中华肝脏病杂志最新文献

{"title":"[Etiological characteristics and drug resistance in patients with hepatitis B virus associated acute -on-chronic liver failure complicated with abdominal infection].","authors":"X L Yu, H B Xie, Y Q Luo, Y Y Zeng","doi":"10.3760/cma.j.cn501113-20240804-00359","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240804-00359","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the distribution of pathogenic microorganisms, drug resistance and influencing factors in patients with hepatitis B virus associated acute -on-chronic liver failure (HBV-ACLF) complicated with abdominal infection (IAI). Methods A retrospective analysis was conducted on 282 HBV-ACLF patients admitted to the Hepatobiliary Internal Medicine Department of Mengchao Hepatobiliary Hospital of Fujian Medical University, from May 2019 to December 2022, with 141 patients who had IAI and positive bacterial culture as the infected group; 141 non-infected patients admitted during the same period were used as the non-infected group. The clinical data, laboratory test results, pathogen species and drug sensitivity test results of the patients were collected, and the influencing factors of IAI in HBV-ACLF patients were analyzed by Logistic regression analysis. <b>Results:</b> A total of 204 pathogenic bacteria were detected in the infection group, including 115 Gram-negative bacteria (56.37%), 74 Gram-positive bacteria (36.28%) and 15 fungi (7.35%). The most frequently detected bacterial genera were <i>Escherichia coli</i> (21.57%, 44/204), <i>Klebsiella pneumoniae</i> (12.25%, 25/204), <i>Enterococcus faecium</i> (6.37%, 13/204), <i>Staphylococcus aureus</i> (5.39%, 11/204) and <i>Staphylococcus epidermidis</i> (4.90%, 10/204). The results of drug sensitivity tests showed that the resistance rates of <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> to <i>levofloxacin</i> and <i>ciprofloxacin</i> were over 50% and 30% respectively; the resistance rate of <i>Pseudomonas aeruginosa</i> to carbapenems (<i>meropenem</i> and <i>imipenem</i>) was 60.00%; the resistance rates of <i>Acinetobacter baumannii</i> to <i>meropenem</i> and <i>imipenem</i> were 100% and 50.00% respectively; the resistance rates of <i>Enterococcus faecium</i> and <i>Enterococcus faecalis</i> to <i>penicillin</i> were 100% and 33.33% respectively; and the resistance rates of <i>Staphylococcus aureus</i> to <i>penicillin</i> (77.78%) and <i>oxacillin</i> (33.33%) were relatively high..The results of the multivariate unconditional logistic regression analysis showed that puncture and drainage (<i>OR</i>=17.90, 95% <i>CI</i>: 7.94~43.42, <i>P</i>< 0.001), procalcitonin (<i>OR</i>=3.23, 95% <i>CI</i>: 1.56~8.98, <i>P</i>=0.012), C-reactive protein (<i>OR</i>=1.05, 95% <i>CI</i>: 1.02~1.00, <i>P</i>=0.003), and age (<i>OR</i>=1.06, 95% <i>CI</i>: 1.02~1.10, <i>P</i>=0.001) were independent risk factors for IAI in patients with HBV-ACLF. Conclusions The pathogenic microorganisms of HBV-ACLF patients with IAI were mainly <i>enterobacteriaceae bacteria</i> and <i>enterococcus</i>. Puncture drainage, procalcitonin, C-reactive protein and age were independent risk factors for IAI in HBV-ACLF patients. Early intervention to avoid the increase of inflammatory in dicators is an effective measure to prevent abdominal infection in HBV-ACLF patients.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long-term prognostic implications of portal vein thrombosis in patients with hepatitis B-related cirrhosis].","authors":"K K Jin, Y Han, Y J Yan, L N Lyu, Y N Liu, Y L He, H G Ding","doi":"10.3760/cma.j.cn501113-20240618-00296","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240618-00296","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the features of portal vein thrombosis (PVT) in patients with hepatitis B-related cirrhosis and its impact on long-term prognosis. &lt;b&gt;Methods:&lt;/b&gt; Clinical data from a cohort of patients with hepatitis B-related cirrhosis from May 2009 to August 2020 were analyzed, enhanced CT examination was employed for the diagnosis and classification of PVT. Patients with hepatitis B-related cirrhosis without PVT at baseline were enrolled. The endpoint events of follow-up were death related to liver disease, liver transplantation, liver cancer, or followed up until December 31, 2023. During the follow-up, patients were divided into PVT group and control group based on the presence or absence of PVT. Changes in clinical data were compared between the groups at baseline and endpoint time; besides, Kaplan-Meier survival curve, Log-rank test, and Cox regression analysis were employed to assess the influence of PVT on prognosis. &lt;b&gt;Results:&lt;/b&gt; A total of 267 patients with hepatitis B-related cirrhosis were included, with a median