Objective To investigate the association of cholecystectomy with non- alcoholic fatty liver. Methods The 110 adults treated by cholecystectomy, who underwent physical examination in the Third Affiliated Hospital of Southern Medical University from January 2011to December 2013, were included in the study. None of the subjects had a history of viral hepatitis and alcohol abuse. All subjects underwent CT scanning and measurement of serum triglyceride and cholesterol levels to confirm the diagnosis of non- alcoholic fatty liver. Results Among the 110 subjects, 42 (38. 18%) had non- alcoholic fatty liver, including 28 males (45. 90%) and 14 females (28. 59%) ; 78 (70.91%) had increased blood lipids, and 32 (29.09%) had normal blood lipids. Conclusion Cholecystectomy may be a risk factor for NAFLD.

Objective To evaluate the efficacy of antiviral therapy in hepatocellular carcinoma (HCC) patients with high HBV DNA levels after radical resection. Methods A retrospective analysis was performed on the clinical data of 113 HCC patients with high HBV DNA levels who underwent radical resection from January 2007 to January 2010. These patients were divided into treatment group (n = 74) and control group (n = 39) . In addition to liver- protecting therapy and supportive care, antiviral therapy was given to the treatment group, but not in the control group. All patients were followed up after operation, and the two groups were compared in terms of HBV DNA level, tumor recurrence rate, and survival rate. Comparison between the two groups was made by t test or chi- square test; the Kaplan- Meier method was used to calculate postoperative survival rates, and the log- rank test was used for survival difference analysis. Results After operation, the treatment group had a continuously decreased HBV DNA level, which was significantly lower at 6, 12, and 24 months after operation than before operation (t = 14. 38, 18. 50, 16. 22, P < 0. 05) ; there were significant differences in HBV DNA levels at 6, 12, and 24 months after operation between the treatment group and control group ( t = 13. 19, 24. 20, 14. 15, P < 0. 05) . The 3- year disease- free survival (DFS) rate showed significant difference between the two groups after operation (P =0.029) . The 1-, 2-, and 3-year cumulative survival rates were 95. 95%, 85. 14%, and 75. 68%, respectively, in the treatment group and 87. 18%, 69. 23%, and 53. 85%, respectively, in the control group; the treatment group had a significantly higher 3- year cumulative survival rate than the control group (P = 0. 016) .Conclusion Antiviral therapy can increase 3- year DFS rate and prolong postoperative survival in HCC patients with high HBV DNA levels after radical resection. Thus, antiviral therapy should be performed early, regularly, and persistently in HCC patients with high HBV DNA levels.

Objective To investigate the value of combined detection of serum alpha- fetoprotein (AFP) and Golgi protein- 73 (GP73) in the diagnosis of hepatocellular carcinoma (HCC) and to provide a basis for early diagnosis and differential diagnosis of HCC. Methods A total of 408 patients hospitalized in Baoji Central Hospital from June 2012 to May 2013, as well as healthy persons who had normal test results in physical examination, were included in the study, and their specimens were collected. These patients were classified into HCC group (n =142) , chronic hepatitis group (n =156) , and liver cirrhosis group (n =110) . Serum levels of AFP and GP73 in the three groups were measured by electrochemiluminescence immunoassay and double- antibody sandwich enzyme- linked immunosorbent assay, respectively.Comparison of test results between groups was made by analysis of variance, and comparison of rates was made by chi- square test. The sensitivity and specificity of the two indicators for the diagnosis of HCC were calculated using MedCalc statistical software. Results The HCC group had significantly higher serum AFP and GP73 levels than the liver cirrhosis group and chronic hepatitis group ( P < 0. 05) ; the liver cirrhosis group had significantly higher serum AFP and GP73 levels than the chronic hepatitis group (P < 0. 05) . The sensitivity and specificity of the two indicators for the diagnosis of HCC were 95. 8% and 98. 6%, respectively, showing significant differences compared with those of each indicator alone (P < 0. 05) . Conclusion Combined detection of serum AFP and GP73 has high diagnostic value and clinical significance for HCC, and they can be used as indicators for early diagnosis and differential diagnosis of HCC.

