-6 mm²/s], both were significantly lower than those in other groups (P<0.05). Conclusion The common MRI features of DILI patients include irregular liver surface, intrahepatic bile duct dilatation, gallbladder wall thickening and splenomegaly. There were no significant differences between different types of patients, but there is a certain degree of differentiation between intrahepatic bile duct dilatation and gallbladder wall thickening in different severity and drug categories.

Analysis of the clinical characteristics and prognosis of 302 patients with drug-induced liver injury

SUN Shuang-shuang, JIN Yin-peng, LI Li, FU Qing-chun

2026, 31(3):  405-411. 

Asbtract ( 4 )   PDF (2144KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the clinical characteristics and related influencing factors of drug-induced liver injury (DILI). Methods A total of 302 patients diagnosed with DILI at Shanghai Public Health Clinical Center from January 2020 to January 2025 were enrolled. Data including medical history, clinical manifestations and classification, laboratory test indicators, disease severity and mortality were collected. Statistical analyses were performed using t-test, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test and logistic regression model. Results Most patients were middle-aged and elderly (72%), with a female predominance. Among the drugs causing DILI, traditional Chinese medicine (TCM) accounted for 128 cases (42.38%), mainly including polygonum multiflorum and gynura segetum; western medicine accounted for 174 cases (57.6%), mainly anti-tuberculosis drugs (30.79%).Compared with the western medicine group, the TCM group had significantly higher rates of skin jaundice, anorexia and dark urine (all P<0.001, P<0.004, P<0.001, respectively), but a lower rate of rash (P<0.004).Peak serum levels of ALT, AST, ALP, TBil and DBil were significantly higher in the TCM group (all P<0.001, P<0.001, P<0.015, P<0.001, P<0.001, respectively), while the peak percentage of eosinophils was significantly higher in the western medicine group.In total, 98.7% of DILI patients were cured or improved, and 1.3% had no recovery. Conclusion Herbal medicines and anti-tuberculosis drugs are the main suspicious agents causing DILI. DILI is more common in middle-aged and elderly women, mostly presenting as hepatocellular injury. The prognosis of most DILI patients is favorable after drug withdrawal.

Other Liver Diseases

Analysis of clinical characteristics and genotypes in 22 cases of glycogen storage disease

SHAN Shan, YU Hai-tian, TAN Yu-le, SHEN Li, ZHONG Yu-bo, ZHOU Dong-hu, ZHU Zhi-jun, SUN Li-ying, ZHAO Xin-yan

2026, 31(3):  412-419. 

Asbtract ( 4 )   PDF (2473KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the clinical and hepatic pathological features, mutation genotype distribution, treatment, and prognosis of patients with hepatic glycogen storage disease (GSD), and to deepen understanding of this rare disease and provide a basis for precise clinical management. Methods A retrospective cohort study was conducted, collecting clinical data from patients with hepatic GSD treated at Beijing Friendship Hospital, Capital Medical University, between January 2014 and December 2025. Clinical manifestations, biochemical abnormalities, complications, and hepatic pathological features were summarized. Clinical characteristics were compared among different subtypes of hepatic GSD. Results A total of 22 patients with hepatic GSD were included, comprising 11 males and 11 females. Among them, 18 were children and 4 were adults, with a median age at diagnosis of 6 (3, 16) years. Subtype distribution included GSD Ⅰa (7 cases), GSD Ⅰb (4 cases), GSD Ⅲ (4 cases), GSD Ⅳ (4 cases), and GSD Ⅸ (3 cases). The most common clinical manifestations were hepatomegaly (81.82%) and abnormal liver function (77.27%). 13.64% of patients were in the compensated stage of cirrhosis, while 18.18% had progressed to decompensated cirrhosis at diagnosis. Histological findings included hepatocyte swelling and frequent glycogen nuclei. Patients with type Ⅰ GSD often exhibited mild to moderate hepatocyte steatosis, whereas those with types Ⅲ, Ⅳ, and Ⅸ showed more severe hepatic fibrosis. A total of 28 GSD-related gene variants were identified, including 11 novel variants, with G6PC1 c.648G>T being a hotspot mutation. All patients received symptomatic treatment based on uncooked cornstarch, and 11 underwent liver transplantation. Conclusion Different types of hepatic GSD exhibited overlapping clinical manifestations, and type Ⅲ and Ⅳ are more prone to progress to cirrhosis, indicating possible diagnostic delay. Genetic testing is essential for definitive diagnosis and subtyping and may aid in prognostic evaluation. Comprehensive management centered on uncooked cornstarch remains the mainstay of treatment. Liver transplantation is reserved for endstage cases. Gene therapy represents a promising future direction.

Analysis of the efficacy and safety of rifampin in the treatment of patients with persistent hepatocellular secretion disorder

PENG Shan-shan, GE Ting-qiu, HE Yue, ZHENG Hui, ZHONG Yan-dan

2026, 31(3):  420-423. 

