Zhonghua Gan Zang Bing Za Zhi [JOURNAL]
Sun
200 papers
[Two-sample Mendelian randomization analysis for the causal relationship between 91 circulating inflammatory proteins and liver cirrhosis].
Li M, Zhou SJ, Qiang L … +3 more , Chen M, Tang Y, Wu G
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660988 · Full text
To analyze the causal relationship between circulating inflammatory proteins and the risk of liver cirrhosis by the two-sample Mendelian randomization (MR) method. Single nucleotide polymorphisms (SNP) strongly associat...
To analyze the causal relationship between circulating inflammatory proteins and the risk of liver cirrhosis by the two-sample Mendelian randomization (MR) method. Single nucleotide polymorphisms (SNP) strongly associated with 91 plasma inflammatory proteins in genome-wide association studies (GWAS) were used as instrumental variables, and liver cirrhosis was used as the outcome variable. Random-effects inverse variance-weighted (IVW), MR Egger regression, odds ratio () and its 95% confidence interval were used to evaluate the causal relationship. Simultaneously, sensitivity analysis was performed using MR pleiotropy residuals and outliers (MR-PRESSO) and the -test. The causal relationship between the expression of seven specific circulating inflammatory proteins and liver cirrhosis was confirmed by the inverse variance-weighted (IVW) method. The results showed that five plasma inflammatory proteins, including leukemia inhibitory factor [()=0.66,=9.73×10], interleukin-18 [()=0.76,=0.013], tumor necrosis factor ligand superfamily member 12[()=0.75,=0.024], monocyte chemoattractant protein 2 [()=0.89,=0.036], and C-C motif chemokine 25 [()=0.84,=0.039], were negatively correlated with cirrhosis and were protective factors for cirrhosis. T cell surface glycoprotein CD5 [ ()=1.29,=0.035] and C-X-C motif chemokine 10 [()=1.32,=0.043] were positively correlated with cirrhosis and were risk factors for cirrhosis. The results of the MR-PRESSO, -test, MR-Egger intercept test, and leave-one-out method all showed the stability. The research results indicated that the increased levels of leukemia inhibitory factor, interleukin-18, tumor necrosis factor ligand superfamily member 12, monocyte chemoattractant protein-2, and C-C motif chemokine 25 were protective factors in the development of cirrhosis, while the increased levels of T cell surface glycoprotein CD5 and C-X-C motif chemokine 10 were risk factors for the development of cirrhosis based on genetic data.
[Effects of PEG-IFN-α treatment on the expression of CD161 and PD-1 in CD8 T cells of patients with chronic hepatitis B].
Li YP, Liu CR, Zhang X … +4 more , Huang N, Zhang W, Yang L, Dang SS
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660987 · Full text
To investigate and explore the expressional condition and therapeutic role of PD-1 and CD161 in the peripheral blood of patients treated with PEG-IFN-α for chronic hepatitis B (CHB), and their correlation with the degree...
To investigate and explore the expressional condition and therapeutic role of PD-1 and CD161 in the peripheral blood of patients treated with PEG-IFN-α for chronic hepatitis B (CHB), and their correlation with the degree of decrease in hepatitis B surface antigen (HBsAg). A retrospective cohort study was conducted. CHB patients who visited the Second Affiliated Hospital of Xi'an Jiaotong University from July 2022 to December 2023 and healthy controls during the same period were included. Peripheral blood samples were collected from the IFN treatment group (31 cases), the non-IFN treatment group (30 cases), and the healthy control group (30 cases). Flow cytometry was used to detect the CD8, PD-1, CD161 T lymphocytes and their subpopulations among the three groups. The proportions of cellular subpopulations were compared to analyze intergroup differences using Kruskal-Wallis and Mann-Whitney tests. The patients in the IFN treatment group were divided into two subgroups, high-and low-level, according to the median levels of PD-1 lymphocytes, CD8PD-1T cells, and CD161 lymphocytes. The magnitude of HBsAg decline was compared between the two groups. The proportions of PD-1 lymphocytes and CD8PD-1T cells in the IFN treatment group were significantly higher than those in the healthy control group and the non-IFN treatment group (<0.001). Moreover, the proportions of PD-1 lymphocytes [IFN treatment group 48 weeks: 24.3 (23.7, 28.0)%, non-IFN treatment group: 12.7 (10.0, 18.5)%, <0.01] and CD8PD-1T cells [IFN treatment group 48 weeks: 29.29 (26.73, 32.98)%, non-IFN treatment group: 17.69 (9.62, 20.68)%, <0.05] were higher in the IFN treatment group than those in the non-IFN treatment group at 48 weeks. The proportion of CD8CD161T cells was significantly lower in patients treated with IFN than in the non-IFN treatment group (<0.05) at 24 and 48 weeks, with no statistically significant difference with the healthy control group (>0.05). In the IFN treatment group, patients with high levels of PD-1 and CD8 PD1 lymphocytes had a significantly lower HBsAg decline compared to low-level patients, whereas no significant correlation was found between CD161 levels and HBsAg decline [PD-1 lymphocytes: 0.15 (0.02, 0.18) log IU/mL . 0.32 (0.13, 0.42) log IU/mL, <0.01; CD8PD-1T cells: 0.16 (0.03, 0.17) log IU/mL . 0.34 (0.13, 0.44) log IU/mL, <0.05]. The proportions of CD8PD-1T cells and CD8CD161T cells were significantly regulated by PEG-IFN-α therapy in the peripheral blood of patients with CHB, revealing the important role of T cell immune activation status during antiviral treatment. The gradual decline of HBsAg is closely related to the high expression of PD-1, suggesting that PD-1 may be negatively regulated during the process of T cell exhaustion and immunological evasion.
