Table of Content

31 December 2021, Volume 26 Issue 12

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Frontier, Exploration and Controversy

Standardize the development of guidelines and improve the quality of guidelines

WANG Ji-yao, XIA Jun

2021, 26(12):  1301-1302. 

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Liver Cancer

Bibliometric study of convolutional neural network in imaging evaluation of hepatocellular carcinoma based on PubMed database

WEI Wei, HUANG Ying-shuo

2021, 26(12):  1316-1319. 

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Objective To investigate imaging evaluation of hepatocellular carcinoma (HCC) using convolutional neural network model in PubMed database based on bibliometric analysis, and provide reference for clinicians. Methods PubMed database was systematically used to search for relevant literatures. The data were collected since the database established to March 3, 2021. Key information in the literature was extracted and quantitatively analyzed. The keyword frequency was analyzed through online software. Results A total of 38 relevant studies were retrieved from the database with publication date ranging from 2017 to 2021, and the maximum number of publication was in 2020 (18, 45%). The highest number of single citations was 229, and the highest average number of citations was the articles published in 2018 (nearly 80). The results of word frequency analysis showed that artificial intelligence, magnetic resonance imaging (MRI), computerized tomography (CT) and liver tumor were keywords of research hotspot. There were 8 literature with high citations, 4 were from Chinese (including Hong Kong) authors and 4 were from foreign authors. Conclusion Convolutional neural network model has been developed to maturation in recent years. More and more researchers use it for imaging evaluation of HCC. However, a visualization and easy-to-operate application system of the model should be further developed due to the complexity.

The value of serum M2BPGi combined with AFP in diagnosing hepatocellular carcinoma

HONG Yu, LIANG Shuang, ZHU Jin-zhou

2021, 26(12):  1320-1323. 

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Objective To investigate the association between serum mac-2 binding protein glycan isomer (M2BPGi) level and the risk of hepatocellular carcinoma (HCC). And to investigate the value of serum M2BPGi combined with AFP in diagnosing HCC. Methods One hundred and eleven patients with HCC, 142 patients with cirrhosis and 95 patients with chronic hepatitis B (CHB) admitted to our hospital from January 2016 to October 2020 were included. Ninety-seven healthy controls were selected from physical examination center during the same period. The phase 0 and A were defined as the early HCC according to the Barcelona Clinic Liver Cancer (BCLC) classification. Serum level of M2BPGi was detected by enzyme-linked immunosorbent assay (ELISA). Binary logistic regression analysis was used to establish new variable (predicting probability). Receiver operator characteristic (ROC) curve was used to analyze the biomarkers, the area under the curve (AUC), sensitivity and specificity were evaluated. Results Serum M2BPGi level of HCC group (3.68 [2.65-5.00] C.O.I) was significantly higher than that of healthy control group (1.63 [1.34-1.90] C.O.I), CHB group (1.77 [1.23-2.16] C.O.I) and cirrhosis group (1.93 [1.54-2.50] C.O.I) (all P<0.001). After adjusting, serum level of M2BPGi was positively correlated with the risk of HCC (odd ratio 2.331, 95% CI [1.756-3.096], P<0.001). The model of serum AFP combined with M2BPGi predicting HCC was established ([AUC] 0.929, 95% CI [0.901-0.956], sensitivity 0.901, specificity 0.823, accuracy 0.843), its diagnosing value was better than AFP or M2BPGi alone (both P<0.001). The prediction model in diagnosing early HCC (AUC 0.923 [95% CI 0.887-0.960], sensitivity 0.900, specificity 0.823, accuracy 0.837) performed better than AFP (P=0.003) or M2BPGi (P<0.001) alone. Conclusion Serum M2BPGi is an independent risk factor for HCC. M2BPGi combined with AFP can improve diagnostic sensitivity in diagnosing HCC, which offers new insights in screening and early diagnosis of HCC.

Relationship between 3-year survival rates after radical resection and BCLC Kinki stage in patients with primary liver cancer

CHEN Xing-yang, CHEN Ying-jie, CHEN Lei, ZHANG Sheng

2021, 26(12):  1324-1327. 

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Objective To investigate the relationship between 3-year survival rate after radical resection and Barcelona Clinic Liver Cancer (BCLC) Kinki stage.in patients with primary liver cancer (PLC). Methods The clinical data of 99 PLC patients underwent open liver resection from April 2016 to April 2018 were retrospectively analyzed. The patients were divided into good prognosis group (n = 64, survival) and poor prognosis group (n = 35, death) according to their 3-year survival condition. The baseline data of the 2 groups including gender, age, residence, ethnicity, tumor diameter, tumor number, tumor site, hepatitis history, family history, Child-Pugh grade, TNM stage, differentiation degree, and BCLC Kinki stage were collected and analyzed. The differences between the 2 groups were analyzed by multivariate logistic regression analysis and the risk factors affecting the prognosis were determined. The patients were followed up for 3 years, and the 3-year survival rates among the paients with different BCLC Kinki stage were compared. Results In poor prognosis group, the number of patients with tumor diameter > 5cm was 30 (85.71%), and the number of patients with tumor diameter ≤ 5 cm was 5 (14.29%). In good prognosis group, the number of patients with tumor diameter > 5 cm was 38 (59.38%), and the number of patients with tumor diameter ≤ 5 cm was 26 (40.63%). The difference was statistically significant (χ²=18.723, P<0.05). There were 13 Child-Pugh grade A cases (37.14%) and 22 Child-Pugh grade B cases (62.86%) in poor prognosis group. There were 40 Child-Pugh grade A cases (62.50%) and 24 Child-Pugh grade B cases (37.50%) in good prognosis group. The difference was statistically significant (χ²=5.849, P<0.05). In poor prognosis group, there were 10 TNM stage I or II cases (28.57%) and 25 TNM stage III or IV cases (71.43%). In good prognosis group, there were 38 TNM stage I or II cases (59.38%) and 26 TNM stage III or IV cases (40.62%), the difference was statistically significant (χ²=8.597, P<0.05). In poor prognosis group, there were 24 cases with poorly differentiated tumors (68.57%) and 11 cases with moderately or highly differentiated (31.43%), while in good prognosis group, there were 14 cases with poorly differentiated tumors (21.88%) and 50 cases with moderately or highly differentiated (78.12%), the difference was statistically significant (χ²=20.861, P<0.05). In poor prognosis group, there were 9 cases in BCLC Kinki B1 stage (25.71%) and 26 cases in BCLC Kinki B2 stage (74.29%). In good prognosis group, there were 39 cases in BCLC Kinki B1 stage (60.94%) and 25 cases in BCLC Kinki B2 stage (39.06%). The difference was statistically significant (χ²=11.239, P<0.05). Multivariate Logistic regression analysis confirmed that tumor diameter > 5 cm, Child-Pugh grade B, TNM stage Ⅲ or IV stage, low differentiation degree, BCLC Kinki B2 stage were risk factors affecting the prognosis of patients with PLC after radical resection, all with P<0.05. The 3-year survival rates of BCLC Kinki stage B1 and stage B2 patients were 60.94% and 39.06%, respectively, and the 3-year survival rates of patients with different BCLC Kinki stage were significantly different (P<0.05). Conclusion The survival rates of patients with PLC after radical resection are affected by tumor diameter, Child-Pugh grade, TNM stage, differentiation degree, and BCLC Kinki stage. Compared to BCLC Kinki stage B2 patients, the survival rates of BCLC Kinki stage B1 patients are higher.

