Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20240103-00005
L Chen, D L Li
Immune checkpoint inhibitor-associated liver injury is a special type of drug-induced liver injury, and its clinical management has already become an emerging topic in recent years. This article focuses on a series of issues that have attracted much attention in the clinical diagnosis and treatment of immune checkpoint inhibitor-associated liver injury, including the clinical type and severity assessment, the role of liver biopsy, differentiation from autoimmune hepatitis, glucocorticoid dose selection, second-line immunosuppressant selection and timing, opportunistic infection prevention, hormone efficacy prediction, and hormone reduction and course of treatment. In addition, this article analyzes the relevant key points and proposes the current issues at the same time that have not yet been resolved, combined with the latest research progress at home and abroad.
{"title":"[Several issues and considerations in the clinical diagnosis and treatment of immune checkpoint inhibitor-associated liver injury].","authors":"L Chen, D L Li","doi":"10.3760/cma.j.cn501113-20240103-00005","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240103-00005","url":null,"abstract":"<p><p>Immune checkpoint inhibitor-associated liver injury is a special type of drug-induced liver injury, and its clinical management has already become an emerging topic in recent years. This article focuses on a series of issues that have attracted much attention in the clinical diagnosis and treatment of immune checkpoint inhibitor-associated liver injury, including the clinical type and severity assessment, the role of liver biopsy, differentiation from autoimmune hepatitis, glucocorticoid dose selection, second-line immunosuppressant selection and timing, opportunistic infection prevention, hormone efficacy prediction, and hormone reduction and course of treatment. In addition, this article analyzes the relevant key points and proposes the current issues at the same time that have not yet been resolved, combined with the latest research progress at home and abroad.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"806-810"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971936","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20240419-00212
H N Fan, Y Q Ma, X Sun, K Huang, F Xing, C H Liu
<p><p><b>Objective:</b> To explore the predictive role of dynamic changes in serum Golgi protein 73 (GP73) and its inflammatory influencing factors on the reversal of hepatitis B virus-related liver fibrosis. <b>Methods:</b> Two hundred and seventy-eight patients with hepatitis B virus-related liver fibrosis who received entecavir or combined Fuzheng Huayu tablets treatment and completed two liver biopsies (biopsy) in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from September 2014 to July 2019 were selected. The correlation between serum GP73 level and fibrosis stage (Ishak) and inflammation grade (HAI) was analyzed. The patients were divided into a fibrosis reversal group (Ishak decreased≥1 point) and a non-reversal group (Ishak score remained unchanged or increased), and an inflammation improvement group (ΔHAI≤-2) and a non-improvement group (ΔHAI>-2) according to the pathological changes of liver tissue before and after treatment. The cross-sectional value of GP73, its change value (ΔGP73), and the role of inflammatory influencing factors on the liver before and after treatment were evaluated for their predictive efficacy regarding liver fibrosis regression. The receiver operating characteristic curve was used to explore the predictive value of serum ΔGP73 combined with liver stiffness change value (ΔLSM) for the reversal of hepatitis B virus-related liver fibrosis. One-way analysis of variance was used to compare the data between the groups of quantitative data, and a paired t-test or rank sum test was used for the data before and after treatment. The <i>χ</i><sup>2</sup> test was used to compare the differences between the groups of enumeration data. Spearman and Pearson correlation methods were used for correlation analysis. <b>Results:</b> The serum GP73 level was higher in the cirrhosis group than that in the group without significant fibrosis (<i>P</i><0.01). The GP73 level was higher in patients with moderate and severe inflammation than that in the mild group (<i>P</i><0.05). Pre-treatment serum GP73 was positively correlated with fibrosis stage (<i>r</i>=0.248), inflammation grade (<i>r</i>=0.318), and alanine aminotransferase level (<i>r</i>=0.203) (<i>P</i><0.01). The area under the receiver operating characteristic curve (AUROC) for the predictive ability of post-treatment GP73 levels in the fibrosis reversal was 0.633 (95%<i>CI</i>: 0.573-0.689, sensitivity 62.68%, and specificity 59.56%). The decrease in ΔGP73 was significantly higher in the liver fibrosis reversal group (<i>n</i>=142) than that in the non-reversal group (<i>n</i>=136) [-39.22(-85.08,-14.31) ng/mL <i>vs</i>. -30.06(-61.29,-5.84) ng/mL, <i>P</i><0.01]. ΔGP73 was also associated with liver inflammation changes (AUROC=0.634, 95%<i>CI</i>: 0.574-0.690, sensitivity of 51.64%, specificity of 69.87%). Additionally, the predictive effectiveness of GP73 for fibrosis reversal improved after normalization of serum ALT (AUROC: 0.651 vs
