中华肝脏病杂志最新文献

The continuous advancement of artificial intelligence (AI)-related technologies is promoting a diagnosis and treatment model for fatty liver disease toward precision medicine. AI assistance reduces human error and enhances the accuracy of non-invasive diagnostics in the field of imaging. Additionally, AI can automatically identify and quantify key histological features when combined with multi-omics data in the field of pathology and can also build more efficient diagnostic and risk assessment models; meanwhile, it aids in personalized treatment decisions and outcome prediction. However, problems such as data heterogeneity, insufficient algorithm interpretability, and lack of multi-center validation remain to be solved, thus necessitating interdisciplinary and multi-center collaboration to promote the in-depth application of AI in the clinical practice of fatty liver disease. This review summarized the current research progress of AI in the diagnosis and treatment of fatty liver disease and discusses the existing issues and challenges.

Objective: To construct a lentiviral plasmid expressing neuropilin-1 (NRP1) and a HepG2-sodium taurocholate cotransporting polypeptide (NTCP) capable of overexpressing stable cell line NRP1 so as to study the susceptibility of this cell line to hepatitis B virus (HBV). Methods: The plasmids pcDNA3.1-NRP1/Myc His B and pCDH-CMV-MCS-EF1-GFP-BSD were used as templates for amplification. The recombinant plasmid pCDH-NRP1-GFP-BSD was obtained using seamless cloning technology. HepG2-NTCP cells were transduced with the recombinant plasmid into lentivirus following packaging. Stable overexpression of NRP1 was obtained following screening of blasticidin S deaminase (BSD) and monoclonal antibody in HepG2-NTCP cell lines. The susceptibility of the resulting cell line to HBV was analyzed by detecting HBV-related markers post-infection. Data between groups were compared using the t-test. Results: The restriction enzyme digestion and sequencing analysis confirmed the successful construction and identification of the recombinant plasmid containing NRP1. Western blot, RT-qPCR, and fluorescence microscopy results showed that the stable overexpression of the targeted NRP1gene had capability in HepG2-NTCP cells. Compared to the control group, NRP1-expressed stable cell lines showed approximately a two-fold increase in efficiency rate in HBV infection. Intracellular HBV covalently closed circular DNA (cccDNA), mRNA, DNA, and viral proteins, including HBsAg, HBeAg, and HBc, were significantly elevated, nearly two-fold, following HBV infection. Conclusion: A stable monoclonal cell line overexpressing NRP1 was successfully constructed, which supports highly efficient HBV infection in vitro and provides a new tool for studying the mechanisms of chronic hepatitis B infection.

Liver failure is severe liver damage caused by multiple factors, with a very high mortality rate. Artificial liver support systems have become a core strategy for alternative or bridging therapy in the context of the rapid progression of liver failure and high mortality rates with comprehensive internal medicine therapy. Non-bioartificial livers mainly serve as partial substitutes for liver function improvement through procedures such as perfusion, dialysis, and filtration methods. Bioartificial livers provide liver support therapy for patients by integrating detoxification, synthesis, and metabolic functions to simulate hepatic biosynthesis, filling the gap that non-bioartificial livers cannot perform and addressing the difficulties of non-bioartificial livers' heavy reliance on blood products. This paper focuses on reviewing the basic and clinical research progress of bioartificial livers, providing a multidimensional perspective to accelerate their clinical translation.

Liver fibrosis is a pathological change caused by hepatocyte inflammation and necrosis due to various etiologies, leading to excessive deposition of the extracellular matrix. Furthermore, it can progress to liver cirrhosis or even cancer if not detected and treated in a timely manner. Therefore, early-stage diagnosis and timely intervention are of great significance for the prevention of liver cirrhosis and cancer. In recent years, the non-invasive diagnosis of liver fibrosis still has certain limitations, hence an ideal non-invasive diagnostic method for early-stage remains a research hotspot. Chitinase-3-like protein 1 (CHI3L1) is a member of the chitinase family, encoded by the human CHI3L1 gene, which is highly expressed in the liver, playing an important role in various inflammatory and fibrotic disease processes with its secretion as a glycoprotein with cytokine and growth factor properties. Recent studies have shown that serum CHI3L1, as an emerging biomarker, has been widely used in the screening and diagnosis of liver-related diseases. This paper reviews the role of serum CHI3L1 in the diagnosis of liver fibrosis non-invasively and its relationship with the staging of liver fibrosis, cirrhosis, and primary liver cancer, providing references for clinical treatment.

