1.Variations of Chemical Components in Gardeniae Fructus Before and After Being Charred Analyzed by UPLC-Q-Orbitrap MS/MS
Lan LI ; Jie HONG ; Yanan SONG ; Yilan LI ; Yun WANG ; Cun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):175-182
ObjectiveTo investigate the changes in chemical components of Gardeniae Fructus(GF) before and after being charred, providing data support for research on the material basis of GF Carbonisata(GFC). MethodsUltra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Orbitrap MS/MS) was used to conduct a comprehensive analysis of the chemical components in GF and GFC under positive and negative ion modes with Compound Discoverer 3.3 software and online database. Then, principal component analysis and partial least squares-discriminant analysis in SIMCA14.1 software were used to analyze the MS data of each sample. Based on the principle of variable importance in the projection(VIP) value>1, differential secondary and primary metabolites before and after carbonization were screened. In addition, MetaboAnalyst website was used for pathway enrichment of Kyoto Encyclopedia of Genes and Genomes(KEGG), so as to provide a reference for clarifying the processing mechanism. ResultsA total of 185 components were identified, including 96 secondary metabolites and 89 primary metabolites. These components were classified into nine categories, primarily including iridoid glycosides, flavonoids, and terpenoids, their fragmentation pathways were also analyzed. Simultaneously, multivariate statistical analysis was performed on the secondary and primary metabolites, identifying 70 and 59 differential metabolites, respectively. The secondary metabolites were enriched in two metabolic pathways, including C5-branched dibasic acid metabolism and flavonoid and flavonol biosynthesis, while the primary differential metabolites were enriched in seven pathways such as linoleic acid metabolism and tyrosine metabolism. ConclusionThe chemical components of GF change significantly after carbonization, with a significant decrease in the contents of iridoid glycosides and terpenoids such as hydroxyisogeniposide, crocin Ⅱ, crocetin, and jasminoside B. while the contents of 4-hydroxycoumarin, geniposidic acid, gentiopicroside, and gardenoside methyl ester increase significantly. This change is presumed to be associated with the enhanced cooling and hemostatic effects of the processed products. The identified key components provide a basis for elucidating the material basis underlying the efficacy changes before and after carbonization.
2.Polydatin Delays Progression of Colitis-associated Colorectal Cancer by Modulating IL-17A/Wnt/β-catenin Signaling Pathway
Jie LIU ; Mengmeng LYU ; Yanfei HONG ; Xinmei NAN ; Jialong SU ; Huachen LIU ; Qing WANG ; Guiying PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):144-154
ObjectiveTo investigate the effects and underlying mechanisms of polydatin in delaying the progression of colitis-associated colorectal cancer (CAC) by constructing an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced CAC mouse model and conducting in vitro experiments. MethodsFifty-four male C57BL/6J mice were randomly divided into normal, model, and polydatin groups (0.045 g·kg-1). The CAC mouse model was established using AOM/DSS, and samples were collected at 4, 7, and 10 weeks. Body weight change rate, disease activity index (DAI), and tumor formation were assessed. Hematoxylin-eosin (HE) staining was used to observe pathological injury in intestinal tissues. Immunohistochemistry (IHC) was performed to detect zonula occludens-1 (ZO-1) expression in colonic tissues, and Western blot was used to detect the expression of E-cadherin, N-cadherin, and Vimentin in colonic epithelial cells. Real-time PCR was used to measure mRNA expression of interleukin-17A (IL-17A), Wnt3a, β-catenin, T cell factor 1 (Tcf1), E-cadherin, N-cadherin, and Vimentin in colonic tissues. Flow cytometry was used to analyze the proportion of CD8+T cells and the expression of exhaustion-related molecules in tumors. Human colon cancer DLD-1 cells were cultured in a polydatin-containing medium, and wound healing assays were performed to observe migration changes. Real-time PCR was used to detect mRNA expression of interleukin-17 receptor A (IL-17RA), Wnt3a, β-catenin, Tcf1, E-cadherin, N-cadherin, and Vimentin in DLD-1 cells. ResultsCompared with the normal group, the model group at all three time points showed significantly decreased body weight change rate (P<0.01), significantly shortened colon length (P<0.01), and markedly increased DAI