{"title":"[Role of serum Golgi protein 73 in the assessment of pathological prognosis and its inflammatory influencing factors for hepatitis B virus-related liver fibrosis].","authors":"H N Fan, Y Q Ma, X Sun, K Huang, F Xing, C H Liu","doi":"10.3760/cma.j.cn501113-20240419-00212","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240419-00212","url":null,"abstract":"<p><p><b>Objective:</b> To explore the predictive role of dynamic changes in serum Golgi protein 73 (GP73) and its inflammatory influencing factors on the reversal of hepatitis B virus-related liver fibrosis. <b>Methods:</b> Two hundred and seventy-eight patients with hepatitis B virus-related liver fibrosis who received entecavir or combined Fuzheng Huayu tablets treatment and completed two liver biopsies (biopsy) in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from September 2014 to July 2019 were selected. The correlation between serum GP73 level and fibrosis stage (Ishak) and inflammation grade (HAI) was analyzed. The patients were divided into a fibrosis reversal group (Ishak decreased≥1 point) and a non-reversal group (Ishak score remained unchanged or increased), and an inflammation improvement group (ΔHAI≤-2) and a non-improvement group (ΔHAI>-2) according to the pathological changes of liver tissue before and after treatment. The cross-sectional value of GP73, its change value (ΔGP73), and the role of inflammatory influencing factors on the liver before and after treatment were evaluated for their predictive efficacy regarding liver fibrosis regression. The receiver operating characteristic curve was used to explore the predictive value of serum ΔGP73 combined with liver stiffness change value (ΔLSM) for the reversal of hepatitis B virus-related liver fibrosis. One-way analysis of variance was used to compare the data between the groups of quantitative data, and a paired t-test or rank sum test was used for the data before and after treatment. The <i>χ</i><sup>2</sup> test was used to compare the differences between the groups of enumeration data. Spearman and Pearson correlation methods were used for correlation analysis. <b>Results:</b> The serum GP73 level was higher in the cirrhosis group than that in the group without significant fibrosis (<i>P</i><0.01). The GP73 level was higher in patients with moderate and severe inflammation than that in the mild group (<i>P</i><0.05). Pre-treatment serum GP73 was positively correlated with fibrosis stage (<i>r</i>=0.248), inflammation grade (<i>r</i>=0.318), and alanine aminotransferase level (<i>r</i>=0.203) (<i>P</i><0.01). The area under the receiver operating characteristic curve (AUROC) for the predictive ability of post-treatment GP73 levels in the fibrosis reversal was 0.633 (95%<i>CI</i>: 0.573-0.689, sensitivity 62.68%, and specificity 59.56%). The decrease in ΔGP73 was significantly higher in the liver fibrosis reversal group (<i>n</i>=142) than that in the non-reversal group (<i>n</i>=136) [-39.22(-85.08,-14.31) ng/mL <i>vs</i>. -30.06(-61.29,-5.84) ng/mL, <i>P</i><0.01]. ΔGP73 was also associated with liver inflammation changes (AUROC=0.634, 95%<i>CI</i>: 0.574-0.690, sensitivity of 51.64%, specificity of 69.87%). Additionally, the predictive effectiveness of GP73 for fibrosis reversal improved after normalization of serum ALT (AUROC: 0.651 vs","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"772-780"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971930","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20231105-00168
J Zhang, Y Li, Q Ye, N N Yan, H Y Yu, F M Wang, F S Di
<p><p><b>Objective:</b> To explore the demographic composition of type 2 diabetes mellitus (T2DM) with metabolic associated fatty liver disease (MAFLD) and the role of energy metabolism in the progression of MAFLD in order to provide theoretical support for improving the prognosis of MAFLD. <b>Methods:</b> A cross-sectional study was conducted. Ninety-four cases with T2DM combined with MAFLD admitted to the Endocrinology Department of Tianjin Third Central Hospital from July 2014 to July 2019 were selected. Patients were divided into three groups: non-metabolic associated steatohepatitis (MASH) group (25 cases), borderline MASH group (49 cases), and MASH group (20 cases) according to the non-alcoholic fatty liver disease activity score (NAS). Patients were further divided into two groups: non/mild fibrosis (F0-1) group (74 cases) and the significant fibrosis (F2-4) group (20 cases) in accordance with liver fibrosis scores. The differences in general clinical and biochemical indicators, body composition, and energy metabolism indicators among the groups were compared. Binary logistic regression analysis was conducted to explore factors affecting liver inflammation and fibrosis severity degree in patients with MAFLD. <b>Results:</b> The visceral fat area (VFA) and body fat percentage (PBF) were significantly higher in the MASH group than in the non-MASH group (<i>P</i><0.05), while the skeletal muscle mass index and body mass index (SMI-BMI) were significantly lower in the MASH group than in the marginal MASH group (<i>P</i><0.05) during the comparison of body composition and substrate metabolism at different stages of MASH. Alanine aminotransferase (ALT) and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the fibrotic group than in those in the no/mild fibrosis group (<i>P</i><0.05) when comparing clinical and biochemical indicators, body composition, and substrate metabolism at different stages of fibrosis. The skeletal muscle mass (SMM), SMI-BMI, SMM-Weight, resting energy expenditure (REE), and fat oxidation rate (FAT<sub>OXR</sub>) were significantly lower in the fibrotic group than those in the no/mild fibrosis group (<i>P</i><0.05). The respiratory quotient and carbohydrate functional ratio (%CHO) were significantly higher in the fibrotic group than in the no/mild fibrosis group (<i>P</i><0.05). Correlation analysis indicated a positive correlation between the NAS score, reflecting the severity of liver inflammatory lesions, with VFA and PBF (<i>r</i>=0.258 and 0.323, <i>P</i><0.05); while the F score was positively correlated with the respiratory quotient, %CHO, and VFA (<i>r</i>=0.292, 0.303, and 0.239, <i>P</i><0.05), and negatively correlated with REE, the energy ratio from fat, FAT<sub>OXR</sub>, SMM, SMI-Weight, and SMI-BMI (<i>r</i>=-0.209, -0.214, -0.333, -0.240, -0.250, and -0.305, <i>P</i><0.05). Logistic regression analysis indicated that SMI-Weight and FAT<sub>OXR</sub> were independent f
{"title":"[Study on the correlation between sarcopenia, energy metabolism, and the severity of liver disease in patients with type 2 diabetes mellitus combined with metabolic associated fatty liver disease].","authors":"J Zhang, Y Li, Q Ye, N N Yan, H Y Yu, F M Wang, F S Di","doi":"10.3760/cma.j.cn501113-20231105-00168","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20231105-00168","url":null,"abstract":"<p><p><b>Objective:</b> To explore the demographic composition of type 2 diabetes mellitus (T2DM) with metabolic associated fatty liver disease (MAFLD) and the role of energy metabolism in the progression of MAFLD in order to provide theoretical support for improving the prognosis of MAFLD. <b>Methods:</b> A cross-sectional study was conducted. Ninety-four cases with T2DM combined with MAFLD admitted to the Endocrinology Department of Tianjin Third Central Hospital from July 2014 to July 2019 were selected. Patients were divided into three groups: non-metabolic associated steatohepatitis (MASH) group (25 cases), borderline MASH group (49 cases), and MASH group (20 cases) according to the non-alcoholic fatty liver disease activity score (NAS). Patients were further divided into two groups: non/mild fibrosis (F0-1) group (74 cases) and the significant fibrosis (F2-4) group (20 cases) in accordance with liver fibrosis scores. The differences in general clinical and biochemical indicators, body composition, and energy metabolism indicators among the groups were compared. Binary logistic regression analysis was conducted to explore factors affecting liver inflammation and fibrosis severity degree in patients with MAFLD. <b>Results:</b> The visceral fat area (VFA) and body fat percentage (PBF) were significantly higher in the MASH group than in the non-MASH group (<i>P</i><0.05), while the skeletal muscle mass index and body mass index (SMI-BMI) were significantly lower in the MASH group than in the marginal MASH group (<i>P</i><0.05) during the comparison of body composition and substrate metabolism at different stages of MASH. Alanine aminotransferase (ALT) and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the fibrotic group than in those in the no/mild fibrosis group (<i>P</i><0.05) when comparing clinical and biochemical indicators, body composition, and substrate metabolism at different stages of fibrosis. The skeletal muscle mass (SMM), SMI-BMI, SMM-Weight, resting energy expenditure (REE), and fat oxidation rate (FAT<sub>OXR</sub>) were significantly lower in the fibrotic group than those in the no/mild fibrosis group (<i>P</i><0.05). The respiratory quotient and carbohydrate functional ratio (%CHO) were significantly higher in the fibrotic group than in the no/mild fibrosis group (<i>P</i><0.05). Correlation analysis indicated a positive correlation between the NAS score, reflecting the severity of liver inflammatory lesions, with VFA and PBF (<i>r</i>=0.258 and 0.323, <i>P</i><0.05); while the F score was positively correlated with the respiratory quotient, %CHO, and VFA (<i>r</i>=0.292, 0.303, and 0.239, <i>P</i><0.05), and negatively correlated with REE, the energy ratio from fat, FAT<sub>OXR</sub>, SMM, SMI-Weight, and SMI-BMI (<i>r</i>=-0.209, -0.214, -0.333, -0.240, -0.250, and -0.305, <i>P</i><0.05). Logistic regression analysis indicated that SMI-Weight and FAT<sub>OXR</sub> were independent f","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"790-798"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971934","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20250518-00194
The Inherited and Metabolic Liver Disease Cooperative Group of the Hepatology Branch of the Chinese Medical Association organized experts in the relevant field to formulate the Expert Consensus on the Diagnosis and Treatment of Inherited Hyperbilirubinemia (2025 version), which includes Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome, based on advancements in clinical and basic research to assist clinicians in making rational decisions.
