Objective To discuss on the relationship among innovation,scientific nature and ethics in medical articles,in order to improve the academic quality of manuscripts.Methods Take Chinese Journal of Radiological Medicine and Protection as an example,innovation was emphasized in the field of radiation diagnosis and treatment,while the cases lack of innovation were pointed.However,the lessons from many papers showed that those papers only with innovation would be rejected because of defect in scientific nature and ethics.Results Innovation is the soul of the paper,and the scientific and ethical nature is the foundation and premise of innovation.Conclusions While the innovation is emphasized,the scientific nature and ethics of the thesis should be not ignored.These three aspects are integral.

Objective To investigate the relation between apolipoproteinC3 (-482C>T ) polymorphism and nonalcoholic fatty liver disease (NAFLD) and its clinical characteristics in the Han Chinese population. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and polyacrylamide gel electrophoresis(PAGE)were used to analyse the genotype of the apolipoproteinC3 (-482C>T) variants. Results No relation between the apolipopreoteinC3 (-482C>T) polymorphism and NAFLD was found. However, NAFLD patients carrying T allele were more susceptible to insulin resistant (IR), hypertension, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol (HDL) than homozygote CC genotype. Conclusion There was no relation between the apolipopreoteinC3 (-482C>T)polymorphism and NAFLD in Han Chinese population, but T-carriers were more susceptible to metabolic disorder.

Aims The purpose of this study is to investigate thediagnostic value of SWEfor fibrosis in patients with CHBand the factorsinfluencing the accuracy. Methods From July 2013 to October 2015, 261 patients with CHB were recruited from the First Affiliated Hospital of Sun Yat-sen University.All patients received SWE, anthropometry measurement, blood cell count, liver function test and virological indicators measurement. Liver fibrosis was staged from F0 to F4 by METAVIR scorebased onliver biopsy results of 133 CHB patients , while 128 patients were diagnosed as decompensated cirrhosis. Diagnostic accuracyof SWE were evaluated by Receiver Operating Characteristic Curve (ROC) using liver hepatic pathology and decompensated cirrhosis as gold standards. Logistic model was used to find out confounding factors that influence the accuracy of SWE. Results The Area Under ROC (AUC) for liver stiffness measurement with SWE were 0.891, 0.932 and 0.910 for the diagnosis of significant fibrosis (≥ F2), advanced fibrosis (≥F3) and cirrhosis (F4), respectively. A multifactor logistic regression combined modelwas built and showed that hepatic steatosis will decrease the accuracy of SWE. Conclusion SWE could be a valuable method for the noninvasive liver fibrosis assessment. The accuracy of SWE may be influenced by hepatic steatosis.

Objective To observe the therapeutic effects of end-to-side and side-to-side portal vein-hepatic artery shunts (P-H shunt) in pigs with liver cirrhosis and portal hypertension.Methods There were 15 pigs in each group (control and experimental),and the P-H shunt was made in each animal to observe the process of blood flow into the liver and the reduction of portal vein blood pressure.Results The portal vein pressures before the P-H shunt of pigs in the control and experimental group were (20.51±0.74) cm H2O (1 cm H2O=0.098 kPa) and (30.82±2.53) cm H2O respectively (P＜0.05).Portal vein pressures 30 days after the P-H shunt were(19.75±0.84) cm H2O and (20.84± 1.36) cm H2 O respectively (P＞0.05).The portal vein pressure differences of pigs in the control and experimental group before P-H shunt were (7.20±0.34) cm H2O and (17.34±0.62) cm H2O respectively (P＜0.05).Pressures differences 30 days after the P-H shunt were (6.40±0.21) cm H2O and (7.84 ± 1.32) cm H2O respectively (P＜0.05).Splenic vein injection of methylene blue after the P-H shunt operation stained the liver well.No necrosis and hepatic encephalopathy occurred for 30 days after the P-H shunt,and the splenomegaly gradually returned to normal.Liver function was most affected after the operation and other biochemical markers were least affected.Conclusions The P-H shunt changed the channel of blood flow into the liver,the portal hemodynamic was not affected,and a new balanced mechanism was established to maintain the portal hemodynamic stability.However,further treatment was needed for liver function recovery.