Application study on three dimensional reconstruction of rotational digital subtraction angiography in interventional treatment for hepatocellular carcinoma

ZHUANG Hua-qing, JIANG Hua, YANG Yi-jing

2021, 26(12):  1328-1331. 

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Objective To investigate the application value of 3D (three-dimensional) reconstruction of rotational digital subtraction angiography (DSA) in interventional treatment for hepatocellular carcinoma (HCC). Methods One hundred and four patients with HCC treated by interventional therapy in our hospital were selected, they were divided into 3D group (3D reconstruction by rotational DSA) and conventional group (conventional DSA) according to different examination methods. The display effect on lesions and the surgical effect of the two examination methods were retrospectively analyzed. Results Compared with the conventional group, the lipiodol deposition rate and the success rate of superselective arterial catheterization in the 3D group were higher (96.30% vs 72.00%, 94.44% vs 76.00%). The operation time of 3D group was shorter [(32.62±5.42) min vs (44.24±6.53) min], P<0.05. There was no significant difference in the amount of arterial contrast agent and the display rate of tumor blood supply arteries between the two groups (P>0.05). Compared with the conventional group, the first film rate (92.59% vs 68.00%) and the detection rate of hepatic artery grade 3/4 (96.30% vs 6.00%) in the 3D group were higher. The display rate of tumor collateral circulation (50.00% vs 24.00%), small lesions (25.93% vs 6.00%), blood supply artery of small lesions (25.93% vs 6.00%) and collateral circulation of small lesions (31.48% vs 0) in the 3D group were higher than those of the conventional group. The differences were all statistically significant (P<0.05). The total remission rate of 3D group was 70.37%, which was significantly higher than that of conventional group (44.00%, P<0.05). Conclusion In the interventional treatment of liver cancer, 3D reconstruction technology of rotational DSA can improve the image quality, shorten the operation time and improve the operation effect.

Application of gadolinium selenite disodium enhanced MRI in risk assessment of highly dysplastic nodules transforming into blood rich hepatocellular carcinoma

FAN Heng-liang, ZHANG Wei, XU Ya-chun

2021, 26(12):  1332-1335. 

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Objective To study the application of Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) in risk assessment of highly dysplastic nodules (HGDN) transforming into blood rich hepatocellular carcinoma (HCC). Methods The clinical data of 72 patients with hgdn diagnosed in our hospital from August 2015 to August 2019 were retrospectively collected. According to the occurrence of hypervascular HCC after follow-up, they were divided into hgdn group (n = 39) and HCC group (n = 33),GD EOB DTPA enhanced MRI was detected at the first admission in both groups, and the number and diameter of nodules were recorded. The axial T1 weighted imaging (T1WI), axial T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), high, equal and low signal of hepatobiliary phase and arteriovenous phase relative to normal liver parenchyma were analyzed Kappa test was used to analyze the sensitivity, specificity and accuracy of GD EOB DTPA enhanced MRI in the diagnosis of hypervascular HCC. Results The incidence of hgdn transformed and blood rich HCC was 45.83% (33/72), and the detection rate of focal nodules in HCC patients was 44.35% (51/114).The proportion of patients with high signal T1WI, low signal T2WI, high signal hepatobiliary stage and isolow signal DWI in hgdn group was significantly higher than that in HCC group (65.08% vs 37.25%, 57.14% vs31.37%, 77.78% vs 11.76%, 74.60% vs23.53%), and the proportion of patients with arterial enhancement and portal vein clearance was significantly lower than that of HCC group (34.92% vs 54.90%, 28.57% vs 49.02%), and the difference was statistically significant (P < 0.05).The sensitivity, specificity, accuracy and kappa value of GD EOB DTPA enhanced MRI were 87.88%, 84.62%, 86.11% and 0.722 respectively. Conclusion GD EOB DTPA enhanced MRI has high value in the risk assessment of hgdn transforming into blood rich HCC, which is worthy of clinical promotion.
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Influence of N-acetylcysteine on hepatocellular carcinoma patients undergoing TACE

XU Xiao-mei, LU Xiao-min, SHEN Yu-cheng, QIAN Li

2021, 26(12):  1336-1338. 

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Objective To investigate the therapeutic effect of N-acetylcysteine (NAC) in hepatocellular carcinoma(HCC) patients undergoing transcatheter arterial chemoembolization (TACE). Methods Seventy-two HCC patients undergoing TACE were divided into 2 groups. On the basis of conventional therapy, the control group was treated with diammonium glycyrrhizinate intravenous infusion, and the observation group was treated with NAC. The changes of oxidative stress, T lymphatic subsets and liver function indexes were recorded. Results After 4-week treatment, the levels of serum superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in observation group were significantly increased, while the levels of malondialdehyde (MDA) and CD8⁺ in observation group were significantly decreased (P<0.05). The levels of alanine aminotransferase (ALT) and total bilirubin (TBIL) in observation group were significantly lower than those in control group (P<0.05). There was no significant difference in the levels of albumin (ALB) and fibrinogen (FIB) between the 2 groups (P>0.05). There was no significant difference in adverse drug reactions (ADR) between the 2 groups (P>0.05). Conclusion NAC can inhibit the oxidative stress level, regulate cellular immune function and improve the liver function of HCC patients undergoing TACE, and it has high safety.


miR-203a-3p inhibits migration and invasion of HCC cells by regulating epithelial mesenchymal transition via SLUG

ZHANG Guo-bing, XU Jiang-hai, WANG Dong-feng

2021, 26(12):  1339-1343. 