{"title":"[Expert consensus on the diagnosis and therapy of inherited hyperbilirubinemia (version 2025)].","authors":"","doi":"10.3760/cma.j.cn501113-20250518-00194","DOIUrl":"10.3760/cma.j.cn501113-20250518-00194","url":null,"abstract":"<p><p>The Inherited and Metabolic Liver Disease Cooperative Group of the Hepatology Branch of the Chinese Medical Association organized experts in the relevant field to formulate the Expert Consensus on the Diagnosis and Treatment of Inherited Hyperbilirubinemia (2025 version), which includes Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome, based on advancements in clinical and basic research to assist clinicians in making rational decisions.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"747-759"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971923","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20240528-00269
N He, X Y Zhang, B B Lyu, Z Y Wang, S Hao, F N Zhang
The incidence rate of metabolic associated fatty liver disease (MAFLD) in our country has risen rapidly and has developed into the largest chronic liver disease with the rise of obesity and type 2 diabetes mellitus. Although obesity is closely related to the occurrence of MAFLD, there are still some MAFLD patients whose body mass index does not meet the criteria for obesity or overweight, which is referred to as lean MAFLD. With the continuous advancement of pathological mechanisms and clinical diagnosis and treatment technologies, relevant research on lean MAFLD has made certain progress. This article reviews the epidemiological status, pathological mechanisms and clinical diagnosis and treatment of lean MAFLD in detail.
{"title":"[Research progress on clinical characteristics and pathological mechanisms of lean metabolic-associated fatty liver disease].","authors":"N He, X Y Zhang, B B Lyu, Z Y Wang, S Hao, F N Zhang","doi":"10.3760/cma.j.cn501113-20240528-00269","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240528-00269","url":null,"abstract":"<p><p>The incidence rate of metabolic associated fatty liver disease (MAFLD) in our country has risen rapidly and has developed into the largest chronic liver disease with the rise of obesity and type 2 diabetes mellitus. Although obesity is closely related to the occurrence of MAFLD, there are still some MAFLD patients whose body mass index does not meet the criteria for obesity or overweight, which is referred to as lean MAFLD. With the continuous advancement of pathological mechanisms and clinical diagnosis and treatment technologies, relevant research on lean MAFLD has made certain progress. This article reviews the epidemiological status, pathological mechanisms and clinical diagnosis and treatment of lean MAFLD in detail.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"811-816"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971943","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20250401-00117
X Bai, Q Q Chen, J Li
Cirrhosis caused by metabolic associated fatty liver disease (MAFLD) has become a major global health challenge. Genetics, metabolic disorders, viruses, and other factors jointly drive the progression of this disease. The development of high-precision, non-invasive models for these diseases within the context of artificial intelligence is a novel direction for future diagnosis. Therapies that improve metabolism and antifibrosis should be strongly emphasized and urgently implemented to establish a standardized and unified endpoint evaluation system for anti-cirrhosis drug trials and therefore accelerate new drug development. This article systematically explores the epidemiological characteristics, risk factors, and the latest diagnosis and treatment strategies, with the aim to provide a reference basis for clinical practice.
