Zhonghua Gan Zang Bing Za Zhi [JOURNAL]
Sun
200 papers
[Focus on schistosomiasis cirrhosis: disease burden, pathogenic characteristics, and research frontiers].
He X, Zhao JP, Chen Q … +2 more , Su C, Chen XP
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528584 · Full text
Schistosomiasis cirrhosis (SAC), as the core pathological outcome of late-stage schistosomiasis, is an important challenge to global public health. Notably, there is still a significant disease burden, especially in the...
Schistosomiasis cirrhosis (SAC), as the core pathological outcome of late-stage schistosomiasis, is an important challenge to global public health. Notably, there is still a significant disease burden, especially in the traditional endemic areas, such as the Yangtze River Basin in China. SAC has unique pathogenic characteristics, including insect-derived molecular-driven disease, chronic inflammation dominated by Th2 immunity, delayed pathogenicity, noticeable symptoms of portal hypertension, and an absence of significant correlation with liver cancer. Therefore, future research should focus on the determinants of individual susceptibility to SAC onset, the core mechanism of liver lesion progression post-pathogen clearance, time nodes, and intervention methods. Additionally, finding the high-risk individuals, analyzing of pathological mechanisms, and optimizing intervention strategies will help in promoting the development of clinical prevention and control and translational research.
[Prioritize a multidisciplinary approach to the diagnosis and management of portal hypertension].
Zhang ZG, Chen XP
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528583 · Full text
Portal hypertension primarily arises from chronic liver disease, which seriously affects people's lives and health, and its treatment has always been considered complex and diverse. With the innovation of ideas and techn...
Portal hypertension primarily arises from chronic liver disease, which seriously affects people's lives and health, and its treatment has always been considered complex and diverse. With the innovation of ideas and technologies, its treatment model has transitioned from unidisciplinary to multidisciplinary collaborative diagnosis and treatment. The treatment of portal hypertension tends to be more individualized, standardized, and minimally invasive under the multidisciplinary diagnosis and treatment model. Furthermore, the greatest extent of therapeutic effect for portal hypertension can be optimized by multidisciplinary collaboration and selection of individualized diagnosis and treatment methods for different populations. Therefore, it is imperative to diagnose and treat portal hypertension propensity in a multidisciplinary collaboration.
[Assessment and management of malnutrition in patients with cirrhosis combined with hepatic encephalopathy].
Xu Y, Kang J, Wang XH … +2 more , Zhang L, Cai DC
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419377 · Full text
Hepatic encephalopathy and malnutrition due to hyperammonemia often interact with each other, forming a vicious circle in patients with cirrhosis. In addition, hepatic encephalopathy and malnutrition have a high incidenc...
Hepatic encephalopathy and malnutrition due to hyperammonemia often interact with each other, forming a vicious circle in patients with cirrhosis. In addition, hepatic encephalopathy and malnutrition have a high incidence in patients with cirrhosis, which seriously affects the quality of life and prognosis. Therefore, identifying whether malnutrition is present in patients with cirrhosis combined with hepatic encephalopathy is crucial for providing appropriate interventions.This article reviews the pathogenesis, nutritional assessment methods, and nutritional management of malnutrition in patients with liver cirrhosis combined with hepatic encephalopathy.
[Occurrence risk of extrahepatic liver tumor with hepatitis B virus infection].
Zhao DL, Wei L
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419376 · Full text
Hepatitis B virus (HBV) infection is a global public health problem, which mainly causes a series of liver diseases such as hepatitis, liver cirrhosis, and hepatocellular carcinoma. However, recent years' studies have sh...
