The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 day...The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2<sup>nd</sup>, 4<sup>th</sup>, 6<sup>th</sup>, 8<sup>th</sup>, 10<sup>th</sup>, 12<sup>th</sup> and 14<sup>th</sup> weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14<sup>th</sup> WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive tool for the identification and characterisation of the Fasciola parasite.展开更多
BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver fu...BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver function of patients with chronic liver disease(CLD).CASE SUMMARY This study involved data from patients whose chief complaint was reduced quality of life attributable to CLD.The new treatment approach resulted in improvements in the liver function and fatty liver of 30 patients with CLD.Im-provements were observed using abdominal ultrasonography.Unlike traditional methods,this protocol provided more sustainable and meaningful results.Treat-ment with 10 mL of HPE administered intravenously once or twice per week significantly improved liver function.The observed improvements in fatty liver and liver function suggest the utility of this approach for the management of patients with CLD.CONCLUSION This case series highlights the potential of innovative treatments for patients with CLD that could improve the quality of life of the patients.展开更多
To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the ex...To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.展开更多
BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated l...BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated liver cirrhosis because of their self-renewal and multidirectional differentiation potential.AIM To explore the safety and effect of treating liver cirrhosis with HBV by hUC-MSCs.METHODS Twenty-four participants were recruited,divided into 3 groups,and injected with different amounts of hUC-MSCs via the peripheral vein.Therapy was administered 3 times.A 24-week follow-up examination of each patient’s liver function,coagulation function,general condition,and immune system was performed.Adverse events were also recorded.A 2-year survival assessment was subsequently performed.RESULTS Infusion therapy rapidly improved liver function.Serum albumin transiently increased on days 57 and 85 but returned to baseline by day 169,while prothrombin time activity demonstrated sustained improvement from day 29 through day 169.Interleukin-8 levels decreased persistently throughout treatment.All dosage groups achieved 100%6-month survival;2-year survival rates were 66.7%(low-dose),100%(medium-dose),and 87.5%(high-dose).The interaction between dosage and efficacy was weak.Notably,the improvement in liver function was statistically significant and sustained for almost 3 months,suggesting clinically meaningful therapeutic durability.CONCLUSION hUC-MSCs can be considered a safe treatment for patients with decompensated liver cirrhosis associated with HBV.However,larger-scale randomized controlled trials are needed to prove its therapeutic effect.展开更多
Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine...Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine preparation used to treat RA.ZF may cause liver injury.In this study,we aimed to develop a prediction model for abnormal liver function caused by ZF.Methods This retrospective study collected data from multiple centers from January 2018 to April 2023.Abnormal liver function was set as the target variable according to the alanine transaminase(ALT)level.Features were screened through univariate analysis and sequential forward selection for modeling.Ten machine learning and deep learning models were compared to find the model that most effectively predicted liver function from the available data.Results This study included 1,913 eligible patients.The LightGBM model exhibited the best performance(accuracy=0.96)out of the 10 learning models.The predictive metrics of the LightGBM model were as follows:precision=0.99,recall rate=0.97,F1_score=0.98,area under the curve(AUC)=0.98,sensitivity=0.97 and specificity=0.85 for predicting ALT<40 U/L;precision=0.60,recall rate=0.83,F1_score=0.70,AUC=0.98,sensitivity=0.83 and specificity=0.97 for predicting 40≤ALT<80 U/L;and precision=0.83,recall rate=0.63,F1_score=0.71,AUC=0.97,sensitivity=0.63 and specificity=1.00 for predicting ALT≥80 U/L.ZF-induced abnormal liver function was found to be associated with high total cholesterol and triglyceride levels,the combination of TNF-αinhibitors,JAK inhibitors,methotrexate+nonsteroidal anti-inflammatory drugs,leflunomide,smoking,older age,and females in middle-age(45-65 years old).Conclusion This study developed a model for predicting ZF-induced abnormal liver function,which may help improve the safety of integrated administration of ZF and Western medicine.展开更多
BACKGROUND Liver failure,particularly acute-on-chronic liver failure,is associated with high mortality(50%-90%).The plasma exchange(PE)mode of the artificial liver support system has been shown to improve clinical out...BACKGROUND Liver failure,particularly acute-on-chronic liver failure,is associated with high mortality(50%-90%).The plasma exchange(PE)mode of the artificial liver support system has been shown to improve clinical outcomes,although its efficacy may vary depending on the regenerative capacity of the liver.Alpha-fetoprotein(AFP),an oncofetal glycoprotein,is reactivated during liver regeneration and may serve as a prognostic biomarker.Previous studies have reported significantly higher post-PE AFP levels in survivors than in non-survivors(286.5 ng/mL vs 82.3 ng/mL at day 7).However,the predictive value of baseline AFP stratification and serial AFP kinetics during PE therapy remains