Chen XY, Yu ZQ, Bai XY
… +4 more, Ruan GC, Guo MY, Han W, Yang H
Zhonghua Gan Zang Bing Za Zhi
· 2026 Feb · PMID 41795972
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To reveal the role of dietary composition in the onset and prognosis of patients with liver cirrhosis by analyzing, exploring, and observing the correlational features between dietary composition and clinical indicators...To reveal the role of dietary composition in the onset and prognosis of patients with liver cirrhosis by analyzing, exploring, and observing the correlational features between dietary composition and clinical indicators and mortality. A cirrhosis population was obtained from the National Health and Nutrition Examination survey from 2001 to 2018. Patients with cirrhosis (155 cases) were matched with healthy controls (615 cases) in accordance with a 1:4 ratio. Data on 37 food patterns, clinical indicators such as personal medical history and laboratory tests, and the status and cause of death of patients were obtained from the database. Univariate and logistic regression analyses were used to identify influencing factors. Kaplan-Meier survival curves were used to examine the impact of specific dietary intake on patient mortality. Multivariate analysis revealed that patients with cirrhosis had higher daily alcohol consumption than healthy controls (=1.11, 95%: 1.03-1.19, <0.01), while there was no statistically significant difference in food intake (>0.05). Total starchy vegetable intake was lower in patients with cirrhosis than in controls (=0.38, 95%: 0.17-0.88, =0.02) among the subgroup of patients with cirrhosis who drank alcohol. Total starchy vegetable intake was higher in patients with cirrhosis than in controls (=1.55, 95%: 1.01-2.38, =0.04) among the subgroup of patients with cirrhosis who did not drink alcohol. Subgroup analysis by gender revealed that male patients with cirrhosis consumed less dark green vegetables (=0.24, 95%: 0.06-0.96, =0.04), while female patients consumed more meat (=1.28, 95%: 1.05-1.54, =0.01). Spearman analysis revealed no statistically significant correlation between any dietary composition and the aspartate aminotransferase-to-platelet ratio index and mortality. Excessive intake of starchy vegetables and meat and insufficient intake of dark green vegetables may be associated with the onset of cirrhosis in non-drinking female and male populations, respectively, suggesting the potential significance of dietary factors in the course of cirrhotic diseases.
Xia EZ, Zhang M, Li CX
… +6 more, Li B, Ma SY, Hu YN, Zheng XH, Han Y, Wang JB
Zhonghua Gan Zang Bing Za Zhi
· 2026 Feb · PMID 41795971
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To characterize the distribution of liver macrophage subsets in metabolic associated steatohepatitis (MASH) mouse models induced by methionine choline-deficient diet (MCD) and a high-fat, high-fructose, and high-choleste...To characterize the distribution of liver macrophage subsets in metabolic associated steatohepatitis (MASH) mouse models induced by methionine choline-deficient diet (MCD) and a high-fat, high-fructose, and high-cholesterol diet (HFFC), in order to provide a research basis for subsequent macrophage subset studies. MASH mouse models were induced by feeding an MCD and HFFC diet for four and sixteen weeks, respectively. Real-time fluorescence quantitative reverse transcription PCR (RT qPCR) was used to detect changes in liver inflammation and fat metabolism-related genes in MASH mice. Liver macrophages were isolated by perfusing and digesting mouse livers. Flow cytometry was used to analyze the subpopulations of liver macrophage subsets. Data between different groups was compared using -test or one-way analysis of variance. The MCD-fed diet led to the inhibition of liver fat synthesis in mice, while the HFFC-fed diet had increased liver fat synthesis in mice. However, both diets led to a decrease in embryonic Kupffer cells (EmKC) that were derived from the livers of mice. The proportion of EmKC in liver macrophages was significantly lower in the HFFC group (73.74%±7.96%) and the MCD group (39.93%±9.03%) than in the normal diet (ND) group (95.14%±1.09%). The proportion of mononuclear macrophages (MDM) in liver macrophages was significantly increased in the HFFC group (19.26%±6.94%) and the MCD group (52.38%±8.38%) compared with the ND group (2.46%±0.53%). The MCD diet led to a greater loss of EmKC and increased recruitment of monocytes. Monocyte-derived Kupffer cells (MoKC) were the main MDM subset in the livers of HFFC diet-fed mice, while lipid-associated macrophages (LAM) and their precursor CCR2+lipid-associated macrophages (C-LAM) were the main MDM subset in MCD diet-fed mice. The recruitment of MDM and the loss of liver EmKC can be induced by both MCD and HFFC diets; however, the composition of MDM subsets varies. The major MDM subset in the HFFC group was MoKC, while the primary MDM subsets in the MCD group were LAM and C-LAM.
