中华肝脏病杂志最新文献

{"title":"[Exploring the protective effects and mechanisms of HYX1-derived exosomes on acute liver failure based on disulfidptosis signaling].","authors":"Q Yang, H X Tang, X X Liu, Y Chen, L Bai","doi":"10.3760/cma.j.cn501113-20250610-00227","DOIUrl":"10.3760/cma.j.cn501113-20250610-00227","url":null,"abstract":"<p><p><b>Objective:</b> To explore the protective effect and molecular mechanism of human liver stem cell line HYX1-derived exosomes (HYX1-Exos) on acute liver failure (ALF) based on disulfidptosis signaling. <b>Methods:</b> Healthy male BALB/c mice were intraperitoneally injected with D-galactosamine/lipopolysaccharide (D-GalN/LPS) to induce ALF. Mice were divided into a normal control group, an acute liver failure group (ALF group), a disulfidptosis inhibitor tris (2-carboxyethyl) phosphine (TCEP) intervention group (TCEP+ALF group), a HYX1-Exos intervention group (HYX1-Exos+ALF group), and a SLC7A11-IN-1 intervention group (SLC7A11-IN-1+ALF group), with five mice per group. Blood and liver tissue samples were collected. The degree of liver tissue damage was assessed based on serum transaminase levels and hematoxylin-eosin staining results. Quantitative PCR was used to analyze the gene expression levels of disulfidptosis markers SLC7A11, GLUT1, and WAVE2 in liver tissues of each group. Cell Counting Kit-8 (CCK-8) was used to evaluate hepatocyte viability. Statistical analysis was performed using the independent samples <i>t</i>-test and one-way ANOVA. <b>Results:</b> TCEP treatment had significantly alleviated liver damage in ALF mice, as indicated by a marked reduction in transaminase levels [alanine aminotransferase: (312.01±19.46) U/L <i>vs</i>. (1 512.09±229.34) U/L, <i>t</i>=10.38, <i>P</i><0.001; aspartate aminotransferase: (76.30±39.63) U/L <i>vs</i>. (324.17±78.27) U/L, <i>t</i>=5.75, <i>P</i><0.001] and a notable improvement in liver histology. HYX1-Exos treatment had significantly reduced liver injury and disulfidptosis levels in ALF mice. Liver injury and disulfidptosis levels were significantly reduced with inhibition of SLC7A11 in ALF mice. <i>In vitro</i> experiments showed that HYX1-Exos protected hepatocytes from disulfidptosis induced by high SLC7A11 under glucose starvation. <b>Conclusion:</b> Disulfidptosis plays an important role in the development of ALF, and HYX1-Exos likely have a hepatoprotective effect on ALF by inhibiting SLC7A11-mediated disulfidptosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 4","pages":"348-355"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Precise clinical classification of metabolic associated fatty liver disease].","authors":"W R Su, J J Ding, Q Pan, J Chai","doi":"10.3760/cma.j.cn501113-20251205-00519","DOIUrl":"10.3760/cma.j.cn501113-20251205-00519","url":null,"abstract":"<p><p>Metabolic associated fatty liver disease (MAFLD) is the most common chronic liver disease worldwide, and its significant clinical and pathophysiological heterogeneity poses a serious challenge to traditional \"one-size-fits-all\" diagnostic and therapeutic approaches. Therefore, constructing a precise clinical classification system to identify patient subgroups with varying risks and treatment responses has become a core frontier in this field. This article systematically summarizes the main current MAFLD classification methods, covering content from simple classification based on clinical phenotypes (e.g., body mass index) to non-invasive risk stratification via serology and imaging markers, and further extending to deep molecular subtyping driven by cutting-edge multi-omics technologies and artificial intelligence. In addition, it analyzes and points out the limitations of single-dimensional classification approaches. The future development trend is to construct a multi-dimensional, dynamic assessment system that integrates clinical, non-invasive biomarkers and deep molecular features, providing a comprehensive framework for laying a scientific foundation for elucidating the origins of disease heterogeneity, achieving personalized risk assessment, precision-targeted interventions, and innovative clinical trial designs, ultimately propelling MAFLD into the era of precision medicine.