[A phase Ⅲ clinical study to evaluate the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of adults with chronic hepatitis C].
Wei L, Shang J, An X … +26 more , Zhang GQ, Guan YJ, Piao HX, Jin JL, Bai L, Yang XX, Yang DK, Luo XH, Yuan SF, Zhao YR, Ma YJ, Li GM, Lin F, Wu XP, Geng JW, Zou GZ, Chang JB, Gong ZJ, Mao XR, Zhu J, Guo WT, He QW, Luo L, Zhuang YL, Xie HM, Zhang YJ
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660986 · Full text
To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis. 394 cases w...
To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis. 394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA<quantitative lower limit" with the experimental drug (antaitasvir phosphate capsule combined with yiqibuvir tablet) were calculated. The safety profile of the drug was evaluated by the incidence and severity degree of adverse events. All efficacy endpoints and safety profile data were summarized using descriptive statistical methods. The results of the full analysis set (FAS) showed that the overall SVR12 rate in the experimental drug group during the double-blind phase was 94.1% (270/287), with SVR12 rates for genotypes 1, 2, 3, and 6 were 98.6% (138/140), 98.4% (60/61), 75.0% (33/44), and 92.9% (39/42), respectively. The SVR12 rate for subjects with compensated cirrhosis was 90.9% (30/33) and those without cirrhosis was 94.5% (240/254). A total of 96 subjects in the placebo group entered the placebo delayed treatment cohort, with an overall SVR12 rate of 95.8% (92/96), with SVR12 rates for genotypes 1, 2, 3, and 6 were 100% (48/48), 100% (21/21), 84.6% (11/13), and 85.7% (12/14), respectively. The rate for subjects with compensated cirrhosis was 92.3% (12/13), and those without cirrhosis was 96.4% (80/83). The results of virology resistance analysis suggested that most virological failures in this study was associated with newly introduced mutation sites or increased mutation proportions, with baseline amino acid mutations had no overall impact on the SVR12 treatment outcomes. The adverse events (TEAEs) related to the experimental drug during this study were mostly grade 1 or grade 2, primarily including hyperuricemia, hypercholesterolemia, and hypertriglyceridemia, with overall good safety and well-tolerability. A total of one case (0.3%) in the experimental drug group was suspended due to TEAEs (fatigue, dizziness, and myalgia), but no TEAEs occurred that led to permanent discontinuation of the drug, termination of treatment, early withdrawal, or death. The combination of antaitasvir phosphate 100 mg combined with yiqibuvir 600 mg demonstrates significant efficacy and a good safety profile in patients with CHC with genotypes 1, 2, 3, and 6, without cirrhosis or with compensated cirrhosis, who have received interferon-based treatment or have received initial treatment.
[Dynamic changes of HBsAb and its predictive value in patients with chronic hepatitis B receiving antiviral therapy for clinical cure].
Yang HY, Hao KY, Liang XE … +8 more , Liu ZH, Zhong CX, Yin JH, Xu Y, Wu LY, Yu YC, Hou JL, Fan R
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660985 · Full text
To explore the predictive value of hepatitis B surface antibody (HBsAb) quantitative level for achieving hepatitis B surface antigen (HBsAg) seroclearance and serological conversion in patients with chronic hepatitis B (...
