中华肝脏病杂志最新文献

{"title":"[Advances in the diagnosis and treatment of portal hypertensive gastrointestinal and bile duct disease].","authors":"J H Xu, Y Y Yu, X Y Xu","doi":"10.3760/cma.j.cn501113-20260416-00157","DOIUrl":"10.3760/cma.j.cn501113-20260416-00157","url":null,"abstract":"<p><p>Portal hypertensive gastrointestinal disease refers to gastrointestinal mucosal lesions secondary to portal hypertension. It is an important cause of gastrointestinal bleeding and chronic anemia in patients with portal hypertension. Gastrointestinal bleeding is also associated with portal hypertensive bile duct disease. The portal vein pressure reduction is the core of the therapy. This review summarizes progress in the clinical diagnosis, treatment, and prevention, with a focus on the differential diagnosis between portal hypertensive gastropathy and gastric antral vascular ectasia, as well as the drug therapy selection indications, endoscopic treatment, and transjugular intrahepatic portosystemic shunt in portal hypertensive gastrointestinal and bile duct diseases.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"618-623"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593670","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 significance and occurrence mechanism of hepatitis B virus DNA integration].","authors":"Y J Shi, K X Zhang, M Y Li, D J Lu, X M Chen","doi":"10.3760/cma.j.cn501113-20250902-00359","DOIUrl":"10.3760/cma.j.cn501113-20250902-00359","url":null,"abstract":"<p><p>Double-stranded linear DNA (dslDNA), considered to serve as a major precursor to integrated HBV DNA (iDNA), is generally located in the livers of patients with chronic HBV infection. Prior research has primarily focused on the role and mechanisms of HBV integration in the progression of hepatocellular carcinoma (HCC), demonstrating that iDNA can lead to genomic instability in the host and induce aberrant expression of host tumor-related genes around the integration sites, while viral proteins expressed by iDNA exhibit tumor-promoting effects. In recent years, the impact of iDNA-derived hepatitis B surface antigen on antiviral therapy in patients with chronic hepatitis B has received increasing attention with a deeper understanding of integrated HBV DNA. Consequently, the field has become a research hotspot and challenge in determining how to eliminate or silence iDNA to improve functional cure in patients with chronic hepatitis B. This paper aims to provide new sights to the clinical significance of iDNA and a theoretical basis for optimizing antiviral therapy strategies by summarizing the occurrence mechanisms of iDNA and its impact on the onset and progression of hepatocellular carcinoma and antiviral therapy for patients with chronic hepatitis B.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"699-707"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593115","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":"[Emphasis on the etiological diagnosis and management of non-cirrhotic portal hypertension].","authors":"J Liu, L L Zhao, J Li","doi":"10.3760/cma.j.cn501113-20260525-00204","DOIUrl":"10.3760/cma.j.cn501113-20260525-00204","url":null,"abstract":"<p><p>Non-cirrhotic portal hypertension (NCPH) refers to portal hypertension that occurs in patients without cirrhosis. Currently, the diagnosis rate is gradually increasing, but the existing etiologies are highly heterogeneous and are not yet fully clarified. The present basic NCPH treatment strategies are etiological intervention and complication management of portal hypertension; however, etiological research is relatively limited. Therefore, an in-depth study of etiology and multidisciplinary collaborative management throughout the entire process is significantly crucial for further improving the accuracy of diagnosis and treatment in patients with NCPH.