follow-up time of 52.0 (46.7, 57.3) months. The PVT group had 99 patients, and the control group had 168 patients. In the PVT group, 28.28% (28/99) had spleen resection, and 74.7% (74/99) did not receive anticoagulant treatment. Main portal vein thrombosis, portal vein branch thrombosis, and both were found in 34.3% (34/99), 23.2% (23/99), and 15.2% (15/99) of patients, respectively, with 27.3% (27/99) involving the splenic vein or superior mesenteric vein. During follow-up, 63.6% (63/99) of PVT cases remained stable, 31.3% (31/99) progressed, and 5.1% (5/99) showed resolution. In the PVT group, white blood cells, hemoglobin, and platelet counts decreased significantly (&lt;i&gt;P&lt;/i&gt;&lt;0.05), international normalized ratio (INR) increased from baseline [1.28 (1.14, 1.39) vs. 1.33 (1.19, 1.46), &lt;i&gt;P&lt;/i&gt;=0.041], and spleen length increased [163.84±30.68 mm vs. 177.26±32.61 mm, &lt;i&gt;P&lt;/i&gt;&lt;0.001]. The incidence of esophageal variceal bleeding was significantly higher in the PVT group compared to the control group (57.0% vs. 28.7%, &lt;i&gt;P&lt;/i&gt;&lt;0.001), while the incidence of hepatic encephalopathy showed no significant difference (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The proportion of ascites patients was reduced in the control group (63.1% vs. 41.7%, &lt;i&gt;P&lt;/i&gt;&lt;0.001), but there was no significant difference in ascites between the PVT group and the control group (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The incidence of composite clinical endpoint events was 21.2% (21/99) in the PVT group and 4.2% (7/168) in the control group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Among PVT patients, those who did not receive anticoagulant treatment had a higher incidence of composite clinical endpoint events compared to those treated with anticoagulation (25.7% vs. 8%, &lt;i&gt;P&lt;/i&gt;=0.062). Cox regression analysis showed that PVT formation was an independent risk factor for liver-related adverse events in hepatitis B cirrhosis patients (&lt;i&gt;HR&lt;/i&gt;=9.36, 95%&lt;i&gt;CI&lt;/i&gt;: 3.65-24.02, &lt;i&gt;P&lt;/i&gt;=0.001). &lt;b&gt;Conclusions","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on predictors of clinical cure of chronic hepatitis B].","authors":"R Y Zhang, W Yue, L Zhu, J B Luo, B Bu, Y L Wang, Y M Wang, J W Geng","doi":"10.3760/cma.j.cn501113-20241015-00541","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241015-00541","url":null,"abstract":"<p><p>Although nucleotide analogs (NAs) and interferons are currently the primary treatments for chronic hepatitis B, they do not entirely remove cccDNA from hepatocytes. Antiviral therapy's desired outcome is the absence of hepatitis B surface antigen(HBsAg), often known as a clinical cure. Although interferon therapy has significantly higher HBsAg clearance and serologic conversion rates than NAs, combination or sequential therapy can improve HBsAg clearance and serologic conversion rates to some extent. Still, only a small proportion of patients will achieve clinical cure. As a result, it is critical to explore indications that might predict clinical cure before and during antiviral medication, allowing for early and prompt identification of patients more likely to achieve HBsAg clearance, improving clinical cure rates, and reducing treatment expenses. In this paper, we review the progress of recent studies on predictors of clinical cure in chronic hepatitis B, and discuss their value in predicting clinical cure to provide a reference for optimizing CHB treatment strategy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Forge ahead with perseverance].","authors":"A L Huang, H Ren, X Y Xu","doi":"10.3760/cma.j.cn501113-20250107-00013","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250107-00013","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Screening and functional identification of HLA-A*24:02-restricted HBsAg-specific TCR based on single-cell TCRαβ double-stranded amplification pairing].","authors":"G J Shen, A Q Zheng, M F Shi, X Y Li, B L Liao, Z H Wang, Y C Yu","doi":"10.3760/cma.j.cn501113-20240307-00117","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240307-00117","url":null,"abstract":"<p><p><b>Objective:</b> To establish a new method and platform for screening, identifying, and exploring a new strategy for anti-hepatitis B immunotherapy based on hepatitis B virus (HBV)-specific TCR. <b>Methods:</b> Peripheral blood mononuclear cells were isolated from patients with acute hepatitis B. CD3⁺CD8⁺CD137⁺T single cells were sorted out after stimulation with the HBsAg peptide library. The α and β chains in TCRs of single cells were amplified by PCR. TCR double-chain pairing and lentiviral packaging were performed through high-throughput