中华肝脏病杂志最新文献

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

{"title":"[Correlation analysis between expression of cytokeratin 19 and clinical pathological characteristics and prognosis of dual-phenotype hepatocellular carcinoma].","authors":"Y Q Yan, L J Qu, X Z Ye, M Li, X J Ouyang","doi":"10.3760/cma.j.cn501113-20240307-00118","DOIUrl":"10.3760/cma.j.cn501113-20240307-00118","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the correlation between the expression of the immunohistochemical marker cytokeratin (CK)-19 and the clinical characteristics and prognosis of dual-phenotype hepatocellular carcinoma (DPHCC). <b>Methods:</b> The data of patients diagnosed with hepatocellular carcinoma (HCC) who underwent surgical resection were collected. DPHCC cases were screened by immunohistochemistry, followed up, and grouped. The correlation between the expression of the immunohistochemical marker CK-19 and the clinical pathological characteristics and prognosis of DPHCC was analyzed by statistical methods. The enumeration data were compared using the <i>χ</i>² test or Fisher's exact probability method between groups. <b>Results:</b> The expression of CK19 was significantly correlated with factors such as the tumor size, histological grade, liver tissue cirrhosis surroundings, microvascular invasion (MVI), and serum carbohydrate antigen 199 (CA-199) levels in DPHCC, and the differences were statistically significant (<i>P</i><0.05). There was no significant correlation between the expression of CK19 and the gender, age, tumor necrosis, multiple lesions, liver capsule invasion, serum alpha-fetoprotein (AFP), and immunohistochemical CK7 and mucin 1 (MUC-1) in DPHCC patients, and the differences were not statistically significant (<i>P</i>>0.05). The results of univariate analysis showed that immunohistochemical CK19 expression, MVI, number of lesions, tumor necrosis, tumor differentiation degree, serum AFP, and carbohydrate antigen 199 levels were related factors affecting the prognosis in DPHCC patients (<i>P</i><0.05); while gender, age, capsule invasion, tumor size, and expression of immunohistochemical markers (vascular endothelial growth factor, CK7, MUC-1) were not significantly correlated with the prognosis in DPHCC patients (<i>P</i>>0.05). The results of multivariate analysis showed that tumor necrosis (<i>P</i>=0.042, 95%<i>CI</i>: 1.031-5.501) and serum AFP levels were independent risk factors affecting the prognosis in DPHCC patients (<i>P</i><0.001, 95%<i>CI</i>: 2.581-24.075). <b>Conclusions:</b> The expression of CK19 is closely related to the prognosis of patients with DPHCC. Patients with high CK19 expression have faster disease progression than those with low CK19 expression. Furthermore, the overall survival rate of patients with high CK19 expression is significantly lower than that of patients with low CK19 expression, which is a risk factor for poor prognosis in patients with DPHCC.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391814","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":"[Distribution characteristics of serum HBsAg levels in Chinese patients with chronic hepatitis B based on CR-HepB].","authors":"S Y Chen, S Shan, Y Y Kong, X Q Xu, H Wang, X N Wu, J L Zhou, B Q Wang, T T Meng, M Y Zhang, J D Jia, Y M Sun, H You","doi":"10.3760/cma.j.cn501113-20240723-00337","DOIUrl":"10.3760/cma.j.cn501113-20240723-00337","url":null,"abstract":"<p><p><b>Objective:</b> To explore the distribution characteristics of HBsAg levels in treatment-naïve and treatment-experienced patients with chronic hepatitis B (CHB) in China. <b>Methods:</b> Data were obtained from the China Registry of Hepatitis B (CR-HepB) platform from the establishment of the platform to April 11, 2024. Patients with CHB who were treatment-naïve and treatment-experienced with nucleos(t)ide analogs (NAs) were included. Relevant clinical data were collected. The distribution of hepatitis B surface antigen (HBsAg) status, as well as the levels in populations of different age groups after different antiviral treatment durations, were retrospectively analyzed. Normally and non-normally distributed measured data were represented by Mean±<i>SD</i>, and <i>M</i>(<i>Q</i>₁, <i>Q</i>₃). <b>Results:</b> A total of 13 505 treatment-naïve patients and 6 390 treatment-experienced patients were included in the analysis. The proportions of treatment-naïve patients with HBsAg<100, <500, and <1 500 IU/mL were 10.51%, 28.47%, and 46.85%, and the corresponding proportions of treatment-experienced patients were 12.88%, 29.84%, and 52.07%. The proportions of treatment-naïve patients with HBsAg levels≥1 500, ≥3 000, and≥8 000 IU/mL were 53.15%, 38.17%, and 15.62%, and the corresponding proportions of treatment-experienced patients were 47.93%, 31.77%, and 10.39%. HBsAg level showed a trend of gradual decrease with the increase of antiviral treatment time. The proportion of treatment-experienced patients with HBsAg<100 IU/mL increased from 12.73% when the treatment duration was less than three years to 26.92% when the treatment duration was≥10 years, while the proportion of patients with HBsAg levels≥3 000 IU/mL or≥8 000 IU/mL decreased from 34.66% to 23.08% and from 12.19% to 5.77%, respectively. The proportion of patients with HBsAg<100, <500, and<1 500 IU/mL increased with age, while the proportion of patients with HBsAg≥1 500, ≥3 000, and ≥8 000 IU/mL decreased sequentially. <b>Conclusions:</b> The CR-HepB platform provides a basis for clarifying the serum HBsAg levels in treatment-naïve and treatment-experienced CHB patients in China. The HBsAg status indicates that with a prolonged antiviral treatment duration, there is a gradual decline trend in HBsAg level.