1.Academic Characteristics of Contemporary Chinese Medicine Masters in Treating Diabetic Kidney Disease Based on SrTO
Yu SUN ; Xiaodan WANG ; Yingzi CUI ; Tianying CHANG ; Fan LI ; Lisha WANG ; Chenxuan DONG ; Shoulin ZHANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):258-269
ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease (DKD) from the perspectives of principles, methods, formulas, and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion (SrTO) process developed by the Joanna Briggs Institute (JBI), an Australian evidence-based healthcare center, the databases including China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Data, and China Biomedical Literature Service System (SinoMed) were searched. Based on predefined inclusion and exclusion criteria, text information extraction, quality evaluation, and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive, involving multiple levels such as disease understanding, therapeutic strategies, formula application, and medication use. In terms of disease understanding, the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors, such as congenital endowment deficiency, interact with external factors such as improper diet, emotional disturbances, invasion of exogenous pathogens, and delayed or inappropriate treatment, to jointly induce the disease. This further gives rise to various pathogenetic theories, including obstruction of renal collaterals by blood stasis, toxin-induced damage to renal collaterals, latent wind disturbing the kidney, and internal heat leading to mass formation. In terms of therapeutic strategies and medication use, the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized, along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments, as well as the combined application of multiple therapeutic approaches, are commonly employed for comprehensive management. Meanwhile, the concept of "preventive treatment of disease" is upheld, and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process, the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized, providing a scientific and standardized basis for future theoretical exploration.
2.Academic Characteristics of Contemporary Chinese Medicine Masters in Treating Diabetic Kidney Disease Based on SrTO
Yu SUN ; Xiaodan WANG ; Yingzi CUI ; Tianying CHANG ; Fan LI ; Lisha WANG ; Chenxuan DONG ; Shoulin ZHANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):258-269
ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease (DKD) from the perspectives of principles, methods, formulas, and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion (SrTO) process developed by the Joanna Briggs Institute (JBI), an Australian evidence-based healthcare center, the databases including China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Data, and China Biomedical Literature Service System (SinoMed) were searched. Based on predefined inclusion and exclusion criteria, text information extraction, quality evaluation, and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive, involving multiple levels such as disease understanding, therapeutic strategies, formula application, and medication use. In terms of disease understanding, the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors, such as congenital endowment deficiency, interact with external factors such as improper diet, emotional disturbances, invasion of exogenous pathogens, and delayed or inappropriate treatment, to jointly induce the disease. This further gives rise to various pathogenetic theories, including obstruction of renal collaterals by blood stasis, toxin-induced damage to renal collaterals, latent wind disturbing the kidney, and internal heat leading to mass formation. In terms of therapeutic strategies and medication use, the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized, along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments, as well as the combined application of multiple therapeutic approaches, are commonly employed for comprehensive management. Meanwhile, the concept of "preventive treatment of disease" is upheld, and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process, the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized, providing a scientific and standardized basis for future theoretical exploration.
