中华肝脏病杂志最新文献

{"title":"[Application value of an aMAP score in predicting the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy].","authors":"Y F Gao, Z Z Liu, L Y Ma, Y X Liu, C Y Zhao","doi":"10.3760/cma.j.cn501113-20240226-00093","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240226-00093","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy. <b>Methods:</b> The medical records of 508 CHB patients who started receiving antiviral treatment in the Third Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from January 2001 to November 2021 were retrospectively analyzed. They were divided into low-, intermediate-, and high-risk groups according to the aMAP, AASL-HCC, PAGE-B, mPAGE-B, and CAMD scoring criteria. At the end of follow-up, they were divided into HCC (33 cases) and non-HCC group (475 cases) according to whether HCC occurred. The occurrence risk factors for HCC were analyzed by univariate and multivariate Cox regression analysis. The cumulative incidence of HCC at different time points was estimated by the Kaplan-Meier method and compared by the log-rank method. The HCC prediction performance of the aMAP score was evaluated by the receiver operating characteristic (ROC) curve and compared with other scores. The Mann-Whitney <i>U</i> test, or Fisher test, was used to compare the non-normally distributed quantitative data between groups. The <i>χ</i>² test was used to compare the count data between groups. <b>Results:</b> A total of 33 cases (6.5%) developed HCC during the median follow-up period of 8.7 (6.8-8.9) years. Multivariate analysis showed that age＞50 years (<i>HR</i>=2.804, 95%<i>CI</i> 1.332-5.902; <i>P</i>=0.007) and liver cirrhosis (<i>HR</i>=11.808, 95%<i>CI</i> 4.360-31.976; <i>P</i><0.001) were independent risk factors for HCC occurrence. The cumulative incidence of HCC defined by the aMAP score at 3 and 5 years was significantly lower in the low-risk group (0, 0) than that in the intermediate-risk group (4.4%, 5.4%) and the high-risk group (10.8%, 18.5%), <i>P</i><0.001. The aMAP score performed similarly to the AASL-HCC score, mPAGE-B score, and CAMD score [area under the ROC curve (AUC) was 0.863, 0.900, 0.851, and 0.886, respectively], with <i>P</i>＞0.05 in terms of the 3-year HCC prediction performance; and was equally superior with the PAGE-B score (AUC was 0.732), with <i>P</i><0.05. The aMAP score was not worse than the AASL-HCC score and CAMD score (AUC was 0.890, 0.894, and 0.882, respectively), with <i>P</i>＞0.05 in terms of the 5-year HCC prediction performance; however, it was significantly superior to the PAGE-B score and mPAGE-B score (AUC was 0.795 and 0.875, respectively), with <i>P</i><0.05. In addition, the AUC of the aMAP score for predicting HCC occurrence at baseline, 1 year, 2 years, and 3 years of antiviral treatment was＞0.9. <b>Conclusions:</b> The aMAP score can accurately assess the risk of HCC in CHB patients receiving antiviral therapy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 4","pages":"359-365"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152053","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 and application progress for liver xenotransplantation].","authors":"Y Xie, D Wang, W T Jiang","doi":"10.3760/cma.j.cn501113-20240528-00270","DOIUrl":"10.3760/cma.j.cn501113-20240528-00270","url":null,"abstract":"<p><p>Liver transplantation is an effective treatment method for many end-stage liver diseases; however, the shortage of donor livers is one of the main obstacles affecting its development. Thus, xenotransplantation is expected to be a potential way to solve the shortage of organs. Gene editing technology has been used to improve animal genes so they can enhance their physiological compatibility with humans, and new immunosuppressive drugs are combined to reduce the occurrence of rejection so as to prolong the survival time of grafts. Liver xenotransplantation is more prominent than that of the heart or kidney transplants, and the related molecular mechanisms, such as xenogeneic rejection and coagulation disorders after surgery, need to be further studied due to the more complex structure and physiological functions of the liver. This paper reviews the historical development, current main problems, and clinical applications based on the latest research progress at home and abroad, with aim to improve clinicians' understanding of liver xenotransplantation.