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 4","pages":"307-311"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ATPase H⁺ transporter expression with prognosis in hepatocellular carcinoma].","authors":"Q Yuan, Y Q Jin, Y X Cao, L J Cheng, H M Fan, Y Liu, L Yang","doi":"10.3760/cma.j.cn501113-20250709-00269","DOIUrl":"10.3760/cma.j.cn501113-20250709-00269","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the expression level of ATPase H⁺ transporting accessory protein 1 (ATP6AP1) in hepatocellular carcinoma (HCC) lines and its effect on cell proliferation and migration, providing a new target for the treatment of HCC. <b>Methods:</b> Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect the differential expression of ATP6AP1 in normal hepatocyte line L02 and hepatocellular carcinoma line HepG2. An ATP6AP1 knockdown group (KD group) and a negative control group (NC group) were constructed by lentiviral infection. The proliferation and migration abilities were detected by CCK8 cell proliferation and cell scratch assay between the two groups. Independent samples <i>t</i>-test was used to analyze the differences between groups. Bioinformatics analysis was performed on the Cancer Genome Atlas (TCGA) databases using Kaplan-Meier Plotter, UALCAN, and GEPIA to explore the differential expression of ATP6AP1 in HCC patients and its impact on prognosis. <b>Results:</b> Bioinformatics results showed that the expression level of ATP6AP1 was significantly higher in HCC tissues than that in normal liver tissues (<i>P</i><0.05). Functional enrichment analysis indicated that ATP6AP1 regulated lysosomal function, intracellular acidification, and the immune microenvironment in HCC progression. RT-PCR results showed that ATP6AP1 mRNA expression was significantly higher in HepG2 liver cancer cells than that in normal hepatocytes L02 (<i>P</i><0.05). The relative expression level of ATP6AP1 mRNA was significantly lower in the KD group (0.18±0.01) than that in the NC group (1.00±0.08) (<i>P</i><0.001). CCK assays showed that the profileration capacity was significantly higher in KD group than that in the NC group from day 3 to day 5 (<i>P</i><0.05), with a significant time-effect relationship (<i>P</i><0.001). Cell scratch assay results showed that the migration rate was significantly higher in the NC group than that of the KD group over time, with a slower scratch repair rate. <b>Conclusion:</b> High expression of ATP6AP1 plays a pro-cancerous role in HCC progression and may serve as a potential biomarker for predicting prognosis and a potential therapeutic target.Therefore, further validation of its mechanism of action in animal models and clinical samples is needed in the future.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 4","pages":"323-331"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics and follow-up in children with Alagille syndrome].","authors":"W W Liu, X M Zhong, P Wang, M J Wang, M Jin, R Zhang, M R Mi","doi":"10.3760/cma.j.cn501113-20250918-00392","DOIUrl":"10.3760/cma.j.cn501113-20250918-00392","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical and genetic features and follow-up outcomes in children with Alagille syndrome (ALGS). <b>Methods:</b> A retrospective cohort study was conducted. Clinical data from 24 children diagnosed with ALGS treated at Capital Children's Medical Center, Capital Medical University, from January 2015 to January 2025 were collected and analyzed. Genetic variation characteristics were collected by comparing biochemical indicator changes in children who were followed up for over six months before and after treatment. Independent samples <i>t</i>-tests or rank-sum tests were used to compare continuous data between groups. The correlation between liver stiffness and bile acid levels was compared using Spearman correlation analysis. <b>Results:</b> Out of the 24 enrolled cases, ten were male. The occurrence rate during the neonatal phase accounted for 62.5% (15/24), while the occurrence rate before six months of age was 87.5% (21/24). The median age at the time of confirmed diagnosis was 16 months (26 days, 11 years). The common clinical manifestations were cholestasis, accounting for 87.5% (21/24); hepatomegaly, 75.0% (18/24); distinctive facial features, 70.8% (17/24); and butterfly-shaped vertebrae, 45.8% (11/24). Cardiovascular involvement accounted for 45.8% (11/24). Growth and development retardation was observed in 37.5% (9/24). The pruritus incidence rate at the time of definite diagnosis in pediatric patients was 54.2% (13/24). Among the five pediatric patients who underwent liver