1.Current Status and Strategies of Integrated Traditional Chinese and Western Medicine in the Treatment of Helicobacter pylori Infection
Xuezhi ZHANG ; Xia DING ; Zhen LIU ; Hui YE ; Xiaofen JIA ; Hong CHENG ; Zhenyu WU ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(1):111-116
This paper systematically reviews the current status of integrated traditional Chinese and western medicine in the treatment of Helicobacter pylori (Hp) infection, as well as recent progress in clinical and basic research both in China and internationally. It summarizes the advantages of traditional Chinese medicine (TCM) in Hp infection management, including improving Hp eradication rates, enhancing antibiotic sensitivity, reducing antimicrobial resistance, decreasing drug-related adverse effects, and ameliorating gastric mucosal lesions. These advantages are particularly evident in patients who are intolerant to bismuth-containing regimens, those with refractory Hp infection, and individuals with precancerous gastric lesions. An integrated, whole-process management approach and individualized, staged comprehensive treatment strategies combining TCM and western medicine are proposed for Hp infection. Future prevention and control of Hp infection should adopt an integrative Chinese-western medical strategy, emphasizing prevention, strengthening primary care, implementing proactive long-term monitoring, optimizing screening strategies, and advancing the development of novel technologies and mechanistic studies of Chinese herbal interventions. These efforts aim to provide a theoretical basis and practical pathways for the establishment and improvement of Hp infection prevention and control systems.
2.Research progress on the role of antigen-presenting cells in xenotransplantation
Kankan SHUI ; Haoran ZHOU ; Ye XU ; Qiulin LUO ; Tengfang LI ; Hedong ZHANG ; Longkai PENG ; Helong DAI
Organ Transplantation 2026;17(1):9-15
Organ transplantation is an effective alternative treatment for patients with end-stage organ failure. However, the shortage of donor organs has limited the widespread application of clinical transplantation. In recent years, breakthroughs in CRISPR-Cas9 gene editing technology have overcome the barrier of hyperacute rejection in xenotransplantation, offering a potential solution to the organ shortage crisis. Rejection remains a critical factor affecting graft survival. Antigen-presenting cells play a vital role in the initiation and progression of rejection and immune regulation in xenotransplantation. Therefore, in-depth investigation into the role of antigen-presenting cells in xenotransplantation is of great significance. This article summarizes the roles and therapeutic strategies of professional antigen-presenting cells, including macrophages, dendritic cells and B cells in xenotransplantation, aiming to provide insights for future research on immune regulation mechanisms in this field.
3.Research progress on the relationship between early life obesogen exposure and childhood obesity
GAO Lei ; YE Zhen ; WANG Wei ; ZHAO Dong ; XU Peiwei ; ZHANG Ronghua
Journal of Preventive Medicine 2026;38(1):48-54
Childhood obesity has become a global public health issue. Current research indicates that early life obesogen exposure has emerged as a significant risk factor for childhood obesity. While obesogens have been confirmed to influence the development and progression of childhood obesity through mechanisms such as endocrine disruption and epigenetic programming, controversies remain regarding the establishment of causal relationships, assessment of combined exposures, and validation of transgenerational effects in humans. In recent years, novel approaches including multi-omics technologies, exposome-based analysis, and multigenerational cohort studies have integrated dynamic biomarker monitoring with analyses of social-environmental interactions, offering new perspectives and methodologies for constructing a systematic "exposure-mechanism-outcome" research framework. This article reviews literature from PubMed and Web of Science up to August 2025 on the association between early life obesogen exposure and childhood obesity, summarizing evidence on the health effects of early life obesogen exposure, major exposure pathways and internal exposure assessment, interactions and amplifying effects of social and environmental factors, as well as the biological mechanisms underlying obesogen action. It further examines current research frontiers and challenges, aiming to provide a theoretical foundation for early prevention and precision intervention of childhood obesity.