unestablished.This study investigated whether serial AFP measurements predict clinical outcomes in liver failure patients receiving PE.AIM To evaluate the predictive value of serial AFP measurements in liver failure patients receiving PE.METHODS This retrospective study included 194 liver failure patients with complete AFP data,excluding those with tumors,bleeding disorders,allergies,or unstable conditions.Patients were stratified by baseline AFP into low-AFP(<100 ng/mL,n=60),medium-AFP(100-200 ng/mL,n=70),and high-AFP(>200 ng/mL,n=64)groups.AFP was measured before PE and on days 1,10,20,and 25.RESULTS Stratification by baseline AFP revealed significant gradients.The high-AFP group required fewer PE sessions than the low-AFP group(2.8±1.0 vs 4.2±1.5)but exhibited greater post-PE AFP elevation(75.1±20.3 ng/mL vs 33.1±10.2 ng/mL;P<0.001).The high-AFP group demonstrated optimal values,including the lowest ammonia,bilirubin,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transferase,and the highest albumin and prothrombin activity(all post hoc P<0.05 vs low-AFP).The medium-AFP group showed intermediate values except for prothrombin activity(35.2%±8.6%),which was significantly lower than in both other groups(P<0.001).The high-AFP group had a reduced incidence of spontaneous bacterial peritonitis(9.4%vs 25.0%;P=0.003),superior three-month survival(90.6%vs 56.7%;P<0.001),and a higher post-treatment three-month receiver operating characteristic area under the curve(0.8851 vs 0.7051).CONCLUSION AFP dynamics correlate with regenerative capacity and clinical outcomes in liver failure.Serial AFP monitoring may enhance risk stratification and support personalized therapeutic strategies.展开更多
BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patien...BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patients.OS carries a higher risk of cirrhosis,hepatocellular carcinoma,and reduced survival.While its pathogenesis remains unclear,gut microbiota dysbiosis and serum metabolite alterations may play key roles.This study uses 16S rRNA sequencing and liquid chromatography-mass spec-trometry(LC-MS)metabolomics to compare gut microbiota and serum metabolites among PBC,AIH,and OS patients,and explores their associations with liver function.AIM To differentiate OS from PBC and AIH based on gut microbiota,serum metabolites,and liver function.METHODS Gut microbiota profiles were analyzed using 16S rRNA sequencing,while untargeted serum metabolomics was conducted via LC-MS.Comparative analyses were performed to identify differences in microbial composition and serum metabolite levels among PBC,AIH,and OS groups.Correlation analyses and network visualization tech-niques were applied to elucidate the interactions among liver function parameters,gut microbiota,and serum metabolites in OS patients.RESULTS Compared to patients with PBC or AIH,OS patients demonstrated significantly reduced microbial diversity and richness.Notable taxonomic shifts included decreased abundances of Firmicutes,Bacteroidetes,and Actinobacteria,alongside increased levels of Proteobacteria and Verrucomicrobia.Distinct serum metabolites,such as pentadecanoic acid and aminoimidazole carboxamide ribonucleotide,were identified in OS patients.Correlation analysis revealed that aspartate aminotransferase(AST)levels were negatively associated with the bacterial genus Fusicatenibacter and the metabolite L-Tyrosine.A microbial-metabolite network diagram further confirmed a strong association between Fusicatenibacter and L-Tyrosine in OS patients.CONCLUSION OS patients show decreased gut microbiota diversity and unique serum metabolites.Multi-omics linked AST,Fusicatenibacter,and L-Tyrosine,revealing OS mechanisms and diagnostic potential.展开更多
Liver-directed therapies such as resection,ablation,and embolization offer potentially curative options for patients with primary and metastatic liver tumors as part of multidisciplinary oncology care.However,these tr...Liver-directed therapies such as resection,ablation,and embolization offer potentially curative options for patients with primary and metastatic liver tumors as part of multidisciplinary oncology care.However,these treatments pose significant hepatic decompensation risks,particularly with underlying liver disease and chemotherapy-associated steatohepatitis.Accurate assessment of liver function and portal hypertension(PH)is critical for candidate selection.While Child-Pugh score and model for end-stage liver disease are commonly used,they have substantial limitations.Hepatic venous pressure gradient(HVPG)measurement remains the gold standard for assessing PH but is invasive and not widely available.Endoscopic ultrasound(EUS)guided portal pressure gradient(PPG)measurement has emerged as a promising minimally invasive alternative.EUSPPG demonstrates excellent technical success rates,safety profile,and correlation with HVPG in early studies.By providing direct portal pressure measurement,EUS-PPG offers several advantages over existing methods for prognostication and risk stratification prior to liver-directed therapies,particularly in detecting presinusoidal hypertension.Furthermore,it has potential applications in assessing response to neoadjuvant treatments and guiding adjuvant therapies.However,research is needed to validate its predictive performance and cost-effectiveness in larger prospective cohorts and to establish its accuracy compared to non-invasive assessment of liver function.展开更多
This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(A...This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.展开更多