To explore the predictive value of hepatitis B surface antibody (HBsAb) quantitative level for achieving hepatitis B surface antigen (HBsAg) seroclearance and serological conversion in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogs (NAs) or interferon (IFN). A two-center prospective cohort study was conducted, including CHB patients from Nanfang Hospital Southern Medical University and Eastern Theater General Hospital treated with NAs and IFN. All patients were followed up once every three to six months. Basic clinical information and test results were collected at each follow-up. The presence or absence of HBsAg seroclearance and serological conversion rate was evaluated. HBsAg serological conversion was defined as HBsAg quantification continuously below the detection limit (<0.05 IU/mL) at two detection time points at least six months apart. HBsAg serological conversion was defined as HBsAb positivity (≥10 IU/L) at the same time as the first HBsAg seroclearance. The Kruskal-Wallis test was used to compare the quantitative data of multiple groups, and the Wilcoxon rank-sum test was used to compare the data between groups. The chi-square test was used for the count data, and the Fisher exact test was used when the chi-square test was not met. Univariate and multivariate Cox analysis was used to determine the predictors of the study endpoints, and stepwise regression was used for variable screening. A total of 2 266 CHB cases were included, of which 86.5% (1 959/2 266) were NA antiviral-received population. The median treatment duration before baseline was 10.5 (2.5, 37.6) months, and the baseline HBsAg quantification was 3.1 (2.6, 3.5) log IU/mL. A total of 68 cases (3.0%) had HBsAg seroclearance, and 44 cases (1.9%) achieved serological conversion after 85.0 (62.7, 97.3) months of prospective follow-up. The level and positivity rate of HBsAb showed a progressive increase 36 months before and significantly after HBsAg seroclearance. Cox regression analysis results showed that baseline HBsAb level was an independent predictor of HBsAg serological conversion (=2.26, =0.002) in the overall population, especially in the subgroup with HBsAg between 100 and 1 000 IU/mL, suggesting HBsAb level had important predictive value. In addition, the serological conversion development rate was significantly higher in the GOLDEN model favourable patients than in the unfavourable patients (11.5% vs. 0, <0.001). The baseline HBsAb quantitative level can predict HBsAg seroclearance and serological conversion for patients with CHB receiving antiviral treatment, which is of significant value in long-term treatment monitoring.
[Introduction to the recommendations of the EASL clinical practice guidelines for genetic cholestatic liver diseases].
Hou W, Zheng SJ
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660984 · Full text
Genetic cholestatic liver disease is a type of disease caused by several different gene mutations, with cholestasis as the main manifestation, and is usually rare. Although these diseases differ in pathophysiology, clini...
Genetic cholestatic liver disease is a type of disease caused by several different gene mutations, with cholestasis as the main manifestation, and is usually rare. Although these diseases differ in pathophysiology, clinical manifestations, and prognosis, they all possess the common feature of cholestasis. To this end, the European Association for the Study of the Liver published the EASL Clinical Practice Guidelines for Genetic Cholestatic Liver Disease in 2024, which provide a general approach to the management of cholestatic pruritus, detailed information on the diagnosis and treatment method of certain hereditary cholestatic liver diseases, and put forward recommendations on diagnosis and treatment with the aim to assist hepatologists (pediatric and adult) in implementing the latest diagnostic and management strategies.
[Expert opinions on the technical guiding principles for clinical trials of drugs in the treatment of chronic hepatitis B virus infection].
Author Group of Expert Opinions
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660983 · Full text
Chronic hepatitis B virus (HBV) infection remains one of the major public health challenges facing our country. There are approximately seventy-five million chronic HBV-infected cases in our country, according to the lat...
Chronic hepatitis B virus (HBV) infection remains one of the major public health challenges facing our country. There are approximately seventy-five million chronic HBV-infected cases in our country, according to the latest epidemiological data. Current first-line antiviral drugs, including nucleos(t)ide analogs and interferons, can effectively suppress viral replication and delay disease progression, but they still struggle to provide a functional cure for chronic hepatitis B or completely eliminate HBV infection. This unmet clinical need has become the core driving force behind the development of new antiviral drugs for chronic HBV infection. In recent years, China's drug regulatory policy reform has continued to deepen, and the indications for antiviral treatment of HBV infection have been continuously broadened, creating a more favorable policy environment for innovative drug research and development. In this context, global drug development for HBV, especially in China, is accelerating, and new drugs with various mechanisms of action are entering the clinical research phase. In order to standardize and guide the rational design, efficient implementation, and accurate evaluation of clinical trials of new antiviral drugs for the treatment of chronic HBV infection, the expert group combined the latest research progress and clinical practice experience at home and abroad to systematically update key issues such as the research endpoints of clinical trials of new antiviral drugs, aiming to provide authoritative and practical technical guidance for new drug research and development.
