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Journal of Clinical and Experimental Hepatology最新文献

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IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-01 Epub Date: 2026-01-24 DOI: 10.1016/j.jceh.2026.103483
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引用次数: 0
Beyond Genetic Protection: Revisiting Hepatic Resilience in Prader-Willi Syndrome 超越基因保护:重新审视普瑞德-威利综合征的肝脏恢复能力
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-11-26 DOI: 10.1016/j.jceh.2025.103419
Nathkapach K. Rattanapitoon, Chutharat Thanchonnang, Patpicha Arunsan, Schawanya K. Rattanapitoon
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引用次数: 0
A Brief Report on Identification of Splice Variants in an In Vitro 3D Spheroid Model for Differentiated Hepatocellular Carcinoma 分化型肝细胞癌体外三维球体模型剪接变异鉴定的简要报告
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-08-09 DOI: 10.1016/j.jceh.2025.103151
Shreyas H. Karunakara, Rohit Mehtani, Gopalakrishna Ramaswamy, Vinutha S. Puttamallapa, Prashant M. Vishwanath, Prasanna K. Santhekadur
Hepatocellular carcinoma (HCC) represents the major form of primary liver cancer. Alternative splicing events (ASEs) are critical to generating mRNA splice variants that can dictate cell fate during HCC development. We report different ASEs in a 3D in vitro HCC spheroid model. This short study serves as a template to design functional studies to target different splicing events in different subtypes of hepatocellular carcinoma.
肝细胞癌(HCC)是原发性肝癌的主要形式。选择性剪接事件(ASEs)对于产生mRNA剪接变异体至关重要,这些变异体可以在HCC发展过程中决定细胞命运。我们在体外肝细胞癌球形三维模型中报道了不同的ase。这个简短的研究可以作为一个模板来设计针对不同亚型肝细胞癌中不同剪接事件的功能研究。
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引用次数: 0
Cystic Duct Anastomosis as a Rescue Strategy to Deal With a Separated Segment 2 Bile Duct During Right Lobe Donor Hepatectomy With Variant Biliary Anatomy 胆囊管吻合术治疗胆解剖结构变异的右肝供肝切除术中2段胆管分离的抢救策略
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-06-21 DOI: 10.1016/j.jceh.2025.102626
Prasanna Gopal, Sathish K. Krishnan, Rajanikanth Patcha, Selvakumar Malleeswaran, Joy Varghese, Mettu S. Reddy
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引用次数: 0
Air Leak Syndrome After Percutaneous-endoscopic Rendezvous for Malignant Biliary Obstruction: A Case Report 恶性胆道梗阻经皮-内窥镜联合治疗后漏气综合征1例
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-08-21 DOI: 10.1016/j.jceh.2025.103158
Jie Tan, Zhuo Li, Zhi-Jun Li, Peng Yan
Endoscopic retrograde cholangiopancreatography (ERCP) is a key therapeutic tool for biliary access, but cannulation failure occurs in 5%–10% of cases. We report a 92-year-old woman with obstructive jaundice and complete distal common bile duct obstruction, in whom standard ERCP failed. A percutaneous-endoscopic rendezvous (PE-RV) approach successfully established biliary drainage via a transhepatic guidewire and stent placement. However, the patient developed pneumoperitoneum, tension pneumothorax, and subcutaneous emphysema following abrupt catheter removal. These manifestations are collectively referred to as “air leak syndrome,” which encompasses the abnormal presence of air in the peritoneal cavity, pleural space, and subcutaneous tissue. Imaging showed no pneumoretroperitoneum, suggesting gas migration through an immature percutaneous tract. Urgent drainage and antibiotics led to gradual recovery. This case highlights PE-RV as a valuable salvage technique but underscores the risk of rare gas-related complications when percutaneous tract closure is premature. To minimize the risk of such complications, procedural protocols may need to incorporate delayed catheter removal or tract embolization to ensure safe outcomes. Careful catheter management, delayed removal, and interdisciplinary coordination are essential for safe outcomes.
内镜逆行胆管造影(ERCP)是胆道通路的关键治疗工具,但插管失败发生率为5%-10%。我们报告一位92岁女性梗阻性黄疸和完全性胆总管远端梗阻,其标准ERCP失败。经皮内镜交会(PE-RV)入路通过经肝导丝和支架置入成功建立胆道引流。然而,在突然拔除导管后,患者出现气腹、紧张性气胸和皮下肺气肿。这些表现统称为“漏气综合征”,包括空气在腹膜腔、胸膜间隙和皮下组织中的异常存在。影像学显示腹膜无气,提示气体通过未成熟的经皮管道迁移。紧急引流和抗生素治疗使患者逐渐恢复。本病例强调PE-RV是一种有价值的抢救技术,但也强调了经皮气管过早闭合时罕见的气体相关并发症的风险。为了将此类并发症的风险降至最低,手术方案可能需要包括延迟拔管或导管栓塞以确保安全结果。谨慎的导管管理,延迟拔除和跨学科协调是安全结果的必要条件。
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引用次数: 0
Reply to Letter to Editor: Predictors of Mortality in Patients Diagnosed With Autoimmune Hepatitis 给编辑的回复:自身免疫性肝炎患者死亡率的预测因素
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-06-09 DOI: 10.1016/j.jceh.2025.102609
Harsh J. Gandhi , Shubham Jain, Pravin Rathi
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引用次数: 0
Fatal Herpes Simplex Hepatitis in a Live Liver Donor. 活体肝供者致死性单纯疱疹肝炎。
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-07-23 DOI: 10.1016/j.jceh.2025.103116
Sanjay Govil, Jayanth Reddy, Sandeep Satsangi, Raje Gowda, Karthik Raichurkar, Anindita Mukherjee, Nagesh Pn, Jayasree Shivadasan, Mukul Vij