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Objective To investigate the effect and mechanism of miR-203a-3p on the migration and invasion of hepatocellular carcinoma (HCC) cells. Methods HepG2 cells were cultured in vitro and divided into control group (human HCC cell line), miRNA-NC group (transfected with mimics control) and miR-203a-3p group (transfected with miR-203a-3p mimic). Transwell and scratch test were used to assess the invasion and migration ability. Luciferase reporter assay was used to verify the targeting relationship between miR-203a-3p and zinc finger transcription factor (SLUG). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of miR-203a-3p and SLUG mRNA. Western blot (WB) was used to detect the expression levels of SLUG protein, E-cadherin, Occludin, N-cadherin and Vimentin. The tumorigenicity ability of transfected cells was detected in nude mice. Results There was no significant difference in invasion and migration ability of cells between control group and miRNA-NC group, and the expression levels of miR-203a-3p, SLUG mRNA, SLUG protein and epithelial mesenchymal transition related protein between the two groups were not significantly different, (P>0.05). In miR-203a-3p group, the invasion and migration ability was significantly decreased. The expression levels of SLUG mRNA, SLUG protein, N-cadherin and Vimentin in miR-203a-3p group were significantly decreased, while the expression levels of miR-203a-3p, E-cadherin and Occludin were significantly increased (P<0.05). Conclusion MiR-203a-3p may inhibit the migration and invasion of HCC cells by inhibiting EMT via regulating SLUG.

Viral Hepatitis

Genotypic analysis of entecavir-resistant mutation in 786 patients with chronic hepatitis B

YUE Xiu-juan, LI Qing, WANG Shan-shan, CHEN De-xi, SHI Ying

2021, 26(12):  1344-1347. 

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Objective To investigate the genotypic features of entecavir-resistant mutation in patients with chronic hepatitis B (CHB) in our hospital, and provide clinical data about characteristics and trends of entecavir-resistant mutation. Methods A total of 786 patients with entecavir-resistant mutation admitted to our hospital from January 2009 to October 2020 were selected. The drug-resistant situation were further analyzed. Results Among the 786 entecavir-resistant mutation patients, the numbers of hepatitis B virus (HBV) C genotype, HBV B genotype and HBV genotype were 705 (89.7%), 79 (10.1%) and 2 (0.3%), respectively. Twenty-one drug-resistant mutation types were found. The numbers of rtL180M + rtM204V (or rtM204I) + rtV173, rtL180M + rtM204V (or rtM204I) + rtT184, rtL180M + rtM204V + rtS202, rtL180M + rtM204V + rtS202 + rtT184, rtL180M + rtM204V + rtM250 mutation types were 219 (27.9%), 218 (27.7%), 175 (22.3%), 52 (6.6%) and 44 (5.6%) respectively. There were other 16 mutation types with a total number of 78 (9.9%). Conclusion HBV genotype C are the most common genotype among patients with entecavir-resistant mutation in our hospital. The rtL180M + rtM204V (or rtM204I) + rtV173 is the most prevalent mutation type and rtT184 is the most prevalent mutation site. Our research can help people understand the HBVgenotypes and mutation types of CHB patients with entecavir-resistant mutation in our hospital.

Prognostic value of qSOFA score in liver cirrhosis patients combined with sepsis

WANG Qing, WENG Yan, CHEN Yi-wen, JIN Chang-ming, SUN Jing

2021, 26(12):  1348-1350. 

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Objective To investigate the prognostic value of quick sequential organ failure assesment (qSOFA) score in decompensated liver cirrhosis (DLC) patients combined with sepsis, and to provide clinical theoretical basis in early rapid assessment. Methods Sixty-five DLC patients combined with sepsis from May 2017 to May 2021 were included (41 males and 24 females). They were divided into death group and survival group according to the different treatment outcomes. Taking death as an indicator of adverse prognosis, receiver operating characteristic curve was used to analyze the clinical value of qSOFA score, modified early warning score (MEWS) and Child-Pugh score in evaluating the prognosis of patients. Results There were 39 cases and 26 cases in the survival and death groups, respectively. The serum levels of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT) and platelet (PLT) in the survival group were (11.8±2.9)×10⁹/L, (32.0±12.9) mg/L, (2.9±0.3) ng/mL and (112.9±37.0)×10⁹/L, respectively. The serum levels of WBC, CRP, PCT and PLT in the death group were (14.3±1.8)×10⁹/L, (67.7±28.4) mg/L, (5.7±2.2) ng/mL and (63.5±23.7)×10⁹/L, respectively. The differences between the 2 groups were statistically significant (P<0.05). The prothrombin time (PT) and international normalized ratio (INR) in survival group were (18.3±6.3) s and (1.2±0.2), which were significantly different from those in death group [(22.8±9.7) s and (2.5±1.0)] (P<0.05). The alanine transaminase (ALT), blood ammonia and total bilirubin (TBiL) in the survival group were (163.8±35.7) U/L, (36.3±12.7) μmol/L and (58.2±18.1) μmol/L, which were significantly higher than those in the death group [(498.2±163.5) U/L, (82.4±8.2) μmol/L and (231.5±75.4) μmol/L] (P<0.05). The qSOFA score, Child-Pugh score and MEWS in the survival group were (1.1±0.4), (6.1±2.1) and (6.3±2.6), which were significantly higher than those in the death group [(2.3±0.5), (7.9±0.8) and (9.8±1.1)] (P<0.05). The area under the curve (AUC) of qSOFA score, MEWS and Child-Pugh score were 0.68, 0.73 and 0.67, respectively. Sensitivity were 89.7%, 97.4% and 84.6%, respectively. Specificity were 46.2%, 88.5% and 65.4%, respectively. Conclusion There is clinical significant of the qSOFA score in evaluating the prognosis of DLC patients combined with sepsis. The evaluation efficacy of qSOFA score is similar to MEWS and Child-Pugh score, but the specificity of qSOFA score is lower than that of MEWS and Child-Pugh score.

The value of energy spectrum CT optimal CNR technique in the diagnosis of esophageal and gastric variceal bleeding in liver cirrhosis

ZHANG Peng, ZHANG Guo-fu

2021, 26(12):  1351-1352. 