Hepatitis B virus (HBV) infection is a global public health problem, which mainly causes a series of liver diseases such as hepatitis, liver cirrhosis, and hepatocellular carcinoma. However, recent years' studies have shown that the occurrence of multiple extrahepatic malignancies may also be associated with HBV infection. For example, studies have found that patients with HBV infection have a significantly higher risk of developing digestive system tumors such as gastric cancer, colorectal cancer, and pancreatic cancer, as well as an increased risk of other systemic malignancies such as lymphoma, leukemia, and oral cancer. Although the liver is the primary target organ of HBV, the presence of the virus in non-hepatic tissues suggests that it may play an impact in the development of other extrahepatic tumors. The findings of these associations have important implications for public health policies and cancer prevention strategies, emphasizing the need for multisystem tumor screening in patients with HBV infection.
[Research and application progress for liver xenotransplantation].
Xie Y, Wang D, Jiang WT
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419375 · Full text
Liver transplantation is an effective treatment method for many end-stage liver diseases; however, the shortage of donor livers is one of the main obstacles affecting its development. Thus, xenotransplantation is expecte...
Liver transplantation is an effective treatment method for many end-stage liver diseases; however, the shortage of donor livers is one of the main obstacles affecting its development. Thus, xenotransplantation is expected to be a potential way to solve the shortage of organs. Gene editing technology has been used to improve animal genes so they can enhance their physiological compatibility with humans, and new immunosuppressive drugs are combined to reduce the occurrence of rejection so as to prolong the survival time of grafts. Liver xenotransplantation is more prominent than that of the heart or kidney transplants, and the related molecular mechanisms, such as xenogeneic rejection and coagulation disorders after surgery, need to be further studied due to the more complex structure and physiological functions of the liver. This paper reviews the historical development, current main problems, and clinical applications based on the latest research progress at home and abroad, with aim to improve clinicians' understanding of liver xenotransplantation.
[A case of congenital hepatic fibrosis accompanied with multiple system abnormalities].
Liu TF, Kong Y, Zhang LY … +1 more , Wang L
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419374 · Full text
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[A case of cavernous transformation of the portal vein treated with transjugular intrahepatic portosystemic shunt assisted by implementing cannulation of the superior mesenteric vein branch].
Zhang Y, Wu YF, Dong CB … +6 more , Li QM, Fan ZH, Yue ZD, Xu GZ, Wang DZ, Wang L
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419373 · Full text
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[Protective effect and mechanism of hyperbaric oxygen therapy on non-alcoholic fatty liver disease in mice].
Zhu HL, Chen L, Zhu WL … +8 more , Ding J, Jiang K, Tao H, Zhou J, Xuan J, Yang MF, Jiang MZ, Wang FY
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419372 · Full text
To investigate the curative effect and mechanism of hyperbaric oxygen therapy on nonalcoholic fatty liver disease in mice. Twenty-one 8-week-old male C57BL/6J mice were divided into three groups: control group (normal d...
To investigate the curative effect and mechanism of hyperbaric oxygen therapy on nonalcoholic fatty liver disease in mice. Twenty-one 8-week-old male C57BL/6J mice were divided into three groups: control group (normal diet), model group (high-fat and high-cholesterol diet), and hyperbaric oxygen group (high-fat and high-cholesterol diet + hyperbaric oxygen therapy), with seven mice in each group. The changes in body weight, serum liver enzymes, and blood lipids were compared after treatment between the three groups. Hematoxylin-eosin staining, Oil Red O staining, Sirius red staining, and F4/80 immunohistochemical staining were used to observe the pathological changes in liver tissues. RT-qPCR and Western blot methods were used to detect the expression levels of oxidative stress and inflammatory factors. One-way analysis of variance was used for comparison among the groups. Mice in the hyperbaric oxygen group had significantly improved liver histopathology. The serological levels of alanine aminotransferase, aspartate aminotransferase, and cholesterol were (77.50±13.59) U/L, (156.06±23.68) U/L, and (4.80±0.53) mmol/L, which were significantly lower than those in the model group [(109.43±16.88) U/L, (216.62±18.79) U/L, and (5.86±0.53) mmol/L, <0.05], and accompanied by lower levels of lipid deposition, macrophage infiltration, and fibrosis. In addition, compared with the model group, the expression of antioxidant stress protein nuclear transcription factor erythroid 2-related factor 2 [(0.30±0.06) and (2.16±1.21), <0.05] and heme oxygenase-1 [(0.48±0.19) and (1.01±0.18), <0.05] in liver tissue showed an upward trend following hyperbaric oxygen treatment, which was also validated at the transcriptional level (<0.05). Simultaneously, compared with the model group, the mRNA expressions of tumor necrosis factor-α [(2.60±0.71) and (0.66±0.15), <0.05], interleukin-1β [(2.41±1.01) and (0.78±0.23), <0.05], and interleukin-6 [(3.61±2.17) and (0.94±0.25), <0.05] in the liver tissue of mice in the hyperbaric oxygen group were decreased. The tumor necrosis factor-α protein level [(7.50±4.73) and (1.05±0.58), <0.05] and interleukin-1β [(1.65±0.35) and (1.02±0.02), <0.05] was reduced following hyperbaric oxygen treatment compared with those in the model group. Hyperbaric oxygen therapy can slow down the progression of nonalcoholic fatty liver disease by regulating the levels of oxidative stress and inflammation in the mice.