scores (P<0.01). HE staining revealed significant inflammatory cell infiltration in the submucosa of the colon in the model group, accompanied by epithelial dysplasia. ZO-1 expression in colonic tissues was significantly reduced (P<0.01). The mRNA expression of the pro-inflammatory factor IL-17A and key molecules of the Wnt/β-catenin pathway (Wnt3a, β-catenin, Tcf1) was significantly elevated (P<0.05). The mRNA and protein expression of epithelial-mesenchymal transition (EMT) markers N-cadherin and Vimentin was significantly upregulated (P<0.05), while E-cadherin expression was significantly downregulated (P<0.05). The proportion of tumor-infiltrating CD8+T cells expressing immunosuppressive molecules (TIM-3, LAG-3, PD-1) was significantly increased (P<0.05). Compared with the model group, the polydatin group showed significant improvement in body weight and DAI score (P<0.01), as well as recovery of colon length and tissue injury. ZO-1 expression in colonic tissue was significantly increased (P<0.01), while IL-17A, Wnt3a, β-catenin, Tcf1, N-cadherin, and Vimentin expression levels were significantly decreased (P<0.05), and E-cadherin expression was significantly increased (P<0.01). Tumor-infiltrating CD8+ T cells expressing immunosuppressive molecules were significantly reduced (P<0.05). In vitro experiments showed that polydatin significantly inhibited migration of DLD-1 cells (P<0.01) and reversed the upregulation of IL-17RA, Wnt3a, β-catenin, N-cadherin, and Vimentin mRNA, as well as the downregulation of E-cadherin mRNA (P<0.05). ConclusionPolydatin inhibits IL-17A secretion and IL-17RA expression, improves the immune microenvironment, blocks activation of the Wnt/β-catenin signaling pathway, suppresses EMT markers (N-cadherin and Vimentin), and restores tight junction protein expression in intestinal epithelial cells, thereby delaying the progression from colitis to colorectal cancer in mice.
3.High Expression of INF2 Predicts Poor Prognosis and Promotes Hepatocellular Carcinoma Progression
Hai-Biao WANG ; Man LIN ; Fu-Sang YE ; Jia-Xin SHI ; Hong LI ; Meng YE ; Jie WANG
Progress in Biochemistry and Biophysics 2025;52(1):194-208
ObjectiveINF2 is a member of the formins family. Abnormal expression and regulation of INF2 have been associated with the progression of various tumors, but the expression and role of INF2 in hepatocellular carcinoma (HCC) remain unclear. HCC is a highly lethal malignant tumor. Given the limitations of traditional treatments, this study explored the expression level, clinical value and potential mechanism of INF2 in HCC in order to seek new therapeutic targets. MethodsIn this study, we used public databases to analyze the expression of INF2 in pan-cancer and HCC, as well as the impact of INF2 expression levels on HCC prognosis. Quantitative real time polymerase chain reaction (RT-qPCR), Western blot, and immunohistochemistry were used to detect the expression level of INF2 in liver cancer cells and human HCC tissues. The correlation between INF2 expression and clinical pathological features was analyzed using public databases and clinical data of human HCC samples. Subsequently, the effects of INF2 expression on the biological function and Drp1 phosphorylation of liver cancer cells were elucidated through in vitro and in vivo experiments. Finally, the predictive value and potential mechanism of INF2 in HCC were further analyzed through database and immunohistochemical experiments. ResultsINF2 is aberrantly high expression in HCC samples and the high expression of INF2 is correlated with overall survival, liver cirrhosis and pathological differentiation of HCC patients. The expression level of INF2 has certain diagnostic value in predicting the prognosis and pathological differentiation of HCC. In vivo and in vitro HCC models, upregulated expression of INF2 triggers the proliferation and migration of the HCC cell, while knockdown of INF2 could counteract this effect. INF2 in liver cancer cells may affect mitochondrial division by inducing Drp1 phosphorylation and mediate immune escape by up-regulating PD-L1 expression, thus promoting tumor progression. ConclusionINF2 is highly expressed in HCC and is associated with poor prognosis. High expression of INF2 may promote HCC progression by inducing Drp1 phosphorylation and up-regulation of PD-L1 expression, and targeting INF2 may be beneficial for HCC patients with high expression of INF2.
4.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
5.Chlorogenic acid mitigates glucocorticoid-induced osteoporosis via modulation of HER2/AKT/mTOR signaling pathway.