{"title":"[Metabolic associated fatty liver disease induced cirrhosis: epidemiology, risk factors, and new strategies for precise prevention and control].","authors":"X Bai, Q Q Chen, J Li","doi":"10.3760/cma.j.cn501113-20250401-00117","DOIUrl":"10.3760/cma.j.cn501113-20250401-00117","url":null,"abstract":"<p><p>Cirrhosis caused by metabolic associated fatty liver disease (MAFLD) has become a major global health challenge. Genetics, metabolic disorders, viruses, and other factors jointly drive the progression of this disease. The development of high-precision, non-invasive models for these diseases within the context of artificial intelligence is a novel direction for future diagnosis. Therapies that improve metabolism and antifibrosis should be strongly emphasized and urgently implemented to establish a standardized and unified endpoint evaluation system for anti-cirrhosis drug trials and therefore accelerate new drug development. This article systematically explores the epidemiological characteristics, risk factors, and the latest diagnosis and treatment strategies, with the aim to provide a reference basis for clinical practice.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"728-733"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971869","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20241007-00528
W Deng, S Y Wang, X Wei, W H Cao, Y Xie, M H Li
{"title":"[A case of hepatitis B surface antigen clearance achievement based on the combination of interferon and intermittent consolidation therapy].","authors":"W Deng, S Y Wang, X Wei, W H Cao, Y Xie, M H Li","doi":"10.3760/cma.j.cn501113-20241007-00528","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20241007-00528","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"802-805"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971909","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20231111-00191
X X Han, Z J Zhang, Q Y Wang
{"title":"[A case of liver cirrhosis combined with reactive perforating collagen disease].","authors":"X X Han, Z J Zhang, Q Y Wang","doi":"10.3760/cma.j.cn501113-20231111-00191","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20231111-00191","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"799-801"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971855","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20250319-00101
Y F Yang, J J Wang, G W Chen, Q C Ge, L G Lu
Liver cirrhosis as the terminal stage of chronic liver disease has seen many new insights and advances in its treatment strategies and perspectives in recent years. However, there are still many controversies about cirrhotic portal hypertension management, prevention, therapy, and complications. This article summarizes the main key controversial points in the current treatment of liver cirrhosis from an evidence-based medicine perspective, including the use of non-selective β-blockers during decompensated stages, exploration of precise strategies for albumin, re-evaluation of the risks of statins, weighing the pros and cons of proton pump inhibitors, new understandings of anticoagulation therapy, breakthroughs in targeting gut microbiota, and nutritional support management. In addition, it combines the latest research data and guideline recommendations to explore future development directions so as to provide clinical practice reference.
{"title":"[Clinical treatment controversies and progress in liver cirrhosis: an evidence-based medicine perspective from managing portal hypertension to preventing complications].","authors":"Y F Yang, J J Wang, G W Chen, Q C Ge, L G Lu","doi":"10.3760/cma.j.cn501113-20250319-00101","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20250319-00101","url":null,"abstract":"<p><p>Liver cirrhosis as the terminal stage of chronic liver disease has seen many new insights and advances in its treatment strategies and perspectives in recent years. However, there are still many controversies about cirrhotic portal hypertension management, prevention, therapy, and complications. This article summarizes the main key controversial points in the current treatment of liver cirrhosis from an evidence-based medicine perspective, including the use of non-selective β-blockers during decompensated stages, exploration of precise strategies for albumin, re-evaluation of the risks of statins, weighing the pros and cons of proton pump inhibitors, new understandings of anticoagulation therapy, breakthroughs in targeting gut microbiota, and nutritional support management. In addition, it combines the latest research data and guideline recommendations to explore future development directions so as to provide clinical practice reference.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"734-737"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971903","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}
Pub Date : 2025-08-20DOI: 10.3760/cma.j.cn501113-20240910-00486
M X Zhang, L Wang, X Zhang, Y C Dong, Y C Wang