Asbtract ( 5 )   PDF (419KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze the efficacy and safety of rifampicin in the treatment of 11 patients with persistent hepatocellular secretory failure (PHSF). Methods Patients who were hospitalized in Nanjing Second Hospital from March 2022 to March 2024 and clinically diagnosed with PHSF and received rifampicin treatment were selected. General information, clinical data and laboratory data were collected, and the laboratory data before and after rifampicin treatment were compared. Results The average age of the 11 PHSF patients was 55.4 years old. The average level of total bilirubin before taking rifampicin was 463.15 μmol/L. All patients received rifampicin treatment at a dose of 150~300 mg/d for a course of 3~4 weeks. The changes in relevant indicators before and after treatment were compared. After treatment, TBil decreased to 51.5 (40.1, 192.8) μmol/L, DBil decreased to 44.5 (30.5, 139.6) μmol/L, and TBA decreased to 18.1 (13.6, 78.5) μmol/L, with statistically significant differences compared with those before treatment (P<0.05). After treatment, mild elevation of ALT and AST was observed in one patient, and absolute values of white blood cells and neutrophils decreased to varying degrees was observed in 3 patients. No abnormal renal function was found in all patients after rifampicin treatment. Conclusion Rifampicin shows good efficacy and high safety in the treatment of patients with persistent hepatocellular secretory failure, but randomized controlled clinical studies are still needed for further confirmation.

Effect of splenectomy on neurological function and prognosis in patients with hepatolenticular degeneration and hypersplenism

ZHAO Guang-long, HU Ming, WANG Xiao-dong

2026, 31(3):  424-427. 

Asbtract ( 5 )   PDF (386KB) ( 1 )  

References | Related Articles | Metrics

Objective To explore the impact of splenectomy on neurological function and prognosis in patients with hepatolenticular degeneration and hypersplenism, and to provide a basis for the management of patients with hepatolenticular degeneration and hypersplenism. Methods From January 2020 to March 2023, 63 patients with hepatolenticular degeneration and hypersplenism were admitted to the hospital. According to whether the patients received splenectomy treatment after admission, the patients were divided into a splenectomy group (n=32) and a non-splenectomy group (n=31). The baseline data, post-treatment neurological function and post-treatment liver function of the two groups were compared. Results The difference in the baseline data of the two groups is not statistically significant (P>0.05).The proportion of abnormal motor function and mental function of the patients in the splenectomy group after treatment were 6.3%, 3.1% and 3.1% respectively, which were significantly lower than those of patients in the non-splenectomy group [19.4%, 12.9% and 16.1% (P<0.05)]. The proportion of Child-Pugh A grade after treatment in the splenectomy group was 81.3%, which was significantly higher than that of the patients in the non-splenectomy group (48.4%). The proportion of Child-Pugh grade B, ALT level, and AST level after treatment were and ALP levels were 6.3%, 65 (6,107) U/L, 48 (3,89) U/L and 90 (57,126) U/L respectively, which were significantly lower than those in the non-splenectomy group [22.6%, 136 (13,546) U/L, 94 (32,637) U/L and 120 (70,382) U/L(P<0.05)].In terms of prognosis, 2 patients died in the splenectomy group and 6 patients died in the non-splenectomy group. Conclusion Splenectomy can significantly improve splenic function, neurological function and prognostic outcomes in hepatolenticular degeneration.

Analysis of non-alcoholic fatty liver disease and its influencing factors in HIV/AIDS patients

WANG Yong-su, ZHANG Lin, NIU Wei-li

2026, 31(3):  428-432. 

Asbtract ( 4 )   PDF (481KB) ( 1 )  

References | Related Articles | Metrics

Objective To understand the non-alcoholic fatty liver disease ( NAFLD ) and its influencing factors in HIV/AIDS patients receiving antiretroviral therapy ( ART ), and to provide reference for the prevention and treatment of NAFLD in HIV/AIDS patients. Methods A total of 76 HIV/AIDS patients who were treated with ART in the Third People′s Hospital of Hebi City from October 2023 to April 2024 were selected as the research objects. Relevant data were collected and statistically analyzed. Results The proportion of NAFLD in 76 HIV/AIDS patients was 53.95%(41/76). The proportion of BMI ≥ 24 kg/m² (82.9%), the proportion of taking EFV regimen and ≥ 60 months(51.2%), the proportion of abnormal TG (73.2%), the proportion of abnormal blood lipid index ( 75.6 % ), the proportion of abnormal blood glucose ( 61.0% ) and body fat content ( 29.51% ± 4.98% ) in patients with NAFLD were higher than those in patients without NAFLD ( 37.1%, 22.9%, 37.1%, 51.4%, 31.4% and 24.83%± 6.14%, respectively ). The difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that BMI≥24 kg/m², taking EFV regimen and ≥ 60 months and abnormal TG may be influencing factors of NAFLD, and the difference were statistically significant (P<0.05). Conclusion The proportion of NAFLD in HIV / AIDS patients receiving ART is high. BMI ≥ 24 kg/m², taking EFV regimen and ≥ 60 months, and abnormal TG were influencing factors of NAFLD.

