1.Long-term prognosis of recompensation in patients with decompensated liver cirrhosis
Zhiwei XIE ; Bo LI ; Lihua LIN ; Ying TAN ; Jianping LI ; Yujuan GUAN ; Yaping WANG
Journal of Clinical Hepatology 2026;42(6):1246-1252
Liver cirrhosis recompensation refers to the process in which patients with decompensated cirrhosis achieve the disappearance of decompensated complications and restoration of liver function and clinical phenotype to a compensated state after etiological treatment or symptomatic treatment. In recent years, with effective control of the etiology of cirrhosis and treatment or prevention of decompensated complications, the clinical significance of recompensation has gained increasing attention. This article elaborates on recompensation from the aspects of definition, diagnostic criteria, influencing factors, mechanisms affecting long-term prognosis, and clinical management strategies, and with reference to the latest research evidence, this article also discusses the core value of recompensation in improving quality of life and reducing the risk of end-stage events, in order to provide a basis for optimizing the comprehensive management of liver cirrhosis.
2.Analysis of Pharmacodynamic Material Basis, Mechanisms, and Efficacy-related Quality Markers of Puerariae Lobatae Radix and Puerariae Thomsonii Radix with Different Therapeutic Effect
Xiaowei MENG ; Zhenzhen YANG ; Wenting WU ; Ronghua LIU ; Yongmei GUAN ; Hui OUYANG ; Liping HUANG ; Yaqi WANG ; Qiong LI ; Huanhuan DONG ; Jianping GONG ; Weifeng ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):269-281
Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family, respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China, the two herbs have been individually recorded. Although they share the same functions and indications, the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator, puerarin, which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production, thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents, while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis, cardiovascular and cerebrovascular protection, and central analgesia, while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation, hypoglycemia, and peripheral analgesia. Based on this, the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects, namely "relieving exterior syndrome and clearing heat", "promoting fluid production to quench thirst", and "dredging channels and activating collaterals", were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway, and their common core target is prostaglandin-endoperoxide synthase 2 (PTGS2). This review provided clinical application recommendations based on the therapeutic differences between the two herbs, elucidated the scientific connotation of their "same origin but different effects", and, grounded in the quality marker (Q-Marker), proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association, as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix, the improvement of quality standards, and the high-quality development of the industry.
3.Multidimensional analysis of diagnosis and treatment status of chronic hepatitis B
Ying TAN ; Bo LI ; Aiqi LU ; Lihua LIN ; Xiaoyuan CHEN ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):449-453
Objective:The aim was to analyze key indicators for the diagnosis and treatment of chronic hepatitis B(CHB),including virus detection rate,standardized treatment rate,and loss to follow-up rate,in order to provide a basis for optimizing diagnosis and treatment plans,improve the diagnosis and treatment level of CHB,and improve patient prognosis.Methods:Patients with CHB admitted to the Guangzhou Eighth People′s Hospital Affiliated to Guangzhou Medical University from January 2024 to January 2025 were enrolled. The datas were collected and organized using Excel. Statistical analysis was conducted using SPSS 26.0 software,with a focus on evaluating core indicators such as virus detection rate,standardized treatment rate,and loss to follow-up rate.Results:The positive rate of hepatitis B surface antigen(HBsAg)in non-specific patients was 28.95%,the antiviral treatment rate in specialized patients was 90.78%,and the standardized antiviral drug conversion treatment rate in low-level viremia(LLV)patients was 61.45%. The standardized antiviral drug conversion treatment rates for high-risk patients with combined kidney/bone injuries were 72.75% and 74.40%,respectively. The overall dropout rate was 10.47%,with a dropout rate of 13.80% for LLV patients.Conclusions:The antiviral treatment coverage rates in CHB patients were over 90%,but in certain groups(such as LLV patients and those with kidney or bone injuries),the standardized treatment rates were still low and loss to follow-up rates were high,suggesting the need to improve HBV screening,treatment for special populations,and patient adherence.