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"[Research progress on liver fibrosis, cirrhosis, and portal hypertension in 2024].","authors":"S L Xin, X Y Xu","doi":"10.3760/cma.j.cn501113-20241128-00601","DOIUrl":"10.3760/cma.j.cn501113-20241128-00601","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391935","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":"[Metabolic-associated fatty liver disease (MAFLD): a multisystemic disease beyond the liver].","authors":"Eda Kaya, Yusuf Yilmaz","doi":"10.3760/cma.j.cn501113-20250103-00003","DOIUrl":"10.3760/cma.j.cn501113-20250103-00003","url":null,"abstract":"<p><p>Nonalcoholic fatty liver disease (NAFLD) is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations, such as obesity, type 2 diabetes mellitus, metabolic syndrome, cardiovascular diseases, chronic kidney disease, extrahepatic malignancies, cognitive disorders, and polycystic ovarian syndrome. Among NAFLD patients, the most common mortality etiology is cardiovascular disorders, followed by extrahepatic malignancies, diabetes mellitus, and liver-related complications. Furthermore, the severity of extrahepatic diseases is parallel to the severity of NAFLD. In clinical practice, aware-ness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum. In 2020, a consensus from 22 countries redefined the disease as metabolic (dysfunction)-associated fatty liver disease (MAFLD), which resulted in the redefinition of the corresponding population. Although the patients diagnosed with MAFLD and NAFLD mostly overlap, the MAFLD and NAFLD populations are not identical. In this review, we compared the associations of key extrahepatic diseases between NAFLD and MAFLD.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"77-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391917","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 in clinical research related to viral hepatitis in 2024].","authors":"Y Ding, Y Li, B C Lu, X G Dou","doi":"10.3760/cma.j.cn501113-20241203-00608","DOIUrl":"10.3760/cma.j.cn501113-20241203-00608","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391918","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":"[Effects of ascites grading and the application of non-selective beta-blockers on the 1-year prognosis of acute-on-chronic liver failure].","authors":"W S Liu, L J Shen, X He, H Tian, Q H Zhai, D Z Li, S J Xin, S L You","doi":"10.3760/cma.j.cn501113-20240130-00067","DOIUrl":"10.3760/cma.j.cn501113-20240130-00067","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects of ascites grading and the application of non-selective beta-blockers (NSBBs) on the 1-year prognosis of acute-on-chronic liver failure (ACLF). <b>Methods:</b> 1 386 ascitic cases with ACLF were graded and followed up for one year. The 1-year prognostic effect of ascites grade and NSBBs was analyzed on ACLF by the Kaplan Meier Log-rank test, Cox stepwise regression, and multivariate regression.The <i>t</i>-test, Mann-Whitney <i>U</i>, or Kruskal-Wallis test were used for intergroup comparison of measurement data. The <i>χ</i>² test was used for intergroup comparison of numerical data. <b>Results:</b> The incidence rate of ascites at admission was 77.56% in 1 386 ACLF cases. The Log-rank (Mantel-Cox) of the 1-year survival curve test for 1 386 ACLF patients with ascites grade was 21.384, <i>P</i><0.01. Multivariate regression and Cox stepwise regression analysis showed that ascites grade, age, gastrointestinal bleeding, pulmonary infection, acute kidney injury, prothrombin activity (PTA), urea, MELD-Na score, and the use of NSBBs were closely related to the 1-year prognosis of ACLF. The log rank (Mantel-Cox) of NSBBs treatment in the grade 2/3 ascites group was 6.113, <i>P</i>=0.013, and the difference was statistically significant, suggesting that NSBBs treatment can help improve the 1-year survival rate in ACLF patients with grade 2 and 3 ascites. <b>Conclusions:</b> Ascites grading and the use of NSBBs affect the prognostic factor of ACLF at one year. NSBBs may be beneficial for the long-term prognosis of ACLF, and treatment can be continued in patients who have already received NSBBs prior to the onset of ACLF.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 ","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on autoimmune liver disease in 2024].","authors":"L H Zheng, Y Han","doi":"10.3760/cma.j.cn501113-20241214-00620","DOIUrl":"10.3760/cma.j.cn501113-20241214-00620","url":null,"abstract":"<p><p>Autoimmune liver disease (AILD) is a group of chronic inflammatory liver diseases mediated by autoimmune disorders. Early-stage diagnosis and standardized treatment are key to controlling the progression of AILD. Clearing mechanism and exploring new treatment options has always been an important research direction. Herein, the research progress emphasizing the field of AILD in 2024 is reviewed.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"10-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress of inherited metabolic liver disease in 2024].","authors":"W Hou, Z P Duan, S J Zheng","doi":"10.3760/cma.j.cn501113-20241202-00606","DOIUrl":"10.3760/cma.j.cn501113-20241202-00606","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 1","pages":"15-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391924","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}