biopsy, three had the typical pathology of intrahepatic bile duct insufficiency. Genetic examinations were performed in all 24 cases. The <i>JAG1</i> gene mutation was present in 22 cases, while the <i>NOTCH2</i> gene mutation was present in two. Exon deletion was detected in one case, splicing variants in eight, frameshift variations in six, nonsense variations in three, and missense variations in six. Among ALGS cases, 21 patients survived following autologous liver transplantation and were followed up for at least six months. Aspartate aminotransferase, total bilirubin, direct bilirubin, γ-glutamyl transferase, triglycerides, and low-density lipoprotein cholesterol were significantly declined (<i>P</i><0.05). Serum cholesterol levels were increased during follow-up compared to the disease onset phase and showed a progressive trend with prolonged disease duration. Liver stiffness values exhibited an annual upward trend and correlated positively with bile acid levels. <b>Conclusion:</b> Cholestasis, hepatomegaly, distinctive facial features, and the presentation of early-stage liver fibrosis are common clinical manifestations during the ALGS diagnosis in pediatric patients. Certain liver disease indicators may improve following treatment, resulting in a substantial reduction in bilirubin levels; however, hypercholesterolemia may develop.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 4","pages":"356-362"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Novel advances following the integration of Baveno VII consensus definitions for the non-invasive testing of portal hypertension].","authors":"J L Chen, C Q Yang","doi":"10.3760/cma.j.cn501113-20250621-00249","DOIUrl":"10.3760/cma.j.cn501113-20250621-00249","url":null,"abstract":"<p><p>Portal hypertension (PH) is a common and severe complication, which significantly affects patients with liver cirrhosis' quality of life and prognosis. In recent years, the assessment and management of PH have gradually gained attention, especially with the Baveno VII consensus, which proposed definitions for key events as well as the latest advances in its diagnosis and treatment method, emphasizing the diagnostic value of non-invasive tests (NITs) and providing novel perspectives for research in this field. This article reviews the existing literature to explore the application of novel NITs in the diagnosis of PH so as to provide prospects for their future development.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"271-277"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploration and application of nanotechnology in precision transarterial chemoembolization for hepatocellular carcinoma].","authors":"J Q Kong, R Li, R N Zuo, X Zhang, Z H Ding, Y Dai","doi":"10.3760/cma.j.cn501113-20251117-00494","DOIUrl":"10.3760/cma.j.cn501113-20251117-00494","url":null,"abstract":"<p><p>Transarterial chemoembolization (TACE) is a first-line therapy for intermediate-to-advanced- stage hepatocellular carcinoma, but its clinical efficacy is often limited by incomplete embolization, systemic toxicity of chemotherapeutic drugs, and tumor recurrence and metastasis caused by the postoperative microenvironment. The emergence of nanotechnology provides a novel solution to overcome these bottlenecks. This article aims to review new strategies and clinical translations of nanoparticles as intelligent carriers in enhancing the TACE efficacy. Furthermore, it focuses on the latest advances of nanotechnology in achieving precise embolization, targeted drug delivery, multimodal imaging guidance, and others. This article further analyzes the new concept of the synergistic therapeutic approach of loading anti-angiogenic drugs or active ingredients from traditional Chinese medicine onto nanocarriers to synergistically enhance the anti-recurrence effect of TACE, and lists relevant nanomedicine cases that have entered clinical trials. Although nanotechnology still faces challenges, such as biosafety profile, large-scale production, and personalized application in the clinical translation of TACE, the deep integration of materials science, interventional medicine, and biotechnology to build an \"integrated diagnosis and treatment\" intelligent nanoplatform will surely propel TACE from empirical treatment to a new era of precision medicine, opening up new avenues for improving the prognosis of patients with intermediate and advanced stage HCC.