1.Effect and mechanism of transplantation of human umbilical cord mesenchymal stem cells with overexpression of the Numb gene in treatment of cholestatic liver fibrosis
Shihao ZHANG ; Changqing ZHAO ; Mingyan YANG ; Feifei XING ; Wei LIU ; Gaofeng CHEN ; Jiamei CHEN ; Ping LIU ; Yongping MU
Journal of Clinical Hepatology 2026;42(1):80-89
ObjectiveTo investigate the effect and mechanism of transplantation of human umbilical cord mesenchymal stem cell (hUC-MSC) with overexpression of the Numb gene in the treatment of cholestatic liver fibrosis (CLF). MethodsThe technique of lentiviral transfection was used to induce the overexpression of the Numb gene in hUC-MSC (hUC-MSCNumb-OE), and hUC-MSC transfected with empty vector (hUC-MSCOE-EV) was used as negative control. Bile duct ligation (BDL) was performed to establish a rat model of CLF, and then the rats were randomly divided into BDL group, hUC-MSC group, hUC-MSCOE-EV group, and hUC-MSCNumb-OE group, while a sham-operation group was also established. The rats in the intervention groups were given a single splenic injection of the corresponding cells after BDL, and samples were collected at the end of week 4. Related indicators were measured, including serum biochemistry, liver histopathology, the content of hydroxyproline (Hyp) in the liver, hepatic stellate cell activation, ductular reaction, liver regeneration, and the expression levels of key molecules in the Numb-p53 signaling axis. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the BDL group, the hUC-MSC group and the hUC-MSCOE-EV group had significant reductions in the levels of serum biochemical parameters (aspartate aminotransferase, gamma-glutamyl transpeptidase, total bile acid, total bilirubin, and direct bilirubin), liver fibrosis markers (the content of Hyp and the expression levels of alpha-smooth muscle actin, tumor necrosis factor-α, and transforming growth factor-beta 1), and ductular reaction markers (the expression levels of CK7 and CK19) (all P <0.05), and compared with the hUC-MSCOE-EV group, the hUC-MSCNumb-OE group had significantly greater improvements in the above indicators (all P <0.05). In addition, compared with the hUC-MSCOE-EV group, the hUC-MSCNumb-OE group had significant improvements in the expression levels of liver regeneration-related markers (albumin and hepatocyte nuclear factor 4α) and the molecules associated with the Numb-p53 signaling axis (Numb, pNumb, Mdm2, and p53) (all P <0.05). ConclusionOverexpression of the Numb gene can enhance the therapeutic effect of hUC-MSC on CLF, possibly by activating the Numb-PTBL-p53-HNF4α axis, promoting the hepatic differentiation of hUC-MSCs and subsequently enhancing liver regeneration.
2.Effect and mechanism of Wnt5a knockdown on the efficacy of M1 bone marrow-derived macrophage in treatment of liver cirrhosis
Feifei XING ; Danyang WANG ; Xinrui ZHENG ; Yannan XU ; Shihao ZHANG ; Junyi ZHAN ; Wei LIU ; Gaofeng CHEN ; Jiamei CHEN ; Ping LIU ; Yongping MU
Journal of Clinical Hepatology 2026;42(3):618-628
ObjectiveTo observe the effect of M1 bone marrow-derived macrophages (M1-BMDM) with Wnt5a knockdown on liver fibrosis and regeneration in a rat model of liver cirrhosis, and to investigate its gain-of-function effect compared with unmodified M1-BMDM. MethodsPrimary bone marrow-derived macrophages were isolated from rats and were polarized to M1 phenotype to construct M1-BMDMWnt5a-KD cells. A rat model of liver cirrhosis induced by CCl4/2-AAF was established, and at the end of week 8, rats were randomly divided into model group, M1-BMDM group, M1-BMDM Wnt5a-knockdown empty vector group (M1-BMDMKD-EV group), and M1-BMDM Wnt5a-knockdown group (M1-BMDMWnt5a-KD group), with 6 rats in each group. On the first day of week 9, the rats in each group were given a single injection of the corresponding cells via the caudal vein, along with an intraperitoneal injection of a CCR2 inhibitor. Six rats without any treatment were used as normal control group. Samples were collected at the end of week 12 to assess liver histopathology, serum liver function parameters, hepatic stellate cell activation, and the expression levels of mature hepatocyte markers. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the model group, all cell treatment groups had significant alleviation of liver inflammatory response and significant reductions in the activities of alanine aminotransferase and aspartate aminotransferase (AST) in serum (all P<0.01), and the M1-BMDMWnt5a-KD group had a significantly lower serum level of AST than the M1-BMDM group (P<0.05). The semi-quantitative analysis based on immunohistochemical staining showed that compared with the model group, all cell treatment groups had a significant reduction in the percentage of CD68-positive area (all P<0.05), and compared with the M1-BMDMKD-EV group, the M1-BMDMWnt5a-KD group had a significant reduction in the percentage of CD68-positive area and a significant increase in the percentage of CD163-positive area (both P<0.05). Compared with the model group, all cell treatment groups had significant reductions in the mRNA expression levels of CD68 and tumor necrosis factor-α (all P<0.05) and the protein expression level of CD68 (all P<0.01); compared with the M1-BMDMKD-EV group, the M1-BMDMWnt5a-KD group had significant increases in the protein and mRNA expression levels of CD163 (both P<0.05), significant reductions in the protein and mRNA expression levels of CD68 (both P<0.05), and a significant reduction in the protein expression level of tumor necrosis factor-α (P<0.01). Sirius Red collagen staining and alpha-smooth muscle actin (α-SMA) immunohistochemical staining showed that compared with the model group, all cell treatment groups had significant alleviation of liver collagen deposition and α-SMA-positive area, with the most significant changes in the M1-BMDMWnt5a-KD group, and compared with the M1-BMDMKD-EV group, the M1-BMDMWnt5a-KD group had significantly smaller Sirius Red-positive area and α-SMA-positive area and a significantly lower content of hydroxyproline in liver tissue (all P<0.05). Compared with the M1-BMDMKD-EV group, the M1-BMDMWnt5a-KD group had significant reductions in the protein and mRNA expression levels of α-SMA and the mRNA expression level of COL-I and TGF-β (all P<0.05). Compared with the model group, all cell treatment groups had a significant increase in the protein expression level of HNF-4α in liver tissue (all P<0.05), and the M1-BMDMWnt5a-KD group had significantly higher protein and mRNA expression levels of HNF-4α and hepatocyte specific antigen than the M1-BMDMKD-EV group (both P<0.05). The M1-BMDMWnt5a-KD group had a significantly higher serum level of albumin than the M1-BMDMKD-EV group (P<0.01). Immunofluorescence co-staining showed that compared with the model group, all cell treatment groups had a significant increase in the number of cells stained positive for HNF and HNF-4α and Ki67 (all P<0.01), and the M1-BMDMWnt5a-KD group had a significantly higher number of such cells than the M1-BMDMKD-EV group (P<0.05). ConclusionInhibition of Wnt5a expression enhances the therapeutic effect of M1-BMDM on rats with liver cirrhosis induced by CCl4/2-AAF, which provides new ideas for enhancing the anti-cirrhotic effect of M1-BMDM through genetic modification.