We present a case report of a living liver donor death from Herpes simplex hepatitis, highlighting the need for vigilance regarding rare but treatable causes of acute liver failure after donor hepatectomy. Early consideration of HSV hepatitis and prompt initiation of antiviral therapy may improve outcomes.

我们呈报一例活体肝供者死于单纯疱疹性肝炎的病例报告,强调对供肝切除术后急性肝衰竭的罕见但可治疗的原因保持警惕的必要性。早期考虑HSV肝炎和及时开始抗病毒治疗可能改善结果。
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引用次数: 0
Comparative Efficacy and Safety of First-Line Treatment With Atezolizumab/Bevacizumab vs. Tyrosine-kinase Inhibitors in Patients With Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-analysis 阿特唑单抗/贝伐单抗一线治疗与酪氨酸激酶抑制剂治疗不可切除肝细胞癌的疗效和安全性比较:系统评价和荟萃分析
IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-07-07 DOI: 10.1016/j.jceh.2025.102633
Sakditad Saowapa , Natchaya Polpichai , Pojsakorn Danpanichkul , Romelia B. Bernal , Pharit Siladech , Lukman Tijani , Kenrick Ng , Yu J. Wong , Ashok Choudhury , Surasak Saokaew , Suthat Liangpunsakul , Apichat Kaewdech

Background/Aims

Sorafenib, lenvatinib, and atezolizumab combined with bevacizumab (Atezo/Bev) are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). However, direct comparisons among these therapies remain limited. This study aims to compare the efficacy and safety of Atezo/Bev versus tyrosine-kinase inhibitors (TKIs) as first-line therapies for uHCC.

Methods

Two independent authors conducted a literature search using electronic databases (Google Scholar, Medline, and PubMed) and manual reference list reviews up to June 2024. We included studies reporting on overall survival (OS), progression free survival (PFS) or safety data comparing Atezo/Bev versus TKI (sorafenib or lenvatinib) in patients with uHCC, irrespective of study design. Data extraction and statistical analysis were performed using RevMan 5.4.

Results

We included a total of 12 studies (Ten retrospective cohort studies, one prospective study, one randomized controlled trial) involving 9952 patients (3560 received Atezo/Bev combination therapy and 6392 received TKI). Atezo/Bev significantly improved OS and PFS compared to lenvatinib (HR: 0.79, 95% CI: 0.71–0.89, P = 0.0001 for OS; HR: 0.76, 95% CI: 0.64–0.90, P = 0.002 for PFS). Atezo/Bev also improved OS in viral patients (HR: 0.72, 95% CI: 0.60–0.86, P = 0.0004), while lenvatinib improved OS (HR: 1.36, 95% CI: 1.13–1.65, P = 0.001) and PFS (HR: 1.46, 95% CI: 1.04–2.05, P = 0.03) in nonviral patients. Atezo/Bev had fewer grade ≥3 adverse events than lenvatinib (OR: 0.43, 95% CI: 0.36–0.51, P = 0.03). Atezo/Bev also demonstrated superior OS and PFS compared to sorafenib (HR: 0.68, 95% CI: 0.57–0.81, P < 0.00001 for OS; HR: 0.67, 95% CI: 0.57–0.77, P < 0.00001 for PFS).