sequencing. Re-infected Jurkat-76-NFAT-GFP cells and the cell lines stably expressing TCR were screened. HBsAg peptide library and immortalized B lymphocytes co-cultured with J76N-TCR were used to screen HBsAg-specific TCRs. K562 cell lines stably expressing HLA-A*24:02 were established to determine epitope peptide by screening A*24:02-restricted TCR. The screened TCRs were replaced with mouse C regions and packaged with lentiviruses. Functional validation was performed on healthy human CD4⁺T and CD8⁺T lymphocytes following infection. <b>Results:</b> Stable TCR-expressing cell lines were successfully prepared based on single-cell TCRαβ double-chain amplification and pairing technology. Twenty-one TCRs were screened using immortalized B lymphocytes, resulting in nine possible HLA-A*24:02-restricted HBsAg-specific TCRs. Further screening with K562-A2402 resulted in six A*24:02-restricted HBsAg-specific TCRs with identically recognized epitope peptide. The functional determination of the two TCR clones revealed their specific recognition function for target cells expressing HBsAg. <b>Conclusion:</b> HLA-A*24:02-restricted HBsAg-specific TCR with recognition function for target cells expressing HBsAg was successfully obtained based on the new experimental technology system, laying an important foundation for further exploration of antiviral immunotherapy based on HBV-specific TCR.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progresses in gene therapy for hepatolenticular degeneration].","authors":"G Chen, H Y Zheng, F Liu, J Yuan, Y H Xu, W S Cheng","doi":"10.3760/cma.j.cn501113-20240501-00238","DOIUrl":"10.3760/cma.j.cn501113-20240501-00238","url":null,"abstract":"<p><p>Hepatolenticular degeneration, also known as Wilson's disease, is a type of autosomal recessive genetic disorder of copper metabolism. The causative gene, ATP7B, is located on the long arm of chromosome 13 and encodes a P-type ATPase that is involved in copper transport. Pathogenic mutations in the ATP7B gene sequence lead to the diminished or lost function of the ATP7B protein, resulting in pathological copper deposition in organs such as the liver, brain, kidneys, and cornea. Currently, the treatment of Wilson's disease primarily involves oral medications to promote copper excretion or reduce copper absorption so as to alleviate the state of illness. However, pharmacological treatment has objective limitations, including the need for lifelong therapy and varying degrees of adverse drug reactions in some patients. Gene therapy can fully correct the genetic defect, restore ATP7B protein function, achieve a curative effect, and improve the patient's quality of life.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical analysis and follow-up outcomes of 25 pediatric cases with hepatic glycogen storage disease].","authors":"W W Liu, M J Wang, M Jin, R Zhang, M R Mi, X M Zhong","doi":"10.3760/cma.j.cn501113-20240609-00288","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240609-00288","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the clinical and genetic characteristics and follow-up status of pediatric patients with hepatic glycogen storage disease in order to further improve the prognosis. &lt;b&gt;Methods:&lt;/b&gt; The clinical data of hospitalized children diagnosed with hepatic glycogen storage disease in the Department of Gastroenterology at the Children's Hospital of Capital Institute of Pediatrics from January 2010 to April 2023 were collected and retrospectively analyzed. The results of laboratory examination and gene sequencing were analyzed, and the number of cases that exceeded three (n) were grouped according to the genetic results: Group 1 was type Ⅰ (&lt;i&gt;n&lt;/i&gt;=8), Group 2 was type Ⅲ (&lt;i&gt;n&lt;/i&gt;=5), and Group 3 was type Ⅸa (&lt;i&gt;n&lt;/i&gt;=8).The growth, development and prognosis of the children were followed up. The related clinical characteristics of pediatric hepatic glycogen storage disease were summarized. &lt;b&gt;Results:&lt;/b&gt; Twenty-five pediatric patients with hepatic glycogen storage disease were enrolled in this study, with fifteen males and ten females. The mean age of diagnosis was (29.1±13.5) months. There were twelve cases (48%) accompanied with varying degrees of hypoglycemia, and two cases (8%) with severe hypoglycemia.There were nineteen cases with stature retardation (76%), four cases with anemia (16%), three cases with proteinuria (12%), and one case with cholestasis (4%).The genetic results showed that there were four cases of type Ⅰa (16%), four cases of type Ⅰb (16%), one case of type Ⅱ (4%), five cases of type Ⅲ (20%), two cases of type Ⅳ (8%), one case of type Ⅵ (4%), and eight cases of type Ⅸ (32%).The three subgroups analysis showed that there were significant