中华肝脏病杂志最新文献

{"title":"[Predictive value of a Chinese visceral adiposity index for metabolic associated fatty liver disease].","authors":"M X Zhang, L Wang, X Zhang, Y C Dong, Y C Wang","doi":"10.3760/cma.j.cn501113-20240910-00486","DOIUrl":"10.3760/cma.j.cn501113-20240910-00486","url":null,"abstract":"<p><p><b>Objective:</b> To explore the correlation between Chinese visceral adiposity index (CVAI) and metabolic associated fatty liver disease (MAFLD) so as to evaluate its predictive value for MAFLD. <b>Methods:</b> Six hundred and thirteen cases admitted to the Department of Gastroenterology, Zhongshan Hospital Affiliated to Dalian University from June 2022 to August 2023 were selected and divided into the MAFLD group (<i>n</i>=312) and the non-MAFLD group (<i>n</i>=301) according to the diagnostic criteria of MAFLD. The clinical data differences between the two groups were compared. The MAFLD group was divided into a mild MAFLD group (<i>n</i>=243) and a moderate to severe MAFLD group (<i>n</i>=69) according to the liver/spleen CT value. The differences in body fat indices such as CVAI, visceral fat index (VAI), and visceral fat area (VFA) were compared between subjects with different degrees of MAFLD. The Spearman test was used to analyze the correlation between CVAI, VAI, and various clinical indicators. The subjects were divided into groups (Q1-Q4) according to the quartile levels of CVAI and VAI, and the distribution of MAFLD conditions among the groups was compared. Logistic regression analysis was used to determine the occurrence risk of MAFLD at different CVAI and VAI levels. The receiver operating characteristic curve was drawn. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the predictive value of CVAI, VAI, VFA, waist circumference, and body mass index for MAFLD. The DeLong test was used to compare the differences in the AUC of each predictive index. <b>Results:</b> The prevalence of hypertension and type 2 diabetes mellitus, and the levels of systolic blood pressure, diastolic blood pressure, CVAI, VAI, VFA, subcutaneous fat area, waist circumference, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, and serum uric acid were higher in the MAFLD group than the non-MAFLD group (<i>P</i><0.05), while the level of high-density lipoprotein cholesterol was lower than the non-MAFLD group (<i>P</i><0.001). The levels of CVAI, VAI, VFA, waist circumference, and body mass index were higher in the mild and the moderate to severe MAFLD group than those in the non-MAFLD group (<i>P</i><0.001). The detection rate of MAFLD gradually increased(<i>χ</i>²=176.953, 133.659, <i>P</i><0.001) with the increase of CVAI and VAI levels. Correlation analysis showed that CVAI was positively correlated with VFA (<i>r</i>=0.755, <i>P</i><0.001) and the homeostasis model assessment of insulin resistance (<i>r</i>=0.579, <i>P</i><0.001). Multivariate logistic regression analysis showed that after adjusting for various risk factors, the risk of MAFLD in the Q4 group o","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"781-789"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971926","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":"[Introduction of the key update points of the 2025 Canadian Association for the Study of the Liver guideline for the management of chronic hepatitis B].","authors":"H Zhuang","doi":"10.3760/cma.j.cn501113-20250630-00257","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250630-00257","url":null,"abstract":"<p><p>The Canadian Association for the Study of the Liver and Association of Medical Microbiology and Infectious Disease Canada developed jointly the 2025 guidelines for the management of chronic hepatitis B in May 2025. The guidelines updated recommendations for universal adult HBV screening, vaccination, laboratory assessment, treatment, patient-centered care, early diagnosis, expanding antiviral treatment. Notably, the guidelines recommend reflex HDV testing and routine use of quantitative HBsAg for the decision of HBV management.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"768-771"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971928","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 research progress in different stages of recompensated cirrhosis].","authors":"Y P Wang, X H Yang, H Y Cai, P Zhou, X P Tang, X Y Xu, Y J Guan","doi":"10.3760/cma.j.cn501113-20250407-00129","DOIUrl":"10.3760/cma.j.cn501113-20250407-00129","url":null,"abstract":"<p><p>The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"715-720"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971945","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":"[Expert consensus on the clinical application of gut microbiota transplant therapy in chronic liver disease (version 2025)].","authors":"","doi":"10.3760/cma.j.cn501113-20250429-00163","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250429-00163","url":null,"abstract":"<p><p>The gut microbiota plays an important role in maintaining host health and liver function, and gut microbiota transplant (also known as fecal microbiota transplantation) has shown potential clinical benefits in the treatment of chronic liver disease. To help clinical professionals to quickly master and standardize the clinical application of gut microbiota transplant in chronic liver disease, the Group of the Liver Disease-related Gastroenterology Branch of the Chinese Medical Association organized experts in related fields to formulate the \"Expert Consensus on the Clinical Application of Gut Microbiota Transplant in the Treatment of Chronic Liver Disease\" such as chronic hepatitis, cirrhosis and liver cancer, including indications, contraindications, effectiveness, safety, donor selection, transplant routes, transplant precautions, prevention and treatment of adverse reactions, and other aspects to provide reference and guidance for clinicians to implement gut microbiota transplant.