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 4","pages":"388-394"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152095","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":"[Assessment and management of malnutrition in patients with cirrhosis combined with hepatic encephalopathy].","authors":"Y Xu, J Kang, X H Wang, L Zhang, D C Cai","doi":"10.3760/cma.j.cn501113-20241214-00622","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241214-00622","url":null,"abstract":"<p><p>Hepatic encephalopathy and malnutrition due to hyperammonemia often interact with each other, forming a vicious circle in patients with cirrhosis. In addition, hepatic encephalopathy and malnutrition have a high incidence in patients with cirrhosis, which seriously affects the quality of life and prognosis. Therefore, identifying whether malnutrition is present in patients with cirrhosis combined with hepatic encephalopathy is crucial for providing appropriate interventions.This article reviews the pathogenesis, nutritional assessment methods, and nutritional management of malnutrition in patients with liver cirrhosis combined with hepatic encephalopathy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 4","pages":"402-408"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152057","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":"[A case of hereditary hemorrhagic telangiectasia treated with bevacizumab].","authors":"W T Chao, H Ma, X H Li, B Feng, H Wang, C C Wu, H Y Rao, R Huang","doi":"10.3760/cma.j.cn501113-20240129-00064","DOIUrl":"10.3760/cma.j.cn501113-20240129-00064","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"375-378"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731888","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 cure and safe drug withdrawal in chronic hepatitis B].","authors":"J L Hu, Y W Ji, P Peng, H Fan, L Y Zhao, H J Deng, N Tang, A L Huang","doi":"10.3760/cma.j.cn501113-20250106-00008","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250106-00008","url":null,"abstract":"<p><p>With the widespread implementation of immunoprophylaxis strategies, the primary challenge in HBV infection prevention and control in China has shifted to reducing the burden of existing infections. A crucial approach to decreasing the burden of existing infections is to develop the effective treatment methods to achieve clinical or functional cures within a limited treatment duration for infected patients. The existing infections can be divided into two parts: those that are easy to cure and those that are difficult to treat. Patients who meet the current drug withdrawal criteria and at the same time have HBsAg<100 IU/mL following treatment with nucelos(t)ide analogue therapy are the easier one to treat, accounting for about 12% of the total infections, and the remaining 88% are difficult to cure. A necessary step toward clinical cure is pushing the HBsAg levels of patients to<100 IU/mL, but this driving effect must stem from effective immune reconstitution against HBV. Recent prevention and control, certain characteristics and implementation of clinical cure, and the safe drug withdrawal are discussed here to offer new perspectives on issues related to hepatitis B.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731890","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":"[Etiological characteristics and drug resistance in patients with hepatitis B virus-associated acute-on-chronic liver failure combined with intra-abdominal infection].","authors":"X L Yu, H B Xie, Y Q Luo, Y Y Zeng","doi":"10.3760/cma.j.cn501113-20240804-00359","DOIUrl":"10.3760/cma.j.cn501113-20240804-00359","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the distribution, drug resistance, and factors influencing pathogenic microorganisms in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) combined with intra-abdominal infection (IAI). &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis was conducted on 282 cases with HBV-ACLF admitted to the Hepatobiliary Internal Medicine Department of Mengchao Hepatobiliary Hospital of Fujian Medical University from May 2019 to December 2022. Patients combined with IAI and positive pathogen culture were enrolled in the infection group (141 cases), and patients combined without IAI admitted during the same period were included in the non-infection group (141 cases). Patient's general clinical data, laboratory examination indicators, pathogen types, and drug sensitivity test results were collected. Logistic regression analysis was used for IAI occurrence risk factors in patients with HBV-ACLF. &lt;b&gt;Results:&lt;/b&gt; A total of 204 pathogenic bacteria were detected in the infection group, including 115 strains of Gram-negative bacteria (56.37%), 74 strains of Gram-positive bacteria (36.28%), and 15 strains of fungi (7.35%). The most frequently detected bacterial genera were Escherichia coli (21.57%, 44/204), &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; (12.25%, 25/204), &lt;i&gt;Enterococcus faecium&lt;/i&gt; (6.37%, 13/204), &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (5.39%, 11/204), and &lt;i&gt;Staphylococcus epidermidis&lt;/i&gt; (4.90%, 10/204). The results of drug sensitivity tests showed that the resistance rates of &lt;i&gt;Escherichia coli&lt;/i&gt; and &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; to &lt;i&gt;levofloxacin&lt;/i&gt; and &lt;i&gt;ciprofloxacin&lt;/i&gt; were over 50% (66.67%,26/39;61.54%,24/39)and 30% (34.79%,8/23;39.13%,9/23)respectively. The resistance rate of &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; to carbapenems (&lt;i&gt;meropenem&lt;/i&gt; and &lt;i&gt;imipenem&lt;/i&gt;) was 60.00%. The resistance rates of &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; to &lt;i&gt;meropenem&lt;/i&gt; and &lt;i&gt;imipenem&lt;/i&gt; were 100% (4/4) and 50.00% (2/4) respectively. The resistance rates of &lt;i&gt;Enterococcus faecium&lt;/i&gt; and &lt;i&gt;Enterococcus faecalis&lt;/i&gt; to &lt;i&gt;penicillin&lt;/i&gt; were 100% (13/13) and 33.33% (1/3) respectively. The resistance rates of &lt;i&gt;Staphylococcus aureus&lt;/i&gt; to &lt;i&gt;penicillin&lt;/i&gt; (77.78%,7/9) and &lt;i&gt;oxacillin&lt;/i&gt; (33.33%, 3/9) were relatively high. The results of the multivariate unconditional logistic regression analysis showed that puncture and drainage (&lt;i&gt;OR&lt;/i&gt;=17.90, 95%&lt;i&gt;CI&lt;/i&gt;: 7.94-43.42, &lt;i&gt;P&lt;/i&gt;&lt;0.001), procalcitonin (&lt;i&gt;OR&lt;/i&gt;=3.23, 95%&lt;i&gt;CI&lt;/i&gt;: 1.56-8.98, &lt;i&gt;P&lt;/i&gt;=0.012), C-reactive protein (&lt;i&gt;OR&lt;/i&gt;=1.05, 95%&lt;i&gt;CI&lt;/i&gt;: 1.02-1.00, &lt;i&gt;P&lt;/i&gt;=0.003), and age (&lt;i&gt;OR&lt;/i&gt;=1.06, 95%&lt;i&gt;CI&lt;/i&gt;: 1.02-1.10, &lt;i&gt;P&lt;/i&gt;=0.001) were independent risk factors for IAI in patients with HBV-ACLF. &lt;b&gt;Conclusions:&lt;/b&gt; The pathogenic microorganisms were mainly enterobacteriaceae and enterococci with varying degrees of drug resistance in HBV-ACLF patients combined with IAI. Early-stage intervention is an effective measure to prevent the occurrence of increase o","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"205-210"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","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":"[Effect of portal vein thrombosis on the long-term prognosis of patients with hepatitis B 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":"10.3760/cma.j.cn501113-20240618-00296","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the characteristics of portal vein thrombosis (PVT) formation in patients with hepatitis B cirrhosis and its effect on long-term prognosis. &lt;b&gt;Methods:&lt;/b&gt; The clinical data of a cohort of patients with hepatitis B cirrhosis who visited Beijing Youan Hospital from May 2009 to August 2020 were retrospectively analyzed. Enhanced CT examination was used as the standard for diagnosing PVT and its classification. Patients with hepatitis B cirrhosis without PVT at baseline were selected as the research subjects. According to whether PVT was formed during the follow-up period, they were divided into the PVT and control groups including 99 and 168 patients in the PVT and control groups with a follow-up time of 52.0 (46.7, 57.3) months. The changes in baseline and endpoint clinical indicators of the two groups were compared. Kaplan-Meier survival curve, log-rank test, and Cox regression were used to analyze the effect of PVT on prognosis. &lt;b&gt;Results:&lt;/b&gt; In the PVT group, 28.28% (28/99) of patients