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"635-639"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593256","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":"[Advances in the diagnosis and treatment of patients with multidrug-resistant bacterial infections combined with severe liver disease].","authors":"X L Lu, W C Xu, H R Ke, Q H Cheng, B L Li, J J Chen","doi":"10.3760/cma.j.cn501113-20251107-00481","DOIUrl":"10.3760/cma.j.cn501113-20251107-00481","url":null,"abstract":"<p><p>Effective antibiotic treatment is crucial for patients with severe liver disease combined with bacterial infections in the early stage. However, the incidence rate of multidrug-resistant bacteria (MDROs) infection in such patients is as high as 34%, and it is increasing year by year, becoming one of the main causes of antibiotic treatment failure and patient mortality. The main common MDROs in clinical practice are methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant Enterococcus, and extended-spectrum β-lactamase-producing Enterobacteriaceae, with limited antimicrobial therapeutic options. Therefore, research on the diagnosis and treatment of MDRO infection can significantly improve the prognosis of patients with severe liver disease. The main risk factors for MDRO infections in these patients include frequent hospitalizations, invasive procedures, MDRO colonization, and repeated exposure to antimicrobial agents. The key measures to reduce MDRO infection are to strengthen nosocomial infection control, use antimicrobial agents rationally, conduct epidemiological surveillance, and actively screen colonized patients.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"582-588"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353820","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":"[Transitional and clinical practice pathways for whole-course management of hepatocellular carcinoma in the infectious diseases department].","authors":"Y C Tao, X Z Lei, T Y Zhou, J J Lu, L Y Zhou, E Q Chen","doi":"10.3760/cma.j.cn501113-20251229-00551","DOIUrl":"10.3760/cma.j.cn501113-20251229-00551","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"607-612"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353783","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":"[Ultrasound technology's new application in the diagnosis and treatment of liver cancer].","authors":"Q Cai, J Yu","doi":"10.3760/cma.j.cn501113-20260312-00105","DOIUrl":"10.3760/cma.j.cn501113-20260312-00105","url":null,"abstract":"<p><p>Primary liver cancer (represented by hepatocellular carcinoma and intrahepatic cholangiocarcinoma) is a common clinical malignant liver tumor with a high mortality burden. The disease has high heterogeneity, and diagnosis stratification and efficacy evaluation heavily rely on imaging. Among imaging modalities, ultrasound, with its advantages of real-time imaging, gradually improving resolution, and dynamic assessment of multi-parameter information such as blood flow perfusion, is continuously expanding its application scenarios in the liver cancer diagnosis and treatment chain along with the rapid development of a series of new technologies. In recent years, technologies such as microvascular blood flow ultrasound, super-resolution ultrasound, three-dimensional multi-parameter contrast-enhanced ultrasound, viscoelasticity, and dispersive imaging have developed rapidly, enabling more refined acquisition of blood flow, perfusion, and mechanical information related to liver cancer. Simultaneously, workflow technologies such as integrated navigation and artificial intelligence-assisted procedures have promoted more precise and visual positioning, quantification, and evaluation during interventional procedures and provided a foundation for the further introduction of closed-loop simulation and decision support frameworks represented by digital twins. This article focuses on the two key aspects of liver cancer diagnosis and treatment, systematically reviews the above-mentioned ultrasound technologies' new clinical value and applicable scenarios and limitations, and looks forward to directions such as standardization, multi-center validation, and workflow integration, with the aim of providing a reference for clinical practice and research design.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"511-518"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353871","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":"[Study on preoperative prediction of microvascular invasion based on contrast-enhanced ultrasound habitat imaging combined with peritumoral radiomics in hepatocellular carcinoma].","authors":"X X Wei, Q Q Tang, J S Pang, Y He, H Yang","doi":"10.3760/cma.j.cn501113-20260312-00106","DOIUrl":"10.3760/cma.j.cn501113-20260312-00106","url":null,"abstract":"<p><p><b>Objective:</b> Hepatocellular carcinoma has a poor prognosis, and microvascular invasion (MVI) is an important indicator for guiding surgical decisions and influencing long-term survival. This study aims to explore the application value of habitat imaging combined with peritumoral radiomics in the preoperative assessment of MVI based on contrast-enhanced