BACKGROUND Advanced chronic liver disease is a progressive condition associated with high mor-bidity and mortality,leading to complications such as decompensation and hepatocellular carcinoma.Although prognostic score...BACKGROUND Advanced chronic liver disease is a progressive condition associated with high mor-bidity and mortality,leading to complications such as decompensation and hepatocellular carcinoma.Although prognostic scores such as the Child-Pugh score(which combines clinical assessment and laboratory parameters)and laboratory-based models,including Model for End-Stage Liver Disease(MELD)3.0,albumin-bilirubin(ALBI)grade,and fibrosis-4(FIB-4),are often used,their accuracy is limited by subjective assessments and variability in laboratory results.The Functional Liver Imaging Score(FLIS),a semi-quantitative magnetic resonance imaging(MRI)measure of liver function,may also be influenced by observer variability.This emphasizes the need for objective,reproducible tools to improve risk stratification and support treatment decision-making.AIM To evaluate the prognostic value of hepatic enhancement(HE)and signal intensity measured by gadoxetate disodium-enhanced MRI.METHODS In this retrospective cohort study,100 patients with advanced chronic liver disease underwent gadoxetateenhanced MRI.HE and signal intensity were measured quantitatively in liver segments III,VI,VIII,and the caudate lobe,and global values were calculated by averaging segmental measurements.Correlations were assessed with FLIS,Child-Pugh,MELD 3.0,ALBI,FIB-4,liver stiffness(FibroScan),and hepatic venous pressure gradient.Cox regression and receiver operating characteristic analysis were used to evaluate associations with hepatic decompensation,mortality,and hepatocellular carcinoma(HCC)occurrence during follow-up.RESULTS Global HE showed a significant correlation with FLIS(r=0.797),Child-Pugh(r=-0.589),MELD 3.0(r=-0.658),ALBI(r=-0.599),FIB-4(r=-0.308),liver stiffness(r=-0.470),and hepatic venous pressure gradient(r=-0.340).Lower HE was significantly associated with a higher risk of decompensation and mortality in univariate Cox regression.After adjustment for MELD 3.0,etiology,and prior HCC,segment VI HE remained independently predictive of mortality.At 12 months,HE improved risk stratification for mortality and reduced unnecessary interventions by 11 per 100 patients at a 10%threshold in the decision curve analysis.HE had an area under the receiver operating characteristic curve of 0.74 for predicting decompensation and 0.74 for predicting mortality.HE was higher in patients who developed or experienced recurrence of HCC during follow-up,but this was not statistically significant(P=0.1).CONCLUSION Lower HE in segment VI improved prognostic classification of high-risk patients.These patients align with Baveno VII criteria for intensified management,supporting the potential role of HE in risk-adapted surveillance.展开更多
BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver fu...BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver function indicators at hospital admission and mortality in children receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO)support following cardiac surgery.METHODS:We retrospectively analysed the clinical data of pediatric patients who received postcardiotomy VA-ECMO support at Fuwai Hospital between January 2010 and June 2020.Univariable and multivariable-adjusted Cox proportional hazard models were constructed to evaluate the risk factors associated with 30-day and 180-day mortality.The cut-off values for the liver function variables measured at hospital admission were categorized into high and low groups and then compared using Kaplan-Meier survival curves and log-rank tests.RESULTS:Our study included 96 pediatric patients who received VA-ECMO support after cardiotomy.Among the patients receiving VA-ECMO,the 30-day and 180-day mortality rates were 37.5% and 52.1%,respectively.The level of aspartate aminotransferase(AST)at admission was associated with 30-day mortality(hazard ratios[HRs]=1.852,95%CI 1.010-3.398,P=0.046).The AST and alkaline phosphatase(ALP)levels were predictors of 180-day mortality,with adjusted HRs of 1.799(95%CI 1.074-3.014;P=0.025)and 1.384(95%CI 1.050-1.825;P=0.021),respectively.The cut-off value for AST to predict mortality at 30 d was 77 U/L,and that for ALP to predict mortality at 180 d was 269 U/L.CONCLUSION:Liver function indicators,including AST and ALP,at hospital admission are associated with mortality risk in children with congenital heart disease receiving VA-ECMO after cardiac surgery.展开更多
BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal...BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal stem cell(hUCMSC)therapy has shown promising potential in the treatment of several metabolic diseases.AIM To investigate how hUC-MSCs affect liver metabolism in diabetic rats with MAFLD and assess their therapeutic potential and underlying mechanisms.METHODS A streptozotocin-induced rat model of DM with MAFLD was established,and hUC-MSCs were administered via tail vein injection.Changes in body weight,fasting blood glucose(FBG),and serum triglyceride(TG),alanine aminotransferase,aspartate aminotransferase levels,and pathological changes of liver were evaluated.Receiver operating characteristic analysis was used to assess the diagnostic value of differential metabolites and their ability to predict the therapeutic effects of hUC-MSCs.Spearman correlation was employed to analyze the relationships between liver metabolites and key biochemical markers.RESULTS hUC-MSC treatment significantly reduced FBG and TG levels in diabetic rats with MAFLD and improved histological steatosis and injury in the liver.Metabolomic analysis indicated that hUC-MSCs significantly ameliorated liver metabolic disturbances via their regulatory effect on several key metabolic pathways related to carbohydrate,amino acid,and lipid metabolism.Receiver operating characteristic curve analysis revealed that 70 differential metabolites had good diagnostic value for DM with MAFLD and could effectively predict the therapeutic effect of hUC-MSCs.Moreover,Spearman correlation analysis confirmed that significant correlations existed between differential liver metabolites and the concentrations of biochemical markers(FBG,TG,alanine aminotransferase,aspartate aminotransferase).CONCLUSION hUC-MSCs alleviate liver metabolic disturbances in diabetic rats with MAFLD,thereby mitigating the pathological state of DM and slowing the progression of MAFLD.展开更多