4.Construction and implementation of a new model for prevention and treatment of hepatitis B in communities in Guangzhou city
Bo LI ; Aiqi LU ; Ying TAN ; Lihua LIN ; Songlian LIU ; Ganqiu LIN ; Qikai NING ; Jiewei LIU ; Huanhui LIANG ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):441-448
Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework[tertiary hospitals-center for disease control and prevention(CDC)-primary care clinics]implemented dual-track screening(fixed-site+mobile units)using rapid hepatitis B surface antigen(HBsAg)testing and structured surveys. Digital closed-loop management integrated screening,referral,and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened(Male∶Female=1∶1.68),overall HBsAg positive rate was 5.21%(1 565/30 012),peaking in the 50-59-year cohort( χ2=271.80, P<0.001). Hepatitis B knowledge awareness was critically low(39.24%). Of 140 referred HBsAg-positive individuals,15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%(41/125)to 86.4%(108/125)post-intervention. aMAP hepatocellular carcinoma(HCC)risk stratification(n=82)revealed low(36.6%),intermediate(32.9%),and high-risk(30.5%)profiles. Conclusions:This coordinated,digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However,persistent knowledge gaps underscore the imperative for targeted community education and adherence support.
5.Clinical features of hepatitis B virus-related early-onset and late-onset liver cancer: A comparative analysis
Songlian LIU ; Bo LI ; Yaping WANG ; Aiqi LU ; Chujing LI ; Lihua LIN ; Qikai NING ; Ganqiu LIN ; Pei ZHOU ; Yujuan GUAN ; Jianping LI
Journal of Clinical Hepatology 2025;41(9):1837-1844
ObjectiveTo compare the clinical features of patients with hepatitis B virus (HBV)-related early-onset liver cancer and those with late-onset liver cancer, to assess the severity of the disease, and to provide a theoretical basis for the early diagnosis and treatment of liver cancer. MethodsA retrospective analysis was performed for 695 patients who were diagnosed with HBV-related liver cancer for the first time in Guangzhou Eighth People’s Hospital, Guangzhou Medical University, from January 2019 to August 2023, among whom 93 had early-onset liver cancer (defined as an age of50 years for female patients and40 years for male patients) and 602 had late-onset liver cancer (defined as an age of ≥50 years for female patients and ≥40 years for male patients). Related clinical data were collected, including demographic data, clinical symptoms at initial diagnosis, comorbidities, smoking history, drinking history, family history, routine blood test results, biochemical parameters of liver function, serum alpha-fetoprotein(AFP), virological indicators, coagulation function, and imaging findings. The pan-inflammatory indices neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were calculated, as well as FIB-4 index, aspartate aminotransferase-to-platelet ratio index (APRI), S index, Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh (CTP) score, albumin-bilirubin (AIBL) grade, and Barcelona Clinic Liver Cancer (BCLC) stage. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or Fisher’s exact test were used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in the proportion of male patients and the incidence rates of diabetes, hypertension, and fatty liver disease (χ2=6.357, 15.230, 11.467, and 14.204, all P0.05), and compared with the late-onset liver cancer group, the early-onset liver cancer group had a significantly higher proportion of patients progressing to liver cancer without underlying cirrhosis (χ2=24.657, P0.001) and a significantly higher proportion of patients with advanced BCLC stage (χ2=6.172, P=0.046). For the overall population, the most common clinical symptoms included abdominal distension, abdominal pain, poor appetite, weakness, a reduction in body weight, edema of both lower limbs, jaundice, yellow urine, and nausea, and 55 patients (7.9%) had no obvious symptoms at the time of diagnosis and were found to have liver cancer by routine reexamination, physical examination suggesting an increase in AFP, or radiological examination indicating hepatic space-occupying lesion; compared with the late-onset liver cancer group, the patients in the early-onset liver cancer group were more likely to have the symptoms of abdominal distension, abdominal pain, and jaundice (all P0.05). Compared with the late-onset liver cancer group, the early-onset liver cancer group had a significantly larger tumor diameter (Z=2.845, P=0.034), with higher prevalence rates of multiple tumors and intrahepatic, perihepatic, or distant metastasis (χ2=5.889 and 4.079, both P0.05), and there were significant differences between the two groups in tumor location and size (χ2=3.948 and 11.317, both P0.05). Compared with the late-onset liver cancer group, the early-onset liver cancer group had significantly lower FIB-4 index, proportion of patients with HBsAg ≤1 500 IU/mL, and levels of LMR and Cr (all P0.05), as well as significantly higher positive rate of HBeAg and levels of log10 HBV DNA, AFP, WBC, Hb, PLT, NLR, PLR, TBil, ALT, Alb, and TC (all P0.05). ConclusionCompared with late-onset liver cancer, patients with early-onset liver cancer tend to develop liver cancer without liver cirrhosis and have multiple tumors, obvious clinical symptoms, and advanced BCLC stage, which indicates a poor prognosis.