[Application value of an aMAP score in predicting the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy].
Gao YF, Liu ZZ, Ma LY … +2 more , Liu YX, Zhao CY
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419371 · Full text
To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy. The medical records of 508 CHB patients...
To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy. The medical records of 508 CHB patients who started receiving antiviral treatment in the Third Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from January 2001 to November 2021 were retrospectively analyzed. They were divided into low-, intermediate-, and high-risk groups according to the aMAP, AASL-HCC, PAGE-B, mPAGE-B, and CAMD scoring criteria. At the end of follow-up, they were divided into HCC (33 cases) and non-HCC group (475 cases) according to whether HCC occurred. The occurrence risk factors for HCC were analyzed by univariate and multivariate Cox regression analysis. The cumulative incidence of HCC at different time points was estimated by the Kaplan-Meier method and compared by the log-rank method. The HCC prediction performance of the aMAP score was evaluated by the receiver operating characteristic (ROC) curve and compared with other scores. The Mann-Whitney test, or Fisher test, was used to compare the non-normally distributed quantitative data between groups. The test was used to compare the count data between groups. A total of 33 cases (6.5%) developed HCC during the median follow-up period of 8.7 (6.8-8.9) years. Multivariate analysis showed that age＞50 years (=2.804, 95% 1.332-5.902; =0.007) and liver cirrhosis (=11.808, 95% 4.360-31.976; <0.001) were independent risk factors for HCC occurrence. The cumulative incidence of HCC defined by the aMAP score at 3 and 5 years was significantly lower in the low-risk group (0, 0) than that in the intermediate-risk group (4.4%, 5.4%) and the high-risk group (10.8%, 18.5%), <0.001. The aMAP score performed similarly to the AASL-HCC score, mPAGE-B score, and CAMD score [area under the ROC curve (AUC) was 0.863, 0.900, 0.851, and 0.886, respectively], with ＞0.05 in terms of the 3-year HCC prediction performance; and was equally superior with the PAGE-B score (AUC was 0.732), with <0.05. The aMAP score was not worse than the AASL-HCC score and CAMD score (AUC was 0.890, 0.894, and 0.882, respectively), with ＞0.05 in terms of the 5-year HCC prediction performance; however, it was significantly superior to the PAGE-B score and mPAGE-B score (AUC was 0.795 and 0.875, respectively), with <0.05. In addition, the AUC of the aMAP score for predicting HCC occurrence at baseline, 1 year, 2 years, and 3 years of antiviral treatment was＞0.9. The aMAP score can accurately assess the risk of HCC in CHB patients receiving antiviral therapy.
[Comparison of the efficacy of anatomical resection versus hepatic parenchymal preservation preference in patients with solitary small hepatocellular carcinoma and cirrhosis: a multicenter retrospective study].