Objective: To investigate the prevalence status and the clinical characteristics of hepatitis D virus (HDV) among patients chronically infected with hepatitis B virus (HBV) in the Xinjiang region. Methods: A cross-sectional study was conducted. Serum samples from 1 830 patients with chronic HBV infection who visited the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from December 2022 to October 2023 were collected. All sera were tested for anti-HDV IgG and IgM. Sera positive for anti-HDV IgG or IgM were selected for HDV RNA detection. HDV RNA-positive sera were sequenced to determine the HDV genotype. Age, gender, HBV course, and anti-HBV treatment status were used as scoring items based on the propensity score matching (PSM) method. Chronic HBV patients with negative anti-HDV were matched in a ratio of 1∶1. The clinical characteristics of anti-HDV -positive-patients were analyzed. The t-test was used for comparison between groups of normally distributed continuous data. The Wilcoxon signed-rank test was used for comparison between groups of skewness distribution. The χ² test was used for comparison between groups of enumeration data. Results: The positive detection rates of anti-HDV IgG, anti-HDV IgM, and HDV RNA in 1 830 cases with chronic HBV infection were 2.24% (41/1 830), 1.09% (20/1 830), and 1.69% (31/1 830), respectively. All HDV RNA-positive patients had HDV genotype 1. Two anti-HDV-positive patients had negative hepatitis B surface antigen (HBsAg). Gender, age, HBV course, and anti-HBV treatment status had no significant difference. The quantification of HBsAg, liver biochemical indexes (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bile acids), the proportion of patients with liver cirrhosis, and alpha-fetoprotein were significantly higher in the anti-HDV-positive group than in those in the anti-HDV-negative group (P<0.05). Conclusion: The prevalence rate of HDV in chronic HBV-infected patients at a single center in the Xinjiang region was 2.24%, with the primary genotype being 1. Furthermore, overlap infection should be paid attention to because it might aggravate liver damage.

The mortality rates are significantly elevated with the rapid progression of acute liver failure in the absence of timely diagnosis and treatment. Liver transplantation is an effective therapeutic approach that can halt disease progression, but transplantation timing is a crucial factor affecting prognosis. Patients with acute liver failure should be promptly transferred to hospitals equipped for liver transplantation while simultaneously preparing for the procedure during the course of treatment to avoid missing the opportunity to save lives when the condition suddenly worsens. Auxiliary liver transplantation preserves the patient's native liver while transplanting a new liver. Therefore, patients are expected to gradually reduce immunosuppressants following the regeneration of the autologous liver, so avoiding the problem of lifelong use of immunosuppressants. This is also a unique advantage, offering benefits to patients undergoing auxiliary liver transplantation therapy for acute liver failure, while simultaneously presenting challenges for clinicians in terms of technical skill and comprehensive management.

Portal hypertensive biliopathy is a secondary condition of intrahepatic and extrahepatic bile duct abnormalities caused by portal hypertension, especially in extrahepatic portal venous obstruction. Most patients may remain asymptomatic for a long time, while a few may present with symptomatic portal hypertensive biliopathy, such as obstructive jaundice, cholelithiasis with or without cholangitis, gastrointestinal bleeding, and others. Such disease is rare in clinical practice and is prone to misdiagnosis and missed diagnosis. Improper treatment can lead to serious adverse consequences. We report a case of unexpected discovery of bile duct dilation due to abdominal pain, which was ultimately diagnosed as portal hypertensive biliopathy based on the medical history, manifestations of portal hypertension, and imaging examinations, especially intraductal ultrasonography.

Hepatocellular carcinoma (hereinafter referred to as liver cancer) is the main indication for liver transplantation in China, but postoperative tumor recurrence and metastasis severely restrict the efficacy of liver transplantation. There exist significant differences between the traditional liver cancer research models due to the long-term immunosuppressive state of transplant recipients and the complex mechanism of tumor recurrence and metastasis, posing enormous challenges to existing theoretical system. Therefore, it is crucial to innovate the scientific research pattern and liver transplantation clinical management model for liver cancer. Herein, the author's team has innovatively proposed a 'Tumor-Donor Liver-Recipient' integrated research horizon for liver transplantation in liver cancer based on prior clinical practice and scientific exploration, with the aim to expand new concepts in basic research, explore new strategies for precise clinical intervention, and establish a refined recipient management system. This paper systematically elaborates on the research general situation and cutting-edge perspectives under the "tumor-donor liver-recipient" so as to classify HCC liver transplantation patients, pre-transplant downstaging therapy, scientific evaluation and application of donor livers, innovations in transplant surgical techniques, and individualized postoperative management.