4.Late identification and its influencing factors of newly reported HIV/AIDS cases in Linhai City from 2015 to 2024
XU Guangming ; ZHANG Zhen ; YE Xiaohong
Journal of Preventive Medicine 2026;38(1):71-74
Objective:
To investigate the late identification and its influencing factors of newly reported HIV/AIDS cases in Linhai City, Zhejiang Province from 2015 to 2024, so as to provide a basis for formulating targeted AIDS prevention and control strategies.
Methods:
Data on newly reported HIV/AIDS cases in Linhai City from 2015 to 2024, including demographic characteristics and detection modes, were collected through the HIV/AIDS Comprehensive Control System of the Chinese Disease Prevention and Control Information System. The new identification rate and late identification proportion of HIV/AIDS cases were analyzed. The average annual percent change (AAPC) was used to assess trends in both the new identification rate and late identification proportion from 2015 to 2024. Multivariable logistic regression model was used to analyze the influencing factors for late identification among HIV/AIDS cases.
Results:
A total of 589 newly reported HIV/AIDS cases were documented in Linhai City from 2015 to 2024. The new identification rate declined from 5.08/105 in 2015 to 3.53/105 in 2024 (AAPC=-6.161%, P<0.05). Among them, 225 cases were late identified. After excluding 4 cases with inferred late identification, the late identification proportion increased from 24.53% in 2015 to 58.97% in 2024 (AAPC=7.595%, P<0.05). Multivariable logistic regression analysis indicated that age ≥25 years (25~<50 years, OR=3.569, 95%CI: 1.567-8.130; ≥50 years, OR=8.683, 95%CI: 3.440-21.917) and passive detection (OR=1.730, 95%CI: 1.022-2.928) were associated with a higher risk of late identification. In contrast, being married or having a spouse (OR=0.565, 95%CI: 0.332-0.960) was associated with a lower risk of late identification.
Conclusions
The new identification rate of HIV/AIDS cases in Linhai City from 2015 to 2024 showed a downward trend, while the proportion of late identification exhibited an upward trend. Age, marital status, and detection mode were identified as influencing factors for late identification among HIV/AIDS cases.
5.Staged Characteristics of Mitochondrial Energy Metabolism in Chronic Heart Failure with Heart-Yang Deficiency Syndrome and Prescription Intervention from Theory of Reinforcing Yang
Zizheng WU ; Xing CHEN ; Lichong MENG ; Yao ZHANG ; Peng LUO ; Jiahao YE ; Kun LIAN ; Siyuan HU ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):129-138
Chronic heart failure (CHF) is a complex clinical syndrome caused by ventricular dysfunction, with mitochondrial energy metabolism disorder being a critical factor in disease progression. Heart-Yang deficiency syndrome, as the core pathogenesis of CHF, persists throughout the disease course. Insufficiency of heart-Yang leads to weakened warming and propelling functions, resulting in the accumulation of phlegm-fluid, blood stasis, and dampness. This eventually causes Qi stagnation with phlegm obstruction and blood stasis with water retention, forming a vicious cycle that exacerbates disease progression. According to the theory of reinforcing Yang, the clinical experience of the traditional Chinese medicine (TCM) master Tang Zuxuan in treating CHF with heart-Yang deficiency syndrome, and achievements from molecular biological studies, this study innovatively proposes an integrated research framework of "TCM syndrome differentiation and staging-mitochondrial metabolism mechanisms-intervention with Yang-reinforcing prescriptions" which is characterized by the integration of traditional Chinese and Western medicine. Heart-Yang deficiency syndrome is classified into mild (Stage Ⅰ-Ⅱ), severe (Stage Ⅲ), and critical (Stage Ⅳ) stages. The study elucidates the precise correlations between the pathogenesis of each stage and mitochondrial metabolism disorders from theoretical, pathophysiological, and therapeutic perspectives. The mild stage is characterized by impaired biogenesis and substrate-utilization imbalance, corresponding to heart-Yang deficiency and phlegm-fluid aggregation. Linggui Zhugantang and similar prescriptions can significantly improve the expression of peroxisome