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"738-746"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971885","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":"[Introduction to the update points of the 2025 European Association for the Study of Liver clinical practice guidelines for the management of chronic hepatitis B infection].","authors":"H Zhuang","doi":"10.3760/cma.j.cn501113-20250630-00256","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250630-00256","url":null,"abstract":"<p><p>The European Association for the Study of Liver (EASL) on May 8, 2025, published the updated clinical practice guidelines for the management of chronic hepatitis B virus infection (HBV), which proposes a comprehensive, evidence-based approach to clinical practice. The recommendations are divided into ten thematic chapters, including diagnosis, treatment goals, treatment indications, treatment options, hepatocellular carcinoma surveillance, management of special populations, HBV reactivation prevention, post-transplant care, HBV prevention strategies, problems to be solved, and future research directions.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"760-767"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971899","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":"[Pathological characteristics and diagnostic criteria of autoimmune hepatitis].","authors":"L Wang, Y F Yang","doi":"10.3760/cma.j.cn501113-20250510-00181","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250510-00181","url":null,"abstract":"<p><p>Autoimmune hepatitis (AIH) is a kind of chronic inflammatory liver disease mainly characterized by hepatocellular damage. There is no gold standard for its diagnosis, and it still relies on liver histological examination. Pathological examination is indispensable in the differential diagnosis and disease assessment of AIH. This article systematically reviews the evolution of pathological diagnostic criteria for AIH since the introduction of the initial scoring system by the International AIH in 1993, moving from early-stage empirical descriptions to quantitative scoring systems and then to the ongoing advancement of the latest international consensus standards. The standardization and accuracy of pathological diagnosis have significantly improved; at the same time, it reflects that the role of pathology in diagnosing AIH has shifted from a traditional auxiliary role to a key role in definitive diagnosis. The core pathological features of AIH include interface hepatitis, lymphoplasmacytic infiltrate, and hepatocellular rosettes; however, none of which are specific. The scarcity of specialized professionals, insufficient diagnostic resources at the foundation level, and the high subjectivity of pathological evaluation are the primary factors promoting to the current challenges in the pathological diagnosis of AIH. Quantitative pathological assessment, digital pathology, artificial intelligence assistance, and other advancements could drive the development of pathological diagnosis in AIH in the future.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 7","pages":"622-627"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817555","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":"[Analysis of liver histological characteristics and clinically related factors in patients with inactive HBsAg carriers].","authors":"X Y Zhang, S Ren, S J Zheng, R S Fan, Q F Ruan, W Q Huang, H B Gao, Y Xie, M H Li, X L Xue, F Yang, J L Fu, X Y Chen","doi":"10.3760/cma.j.cn501113-20241115-00580","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241115-00580","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the liver histological characteristics and clinically related factors in inactive hepatitis B surface antigen (HBsAg) carriers (IHC), and also explore whether antiviral treatment is necessary for IHC, as defined in the 2022 version of the hepatitis B prevention and treatment guidelines. <b>Methods:</b> A multicenter, retrospective cohort study was conducted. Two hundred and thirty-one IHC cases who underwent liver biopsy histopathological examination in nine medical institutions, including Beijing Youan Hospital affiliated with Capital Medical University, from January 2018 to December 2023 were included. General informative data, clinical serological markers, and transient elastography (TE) examination results were collected. Patients were divided into a positive (148 cases) and a negative group (83 cases) according to the results of hepatitis B virus (HBV) DNA detection. The differences in liver