underwent splenectomy, and 74.75% (74/99) did not receive anticoagulation therapy. The main portal vein thrombosis, portal vein branch thrombosis, and thrombosis in both groups accounted for 34.34% (34/99), 23.23% (23/99), and 15.15% (15/99), respectively. The splenic vein or superior mesenteric vein accounted for 27.27% (27/99). PVT was stable in 63.27% (63/99), progressed in 31.31% (31/99), and relieved in 5.05% (5/99) during the follow-up period. The white blood cell, hemoglobin, and platelet counts were all decreased in the PVT group compared with the baseline (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The international normalized ratio (INR) [1.28 (1.14, 1.39) &lt;i&gt;vs&lt;/i&gt;. 1.33 (1.19, 1.46), &lt;i&gt;P&lt;/i&gt;=0.041] and spleen length [(163.84±30.68) mm &lt;i&gt;vs&lt;/i&gt;. (177.26±32.61) mm, &lt;i&gt;P&lt;/i&gt;&lt;0.001] was increased compared with the baseline. The proportion of gastroesophageal variceal bleeding was higher in the PVT group than in the control group (57.0% &lt;i&gt;vs&lt;/i&gt;. 28.7%, &lt;i&gt;P&lt;/i&gt;&lt;0.001), and the constituent ratio of hepatic encephalopathy was not statistically significantly different (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The proportion of patients with ascites in the control group decreased (63.1% &lt;i&gt;vs&lt;/i&gt;. 41.7%, &lt;i&gt;P&lt;/i&gt;&lt;0.001), while the proportion of patients with ascites in the PVT group was not statistically significantly different (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The incidence of composite clinical endpoint events in the PVT and the control group was 21.21% (21/99) and 4.17% (7/168), respectively (&lt;i&gt;P&lt;/i&gt;＜0.05). The incidence of composite clinical endpoint events in PVT patients without anticoagulation and anticoagulation treatment was 25.68% (19/74) and 8.00% (2/25), respectively (&lt;i&gt;P&lt;/i&gt;=0.062). Cox regression analysis found that PVT formation was an independent risk factor for liver-related adverse events in patients with hepatitis B cirrhosis (&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:&lt;/b&gt; The presence of PVT in patients with hepatitis B cirrhosis is a","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 ","pages":"217-226"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","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":"[A case of cirrhosis combined with myeloproliferative neoplasms].","authors":"W C Li, S X Zhao, S H Liu, F Han, Y M Nan","doi":"10.3760/cma.j.cn501113-20240409-00187","DOIUrl":"10.3760/cma.j.cn501113-20240409-00187","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 ","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629231","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":"[A case of drug-induced hypersensitivity syndrome combined with acute hepatitis E].","authors":"T T Ji, T L Wang, H C Xing, Y Y Ren, Y Y Yu, T T Yao, S Wang, J H Xu","doi":"10.3760/cma.j.cn501113-20240531-00277","DOIUrl":"10.3760/cma.j.cn501113-20240531-00277","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 3","pages":"270-272"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989180","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":"[Are antibiotics immunomodulators? An attempt to use vancomycin in the treatment of primary sclerosing cholangitis].","authors":"L P Guo, W R Wang, B M Wang, L Zhou","doi":"10.3760/cma.j.cn501113-20240424-00225","DOIUrl":"10.3760/cma.j.cn501113-20240424-00225","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is a type of chronic idiopathic liver disease characterized by bile duct inflammation and concentric fibrosis. Currently, no drug therapy can change the natural progression of PSC. The mechanism by which PSC is accompanied by the occurrence of inflammatory bowel disease (IBD) is still unclear. Oral antibiotic therapy with vancomycin being the most widely used has been shown to be effective for PSC combined with IBD. This paper analyzes case reports and clinical studies on the use of vancomycin in PSC, with the aim of providing a reference for clinical therapy and in-depth exploration of novel therapeutic directions.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 3","pages":"287-292"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018950","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}