Luo YL, Gao XL, Wang JZ
… +4 more, Xiao MZ, Tao JX, Ouyang QN, Xiang C
Zhonghua Gan Zang Bing Za Zhi
· 2026 Feb · PMID 41795970
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To explore the occurrence of risk factors, construct a nomogram, and evaluate its predictive value for progressive liver fibrosis (PLF) in patients with metabolic-associated fatty liver disease (MAFLD). The clinical dat...To explore the occurrence of risk factors, construct a nomogram, and evaluate its predictive value for progressive liver fibrosis (PLF) in patients with metabolic-associated fatty liver disease (MAFLD). The clinical data of 259 MAFLD cases who visited the Obesity Department of Hubei Provincial Hospital of Traditional Chinese Medicine from May 2022 to October 2023 was retrospectively analyzed. Patients were divided into the PLF and non-progressive liver fibrosis (NPLF) group based on whether their liver stiffness measurement (LSM) value detected by FibroTouch >12 kPa. Univariate analysis was used to screen influencing factors. The original dataset of influencing factors was reconstructed using the Synthetic Minority Over-sampling Technique (SMOTE) algorithm. LASSO-logistic regression was used to determine independent risk factors for progressive liver fibrosis in MAFLD patients based on the SMOTE algorithm. A nomogram was constructed. Receiver operating characteristic (ROC) curves, Hosmer-Lemeshow calibration curves, and decision curves were plotted to evaluate the nomogram performance. Univariate analysis showed statistically significant differences in terms of gender, smoking history, body mass index, visceral fat area, skeletal muscle content, basal metabolic rate, waist circumference, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin, homeostatic model assessment for insulin resistance index (HOMA-IR), ultrasound attenuation parameter (UAP), and stages of liver fatty degeneration (<0.05) between the PLF group and the NPLF group. LASSO-logistic regression showed that HDL-C, hs-CRP, HOMA-IR, and UAP were independent occurrence risk factors for progressive liver fibrosis in MAFLD (<0.05). The nomogram model constructed based on logistic regression results showed areas under the ROC curves of 0.893 (95% : 0.848-0.938), 0.802 (95% : 0.711-0.892), and 0.863 (95% : 0.815-0.911) in the SMOTE training, validation, and original datasets, respectively. The Hosmer-Lemeshow tests showed all >0.05. The calibration curves indicated substantial consistency between the model's predictions and actual results. Decision curve analysis showed that the model had high clinical benefit when the threshold probabilities were 0.02-0.87, 0.03-0.96, and 0.02-0.79, respectively. HDL-C, hs-CRP, HOMA-IR, and UAP levels are independent risk factors for progressive liver fibrosis. The nomogram model established on these grounds has high accuracy and can be used for early-stage identification and risk prediction of progressive liver fibrosis in patients with MAFLD.