3.Heartbeat-evoked responses to cue-induced craving in heroin use disorder individuals
Dingming CHANG ; Yongxin CHENG ; Juan WANG ; Ruowan LI ; Fang DONG ; Kai YUAN ; Dahua YU
Chinese Journal of Clinical Medicine 2026;33(2):230-239
Objective To explore the differences in heartbeat-evoked response (HER) under drug-related cues and neutral cues in individuals with heroin use disorder (HUD), and analyze the correlation between HER potentials and immediate cue-induced craving scores. Methods Fifty HUD participants were recruited from the Chang’an Compulsory Isolation Drug Rehabilitation Center in Shaanxi Province from June to September 2024. Simultaneous acquisition of 64-channel electroencephalography (EEG) and electrocardiogram signals was performed. Twenty alternating segments of drug-related and neutral cue videos were presented, and participants rated their subjective craving after each segment using visual analogue scale (VAS) scores. Scalp EEG data were source analyzed to obtain cortical EEG signals and corresponding HER. Short-time Fourier transform was used to calculate the power spectral density (PSD) of EEG within a time window from 100 ms before the R-peak to 500 ms after it, using the R-peak as the time zero point. Cluster-based permutation testing was used to analyze PSD differences between drug-related and neutral cues in the HUD individuals. Pearson correlation analysis was performed to evaluate the correlation between HER potentials and VAS scores. Results In the 350–420 ms time window, HER potentials in the left posterior parietal, temporal, and posterior cingulate cortices were significantly lower under drug-related cues compared to neutral cues (P<0.01); in the 140–210 ms time window, HER potentials in the right prefrontal cortex were significantly higher under drug-related cues compared to neutral cues (P<0.01). Correlation analysis showed that HER potentials in the left temporal and left posterior cingulate cortices were significantly negatively correlated with VAS scores (P<0.05). Drug-related cues enhanced PSD of γ power (30–100 Hz) in salience network (fronto-insular), parietal and occipital regions (P<0.05). PSD integrations of low-γ power (40–60 Hz) in parietal region (350–400 ms) and high-γ power (70–100 Hz) in left salience network (fronto-parietal) and occipital regions (300–350 ms) were positively correlated with VAS scores (P<0.05). Conclusions Drug-related cues may modulate cortical activity related to heartbeat perception in HUD individuals, and such dynamic changes in both time and frequency domains are stably associated with subjective craving.
4.Qiangjing Tablets Regulate CDK4-E2F Signaling Pathway to Delay Aging of Leydig Cells and Testicular Tissue in Rats
Xiucheng LAN ; Meijing WANG ; Jingyi ZHANG ; Junjun LI ; Liang DONG ; Xujun YU ; Fang YANG ; Degui CHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):328-336
ObjectiveTo reveal the molecular mechanism by which the traditional Chinese medicine compound prescription Qiangjing tablets regulate the aging of the testicular tissue and Leydig cells in rats through the cyclin-dependent kinase 4 (CDK4)-early 2 factor (E2F) signaling pathway. MethodsFor the cell experiment, 2-month-old SPF-grade SD male rats were selected and randomly assigned into a blank control group (administrated with an equal volume of 0.9% sodium chloride injection) and a Qiangjing tablets group (20 rats in each group) according to body weight. The Leydig cell model of aging was established by treatment of TM3 cells with 100 μmol·L-1 H2O2, and the modeling performance was evaluated based on the levels of p16 and p21 determined by Western blot. The antioxidant NAC (1 mmol·L-1) was used as the positive control for eliminating reactive oxygen species (ROS). Cells were intervened with Qiangjing tablets-containing serum at low (2.5%), medium (5%), and high (10%) concentrations. The testosterone level in the cell supernatant was determined by enzyme-linked immunosorbent assay (ELISA), and the protein levels of CDK4, E2F1, and E2F2 were analyzed by Western blot. In the animal experiment, 19-month-old naturally aging rats were used as the model group, and 2-month-old rats as the young control group. The positive control group was subcutaneously injected with 5.21 mg·kg-1·d-1 testosterone propionate. Qiangjing tablets were administered by gavage at low, medium, and high doses of 0.72, 1.44, 2.88 g·kg-1·d-1, respectively. The general conditions of rats were observed, and the protein levels of CDK4, E2F1, and E2F2 in the testicular tissue were determined by Western blot. ResultsIn the cell experiment, compared with the blank control group, the model group showed upregulated expression