Objective: To explore the correlation between Chinese visceral adiposity index (CVAI) and metabolic associated fatty liver disease (MAFLD) so as to evaluate its predictive value for MAFLD. Methods: Six hundred and thirteen cases admitted to the Department of Gastroenterology, Zhongshan Hospital Affiliated to Dalian University from June 2022 to August 2023 were selected and divided into the MAFLD group (n=312) and the non-MAFLD group (n=301) according to the diagnostic criteria of MAFLD. The clinical data differences between the two groups were compared. The MAFLD group was divided into a mild MAFLD group (n=243) and a moderate to severe MAFLD group (n=69) according to the liver/spleen CT value. The differences in body fat indices such as CVAI, visceral fat index (VAI), and visceral fat area (VFA) were compared between subjects with different degrees of MAFLD. The Spearman test was used to analyze the correlation between CVAI, VAI, and various clinical indicators. The subjects were divided into groups (Q1-Q4) according to the quartile levels of CVAI and VAI, and the distribution of MAFLD conditions among the groups was compared. Logistic regression analysis was used to determine the occurrence risk of MAFLD at different CVAI and VAI levels. The receiver operating characteristic curve was drawn. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the predictive value of CVAI, VAI, VFA, waist circumference, and body mass index for MAFLD. The DeLong test was used to compare the differences in the AUC of each predictive index. Results: The prevalence of hypertension and type 2 diabetes mellitus, and the levels of systolic blood pressure, diastolic blood pressure, CVAI, VAI, VFA, subcutaneous fat area, waist circumference, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, and serum uric acid were higher in the MAFLD group than the non-MAFLD group (P<0.05), while the level of high-density lipoprotein cholesterol was lower than the non-MAFLD group (P<0.001). The levels of CVAI, VAI, VFA, waist circumference, and body mass index were higher in the mild and the moderate to severe MAFLD group than those in the non-MAFLD group (P<0.001). The detection rate of MAFLD gradually increased(χ2=176.953, 133.659, P<0.001) with the increase of CVAI and VAI levels. Correlation analysis showed that CVAI was positively correlated with VFA (r=0.755, P<0.001) and the homeostasis model assessment of insulin resistance (r=0.579, P<0.001). Multivariate logistic regression analysis showed that after adjusting for various risk factors, the risk of MAFLD in the Q4 group o
{"title":"[Predictive value of a Chinese visceral adiposity index for metabolic associated fatty liver disease].","authors":"M X Zhang, L Wang, X Zhang, Y C Dong, Y C Wang","doi":"10.3760/cma.j.cn501113-20240910-00486","DOIUrl":"10.3760/cma.j.cn501113-20240910-00486","url":null,"abstract":"<p><p><b>Objective:</b> To explore the correlation between Chinese visceral adiposity index (CVAI) and metabolic associated fatty liver disease (MAFLD) so as to evaluate its predictive value for MAFLD. <b>Methods:</b> Six hundred and thirteen cases admitted to the Department of Gastroenterology, Zhongshan Hospital Affiliated to Dalian University from June 2022 to August 2023 were selected and divided into the MAFLD group (<i>n</i>=312) and the non-MAFLD group (<i>n</i>=301) according to the diagnostic criteria of MAFLD. The clinical data differences between the two groups were compared. The MAFLD group was divided into a mild MAFLD group (<i>n</i>=243) and a moderate to severe MAFLD group (<i>n</i>=69) according to the liver/spleen CT value. The differences in body fat indices such as CVAI, visceral fat index (VAI), and visceral fat area (VFA) were compared between subjects with different degrees of MAFLD. The Spearman test was used to analyze the correlation between CVAI, VAI, and various clinical indicators. The subjects were divided into groups (Q1-Q4) according to the quartile levels of CVAI and VAI, and the distribution of MAFLD conditions among the groups was compared. Logistic regression analysis was used to determine the occurrence risk of MAFLD at different CVAI and VAI levels. The receiver operating characteristic curve was drawn. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the predictive value of CVAI, VAI, VFA, waist circumference, and body mass index for MAFLD. The DeLong test was used to compare the differences in the AUC of each predictive index. <b>Results:</b> The prevalence of hypertension and type 2 diabetes mellitus, and the levels of systolic blood pressure, diastolic blood pressure, CVAI, VAI, VFA, subcutaneous fat area, waist circumference, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, and serum uric acid were higher in the MAFLD group than the non-MAFLD group (<i>P</i><0.05), while the level of high-density lipoprotein cholesterol was lower than the non-MAFLD group (<i>P</i><0.001). The levels of CVAI, VAI, VFA, waist circumference, and body mass index were higher in the mild and the moderate to severe MAFLD group than those in the non-MAFLD group (<i>P</i><0.001). The detection rate of MAFLD gradually increased(<i>χ</i><sup>2</sup>=176.953, 133.659, <i>P</i><0.001) with the increase of CVAI and VAI levels. Correlation analysis showed that CVAI was positively correlated with VFA (<i>r</i>=0.755, <i>P</i><0.001) and the homeostasis model assessment of insulin resistance (<i>r</i>=0.579, <i>P</i><0.001). Multivariate logistic regression analysis showed that after adjusting for various risk factors, the risk of MAFLD in the Q4 group o","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"33 8","pages":"781-789"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971926","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号