An-Na XIE ; Sun-Zheng-Yuan ZHANG ; Yu ZHANG ; Jin-Long CAO ; Cheng-Long WANG ; Li-Bo WANG ; Hong-Jin WU ; Jie ZHANG ; Wei-Wei DAI
Journal of Integrative Medicine 2025;23(6):670-682
OBJECTIVE:
Glucocorticoid-induced osteoporosis (GIOP) is a common complication of prolonged glucocorticoid therapy. Chlorogenic acid (CGA), a polyphenol with antioxidant properties that is extracted from traditional Chinese medicines such as Eucommiae Cortex, has potential anti-osteoporotic activity. This study aimed to investigate the possible effects of CGA on GIOP in mice and murine long bone osteocyte Y4 (MLO-Y4) cells and explore the underlying molecular mechanisms.
METHODS:
The protective effects of CGA were initially evaluated in the GIOP mouse model induced by dexamethasone (Dex). The micro-computed tomography, hematoxylin-eosin staining, silver nitrate staining, and serum detection were used to assess the efficacy of CGA for improving bone formation in vivo. Then, network pharmacology analysis was used to predict the potential targets and molecular mechanisms underlying the therapeutic efficacy of CGA against GIOP. After that, 2',7'-dichlorofluorescein diacetate staining, flow cytometry, real-time quantitative reverse transcription polymerase chain reaction, and Western blotting were used to verify the mechanisms of CGA against GIOP in vitro.
RESULTS:
Animal experiments showed that CGA treatment effectively attenuated Dex-induced decreases in bone mass and strength and improved disrupted osteocyte morphology in mice. The protein-protein interaction analysis highlighted erb-b2 receptor tyrosine kinase (ERBB2), which is also known as human epidermal growth factor receptor 2 (HER2), caspase-3, kinase insert domain receptor, matrix metallopeptidase 9, matrix metallopeptidase 2, proto-oncogene tyrosine-protein kinase Src, and epidermal growth factor receptor as core targets. The Kyoto Encyclopedia of Genes and Genomes analysis revealed several significantly enriched pathways (P < 0.05), including the ERBB, phosphoinositide 3 kinase-AKT serine/threonine kinase 1 (AKT), and mechanistic target of rapamycin kinase (mTOR) pathways. Cellular experiments verified that CGA enhanced bone formation and promoted autophagy while inhibiting apoptosis in MLO-Y4 cells exposed to Dex, which was associated with the upregulated expression of HER2 and activation of the HER2/AKT/mTOR signaling pathway.
CONCLUSION
CGA exerted anti-osteoporotic effects against GIOP, partially through targeting osteocytes and modulating the HER2/AKT/mTOR signaling pathway. Please cite this article as: Xie AN, Zhang SZY, Zhang Y, Cao JL, Wang CL, Wang LB, Wu HJ, Zhang J, Dai WW. Chlorogenic acid mitigates glucocorticoid-induced osteoporosis via modulation of HER2/AKT/mTOR signaling pathway. J Integr Med. 2025; 23(6):670-682.
Animals
;
Chlorogenic Acid/therapeutic use*
;
Osteoporosis/metabolism*
;
Signal Transduction/drug effects*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
TOR Serine-Threonine Kinases/metabolism*
;
Mice
;
Glucocorticoids/adverse effects*
;
Receptor, ErbB-2/metabolism*
;
Proto-Oncogene Mas
;
Dexamethasone/adverse effects*
;
Osteocytes/drug effects*
;
Osteogenesis/drug effects*
;
Male
;
Cell Line
;
Mice, Inbred C57BL
;
Humans
6.A Retrospective Study of Pregnancy and Fetal Outcomes in Mothers with Hepatitis C Viremia.
Wen DENG ; Zi Yu ZHANG ; Xin Xin LI ; Ya Qin ZHANG ; Wei Hua CAO ; Shi Yu WANG ; Xin WEI ; Zi Xuan GAO ; Shuo Jie WANG ; Lin Mei YAO ; Lu ZHANG ; Hong Xiao HAO ; Xiao Xue CHEN ; Yuan Jiao GAO ; Wei YI ; Yao XIE ; Ming Hui LI
Biomedical and Environmental Sciences 2025;38(7):829-839
OBJECTIVE:
To investigate chronic hepatitis C virus (HCV) infection's effect on gestational liver function, pregnancy and delivery complications, and neonatal development.