of CDK4 and E2F1 (P<0.05) and slightly downregulated expression of E2F2. Compared with that in the model group, the expression of CDK4 was upregulated in the NAC group and the low-dose Qiangjing tablets group (P<0.05), slightly upregulated in the medium-dose Qiangjing tablets group, and downregulated in the high-dose Qiangjing tablets group (P<0.05). The NAC group showed downregulated expression of E2F1 (P<0.05) and E2F2, and the low-, medium-, and high-dose Qiangjing tablets groups showed downregulated expression of both E2F1 and E2F2 (P<0.05). Compared with that in the NAC group, the expression of CDK4 was upregulated in the low-dose Qiangjing tablets group and downregulated in the medium-dose and high dose (P<0.05) groups. The expression of E2F1 was down-regulated in all the three dose groups, with statistically significance in the high dose group (P<0.05), and that of E2F2 were downregulated in all the three dose groups (P<0.05). In the animal experiment, compared with the young control group, the model group exhibited downregulated expression of CDK4 (P<0.05) and slightly upregulated expression of E2F1 and E2F2. Compared with that in the model group, the expression of CDK4 decreased in the testosterone propionate group and the low-dose Qiangjing tablets group (P<0.05) but increased in the medium-dose (P<0.05) and high-dose groups. In addition, the expression of E2F1 decreased (P<0.05), and that of E2F2 was slightly elevated. Compared with that in the NAC group, CDK4 expression was elevated in the Qiangjing tablets groups, with statistical significance in the medium- and high-dose groups (P<0.05). Similarly, the E2F1 expression was also upregulated in the Qiangjing tablets groups, with statistical significance in the medium-dose group (P<0.05). The expression of E2F2 was downregulated in all the Qiangjing tablets groups. ConclusionQiangjing tablets delay the aging process of Leydig cells and testicular tissue by up-regulating the expression of CDK4 and lowering the levels of E2F1 and E2F2.
5.Construction of a biomimetic three-layered PLLA/PCL large-diameter vessel via electrospinning and ultrasonic pore-forming: Preliminary animal evaluation
Wenjun WANG ; Yang GAO ; Feng GAO ; Lei SHI ; Wei LIU ; Weiwang FAN ; Chang XU ; Hong ZHENG ; Xufeng DONG ; ZHUANG Xijing
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(07):1093-1100
Objective To fabricate a large-diameter vascular graft with a pore size gradient structure mimicking that of natural blood vessels, using poly-L-lactic acid (PLLA) and polycaprolactone (PCL) as base materials through electrospinning and ultrasonic pore-forming techniques, and to evaluate its application potential. Methods A three-layered tubular graft was fabricated from a PCL/PLLA blend (mass ratio 6 : 4) via electrospinning, followed by an ultrasonic pore-forming process to create a gradient porosity. The resulting graft (diameter: 2 cm, length: 4 cm) was implanted into the descending thoracic aorta of an experimental pig using an end-to-end anastomosis. Graft patency and anastomotic sites were monitored by computed tomography angiography (CTA) at 1 and 6 weeks post-surgery. After 2 months, the graft was explanted for systematic evaluation of vascular regeneration and repair through gross examination, histopathology (H&E and elastic fiber staining), immunohistochemistry [for ETS-related gene (ERG), Actin, and Vimentin], and scanning electron microscopy (SEM). Results Postoperative CTA confirmed excellent graft patency at both 1 and 6 weeks, with no evidence of thrombosis or anastomotic stenosis. Gross examination of the 2-month explant revealed a smooth luminal surface covered by neotissue. Histopathological analysis demonstrated that the graft successfully induced the formation of a three-layered structure resembling a native vessel wall, comprising endothelial cells, smooth muscle cells, and fibroblasts. Immunohistochemistry further verified coverage of the luminal surface by endothelial cells (ERG-positive), along with the presence of neosmooth muscle (Actin-positive) and fibroblasts (Vimentin-positive). Endothelial cells were observed adhering to the inner surface of the artificial vessel under SEM. Conclusion The biomimetic, three-layered PLLA/PCL large-diameter vascular graft, constructed via electrospinning and ultrasonic pore-forming, exhibits excellent short-term patency and biocompatibility in a large animal model. More importantly, it demonstrates a significant potential to promote host cell infiltration and achieve in situ regeneration of a three-layered vascular wall structure, providing a promising experimental basis for the development of next-generation functional vascular substitutes.
