1.Expand screening, increase the diagnosis and treatment rates, and accelerate the elimination of the public health threat posed by hepatitis B
ZHANG Shaoquan ; LIN Bingliang
China Tropical Medicine 2025;25(3):259-
Chronic hepatitis B (CHB) caused by the hepatitis B virus (HBV), constitutes a significant public health issue, with approximately 254 million individuals affected globally, of which 75 million are in China. HBV infection not only severely impacts individual health, leading to conditions such as liver cirrhosis, hepatocellular carcinoma, and liver failure, but also imposes considerable economic burdens on society. This review provides an overview of the current epidemiological characteristics and disease burden of CHB, along with the progress towards, and challenges faced in achieving the World Health Organization's (WHO) goal of eliminating viral hepatitis as a public health threat by 2030. It delves into strategies aimed at reducing new infections, enhancing diagnosis rates, and improving treatment coverage. These strategies include universal screening, expanding the scope of antiviral therapy, and implementing specific measures for treating patients with end-stage liver disease. The review underscores critical actions necessary to accelerate the elimination of hepatitis B-related harms, proposing an integrated control and prevention strategy that incorporates new technologies and approaches. Achieving WHO's 2030 target requires concerted efforts from governments, healthcare institutions, and the broader community, alongside active public participation and support.
2.Patients waiting for a liver transplantation from the perspective of psychological resilience:a qualitative study
Jiamin WANG ; Dan ZHOU ; Yinghao ZHOU ; Lei SONG ; Bingliang ZHANG ; Yufei GONG ; Lin ZHAO
Chinese Journal of Nursing 2025;60(15):1864-1871
Objective To explore the psychological feelings and coping resources of patients waiting for a liver transplantation,in order to provide references for implementing psychological nursing care.Methods Using purposive sampling,15 patients waiting liver transplantation surgery from June to November 2024 at a tertiary hospital in Qingdao were selected as study subjects.Semi-structured in-depth interviews were conducted,and data were analyzed using interpretative phenomenological analysis to extract themes.Results The psychological feelings of patients waiting for a liver transplantation included 2 main themes with 6 sub-themes,namely,the complex and contradictory psychological feelings of liver transplant patients during the waiting period(expectations for transplanta-tion and future outlook,multiple psychological burdens intertwining,introspection and growth),and mobilizing psychological resilience resources to deal with complex psychological feelings(core resources,internal resources,external resources).Conclusion Clinical medical staff should implement psychological care for patients waiting for a liver transplantation based on the complex and contradictory psychological feelings they experience.Also,they should target the coping resources for psychological feelings to construct coping strategies,thereby comprehensively improving patients' psychological health during the waiting period.The coping strategies include promoting patients' health behaviors,improving their psychological status,and providing multidimensional social support for them.
3.Patients waiting for a liver transplantation from the perspective of psychological resilience:a qualitative study
Jiamin WANG ; Dan ZHOU ; Yinghao ZHOU ; Lei SONG ; Bingliang ZHANG ; Yufei GONG ; Lin ZHAO
Chinese Journal of Nursing 2025;60(15):1864-1871
Objective To explore the psychological feelings and coping resources of patients waiting for a liver transplantation,in order to provide references for implementing psychological nursing care.Methods Using purposive sampling,15 patients waiting liver transplantation surgery from June to November 2024 at a tertiary hospital in Qingdao were selected as study subjects.Semi-structured in-depth interviews were conducted,and data were analyzed using interpretative phenomenological analysis to extract themes.Results The psychological feelings of patients waiting for a liver transplantation included 2 main themes with 6 sub-themes,namely,the complex and contradictory psychological feelings of liver transplant patients during the waiting period(expectations for transplanta-tion and future outlook,multiple psychological burdens intertwining,introspection and growth),and mobilizing psychological resilience resources to deal with complex psychological feelings(core resources,internal resources,external resources).Conclusion Clinical medical staff should implement psychological care for patients waiting for a liver transplantation based on the complex and contradictory psychological feelings they experience.Also,they should target the coping resources for psychological feelings to construct coping strategies,thereby comprehensively improving patients' psychological health during the waiting period.The coping strategies include promoting patients' health behaviors,improving their psychological status,and providing multidimensional social support for them.
4.Current situation of primary and secondary school students health services in community health service organizations in Shenzhen
LU Wenlong, LIN Bingliang, XUAN Peng, LI Yan, WEN Erya, LAN Lina, XIONG Jingfan
Chinese Journal of School Health 2024;45(12):1699-1703
Objective:
To understand and assess the current situation of primary and secondary school students health services in community health service organizations in Shenzhen, so as to provide a basis for upgrading the capacity of health services.
Methods:
A total of 684 community health service organizations and 587 part time health vice principals in the Shenzhen City were selected for the study in June 2022, and the special questionnaire surveys regarding primary and secondary school students health service capacity and the community health service organizations and part time health vice principals performance ability were administered in Shenzhen. SPSS 26.0 software was used for a descriptive analysis.
