Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients,consensus on the bleeding risk and thresholds of hemostatic parameters has not been achieved.The purpose of this consensus is to establish an expert opinion on the bleeding risk associated with invasive procedures in cirrhotic patients,categorizing 80 procedures as"high risk"and"low risk".The consensus also informs physicians of the laboratory thresholds for platelet count,international normalized ratio,fibrinogen,and activated partial thromboplastin time that experts consider acceptable for elective invasive procedures in patients with cirrhosis.This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients,consensus on the bleeding risk and thresholds of hemostatic parameters has not been achieved.The purpose of this consensus is to establish an expert opinion on the bleeding risk associated with invasive procedures in cirrhotic patients,categorizing 80 procedures as"high risk"and"low risk".The consensus also informs physicians of the laboratory thresholds for platelet count,international normalized ratio,fibrinogen,and activated partial thromboplastin time that experts consider acceptable for elective invasive procedures in patients with cirrhosis.This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Objective:To clarify the definition and attributes of change fatigue among nurses.Methods:A comprehensive literature search was conducted across both Chinese and international databases, including CINAHL, Cochrane Library, Web of Science, PubMed, ProQuest, ScienceDirect, Springer Link, Wanfang Data, China National Knowledge Infrastructure, VIP, and China Biology Medicine disc, from inception to December 2024. Walker and Avant's classic concept analysis method was adopted.Results:A total of 30 relevant studies were included. The defining attributes of nurse change fatigue include perception of change, negative psychological responses, and passive reactions. Antecedents involve personal and organizational factors, and the consequences affect nurses themselves, patients, and the organization.Conclusions:Concept analysis helps clarify the connotation of nurse change fatigue, enabling managers to identify its features and providing a foundation for future targeted interventions to mitigate fatigue and promote nurses' positive responses to organizational change.

Objective:To clarify the definition and attributes of change fatigue among nurses.Methods:A comprehensive literature search was conducted across both Chinese and international databases, including CINAHL, Cochrane Library, Web of Science, PubMed, ProQuest, ScienceDirect, Springer Link, Wanfang Data, China National Knowledge Infrastructure, VIP, and China Biology Medicine disc, from inception to December 2024. Walker and Avant's classic concept analysis method was adopted.Results:A total of 30 relevant studies were included. The defining attributes of nurse change fatigue include perception of change, negative psychological responses, and passive reactions. Antecedents involve personal and organizational factors, and the consequences affect nurses themselves, patients, and the organization.Conclusions:Concept analysis helps clarify the connotation of nurse change fatigue, enabling managers to identify its features and providing a foundation for future targeted interventions to mitigate fatigue and promote nurses' positive responses to organizational change.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients,consensus on the bleeding risks and hemostatic parameter thresholds has not been achieved.The purpose of this consensus is to establish an opinion on the bleeding risks associated with invasive procedures in cirrhotic patients,categorizing 80 procedures as"high risk"or"low risk".The consensus will also inform physicians of the acceptable laboratory thresholds for platelet count,international normalized ratio,fibrinogen,and activated partial thromboplastin time that experts consider acceptable before elective invasive procedures in patients with cirrhosis.This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Liver diseases in pregnancy comprise both gestational liver disorders and acute and chronic hepatic disorders occurring coincidentally in pregnancy.Whether pregnancy-related or not,liver diseases in pregnancy are associated with a significant risk of maternal and fetal morbidity and mortality.Thus,the European Association for the Study of the Liver invited a panel of experts to develop clinical practice guidelines aimed at providing recommendations,based on the best available evidence,for the management of liver diseases in pregnancy for hepatologists,gastroenter-ologists,obstetric physicians,general physicians,training specialists and other healthcare professionals who provide care for this patient population.

This Practice Guidance intends to coalesce best practice recommendations for the identification of portal hypertension （PH）， for prevention of initial hepatic decompensation， for the management of acute variceal hemorrhage （AVH）， and for reduction of the risk of recurrent variceal hemorrhage in chronic liver disease. The most significant changes in the current Guidance relate to recognition of the concept of compensated advanced chronic liver disease， codification of methodology to use noninvasive assessments to identify clinically significant PH （CSPH）， and endorsement of a change in paradigm with the recommendation of early utilization of nonselective beta-blocker therapy when CSPH is identified. The updated guidance further explores potential future pharmacotherapy options for PH， clarifies the role of preemptive transjugular intrahepatic portosystemic shunt in AVH， discusses more recent data related to the management of cardiofundal varices， and addresses new topics such as portal hypertensive gastropathy and endoscopy prior to transesophageal echocardiography and antineoplastic therapy.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients,consensus on the bleeding risks and hemostatic parameter thresholds has not been achieved.The purpose of this consensus is to establish an opinion on the bleeding risks associated with invasive procedures in cirrhotic patients,categorizing 80 procedures as"high risk"or"low risk".The consensus will also inform physicians of the acceptable laboratory thresholds for platelet count,international normalized ratio,fibrinogen,and activated partial thromboplastin time that experts consider acceptable before elective invasive procedures in patients with cirrhosis.This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients, consensus on the bleeding risks and hemostatic parameter thresholds has not been achieved. The purpose of this consensus is to establish an opinion on the bleeding risks associated with invasive procedures in cirrhotic patients, categorizing 80 procedures as " high risk" or " low risk". The consensus will also inform physicians of the acceptable laboratory thresholds for platelet count, international normalized ratio, fibrinogen, and activated partial thromboplastin time that experts consider acceptable before elective invasive procedures in patients with cirrhosis. This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients, consensus on the bleeding risks and hemostatic parameter thresholds has not been achieved. The purpose of this consensus is to establish an opinion on the bleeding risks associated with invasive procedures in cirrhotic patients, categorizing 80 procedures as " high risk" or " low risk". The consensus will also inform physicians of the acceptable laboratory thresholds for platelet count, international normalized ratio, fibrinogen, and activated partial thromboplastin time that experts consider acceptable before elective invasive procedures in patients with cirrhosis. This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.