Study on the changes of serum TIMP3 and systemic immune inflammation index in non-alcoholic fatty liver disease patients and their relationship with carotid artery atherosclerosis

WANG Zhen-zhe, XUE Lin, ZHANG Xi

2026, 31(3):  433-437. 

Asbtract ( 5 )   PDF (647KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the serum levels of tissue inhibitor of metalloproteinase 3 (TIMP3) and systemic immune inflammation index (SII) in patients with non-alcoholic fatty liver disease (NAFLD), and to assess their relationship with carotid artery atherosclerosis (CAS). Methods A total of 149 NAFLD patients treated in our hospital from October 2021 to September 2023 were enrolled in this study. All patients underwent abdominal ultrasound examination and serum TIMP3 and SII testing. Based on carotid ultrasound results, the patients were divided into a CAS group and a non-CAS group. Statistical methods were used to compare the differences in TIMP3 and SII levels between the two groups, and a multivariate analysis of factors influencing CAS occurrence in NAFLD patients was performed. The predictive value of TIMP3 and SII levels for the development of CAS in NAFLD patients was also analyzed. Results In the CAS group, BNP, TC, TG, and LDL-C levels were(186.49±19.39) pg/mL,(5.32±0.73)mmol/L, (2.43±0.62)mmol/L, and (3.18±0.77) mmol/L, respectively, which were significantly higher than those in the control group(P<0.05). The HDL-C level in the CAS group was (1.03±0.35)mmol/L, significantly lower than that in the control group (P<0.05). The TIMP3 level in the CAS group was (159.62±22.63)pg/mL, significantly lower than that in the control group (P<0.05); the SII in the CAS group was 1 035.26±182.15, significantly higher than the control group (P<0.05). After incorporating these differential indicators as independent variables in the logistic multivariate regression analysis, BNP, TC, TG, HDL-C, LDL-C, TIMP3, and SII were identified as factors influencing the occurrence of CAS in NAFLD patients (P<0.05). Conclusion In NAFLD patients who develop CAS, serum TIMP3 levels are reduced while SII levels are elevated. TIMP3 and SII may serve as potential biomarkers for carotid artery atherosclerosis in NAFLD patients, providing new directions for early diagnosis and intervention.

CT analysis of schistosomiasis combined with hepatic cyst

KAN Wen-hao, XING Xue-lian

2026, 31(3):  438-440. 

Asbtract ( 5 )   PDF (3486KB) ( 1 )  

References | Related Articles | Metrics

Objective To analyze CT findings of chronic schistosomiasis combined with hepatic cyst. Methods 7 cases of chronic schistosomiasis of hepatic cyst confirmed by operation and pathology were retrospectively analyzed. Results The maximum length and diameter of hepatic cyst in 7 patients were more than 5 cm. Internal CT plain scan and multi-plane recombination showed high density linear opacity in the focus, while the calcification opacity of the nodule in the linear separation and of paramural nodules of cysts were partially visible. Delayed phase imaging showed nodules exhibiting mild to moderate enhancement. Conclusion CT in diagnosing hepatic cysts combined with chronic schistosomiasis are relatively characteristic, and requires a combination of water exposure history and laboratory examination.

Efficacy of bifidobacterium tri-species probiotic combination with ganciclovir in the treatment of neonatal cytomegalovirus hepatitis

WANG Pin, ZHANG Jing, REN Ya-fang

2026, 31(3):  441-444. 

Asbtract ( 5 )   PDF (468KB) ( 1 )  

References | Related Articles | Metrics

Objective To investigate the therapeutic effect of Bifidobacterium tri-species probiotics combined with ganciclovir in neonatal cytomegalovirus (CMV) hepatitis. Methods A total of 106 neonates diagnosed with CMV hepatitis were treated between January 2021 and January 2024 in Nanyang Central Hospital. They were subsequently randomized into two groups, comprising 53 patients in each.The control group received ganciclovir alone, while the observation group received Bifidobacterium tri-species probiotics in addition to ganciclovir. After 3 weeks of treatment, evaluations were performed. The time of symptom resolution was recorded. Adverse reactions during treatment were also documented. Results The time for symptom improvement in the observation group for scleral jaundice [(6.23±1.21)days, (4.97±0.89)days, (3.40±0.84)days, (3.31±0.69) days], with differences being statistically significant (P<0.05). Post-treatment, the observation group showed a significantly lower viral load of (8.93±1.08) copies/mL and a higher CD4⁺/CD8⁺ ratio of (2.03±0.41) compared to the control group, with statistical significance (P<0.05). Conclusion The combination of bifidobacterium tri-species probiotics and ganciclovir significantly enhances the therapeutic effect in neonates with CMV hepatitis.