Huang LM, Yang Y, Li YT … +12 more , Wang XM, Zheng SM, Lu Q, Lai ZS, Lai YP, Ding ZR, Lyu JH, Zhang JC, Qiu XF, Zhou WP, Lin KY, Zeng YY
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419370 · Full text
To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical...
To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR). The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias. The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% . 41.9%,<0.05; OS rate: 64.4% . 62.9%, >0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% . 37.2%,<0.001; OS rate: 69.0% . 57.3%, <0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% . 45.1%,>0.05; OS rate: 64.0% . 64.3%, >0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference (<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.
[Study on the value of abnormal prothrombin in the diagnosis of HBV-related hepatocellular carcinoma].
Zhang JM, Zhao SX, Liu LD … +6 more , Han F, Ren WG, Wu XQ, Sun MJ, Song JJ, Nan YM
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419369 · Full text
To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (H...
To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve. The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group (<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% . 59.89%,<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% . 64.29%,<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% (<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models (<0.05). DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.
[Guidelines for the diagnosis and treatment of acute-on-chronic liver failure (2025 version)].
Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association, Nutrition and Regeneration in End-Stage Liver Disease Group, Chinese Society of Hepatology, Chinese Medical Association
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419368 · Full text
Acute-on-chronic liver failure (ACLF) is one of the leading causes of mortality among patients with chronic liver disease. Potentially reversible, ACLF requires precise clinical classification to facilitate accurate diag...
Acute-on-chronic liver failure (ACLF) is one of the leading causes of mortality among patients with chronic liver disease. Potentially reversible, ACLF requires precise clinical classification to facilitate accurate diagnosis, targeted treatment, and comprehensive management. Based on the latest research findings and clinical evidence, the Severe Liver Disease and Artificial Liver Group and the Nutrition and Regeneration in End-Stage Liver Disease Group, Chinese Society of Hepatology, Chinese Medical Association, together with multidisciplinary experts, have jointly compiled China's first guideline for the diagnosis and treatment of ACLF. The guideline aims to provide guidance for the diagnosis, treatment, and individualized management of patients with ACLF in clinical practice.
[Diagnosis and differential diagnosis of small hepatocellular carcinoma in the context of cirrhosis].
Chen L, Lu SW, Xiang TD … +2 more , Yu YX, Zhao WF
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419367 · Full text
In China, most patients with hepatocellular carcinoma (HCC) have progressed to the middle and advanced stages when they are diagnosed, so early-stage diagnosis is a significant key to improving the prognosis. Tumor diame...
In China, most patients with hepatocellular carcinoma (HCC) have progressed to the middle and advanced stages when they are diagnosed, so early-stage diagnosis is a significant key to improving the prognosis. Tumor diameter significantly correlates with the prognosis of patients with small hepatocellular carcinoma (sHCC), which is further classified as early-stage HCC (eHCC) and advanced HCC (pHCC). The "fast in and fast out" enhancement pattern is a typical feature of liver cancer imaging (CECT/CEMRI/CEUS); yet, eHCC with a diameter of <2 cm frequently exhibits hypovascularity. Hepatocyte-specific enhanced MRI (EOB-MRI) displays a unique hepatobiliary-specific phase (HBP) hypointensity, along with atypical manifestations such as lipid-containing nodules, T2 hyperintensity, and restricted diffusion. HBP is a functional radiographic imaging feature for cancerous nodules in cirrhosis. EOB-MRI can significantly increase the hypovascularity detection rate of eHCC in conjunction with serologic markers like alpha-fetoprotein. With a focus on the dynamic changes in hypovascular hypointense nodules in HBP (including diameter size, APHE, DWI, and other parameters), it is recommended that high-risk cirrhotic cohorts undergo routine monitoring (EOB-MRI follow-up every three months) to diagnose early-stage eHCC, based on the existing evidence-based medicine. This recommendation in clinical practice guidelines provides a crucial strategy that can markedly enhance patients' five-year survival rates.