3.Safety and efficacy of argon-helium cryoablation combined with targeted therapy and anti-programmed death-1 monoclonal antibody in treatment of patients with unresectable hepatocellular carcinoma aged 60 years or older
Shujuan GONG ; Xiujuan CHANG ; Yan LIU ; Dong JI ; Yan CHEN ; Quanwei HE ; Yongping YANG
Journal of Clinical Hepatology 2026;42(3):629-638
ObjectiveTo investigate whether anti-programmed death-1 (PD-1) monoclonal antibody can enhance the efficacy and safety of argon-helium cryoablation combined with targeted therapy in patients with unresectable hepatocellular carcinoma (uHCC) aged 60 years or older. MethodsA retrospective analysis was performed for the clinical data of 124 patients with advanced uHCC aged 60 years or older who were treated at The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to September 2024. After propensity score matching, 57 patients received cryoablation combined with targeted therapy (double combination group), while 57 received cryoablation combined with targeted therapy and anti-PD-1 monoclonal antibody (triple combination group). The indicators for efficacy assessment included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and the incidence rate of adverse events. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison between groups. A Cox proportional-hazards regression model analysis was used to investigate the influencing factors for survival prognosis. ResultsThe triple combination group had a significantly higher ORR than the double combination group (59.6% vs 29.8%, χ2=9.083, P=0.003), while there was no significant difference in DCR between the two groups (87.7% vs 77.2%, χ2=1.516, P=0.218), and compared with the double combination group, the triple combination group had significantly longer median PFS (9.1 months vs 4.8 months, χ2=7.813, P=0.005) and median OS (26.1 months vs 13.6 months, χ2=14.199, P<0.001). The multivariate Cox proportional-hazards regression model analysis showed that triple combination treatment was an independent influencing factor for PFS (hazard ratio [HR]=0.52, 95% confidence interval [CI]: 0.35 — 0.78, P=0.001) and OS (HR=0.32, 95%CI: 0.20 — 0.51, P<0.001). There was no significant difference in the incidence rate of adverse events between the two groups (P>0.05). ConclusionTriple combination treatment with argon-helium cryoablation, targeted therapy, and anti-PD-1 monoclonal antibody can significantly improve survival benefits in uHCC patients aged 60 years or older, with a controllable safety profile.
4.Association of serum exosomal miR-122-5p with the prognosis of hepatic confluent necrosis and fibrosis in patients with chronic hepatitis B
Quanwei HE ; Ran XU ; Wei HAN ; Sihao WANG ; Yan CHEN ; Yongping YANG
Journal of Clinical Hepatology 2025;41(5):888-899
ObjectiveTo investigate the association of serum exosomal microRNAs (miRNAs) with hepatic inflammatory injury and histological outcomes in patients with chronic hepatitis B (CHB). MethodsPeripheral serum samples were collected from six healthy adults and six patients with CHB, and size exclusion chromatography was used to extract exosomes. Small RNA sequencing and transcriptomic analysis were used to identify the serum exosomal miRNAs associated with liver inflammatory injury and fibrosis, and quantitative real-time PCR was used for validation in a mouse model of acute liver injury induced by lipopolysaccharide/D-galactosamine, a rat model of liver fibrosis induced by carbon tetrachloride, and 84 CHB patients undergoing liver biopsy twice before and after treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the Tukey 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 Dunn test was used for further comparison between two groups. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The univariate and multivariate Logistic regression analyses were used to investigate influencing factors. ResultsAbnormal expression of serum exosomal miR-122-5p was observed in patients with CHB, and it was downregulated in patients with confluent necrosis and advanced fibrosis. In the mouse model of acute liver injury and the rat model of liver fibrosis, compared with the control group, the model group had a significant reduction in the expression level of miR-122-5p in the liver (P=0.048 and 0.014), and compared with the patients with mild liver injury, the patients with severe confluent necrosis and advanced fibrosis showed a significant reduction in the expression level of miR-122-5p in liver tissue (P<0.05). Among the 84 CHB patients, the patients with severe hepatic confluent necrosis or advanced liver fibrosis had a significantly lower expression level of serum exosomal miR-122-5p than those with mild liver injury (P<0.001 and P=0.003). The multivariate Logistic regression analysis showed that the expression level of miR-122-5p was an independent influencing factor for confluent necrosis (odds ratio [OR]=0.001, 95% confidence interval [CI]: 0.000 — 0.037, P=0.005) and liver fibrosis degree (OR=0.568, 95%CI: 0.331 — 0.856, P=0.019). In addition, compared with the patients with low expression of miR-122-5p, the patients with high expression of miR-122-5p before treatment had a significantly higher reversal rate of liver fibrosis after 72 weeks of antiviral therapy (64.3% vs 38.1%, P=0.029). ConclusionSerum exosomal miR-122-5p in CHB patients is closely associated with the progression of hepatic confluent necrosis and fibrosis, and the reduction in the expression level of miR-122-5p may aggravate hepatic confluent necrosis, promote the progression of fibrosis, and affect the histological outcome of CHB patients after antiviral therapy.