proliferator-activated receptor gamma co-activator-1α(PGC-1α)/silent information regulator 2 homolog 1 (SIRT1) and ATPase activity. The severe stage centers on oxidative stress and structural damage, reflecting Yang deficiency with water overflow and phlegm-blood stasis intermingling. At this stage, Zhenwu Tang and Qiangxin Tang can effectively mitigate oxidative stress damage, increase adenosine triphosphate (ATP) content, and repair mitochondrial structure. The critical stage arises from calcium overload and mitochondrial disintegration, leading to the collapse of Yin-Yang equilibrium. At this stage, Yang-restoring and crisis-resolving prescriptions such as Fuling Sini Tang and Qili Qiangxin capsules can inhibit abnormal opening of the mitochondrial permeability transition pore (MPTP), reduce cardiomyocyte apoptosis rate, and protect mitochondrial function. By summarizing the characteristics of mitochondrial energy metabolism disorders at different stages of CHF, this study explores the application of the theory of reinforcing Yang in treating heart-Yang deficiency syndrome and provides new insights for the clinical diagnosis and treatment of CHF.
6.Danhong Injection Regulates Ventricular Remodeling in Rat Model of Chronic Heart Failure with Heart-Blood Stasis Syndrome via p38 MAPK/NF-κB Signaling Pathway
Zizheng WU ; Xing CHEN ; Jiahao YE ; Lichong MENG ; Yao ZHANG ; Junyu ZHANG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):149-159
ObjectiveTo explore the mechanism of ventricular remodeling mediated by the p38 mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) signaling pathway in the rat model of chronic heart failure (CHF) with heart-blood stasis syndrome, as well as the intervention effect of Danhong injection. MethodsIn vivo experiment: SPF-grade male SD rats were assigned via the random number table method into 4 groups: Sham operation, model, captopril (8.8 mg·kg-1), and Danhong injection (6.0 mL·kg-1). The model of CHF with heart-blood stasis syndrome was established by abdominal aortic constriction, and the sham operation group only underwent laparotomy without constriction. All the groups were treated continuously for 15 days. The tongue color of rats was observed. Echocardiography, hemorheology, heart mass index (HMI), and left ventricular mass index (LVMI) were measured. Hematoxylin-eosin (HE) staining and Masson staining were performed to observe the pathological and fibrotic changes of the myocardial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to quantify the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), angiotensin Ⅱ (AngⅡ), tumor necrosis factor-α (TNF-α), and Creactive protein (CRP) in the serum, as well as the levels of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in the myocardial tissue. Western blot was used to quantify the protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue. In vitro experiment: H9C2 cardiomyocytes were treated with 1×10-6 mol·L-1 AngⅡ to establish a model of myocardial hypertrophy. H9C2 cardiomyocytes were allocated into normal, model, inhibitor + Danhong injection, Danhong injection (20 mL·L-1), and inhibitor (SB203580, 5 μmol·L-1) groups. CCK-8 assay was used to detect the viability of H9C2 cardiomyocytes. Rhodamine-labeled phalloidin staining was used to reveal the area of cardiomyocytes. Real-time PCR was performed to determine the mRNA levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). Western blot was used to assess the protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65. ResultsIn vivo experiment: Compared with the sham operation group, the model group showed purplish-dark tongue with decreased R, G, B values of the tongue surface (P<0.01), increased whole blood viscosity (at low, medium, and high shear rates) (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), increased left ventricular end-diastolic diameter (LVIDd), left ventricular end-systolic diameter (LVIDs), and left ventricular posterior wall thickness at end-diastole (LVPWd) (P<0.01), raised LVMI and HMI (P<0.01), and elevated levels of NT-proBNP, TNF-α, IL-6, and CRP in the serum and MMP-2 and MMP-9 in the myocardial tissue (P<0.01). The HE and Masson staining of the myocardial tissue showed compensatory myocardial hypertrophy, fibrosis, and