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"263-270"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploring the research on the molecular mechanisms of autoimmune liver diseases].","authors":"Y Q Liu, X W Jiang, Y Li, X L Liu","doi":"10.3760/cma.j.cn501113-20250930-00418","DOIUrl":"10.3760/cma.j.cn501113-20250930-00418","url":null,"abstract":"<p><p>Autoimmune liver diseases include subtypes such as autoimmune hepatitis and primary biliary cholangitis, which are caused by abnormal immune system attacks on hepatocytes or bile ducts. This article reviews their molecular mechanisms from three aspects: genetics, environment, and immunity. Human leukocyte antigen (HLA) gene polymorphisms such as <i>DRB10301</i> and <i>DRB10405</i> show regional specificity, and non-HLA gene variants such as CTLA4 and FAS also contribute to disease development in terms of genetic factors. Cross-immune responses are triggered through 'molecular mimicry,\" disturbances in bile acid metabolism and gut microbiota imbalances affect disease progression via the gut-liver axis; and Escherichia coli infection is closely related to primary biliary cholangitis on the basis of environmental factors. Regulatory T cell dysfunction disrupts self-tolerance, abnormal activation of Th17 cells, and alterations in mucosa-associated invariant T cell function lead to liver damage, and chemokines exacerbate local inflammation in terms of immune regulation. The above mechanisms collectively form a molecular network for the pathogenesis of autoimmune liver disease, providing a basis for targeted therapy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"286-291"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical features and pathological scoring analysis of hepatic amyloidosis].","authors":"Y X Gong, Z X Du, Y Yang, S S Li, J L Wang, Y F Yang","doi":"10.3760/cma.j.cn501113-20250708-00268","DOIUrl":"10.3760/cma.j.cn501113-20250708-00268","url":null,"abstract":"<p><p><b>Objective:</b> To explore the relationship between clinical manifestations and pathological features so as to provide a theoretical basis for the assessment of the condition in patients with hepatic amyloidosis. <b>Methods:</b> Twelve patients diagnosed with hepatic amyloidosis at the Second Hospital of Nanjing City from 2018 to 2024 were included. General condition, clinical manifestations, pathological features, and prognostic status were analyzed. Hematoxylin-eosin staining was performed on liver biopsy specimens to assess the pathological features of amyloidosis. The area of amyloidosis relative to the area of liver biopsy tissue in random fields was used as the score for the degree of liver degeneration. The Child-Pugh score was used to assess the patients' clinical phenotype. Data analysis was performed using R4.4.2 software. Univariate logistic regression and Spearman analysis were conducted. <b>Results:</b> Of the twelve cases, one was female and eleven were male, with a median age of onset of 63.5 (62, 65) years. All patients presented with fatigue, poor appetite, and hepatomegaly. Liver function tests showed cholestatic liver injury. Six patients had a Child-Pugh score of A, while six had a B or C. Four had a pathological score of two, while eight had a score of three. Univariate logistic regression analysis and Spearman analysis showed no correlation between the degree of pathological damage and the patients' clinical indicators or Child-Pugh scores. <b>Conclusion:</b> Patients presenting with fatigue, poor appetite, hepatomegaly, and cholestatic liver injury should be further differentiated from amyloidosis after ruling out other necessary common causes in clinical practice. To prevent any delay in therapy, clinicians should accurately evaluate the patient's condition for liver biopsy tolerance and conductance.