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Objective To study on the value of energy spectrum CT best contrast signal-to-noise ratio (CNR) technique in the diagnosis of esophageal variceal bleeding (EGVB) in liver cirrhosis. Methods Sixty-three patients with cirrhosis and portal hypertension admitted between June 2018 and December 2020 were enrolled in this study. All patients received 3 phases of abdominal enhanced scan (arterial phase, portal vein phase and delayed phase). Energy spectrum scanning mode was started in the portal phase to obtain the best single-energy portal CNR images (the best CNR group) and 70 keV single-energy portal vein images (the 70 keV group), and the portal vein CT values, hepatic parenchyma CT values, portal vein main (MPV) CNR and image quality scores were recorded in these two groups. Kappa consistency test was used to evaluate the consistency between the grade of esophageal and gastric fundus varices diagnosed by the best CNR single energy portal vein image and gastroscopy. Results The CT value of portal vein, CT value of liver parenchyma, MPV CNR and image quality score in the best CNR group were (298.6±32.6)Hu, (165.5±22.6)Hu, (6.6±1.3) and (4.5±0.8)points, respectively, which were significantly higher than those of [144.8±28.4)Hu, (107.9±16.3)Hu, (4.7±1.5) and (4.1±0.7)points in the 70 keV Group, respectively(t=2.987,t=28.235,t=16.407,t=7.596,P<0.05). The Kappa value of the grade of esophageal and gastric varices diagnosed by the best CNR single energy portal vein image and the consistency test of gastroscopy was 0.8 (P<0.05). Conclusion The best CNR technology of energy spectrum CT can provide the best single energy level image, optimize the image quality of portal vein, and contribute to the prediction of EGVB risk.

Predictive value of serum PGE2 on the infection of patients with decompensated liver cirrhosis

CHEN Wen-xiao, CHEN Liu, ZHANG Yan, HUANG Hui-feng, WU Zhen-xing, SHENG Xian-cang

2021, 26(12):  1353-1355. 

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Objective To analyze the predictive value of serum prostaglandin E2 (PGE2) on the occurrence of infection in patients with decompensated liver cirrhosis. Methods Sixty-six patients with decompensated liver cirrhosis admitted from March 2016 to March 2018 were selected. The patients were divided into an infection group (n=23) and a non-infection group (n=43) according to whether they had the occurrence of infection. Another 40 patients with compensated liver cirrhosis treated at the same period of time were selected as the control group. Serum PGE2 levels were measured in all three groups of patients. The predictive value of PGE2 levels on the occurrence of infection in patients with decompensated liver cirrhosis was analyzed. Results The PGE2 levels in the infection group (3686.87±232.25 pg/mL) and the non-infection group (2132.03±120.04 pg/mL) were significantly higher than that in the control group(1348.97±87.58) (P<0.05), and the level in the infection group was higher than that in the non-infection group (P<0.05). The area under the receiver operating characteristic curve (ROC) of PGE2 level to predict the occurrence of infection in patients with decompensated liver cirrhosis was 0.84 (95%CI=0.74-0.90), which was statistically significant (P<0.01). When the cut-off value of PGE2 level was set at 2758 pg/mL, the specificity for predicting the occurrence of infection was 0.785, and the sensitivity was 0.829. Conclusion The level of PGE2 in patients with decompensated liver cirrhosis is closely related to the occurrence of infection. PGE2 level has higher specificity and sensitivity for predicting infection occurrence in patients with decompensated liver cirrhosis.

Diagnostic value of real-time shear wave elastography for different stages of hepatic fibrosis in children

TANG Wen-Jing, ZHU Ting, FANG Jin, WANG Song-Ping

2021, 26(12):  1356-1359. 

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Objective To analyze the clinical value of real-time shear wave elastography (SWE) in evaluating the stages of liver fibrosis in children. Methods Eighty-five children with chronic liver diseases or biliary atresia admitted from January 2018 to December 2020 were selected. Routine serological tests and real-time shear wave elastography were performed in all children. The pathological results of liver biopsies were used as the "Gold standard" for diagnosing liver fibrosis, and in the comparison between the efficacies of serum markers and SWE indexes in evaluating the stages of liver fibrosis, as well as the diagnostic value of SWE. Results There were significant differences in serum procollagen III (PC III), collagen type IV (IV C), hyaluronic acid (HA), laminin (LN) and elastic modulus among children with fibrosis ≥ S1, ≥ S2, ≥ S3 and S4 stages, and the serum PC III, IV C, HA, LN and elastic modulus increased significantly (P<0.05). SWE elastic modulus was positively correlated with PC III, IV C, HA, LN and the stage of liver fibrosis (P<0.05). The AUC (area under the curve) of SWE elastic modulus for the diagnosis of liver fibrosis in children ≥S1, ≥S2, ≥S3 and S4 stages were 0.818, 0.821, 0.837 and 0.829, and the best cut-off values were 5.57 kPa, 7.21 kPa, 8.33 kPa and 9.62 kPa, respectively. The sensitivity was 64.77%, 63.21%, 59.87% and 65.13%, and the specificity was 94.37%, 92.32%, 90.11% and 87.48%, respectively. Conclusion SWE technique quantitatively detects liver fibrosis with good diagnostic efficacy for different stages of liver fibrosis in children, and provides a reference for the diagnosis and treatment of liver fibrosis in children with chronic liver diseases.

An analysis of the relationship between serum C3, C4 and IgG levels and the severity of liver cirrhosis in patients with chronic hepatitis B

ZHOU Ang, WANG Shao-chuang, ZHU Chuan-rong, XU Qi-qi, WU Jin-sheng

2021, 26(12):  1360-1363. 

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Objective To analyze the changes of serum complement 3 (C3), complement 4 (C4) and immunoglobin G (IgG) levels in patients with chronic hepatitis B (CHB) and liver cirrhosis and their clinical significance. Methods One hundred and sixteen patients with CHB admitted from March 2018 to December 2019 were selected as the observation group and 116 healthy persons who underwent physical examination at the same period of time were enrolled as the control group. The serum levels of C3, C4 and IgG were detected in both groups of people, and the correlation between the levels of C3, C4 and IgG and the grades and stages of liver histopathology in the observation group were analyzed. Results The levels of C3[(0.84±0.12)g/L] and C4[(0.23±0.05)g/L] of the observation group were lower than those of the control group [C3:(1.07±0.21)g/L] [C4:(0.31) ±0.06)g/L], while the serum IgG [(27.59±6.27)mg/L] level of the observation group was higher than that of the control group [(16.81±3.15)mg/L] (P<0.05). The levels of C3 and C4 in patients with G2-G4 grades of inflammation in the observation group were significantly lower than those in patients with grade G1 (F=4.142, P<0.05; F=4.142, P<0.05). In the observation group, the levels of complement C3 and C4 in patients with grades of S2-S4 inflammation were significantly lower than those in patients with grade S1 (F=8.512, P<0.05). The grades of≥G2 and G4 were negatively correlated with complement C3 and C4, and positively correlated with IgG levels (r=0.572, P=0.014; r=0.589, P=0.009). The grades of ≥S2 and S4 were negatively correlated with C3, C4, whereas positive correlated with IgG (r=0.631, P=0.007; r=0.551, P=0.007). Conclusion There is a certain correlation between serum C3, C4 and IgG levels and the severity of liver cirrhosis in CHB patients, which has significance for the diagnosis, treatment and prognostic evaluation of patients with CHB.

