Objective To present the computed tomography (CT) findings and associated pathological features of eight cases of primary hepatic angiosarcoma (PHA) .Methods All cases were confirmed by pathology.After a CT scan of the upper abdomen, all cases of PHA underwent enhanced scans in the arterial phase, portal venous phase, and delayed phase to observe the CT manifestations.The surgical specimens were subjected to conventional hematoxylin- eosin staining and immunohistochemistry and observed under a microscope.Results Of all patients, 5 cases were massive type, 2 cases were mixed type, and 1 case was multiple nodule type.CT scans revealed inhomogeneous low- density lesions, with necrosis of even lower density in the central part.In 4 cases of massive type, scattered high- density small pieces were observed in low- density areas;in one case of mixed type, high- density nodules were observed on the edge of mass.There were 7 cases of peripheral nodular irregular enhancement in the arterial phase, including 1 case with flocculent central enhancement and another with no enhancement.Lesions remained enhanced in the portal venous and delayed phases, but 1 case had no enhancement.Five in 9 lesions had sharp edges in the arterial and portal venous phases, with“sharpen rim perpendicular to pleura”signs at the boundaries with the surrounding normal liver tissue.The outer edges of 7 lesions were found to have“pseudocapsules”in the portal venous phase.Conclusion CT scans showed a large hypodense lesion with irregular necrotic areas or scattered hemorrhage in PHA patients, whist enhanced scans showed a progressive filling and necrotic area in the central part.There could be“sharpen rim perpendicular to pleura”and“pseudocapsule”signs at the edge.It might be helpful to improve the diagnosis through the above characteristic features.

Objective To observe the therapeutic effect of terlipressin combined with albumin in management of patients with hepatorenal syndrome.Methods A retrospective study enrolling 46 patients with hepatorenal syndrome from May 2011 to August 2013 was conducted, in which 22 patients were allocated to control group, and 24 patients to treatment group.In addition to conventional treatment, albumin was used in control group, and the patients in treatment group were treated with terlipressin plus albumin.Clinical symptoms, urine volume, serum creatinine, urea nitrogen, ascites, and prognosis were observed in the study.The Student's t test was used for comparison between the two groups, and the chi- square test was used for comparison of rates.Results The treatment group showed significant improvements in clinical symptoms, while the control group did not.In treatment group, urine volume (ml /24 h) increased from (758.5 ± 284.9) to (2277.1 ±704.8) (P<0.01) ;serum creatinine level (μmol/L) dropped from (234.2 ±87.2) to (126.8 ±62.2) (P <0.01) ;urea nitrogen level (mmol /L) dropped from (18.1 ± 6.4) to (10.3 ± 4.5) (P < 0.01) ;body weight (kg) dropped from (68.1 ± 3.9) to (64.6± 3.9) (P < 0.01) ;abdominal circumference (cm) dropped from (95.0 ± 5.1) to (90.8 ± 4.9) (P < 0.01) .However, the control group showed no significant changes in urine volume, serum creatinine, urea nitrogen, body weight, and abdominal circumference after treatment (P >0.05) .There were significant differences in these indices between the two groups after treatment (P < 0.05) .Significant differences in remission rate and survival rate were observed between the control group and treatment group (P < 0.05) .Conclusion A combination of terlipressin and albumin has favorable therapeutic effect on hepatorenal syndrome and improves the prognosis of patients with hepatorenal syndrome.

Objective To compare the levels of Golgi glycoprotein 73 (GP73) , alpha- fetoprotein heterogeneity 3 (AFP- L3) , alpha-fetoprotein (AFP) , and α- L- fucosidase (AFU) between patients with different liver diseases and the diagnostic value of any or a combination of these makers for liver cancer.Methods The 272 patients with liver cancer, 203 patients with liver cirrhosis, and 248 patients with chronic hepatitis admitted to our hospital from January to December, 2013, as well as 210 healthy individuals, were included in the study.Serum levels of GP73, AFP- L3, AFP, and AFU were determined.Comparison of non- normally distributed data was made by Kruskal- Wallis H test, and multiple comparisons were made by Mann- Whitney U test.Comparison of rates was made by chi- square test.P < 0.05 was considered significantly different.Receiver operating characteristic (ROC) curves were drawn with healthy individuals and patients with chronic hepatitis or liver cirrhosis as controls, and Logistic fitting and ROC analysis were used to evaluate the diagnostic values of these markers.Results The GP73 level of liver cirrhosis group (177.0 (116.0, 247.0) ng /ml) was significantly higher than those of liver cancer group (141.0 (83.3, 218.8) ng /ml) and chronic hepatitis group (151.0 (83.0, 235.3) ng /ml) (U = 22 116.5 and 21 052.0, P<0.05 for both) .The AFP- L3 and AFP levels of liver cancer group (11.3 (4.3, 21.2) % and 78.4 (7.1, 2455.8) ng /ml) were significantly higher than those of liver cirrhosis group (6.0 (4.0, 8.0) % and 10.0 (3.8, 49.5) ng /ml) and chronic hepatitis group (7.0 (5.0, 9.0) % and 18.8 (4.4, 79.6) ng /ml) (U = 16009.0 /16083.5 and 22456.5 /22346.5, P < 0.05 for all) .According to the ROC curves drawn using healthy individuals as a control, the areas under the ROC curve (AUCs) for GP73, AFP- L3, AFP, and AFU were 0.827, 0.817, 0.901, and 0.680, respectively;GP73, AFP- L3, and AFP had a higher diagnostic accuracy for liver cancer than AFU.According to the ROC curves drawn using non- liver cancer patients as a control, the AUCs for the four markers were 0.573, 0.734, 0.753, and 0.552, respectively;AFP- L3 and AFP had some diagnostic accuracy for liver cancer, and their cut- off values were 8.55% (56.6%, 84.9%) and 49.88 ng /ml (57.7%, 80.9%) , respectively, when the sensitivity and specificity reached the peak values.Conclusion Increased GP73 is related to hepatic impairment and chronic fibrosis, and it has a better sensitivity for the diagnosis of liver diseases.AFP- L3 and AFP have good specificity for the diagnosis of liver cancer, and a combination of the two markers can increase the diagnostic sensitivity for liver cancer to 62.1%.

Objective To investigate the role and action mechanism of chemokine (C- X- C motif) receptor 3 (CXCR3) in hepatic ischemia- reperfusion injury (IRI) .Methods Forty- eight mice were divided into operation group and sham- operation group.The operation group was treated to establish a mouse model of IRI.Liver tissues were obtained at 3, 6, 12, and 24 h after IRI, with 6 mice at each time point.The expression of chemokine (C- X- C motif) ligand 9- 11 (CXCL9- 11) and their receptor CXCR3 were measured by real- time PCR and Western blot.The effect of CXCR3 was blocked by its specific antagonist C6.Hepatic injury was estimated based on the activity of hepatic transaminase and morphological indices.The distribution of subsets of infiltrating T cells was analyzed by flow cytometry.All data were expressed as mean ± standard deviation.Comparison between groups was made by one- way analysis of variance.Results Compared with the sham- operation group, the operation group had significantly upregulated expression of CXCL9- 11 and CXCR3 at all time points after IRI (P < 0.05) .Blocking CXCR3 significantly protected liver function and morphology (P < 0.05) .Antagonist C6 significantly reduced Th1 cell infiltration (P < 0.01) , but significantly increased Treg infiltration (P < 0.01) .Conclusion CXCR3 is an ideal therapeutic target in IRI treatment due to its relationship with immunoregulation.