ultrasound (CEUS) images in hepatocellular carcinoma. <b>Methods:</b> The contrast-enhanced ultrasound images and clinical data of 186 patients with pathologically confirmed hepatocellular carcinoma at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed and randomly divided into a training group (<i>n</i>=130) and a test group (<i>n</i>=56) in a 7∶3 ratio. Eleven clinical indicators, such as patient age and alpha-fetoprotein (AFP) were extracted. Microvascular invasion (MVI)-independent risk factors were screened to construct clinical prediction models for tumors. Peritumoral and intratumoral regions of interest (ROIs) were depicted at 5 mm and 10 mm on arterial and delayed CEUS phase images. Traditional radiomic features were extracted. Corresponding prediction models were constructed. The above-mentioned depicted intratumoral regions of interest were concurrently applied using K-means clustering to divide the tumor habitat subregions, habitat features, and establish an intratumoral habitat model. Furthermore, a combined model was constructed by integrating a habitat with 5 mm peritumoral features. The predictive efficacy of each model was comprehensively evaluated using indicators such as the area under the receiver operating characteristic (AUC), calibration curve, and decision curve. <b>Results:</b> The clinical model had poorly performed predictions for MVI (training set AUC=0.762; validation set AUC=0.668). The 5 mm peritumoral radiomics model showed better generalization ability and stability than the 10 mm peritumoral and intratumoral models (training set AUC=0.785 <i>vs</i>. 0.786, 0.802; validation set AUC=0.727 <i>vs</i>. 0.672, 0.708). The intratumoral habitat model (training set AUC=0.824; validation set AUC=0.753) was more effective in predicting MVI than both the clinical and the traditional radiomics models in hepatocellular carcinoma. Furthermore, the predictive efficacy of MVI with the selection of a constructed intratumoral habitat combined with 5 mm peritumoral was improved (training set AUC=0.888; test set AUC=0.843), with accuracy, sensitivity, specificity, and clinical net benefit all significantly higher than those of other models. The classification ability had a positive improvement effect. <b>Conclusion:</b> Intratumoral habitat analysis can effectively assess the MVI status based on contrast-enhanced ultrasound in patients with hepatocellular carcinoma. In addition, the combined 5-mm peritumoral radiomics model can more accurately assess the MVI status in patients with hepatocellular carcinoma.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"554-563"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353833","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":"[Ultrasound technologies' new clinical application for chronic liver diseases].","authors":"M Y Xiao, X Lu, J Y Jin, M L Wu, J Ren","doi":"10.3760/cma.j.cn501113-20260408-00143","DOIUrl":"10.3760/cma.j.cn501113-20260408-00143","url":null,"abstract":"<p><p>Chronic liver disease and its complications impose a heavy burden，and the limits of liver biopsy tests have rendered non-invasive assessment an urgent clinical need. Multiple novel parameters，such as elasticity，viscosity，fat quantification，and micro-flow imaging，have been established as reliable methods for staging liver fibrosis，monitoring inflammatory activity，and quantifying steatosis，providing considerable potential for diagnosis，disease monitoring，and prognostic management of chronic liver diseases via ultrasonically technology at an early stage. Challenges such as the non-universal nature of diagnostic thresholds，interference from confounding factors，and a lack of technical standardization remain，despite the considerable value of each technology. Therefore，the integration of multiple parameters and artificial intelligence models may be a breakthrough direction in the future.