Writing and publishing scientific papers is a very important part of the research work.The quality of the thesis is also an important indicator to measure the achievements of scientific research workers.The quality of the thesis mainly includes the academic quality and the writing quality,but some of the researchers are mostly proficient in practice and neglect the writing,so there are still many writing problems in the manuscript.By reading the submission specification,this article summarizes the common problems in the writing,so as to provide the reference value for the readers.

Objective To observe changes of hepatic hemodynamics and hepatic functional reserve after splenectomy and periesophagogastric devascularization. Methods From July 2006 to August 2007, thirty patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy and periesophagogastric devascuiarization. The PVPG (portal venous pressure gradient) was measured by inductor continually during operation. The HAF (hepatic artery flow), PVF (portal venours flow) and hepatic arterial RI(resistant index) were measured with Doppler sonography. The EHBF(effective hepatic blood flow) and ICGR15 (indocyaninegreen retention rate at 15 minutes) were obtained respectively by indocyaninegreen clearance test before and after the operation. Results PVPG after laparotomy (19±4) mm Hg, ligating the splenic artery(14±4) mm Hg, splenectomy(14±3)mm Hg and periesophagogastric devascularization (12±4) mm Hg showed a tendency to decrease progressively. The PVF decreased [from (42±14) ml/s to (16±8) ml/s] and HAF increased in compensation after operation. The EHBF increased [from (0.48±0.10) L/min to (0.56±0.10) L/min], and the ICGR15 decreased (from 23%±8% to 18%±4%) postoperatively. Conclusion After splenectomy and periesophagogastric devascularization, the hepatic functional reserve improves at least in a short term notwithstanding the decrease of PVPG and PVF.

Nonalcoholic fatty liver disease (NAFLD) has replaced viral hepatitis and become the most important chronic liver disease in the world. Abdominal ultrasound remains the main method for the diagnosis of NAFLD in China. The studies in China showed that in the last two decades, the prevalence rate of NAFLD was 13%-43% and tended to increase year by year, and the new cases accounted for about 4% each year, with a certain proportion of patients with non-obese NAFLD. There is a significant difference in prevalence rate between the populations from different regions, with a higher prevalence rate of NAFLD in the well-developed southeast coastal regions where people have a similar lifestyle to those in Western countries. Metabolic disorders, such as type 2 diabetes, obesity, hyperlipidemia, hyperuricemia, and hypertension, are risk factors for NAFLD. National-wide large-sample epidemiological investigation is still needed in China to help support the diagnosis, treatment, and prevention of NAFLD.

Abnormal uric acid metabolism is closely associated with the development and progression of nonalcoholic fatty liver disease (NAFLD). This article describes the relationship between uric acid and the prevalence and severity of NAFLD, and point out that uric acid metabolic disorders directly affect the development and progression of NAFLD through complicated pathways such as insulin resistance, oxidative stress, direct influence on the expression of lipid synthetase, and inflammatory response. Control of uric acid is expected to become one of the multimodality therapies for NAFLD.

Hepatorenal syndrome (HRS) is one of the common serious complications in patients with end-stage liver disease and has poor prognosis and high mortality, and in-depth studies on its pathogenesis will help to achieve precise prevention and treatment. Although the exact pathogenesis of HRS has not yet been fully elucidated, achievements have been made in the pathogenesis of HRS. The classic mechanism of the hypothesis of visceral vasodilation continues to be enriched and perfected, and new understandings have been gained for the role of systemic inflammation and intestinal bacterial translocation in pathogenesis. In addition, a new concept of cardiorenal syndrome is put forward for the involvement of cardiac dysfunction in HRS, and renal pathology has been questioned and challenged. This article reviews the research advances in the pathogenesis of HRS in recent years and related implications for clinical work.

Background: Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear. Methods: Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Results: There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals. Conclusion A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.