6.Multidimensional analysis of diagnosis and treatment status of chronic hepatitis B
Ying TAN ; Bo LI ; Aiqi LU ; Lihua LIN ; Xiaoyuan CHEN ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):449-453
Objective:The aim was to analyze key indicators for the diagnosis and treatment of chronic hepatitis B(CHB),including virus detection rate,standardized treatment rate,and loss to follow-up rate,in order to provide a basis for optimizing diagnosis and treatment plans,improve the diagnosis and treatment level of CHB,and improve patient prognosis.Methods:Patients with CHB admitted to the Guangzhou Eighth People′s Hospital Affiliated to Guangzhou Medical University from January 2024 to January 2025 were enrolled. The datas were collected and organized using Excel. Statistical analysis was conducted using SPSS 26.0 software,with a focus on evaluating core indicators such as virus detection rate,standardized treatment rate,and loss to follow-up rate.Results:The positive rate of hepatitis B surface antigen(HBsAg)in non-specific patients was 28.95%,the antiviral treatment rate in specialized patients was 90.78%,and the standardized antiviral drug conversion treatment rate in low-level viremia(LLV)patients was 61.45%. The standardized antiviral drug conversion treatment rates for high-risk patients with combined kidney/bone injuries were 72.75% and 74.40%,respectively. The overall dropout rate was 10.47%,with a dropout rate of 13.80% for LLV patients.Conclusions:The antiviral treatment coverage rates in CHB patients were over 90%,but in certain groups(such as LLV patients and those with kidney or bone injuries),the standardized treatment rates were still low and loss to follow-up rates were high,suggesting the need to improve HBV screening,treatment for special populations,and patient adherence.
7.Construction and implementation of a new model for prevention and treatment of hepatitis B in communities in Guangzhou city
Bo LI ; Aiqi LU ; Ying TAN ; Lihua LIN ; Songlian LIU ; Ganqiu LIN ; Qikai NING ; Jiewei LIU ; Huanhui LIANG ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):441-448
Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework[tertiary hospitals-center for disease control and prevention(CDC)-primary care clinics]implemented dual-track screening(fixed-site+mobile units)using rapid hepatitis B surface antigen(HBsAg)testing and structured surveys. Digital closed-loop management integrated screening,referral,and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened(Male∶Female=1∶1.68),overall HBsAg positive rate was 5.21%(1 565/30 012),peaking in the 50-59-year cohort( χ2=271.80, P<0.001). Hepatitis B knowledge awareness was critically low(39.24%). Of 140 referred HBsAg-positive individuals,15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%(41/125)to 86.4%(108/125)post-intervention. aMAP hepatocellular carcinoma(HCC)risk stratification(n=82)revealed low(36.6%),intermediate(32.9%),and high-risk(30.5%)profiles. Conclusions:This coordinated,digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However,persistent knowledge gaps underscore the imperative for targeted community education and adherence support.
8.Clinical management of thrombocytopenia in cirrhosis
Jianping LI ; Ying TAN ; Hang SUN ; Ganqiu LIN ; Binbin CHEN ; Yue WU ; Zhiwei XIE ; Yaping WANG ; Aiqi LU ; Yujuan GUAN
Chinese Journal of Hepatology 2024;32(6):489-492
Thrombocytopenia is one of the common complications of cirrhotic patients, which can induce an increasing bleeding risk and closely correlate with bleeding following invasive procedures. Consequently, how to respond to thrombocytopenia is crucial for improving the prognosis of patients with cirrhosis. This article reviews the main mechanisms of cirrhosis concurrent with thrombocytopenia, as well as the corresponding clinical management strategies.