5.Intergenerational Associations of Hypertensive Disorders of Pregnancy With Offspring Metabolomics: A Systematic Review
Jinrui XIONG ; Ling-Jun LI ; Yongping ZHANG ; Zhihong ZHANG ; Yue YANG ; Huan HU ; Jinhong LIU ; Zimeng CHEN ; Peng HUANG ; Mengjiao LIU
Maternal-Fetal Medicine 2025;07(3):157-165
Objective::To examine the impact of hypertensive disorders of pregnancy (HDP) on offspring metabolomics.Methods::We searched five databases: PubMed, Ovid Embase, MEDLINE, Web of Science, and China National Knowledge Infrastructure, and included studies that reported metabolomics among human offspring born to HDP-complicated pregnancies.Results::Database search yielded 4054 articles, and after full-text screening, ten observational studies met inclusion criteria. Half of the studies had a sample size of less than 100 and were all observational studies in preeclampsia (PE) and gestational hypertension.Neonates were the most focused group in all included studies. Offspring born to HDP-complicated pregnancies exhibited statistically significant variations in blood metabolomics compared to their counterparts, characterized by amino acids, lipids, carnitine, and others (e.g., 1α,25-(OH) 2-D). Most studies reported a significant increase in differential metabolites of offspring born to HDP-complicated pregnancies. Four studies ( n = 1109) measured lipids-related metabolites, and all consistently showed that offspring born to PE-complicated pregnancies had significantly higher concentrations than non-PE exposed offspring. Conclusion::The existing evidence suggests an intergenerational effect of HDP on offspring metabolomics. Long-term follow-up studies are needed to advance the health effects of related adverse health outcomes and inform the prevention of offspring’s health.
6.Ameliorative effects of the liver X receptor agonist T0901317 on retinal struc-ture and function damage induced by high glucose in mice
Yongping TANG ; Daosen CHEN ; Jing CHEN
Recent Advances in Ophthalmology 2025;45(6):457-462
Objective To investigate the ameliorative effects of the liver X receptor(LXR)agonist T0901317 on reti-nal structure and function damage caused by high glucose in mice.Methods A total of 30 12-week-old male C57BL/6J mice were randomly divided into the control,STZ-DMSO,and STZ-T0901317 groups,with 10 mice in each group.After a 12-hour fast,the mice were intraperitoneally injected with streptozotocin(STZ)at a dosage of 50 mg·kg-1 for 5 days.The mice in the control group were intraperitoneally injected with an equal volume of citrate buffer.The random blood glucose level was measured 72 hours after injection,and mice with the random blood glucose level exceeding 16.7 mmol·L-1 and polyuria were considered successful model candidates.These model mice were included in the STZ-DMSO and STZ-T0901317 groups,respectively,and the mice in the two groups were intravitreally injected with 1 μL of DMSO and 1 μL of T0901317(30 μmol·L-1),respectively.The thickness of the retinal nerve fiber layer(RNFL)was measured at 100 μm,200 μm,300 μm,400 μm,and 500 μm from the optic disc 6 weeks after STZ modeling.The cell density of the ganglion cell layer(GCL)(cells·mm-1)was quantified using ImageJ.Electroretinogram(ERG)analyses were employed to record the amplitude and latency of dark-adapted 0.01 ERG b-wave,dark-adapted 3.0 ERG a-and b-waves,dark-adapted 3.0 oscilla-tory potentials(OPs),and light-adapted 3.0 ERG a-and b-waves.The quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression changes of inflammatory factors NLRP3,Caspase1,interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in the retinal tissue of mice from each group.Results The optical coherence tomography(OCT)findings indicated that the RNFL thickness measured at 100 μm,200 μm,300μm,400 μm,and 500 μm from the optic disc in the STZ-DMSO group was significantly lower than that observed in the con-trol group,and the differences were statistically significant(all P<0.05).In the STZ-T0901317 group,the RNFL thickness at all measurement points was greater than that in the STZ-DMSO group,and the differences were statistically significant(all P<0.05).However,there were no statistically significant differences in the RNFL thickness at all measurement points between the STZ-T0901317 group and the control group(all P>0.05).The hematoxylin and eosin(HE)staining results re-vealed that the GCL cell count in the control,STZ-DMSO,and STZ-T0901317 groups was(90.53±9.13)cells·mm-1,(82.06±0.98)cells·mm-1,and(94.94±10.61)cells·mm-1,respectively,with no significant differences among these groups(P>0.05).The ERG results demonstrated that the amplitude of dark-adapted 0.01 ERG b-wave,dark-adapted 3.0 ERG a-and b-waves,the second wave of dark-adapted 3.0 oscillatory potentials(OPs2),and light-adapted ERG a-and b-waves