Results:
The staffing rate of general practitioners or clinical physicians in Shenzhen s community health service organizations was 99.9%, 67.1% of community health service organizations established counterpart collaborative relationships with schools, 50.8% of community health service organizations provided diagnostic and treatment services for students, 24.8% of community health service organizations provided health check up services for students, 85.2% of community health service organizations provided health guidance to schools, and 94.3% of community health service organizations had a part time vice principal of health with a score of (7.63±1.59) in the self assessment of their ability to carry out their duties, and space constraints and shortage of nursing were the main problems in promoting student medical check ups in the community health service organizations.
Conclusions
The community health service organizations in Shenzhen suffer from inadequate medical service resources and inadequate training for professional staff, resulting in low service capacity for providing physical examinations and health management for primary and secondary school students. There is a need to further promote the integrated development of education and health, and continuously enhance service capabilities, to promote the orderly development of student health work.
5.Expert recommendations on screening,testing and management for hepatitis B virus infection in adults
Society of Prevention and Control of Infectious Diseases of Chinese Preventive Medicine Association ; Working Committee of Promoting the Elimination of Viral Hepatitis of Chinese Preventive Medicine Association ; Bingliang LIN ; Fuqiang CUI ; Zhiliang GAO
Journal of Clinical Hepatology 2024;40(8):1543-1550
The prevalence of hepatitis B represents a significant public health concern with a heavy disease burden.In China,there is still a big gap between the current diagnosis and treatment rates of hepatitis B and the goal of eliminating viral hepatitis as a public health threat by 2030 set by the World Health Organization(WHO).In order to achieve the WHO goal and the goal of 2030 Healthy China Outline,the Chinese Preventive Medicine Association organized domestic experts in the fields of clinical medicine,public health and clinical laboratory medicine to develop the Expert Recommendations on Screening,Testing and Management for Hepatitis B Virus Infection in Adults after several rounds of discussion based on comprehensive review of relevant domestic and international guidelines and literatures,the purpose is to facilitate universal screening of hepatitis B virus(HBV)infection in adults and provide practical guidance on disease assessment,treatment and long-term follow-up management of people infected with HBV and vaccination for people susceptible to HBV infection,thus promoting the elimination of the threat of hepatitis B.
6.Multi-omics combined test performance effectiveness on opportunistic screening of high-risk liver cancer population
Chan XIE ; Bingliang LIN ; Hong DENG ; Xiaohong ZHANG ; Qiyi ZHAO ; Zhiliang GAO
Chinese Journal of Hepatology 2024;32(2):140-147
Objective:To validate the performance of a multi-omics combined test for early screening of high-risk liver cancer populations.Methods:173 high-risk patients with liver cancer were prospectively screened in a real-world setting, and 164 cases were finally enrolled. B-ultrasound, alpha-fetoprotein (AFP), and HCC screens were conducted in all patients. A multi-omics early screening test was performed for liver cancer in combination with multi-gene methylation, TP53/TERT/CTNNB1 mutations, AFP, and abnormal prothrombin (PIVKA-II). Differences in rates were compared using the chi-square test, adjusted chi-square test, or Fisher's exact probability method for count data. A non-parametric rank test (Mann-Whitney) was used to compare the differences between the two groups of data.Results:The HCCscreen detection had a sensitivity of 100% for liver cancer screening, 93.8% for liver cancer and precancerous diseases, 34.1% for positive predictive value, 99.2% for negative predictive value, and 0.89 for an area under the curve (AUC). Parallel detection of AFP, AFP+B-ultrasound, and methylation+mutation had a sensitivity/specificity and AUC of 31.3%/88.5% (AUC=0.78), 56.3%/88.2% (AUC=0.86), and 81.3%/82.4 % (AUC=0.84). At the same time, the disease severity range was significantly correlated with the methylation+mutation score, HCCscreen score, or positive detection rate (PDR). There was no significant correlation between AFP serum levels and methylation+mutation or HCCscreen scores, while there was a significant linear correlation between methylation+mutation scores and HCCscreen scores ( r ?=?0.73, P ?0.001). Conclusion:In real-world settings, HCCscreen shows high sensitivity for screening opportunistic, high-risk liver cancer populations. Furthermore, it may efficaciously detect liver cancer and precancerous diseases, with superior performance to AFP and AFP+ultrasound. Hence, HCCscreen has the potential to become an effective screening tool that is superior to existing screening methods for high-risk liver cancer populations.