[Controversy and consensus on antiviral treatment strategies for low-level hepatitis B surface antigens].
Hou YH, Zhang LY
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660982 · Full text
Hepatitis B virus infection is a global public health issue, and there exist many controversies about the antiviral treatment strategies for patients with low-level hepatitis B surface antigen. This article reviews the d...
Hepatitis B virus infection is a global public health issue, and there exist many controversies about the antiviral treatment strategies for patients with low-level hepatitis B surface antigen. This article reviews the definition, clinical significance, and current controversial focus of treatment strategies for low-level hepatitis B surface antigen, including treatment timing, drug selection, treatment course determination, and other aspects, while also suggesting future research directions.
[The concept of a fountional cure for hepatitis B keeps pace with the times].
Liu ZH, Liang XE
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660981 · Full text
Hepatitis B surface antigen (HBsAg) seroclearance, or s-loss, has traditionally been regarded as a key indicator of hepatitis B virus (HBV) functional cure. However, growing insights into HBV pathogenesis and treatment s...
Hepatitis B surface antigen (HBsAg) seroclearance, or s-loss, has traditionally been regarded as a key indicator of hepatitis B virus (HBV) functional cure. However, growing insights into HBV pathogenesis and treatment strategies have reshaped our understanding of the relationship between s-loss and functional cure. While an HBsAg level below 100 IU/mL is often used to define partial cure, it primarily reflects a therapeutic milestone that facilitates eventual s-loss rather than a definitive endpoint. New biomarkers such as serum HBV RNA and hepatitis B core-related antigen are promising but, due to limitations in sensitivity, are not yet adequate substitutes for s-loss in defining functional cure. Importantly, achieving s-loss alone does not guarantee functional cure. Other factors-such as HBeAg seroclearance, the durability of s-loss, and whether single timepoint of rebound ("Blips") are permissible-must be considered in evaluating functional cure. These evolving perspectives underscore the importance of consolidation therapy. Further researches are needed to elucidate the mechanisms between different therapies induced s-loss, the implications of lower detection limits for HBsAg, and the role of hepatitis B surface antibodies in seeking functional cure.
[Sounding the call for functional cure of hepatitis B and opening a new era of combination therapy].
Cheng C, Liang XE, Liu ZH … +1 more , Hou JL
Zhonghua Gan Zang Bing Za Zhi · 2025 Jun · PMID 40660980 · Full text
Functional cure (i.e., clinical cure) of chronic hepatitis B (CHB) is a core research objective in the field of hepatology. With the revision of the Expert opinions on the technical guiding Principles for clinical trials...
Functional cure (i.e., clinical cure) of chronic hepatitis B (CHB) is a core research objective in the field of hepatology. With the revision of the Expert opinions on the technical guiding Principles for clinical trials of drugs in the treatment of chronic hepatitis B virus infection, this article concisely reviews the evolving concept of functional cure for hepatitis B, research progress on the dynamic trajectories and threshold of key serological markers (such as HBsAg/anti-HBs), strategies for safety evaluation of treatment discontinuation, and the importance of building a collaborative innovation ecosystem involving scientific research, industry, healthcare, policy, and societal forces. Through multidimensional technological breakthroughs and interdisciplinary collaboration, the functional cure rate of chronic hepatitis B infection is expected to improve significantly over the next 5-10 years, laying the foundation for achieving the World Health Organization (WHO)'s goal of eliminating viral hepatitis as a public health threat by 2030.
[Research advances in occurrence risk assessment and early-stage diagnosis of hepatocellular carcinoma].
Li YJ, Li JF, Chen Y
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528595 · Full text
Evaluating and identifying the occurrence risk of hepatocellular carcinoma (HCC) can make the gateway for prevention and diagnosis advance as well as assist in the early detection and intervention of future HCC occurrenc...
Evaluating and identifying the occurrence risk of hepatocellular carcinoma (HCC) can make the gateway for prevention and diagnosis advance as well as assist in the early detection and intervention of future HCC occurrences within the population. Early-stage diagnosis and treatment are crucial for improving survival rates in patients with HCC. This article reviews the recent years' research progress in terms of combining three aspects-molecular markers, scoring models, and early-stage diagnostics-to predict the evaluation of HCC occurrence risk, with the hope of providing guiding significance for clinical practice.