was lower in the STZ-DMSO and STZ-T0901317 groups compared with the control group,and the differences were statistically significant(all P<0.05).However,in the STZ-T0901317 group,the amplitude of dark-adapted 3.0 ERG a-and b-waves and OPs2 was higher than that in the STZ-DMSO group,and the differences were statistically significant(all P<0.05).qRT-PCR analyses revealed that in the STZ-DMSO group,the relative mRNA expression level of NLRP3,Caspase-1,IL-1β,and IL-6 was elevated compared with the control group,and the differences were statistically significant(all P<0.05).The relative mRNA expression level of NLRP3 and IL-6 in the STZ-T0901317 group was higher compared with the control group,and the differences were statistically significant(both P<0.05).The relative mRNA expression level of NLRP3,Caspase-1,and IL-1β in the STZ-T0901317 group decreased compared with the STZ-DMSO group,and the differences were statistically significant(all P<0.05).Conclusion The LXR agonist T0901317 may ameliorate early RNFL thickness alterations and im-prove visual function in DR mice by down-regulating the expression of NLRP3,Caspase-1,and IL-1β in mouse retinal tissues.
7.Clinical features of chronic hepatitis C patients with genotype 3 infection:A multicenter retrospective cohort study
Jingyi XIE ; Yujia JING ; Yishan LIU ; Manling BAI ; Zhangqian CHEN ; Qiang XU ; Hong DU ; Yuxiu MA ; Liting ZHANG ; Shanshan ZHU ; Xiaoqin GAO ; Xinggang BAI ; Guoying YU ; Jianqi LIAN ; Xiaozhong WANG ; Yongping ZHANG ; Jiuping WANG ; Fanpu JI ; Jianjun FU ; Ning GAO
Journal of Clinical Hepatology 2025;41(8):1533-1540
Objective To investigate the clinical features of chronic hepatitis C(CHC)patients with hepatitis C virus genotype 3(HCV GT3)infection and the risk factors for disease progression.Methods A multicenter retrospective cohort study was conducted among 1 002 CHC patients from 11 clinical centers in Northwest China from December 2017 to November 2023,and according to their genotype,they were divided into GT1,GT2,GT3,and GT6 groups.Clinical features were compared between the patients with different genotypes.The one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Scheffe test was used for further comparison between two groups.The Kruskal-Wallis H test was used for comparison of data with skewed distribution between groups;the chi-square test or Fisher test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was used to explore the influencing factors for the progression of CHC to liver cirrhosis.Results In terms of the genotype,there were 427 patients with GT1 infection,242 with GT2 infection,299 with GT3 infection(210 patients with GT3a infection,87 with GT3b infection,and 2 with unclassified genotype),and 34 with GT6 infection.The patients with GT3 infection had a significantly younger age than those with GT1 infection(51.3±0.5 years vs 53.2±0.6 years,P<0.05)or GT2 infection(51.3±0.5 years vs 53.7±0.8 years,P<0.05),and for the patients with liver cirrhosis,the patients with GT3 infection had a significantly younger age than those with GT1 infection(52.1±0.5 years vs 59.4±0.9 years,P<0.001)or GT2 infection(52.1±0.5 years vs 58.1±1.1 years,P<0.001).Among the patients with GT3 infection,male patients accounted for 77.9%and the patients with liver cirrhosis accounted for 46.2%,which were significantly higher than those among the patients with GT1,GT2 or GT6 infection(all P<0.001).At baseline,the patients with GT3 infection had significantly higher levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)than those with GT1 or GT2 infection,significantly higher aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB4)than those with GT1,GT2 or GT6 infection,a significantly lower platelet count(PLT)than those with GT2 or GT6 infection,a significantly higher level of alpha-fetoprotein than those with GT2 or GT6 infection,and a significantly lower level of albumin(Alb)than those with GT6 infection(all P<0.05).There were no significant differences between the patients with GT3a infection and those with GT3b infection in age,sex,the proportion of patients with liver cirrhosis,comorbidities,HCV RNA quantification,PLT,ALT,AST,alkaline phosphatase,Alb,APRI,and FIB-4(all P>0.05).The multivariate logistic regression analysis showed that PLT≤150×109/L(odds ratio[OR]=10.72,95%confidence interval[CI]:5.76-35.86,P<0.001)and Alb≤35 g/L(OR=3.74,95%CI:1.22-11.45,P=0.021)were risk factors for liver cirrhosis.Conclusion Most CHC patients with GT3 infection are male in Northwest China,and compared with the patients with other genotypes,such patients tend to have a younger age of onset and higher degrees of liver inflammation activity and fibrosis.Low PLT and a low level of Alb are risk factors for progression to liver cirrhosis in CHC patients with GT3 infection.