6.The first record of Anopheles messeae (Diptera: Culicidae) parasitized by water mites in China
Xue-ru CHEN ; Wen-zhen YAO ; Yu-hao LI ; Gui-chang LI ; Tao MENG ; Qun-ling FENG ; Xin-hui LIU ; Li-hong QIAO ; Xiang-ting WU ; Xue-feng ZHANG ; Cheng-lin LI ; Xue-cheng DONG ; Da-wei WANG ; Xiao-yan SI ; Yu-hong GUO
Acta Parasitologica et Medica Entomologica Sinica 2026;33(1):53-57
Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.
7.Influencing factors for recompensation in patients with decompensated hepatitis C cirrhosis
Danqing XU ; Huan MU ; Yingyuan ZHANG ; Lixian CHANG ; Yuanzhen WANG ; Weikun LI ; Zhijian DONG ; Lihua ZHANG ; Yijing CHENG ; Li LIU
Journal of Clinical Hepatology 2025;41(2):269-276
ObjectiveTo investigate the influencing factors for recompensation in patients with decompensated hepatitis C cirrhosis, and to establish a predictive model. MethodsA total of 217 patients who were diagnosed with decompensated hepatitis C cirrhosis and were admitted to The Third People’s Hospital of Kunming l from January, 2019 to December, 2022 were enrolled, among whom 63 patients who were readmitted within at least 1 year and had no portal hypertension-related complications were enrolled as recompensation group, and 154 patients without recompensation were enrolled as control group. Related clinical data were collected, and univariate and multivariate analyses were performed for the factors that may affect the occurrence of recompensation. The independent-samples t test was used for comparison of normally distributed measurement data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed measurement data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. A binary Logistic regression analysis was used to investigate the influencing factors for recompensation in patients with decompensated hepatitis C cirrhosis, and the receiver operating characteristic (ROC) curve was used to assess the predictive performance of the model. ResultsAmong the 217 patients with decompensated hepatitis C cirrhosis, 63 (29.03%) had recompensation. There were significant differences between the recompensation group and the control group in HIV history (χ2=4.566, P=0.034), history of partial splenic embolism (χ2=6.687, P=0.014), Child-Pugh classification (χ2=11.978, P=0.003), grade of ascites (χ2=14.229, P<0.001), albumin (t=4.063, P<0.001), prealbumin (Z=-3.077, P=0.002), high-density lipoprotein (t=2.854, P=0.011), high-sensitivity C-reactive protein (Z=-2.447, P=0.014), prothrombin time (Z=-2.441, P=0.015), carcinoembryonic antigen (Z=-2.113, P=0.035), alpha-fetoprotein (AFP) (Z=-2.063, P=0.039), CA125 (Z=-2.270, P=0.023), TT3 (Z=-3.304, P<0.001), TT4 (Z=-2.221, P=0.026), CD45+ (Z=-2.278, P=0.023), interleukin-5 (Z=-2.845, P=0.004), tumor necrosis factor-α (Z=-2.176, P=0.030), and portal vein width (Z=-5.283, P=0.005). The multivariate analysis showed that history of partial splenic embolism (odds ratio [OR]=3.064, P=0.049), HIV history (OR=0.195, P=0.027), a small amount of ascites (OR=3.390, P=0.017), AFP (OR=1.003, P=0.004), and portal vein width (OR=0.600, P<0.001) were independent influencing factors for the occurrence of recompensation in patients with decompensated hepatitis C cirrhosis. The ROC curve analysis showed that HIV history, grade of ascites, history of partial splenic embolism, AFP, portal vein width, and the combined predictive model of these indices had an area under the ROC curve of 0.556, 0.641, 0.560, 0.589, 0.745, and 0.817, respectively. ConclusionFor patients with decompensated hepatitis C cirrhosis, those with a history of partial splenic embolism, a small amount of ascites, and an increase in AFP level are more likely to experience recompensation, while those with a history of HIV and an increase in portal vein width are less likely to experience recompensation.