[Research progress on new drugs for the treatment of chronic hepatitis B virus infection].
Yu YY, Li J, Wang WX … +2 more , Fan PY, Wang FS
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528594 · Full text
Hepatitis B virus (HBV) infection is a major global public health problem. There will be about 257 million chronic HBV-infected patients worldwide, according to the World Health Organization's estimation by 2025. Current...
Hepatitis B virus (HBV) infection is a major global public health problem. There will be about 257 million chronic HBV-infected patients worldwide, according to the World Health Organization's estimation by 2025. Currently, the main drugs for the treatment of chronic HBV infection are nucleos(t)ide analogues and pegylated interferon (PEG-IFN). However, previous research results show that whether it is nucleos(t)ide analogues and PEG-IFN-α monotherapy or combination therapy, or sequential combination therapy, the rate of hepatitis B surface antigen seroconversion in patients is low, and there is still a high risk of disease progression after a certain course of antiviral treatment. Therefore, to achieve the ambitious target of "eliminating viral hepatitis by 2030" set by the World Health Organization and help more hepatitis B patients achieve functional cure, a large number of new drugs have been developed and entered clinical trials. This paper summarizes and reviews the types, safety, and efficacy of new drugs to further promote advancements in the field of treatment of chronic HBV infection.
[A case of type 4A familial hereditary hemochromatosis].
Wang KF, Hou W, Song WY … +2 more , Liu H, Zheng SJ
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528593 · Full text
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[Clinical and molecular genetic analysis of nine patients with neonatal Dubin-Johnson syndrome].
Xu T, Li D, Guo L … +3 more , Deng M, Lin WX, Song YZ
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528592 · Full text
Dubin-Johnson syndrome (DJS) is a hereditary liver disease caused by biallelic pathogenic variants in the gene. As a rare disease, the genotype and clinical phenotype characteristics of DJS patients still need to be su...
Dubin-Johnson syndrome (DJS) is a hereditary liver disease caused by biallelic pathogenic variants in the gene. As a rare disease, the genotype and clinical phenotype characteristics of DJS patients still need to be summarized in depth. Nine cases diagnosed with DJS and treated in the Department of Pediatrics of the First Affiliated Hospital of Jinan University were collected as the study subjects. Clinical and laboratory data, general information, symptoms, signs, pathological changes, treatment, and prognostic conditions were systematically analyzed. Targeted high-throughput sequencing was used to detect hereditary diseases. The positive results for the family lineage were verified by Sanger sequencing. The pathogenicity of the novel variants was evaluated according to the American College of Medical Genetics and Genomics guidelines and standards. One-way analysis of variance or Kruskal-Wallis test was used to compare the statistical differences between multiple groups of data. Among the nine DJS cases, seven and two were males, and females. All of them had the initial symptom of jaundice (100%), with a median age of onset of 5 (2,15) days. During the course of the disease, seven (7/9) and two (2/9) cases had hepatomegaly and splenomegaly. All of the patients exhibited direct hyperbilirubinemia, concurrently with elevated total bile acids (TBA) and γ-glutamyl transferase (GGT). Serum transaminases (4/9) and alkaline phosphatase levels (3/9) were elevated in some patients. A total of twelve types of variants were detected in nine cases, of which c.2362_2363del (p.Leu788ValfsTer13), c.364C>T (p.Gln122Ter), c.338T>C (p.Leu113Pro) and c.419T>A (p.Ile140Lys) were novel pathogenic/likely pathogenic variants. Jaundice disappeared and alleviated in five cases (5/9) and four cases (4/9), while hepatomegaly improved in five cases (5/9) at the last follow-up at 7.79 (7.0,15.25) months following treatment with drugs such as liver protectives, choleretics, and jaundice-reducing agents. Among them, three cases (3/9) had a normal restored liver size. All patients had varying degrees of improvement in bilirubin, TBA, GGT, and ALP levels. The onset of high GGT cholestatic jaundice is the main clinical manifestation in patients with neonatal DJS. The genetic analysis results showed four novel types of variants, which expanded the gene variation spectrum, providing novel molecular markers for confirming a diagnosis of DJS. The patient's clinical manifestations and laboratory abnormalities improved or disappeared after internal medicine treatment, suggesting that DJS may be a type of genetic disease with a favorable long-term prognosis.
[Comparison of clinical characteristics between patients with Polygonum multiflorum-induced liver injury and those with other drug-induced liver injuries].