Conclusions

Atezo/Bev demonstrates better survival outcomes and safety profile compared to TKI. However, for patients with HCC of nonviral etiology, lenvatinib may be a more suitable alternative.
背景/目的索拉非尼、lenvatinib和atezolizumab联合贝伐单抗(Atezo/Bev)是被批准用于不可切除肝细胞癌(uHCC)的一线治疗药物。然而,这些疗法之间的直接比较仍然有限。本研究旨在比较Atezo/Bev与酪氨酸激酶抑制剂(TKIs)作为uHCC一线治疗的疗效和安全性。方法2名独立作者使用电子数据库(谷歌Scholar、Medline和PubMed)和人工参考文献列表进行文献检索,检索截止到2024年6月。我们纳入了报告了Atezo/Bev与TKI(索拉非尼或lenvatinib)在uHCC患者中的总生存期(OS)、无进展生存期(PFS)或安全性数据的研究,而不考虑研究设计。使用RevMan 5.4软件进行数据提取和统计分析。结果共纳入12项研究(10项回顾性队列研究,1项前瞻性研究,1项随机对照试验),涉及9952例患者(3560例接受Atezo/Bev联合治疗,6392例接受TKI治疗)。与lenvatinib相比,Atezo/Bev显著改善了OS和PFS (HR: 0.79, 95% CI: 0.71-0.89, P = 0.0001);HR: 0.76, 95% CI: 0.64-0.90, PFS P = 0.002)。Atezo/Bev还改善了病毒患者的OS (HR: 0.72, 95% CI: 0.60-0.86, P = 0.0004),而lenvatinib改善了非病毒患者的OS (HR: 1.36, 95% CI: 1.13-1.65, P = 0.001)和PFS (HR: 1.46, 95% CI: 1.04-2.05, P = 0.03)。Atezo/Bev的≥3级不良事件少于lenvatinib (OR: 0.43, 95% CI: 0.36-0.51, P = 0.03)。与索拉非尼相比,Atezo/Bev也显示出更好的OS和PFS (HR: 0.68, 95% CI: 0.57-0.81, P <;0.00001操作系统;HR: 0.67, 95% CI: 0.57-0.77, P <;0.00001为PFS)。结论与TKI相比,satezo /Bev具有更好的生存结局和安全性。然而,对于非病毒性HCC患者,lenvatinib可能是一个更合适的选择。
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引用次数: 0
The Interaction of Human Factors and Resistance-associated Substitutions in Hepatitis C Elimination 丙型肝炎消除中人为因素与耐药性相关替代的相互作用
IF 3.2 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-17 DOI: 10.1016/j.jceh.2025.103188
Judah Kupferman, Paul Y. Kwo
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引用次数: 0
Toward Real-time Detection of Drug-induced Liver Injury Using Large Language Models: A Feasibility Study From Clinical Notes 使用大语言模型实时检测药物性肝损伤:来自临床记录的可行性研究
IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-06-21 DOI: 10.1016/j.jceh.2025.102627
Thanathip Suenghataiphorn , Pojsakorn Danpanichkul , Narisara Tribuddharat , Narathorn Kulthamrongsri

Background

Drug-induced liver injury (DILI) is a significant clinical problem. Current detection methods are often delayed. Real-time analysis of electronic medical records (EMRs) using a large language model (LLM) could enable earlier surveillance.

Objective

To evaluate the technical feasibility of an LLM-powered system for real-time DILI identification assessment by extracting medication information from unstructured clinical notes.

Methods

We developed a system using a large language model (LLM) to extract medication lists from clinical text. Prompts were iteratively refined for optimal performance. We integrated DILI risk data from DILIrank and LiverTox, utilizing LLM and algorithmic matching to link extracted medications to database entries. We utilized the RxNORM database and manual mistyped medication, as well as the NHANES database for a structured medication list, to verify accurate results.

Results

Using 30 entries each from NHANES, RxNORM, and real-world cases, the LLM-based medication extraction achieved a precision of 0.96, recall of 0.97, and an F1-score of 0.97%. For NHANES data, no errors were found. Applying to real-world cases and mistyped dataset, the LLM-based extraction fared acceptably, with F1-scores of 0.94 and 0.97, respectively. The majority of error are due to trade name and combined medication names.

Conclusion

This study demonstrates the potential of LLMs for accurate medication extraction from clinical notes, a crucial step towards real-time DILI risk assessment. However, the system requires further development and clinical validation before implementation. Future work will focus on matching methods, clinical validation, EMR integration, and development of an agentic AI to triage future DILI risk.
药物性肝损伤(DILI)是一个重要的临床问题。目前的检测方法往往是滞后的。使用大型语言模型(LLM)对电子医疗记录(emr)进行实时分析可以实现早期监测。目的探讨基于llm的从非结构化临床记录中提取药物信息的DILI实时识别评估系统的技术可行性。方法采用大语言模型(large language model, LLM)开发了一个从临床文献中提取药物清单的系统。提示被迭代地改进以获得最佳性能。我们整合了DILIrank和LiverTox的DILI风险数据,利用LLM和算法匹配将提取的药物与数据库条目联系起来。我们使用RxNORM数据库和手动输入错误的药物,以及NHANES数据库的结构化药物列表来验证准确的结果。结果采用NHANES、RxNORM和真实案例各30个条目,基于llm的药物提取精度为0.96,召回率为0.97,f1得分为0.97%。对于NHANES数据,没有发现错误。应用于真实案例和输入错误的数据集,基于llm的提取效果可以接受,f1得分分别为0.94和0.97。大多数错误是由于商品名称和组合药物名称。结论本研究证明了LLMs从临床记录中准确提取药物的潜力,这是实时评估DILI风险的关键一步。然而,该系统在实施前需要进一步开发和临床验证。未来的工作将集中在匹配方法、临床验证、电子病历整合和开发代理人工智能来分类未来DILI风险。
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引用次数: 0
期刊
Journal of Clinical and Experimental Hepatology
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