massive inflammatory cell infiltration in the model group. Additionally, the model group presented up-regulated protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue (P<0.01). Compared with the model group, each administration group showed increased R, G, B values of the tongue surface (P<0.05, P<0.01), decreased whole blood viscosity (at low, medium, and high shear rates) (P<0.05, P<0.01), increased LVEF and LVFS (P<0.01), decreased LVIDd, LVIDs, and LVPWd (P<0.05, P<0.01), declined LVMI and HMI (P<0.05, P<0.01), and lowered levels of NT-proBNP, TNF-α, IL-6, and CRP in the serum and MMP-2 and MMP-9 in the myocardial tissue (P<0.01). HE and Masson staining showed alleviated compensatory myocardial hypertrophy, reduced fibrosis, and decreased expression of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue (P<0.01). In vitro experiment: When the concentration of Danhong injection reached 20 mL·L-1, the survival rate of H9C2 cardiomyocytes was the highest (P<0.01). Compared with the normal group, the model group showed up-regulated mRNA levels of ANP and BNP (P<0.01), increased relative cell surface area (P<0.01), and raised protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 (P<0.01). Compared with the model group, each administration group showed down-regulated mRNA levels of ANP and BNP (P<0.01), reduced relative cell surface area (P<0.05, P<0.01), and down-regulated protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 (P<0.05, P<0.01). ConclusionDanhong injection can regulate ventricular remodeling through the p38 MAPK/NF-κB pathway, thereby exerting a protective effect on the rat model of CHF with heart-blood stasis syndrome.
7.Expert consensus on neoadjuvant PD-1 inhibitors for locally advanced oral squamous cell carcinoma (2026)
LI Jinsong ; LIAO Guiqing ; LI Longjiang ; ZHANG Chenping ; SHANG Chenping ; ZHANG Jie ; ZHONG Laiping ; LIU Bing ; CHEN Gang ; WEI Jianhua ; JI Tong ; LI Chunjie ; LIN Lisong ; REN Guoxin ; LI Yi ; SHANG Wei ; HAN Bing ; JIANG Canhua ; ZHANG Sheng ; SONG Ming ; LIU Xuekui ; WANG Anxun ; LIU Shuguang ; CHEN Zhanhong ; WANG Youyuan ; LIN Zhaoyu ; LI Haigang ; DUAN Xiaohui ; YE Ling ; ZHENG Jun ; WANG Jun ; LV Xiaozhi ; ZHU Lijun ; CAO Haotian
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):105-118
Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.
8.Mechanism of Xianfang Huomingyin in Treating Type Ⅲ Prostatitis Based on Biological Analysis and Animal Experiments
Yuqin ZHANG ; Wenliang YAO ; Mian YE ; Yuliang ZHOU ; Shenghui CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):62-71
ObjectiveTo explore the mechanism of Xianfang Huomingyin (XFHMY) in the treatment of type Ⅲ prostatitis (CP/CPPS) through network pharmacology, molecular docking, and animal experiments. MethodsThe traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Swiss Target Prediction database were used to screen and sort out the active ingredients and corresponding targets of XFHMY. The potential therapeutic targets of CP/CPPS were collected from online databases, such as the Online Mendelian Inheritance in Man (OMIM), GeneCards, and DisGeNET. The potential core targets of XFHMY for treating CP/CPPS were further screened by constructing a protein-protein interaction (PPI) network and performing topological analysis. Meanwhile, the DAVID database was chosen to perform enrichment analysis on the intersection targets. On this basis, the AutoDock software was used for molecular docking, and the data was subsequently imported into the GraphPad Prism 8 software to generate a heat map. SD rats were divided into seven groups: A blank group, a sham operation group, a model group, low-, medium-, and high-dose XFHMY groups (3.645, 7.29, 14.58 g·kg-1), and a tamsulosin hydrochloride group (0.018 mg·kg-1). Hematoxylin-eosin (HE) staining was used to evaluate the pathological changes in prostate tissue. The inflammatory factor indicators of rats in each group were detected via enzyme-linked immunosorbent assay (ELISA). Real-time fluorescence quantitative reverse transcription polymerase chain reaction (Real-time PCR) and Western blot were used to evaluate the mRNA and protein expression levels of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), and nuclear transcription factor-κB (NF-κB) p65 in prostate tissue. ResultsThe HE staining showed no significant signs of inflammatory cell infiltration in the prostate of the sham operation group compared to the blank group, while the model group had significantly inflammatory cell infiltration. The ELISA results showed that compared to the blank group, TNF-α, IL-1β, and COX-2 in the sham operation group had no significant differences. However, they were significantly higher in the model group (P<0.01), indicating successful CP/CPPS modeling in rats. Compared with the model group, the low-,medium-and high-dose XFHMY group and the tamsulosin hydrochloride group showed significant decreases in TNF-α, IL-1β, and COX-2 (P<0.05,P<0.01). The Real-time PCR analysis revealed that compared to the model group, the low-dose XFHMY group had reduced Akt and NF-κB p65 mRNA expression(P<0.05,P<0.01). In the medium-and high-dose XFHMY group and tamsulosin hydrochloride group, PI3K, Akt, and NF-κB p65 mRNA levels decreased significantly(P<0.05,P<0.01). Western blot analysis showed that compared to the model group, the low-dose XFHMY group had lower p-NF-κB p65/NF-κB p65 (P<0.05). The medium- and high-dose XFHMY group and the tamsulosin hydrochloride group showed significant decreases in p-PI3K/PI3K, p-Akt-ser473/Akt, p-Akt-thr308/Akt, and p-NF-κB p65/NF-κB p65 (P<0.01). ConclusionXFHMY may exert therapeutic efficacy on CP/CPPS by inhibiting the PI3K/Akt/NF-κB signaling pathway and reducing inflammatory responses. Additionally, NF-κB activation may be related to the activation of ser473 and thr308 sites.
9.Effect and Mechanisms of Ermiao Formula Analogs and Their Active Components in Treating Dampness-heat Type Gouty Arthritis: A Review
Xueping ZHAO ; Xinya ZHANG ; Le YANG ; Ye SUN ; Xin SUN ; Hui SUN ; Qimeng ZHANG ; Guangli YAN ; Xijun WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):276-285
Gouty arthritis (GA) is caused by monosodium urate(MSU) deposition due to purine metabolism disorders. In traditional Chinese medicine (TCM), it falls under the category of "dampness-heat Bi syndrome", with core pathogenesis involving dampness-heat accumulation and dysfunction of the spleen and kidney. The dampness-heat syndrome is the most common and the primary syndrome type during acute attacks. In Western medicine, GA is associated with purine metabolism imbalance and inflammation triggered by MSU crystals, involving pathways such as NOD-like receptor protein 3 (NLRP3) inflammasome activation and Toll-like receptor 2/4 (TLR2/4) signaling. Clinically, colchicine and similar drugs are commonly used to treat GA, although long-term use carries potential side effects. Ermiao Formula analogs originate from ancient prescriptions, including Ermiao, Sanmiao, and Simiao compound formulas. All contain Atractylodis Rhizoma and Phellodendri Chinensis Cortex. Ermiaowan follow a 1∶1 formulation ratio. Sanmiaowan add Cyathulae Radix. Simiaowan further incorporate Coicis Semen. These formulas are rich in active ingredients, including alkaloids, terpenoids, flavonoids, and sterols, and treat GA through multi-component, multi-pathway, and multi-target mechanisms. Ermiaosan primarily exerts anti-inflammatory effects by inhibiting pathways such as TLR4/nuclear factor kappa-B (NF-κB) or regulating immune responses to reduce the release of inflammatory mediators, while also suppressing xanthine dehydrogenase (XDH) and xanthine oxidase (XO) activity to decrease uric acid production. Sanmiaowan enhance uric acid-lowering and anti-inflammatory effects through the guiding herb Cyathulae Radix, while also protecting cartilage from damage. Simiaowan utilizes Coicis Semen to regulate intestinal flora, alleviate dampness-heat symptoms, and exert multi-pathway anti-inflammatory and uric acid-lowering effects. The active ingredients contribute differently to uric acid metabolism regulation, anti-inflammation, antioxidant activity, and bone repair, resulting in varying therapeutic effects due to differences in formula composition. In summary, formulas derived from Ermiaosan demonstrate significant efficacy in treating dampness-heat type GA. This review summarizes their research progress and mechanisms, providing a reference for clinical application, new drug development, and further studies.
