ObjectiveTo investigate the influence of different diagnostic criteria on the short-term prognosis of patients with acute-on-chronic liver failure （ACLF）. MethodsA total of 115 ACLF patients who were hospitalized in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from January 2018 to January 2022 were enrolled， and all patients received internal medical treatment combined with artificial liver therapy. According to the guidelines， the patients were divided into CMA guideline group （Diagnostic and treatment guidelines for liver failure by Chinese Medical Association）（n=100）， APASL guideline group （Consensus statements of Asian Pacific Association for the Study of the Liver）（n=94）， and EASL guideline group （Criteria proposed by European Association for the Study of the Liver）（n=36）. The above three guidelines were compared in terms of 90-day mortality rate. A one-way analysis of variance was used for comprision of continuous date between groups； the chi-square test was used for comprision of categorical date between groups. The receiver operating characteristic （ROC） curve of related variables. ResultsThe 90-day mortality rate was 50.0% in the CMA guideline group， 51.1% in the APASL guideline group， and 77.8% in the EASL guideline group， and the EASL guideline group had a significantly higher 90-day mortality rate than the CMA guideline group （χ²=8.351， P=0.004） and the APASL guideline group （χ²=7.650， P=0.006）. EASL guideline had a sensitivity of 22.2% and a specificity of 92.3% in predicting the risk of short-term mortality， with an area under the ROC curve was 0.576. ConclusionACLF patients who meet EASL guideline tend to have a worse short-term prognosis， and this guideline may help to identify patients at a relatively high risk of short-term death.

ObjectiveTo investigate the association between metabolic associated fatty liver disease （MAFLD） and carotid atherosclerotic plaque. MethodsA total of 1 107 patients who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from July， 2014 to December， 2022 were enrolled， and all patients underwent abdominal ultrasound and CT angiography of the head and neck arteries. Baseline data and clinical diagnosis were collected， and the patients were divided into MAFLD group with 499 patients and non-MAFLD group with 608 patients based on medical history， clinical tests， and imaging findings. According to the CT value， carotid plaques were classified into calcified plaques， non-calcified plaques， and mixed plaques. According to the NASCET criteria， carotid stenosis was categorized as normal vessel， slight stenosis， mild stenosis， moderate stenosis， and severe stenosis/occlusion. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for carotid atherosclerosis. ResultsCompared with the non-MAFLD group， the MAFLD group had a significantly higher proportion of patients with calcified plaques （74.3% vs 63.3%， P<0.05）， non-calcified plaques （27.1% vs 17.1%， P<0.05）， or mixed plaques （27.3% vs 20.7%， P<0.05）， as well as a significantly higher proportion of patients with mild stenosis （50.9% vs 44.9%， P<0.05）， moderate stenosis （14.6% vs 8.4%， P<0.05）， or severe stenosis/occlusion （6.6% vs 3.5%， P<0.05）. The univariate logistic regression analysis showed that MAFLD was a risk factor for calcified carotid plaques， non-calcified plaques， and mixed plaques， and it was also a risk factor for mild stenosis， moderate stenosis， and severe stenosis/occlusion of the carotid artery （all P<0.05）. After adjustment for confounding factors， the multivariate Logistic regression analysis showed that MAFLD was an independent risk factor for calcified plaque， non-calcified plaque， mixed plaque， and moderate stenosis of the carotid arteries （all P<0.05）. ConclusionMAFLD is an independent risk factor for moderate stenosis， calcified plaques， non-calcified plaques， and mixed plaques of the carotid arteries.