7.Therapeutic strategies, practice, and prospect of a clinical cure for chronic hepatitis B in China
Zhishuo MO ; Dongying XIE ; Bingliang LIN ; Xiaoguang DOU ; Mobin WAN ; Jiaji JIANG ; Yingren ZHAO ; Hong TANG ; Hui ZHUANG ; Zhiliang GAO
Chinese Journal of Hepatology 2024;32(5):411-417
Clinical cure (herein referred to as functional cure) is currently recognized as the ideal therapeutic goal by the guidelines for the prevention and treatment of chronic hepatitis B (CHB) at home and abroad. China has achieved significant results in research and exploration based on pegylated interferon alpha therapeutic strategies to promote the effectiveness of CHB clinical cure rates in clinical practice. The summary and optimization of clinical cure strategies in different clinical type classifications, as well as the exploration of clinical cure continuity and long-term outcomes, are of great significance for solving the current bottleneck problem and our future efforts in the developmental directions of clinical cure in CHB populations.
8.Satisfaction survey on infectious diseases online teaching for medical interns
Zeqian WU ; Haoyu CHEN ; Yusheng JIE ; Bingliang LIN ; Shaoquan ZHANG ; Lei TAN
Modern Hospital 2024;24(8):1309-1312
Objective To investigate the satisfaction degree among medical interns with the effect of infectious diseases online teaching.Methods A questionnaire survey was conducted among 172 interns from a 5-year clinical medicine program who were doing internship with infectious diseases in the Third Affiliated Hospital of Sun Yat-Sen University in the spring and fall semesters of 2022.The survey aimed to investigate the advantages and disadvantages of online teaching for medical interns com-pared with traditional offline teaching.Results In terms of the advantages,online internship online teaching saved commuting time among 95.4%(164/172)of the students,enhanced self-management ability among 41.9%(72/172)of the students,en-riched teaching elements among 71.5%(123/172),promoted reviewing and consolidation of clinical knowledge among 38.4%(66/172)of the students.As regarding the disadvantages,online internship decreased clinical situational experience among 83.7%(144/172)students,reduced teaching-student interactions among 76.2%(131/172)of the students,decreased learn-ing efficiency among 51.7%(89/172)of the students and lowered quality of learning among 59.3%(102/172)of the students due to frequent network inefficiency.For prospection,37.8%(65/172)of the students expressed their wish to resume the tradi-tional offline teaching model continue and 57.6%(99/172)of them suggested that the combination of online and offline teaching mode should be adopt.Conclusion The inevitability and possibility of online internship of infectious diseases are gradually in-creasing.Compared with offline internships in infectious disease,students welcome a hybrid model of internships that combines online and offline models.
9.Summary of best evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients
Ao FENG ; Dan ZHOU ; Bingliang ZHANG ; Yinghao ZHOU ; Hui LIN ; Yufei GONG ; Lin ZHAO
Chinese Journal of Modern Nursing 2024;30(3):365-371
Objective:To summarize the best evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients, providing reference for postoperative delirium management in liver transplant recipients.Methods:Evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients was retrieved through computer in databases such as UpToDate, British Medical Journal (BMJ) Best Practice, Embase, PubMed, Cochrane Library, Joanna Briggs Institute Evidence-Based Health Care Center Database, Guidelines International Network, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to January 31, 2023. The types of literature included guidelines, clinical decision-making, best practices, systematic review, summary of evidence, and expert consensus. Two researchers conducted quality evaluation and evidence extraction on the included literature.Results:A total of 10 articles were included, involving 1 clinical decision-making, 4 guidelines, 3 systematic reviews, and 2 expert consensuses. A total of 25 best pieces of evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients were summarized from four aspects, including screening, evaluation, non-pharmacological prevention, and non-pharmacological treatment.Conclusions:The best evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients summarized provides a reference for postoperative delirium management in liver transplant recipients.
10.Clinical research advances in mesenchymal stem cells for the treatment of end-stage liver disease
Yu FENG ; Junfeng CHEN ; Bingliang LIN
Journal of Clinical Hepatology 2023;39(5):1010-1018
End-stage liver disease (ESLD) includes decompensated liver cirrhosis and liver failure, which usually have dangerous conditions and a poor prognosis. Liver transplantation is the only effective therapy for ESLD, but its clinical application is limited due to shortage of liver donors, immunological rejection, and expensive costs. Mesenchymal stem cells (MSCs) can differentiate into hepatocyte-like cells and alleviate liver fibrosis by regulating immune function through paracrine, and therefore, MSCs have a wide application prospect in the field of ESLD treatment. A number of clinical studies have shown that MSC infusion is safe and effective in the treatment of ESLD during a short period of time, and there is also certain clinical evidence for its long-term safety and efficacy. MSC-derived exosomes (MSC-Exo) do not have a complete cellular structure and can promote hepatocyte regeneration through a variety of mechanisms, and their clinical value has attracted more and more attention, but there are few studies on this issue. Currently, the core mechanism of MSC therapy for ESLD and the standardized process of MSC preparation are the problems needing to be solved urgently.


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