BACKGROUND The albumin-bilirubin(ALBI)score was developed as a prognostic tool for pa-tients with hepatocellular carcinoma.However,its new role as an indicator of liver fibrosis in chronic hepatitis C virus(HCV)patien...BACKGROUND The albumin-bilirubin(ALBI)score was developed as a prognostic tool for pa-tients with hepatocellular carcinoma.However,its new role as an indicator of liver fibrosis in chronic hepatitis C virus(HCV)patients is under investigation.AIM To investigate the ALBI score as a non-invasive means of assessing the extent of liver fibrosis in chronic HCV patients.METHODS We evaluated hospital records of 231 eligible chronic HCV patients from King Fahad Specialist Hospital in Buraydah,Saudi Arabia.Demographic/clinical data,liver function tests,non-invasive tests for liver fibrosis,and ALBI score/grades were evaluated before and two years after direct-acting antivirals(DAA)treatment.RESULTS The median ALBI score improved from-2.51 to-2.62 after DAA treatment(P<0.05).Additionally,the ALBI score improved irrespective of the level of fibrosis,with improvement more evident in patients with advanced fibrosis(-2.26 to-2.41,P<0.05).The ALBI score showed significant positive correlation with non-invasive tests for liver fibrosis(aspartate aminotransferase/alanine aminotransferase ratio,aspartate aminotransferase to platelet ratio index,and fibrosis-4 index)at baseline and after DAA treatment(P<0.05).Moreover,the receiver operating characteristic curve demonstrated ALBI score’s ability to predict advanced fibrosis(F3,F4)[area under the curve=0.76,(95%confidence interval:0.70-0.81),P<0.001,best cut-off value=-2.38(sensitivity 60%and specificity 83%)].CONCLUSION The ALBI score appears to be a useful non-invasive marker for assessing liver fibrosis in chronic HCV patients and may serve as a valuable tool for monitoring hepatic function during and after DAA treatment.展开更多
BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited rese...BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.展开更多
BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but da...BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.展开更多
BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a ne...BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.展开更多
Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in ...Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.展开更多
Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional ...Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional comorbidities.COVID-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among patients.The molecular mechanism underlying this phenomenon,however,is still unknown.In this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.展开更多
Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predicto...Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.展开更多
BACKGROUND: The indocyanine green (ICG) clearance test (clearance rate (K) and retention rate at 15 minutes (R(15))) is a sensitive indicator to evaluate liver function. The model for end-stage liver disease (MELD) sc...BACKGROUND: The indocyanine green (ICG) clearance test (clearance rate (K) and retention rate at 15 minutes (R(15))) is a sensitive indicator to evaluate liver function. The model for end-stage liver disease (MELD) score has emerged as a useful tool for estimating the mortality of patients awaiting liver transplantation and has recently been validated on patients with liver diseases of various etiologies and severity. In this study, we investigated the correlation between the ICG clearance test and MELD score of patients with liver cirrhosis. METHODS: From June 2007 to March 2008, 52 patients with liver cirrhosis admitted to our center were classified into Child-Pugh class A (8 patients), B (14) and C (30). The ICG clearance test (K value and R(15)) was performed by ICG pulse spectrophotometry (DDG-3300K), and the MELD scores of patients were calculated. RESULTS: As the Child-Pugh classification of liver function gradually deteriorated, the K value decreased, while R(15) and MELD score increased. There were significant statistical differences in K value, R(15) and MELD score in patients with different Child-Pugh classifications. Significant correlations were found between the parameters of the ICG clearance test (K value and R(15)) and MELD score. A negative correlation was observed between K value and MELD score (r=-0.892, P < 0.05), while a positive correlation was observed between R(15) and MELD score (r=0.804, P < 0.05). CONCLUSIONS: The ICG clearance test and MELD score are good parameters for evaluating liver function. Moreover, K value and R(15) have significant correlations with MELD score, especially the K value, which may be a convenient and appropriate indicator to evaluate liver function of patients with liver cirrhosis.展开更多
文摘The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2<sup>nd</sup>, 4<sup>th</sup>, 6<sup>th</sup>, 8<sup>th</sup>, 10<sup>th</sup>, 12<sup>th</sup> and 14<sup>th</sup> weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14<sup>th</sup> WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive tool for the identification and characterisation of the Fasciola parasite.
