1.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.
2.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.
3.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.
4.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.
5.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.
6.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.
7.Research advances in the diagnosis and treatment of acute-on-chronic liver failure with infection
Aiqi LU ; Keli YANG ; Yujuan GUAN
Journal of Clinical Hepatology 2019;35(11):2596-2599
Acute-on-chronic liver failure (ACLF) is a severe syndrome of liver diseases commonly seen in clinical practice and can lead to severe disorders and decompensation of liver synthesis, metabolism, detoxification, and biotransformation, as well as multiple organ failure and an extremely high short-term mortality rate. Infection can induce or aggravate the condition of ACLF and is an independent influencing factor for patient prognosis. This article describes the mechanism and characteristics of ACLF with infection, summarizes the common types and clinical features of infection, reviews the recommended anti-infective regimens, and emphasizes the importance of early prophylactic treatment. ACLF patients with infection tend to have critical conditions, and early diagnosis and empirical anti-infective treatment is the key to successful treatment.

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