METHODS:
A total of 157 HCV antibody-positive (anti-HCV[+]) and HCV RNA(+) patients (Group C) and 121 anti-HCV(+) and HCV RNA(-) patients (Group B) were included as study participants, while 142 anti-HCV(-) and HCV RNA(-) patients (Group A) were the control group. Data on biochemical indices during pregnancy, pregnancy complications, delivery-related information, and neonatal complications were also collected.
RESULTS:
Elevated alanine aminotransferase (ALT) rates in Group C during early, middle, and late pregnancy were 59.87%, 43.95%, and 42.04%, respectively-significantly higher than Groups B (26.45%, 15.70%, 10.74%) and A (23.94%, 19.01%, 6.34%) ( P < 0.05). Median ALT levels in Group C were significantly higher than in Groups A and B at all pregnancy stages ( P < 0.05). No significant differences were found in neonatal malformation rates across groups ( P > 0.05). However, neonatal jaundice incidence was significantly greater in Group C (75.16%) compared to Groups A (42.25%) and B (57.02%) ( χ 2 = 33.552, P < 0.001). HCV RNA positivity during pregnancy was an independent risk factor for neonatal jaundice ( OR = 2.111, 95% CI 1.242-3.588, P = 0.006).
CONCLUSIONS
Chronic HCV infection can affect the liver function of pregnant women, but does not increase the pregnancy or delivery complication risks. HCV RNA(+) is an independent risk factor for neonatal jaundice.
Humans
;
Female
;
Pregnancy
;
Adult
;
Pregnancy Complications, Infectious/epidemiology*
;
Retrospective Studies
;
Pregnancy Outcome
;
Infant, Newborn
;
Viremia/virology*
;
Hepatitis C
;
Hepacivirus/physiology*
;
Hepatitis C, Chronic/virology*
;
Young Adult
;
Alanine Transaminase/blood*
7.Re-Exploration for Dietary Iodine Intake in Chinese Adults using the Obligatory Iodine Loss Hypothesis.
Xiao Bing LIU ; Jun WANG ; Ya Jie LI ; Hong Xing TAN ; De Qian MAO ; Yan Yan LIU ; Wei Dong LI ; Wei YU ; Jun An YAN ; Jian Hua PIAO ; Chong Zheng GUO ; Xiao Li LIU ; Xiao Guang YANG
Biomedical and Environmental Sciences 2025;38(8):952-960
OBJECTIVE:
This study aimed to reexplore minimum iodine excretion and to build a dietary iodine recommendation for Chinese adults using the obligatory iodine loss hypothesis.
METHODS:
Data from 171 Chinese adults (19-21 years old) were collected and analyzed based on three balance studies in Shenzhen, Yinchuan, and Changzhi. The single exponential equation was accordingly used to simulate the trajectory of 24 h urinary iodine excretion as the low iodine experimental diets offered (iodine intake: 11-26 μg/day) and to further deduce the dietary reference intakes (DRIs) for iodine, including estimated average requirement (EAR) and recommended nutrient intake (RNI).
RESULTS:
The minimum iodine excretion was estimated as 57, 58, and 51 μg/day in three balance studies, respectively. Moreover, it was further suggested as 57, 58, and 51 μg/day for iodine EAR, and 80, 81, and 71 μg/day for iodine RNI or expressed as 1.42, 1.41, and 1.20 μg/(day·kg) of body weight.
CONCLUSION
The iodine DRIs for Chinese adults were established based on the obligatory iodine loss hypothesis, which provides scientific support for the amendment of nutrient requirements.