8.Intergenerational Associations of Hypertensive Disorders of Pregnancy With Offspring Metabolomics: A Systematic Review
Jinrui XIONG ; Ling-Jun LI ; Yongping ZHANG ; Zhihong ZHANG ; Yue YANG ; Huan HU ; Jinhong LIU ; Zimeng CHEN ; Peng HUANG ; Mengjiao LIU
Maternal-Fetal Medicine 2025;07(3):157-165
Objective::To examine the impact of hypertensive disorders of pregnancy (HDP) on offspring metabolomics.Methods::We searched five databases: PubMed, Ovid Embase, MEDLINE, Web of Science, and China National Knowledge Infrastructure, and included studies that reported metabolomics among human offspring born to HDP-complicated pregnancies.Results::Database search yielded 4054 articles, and after full-text screening, ten observational studies met inclusion criteria. Half of the studies had a sample size of less than 100 and were all observational studies in preeclampsia (PE) and gestational hypertension.Neonates were the most focused group in all included studies. Offspring born to HDP-complicated pregnancies exhibited statistically significant variations in blood metabolomics compared to their counterparts, characterized by amino acids, lipids, carnitine, and others (e.g., 1α,25-(OH) 2-D). Most studies reported a significant increase in differential metabolites of offspring born to HDP-complicated pregnancies. Four studies ( n = 1109) measured lipids-related metabolites, and all consistently showed that offspring born to PE-complicated pregnancies had significantly higher concentrations than non-PE exposed offspring. Conclusion::The existing evidence suggests an intergenerational effect of HDP on offspring metabolomics. Long-term follow-up studies are needed to advance the health effects of related adverse health outcomes and inform the prevention of offspring’s health.
9.Current status and influencing factors of clinical leadership among Interventional Operating Room nurses in Shandong Province
Hongxia LI ; Pingwei SONG ; Hongling WANG ; Yongping YANG ; Yichuan ZHANG ; Jiakai LI ; Mingming CHEN
Chinese Journal of Modern Nursing 2025;31(16):2202-2209
Objective:To investigate the current status of clinical leadership among Interventional Operating Room nurses in Shandong Province and to analyze its influencing factors.Methods:In December 2024, 220 Interventional Operating Room nurses from 46 ClassⅢ Grade A general hospitals in Shandong Province were selected for a cross-sectional survey using convenience sampling. General Information Questionnaire, Clinical Leadership Survey, Chinese version of Wong and Law Emotional Intelligence Scale (WLEIS-C) , and Jefferson Scale of Empathy-Health Professionals (JSE-HP) were used as survey instruments. Multiple linear regression was used to analyze the factors influencing clinical leadership among Interventional Operating Room nurses. Pearson correlation analysis was used to explore the relationship between emotional intelligence, empathy, and clinical leadership.Results:A total of 220 questionnaires were distributed and 204 valid questionnaires were recovered, with a valid recovery rate of 92.73% (204/220) . The clinical leadership scores of the 204 Interventional Operating Room nurses were (66.35±8.74) , and the dimensions scored, in descending order, as encouraging the heart, enabling others to act, modeling the way, inspiring a shared vision, and challenging the process. The mean scores of WLEIS-C and JSE-HP items were (5.88±0.90) and (4.61±0.63) , respectively. Multiple linear regression analysis showed that the nature of employment and whether or not they participated in leadership training were influencing factors for clinical leadership among Interventional Operating Room nurses (partial regression coefficients of -2.831 and -2.999, respectively; P<0.05) . Emotional intelligence and empathy ability among Interventional Operating Room nurses were positively correlated with clinical leadership ( P<0.05) . Conclusions:Clinical leadership of nurses in the Interventional Operating Room of ClassⅢ Grade A general hospitals in Shandong Province is at a moderate to high level. Nurses who participate in leadership training, have staffing, have greater empathy, and have higher emotional intelligence have greater clinical leadership. It is recommended that nursing administrators add leadership-related courses to the training of nurses in the Interventional Operating Room, and take steps to improve nurses' emotional intelligence and empathy ability, thereby promoting clinical leadership among Interventional Operating Room nurses.
