Objective To assess the value of hysterosalpingo-contrast-sonography (HyCoSy) with the contrast agent SonoVue in the diagnosis of women infertility. Methods Thirty-six cases of infertility underwent HyCoSy using SonoVue and compared with laparoscopie hydrotubation. Resnlts Among 69 fallopian tubes,22 of them were diagnosed to be obstructive by HyCoSy. Compared with laparoscopic hydrotubation, the sensitivity and specificity of HyCoSy were 90. 5 % and 93.8 %, respectively. Conclusions HyCoSy is a convenient, non-invasive, non-radiative method,which may be regarded as an effective tool to assess the fallopian tubes in patients with infertility.

Objective To explore the clinical characteristics of chronic hepatitis B patients with metabolic syndrome (MS).Methods A total of 127 patients with untreated chronic hepatitis B infection were recruited.The patients were divided into two groups according to the diagnosis of MS,with 45 in MS group and 82 in non-MS group.Age,gender,body mass index (BMI),waist-to-hip ratio (WHR),fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST),alanine aminotransferase (ALT),hepatitis B e antigen (HBeAg),hepatitis B virus deoxyribonucleic acid (HBV DNA) were compared between groups.Liver biopsy was performed in 94 patients,including 31 in MS group and 63 in non-MS group,to compare the histological characteristics of liver between two groups.A chi-square test and t test were used for the data analysis.Results BMI,WHR,TG,TC,and FBG results of patients in MS group and nonMS group were (28.88±3.00) kg/m2,0.93±0.03,(2.77±0.17) mmol/L,(6.51±0.95) mmol/L,(6.67±0.45) mmol/L,and (24.64± 2.21) kg/m2,0.91±0.04,(1.50±0.65) mmol/L,(4.38±0.71) mmol/L,(4.91±0.92) mmol/L,respectively.Patients in MS group had higher BMI,WHR,FBG,TG and TC compared with those in non-MS group (t=9.109,3.245,2.642,3.762 and 2.586,respectively; all P＜0.05).No statistical significant differences were found in age,ALT or AST between two groups (t=2.224,0.703 and 0.141,respectively; all P＞0.05).Neither any statistical difference was found in gender,the positive rate of HBeAg and HBV DNA between two groups (x2 =1.662,0.037 and 0.944,respectively; all P＞0.05).In inflammation activity comparison,the result of liver biopsy showed that 48.39 ％ (15/31) were classified as G0-G1 and 51.61％(16/31) as G2-G4 in MS group,and those in non MS group were 49.21％(31/63) and 50.79％(32/63),respectively.No statistical significance was reached (x2 =0.006,P＞0.05).In fibrosis stage comparison,patients in MS group classifies as S0-S1 and S2-S4 were 32.26％ (10/31) and 67.74％(21/31),respectively,and those in non-MS group were 60.32％ (38/63)and 39.68％ (25/63),respectively.The liver fibrosis in MS group was significantly more severe than that in non-MS group (x2 =6.546,P＜0.05).Conclusions The CHB patients with MS have higher BMI,WHR,FBG,TG and TC.The presence of MS may promote the progress of liver fibrosis in CHB patients.

OBJECTIVE: To evaluate the efficacy and safety of Danning Tablet (DNT) in patients with non-alcoholic fatty liver disease (NAFLD) of damp-heat syndrome type. METHODS: A multicenter, randomized, double-blinded and positive drug parallel controlled trial was performed. One hundred and thirty-five patients were enrolled into the study and divided into two groups: DNT-treated group (n=102) and ursodeoxycholic acid (UDCA)-treated group (n=33). Body mass index (BMI), principal symptoms, liver function, blood lipids, iconographic, and compositional parameters were measured before and after treatment, respectively. RESULTS: In the two groups, BMI, distress in hepatic region, fatigue, anorexia, liver function, blood lipids and iconographic parameters were significantly improved, and the improvements of BMI, distress in hepatic region were better in DNT-treated group than in UDCA-treated group. The histological study also showed that DNT had positive effect in treatment of NAFLD. CONCLUSION: DNT is an effective drug to treat patients with NAFLD of damp-heat syndrome type and is more effective than UDCA.

Metabolic associated fatty liver disease (MAFLD) is a hotspot in the field of fatty liver disease at present and it has become the most common chronic liver disease around the world. It is predicted that the incidence rates of MAFLD and related liver cirrhosis will continue to grow in the next 20 years and that they will become new global health issues. Acute-on-chronic liver failure (ACLF) is defined as a clinical syndrome of acute or subacute liver function decompensation within a short period of time in the presence of existing chronic liver diseases, with the main clinical manifestations of ascites, jaundice, coagulation disorder, and hepatic encephalopathy. Based on the existing data, this article discusses the epidemiology, pathogenesis, treatment and management strategies, and future prospects of MAFLD-ACLF.

OBJECTIVETo evaluate the controlled attenuation parameter (CAP) assessment of fatty liver and choose a cut-off value of hepatic steatosis more than 5%.

METHODSConsecutive patients, 18 years or older, who had undergone percutaneous liver biopsy and CAP measurement were recruited from five liver healthcare centers in China. All enrollees were categorized as hepatic steatosis grade S0 (<5%) or S1 (5%). An M-probe equipped FibroScan 502 was used to capture CAP values. Receiver operating characteristic (ROC) curves were plotted, and the areas under (AU) the curves were calculated to determine the diagnostic efficacy. The CAP cut-off values at the optimal thresholds were defined by maximum Youden indices; sensitivity and specificity were also calculated.

RESULTSA total of 332 patients were enrolled in the study, including 67 patients with non-alcoholic fatty liver disease (NAFLD) and 265 with chronic hepatitis B (CHB) viru: infection. The median age (inter quartile range, IQR) of the study cohort was 39.0 (32.0-50.5) years-old. There were 46 males (68.7%) in the NAFLD group, with a median age of 37.0 (28.0-45.0) years-old, and 182 males (68.7%) in the CHB group; the differences between the two groups in median age and male: female ratio did not reach statistical significance. Multivariate linear regression analysis identified steatosis grade and body mass index (BMI) as independently associated with CAP. The median (IQR) CAP values among patients with S0 and S1 grade steatosis were 215.0 (190.0-241.0) dB/m and 294.0 (255.0-325.5) dB/m (P<0.001), respectively. For all patients, when BMI was <25 kg/m2, the ability of the AUROC of the CAP to discriminate hepatic steatosis more than or equal to 5% was 0.853, and the optimal cut-off value was 244.5 dB/m; however, when BMI≥25 kg/m2, the AUROC was 0.835 and the optimal cut-off value 269.5 dB/m.

CONCLUSIONCAP can identify hepatic steatosis more than or equal to 5% and is applicable for the diagnosis of fatty liver if it is adjusted for BMI.

Adult ; Area Under Curve ; Bile ; Biopsy ; Body Mass Index ; China ; Fatty Liver ; Female ; Hepatitis B, Chronic ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Tissue Extracts

BACKGROUND: Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH. METHODS: Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 with a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL). RESULTS: A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69-1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension ( P  < 0.001, P  = 0.026 and P  = 0.049, respectively). CK-18 M30 levels were positively associated with histological NAS in most centers. The area under the receiver operating characteristics (AUROC) for NASH was 0.750 (95% confidence intervals: 0.714-0.787), and CK-18 M30 at Youden's index maximum was 275.7 U/L. Both sensitivity (55% [52%-59%]) and positive predictive value (59%) were not ideal. CONCLUSION This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH.
Humans ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Keratin-18 ; Biomarkers ; Biopsy ; Hepatocytes/pathology* ; Apoptosis ; Liver/pathology*