文摘BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver function of patients with chronic liver disease(CLD).CASE SUMMARY This study involved data from patients whose chief complaint was reduced quality of life attributable to CLD.The new treatment approach resulted in improvements in the liver function and fatty liver of 30 patients with CLD.Im-provements were observed using abdominal ultrasonography.Unlike traditional methods,this protocol provided more sustainable and meaningful results.Treat-ment with 10 mL of HPE administered intravenously once or twice per week significantly improved liver function.The observed improvements in fatty liver and liver function suggest the utility of this approach for the management of patients with CLD.CONCLUSION This case series highlights the potential of innovative treatments for patients with CLD that could improve the quality of life of the patients.
基金Supported by the Science and Technology Innovation Team Project of Colleges and Universities in Gansu Province(2016C-09)National Natural Science Foundation of Gansu Province(17JR5RA158)+3 种基金Talent Innovation and Venture Project of Lanzhou City(2016-RC-85)Project of Research Center of Investigation Theory and Practice in Northwest Ethnic RegionsCharacteristic Subject Project of Evidence Science of Gansu ProvinceScience and Technology Project of Lanzhou City(2015-3-80)
文摘To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.
基金Supported by the Foundation of Health Commission of Hubei Province,No.WJ2019H053Natural Science Foundation of Hubei Province,No.2023AFB169+1 种基金Foundation of Health Commission of Hubei Province,No.ZY2021Q019Open Fund Hubei Provincial Clinical Research Center for Umbilical Cord Blood Hematopoietic Stem Cells,Taihe Hospital,No.2024SCOF008.
文摘BACKGROUND Large number of decompensated liver cirrhosis patients in China have been diagnosed with hepatitis B virus(HBV).Human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)can possibly cure decompensated liver cirrhosis because of their self-renewal and multidirectional differentiation potential.AIM To explore the safety and effect of treating liver cirrhosis with HBV by hUC-MSCs.METHODS Twenty-four participants were recruited,divided into 3 groups,and injected with different amounts of hUC-MSCs via the peripheral vein.Therapy was administered 3 times.A 24-week follow-up examination of each patient’s liver function,coagulation function,general condition,and immune system was performed.Adverse events were also recorded.A 2-year survival assessment was subsequently performed.RESULTS Infusion therapy rapidly improved liver function.Serum albumin transiently increased on days 57 and 85 but returned to baseline by day 169,while prothrombin time activity demonstrated sustained improvement from day 29 through day 169.Interleukin-8 levels decreased persistently throughout treatment.All dosage groups achieved 100%6-month survival;2-year survival rates were 66.7%(low-dose),100%(medium-dose),and 87.5%(high-dose).The interaction between dosage and efficacy was weak.Notably,the improvement in liver function was statistically significant and sustained for almost 3 months,suggesting clinically meaningful therapeutic durability.CONCLUSION hUC-MSCs can be considered a safe treatment for patients with decompensated liver cirrhosis associated with HBV.However,larger-scale randomized controlled trials are needed to prove its therapeutic effect.
基金supported by the Budgeted Fund of Shanghai University of Traditional Chinese Medicine(Natural Science)(No.2021LK037)the Open Project of Qinghai Province Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation(No.2021-ZY-03).
文摘Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine preparation used to treat RA.ZF may cause liver injury.In this study,we aimed to develop a prediction model for abnormal liver function caused by ZF.Methods This retrospective study collected data from multiple centers from January 2018 to April 2023.Abnormal liver function was set as the target variable according to the alanine transaminase(ALT)level.Features were screened through univariate analysis and sequential forward selection for modeling.Ten machine learning and deep learning models were compared to find the model that most effectively predicted liver function from the available data.Results This study included 1,913 eligible patients.The LightGBM model exhibited the best performance(accuracy=0.96)out of the 10 learning models.The predictive metrics of the LightGBM model were as follows:precision=0.99,recall rate=0.97,F1_score=0.98,area under the curve(AUC)=0.98,sensitivity=0.97 and specificity=0.85 for predicting ALT<40 U/L;precision=0.60,recall rate=0.83,F1_score=0.70,AUC=0.98,sensitivity=0.83 and specificity=0.97 for predicting 40≤ALT<80 U/L;and precision=0.83,recall rate=0.63,F1_score=0.71,AUC=0.97,sensitivity=0.63 and specificity=1.00 for predicting ALT≥80 U/L.ZF-induced abnormal liver function was found to be associated with high total cholesterol and triglyceride levels,the combination of TNF-αinhibitors,JAK inhibitors,methotrexate+nonsteroidal anti-inflammatory drugs,leflunomide,smoking,older age,and females in middle-age(45-65 years old).Conclusion This study developed a model for predicting ZF-induced abnormal liver function,which may help improve the safety of integrated administration of ZF and Western medicine.
基金Supported by National Natural Science Foundation of China,No.82160106.