pathological inflammatory activity (G) and liver fibrosis stage (S) were analyzed between the two groups to explore the correlation between liver tissue conditions and clinically related factors. Comparsions of normally distributed continwous data, skeukd continuous data, and categorical data between groups are performed using <i>t</i> tests, Mann-Whitney <i>U</i> tests and <i>􀱽</i>² tests, respectively. <b>Results:</b> The age of 231 IHC cases was 43 (38, 51) years old, with 95.2% (220/231) aged ≥30 years, and males accounted for 64.9% (150/231). HBsAg and HBV DNA levels were 131.9 (20.8, 400.9) IU/mL and 94.0 (0, 448.5) IU/mL, respectively, of which 35.9% (83/231) were HBV DNA negative (<20 IU/mL). The remarkable proportions of G≥2, S≥2, and liver injury (G≥2 and/or S≥2) in liver tissue were 16.5% (38/231), 29% (67/231), and 35.9% (83/231), respectively. The S≥2 proportion was significantly higher in the HBV DNA-negative group than the positive group (42.2% <i>vs</i>. 21.6%, <i>P</i><0.001), and it mainly occurred in the population cohort over 30 years old (44.9% <i>vs</i>. 31.0%, <i>P</i>=0.04). The liver stiffness measurement (LSM), aspartate transaminase to platelet ratio index (APRI), and platelet (PLT) were significantly higher in the S≥2 group than the S<2 group (<i>P</i><0.05). <b>Conclusion:</b> Clinicians can comprehensively evaluate the degree of liver fibrosis in IHC based on clinical factors such as age, PLT, APRI, and LSM, even if the liver histological results are lacking. The China 2022 version guidelines define that nearly half of IHC has histological indications for antiviral therapy, and liver biopsy and prompt treatment can be recommended.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 7","pages":"660-666"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817578","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":"[Progress on the research of hepatolenticular degeneration].","authors":"S Tang, W Hou, Z P Duan, S J Zheng","doi":"10.3760/cma.j.cn501113-20241118-00585","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241118-00585","url":null,"abstract":"<p><p>Hepatolenticular degeneration, also known as Wilson disease (WD), is a type of copper metabolism disorder caused by an <i>ATP7B</i> gene variant, which is manifested by the abnormal accumulation of copper in the liver and other organs, resulting in multisystem damage. This article summarizes the latest research progress, with an emphasis on clinical characteristics, analysis of the optimization of diagnostic technology, and the clinical application of novel copper chelator therapy, as well as the development status and future prospects of gene therapy for WD. Future research should focus on the in-depth analysis of the mechanism, the application of multidimensional precision diagnosis technology, the development of individualized treatment plans, and the development of multicenter clinical trials in order to improve the comprehensive treatment effects and quality of life for patients with WD.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 7","pages":"704-708"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817557","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":"[Diagnosis and treatment strategies of autoimmune hepatitis and future challenges].","authors":"T Y Mao, X Xiao, X Ma","doi":"10.3760/cma.j.cn501113-20250508-00179","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250508-00179","url":null,"abstract":"<p><p>Autoimmune hepatitis (AIH) is a kind of immune-mediated chronic liver disease, and its specific pathogenesis has not yet been fully elucidated. In recent years, the International Autoimmune Hepatitis Expert Group has revised histology and autoantibody evaluation criteria for diagnosing AIH and has clarified the definition of treatment response. The current standard treatment regimen is still glucocorticoids and azathioprine, but novel biological agents offer new therapeutic options for patients with refractory AIH. This article reviews the new progress in the diagnosis and treatment of AIH and explores the current challenges and future research directions.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 7","pages":"617-621"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817583","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":"[Advances in clinical diagnosis and treatment of autoimmune liver diseases combined with viral hepatitis].","authors":"L H Zheng, Y Han","doi":"10.3760/cma.j.cn501113-20250511-00183","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250511-00183","url":null,"abstract":"<p><p>Autoimmune liver diseases (AILDs) is a group of chronic inflammatory liver diseases mediated by autoimmune disorders, while viral hepatitis is a group of infectious diseases mainly induced by hepatotropic viruses, resulting in liver inflammation and necrotic lesions. A viral infection is a risk factor for AILDs, and the two conditions may coexist. This article provides a review of the diagnosis and treatment of AILDs combined with viral hepatitis in recent years.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 7","pages":"613-616"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817575","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}