statistical differences in uric acid and triglycerides among the three groups (&lt;i&gt;P&lt;/i&gt;&lt;0.05), while there were no statistical significant differences in transaminase levels, fasting blood glucose, lactate, cholesterol, and low-density lipoprotein levels (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The height-for-age &lt;i&gt;Z&lt;/i&gt; scores of the three groups were -2.86±1.62, -1.46±1.06, and -1.83±0.98, respectively. The growth and development of groups 2 and 3 were significantly improved compared with group 1 (&lt;i&gt;P&lt;/i&gt;&lt;0.05), with &lt;i&gt;Z&lt;/i&gt; scores of -2.28±1.07, 0.20±1.54, and 0.10±1.44 after at least one year of follow-up. All pediatric patients with type Ⅸa had discontinued using raw corn starch after more than one year of follow-up and their transaminases had returned to normal. Four pediatric patients with type Ia were orally administered raw corn starch on a regular basis, and the aminotransferases, uric acid, and lactate were normal, with hypoglycemia being monitored. Among the four cases with type Ⅰb, one had recurrent respiratory tract and intestinal infections, two were combined with Crohn's disease, and one was monitored for hypoglycemia. In four cases of type Ⅲ, raw corn starch was discontinued, and a high-protein, low-carbohydrate diet was adopted, with the exception of the presence of high ","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"63-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on dietary and exercise intervention for the prevention and treatment of non-alcoholic fatty liver disease in obese children].","authors":"L H Tao, G Z Mo, B L Li, Q L Tang","doi":"10.3760/cma.j.cn501113-20240422-00220","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240422-00220","url":null,"abstract":"<p><p>Childhood obesity has become a global public health issue. The incidence rate of non-alcoholic fatty liver disease (NAFLD) in children has rapidly increased with the increase in obesity. Thus, NAFLD has become one of the most common causes of chronic liver disease in children. Currently, there are no officially approved drugs for the treatment of NAFLD in children. Lifestyle changes, including dietary and exercise interventions, are first-line treatment options for NAFLD in children in the absence of effective drugs. This article reviews the latest progress of these years in dietary and exercise interventions in the prevention and treatment of NAFLD in obese children.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guidelines for diagnosis and treatment of liver failure (2024 version)].","authors":"","doi":"10.3760/cma.j.cn501113-20241206-00614","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241206-00614","url":null,"abstract":"<p><p>Liver failure is a severe clinical syndrome of liver disease with an extremely high mortality rate. Over the years, scholars worldwide have continuously investigated various aspects of liver failure, including its definition, etiology, classification, types, diagnosis and treatment, and prognostic assessment. Based on the latest advances in research, Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association along with Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association have conducted a comprehensive update on the <i>Guidelines for diagnosis and treatment of liver failure (2018 version)</i>. This update aims to offer standardized protocols and evidence-based recommendations to guide the management of liver failure in clinical settings.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"18-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress of tolvaptan in the treatment of refractory ascites in cirrhosis].","authors":"Q Q Zhang, Y Chen, Y X Chen, L Yang","doi":"10.3760/cma.j.cn501113-20231225-00299","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20231225-00299","url":null,"abstract":"<p><p>Ascites is the most common complication in the decompensated stage of cirrhosis, with approximately 5% to 10% progressing to refractory ascites (RA). The complex pathogenesis, difficult treatment, and poor prognosis are major challenges and difficulties in the clinical treatment of RA. Tolvaptan (TLV) is a kind of novel non-peptide, selective arginine vasopressin V2 receptor antagonist that can inhibit renal water reabsorption, promote free water excretion, and increase blood sodium levels, providing a new clinical option for the treatment of cirrhotic RA. This paper briefly summarizes the mechanism of action of TLV and introduces its effectiveness, safety, and predictive factors response in order to provide a reference for clinical application in the treatment of cirrhotic RA.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"88-92"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}