文摘BACKGROUND Liver failure,particularly acute-on-chronic liver failure,is associated with high mortality(50%-90%).The plasma exchange(PE)mode of the artificial liver support system has been shown to improve clinical outcomes,although its efficacy may vary depending on the regenerative capacity of the liver.Alpha-fetoprotein(AFP),an oncofetal glycoprotein,is reactivated during liver regeneration and may serve as a prognostic biomarker.Previous studies have reported significantly higher post-PE AFP levels in survivors than in non-survivors(286.5 ng/mL vs 82.3 ng/mL at day 7).However,the predictive value of baseline AFP stratification and serial AFP kinetics during PE therapy remains unestablished.This study investigated whether serial AFP measurements predict clinical outcomes in liver failure patients receiving PE.AIM To evaluate the predictive value of serial AFP measurements in liver failure patients receiving PE.METHODS This retrospective study included 194 liver failure patients with complete AFP data,excluding those with tumors,bleeding disorders,allergies,or unstable conditions.Patients were stratified by baseline AFP into low-AFP(<100 ng/mL,n=60),medium-AFP(100-200 ng/mL,n=70),and high-AFP(>200 ng/mL,n=64)groups.AFP was measured before PE and on days 1,10,20,and 25.RESULTS Stratification by baseline AFP revealed significant gradients.The high-AFP group required fewer PE sessions than the low-AFP group(2.8±1.0 vs 4.2±1.5)but exhibited greater post-PE AFP elevation(75.1±20.3 ng/mL vs 33.1±10.2 ng/mL;P<0.001).The high-AFP group demonstrated optimal values,including the lowest ammonia,bilirubin,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transferase,and the highest albumin and prothrombin activity(all post hoc P<0.05 vs low-AFP).The medium-AFP group showed intermediate values except for prothrombin activity(35.2%±8.6%),which was significantly lower than in both other groups(P<0.001).The high-AFP group had a reduced incidence of spontaneous bacterial peritonitis(9.4%vs 25.0%;P=0.003),superior three-month survival(90.6%vs 56.7%;P<0.001),and a higher post-treatment three-month receiver operating characteristic area under the curve(0.8851 vs 0.7051).CONCLUSION AFP dynamics correlate with regenerative capacity and clinical outcomes in liver failure.Serial AFP monitoring may enhance risk stratification and support personalized therapeutic strategies.
基金Supported by WBE Liver Foundation,No.WBE20220182022 Young and Middle-aged Talents Incubation Project(Youth Innovation)of Beijing Youan Hospital,Capital Medical University,No.BJYAYY-YN-2022-092023 Young and Middle-aged Talents Incubation Project(Youth Innovation)of Beijing Youan Hospital,Capital Medical University,No.BJYAYYYN2023-14.
文摘BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patients.OS carries a higher risk of cirrhosis,hepatocellular carcinoma,and reduced survival.While its pathogenesis remains unclear,gut microbiota dysbiosis and serum metabolite alterations may play key roles.This study uses 16S rRNA sequencing and liquid chromatography-mass spec-trometry(LC-MS)metabolomics to compare gut microbiota and serum metabolites among PBC,AIH,and OS patients,and explores their associations with liver function.AIM To differentiate OS from PBC and AIH based on gut microbiota,serum metabolites,and liver function.METHODS Gut microbiota profiles were analyzed using 16S rRNA sequencing,while untargeted serum metabolomics was conducted via LC-MS.Comparative analyses were performed to identify differences in microbial composition and serum metabolite levels among PBC,AIH,and OS groups.Correlation analyses and network visualization tech-niques were applied to elucidate the interactions among liver function parameters,gut microbiota,and serum metabolites in OS patients.RESULTS Compared to patients with PBC or AIH,OS patients demonstrated significantly reduced microbial diversity and richness.Notable taxonomic shifts included decreased abundances of Firmicutes,Bacteroidetes,and Actinobacteria,alongside increased levels of Proteobacteria and Verrucomicrobia.Distinct serum metabolites,such as pentadecanoic acid and aminoimidazole carboxamide ribonucleotide,were identified in OS patients.Correlation analysis revealed that aspartate aminotransferase(AST)levels were negatively associated with the bacterial genus Fusicatenibacter and the metabolite L-Tyrosine.A microbial-metabolite network diagram further confirmed a strong association between Fusicatenibacter and L-Tyrosine in OS patients.CONCLUSION OS patients show decreased gut microbiota diversity and unique serum metabolites.Multi-omics linked AST,Fusicatenibacter,and L-Tyrosine,revealing OS mechanisms and diagnostic potential.
文摘Liver-directed therapies such as resection,ablation,and embolization offer potentially curative options for patients with primary and metastatic liver tumors as part of multidisciplinary oncology care.However,these treatments pose significant hepatic decompensation risks,particularly with underlying liver disease and chemotherapy-associated steatohepatitis.Accurate assessment of liver function and portal hypertension(PH)is critical for candidate selection.While Child-Pugh score and model for end-stage liver disease are commonly used,they have substantial limitations.Hepatic venous pressure gradient(HVPG)measurement remains the gold standard for assessing PH but is invasive and not widely available.Endoscopic ultrasound(EUS)guided portal pressure gradient(PPG)measurement has emerged as a promising minimally invasive alternative.EUSPPG demonstrates excellent technical success rates,safety profile,and correlation with HVPG in early studies.By providing direct portal pressure measurement,EUS-PPG offers several advantages over existing methods for prognostication and risk stratification prior to liver-directed therapies,particularly in detecting presinusoidal hypertension.Furthermore,it has potential applications in assessing response to neoadjuvant treatments and guiding adjuvant therapies.However,research is needed to validate its predictive performance and cost-effectiveness in larger prospective cohorts and to establish its accuracy compared to non-invasive assessment of liver function.