Wang WL, Xu MM, Wu Y
… +3 more, You SL, Han T, Chen Y
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629083
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To compare and analyze the impact of key indicator dynamic change on the 90-day prognosis of patients who remain in a state of acute-on-chronic liver failure (ACLF) at 28 days so as to provide new evidence for individual...To compare and analyze the impact of key indicator dynamic change on the 90-day prognosis of patients who remain in a state of acute-on-chronic liver failure (ACLF) at 28 days so as to provide new evidence for individualized treatment. ACLF patients who visited Beijing You'an Hospital, affiliated with Capital Medical University; Tianjin Third Central Hospital; and the Fifth Medical Center of the Chinese PLA General Hospital between January 2015 and December 2023 were prospectively included. Follow-up was conducted until 90 days for patients who remained in an ACLF state at 28 days. The key clinical indicator dynamic changes were compared from baseline to 28 days, including total bilirubin (TBil) and international normalized ratio (INR) for their impact on 90-day prognosis. TBil trends were classified as recovery, improvement, and deterioration. INR trends were classified as improvement and deterioration. Patients of both groups were divided into survival and death (including liver transplantation) according to their 90-day outcomes. Continuous data were compared using independent t-tests or rank-sum tests. Categorical data were compared using tests. Kaplan-Meier survival analysis was used to compare survival curves among different patient groups. A total of 739 cases were included, of which 313 remained in an ACLF state at 28 days, with a 90-day survival rate of 66.1% (207/313), a liver transplantation rate of 5.1% (16/313), and a mortality rate of 28.8% (90/313). The proportion of INR deterioration was 30.9% (64/207) and 90.6% (96/106), and the improvement was 69.1% (143/207) and 9.4% (10/106) in the survival group and the death group (including liver transplantation), respectively. The proportion of TBil deterioration was 31.4% (65/207) and 71.7% (76/106) and the proportion of improvement 68.6% (142/207) and 28.3% (30/106), with statistically significant differences ( < 0.05). Univariate and multivariate Cox analyses indicated that 28-day INR deterioration [8.06 (4.07-15.95)] and TBil deterioration [3.03 (1.04-8.82)] were independent risk factors affecting 90-day mortality. The area under the curve (AUC) was higher in the INR trend than the TBil trend (0.80 vs. 0.71, < 0.05) for predicting 90-day mortality. INR and TBil deterioration are independent risk factors for 90-day mortality for patients who remain in an ACLF state at 28 days. However, the INR trend has a greater impact on the 90-day prognosis compared to the TBil trend. This finding provides new insights for prognostic assessment of ACLF patients, aiding individualized treatment achievement and guiding clinicians in developing rational diagnostic and therapeutic strategies.
Liu Y, Zhang F, Yin Q
… +5 more, Xiao JQ, Zhang M, Zhang W, Wang L, Zhuge YZ
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629082
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To assess the blood ammonia levels value for predicting survival following transjugular intrahepatic portosystemic shunt (TIPS) therapy in patients with cirrhosis. Data from 236 cirrhotic patients who underwent TIPS tre...To assess the blood ammonia levels value for predicting survival following transjugular intrahepatic portosystemic shunt (TIPS) therapy in patients with cirrhosis. Data from 236 cirrhotic patients who underwent TIPS treatment at Nanjing Drum Tower Hospital from March 2018 to January 2020 were retrospectively collected. Data included patients' blood routine, liver and kidney function, coagulation function tests, hepatic encephalopathy status, and etiology leading to TIPS treatment at the initial admission. The Child-Turcotte-Pugh (CTP) score and the Model for End-Stage Liver Disease (MELD) score were concurrently calculated for patients' liver function. Patients were grouped into a high AMM-ULN group and a low AMM-ULN group based on the criterion of 1.4 times the upper limit of normal for calibrated ammonia levels (AMM-ULN). Postoperative follow-up information such as rebleeding of the upper gastrointestinal tract, ascites, hepatic encephalopathy, and survival-related outcomes was collected for analysis. Measurement data that did not conform to a non-normal distribution were compared using the Mann-Whitney test. Categorical data were compared using the test between the groups. Kaplan-Meier survival curves were used to plot survival rate. Cox regression models were used for univariate and multivariate analysis. AMM-ULN, CTP score, and ascites were independent risk factors affecting the liver function in surviving patients with cirrhosis following TIPS (<0.05). The 3-year survival rates for the high and low AMM-ULN groups were 66.3% and 92.4%, respectively, showing a significant statistical difference (<0.001) in terms of survival rate. AMM-ULN was superior in terms of predicting 3-year survival rates (0.850 vs. 0.598, <0.05) compared to the CTP score and had no significant difference compared to the MELD score models in accordance with the receiver operating characteristic curves. AMM-ULN is an independent predictor for cirrhotic patients who have survived following TIPS and has certain advantages in terms of predicting survival rates.