Tan KA, Yang WN, Qiu YW … +4 more , Liu XZ, Sun XW, Pang LL, Hou FQ
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528591 · Full text
To compare the clinical characteristics of patients with drug-induced liver injury (DILI) caused by Polygonum multiflorum and other drug-induced liver injuries (DILI). A retrospective cohort study was conducted. Clinica...
To compare the clinical characteristics of patients with drug-induced liver injury (DILI) caused by Polygonum multiflorum and other drug-induced liver injuries (DILI). A retrospective cohort study was conducted. Clinical data of seventy-three cases confirmedly diagnosed with DILI caused by Polygonum multiflorum, 168 cases diagnosed with DILI caused by other traditional Chinese medicines, and 225 cases diagnosed with DILI caused by modern medicines admitted to Peking University First Hospital, the Fipth People's Hospital of Wuxi, Yantai Qishan Hospital, and Qinhuangdao Third Hospital from January 1995 to August 2019 were selected and collected as the research subjects. The Mann-Whitney test was used for comparison of skewed distribution of continuous data between two groups. The Kruskal-Wallis rank-sum test was used for comparison between three groups. The test was used for comparing count data between groups. Among the 73 cases with DILI caused by Polygonum multiflorum, 11 (15.1%) took a single herb of Polygonum multiflorum (including its powder and boiled water), 37 (50.7%) took traditional Chinese patent medicines containing Polygonum multiflorum, and 25 (34.2%) took a traditional Chinese medicine formula containing Polygonum multiflorum. The age of the DILI group caused by Polygonum multiflorum was 48 years old, which was lower than the other two groups (the DILI group caused by other traditional Chinese medicines: 55 years old, the DILI group caused by modern medicines: 52 years old; <0.01). The levels of alanine aminotransferase (ALT), aspartate aminotransferase, and alkaline phosphatase were all higher than the other two groups (<0.05). The proportion of patients with antinuclear antibody positivity rate and severity of liver damage grade 3 was higher in the DILI group induced by Polygonum multiflorum than those in the modern drug-induced DILI group (<0.05). The liver cell injury type accounted for 96.6% (57/59) in the DILI group caused by Polygonum multiflorum, which was higher than that in the modern drug-induced DILI group (69.3%, 156/225) (<0.001). There was no statistically significant difference (>0.05) in gender, age, medication duration, and various biochemical indicators between patients with DILI caused by Polygonum multiflorum monotherapy and compound preparations in terms of compatibility. The ALT level in the DILI group caused by raw Polygonum multiflorum was higher than that in the DILI group caused by processed Polygonum multiflorum [the DILI group caused by raw Polygonum multiflorum: 1 289.0(921.8, 1 851.8)U/L, the DILI group caused by processed Polygonum multiflorum: 890.0(304.0,1 320.0)U/L;<0.05] according to the comparison of processing methods. The degree of DILI caused by Polygonum multiflorum is more obvious than that caused by other drugs. There was no difference in the degree of DILI caused by the single and the compound formulation. However, the liver damage caused by raw Polygonum multiflorum was more severe than that caused by processed Polygonum multiflorum.
[Evaluation of the short-term prognosis of patients with HBV-related acute-on-chronic liver failure by combining ferritin with COSSH-ACLF II score].
Liu YX, Li ZY, Ma LY … +3 more , Gao YF, Wang Y, Zhao CY
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528590 · Full text
To explore the predictive value of ferritin combined with the COSSH-ACLF Ⅱ score for the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). The clinical data of 419 cas...
