中华肝脏病杂志最新文献

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.

Objective: 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). Methods: 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 t-test, Mann-Whitney U, or Kruskal-Wallis test were used for intergroup comparison of measurement data. The χ² test was used for intergroup comparison of numerical data. Results: 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, P<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, P=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. Conclusions: 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.

Hepatocellular carcinoma is the most common type of primary liver cancer. Many patients who have been diagnosed with hepatocellular carcinoma are already at an advanced stage, leading to very limited treatment options and poor prognosis. Therefore, the key to improving prognosis is early-stage diagnosis. In recent years, with deeper analysis of the underlying biological mechanisms of HCC, new diagnostic methods have emerged, including emerging serum markers, liquid biopsy, molecular diagnostics, and imaging techniques. This article reviews and analyzes the research progress on early-stage screening and explores their value and application prospects in the early predictive diagnosis of HCC..

Objective: To analyze the epidemiological characteristics of hepatitis B mortality among Chinese residents from 2006 to 2021 and predict the mortality trends from 2022 to 2027, providing reference for hepatitis B prevention and control efforts. Methods: A retrospective study was conducted using hepatitis B mortality data from 2006 to 2021 published by the Chinese Center For Disease Control And Prevention. Age-standardized mortality rates (ASMR) were calculated based on the 2000 Chinese population as the standard population. The crude mortality rate (CMR) and ASMR were analyzed for temporal, regional, gender, and age distribution characteristics. The Joinpoint regression model was used to analyze trends, and the grey model was applied to predict CMR and ASMR from 2022 to 2027. Results: From 2006 to 2021, a total of 77 722 hepatitis B deaths were recorded, with an average CMR of 2.69/10 thousands and an ASMR of 2.00/10 thousands. The ASMR showed an overall decreasing trend for both males (AAPC=-5.4%, 95%CI: -8.1 to -2.7, P<0.001) and females (AAPC=-5.7%, 95%CI: -8.4 to -3.0, P<0.001). Declining trends were also observed in urban areas (AAPC=-5.0%, 95%CI: -7.7 to -2.2, P=0.001) and rural areas (AAPC=-5.7%, 95%CI: -9.0 to -2.4, P=0.001). Regional analysis indicated that the western, central, and eastern regions had average ASMRs of 2.86/10 thousands, 2.05/10 thousands, and 1.42/10 thousands, respectively, all showing downward trends. The grey model predicted that from 2022 to 2027, the CMR would decrease annually from 2.36/10 thousands to 2.03/10 thousands, while the ASMR would decline from 1.37/10 thousands to 1.04/10 thousands. Conclusions: Hepatitis B mortality rates in China, reflected by CMR and ASMR, have shown a consistent downward trend, indicating progress in hepatitis B prevention and control. Future efforts should prioritize targeted screening and preventive measures for rural populations, western regions, and males to further reduce mortality.

Hepatocellular carcinoma (HCC) is a kind of malignant tumor with an extremely high morbidity and mortality incidence rate. Although some new progress has been made in recent treatment, the overall prognosis is still poor. Therefore, the prevention and treatment of HCC have important clinical significance. Statin drugs are mainly used for the treatment of hypercholesterolemia and the prevention of cardiovascular and cerebrovascular diseases. In recent years, an increasing number of research results have shown that statins have advantages in preventing the occurrence and improving the prognosis of HCC. This paper reviews the new progress performed in the mechanism of statin drug and the current clinical prevention and treatment for HCC.

Objective: To determine the distributions of serum HBsAg level in treatment-naive or treatment-experienced chronic hepatitis B (CHB) patients. Methods: Based on the China Registry of Hepatitis B (CR-HepB), a nationwide hospital-based electronic platform, treatment-naive or treatment-experienced CHB patients who receive nucleos(t)ide analog (NA) therapy were enrolled in our study. We collected patients' clinical characteristics, including demographic, virological and biochemical data. The distributions of HBsAg levels in those two groups were summarized with counts and percentages. Continuous variables were expressed as median (interquartile range, IQR) or mean±SD. Results: A total of 13 505 treatment-naive CHB patients and 6 309 patients with previous NAs therapy were enrolled in the final analysis. The proportion of patients in those two groups with serum HBsAg<100 IU/ml, <500 IU/ml, <1 500 IU/ml or HBsAg level not lower than 1 500 IU/ml, 3 000 IU/ml or 8 000 IU/ml were 10.51% vs. 12.88%, 28.47% vs. 29.84%, 46.85% vs. 52.07%, 53.15% vs. 47.93%, 38.17% vs. 31.77%, 15.62% vs. 10.39%, respectively. HBsAg levels tended to decrease gradually with the duration of antiviral therapy: the percentage of patients with HBsAg levels below 100 IU/ml increased from 12.73% at less than 3 years of treatment to 26.92% at≥10 years of treatment, whereas the percentage of patients with HBsAg levels of 3 000 IU/ml or 8 000 IU/ml and above decreased from 34.66% to 23.08% and from 12.19% to 5.77%, respectively. Conclusions: Our investigation manifested the distribution of the serum HBsAg in treatment-naive CHB patients and patients who received previous NAs treatment. As the duration of antiviral therapy is prolonged, the HBsAg level tends to decrease gradually.