10.Clinical features of chronic hepatitis C patients with genotype 3 infection:A multicenter retrospective cohort study
Jingyi XIE ; Yujia JING ; Yishan LIU ; Manling BAI ; Zhangqian CHEN ; Qiang XU ; Hong DU ; Yuxiu MA ; Liting ZHANG ; Shanshan ZHU ; Xiaoqin GAO ; Xinggang BAI ; Guoying YU ; Jianqi LIAN ; Xiaozhong WANG ; Yongping ZHANG ; Jiuping WANG ; Fanpu JI ; Jianjun FU ; Ning GAO
Journal of Clinical Hepatology 2025;41(8):1533-1540
Objective To investigate the clinical features of chronic hepatitis C(CHC)patients with hepatitis C virus genotype 3(HCV GT3)infection and the risk factors for disease progression.Methods A multicenter retrospective cohort study was conducted among 1 002 CHC patients from 11 clinical centers in Northwest China from December 2017 to November 2023,and according to their genotype,they were divided into GT1,GT2,GT3,and GT6 groups.Clinical features were compared between the patients with different genotypes.The one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Scheffe test was used for further comparison between two groups.The Kruskal-Wallis H test was used for comparison of data with skewed distribution between groups;the chi-square test or Fisher test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was used to explore the influencing factors for the progression of CHC to liver cirrhosis.Results In terms of the genotype,there were 427 patients with GT1 infection,242 with GT2 infection,299 with GT3 infection(210 patients with GT3a infection,87 with GT3b infection,and 2 with unclassified genotype),and 34 with GT6 infection.The patients with GT3 infection had a significantly younger age than those with GT1 infection(51.3±0.5 years vs 53.2±0.6 years,P<0.05)or GT2 infection(51.3±0.5 years vs 53.7±0.8 years,P<0.05),and for the patients with liver cirrhosis,the patients with GT3 infection had a significantly younger age than those with GT1 infection(52.1±0.5 years vs 59.4±0.9 years,P<0.001)or GT2 infection(52.1±0.5 years vs 58.1±1.1 years,P<0.001).Among the patients with GT3 infection,male patients accounted for 77.9%and the patients with liver cirrhosis accounted for 46.2%,which were significantly higher than those among the patients with GT1,GT2 or GT6 infection(all P<0.001).At baseline,the patients with GT3 infection had significantly higher levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)than those with GT1 or GT2 infection,significantly higher aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB4)than those with GT1,GT2 or GT6 infection,a significantly lower platelet count(PLT)than those with GT2 or GT6 infection,a significantly higher level of alpha-fetoprotein than those with GT2 or GT6 infection,and a significantly lower level of albumin(Alb)than those with GT6 infection(all P<0.05).There were no significant differences between the patients with GT3a infection and those with GT3b infection in age,sex,the proportion of patients with liver cirrhosis,comorbidities,HCV RNA quantification,PLT,ALT,AST,alkaline phosphatase,Alb,APRI,and FIB-4(all P>0.05).The multivariate logistic regression analysis showed that PLT≤150×109/L(odds ratio[OR]=10.72,95%confidence interval[CI]:5.76-35.86,P<0.001)and Alb≤35 g/L(OR=3.74,95%CI:1.22-11.45,P=0.021)were risk factors for liver cirrhosis.Conclusion Most CHC patients with GT3 infection are male in Northwest China,and compared with the patients with other genotypes,such patients tend to have a younger age of onset and higher degrees of liver inflammation activity and fibrosis.Low PLT and a low level of Alb are risk factors for progression to liver cirrhosis in CHC patients with GT3 infection.

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