To explore the predictive value of ferritin combined with the COSSH-ACLF Ⅱ score for the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). The clinical data of 419 cases with HBV-ACLF hospitalized at the Third Hospital of Hebei Medical University were retrospectively analyzed between January 1, 2013 and September 30, 2022, and were divided into the death (=127) and survival group (=292) according to the survival status of 28 days of follow-up. The Mann-Whitney U test was used to compare confirmation of non-normally distributed continuous data between two groups. The chi-square test was used for the comparison of numerical data between the two groups. Binary logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of HBV-ACLF patients. The predictive value of ferritin combined with the COSSH-ACLF Ⅱ score on the prognosis of HBV-ACLF was evaluated by the receiver operating characteristic curve (ROC curve) and area under the curve (AUC), net reclassification index (NRI), and comprehensive discriminant improvement index (IDI). There were statistically significant differences in age, neutrophil count (NEUT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), serum creatinine (Scr), serum urea, prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (INR), serum ferritin (SF), hepatic encephalopathy, and COSSH-ACLF Ⅱ scores between the two groups (<0.05). Ferritin (=1.001, 95%:1.001-1.002, <0.001) and COSSH-ACLF Ⅱ score (=2.898, 95%:1.560-5.384, <0.001) were independent factors for predicting short-term prognosis for patients with HBV-ACLF. Ferritin combined with COSSH-ACLF II score had a higher prognostic predictive value than ferritin (AUC=0.697, 95%: 0.651-0.741) and COSSH-ACLF II score (AUC=0.819, 95% : 0.779-0.855) for patients with HBV-ACLF (AUC=0.857, 95%: 0.819-0.889), with a statistically significant difference (=6.287 and 2.666, respectively, <0.05). The predictive effect was significantly improved following the addition of ferritin to the COSSH-ACLF Ⅱ score (<0.001), and the NRI and IDI were both >0 (NRI=0.144, 95%: 0.064-0.225; IDI=0.080, 95%: 0.052-0.108). Ferritin and COSSH-ACLF Ⅱ scores are independent factors that can predict short-term prognosis for patients with HBV-ACLF, and combing both has a higher predictive value.
[Sulfasalazine relieves cholestatic liver injury by activating peroxisome proliferator-activated receptor-α].
Xu J, Wang X, Zhang Y … +8 more , Xiao J, You H, Liu ZY, Sun Y, Lan YH, Ren H, Liu CG, Peng ML
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528589 · Full text
To investigate the efficacy and potential mechanism of sulfasalazine (SASP) therapy for intrahepatic cholestasis. Forty SD rats were randomly divided into a normal group (carboxymethylcellulose sodium 0.5%), a model gro...
To investigate the efficacy and potential mechanism of sulfasalazine (SASP) therapy for intrahepatic cholestasis. Forty SD rats were randomly divided into a normal group (carboxymethylcellulose sodium 0.5%), a model group (carboxymethylcellulose sodium 0.5%), a SASP group (sulfasalazine 150 mg/kg), and an ursodeoxycholic acid (UDCA 100 mg/kg) group, with ten rats in each group. The cholestatic liver injury model was induced using α-naphthylisothiocyanate. Blood samples were collected to detect liver biochemistry and cholestasis indexes. Rat liver tissue was collected for hematoxylin-eosin staining and Mason staining. Liver tissue was analyzed using transcriptome sequencing, real-time reverse transcription quantitative polymerase chain reaction, Western blotting and flow cytometry. Simultaneously, the level of inflammatory factors, total cholesterol, and total bile acids were measured in liver tissue. A -test or a nonparametric test was selected based on the distribution and variance characteristics of the data. The serum levels of alanine aminotransferase [(386.88±155.77) U/L], aspartate aminotransferase [(593.13±251.44) U/L], alkaline phosphatase [(561.25±167.54) U/L], total bilirubin [(38.00±29.75) mol/L] and total bile acids [(191.31±91.48) mol/L] were significantly lower in the SASP than the model groups [(778.75±313.59) U/L, (1 159.38±274.62) U/L, (801.25±161.28) U/L, (86.63±27.83) mol/L, (432.63±151.54) mol/L,<0.05]. Liver histopathology showed that the inflammatory cells in the manifold area, the bile duct proliferation and dilation, and the collagen deposition in the manifold area were significantly improved under the pathological state of cholestasis in the SASP group. The results of transcriptome sequencing demonstrated that SASP activated the peroxisome proliferator actived receptor (PPAR) and inhibited Th17 cell differentiation. The mRNA level in the liver tissue of rats was significantly increased in the SASP group compared with that in the model group [(0.41±0.28) . (0.16±0.04), <0.05], and the expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase was decreased compared with that in the model group [(3.09±1.16) . (8.19±2.19), <0.05], which was also verified at the protein level. The concentrations of total cholesterol [(0.31±0.34) mmol/g] and total bile acids [(2.58±0.99) μmol/g] were lower than the model group [(0.83±0.62) mmol/g and (4.07±0.91) μmol/g] (<0.05), and at the same time it was accompanied by lower levels of inflammatory factors (<0.05). SASP treatment decreased the expression of retinoic acid receptor-related orphan receptor γt gene (<0.05) and the proportion of Th17 (<0.05). SASP can improve cholestatic liver injury, and its mechanism is related to the activation of peroxisome proliferator-activated receptor α and the inhibition of Th17 cell differentiation.
[The impact of spontaneous portosystemic shunt on clinical outcomes in patients with liver cirrhosis and hepatic encephalopathy].