文摘This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.
文摘BACKGROUND Advanced chronic liver disease is a progressive condition associated with high mor-bidity and mortality,leading to complications such as decompensation and hepatocellular carcinoma.Although prognostic scores such as the Child-Pugh score(which combines clinical assessment and laboratory parameters)and laboratory-based models,including Model for End-Stage Liver Disease(MELD)3.0,albumin-bilirubin(ALBI)grade,and fibrosis-4(FIB-4),are often used,their accuracy is limited by subjective assessments and variability in laboratory results.The Functional Liver Imaging Score(FLIS),a semi-quantitative magnetic resonance imaging(MRI)measure of liver function,may also be influenced by observer variability.This emphasizes the need for objective,reproducible tools to improve risk stratification and support treatment decision-making.AIM To evaluate the prognostic value of hepatic enhancement(HE)and signal intensity measured by gadoxetate disodium-enhanced MRI.METHODS In this retrospective cohort study,100 patients with advanced chronic liver disease underwent gadoxetateenhanced MRI.HE and signal intensity were measured quantitatively in liver segments III,VI,VIII,and the caudate lobe,and global values were calculated by averaging segmental measurements.Correlations were assessed with FLIS,Child-Pugh,MELD 3.0,ALBI,FIB-4,liver stiffness(FibroScan),and hepatic venous pressure gradient.Cox regression and receiver operating characteristic analysis were used to evaluate associations with hepatic decompensation,mortality,and hepatocellular carcinoma(HCC)occurrence during follow-up.RESULTS Global HE showed a significant correlation with FLIS(r=0.797),Child-Pugh(r=-0.589),MELD 3.0(r=-0.658),ALBI(r=-0.599),FIB-4(r=-0.308),liver stiffness(r=-0.470),and hepatic venous pressure gradient(r=-0.340).Lower HE was significantly associated with a higher risk of decompensation and mortality in univariate Cox regression.After adjustment for MELD 3.0,etiology,and prior HCC,segment VI HE remained independently predictive of mortality.At 12 months,HE improved risk stratification for mortality and reduced unnecessary interventions by 11 per 100 patients at a 10%threshold in the decision curve analysis.HE had an area under the receiver operating characteristic curve of 0.74 for predicting decompensation and 0.74 for predicting mortality.HE was higher in patients who developed or experienced recurrence of HCC during follow-up,but this was not statistically significant(P=0.1).CONCLUSION Lower HE in segment VI improved prognostic classification of high-risk patients.These patients align with Baveno VII criteria for intensified management,supporting the potential role of HE in risk-adapted surveillance.
基金supported by the CAMS Innovation Fund for Medical Sciences(2024-12M-C&T-B-045).
文摘BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver function indicators at hospital admission and mortality in children receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO)support following cardiac surgery.METHODS:We retrospectively analysed the clinical data of pediatric patients who received postcardiotomy VA-ECMO support at Fuwai Hospital between January 2010 and June 2020.Univariable and multivariable-adjusted Cox proportional hazard models were constructed to evaluate the risk factors associated with 30-day and 180-day mortality.The cut-off values for the liver function variables measured at hospital admission were categorized into high and low groups and then compared using Kaplan-Meier survival curves and log-rank tests.RESULTS:Our study included 96 pediatric patients who received VA-ECMO support after cardiotomy.Among the patients receiving VA-ECMO,the 30-day and 180-day mortality rates were 37.5% and 52.1%,respectively.The level of aspartate aminotransferase(AST)at admission was associated with 30-day mortality(hazard ratios[HRs]=1.852,95%CI 1.010-3.398,P=0.046).The AST and alkaline phosphatase(ALP)levels were predictors of 180-day mortality,with adjusted HRs of 1.799(95%CI 1.074-3.014;P=0.025)and 1.384(95%CI 1.050-1.825;P=0.021),respectively.The cut-off value for AST to predict mortality at 30 d was 77 U/L,and that for ALP to predict mortality at 180 d was 269 U/L.CONCLUSION:Liver function indicators,including AST and ALP,at hospital admission are associated with mortality risk in children with congenital heart disease receiving VA-ECMO after cardiac surgery.
基金Supported by the National Key Specialty Major Scientific Research Project of the Hunan Provincial Health Commission,No.Z2023158.