Association between serum high-molecular weight adiponectin,homeostatic model assessment insulin resistance index and their ratio and liver fibrosis in newly diagnosed diabetic patients with nonalcoholic fatty liver disease

GE Ying, YAN Wen-sheng, ZHANG Yan-fei

2021, 26(12):  1364-1368. 

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Objective To investigate the association between serum high-molecular weight adiponectin(HMWA),homeostatic model assessment insulin resistance index (HOMA-IR)and their ratio(A/H)and liver fibrosis in patients with newly diagnosed type 2 diabetes mellitus(T2DM)and nonalcoholic fatty liver disease(NAFLD). Methods The clinical data of 279 newly diagnosed T2DM patients with NAFLD enrolled in our hospital from May 2020 to May 2021 were retrospectively analyzed for their status of liver fibrosis.Univariate analysis and multivariate logistic regression analysis was applied to explore the independent influence factors of liver fibrosis,and to determine the predictive value of HMWA, HOMA-IR and A/H ratio for liver fibrosis. Results The prevalence of liver fibrosis in newly diagnosed T2DM patients with NAFLD was 15.77%(44/279).The serum levels of HMWA,HOMA-IR and A/H ratio of patients with liver fibrosis were 1.20 (0.91,1.78) mg/L,3.41 (2.57,5.70) and 0.33 (0.18,0.62),respectively.The serum levels of HMWA,HOMA-IR and A/H ratio of patients with non-liver fibrosis were 2.74 (1.57,3.84) mg/L,2.18 (1.61,3.12) and 1.21 (0.55,2.16) respectively. There were significant differences in the serum levels of HMWA,HOMA-IR and A/H ratio between the two groups(P<0.05).In addition to age and waist circumference,HMWA,HOMA-IR and A/H ratio were also independent predictive factor associated with liver fibrosis(P<0.05),and had a certain predictive value for liver fibrosis. The area under the curve of A/H was significantly larger than those of HMWA and HOMA-IR(Z=2.768,P=0.006;Z=2.491,P=0.013). The optimal cutoff value of the A/H ratio was 0.52,which displayed a sensitivity of 75.00% and a specificity of 78.72% for the prediction of liver fibrosis in newly diagnosed T2DM patients with NAFLD. Conclusion HMWA,HOMA-I and A/H are independently associated with the risk of liver fibrosis in newly diagnosed T2DM patients with NAFLD,and have certain predictive value. A/H has the best predictive efficacy.

A study on the role of umbilical cord mesenchymal stem cells in the regulation of inflammatory environment through regulating the maturation and differentiation of dendritic cells in patients with acute hepatic failure

WANG Lin, WU Hui-li, XIAO Xing-guo, ZHANG Lei

2021, 26(12):  1369-1373. 

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Objective To investigate the role of umbilical cord mesenchymal stem cells (hU-MSCs) in the regulation of inflammatory environment by regulating the maturation and differentiation of dendritic cells (DCs) in patients with acute hepatic failure (AHF). Methods DCs derive from five patients with AHF were co-cultured with hU-MSCs. The maturation and activation levels of DCs and the proportion of regulatory DC cells (regDCs) and the cytokine levels in the cell culture supernatants were measured with or without the administration of NS398, a selective cyclooxygenase-2 (COX-2) inhibitor, to the co-culture system. The expression of Toll like receptor 4 (TLR4), inhibitor of nuclear factor kappa-B kinase subunit alpha (IKKα) and nuclear factors-κB p65 (NF-κB-p65) were then detected by Western blot. New therapeutic targets were screened by whole transcriptomic sequencing analysis on the DCs before and after co-culture with hU-MSCs. Results After co-cultured with hU-MSCs, regDCs increased. The expression levels of surface markers MHC-II, CD80 and CD86 on immature DCs (imDCs) increased. The levels of IL-1 and IL-6 decreased in cocultured DCs compared to DCs that cultured alone [IL-1α: (754.68±22.65)pg/ml vs (76.67±11.25)pg/mL;IL-1β:(336.49±55.75)pg/mL vs (85.33±12.58)pg/mL;IL-6:(38027.85±5231.14)pg/mL vs (12000.75±6793.69)pg/mL; P<0.0500)], whereas the level of IL-10 increased significantly [(0.41±0.01)pg/mL vs (0.61±0.01)pg/mL; P<0.05]. After co-cultured with hU-MSCs, the down-regulation of NF-κB-p65 [(0.777±0.01 vs 0.55±0.02; P<0.05)] and TLR4[(1.12±0.01 vs 0.54±0.01; P<0.05)] expression and up-regulation of IKKα expression in DCs were significant [(0.12±0.01 vs 0.88±0.01; P<0.05)]. After the administration of NS398 to DCs that cocultured with hU-MSCs, the expression of NF-κB-p65 and TLR4 (0.14±0.01, 0.12±0.01) in DCs were down-regulated, and IKKα was significantly up-regulated (1.18±0.01). By transcriptomic sequencing analysis it was found that the expressions of 909 genes were up-regulated and 363 genes were down-regulated in DCs co-cultured with hU-MSCs when compared with those without. Most of the genes played important roles in inflammation. Conclusion hU-MSCs showed an immuno-suppressive effect by inducing the differentiation of imDCs derived from AHF to CD11bhigh1alowCD11clowregDCs in vitro, and played an anti-inflammatory role by suppressing the inflammatory cascade reaction through TLR4/NF-κB/COX-2 pathway.

The distribution of pathogenic bacteria in patients with liver failure complicated with pulmonary fungal infection and the alteration of immune function after voriconazole treatment

YUAN Zhen, YANG Hai-ping, MA Xiao-yan, YUAN Fang-ju

2021, 26(12):  1374-1377. 