Ke Q, Lin T, Lei XJ … +5 more , Weng XT, He J, Huang XH, Li L, Guo WH
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528588 · Full text
To investigate the incidence, clinical characteristics, and impact of spontaneous portosystemic shunt (SPSS) in patients with liver cirrhosis combined with hepatic encephalopathy (HE). The basic clinical and follow-up d...
To investigate the incidence, clinical characteristics, and impact of spontaneous portosystemic shunt (SPSS) in patients with liver cirrhosis combined with hepatic encephalopathy (HE). The basic clinical and follow-up data were retrospectively analyzed for patients diagnosed with cirrhosis combined with HE at Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2017 to December 2022. The patients were divided into large and small SPSS groups and a control group based on the results of abdominal enhanced CT or MRI.The clinical characteristics and outcome differences were compared among the three groups. Kaplan-Meier survival curves were used to compare HE-free survival time and overall survival time among the three groups. The log-rank test was used to compare the differences between groups. Cox regression analysis was used to identify the relevant risk factors affecting HE-free survival time and overall survival time. A total of 223 cases with liver cirrhosis combined with HE were enrolled, including 150 in the SPSS and 73 in the control groups. The incidence rate of SPSS was 67.3% (150/223). The group was divided into small SPSS (79/150, 52.7%) and large SPSS group (71/150, 47.3%) according to the cross-sectional area of the diversion channel. The HE-free survival was shorter in the small and large SPSS groups compared with the control group (35.5 months in the small SPSS group and 21.3 months in the large SPSS group; <0.001). The HE-free survival time was shorter in the large SPSS than with small SPSS group (=0.003). The overall survival time in the small SPSS group and the large SPSS group was shorter compared with the control group (small SPSS group: 39.4 months, large SPSS group: 52.9 months; <0.001). There was no statistically significant difference in overall survival time between the small SPSS and large SPSS groups (=0.700). Cox regression analysis showed that SPSS was an independent risk factor affecting patients' HE-free survival time and overall survival time (<0.05). SPSS is more common in patients with liver cirrhosis combined with HE. Patients who combined with SPSS showed significant reductions in both HE-free survival time and overall survival time, especially evident in those with combined large SPSS.
[An excerpt of European Association for the Study of the Liver clinical practice guidelines on transjugular intrahepatic portosystemic shunt in 2025].
Wang ZY, Han GH
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528587 · Full text
Transjugular intrahepatic portosystemic shunt (TIPS) is a proven procedure therapy for complications in cirrhotic portal hypertension (PH). In recent years, there has been a lot of progress in the field of TIPS, especial...
Transjugular intrahepatic portosystemic shunt (TIPS) is a proven procedure therapy for complications in cirrhotic portal hypertension (PH). In recent years, there has been a lot of progress in the field of TIPS, especially in terms of technical operation, prognostic models, and indication expansion. Therefore, the guidelines aim to provide a comprehensive overview of all aspects of the use of TIPS in patients with cirrhosis while separating sections pertaining to other specialized subjects (e.g., the usage of TIPS in surgical procedures and hepatovascular disorders).
[Guideline for diagnosis and management of metabolic dysfunction-associated fatty liver disease in primary care (2025)].
Chronic Disease Management Branch of China Medical Biotechnology Association, Chinese Research Hospital Society (Integrative Chinese and Western Medicine), Chinese Society of General Practice, Chinese Medical Association … +1 more , Expert Group of Guideline for Diagnosis and Management of Metabolic Dysfunction-Associated Fatty Liver Disease in Primary Care
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528586 · Full text
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[Paradoxical roles of spontaneous portosystemic shunts and their management strategy in splenectomy with devascularization].
Bu Y, Tian MG
Zhonghua Gan Zang Bing Za Zhi · 2025 May · PMID 40528585 · Full text
Spontaneous portosystemic shunt (SPSS) is an important pathological feature in the progression of cirrhotic portal hypertension and acts as the body's compensatory mechanism for reducing portal hypertension. Recent resea...
Spontaneous portosystemic shunt (SPSS) is an important pathological feature in the progression of cirrhotic portal hypertension and acts as the body's compensatory mechanism for reducing portal hypertension. Recent research results show that SPSS is an important link in the development of cirrhosis into the decompensated stage and is also the main cause of hepatic encephalopathy after splenectomy combined with devascularization. Therefore, during splenectomy combined with devascularization, it is necessary to decide on treatment measures such as disconnection, flow limitation, or retention of the distal side as a selective shunt channel according to its location and shunt volume.
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