[Bile acid metabolism and the occurrence and development of primary liver cancer].
Han J, Lu YY
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419366 · Full text
Primary liver cancer is a common malignant tumor with a high mortality rate. Therefore, early-stage diagnosis and screening are of enormous significance. In recent years, studies have found that bile acids play a key rol...
Primary liver cancer is a common malignant tumor with a high mortality rate. Therefore, early-stage diagnosis and screening are of enormous significance. In recent years, studies have found that bile acids play a key role in the occurrence and development of liver cancer and are expected to become novel diagnostic markers and intervention targets. This article reviews the abnormal changes in bile acid metabolism during the occurrence and development of liver cancer, including the changes in bile acid composition and levels in liver tissue, plasma, feces, and urine, as well as the changes in enzymes related to bile acid metabolism. Furthermore, it expounds the mechanism by which bile acids affect the occurrence of liver cancer, such as participating in multiple signaling pathways to initiate the occurrence and affecting the immune microenvironment, and discusses the potential of bile acids as diagnostic markers for prevention and treatment strategies targeting bile acid metabolism. Bile acids have potential value in the diagnosis and prevention of liver cancer; yet, there are still challenges. In the future, it is necessary to build a large-scale follow-up cohort and biobank, innovate technology for detecting bile acids, and integrate it with multi-omics so as to improve the accuracy of early-stage diagnosis and prevention and treatment of liver cancer.
[New progress in the technology of non-invasive diagnosis for small hepatocellular carcinoma].
Zhao SX, Zhang ZA, Nan YM
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419365 · Full text
The diagnosis of small liver cancer is crucial to improving the survival rate of patients. However, traditional diagnostic methods are highly invasive, so the development of non-invasive diagnostic techniques is particul...
The diagnosis of small liver cancer is crucial to improving the survival rate of patients. However, traditional diagnostic methods are highly invasive, so the development of non-invasive diagnostic techniques is particularly important. In recent years, non-invasive diagnostic techniques have shown good prospects in the early-stage detection of liver cancer. Therefore, current research focuses on biomarkers, imaging technologies, and artificial intelligence applications. This article aims to review the latest advances in non-invasive diagnostic technologies, discuss their advantages and challenges in clinical application, and look forward to future research directions so as to provide a reference for further improving the diagnosis rate of small liver cancer.
[Research progress and clinical application in the early diagnosis and treatment technology of hepatocellular carcinoma].
Nan YM, Zhao SX, Liu LD
Zhonghua Gan Zang Bing Za Zhi · 2025 Apr · PMID 40419364 · Full text
Hepatocellular carcinoma (HCC) is a malignant tumor that endangers human health globally. Diagnosis and treatment at an early stage are the keys to receiving radical treatment and improving survival rates. A clinical sol...
Hepatocellular carcinoma (HCC) is a malignant tumor that endangers human health globally. Diagnosis and treatment at an early stage are the keys to receiving radical treatment and improving survival rates. A clinical solution for HCC diagnosis at an early stage is the combination of serum markers and imaging technology. A basic strategy for screening and diagnosis at an early stage with a favorable cost-effectiveness ratio is the alpha-fetoprotein combined with abdominal ultrasound. The HCC diagnostic rate at an early stage can be improved with AFP combined with des-gamma carboxy prothrombin, aldehyde-keto reductase 1B10, liquid biopsy, and imaging tests. The radical treatment for early-stage HCC has entered a new era of diversification. The effectiveness of radical treatment can assist in improving the combined use of small molecule targeted medications and immune checkpoint inhibitors. The prevention and control of liver cancer will move toward a new stage of greater precision and efficiency with the advancement of biotechnology and policy promotion.
[The evaluation value of mNUTRIC and NRS-2002 scores in assessing nutritional status and clinical outcomes in patients with end-stage liver disease].