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Objective To explore the distribution of pathogenic bacteria in patients with liver failure complicated with pulmonary fungal infection, and to compare the treatment effects of itraconazole and voriconazole in these patients, and their influence on immune function. Methods One hundred and sixteen patients with liver failure complicated with pulmonary fungal infection that were admitted between April 2018 and August 2020 were enrolled in this study. They were retrospectively analyzed on the distribution of pathogenic bacteria that they affected. The patients were divided into 2 groups according to the treatment method. 57 cases in the control group were treated with itraconazole, while 59 patients in the observation group were treated with voriconazole. The immune function, disease remission rate, and liver function were compared between these two groups of patients at different time points post treatment. Results In 116 patients with liver failure and pulmonary fungal infection, Cryptococcus neoformans infection was the most common, accounting for 49.14% of the patients, followed by Aspergillus and Mucor, accounting for 27.59% and 18.96%. Candida albicans was the most rare pathogen, accounting for 4.31% of the patients. There was no statistical difference between these two groups of patients at different time points post treatment (P>0.05). The observation group had CD3⁺ (60.46±2.65)%, CD4⁺ (34.46±2.65)% at 4 weeks after treatment, and CD3⁺ (62.41±2.43)%,CD4⁺ (3, 6.86±2.65)% at 8 weeks after treatment, which were higher than those of the control group. On the contrary, the CD8⁺ (20.13±2.36)% at 4 weeks, and CD8⁺ (19.12±2.33)% at 8 weeks after treatment were lower than those of the control group. Meanwhile, the disease remission rate of the observation group was 59.32% at 4 weeks after treatment, 74.58% at 6 weeks after treatment, and 81.36% disease remission rate at 8 weeks after treatment, all were higher than those of the control group (P<0.05). Conclusion In patients with liver failure and pulmonary fungal infection, Cryptococcus neoformans infection is the most common pathogen. Voriconazole treatment has no major impact on the liver. It can improve the immune function and increase the disease remission rate.

Correlation between neutrophil CD64 in combination with procalcitonin and anti-infectious ability of patients with chronic and acute liver failure

DONG Jie, ZHONG Man-hua, ZHENG Ying, DONG Yun, ZHOU Xiao-lei

2021, 26(12):  1378-1380. 

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Objective To explore the correlation between neutrophil CD64 (nCD64) in combined with procalcitonin (PCT) and anti-infection ability of patients with acute-on-chronic liver failure (ACLF). Methods Eighty patients with ACLF admitted to Zhuhai People's Hospital from 2019 to 2020 were randomly divided into infection group and non-infection group, with 40 cases in each group. According to the treatment effect, the infection group was divided into three subgroups: high risk group, medium risk group and low risk group. The venous blood of patients was collected, and the levels of nCD64 and PCT in serum were detected. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. Results There was no significant difference in general data such as gender and age between the two groups (P>0.05). The levels of nCD64 and PCT in infected group were higher than those in non-infected group (P<0.01). The levels of nCD64 and PCT in high-risk group were (83.56±16.48)% and (3.65±2.43)ng/mL, which were significantly higher than those in middle-risk group [(75.63±17.54)%, (2.28±2.03) ng/mL] and low-risk group [(70.44±14.29)%, (0.82±0.02)ng/mL]; the AUC of nCD64, PCT and nCD64 combined PCT were 0.9212 (95% CI 0.861-0.982), 0.9125 (95% CI 0.835-0.990) and 0.9731 (95% CI 0.876-0.994), respectively, all of which were greater than 0.9. The AUC of nCD64 combined with PCT was higher than that of nCD64 and PCT alone. Conclusion The levels of nCD64 and PCT are closely related to the anti-infection ability of ACLF patients, and the diagnostic efficiency of nCD64 combined with PCT is higher than that of nCD64 and PCT alone, which can be used to evaluate the severity of infection diseases in ACLF patients.

Other Liver Diseases

Correlation antinuclear antibody and antineutrophil cytoplasmic antibody with severity and prognosis in biliary atresia

LI Ke-xin, LIU Li-wei, LI Min, WANG Yu, MA Zi-kun, GUO Tian-tian, SUN Li-ying, ZHU Zhi-jun, JIA Ji-dong, ZHAO Xin-yan

2021, 26(12):  1381-1386. 

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Objective To investigate the prevalence rate and clinical significance of plasma antinuclear antibody (ANA) and antineutrophil cytoplasmic antibody (ANCA) in patients with biliary atresia (BA). Methods The clinical and follow-up data of BA patients underwent liver transplantation (LT) from April 2017 to October 2020 were retrospectively collected. The plasma ANA were semi-quantitatively measured and ANCA were qualitatively detected, and the correlation with laboratory parameters, severity, pathological histological features and post-LT complications were analyzed. Rank sum test was used for continuous data and Chi-square test was used for categorical data. Correlations were evaluated by the Spearman's correlation analysis. Results The prevalence rate of ANA was 3.3% (3/90), and the ANA ratio decreased with the length of native liver survival (R=-0.326). There was a positive correlation between the ANA ratio and Child-Pugh score (R = 0.230), as well as score of pediatric model of end-stage liver disease (R=0.257). The ANA ratio was significantly higher in patients with cirrhosis (0.24 vs 0.20, P=0.016) and the ratio increased with higher degree of ductular cholestasis (P=0.040). In addition, the ANA ratio was significantly higher in patients with CMV infection post-LT (0.31 vs 0.22, P=0.034). The ANCA positive rate was 10.2% (10/98). Prior-LT, plasma Albumin (Alb) and cholinesterase (CHE) level in ANCA-positive patients was significantly lower than that in ANCA-negative patients (Alb: 30.4 vs 34.3 g/L, P=0.018; CHE: 2.6 vs 3.9 KU/L, P=0.009). Conclusion The prevalence rate of ANCA and ANA of patients with BA is low, but it correlates with liver synthetic function, fibrosis stage and post-LT CMV infection. Autoantibodies may be of clinical value for the assessment of BA severity and post-LT prognosis.

Clinicopathological analysis of 40 patients with unexplained liver injury

LIU Xiang-li, ZHANG Li-hui, CHAI Jie, YANG Xiao-qing, WANG Huan, LIU Xue-tao, ZHAO Wen-xia

2021, 26(12):  1387-1390. 