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"519-525"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353796","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 study on the efficacy of Wuling capsules combined with nucleos(t)ide analogues in the treatment of low-level viremia patients with chronic hepatitis B].","authors":"S X Zhao, W G Ren, M B Yang, X L Chi, H M Xiao, S P Ma, P Jia, Y M Nan","doi":"10.3760/cma.j.cn501113-20251215-00532","DOIUrl":"10.3760/cma.j.cn501113-20251215-00532","url":null,"abstract":"<p><p><b>Objective:</b> To comprehensively evaluate the efficacy and safety profile of Wuling capsules combined with nucleos(t)ide analogues in the treatment of low-level viremia in chronic hepatitis B. <b>Methods:</b> A randomized, controlled, multicenter clinical trial was conducted. One hundred patients with low-level viremia in chronic hepatitis B admitted between December 2021 and March 2024 were randomly divided into an experimental group and a control group, with 50 cases in each group. The experimental group received nucleos(t)ide analogues combined with Wuling capsules, while the control group received nucleos(t)ide analogues alone. Of the 100 subjects, 96 in the full analysis set (FAS) (experimental group: 47; control group: 49) were included for statistical analysis. Changes in hepatitis B virus (HBV) DNA levels, serological markers of hepatitis B, liver function parameters, and clinical symptom scores were compared following 180 days of treatment between the two groups. Categorical data were analyzed using the <i>χ</i>² test, with results expressed as percentages (%). Quantitative data were expressed as mean ± standard deviation (x¯±<i>s</i>) for normally distributed datasets and analyzed using the <i>t</i>-test. The Wilcoxon rank-sum test was used for non-normally distributed data. <b>Results:</b> The HBV DNA seroconversion rate was significantly higher in the experimental group compared to the control group [67.39% (31/46) vs. 48.98% (24/49), <i>χ</i>²=6.65, <i>P</i><0.05], while HBsAg, HBeAg, and anti-HBc were all lower in the experimental group than the control group (<i>P</i><0.05) following 180 days of treatment. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin were all significantly higher in the experimental group than in the control group [(24.17±10.07) U/L vs. (30.77±19.00) U/L, (23.70±6.58) U/L vs. (27.66±10.46) U/L, and (12.69±5.72) μmol/L vs. (15.36±5.90) μmol/L, <i>P</i><0.05]. The normalization rates of ALT, AST, and γ-glutamyl transferase were significantly higher in the treatment group than those in the control group (85.71% vs. 66.67%, 83.33% vs. 60.00%, and 100% vs. 66.67%, <i>P</i><0.05). The visual analogue scale (VAS) scores and clinical symptom scores were also superior in the treatment group to those in the control group (<i>P</i><0.01 or <i>P</i><0.05). The main symptoms of patients, including hypochondriac pain, belching, and anorexia, were significantly improved in the treatment group compared to the control group (<i>P</i><0.05 or <i>P</i><0.01). No adverse reactions related to Wuling Capsules were found. <b>Conclusion:</b> Wuling capsules combined with nucleos(t)ide analogues achieved significant efficacy in treating low-level viremia patients with chronic hepatitis B. This treatment significantly improved HBV DNA seroconversion rate, hepatitis B blood markers, liver function levels, and clinical symptoms, with a favorable safety profile.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"564-570"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353805","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":"[Application and prospects of artificial intelligence from tool empowerment to paradigm reconstruction for whole-course diagnosis and treatment of liver diseases by ultrasound].","authors":"J Y Huang, Q Q Xu, L D Chen, W Wang","doi":"10.3760/cma.j.cn501113-20260311-00100","DOIUrl":"10.3760/cma.j.cn501113-20260311-00100","url":null,"abstract":"<p><p>The research system and clinical decision-making pathways have been systematically reshaped as the application of artificial intelligence (AI) in the field of ultrasonically has become increasingly mature recently for liver disease imaging. Research focus has shifted at the clinical level from low-dimensional classification and diagnostic tasks to high-dimensional, task-driven intelligent diagnosis and treatment. The underlying algorithms are undergoing a profound transition at the technological level from single-modality to multi-modal collaboration and from isolated feature extraction to spatiotemporal sequential reasoning. Therefore, to provide a forward-looking analysis and reflection on future development trends and existing challenges, this article systematically reviews the latest research progress of AI in the field of liver disease in terms of four aspects of ultrasonography: early-stage screening, precise diagnosis, personalized treatment, and prognostic monitoring.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 6","pages":"526-533"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353855","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}