8.The Near-infrared II Emission of Gold Clusters and Their Applications in Biomedicine
Zhen-Hua LI ; Hui-Zhen MA ; Hao WANG ; Chang-Long LIU ; Xiao-Dong ZHANG
Progress in Biochemistry and Biophysics 2025;52(8):2068-2086
Optical imaging is highly valued for its superior temporal and spatial resolution. This is particularly important in near-infrared II (NIR-II, 1 000-3 000 nm) imaging, which offers advantages such as reduced tissue absorption, minimal scattering, and low autofluorescence. These characteristics make NIR-II imaging especially suitable for deep tissue visualization, where high contrast and minimal background interference are critical for accurate diagnosis and monitoring. Currently, inorganic fluorescent probes—such as carbon nanotubes, rare earth nanoparticles, and quantum dots—offer high brightness and stability. However, they are hindered by ambiguous structures, larger sizes, and potential accumulation toxicity in vivo. In contrast, organic fluorescent probes, including small molecules and polymers, demonstrate higher biocompatibility but are limited by shorter emission wavelengths, lower quantum yields, and reduced stability. Recently, gold clusters have emerged as a promising class of nanomaterials with potential applications in biocatalysis, fluorescence sensing, biological imaging, and more. Water-soluble gold clusters are particularly attractive as fluorescent probes due to their remarkable optical properties, including strong photoluminescence, large Stokes shifts, and excellent photostability. Furthermore, their outstanding biocompatibility—attributed to good aqueous stability, ultra-small hydrodynamic size, and high renal clearance efficiency—makes them especially suitable for biomedical applications. Gold clusters hold significant potential for NIR-II fluorescence imaging. Atomic-precision gold clusters, typically composed of tens to hundreds of gold atoms and measuring only a few nanometers in diameter, possess well-defined three-dimensional structures and clear spatial coordination. This atomic-level precision enables fine-tuned structural regulation, further enhancing their fluorescence properties. Variations in cluster size, surface ligands, and alloying elements can result in distinct physicochemical characteristics. The incorporation of different atoms can modulate the atomic and electronic structures of gold clusters, while diverse ligands can influence surface polarity and steric hindrance. As such, strategies like alloying and ligand engineering are effective in enhancing both fluorescence and catalytic performance, thereby meeting a broader range of clinical needs. In recent years, gold clusters have attracted growing attention in the biomedical field. Their application in NIR-II imaging has led to significant progress in vascular, organ, and tumor imaging. The resulting high-resolution, high signal-to-noise imaging provides powerful tools for clinical diagnostics. Moreover, biologically active gold clusters can aid in drug delivery and disease diagnosis and treatment, offering new opportunities for clinical therapeutics. Despite the notable achievements in fundamental research and clinical translation, further studies are required to address challenges related to the standardized synthesis and complex metabolic behavior of gold clusters. Resolving these issues will help accelerate their clinical adoption and broaden their biomedical applications.
9.Establishment and application of a rapid high-throughput detection method for Huanglongbing.