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Objective To investigate the etiology of liver injury through pathological analysis of 40 patients with unexplained liver injury in order to guide clinical treatment. Methods Collect 40 patients with unexplained liver injury admitted from January 2017 to December 2019, and retrospectively analyze histopathological examination and clinical characteristics of liver biopsy. Results Among 40 hospitalized patients with abnormal liver function, 15 cases (37.5%) of drug-induced liver injury (DILI), 7 cases (17.5%) of non-alcoholic fatty liver disease (NAFLD), and 18 cases of liver damage caused by other reasons (45%); Different causes of liver injury have their own specific pathological characteristics. DILI is mainly manifested as lobular hepatitis, non-alcoholic steatohepatitis is manifested as fatty liver cell necrosis with hepatocyte ballooning, autoimmune hepatitis (AIH) Mainly manifested as obvious interface inflammation and clusters of plasma cells at the interface. Primary biliary cholangitis (PBC) is mainly manifested as biliary granuloma. Conclusion There are many causes of liver injury, drug-induced liver injury and fatty liver disease are the most common; liver biopsy has important diagnostic value in liver injury of unknown cause.

Predictive value of serum acid sphingomyelinase combined with FIB-4 index for early liver fibrosis in patients with non-alcoholic fatty liver complicated by diabetes

YU Pei-ru, FANG Tuan-yu, LIU Zheng-jin, WEN Ze-yun, MO Qi-jin

2021, 26(12):  1391-1395. 

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Objective To explore the value of serum acid sphingomyelinase (ASMase) combined with liver fibrosis index (FIB-4) in predicting early liver fibrosis in non-alcoholic fatty liver (NAFLD) patients with diabetes. Methods 126 patients with NAFLD complicated by diabetes who were admitted to the hospital from February 2018 to February 2021 were selected and divided into the early liver fibrosis group (n=74 cases) and the non-fibrosis group (n=52 cases) according to the pathological diagnosis. The serum ASMase level and FIB-4 index of the two groups of patients were compared, the clinical characteristics of the two groups of patients were compared, Logistic regression analysis was used to determine the factors affecting early liver fibrosis in patients with NAFLD complicated by diabetes, the receiver operating characteristic curve (ROC) was used to analyze the value of serum ASMase level and FIB-4 index in predicting early liver fibrosis in patients with NAFLD complicated by diabetes. Results Serum ASMase level and FIB-4 index [(58.49±9.15)nmol/L, (0.82±0.13)] of patients with liver fibrosis were higher than those without liver fibrosis [(44.06±7.63)nmol/L, (0.65±0.10)] (P<0.05). Univariate analysis showed that the gender, age, smoking history, drinking history, underlying disease composition, age, waist circumference, diabetes course, mean arterial pressure, serum blood glucose, urea nitrogen, uric acid, albumin, and total bilirubin of patients in the liver fibrosis group, Direct bilirubin, glutamyl aminotransferase, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, platelets, alkaline phosphatase composition ratio compared with the non-liver fibrosis group, the difference was not statistically significant (P>0.05). The body mass (BMI) and serum alkaline phosphatase levels of the liver fibrosis group were compared with those without liver fibrosis, and the differences were statistically significant (P<0.05), Logistic multivariate regression analysis showed that ASMase, FIB-4 index, and BMI were independent risk factors for early liver fibrosis in NAFLD patients with diabetes (OR=3.031, 3.501, 3.114, P<0.05). ROC analysis showed that the best cut-off points of serum ASMase level and FIB-4 index for predicting early liver fibrosis in NAFLD patients with diabetes were 50.73 nmol/L and 0.68, respectively, the sensitivity were 83.78% and 81.08%, and the specificity were 71.15% and 80.77%, respectively, and the area under the curve (AUC) were 0.854 and 0.838, respectively, the sensitivity, specificity and AUC of the combination of the two were 83.78%, 98.08% and 0.874, respectively. Conclusion The serum ASMase level and FIB-4 index of patients with early liver fibrosis for NAFLD complicated by diabetes are abnormally increased, both are independent risk factors for early liver fiber in NAFLD complicated by diabetes, dynamic monitoring of its level changes can be used as the sensitive indicator to predict early liver fiber in patients with NAFLD complicated by diabetes.

Prevalence and characteristics of metabolic-associated fatty liver disease in Changzhou college students

SUN Qing, YE Chun-yan, CHEN Qing-hua, ZHU Yan, CHAO Xi-xia, ZHAO Dan-jie, FU Wen-yu, ZHA Chen-lin

2021, 26(12):  1396-1400. 

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Objective We sought to investigate the prevalence and characteristics of MAFLD and the influencing factor on the occurrence of MAFLD in 308 Changzhou college students. Methods We used a cross-sectional study design to investigate the occurrence of MAFLD in 308 college students and to establish the differences in parameters between MAFLD students and non-MAFLD students. Binary logistic regression analysis was used to assess the influence of body mass index (BMI), homeostatic model assessment of insulin resistance (HOMA-IR), cardiopulmonary fitness, and dietary risk on the occurrence of MAFLD. Results Using the controlled attenuation parameters (CAP) of liver and ultrasonic as diagnostic criteria, MAFLD occurred in 31.2% and 20.6% of participants. BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), triglyceride (TG), low-density lipoprotein (LDL), HOMA-IR, white blood cell count (WBC), red blood cell count(RBC), and platelet count (PLT) of MAFLD students were higher than those of non-MAFLD students, BMI was 26.85 (24.8-28.5) vs 20.7 (18.9-22.08), systolic blood pressure was 120 (113-128) vs 110 (100-120), diastolic blood pressure was 76.88±7.60 vs 72.06±8.33, ALT was 20 (10-42) vs 11 (9-14), GGT was 23 (17-29) vs 15 (11-18), TG was 0.92 (0.69-1.51) vs 0.71 (0.56-0.9), LDL was (2.79±0.61) vs (2.41±0.67), HOMA-IR was 1.59 (1.37-3.05) vs1.14 (0.81-1.48), WBC was(7.64±1.59)vs (6.23±1.28), RBC was (5.21±0.53) vs (4.90±0.49), PLT was (284.00±42.73) vs (247.11±48.83). While dietary screening tool (DST) scores, VO₂Max, and high-density lipoprotein (HDL) were lower than those of non-MAFLD students (P<0.05), HDL was (1.21±0.25) vs (1.45±0.33), DST score was (55.57±12.47) vs (60.94±9.67), VO₂Max was 37 (32.75-42.01) vs 40.71 (37.21-49.17). BMI ≥ 28, HOMA-IR ≥ 1.5, nutritional in risk and poor cardiopulmonary fitness increased the risk for MAFLD (OR=22.5, 5.1, 15.3, 3.3, P<0.05). Conclusion MAFLD in college students requires attention and early intervention.