文摘BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal stem cell(hUCMSC)therapy has shown promising potential in the treatment of several metabolic diseases.AIM To investigate how hUC-MSCs affect liver metabolism in diabetic rats with MAFLD and assess their therapeutic potential and underlying mechanisms.METHODS A streptozotocin-induced rat model of DM with MAFLD was established,and hUC-MSCs were administered via tail vein injection.Changes in body weight,fasting blood glucose(FBG),and serum triglyceride(TG),alanine aminotransferase,aspartate aminotransferase levels,and pathological changes of liver were evaluated.Receiver operating characteristic analysis was used to assess the diagnostic value of differential metabolites and their ability to predict the therapeutic effects of hUC-MSCs.Spearman correlation was employed to analyze the relationships between liver metabolites and key biochemical markers.RESULTS hUC-MSC treatment significantly reduced FBG and TG levels in diabetic rats with MAFLD and improved histological steatosis and injury in the liver.Metabolomic analysis indicated that hUC-MSCs significantly ameliorated liver metabolic disturbances via their regulatory effect on several key metabolic pathways related to carbohydrate,amino acid,and lipid metabolism.Receiver operating characteristic curve analysis revealed that 70 differential metabolites had good diagnostic value for DM with MAFLD and could effectively predict the therapeutic effect of hUC-MSCs.Moreover,Spearman correlation analysis confirmed that significant correlations existed between differential liver metabolites and the concentrations of biochemical markers(FBG,TG,alanine aminotransferase,aspartate aminotransferase).CONCLUSION hUC-MSCs alleviate liver metabolic disturbances in diabetic rats with MAFLD,thereby mitigating the pathological state of DM and slowing the progression of MAFLD.
文摘BACKGROUND The albumin-bilirubin(ALBI)score was developed as a prognostic tool for pa-tients with hepatocellular carcinoma.However,its new role as an indicator of liver fibrosis in chronic hepatitis C virus(HCV)patients is under investigation.AIM To investigate the ALBI score as a non-invasive means of assessing the extent of liver fibrosis in chronic HCV patients.METHODS We evaluated hospital records of 231 eligible chronic HCV patients from King Fahad Specialist Hospital in Buraydah,Saudi Arabia.Demographic/clinical data,liver function tests,non-invasive tests for liver fibrosis,and ALBI score/grades were evaluated before and two years after direct-acting antivirals(DAA)treatment.RESULTS The median ALBI score improved from-2.51 to-2.62 after DAA treatment(P<0.05).Additionally,the ALBI score improved irrespective of the level of fibrosis,with improvement more evident in patients with advanced fibrosis(-2.26 to-2.41,P<0.05).The ALBI score showed significant positive correlation with non-invasive tests for liver fibrosis(aspartate aminotransferase/alanine aminotransferase ratio,aspartate aminotransferase to platelet ratio index,and fibrosis-4 index)at baseline and after DAA treatment(P<0.05).Moreover,the receiver operating characteristic curve demonstrated ALBI score’s ability to predict advanced fibrosis(F3,F4)[area under the curve=0.76,(95%confidence interval:0.70-0.81),P<0.001,best cut-off value=-2.38(sensitivity 60%and specificity 83%)].CONCLUSION The ALBI score appears to be a useful non-invasive marker for assessing liver fibrosis in chronic HCV patients and may serve as a valuable tool for monitoring hepatic function during and after DAA treatment.
基金Supported by Guangdong Provincial Hospital of Chinese Medicine Science and Technology Research Special Project,No.YN2023WSSQ01State Key Laboratory of Traditional Chinese Medicine Syndrome.
文摘BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.
文摘BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.
文摘BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.
文摘Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.
文摘Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional comorbidities.COVID-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among patients.The molecular mechanism underlying this phenomenon,however,is still unknown.In this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.
文摘Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.
文摘BACKGROUND: The indocyanine green (ICG) clearance test (clearance rate (K) and retention rate at 15 minutes (R(15))) is a sensitive indicator to evaluate liver function. The model for end-stage liver disease (MELD) score has emerged as a useful tool for estimating the mortality of patients awaiting liver transplantation and has recently been validated on patients with liver diseases of various etiologies and severity. In this study, we investigated the correlation between the ICG clearance test and MELD score of patients with liver cirrhosis. METHODS: From June 2007 to March 2008, 52 patients with liver cirrhosis admitted to our center were classified into Child-Pugh class A (8 patients), B (14) and C (30). The ICG clearance test (K value and R(15)) was performed by ICG pulse spectrophotometry (DDG-3300K), and the MELD scores of patients were calculated. RESULTS: As the Child-Pugh classification of liver function gradually deteriorated, the K value decreased, while R(15) and MELD score increased. There were significant statistical differences in K value, R(15) and MELD score in patients with different Child-Pugh classifications. Significant correlations were found between the parameters of the ICG clearance test (K value and R(15)) and MELD score. A negative correlation was observed between K value and MELD score (r=-0.892, P < 0.05), while a positive correlation was observed between R(15) and MELD score (r=0.804, P < 0.05). CONCLUSIONS: The ICG clearance test and MELD score are good parameters for evaluating liver function. Moreover, K value and R(15) have significant correlations with MELD score, especially the K value, which may be a convenient and appropriate indicator to evaluate liver function of patients with liver cirrhosis.