Objective To study the features of Kawasaki disease (KD) with liver damage and investigate the possible related factors, and to improve the understanding of liver damage in KD patients. Methods The clinical data of 75 KD patients admitted from 2008 to 2013 were collected to retrospectively analyze the clinical features of liver damage, as well as routine blood test, C- reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , liver function, and abdominal ultrasound. Categorical data were analyzed by chi- square test; continuous data were expressed as mean ± standard deviation; comparison between groups was made by t test and multivariate stepwise regression analysis. Results The incidence of abnormal alanine aminotransferase (ALT) level in 75 cases was 32%, and 79. 2% of these patients had a serum ALT level of less than 200 IU /L, including 3 patients with hepatomegaly, 1 patient with jaundice, and 1 patient with splenomegaly, which accounted for 12. 5%, 4. 2%, and 4. 2%, respectively, of patients with liver damage. CRP and ESR were not found to be related to liver damage (t = 1. 560, P = 0. 123; t = 1. 291, P = 0. 201) . There was significant difference in platelet count between patients with liver damage and controls (t =- 3. 228, P = 0. 003) . No significant difference in white blood cell (WBC) count increase was found between the liver damage group and control group, but simultaneous increase in WBC count and platelet count was significantly associated with an increased risk of liver damage (P < 0. 05) . Conclusion CRP and ESR are not found to be significantly related to the development of liver damage, but there is a close relationship between liver damage and abnormal platelet count. WBC count shows a certain relationship with liver damage. Clinicians should pay attention to these factors and take timely measures for intervention.

Objective To investigate the significance of serum cystatin C (CysC) level for the early diagnosis of acute kidney injury (AKI) in patients with acute- on- chronic liver failure (ACLF) . Methods Sixty patients with chronic hepatitis B- related ACLF and 60 patients with CHB, as well as 60 healthy controls, were included in the study. The ACLF patients were followed up until discharge, and serum samples were collected during hospital stay. Serum CysC level was measured by latex- enhanced immunoturbidimetric assay. The receiver operating characteristic (ROC) curves of serum CysC, creatinine (Cr) , and sodium levels for the diagnosis of AKI were drawn, and the areas under the ROC curves (AUCs) and optimal cut- off values were determined. For normally distributed measurement data, comparison between groups was made by one- way analysis of variance, and multiple comparisons were made by two- sided t test; otherwise, comparison between groups was made by Mann- Whitney U test. Enumeration data were analyzed by chi- square test. The Pearson correlation test was used for correlation analysis. The AUCs and optimal cut- off values were calculated by Medcal 12. 7. 1. 0. Results The serum CysC level in ACLF patients was 1050 ± 444 ng /ml, which was significantly higher than those in healthy controls (638 ± 275 ng /ml, P = 0. 016) and CHB patients (661 ± 225 ng /ml, P = 0. 028) ; for ACLF patients, serum CysC level was not significantly correlated with serum Cr level (r =0.311, P >0.05) , but showed a significant positive correlation with MELD score (r =0. 529, P <0. 01) . During hospital stay, 8 (13.3%) of ACLF patients developed AKI. The multivariate logistic regression analysis indicated that serum CysC level was the independent risk factor for AKI development in ACLF patients (OR = 1. 008, P = 0. 021) . The cut- off value of serum CysC level for the early diagnosis of AKI in ACLF patients was 1210 ng /ml. Conclusion Elevated serum CysC level may provide an early prediction of AKI development in ACLF patients with a normal serum Cr level during hospital stay.

Objective To summarize the complications of subclavian catheterization in severe hepatitis patients and to investigate clinical safety and treatment. Methods Five hundred and six cases of severe hepatitis, who underwent subclavian catheterization before non- bioartificial liver operation like double plasma molecular adsorption system, were enrolled. Intraoperative and postoperative adverse reactions were under close observation and recording. Results Of all patients, 492 (97. 2%) were punctured and catheterized successfully, and 38 (7.5%) developed complications, including local hematoma and bleeding at puncture sites (15 cases) , catheter infection (13 cases) , and catheterization into the subclavian artery (10 cases) . Conclusion Subclavian catheterization has a high success rate, and is sufficient to meet the need of clinical rescue and treatment. Most complications would not interfere with treatment outcome after proper disposal. Subclavian catheterization can be safely applied to severe hepatitis patients with coagulation disturbance.

Objective To investigate the clinical significance of late- onset abnormal elevation of transaminase after hepatectomy. Methods A retrospective analysis was performed on the clinical data of 15 patients with abnormal elevation of transaminase after partial hepatectomy, who were admitted to our center from March 2009 to March 2012. The clinical implication of different types of late- onset elevation of transaminase was analyzed. Comparison between groups was made by t test or chi- square test. Results There were two different populations with abnormal elevation of transaminase after operation. There were differences in time of postoperative transaminase elevation, duration of transaminase elevation, and peak level of transaminase between survival cases and death cases. Conclusion Abnormal elevation of transaminase after hepatectomy is not commonly seen in clinical practice. The patients with late- onset elevation of transaminase at 3- 5 d after operation have poor prognosis, which should be given enough attention.