10.Thromboelastographic features of patients with primary liver cancer and their value in assessing coagulation function
Chunjuan YE ; Chun ZHANG ; Jialu LI ; Sinan LIU ; Zheng WANG
Journal of Clinical Hepatology 2026;42(1):111-116
ObjectiveTo investigate the clinical application value of thromboelastographic parameters in assessing coagulation function by analyzing the thromboelastographic features of patients with primary liver cancer (PLC), and to provide a basis for coagulation management and prognostic evaluation in liver cancer patients. MethodsA retrospective analysis was performed for 1 253 PLC patients who were admitted to The First Affiliated Hospital of Xi’an Jiaotong University from May 2015 to December 2022. According to the presence or absence of cirrhosis, the patients were divided into non-cirrhosis group with 262 patients and cirrhosis group with 991 patients, and according to the presence or absence of HBV infection, they were divided into HBV infection group with 1 055 patients and non-HBV infection group with 198 patients. The patients were stratified based on the severity of liver cirrhosis (Child-Pugh class and MELD score) and liver reserve function (indocyanine green retention rate at 15 minutes [ICGR15]), and thromboelastography was used to measure thromboelastographic parameters (reaction time [R], coagulation formation time [K], α-angle, maximum thrombosis amplitude [MA], and coagulation composite index [CI]) and conventional coagulation markers. The t-test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for comparison between multiple groups, and the Bonferroni correction method was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between grouips, and the Spearman test was used for correlation analysis. ResultsAmong the 991 patients in the cirrhosis group, 826 had Child-Pugh class A (5 — 6 points), and 165 had Child-Pugh class B (7 — 9 points); 812 had an MELD score of <10, and 179 had an MELD score of ≥10; 679 had an ICGR15 of <10%, and 294 had an ICGR15 of ≥10%. Compared with the patients with Child-Pugh class A, the patients with Child-Pugh class B had a significantly longer K time and significant reductions in α-angle, MA, and CI (all P <0.001); compared with the MELD score <10 group, the MELD score ≥10 group had a significantly longer K time and significant reductions in α-angle, MA, and CI (all P<0.001); compared with the ICGR15 <10% group, the ICGR15 ≥10% group had a significantly longer K time and a significant reduction in MA (both P <0.001). Among the 1 253 patients, MA was strongly positively correlated with fibrinogen and platelet count (r=0.675 and 0.667, both P<0.001); The MA had a weak correlation with Child-Pugh score, MELD score, and ICGR15 (r=-0.112, -0.250, and -0.117, all P<0.001), while the K time,α-angle and CI were weakly correlated with the MELD score (r=0.222, -0.184, and -0.183, all P<0.001),R time was negatively correlated with ICGR15 (r=-0.080, P=0.005). The HBV infection group had significantly higher MA and CI than the non-HBV infection group (P<0.05). ConclusionThromboelastography can sensitively identify the hypocoagulable state associated with the progression of liver cirrhosis and the hypercoagulable tendency in HBV-related liver cancer, which provides an important reference for individualized anticoagulant therapy in clinical practice.


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