Wang ZW, Dong Y, Ouyang WX
… +9 more, Cao LL, Pang L, Xu HM, Yan JG, Zhu Y, Xu Y, Fu JL, Wang FS, Zhang M
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629081
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To explore the antiviral efficacy and safety profile of nucleos(t)ide analogue (NA) mono-or combination therapy with interferon-α (IFN-α) in children 1-6 years old with hepatitis B e antigen (HBeAg)-positive chronic hepa...To explore the antiviral efficacy and safety profile of nucleos(t)ide analogue (NA) mono-or combination therapy with interferon-α (IFN-α) in children 1-6 years old with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). Seventy-eight children 1-6 years old with HBeAg-positive CHB from multiple centers from November 2020 to August 2023 were enrolled as research subjects and were divided into the NA group (=24) and the NA+IFN group (=54) according to the antiviral treatment regimen. Oral lamivudine or entecavir and interferon-α (IFN-α) or pegylated interferon-α (PEG-IFN-α) were administered to the NA and NA+IFN groups. The HBV DNA negativity rate, HBeAg negative seroconversion rate, and HBsAg clearance rate were compared at 48 weeks between the two groups, with further stratification by 1-3 and 4-6 years old for the aforementioned comparison. An independent samples -test or Mann-Whitney test was used for inter-group comparison of quantitative data. The test or Fisher's exact test was used for inter-group comparison of categorical data. The Benjamini-Hochberg false discovery rate (FDR) method was used for multiple comparison correction. The HBV DNA negativity rate [81.82% (27/33) vs. 41.18% (7/17), =0.004, =0.018] and HBsAg clearance rate [36.36% (12/33) vs. 0 (0/17), =0.004,=0.018] were higher in the NA+IFN group than in those in the NA group at 48 weeks among children 4-6 years old (=50), with statistically significant differences. However, there were no statistically significant differences in the HBV DNA negativity rate [57.14% (12/21) vs. 71.43% (5/7)], HBeAg negative seroconversion rate [47.62% (10/21) vs. 28.57% (2/7)], and HBsAg clearance rate [19.05%(4/21) vs. 28.57%(2/7)] for children 1-3 years old (=28) between the NA+IFN group and the NA group. The antiviral efficacy of the NA+IFN combination therapy group was superior to that of the NA monotherapy group at 48 weeks in children with CHB 4-6 years old. However, there was no statistically significant difference in the efficacy of the two antiviral regimens among young children 1-3 years old, hinting that NA therapy may be a priority for young children.
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629080
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To assist relevant clinicians specializing in liver diseases in making informed decisions regarding the diagnosis and treatment of hereditary hyperbilirubinemia, the Inherited and Metabolic Liver Disease Cooperative Grou...To assist relevant clinicians specializing in liver diseases in making informed decisions regarding the diagnosis and treatment of hereditary hyperbilirubinemia, the Inherited and Metabolic Liver Disease Cooperative Group of the Hepatology Branch of the Chinese Medical Association has formulated the "Expert consensus on the diagnosis and treatment of hereditary hyperbilirubinemia". This consensus highlights ten key points across aspects such as epidemiology, pathogenesis, clinical features, laboratory tests, diagnosis, treatment, and monitoring, providing an in-depth analysis to assist clinicians in conveniently grasping the relevant content.
Infectious Diseases Prevention and Control Branch, Chinese Preventive Medicine Association
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629079
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Liver nodules are one of the common and complex clinical conditions, with certain ones developing into malignant lesions, hence significantly affecting patient prognosis. The detection rate of liver nodules has significa...Liver nodules are one of the common and complex clinical conditions, with certain ones developing into malignant lesions, hence significantly affecting patient prognosis. The detection rate of liver nodules has significantly improved with advances in modern imaging technology; however, there is still a lack of unified guidance on their diagnosis, treatment, and management. The "Expert Consensus on the Diagnosis, Treatment, and Management of Liver Nodules (version 2026)" systematically summarizes and standardizes aspects of liver nodules, including definition, classification, screening, diagnosis, treatment, and follow-up, through multidisciplinary collaboration based on the latest domestic and international research findings and expert clinical experience. This article emphasizes the importance of multidimensional assessment for liver nodules, including quantity, size, liver imaging reports, classification in data management systems, and pathological type. The implementation of individualized screening in high-risk populations is recommended at least once every six months starting at age 40, while for those with liver cirrhosis, malignant liver nodules, or a family history of liver cancer, screening should begin at age 30. The diagnostic strategy integrates systematic medical history, physical examination, imaging, and the detection of multiple serum marker collections. The usage of scoring models such as aMAP, GALAD, and GAAD highlights the diagnostic value of liver pathology and advocates a multidisciplinary team approach for risk assessment. Treatment plans emphasize individualization and involve etiological treatment, surgical therapy, interventional therapy, radiotherapy and systemic therapy. The aim of this consensus is to standardize the diagnosis and treatment of liver nodules, enhance precision, implement graded management, enable early differentiation between benign and malignant liver nodules, and improve patient prognosis.