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"232-239"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research advances on hepatic encephalopathy following transjugular intrahepatic portosystemic shunt].","authors":"J J Ye, Y L Pan, J Wang, Y Lyu","doi":"10.3760/cma.j.cn501113-20250527-00202","DOIUrl":"10.3760/cma.j.cn501113-20250527-00202","url":null,"abstract":"<p><p>Transjugular intrahepatic portosystemic shunt (TIPS) is an important therapeutic method for complications of portal hypertension in cirrhosis, but the high incidence rate of postoperative hepatic encephalopathy seriously affects patient prognosis. Current research focuses on the core mechanisms and intervention methods specific to or related to TIPS, clarifying that the risk factors for hepatic encephalopathy are centered on perioperative TIPS parameters (stent diameter, portosystemic venous pressure gradient, spontaneous portosystemic shunt). The pathogenesis is key to shunt-related ammonia metabolism imbalance, hemodynamic abnormalities, and gut-hepatic-brain axis abnormalities. Prevention and treatment strategies revolve around a comprehensive management system of \"preoperative risk stratification-intraoperative precise shunt-postoperative targeted intervention,\" emphasizing TIPS-specific procedures such as stent optimization, spontaneous portosystemic shunt closure, and flow-limiting stents, as well as targeted technologies like fecal microbiota transplantation and artificial intelligence risk prediction, ultimately providing practical evidence for the precise prevention and treatment of hepatic encephalopathy following TIPS.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"249-255"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A dual-center study of enhanced CT-based nomograms predicts spontaneous portosystemic shunts on initial hemorrhage from rupture of esophageal gastric varices in cirrhosis].","authors":"X Z Yan, J H Chu, B Li, X Y Chen, B S Yuan, H Y Li, G L Wang, Q Ji","doi":"10.3760/cma.j.cn501113-20241125-00594","DOIUrl":"10.3760/cma.j.cn501113-20241125-00594","url":null,"abstract":"<p><p><b>Objective:</b> To explore the value of an enhanced CT-based nomogram for predicting spontaneous portosystemic shunts (SPSS) on initial hemorrhage from rupture of esophageal gastric varices in cirrhosis. <b>Methods:</b> Clinical and imaging data from 212 cases with esophageal gastric varices in cirrhosis were retrospectively collected from two hospitals. The 166 cases collected from one hospital were used as the training group (87 patients in the hemorrhagic group and 79 patients in the non-hemorrhagic group), while 46 patients collected from the other hospital were used as the external validation group (18 patients in the hemorrhagic group and 28 patients in the non-hemorrhagic group). Logistic regression analysis was used to identify variables for constructing the optimal predictive model. The nomogram was used to illustrate the model. The training set was internally validated by the Bootstrap method. The area under the receiver operating characteristic curve (AUC) was used to evaluate the discrimination of the model. The accuracy and clinical benefit of the model were assessed using standard curves and clinical decision curves. Statistical analysis was performed using the independent samples <i>t</i>-test, Mann-Whitney <i>U</i> test, <i>χ</i>² test, or Fisher's exact probability method according to the different data. <b>Results:</b> There were statistically significant differences in Child-Pugh grade, model for end-stage liver disease score, albumin, direct bilirubin, total bilirubin, prothrombin time, alanine aminotransferase, international normalized ratio, white blood cell count, hemoglobin, inferior vena cava diameter, portal vein diameter, splenic vein diameter, SPSS diameter, SPSS volume, and portal vein thrombosis between the two training groups (<i>P</i><0.05). Univariate logistic regression analysis revealed statistically significant differences with statistical significance between the two groups for some indicators (<i>P</i><0.05). Multivariate logistic regression analysis showed that SPSS volume, portal vein diameter, portal vein thrombosis, prothrombin time and hemoglobin had the optimal prediction model for establishment of the initial hemorrhage from rupture of esophagogastric variceal in cirrhosis. The AUCs for the training, internal validation, and external validation groups were 0.822, 0.806, and 0.802, respectively. The calibration curve demonstrated good consistency. The clinical decision curve indicated that the net benefit of the prediction model was significantly higher than all positive or negative predictions within a larger threshold range. <b>Conclusion:</b> An enhanced CT-based nomogram can accurately predict SPSS on the initial hemorrhage from rupture of esophagogastric varices in cirrhosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 3","pages":"205-214"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}