Qin YUAN ; Zhi-Peng LI ; Tie-Lin WANG ; Ting DONG ; Yu-Wen YANG ; Wei GUAN ; Ting-Chang ZHAO
China Journal of Chinese Materia Medica 2025;50(7):1735-1740
The dried mature peel of Citrus reticulata, a plant in the Rutaceae family and its cultivated varieties, is a commonly used Chinese medicinal material known as Chenpi(Citri Reticulatae Pericarpium). It is rich in nutritional components and medicinal value, with pharmacological effects including relieving cough and eliminating phlegm, strengthening the spleen and drying dampness, protecting the liver and benefiting the stomach, tonifying Qi, and calming the mind. Huanglongbing(HLB), also known as Citrus Huanglongbing, is a destructive disease in citrus production that seriously threatens the development of the citrus industry. HLB causes symptoms such as the inability of Rutaceae plants to produce mature fruit, gradual weakening of the tree, and eventual death, posing a significant threat to the yield and quality of Chenpi. Due to the uneven distribution of the HLB pathogen in infected plants, accurate detection of the pathogen requires the collection of a large number of plant samples. Current sample pretreatment methods, such as traditional extraction methods and commercial extraction kits, are time-consuming and involve multiple steps, which significantly increase the difficulty and workload of HLB diagnosis and have become a bottleneck in HLB detection. In this study, a rapid high-throughput detection method combining alkali lysis and TaqMan qPCR was developed. This method allows the pretreatment of multiple samples within 5 min, and the entire detection process can be completed within 45 min, with a detection limit of 6.67 fg·μL~(-1). The alkali lysis method and commercial kits were used for parallel detection of field-collected citrus samples, and the results showed no significant difference. The sample pretreatment method established in this study is characterized by low cost, simplicity, and high efficiency. Combined with TaqMan qPCR, it can provide technical support for early and on-site diagnosis of HLB. This method is of great significance for disease prevention and control in the citrus industry and is expected to help improve the yield and quality of citrus medicinal materials.
Citrus/microbiology*
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Plant Diseases/microbiology*
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Rhizobiaceae/physiology*
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High-Throughput Screening Assays/methods*
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Liberibacter/physiology*
10.Influence of antiviral treatment adjustment on the prognosis of chronic hepatitis B patients with low-level viremia
Mengwen HE ; Wucai YANG ; Chunyan WANG ; Yiming FU ; Chang GUO ; Jianjun WANG ; Dong JI
Journal of Clinical Hepatology 2025;41(6):1056-1061
ObjectiveTo investigate the incidence rate of primary liver cancer (PLC) and the progression of liver fibrosis in chronic hepatitis B (CHB) patients with low-level viremia (LLV) (HBV DNA<2 000 IU/mL but ≥20 IU/mL) after treatment adjustment, and to provide more robust evidence for clinical practice. MethodsA retrospective analysis was performed for the clinical data of LLV patients who initially received nucleos(t)ide analogue (NAs) for at least 48 weeks at the Fifth Medical Center of PLA General Hospital from August 2007 to April 2017 and subsequently underwent NAs adjustment due to LLV, and according to the virologic response after 48 weeks of treatment adjustment, the patients were divided into LLV group and complete virological response (CVR) group (HBV DNA<20 IU/mL). The patients were followed up once every 3 — 6 months till the primary endpoint event of PLC or October 2024. The incidence rate of PLC and the progression of liver fibrosis were observed, and the progression of liver fibrosis was defined as an increase of ≥1 grade in fibrosis-4 (FIB-4) index. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups; the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to calculate the cumulative incidence rate of PLC, and the Log-rank test was used for comparison between groups; the Cox regression analysis was used to investigate the risk factors for PLC, and the Logistic regression analysis was used to investigate the influencing factors for the progression of liver fibrosis. ResultsA total of 307 patients were enrolled, with a mean age of 50.0 years, and the male patients accounted for 80.5%. After 48 weeks of treatment with the adjusted NAs regimen, 254 patients (82.7%) achieved CVR, and 53 patients (17.3%) still had LLV. For the LLV group, the incidence rate of PLC was 30.2% and the rate of liver fibrosis progression was 22.6%, while for the CVR group, the incidence rate of PLC was only 13.4%, and the rate of liver fibrosis progression was 7.5%. The multivariate regression analyses showed that LLV was an independent risk factor for the onset of PLC (hazard ratio=2.623, 95% confidence interval [CI]: 1.315 — 5.234, P=0.006) and the progression of liver fibrosis (odds ratio=3.213, 95%CI: 1.385 — 7.455, P=0.007). ConclusionActive adjustment of treatment is needed immediately after the diagnosis of LLV to improve CVR, and if LLV persists after treatment adjustment, it is necessary to enhance the monitoring of liver fibrosis progression and PLC, so as to facilitate early diagnosis and treatment.


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