Abdomen Group of Chinese Society of Radiology, Chinese Medical Association, Nursing Group of Chinese Society of Imaging Technology, Chinese Medical Association, Chongqing Society of Radiology, Chongqing Medical Association
… +1 more, Imaging Nursing Committee, Chongqing Nursing Association
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629078
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Gadoxetate disodium (Gd-EOB-DTPA), as a hepatocyte-specific MRI contrast agent, plays a key role in the early-stage diagnosis, differential diagnosis, and treatment evaluation of liver diseases. Gd-EOB-DTPA-enhanced MRI...Gadoxetate disodium (Gd-EOB-DTPA), as a hepatocyte-specific MRI contrast agent, plays a key role in the early-stage diagnosis, differential diagnosis, and treatment evaluation of liver diseases. Gd-EOB-DTPA-enhanced MRI has been recommended as a first-line imaging diagnostic method for the diagnosis of liver lesions by clinical guidelines in many countries and regions. However, there is currently a lack of standardized management consensus to guide the clinical practice of Gd-EOB-DTPA-enhanced MRI examinations. Therefore, there is an urgent need to establish a scientifically based, full-process management protocol to improve image quality and professional standards and ensure the effectiveness of examinations. The "Expert Consensus on Standardized Management of Gadoxetate Disodium-Enhanced MRI Examinations (version 2026)" integrates the latest evidence-based data and clinical experience to standardize the entire process-from contrast agent storage management, pre-examination assessment and preparation, and operational coordination during the examination to post-examination observation guidance. In addition, it aims to enhance the professional competence and emergency response level of radiology medical personnel, thereby improving patient compliance, diminishing the incidence rate of adverse events, and providing a scientific and reliable clinical practice basis for the standardized implementation and technical promotion of Gd-EOB-DTPA-enhanced MRI examination in clinical practice.
Translational Medicine Branch, China Association of Gerontology and Geriatrics, Society of Hepatology, Beijing Medical Association, Expert Committee on Liver Cancer, Chinese Society of Clinical Oncology
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629077
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With the rapid development of systemic therapy for primary hepatocellular carcinoma, how to scientifically formulate subsequent treatment strategies following first-line treatment failure has become a key issue that urge...With the rapid development of systemic therapy for primary hepatocellular carcinoma, how to scientifically formulate subsequent treatment strategies following first-line treatment failure has become a key issue that urgently needs to be addressed in clinical practice. In this context, developing a consensus on standardized second-line drugs that corresponds with the characteristics of patients and clinical practice in China is of significant practical importance. This consensus is based on high-level evidence-based medicine, combined with the experience of multidisciplinary experts in China, proposing unified evaluation criteria and stratified treatment recommendations for core issues such as disease progression assessment, drug resistance evaluation, and timing of switching therapy following failure of targeted therapy, immune checkpoint inhibitors, and combination therapy. In addition, it advocates for evidence-based, individualized treatment decisions that balance efficacy and safety profile, with the aim of promoting the standardization and homogenization of second-line drugs for hepatocellular carcinoma in our country, thereby providing authoritative guidance for clinical practice and effectively improving and benefiting patients' long-term survival and quality of life.
Zhonghua Gan Zang Bing Za Zhi
· 2026 Jan · PMID 41629076
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In order to effectively utilize hepatitis B information obtained during routine health checkups, a panel of experts from clinical medicine, public health, laboratory testing, and methodology reviewed the latest research...In order to effectively utilize hepatitis B information obtained during routine health checkups, a panel of experts from clinical medicine, public health, laboratory testing, and methodology reviewed the latest research findings in guidelines for hepatitis B prevention and treatment and combined with the actual situation of medical and health institutions within China to formulate the "Expert Consensus on the Management Process within Medical Institutions for Patients with Hepatitis B Virus Infection", outlining the management processes, quality control indicators, referring, diagnosis, and treatment. The implementation of this consensus is expected to increase the diagnosis and treatment rate of viral hepatitis B in Chinese medical institutions, thereby contributing to achieving the World Health Organization's 2030 goal of eliminating viral hepatitis as public health threat.