9.Reduction ascending aortoplasty in adult patients undergoing aortic valve replacement: Aorta diameter change, mid- and long-term clinical results
Xiaohui ZHOU ; Qiang GUAN ; Rui LIU ; Hansong SUN ; Yunhu SONG ; Shuiyun WANG ; Jianping XU ; Feng LV ; Liqing WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(03):381-388
Objective To assess mid- and long-term outcomes and share our clinical method of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods We retrospectively analyzed clinical data of 41 adult patients with aortic valve disease and ascending aortic dilatation before and after operation of RAA+AVR in Fuwai Hospital from January 2010 to July 2017. There were 28 male and 13 female patients aged 28-76 (53.34±12.06) years. Twenty-three patients received AVR+RAA using the sandwich technique (a sandwich technique group), while other 18 patients received AVR+ascending aorta wrap (a wrapping technique group). Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results There was no perioperative death. The mean preoperative AAD in the sandwich technique group and the wrapping technique group (47.04±3.44 mm vs. 46.67±2.83 mm, P=0.709) was not statistically different. The mean postoperative AAD (35.87±3.81 mm vs. 35.50±5.67 mm, P=0.804), and the mean AAD at the end of follow-up (41.26±6.54 mm vs. 38.28±4.79 mm, P=0.113) were also not statistically different between the two groups. There were statistical differences in AAD before, after operation and at follow-up in each group. All 41 patients were followed up for 23-108 (57.07±28.60) months, with a median follow-up of 51.00 months. Compared with that before discharge, the AAD growth rate at the last follow-up was –1.50-6.78 mm/year, with a median growth rate of 0.70 mm/year, and only 3 patients had an annual growth rate of above 3 mm/year. Conclusion Mid- and long-term outcomes of RAA in adult patients undergoing AVR with both methods are satisfying and encouraging.
10.Clinical application of excimer laser ablation in lower extremity arterial ischemic diseases
Yangyang LI ; Sicheng YAO ; Jiareke TANG ; Jianping YANG ; Bing ZHU ; Sheng GUAN ; Xiaohu GE ; Hongbo CI
International Journal of Surgery 2023;50(7):468-473
Objective:To evaluate the therapeutic effect of excimer laser ablation (ELA) in the treatment of lower extremity arterial ischemic diseases.Methods:The clinical data of 44 patients with lower extremity ischemic diseases treated with ELA in the People′s Hospital of Xinjiang Uygur Autonomous Region from December 2020 to April 2021 were analyzed retrospectively. Among the 44 patients, there were 29 patients in lower extremity arteriosclerosis obliterans (ASO), including 3 patients with femoral artery stent occlusion. 8 patients of diabetes foot (DF) and 7 patients of thromboangiitis obliterans (TAO). Observation indicators include target vascular patency rate, amputation rate, vascular reintervention rate and mortality rate. The measurement data were expressed as mean ± standard deviation ( ± s), one-way analysis of variance was used for inter-group comparison, and paired sample t-test was used for intra-group comparison. The Chi-square test was used for comparison between count data. Results:The success rate of operation was 100% in 44 patients. The rate of major amputation in ASO group was 10.3%, while the other two groups had a major amputation rate of 0. The minor amputation rates of the three groups were 6.9%, 25.0% and 28.6%, respectively. The vascular reintervention rate was 10.3% in ASO group, 12.5% in DF group and 0 in TAO group. The 1-year mortality rate in the ASO group was 10.3%, while the other two groups had a mortality rate of 0. The 2-year mortality rate of the three group were 31.0%, 12.5% and 0, respectively.Conclusion:For the treatment of lower extremity arterial ischemic diseases, ELA is safe and effective, but the curative effect need to further clarify by large sample and long-term clinical follow-up observation.

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