CLinicaL appLication of Liver stiffness measurement in patients with cavernous transformation of portaL vein

SHI Tai-ying, HAN Hua, LI Jian-Ling

2021, 26(12):  1401-1403. 

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Objective To evaLuate Liver cirrhosis in patients with cavernous transformation of portaL vein (CTPV) by measurement of Liver stiffness measurement (LSM) using transient eLastography. Methods From January 2012 to ApriL 2021, 22 CTPV patients (12 maLes and 10 femaLes) with an age of (50.2±11.8) years were reviewed. MeanwhiLe, 30 patients with chronic hepatitis B reLated cirrhosis were selected as control group. t-test or Mann-Whitney U-test was used for measurement data, and Chi-square test was used for counting data. Results Comparing the cLinicaL data of CTPV patients (CTPV group) and controL group, ALT, AST and ALP in CTPV group were 36 (22, 52), 38 (26, 56)and 71 (52, 92) U/L, which were significantly higher than those in control group [19 (14, 31), 26(19, 42) and 88(72, 116)U/L, P<0.05]. The LSM of CTPV group and control group were 12.6(6.8, 21.4) and 21.2(15.4, 26.8) kPa, the difference was statistically significant (P<0.05). The staging of liver fibrosis in CTPV group was 8 (36.4%), 2 (9.1%) and 12 cases (54.5%), while that in control group was 0(0), 0(0) and 30(100), the difference was statistically significant (P<0.05). Comparing the data of CTPV patients with cirrhosis (cirrhosis group) and without cirrhosis (non-cirrhosis group), the ages of cirrhosis group and non-cirrhosis group were (56.2±13.8) and (44.1±9.7) years, and the difference was statistically significant (P<0.05). The Alb of cirrhosis group and non-cirrhosis group were 35.0(35.0, 40.2) and 39.6(38.2, 42.7) g/L, with statistical significance (P<0.05). The HBsAg in cirrhosis group and non-cirrhosis group was 9 (75.0%) and 2(20.0%), with statistical significance (P<0.05). HVPG in cirrhotic group and non-cirrhotic group was 16.8(13.2, 22.0) and 6.4(5.0, 9.8) mmHg, the difference was statistically significant (P<0.05). The LSM of cirrhosis group and non-cirrhosis group were 17.6(6.8, 29.5) and 6.8(5.3, 8.2) kPa, with statistical significance (P<0.05). Conclusion The LSM value of CTPV patients is significantly different from that of chronic hepatitis B-related cirrhosis, and the LSM value of CTPV patients with cirrhosis is significantly higher than that of patients without cirrhosis. Transient elastography can effectively evaluate the cirrhosis of CTPV patients.

Changes of OX40/OX40L in peripheral blood of patients with autoimmune hepatitis and its clinical significance

ZHANG Yu, YANG Jing, TIAN Lan

2021, 26(12):  1404-1406. 

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Objective To explore the changes and clinical significance of OX40/OX40L in peripheral blood of patients with autoimmune hepatitis (AIH). Methods The 85 AIH patients admitted to the hospital from July 2019 to December 2020 (research group) and 62 healthy people (control group) undergoing physical examination at the same time period were selected as the research objects. The clinical characteristics and the positive expression rate of OX40/OX40L in peripheral blood were compared between the two groups, and the factors affecting the occurrence of AIH were analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic value of OX40/OX40L in predicting the occurrence of AIH. Results The two groups of T lymphocyte subsets, C-reactive protein, white blood cell count, interleukin-6, interleukin-4, interleukin-21, chemokine, and alanine aminotransferase levels were statistically significant (P< 0.05). The positive expression rates of OX40/OX40L in the peripheral blood of the study group were (12.43±2.13)% and (14.91±2.18)%, respectively, and the control group were (6.59±1.16)% and (4.82±0.73)%, respectively. The difference was statistically significant (P<0.05). Logistic multivariate analysis showed that the levels of interleukin-21 and OX40/OX40L were the influencing factors of AIH (95%CI were 1.517~6.073, 4.903~8.418, 0.844~0.985, all P<0.05). ROC curve analysis showed that the AUC of OX40/OX40L and the combination of the two in the diagnosis of AIH were 0.804 (95%CI: 0.699~0.909), 0.789 (95%CI: 0.682~0.895), 0.914 (95%CI: 0.844~0.985). Conclusion OX40/OX40L is overexpressed in the peripheral blood of patients with AIH, and the combination of OX40 and OX40L has high value in the diagnosis of AIH.

The characteristics of injury in mice with Gao-Binge alcoholic liver disease

ZHOU Mei-yue, QUAN Hui, CHEN He-ning, JIANG Yu-yong

2021, 26(12):  1407-1410. 

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Objective To study the injury characteristics of Gao-Binge alcoholic liver disease model in mice. Methods C57BL/6N male mice were randomly divided into normal group and model group. The normal group was fed with control liquid diet, the model group was fed with control liquid diet for 5 days, and then fed with alcohol liquid diet for 10 days. On the morning of the 16th day, the mice in the model group were given a high dose of alcohol (5 g/kg), while the mice in the normal group were fed with equal calorie maltodextrin solution (9 g/kg). Nine hours later, blood, liver and small intestine were collected to detect plasma ALT, AST activity and endotoxin levels. HE staining was used to observe the pathological injury of liver and small intestine. Western Blot was used to detect the levels of tight junction protein Zo-1 and Occludin in small intestine. Results In the model group, the liver index, ALT, AST and endotoxin levels were significantly increased(P<0.01), the liver pathology showed steatosis, intestinal barrier was damaged, intestinal vasodilation and hyperemia were found in the model group, and the levels of tight junction protein Zo-1 (P<0.05)and Occludin (P<0.01)were significantly decreased. Conclusion Gao-Binge alcoholic liver disease model can lead to liver injury and small intestinal pathological injury in mice, and the level of plasma endotoxin increases, which provides a good animal model basis for the theoretical study of intestinal-liver axis of alcoholic liver disease. It is suggested that the prevention and treatment of alcoholic liver disease should also reduce small intestinal injury and reduce the level of plasma endotoxin as one of the key points in the future.