Humans
;
Iodine/administration & dosage*
;
Male
;
Female
;
China
;
Young Adult
;
Diet
;
Adult
;
Nutritional Requirements
;
East Asian People
8.Relationship between osteotomy mode and three kinds of callus morphology in extension area during single plane tibial bone transfers
Jianguo AI ; Feng ZHAO ; Zhenxing TU ; Bin WANG ; Jie CAO ; Da LI ; Qingnan HONG
Chongqing Medicine 2025;54(2):345-351,359
Objective To investigate the impact of osteotomy mode on the callus morphology in the ex-tension area of tibial bone transfer and its efficacy.Methods The information of the patients with bone defect treated in 910 Hospital of Joint Logistics and Security Force of Chinese People's Liberation Army from May 2016 to June 2022 was collected.By comparing the general data of the patients with different osteotomy meth-ods(minimally invasive osteotomy group,subperiosteal osteotomy group and extraperiosteal osteotomy group),callus morphology in the extension area(sunken type,uniform type and protruding type),healing in-dex,Ilizarov Method Research and Application Society(ASAMI)bone healing and functional evaluation and other information,the curative effect differences of different osteotomy methods on tibial bone transfer were investigated.Results The incidence rate of sunken type of callus in the extension area was 15.8%in the mini-mally invasive osteotomy group,18.9%in the subperiosteal osteotomy group,and 14.3%in the extraperioste-al osteotomy group,with statistically significant differences among the three groups(P<0.05);in which,the incidence of sunken type of callus in the minimally invasive osteotomy group was lower than that in the subpe-riosteal osteotomy group(χ2=10.178,P=0.005),but there was no statistically significant difference when compared to the extraperiosteal osteotomy group(χ2=0.102,P=0.814),the difference betrrween the extra-periosteal osteotomy group and subperiosteal osteotomy group also had no statistical difference(χ2=0.084,P=0.772).The incidence rate of uniform type of callus in the minimally invasive osteotomy group was lower than that in the subperiosteal osteotomy group(χ2=6.579,P=0.013),but there was no statistically signifi-cant difference when compared to the extraperiosteal osteotomy group(χ2=0.443,P=0.506).The difference in the subperiosteal osteotomy group and extraperiosteal osteotomy group also had no statistically significant(χ2=2.602,P=0.107).The incidence rate of protruding type of callus in the minimally invasive osteotomy group was higher than that in the subperiosteal osteotomy group(χ2=9.795,P=0.002),and the incidence rate of protruding type of callus in the extraperiosteal osteotomy group was higher than that in the subperios-teal osteotomy group(χ2=5.170,P=0.023),however,there was no statistically significant difference be-tween the minimally invasive osteotomy group and the extraperiosteal osteotomy group(χ2=0.308,P=0.579).There were no statistically significant differences in healing index,ASAMI scores,contact point non-union,pin tract infection and refracture incidence rate rates among the three groups(P>0.05).Conclusion Sub-periosteal osteotomy in the single plane tibial bone moving does not show the expected results in favor of the extension area mineralization,on the contrary,extraperiosteal osteotomy has the similar clinical efficacy to minimally invasive osteotomy.
9.Subxiphoid uniportal approach using double sternum retractors versus subxiphoid and subcostal arch three-portal approach of video-assisted thoracoscopic surgery thymectomy for thymoma treatment: A retrospective cohort study
Jinlan ZHAO ; Weiyang CHEN ; Lin LIN ; Lei WANG ; Jie LI ; Lin MA ; Longqi CHEN ; Hong CHEN ; Dong TIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(04):482-487
Objective To compare the efficacy and safety of video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of thymoma through subxiphoid uniportal approach using double sternum retractors, and subxiphoid and subcostal arch approach. Methods We retrospectively analyzed the clinical data of the patients diagnosed with thymoma who underwent VATS thymectomy from June 2023 to June 2024 in West China Hospital. Patients were categorized based on the surgical approach into two groups: a subxiphoid uniportal VATS thymectomy (SUVT) group and a subxiphoid and subcostal arch VATS thymectomy (SASAT) group. Comparisons were made between the two groups regarding surgical duration, intraoperative blood loss, postoperative drainage, thymoma size and location, and postoperative pain assessed using the visual analogue scale (VAS). Results The SUVT group consisted of 20 patients, including 11 males and 9 females, with an average age of (51.5±14.3) years. The SASAT group comprised 40 patients, including 26 males and 14 females, with an average age of (50.0±13.0) years. Compared to the SASAT group, the SUVT group had significantly larger thymomas [ (5.9±2.7) cm vs. (4.2±2.1) cm, P=0.010] and a higher proportion of neoplasms located in the superior mediastinum (30.0% vs. 2.5%, P=0.007). Additionally, the VAS pain scores on postoperative days 3, 7, and 30 were significantly lower in the SUVT group compared to the SASAT group (P<0.05). There were no statistical differences between the two groups in demographic characteristics, operative time, intraoperative blood loss, duration and volume of postoperative drainage, length of postoperative hospital stay, or the VAS pain score on the first postoperative day. Conclusion SUVT using double sternum retractors significantly reduces postoperative pain and provides superior efficacy in the resection of larger thymomas or those situated in the superior mediastinum.
10.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

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