Yang JY, Mao XR, Yang ZH … +3 more , Zhou XJ, Gou X, Li JF
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40296439 · Full text
Comparative analysis of the mNUTRIC and NRS-2002 scores for evaluating nutritional risk and predicting clinical outcomes in end stage liver disease patients. A retrospective cohort study method was used to screen 114 ca...
Comparative analysis of the mNUTRIC and NRS-2002 scores for evaluating nutritional risk and predicting clinical outcomes in end stage liver disease patients. A retrospective cohort study method was used to screen 114 cases with end-stage liver disease admitted to the intensive care unit (ICU) of the First Hospital of Lanzhou University from December 1, 2016 to March 31, 2021 according to the inclusion and exclusion criteria. The patient's demographic data, blood routine, blood biochemical indexes, coagulation function indexes, arterial blood gas analysis and imaging examination data were collected. The mNUTRIC score, NRS-2002 score, sequential organ failure (SOFA) score, model for end-stage liver disease (MELD) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Child-Pugh grade, and clinical outcomes at 28 and 90 days at 24 h post-ICU admission were collected. The differences in clinical indicators between the mNUTRIC high group (≥5 points) and the low group, and the NRS-2002 high group (≥3 points) and the low group were compared. Spearman correlation analysis was used to explore the correlation between the mNUTRIC score and NRS-2002 score, clinical indicators, and 28 and 90-day mortality rates. Multivariate logistic regression analysis was used to determine the risk factors associated with 28-day and 90-day mortality in patients. The value of mNUTRIC score and NRS-2002 score in assessing the clinical outcomes of patients with end-stage liver disease was explored by receiver operating characteristic (ROC) curve. The clinical indicators related to nutritional status of patients were worse in the high-mNUTRIC group than those in the low-mNUTRIC group, and the 28-day and 90-day mortality rates were significantly higher than those in the low-mNUTRIC group [89.0%(65/73) vs. 29.2%(12/41), 97.2%(71/73) vs. 39.0%(16/41), <0.001]. There was no statistically significant difference in the incidence rate of hepatic encephalopathy, esophageal variceal bleeding, and ascites between the high and low mNUTRIC group. The clinical indicators related to nutritional status were worse in the high-NRS-2002 group than those in the low-NRS-2002 group of patients, and the 28-day and 90-day mortality rates were significantly higher than those in the low-group [73.0%(73/100) vs. 4/14, 81.0%(81/100) vs. 6/14, =0.008, 0.004]. The NRS-2002 high-score group did not differ significantly from the low-score group in terms of hepatic encephalopathy, esophagogastric variceal bleeding, or ascites prevalence. Patient's age, white blood cell count (WBC), urea nitrogen (BUN), creatinine (UREA), uric acid (UA), total cholesterol (TG), Child-Pugh, MELD, SOFA, APACHE Ⅱscores were significantly positively correlated with the mNUTRIC score. Conversely, albumin (Alb) and Glasgow Coma Scale (GCS) were significantly negatively correlated. Patient's age, WBC, CREA, BUN, UREA, UA, Child-Pugh, MELD, SOFA, APACHE Ⅱwere significantly positively correlated with the NRS-2002 score.Conversely, albumin (Alb) and Glasgow Coma Scale (GCS) were significantly negatively correlated (<0.05). The 28-day and 90-day mortality rates of patients increased with the increase in the mNUTRIC scores. The mNUTRIC score was an independent predictor of death within 28 and 90 days in patients with end-stage liver disease. The area under the curve (AUC) of mNUTRIC for predicting patient death at 28 days was 0.864 (95%: 0.794-0.934). The AUC of NRS-2002 for predicting patient death at 28 days was 0.683 (95%: 0.573-0.792). The AUC of the two indicators combined for predicting patient death at 28 days was 0.868 (95%: 0.799-0.936). The AUC of mNUTRIC for predicting patient death at 90 days was 0.915 (95%: 0.861-0.969). The AUC of NRS-2002 for predicting patient death at 90 days was 0.715 (95%: 0.599-0.832). The AUC of the two indicators combined for predicting patient death at 90 days was 0.922 (95%: 0.871-0.972). mNUTRIC score and NRS-2002 score can better evaluate the nutritional status in patients with end-stage liver disease. The mNUTRIC score is a good predictor of 28-day and 90-day mortality in patients with end-stage liver disease, and its application value efficacy is enhanced when combined with NRS-2002.
[Current status of research on the impairment of natural killer cell function caused by hepatitis B virus infection].
Zhu XY, Zhou YF, Zhu SG
Zhonghua Gan Zang Bing Za Zhi · 2025 Mar · PMID 40274557 · Full text
Hepatitis B is a global health problem caused by hepatitis B virus (HBV) infection, with approximately 240 million people worldwide being hepatitis B surface antigen positive. However, existing antiviral therapies can on...
Hepatitis B is a global health problem caused by hepatitis B virus (HBV) infection, with approximately 240 million people worldwide being hepatitis B surface antigen positive. However, existing antiviral therapies can only control HBV replication and cannot eliminate it, thereby seriously affecting the disease's prognosis. Immunotherapy has received widespread attention in recent years due to its long-lasting effects and safety profile. As one of the innate immune cells, natural killer cells play an important role in targeting HBV-infected cells and completely eliminating HBV infection. Natural killer cells can not only directly recognize and kill virus-infected cells but also regulate adaptive immune responses by secreting the cytokine interferon gamma. This article aims to review the regulatory relationship between natural killer cells and HBV-infected cells, research progress of natural killer cell-based immunotherapy targeting HBV infection, and explore the impact of natural killer cells on the occurrence and development of hepatocellular carcinoma in order to provide some enlightenment for improved treatment of HBV infection.
[Interactions between common drug metabolism and precautions for drug usage in Gilbert syndrome].
Dacheng DC, Liang C, Zheng SJ
Zhonghua Gan Zang Bing Za Zhi · 2025 Mar · PMID 40274556 · Full text
Gilbert's syndrome is a type of hereditary disease caused by mutations in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene, which leads to decreased UGT1A1 activity. Clinically, it is mainly characterize...
Gilbert's syndrome is a type of hereditary disease caused by mutations in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene, which leads to decreased UGT1A1 activity. Clinically, it is mainly characterized by increased unconjugated bilirubin and is often considered a benign disease. The incidence rate of Gilbert's syndrome is as high as 5%-10% in the population, and its interaction with commonly used clinical drugs deserves attention. On the one hand, some drugs can enhance or reduce UGT1A1 activity, causing bilirubin levels to decrease or increase. On the other hand, the decrease of UGT1A1 activity can also change part of drug metabolism, increase or reduce drug efficacy, and may cause adverse reactions and even endanger the patient's life in severe conditions. This article summarizes the interactions between common drug metabolism and precautions for drug usage in Gilbert syndrome.
[Are antibiotics immunomodulators? An attempt to use vancomycin in the treatment of primary sclerosing cholangitis].
Guo LP, Wang WR, Wang BM … +1 more , Zhou L
Zhonghua Gan Zang Bing Za Zhi · 2025 Mar · PMID 40274555 · Full text
Primary sclerosing cholangitis (PSC) is a type of chronic idiopathic liver disease characterized by bile duct inflammation and concentric fibrosis. Currently, no drug therapy can change the natural progression of PSC. Th...
Primary sclerosing cholangitis (PSC) is a type of chronic idiopathic liver disease characterized by bile duct inflammation and concentric fibrosis. Currently, no drug therapy can change the natural progression of PSC. The mechanism by which PSC is accompanied by the occurrence of inflammatory bowel disease (IBD) is still unclear. Oral antibiotic therapy with vancomycin being the most widely used has been shown to be effective for PSC combined with IBD. This paper analyzes case reports and clinical studies on the use of vancomycin in PSC, with the aim of providing a reference for clinical therapy and in-depth exploration of novel therapeutic directions.
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