1.Normal-weight metabolic dysfunction-associated steatotic liver disease: reclassification, characteristics, and adverse liver outcomes across diverse populations
Sherlot Juan SONG ; Eileen Laureal YOON ; Vincent Wai-Sun WONG ; Ae Jeong JO ; Grace Lai-Hung WONG ; Jimmy Che-To LAI ; Dae Won JUN ; Terry Cheuk-Fung YIP
Clinical and Molecular Hepatology 2026;32(2):646-660
Background/Aims:
Previous studies have identified a substantial degree of agreement between the non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) populations, but the same notion may not apply to normal-weight patients with a lower cardiometabolic risk burden. This study aims to investigate the cardiometabolic risk factor (CMRF) distributions between normal-weight and overweight/obese MASLD, the agreement between historical NAFLD and MASLD, and to compare the risk of liver-related events (LREs) and all-cause mortality in normal-weight versus overweight or obese MASLD.
Methods:
This study included participants with steatotic liver disease (SLD) from five cohorts in China (Hong Kong), South Korea, and the United States. Participants were recruited from settings including both hospitals and communities. Individuals were classified into normal-weight and overweight/obese groups.
Results:
This study included 33,793 participants with SLD from five cohorts, of whom 20,893 and 20,701 patients met the diagnosis of NAFLD and MASLD, respectively. Normal-weight patients with NAFLD demonstrated a lower CMRF distribution compared to those with overweight/obese NAFLD. In the community-based cohorts, the proportions with 0 CMRF ranged from 9.0 to 26.7% among normal-weight NAFLD patients, representing the discrepancy between MASLD and NAFLD definitions. Compared with the overweight/obese MASLD, the normalweight MASLD had increased all-cause mortality (normal-weight vs. overweight/obese, 23.44 and 13.80 per 1,000 person-years; P<0.001) but not LREs (2.81 and 2.59 per 1,000 person-years; P=0.54) in the Hong Kong Clinical Data Analysis and Reporting System cohort.
Conclusions
Normal-weight individuals with NAFLD demonstrated a lower distribution of CMRFs, resulting in the incomplete agreement between historical NAFLD and MASLD.
2.Isolation,identification and biological characterization of influenza D viruses in Jilin region
Hongjin LI ; Hailin JIN ; Xinxin LIU ; Weiwen YAN ; Xianwen LIN ; Yue YIN ; Bing GAO ; Xianyuan KONG ; Che SONG ; Guang WANG ; Renfu YIN
Chinese Journal of Veterinary Science 2025;45(11):2405-2410
To investigate the prevalence of influenza D virus(IDV)in cattle and swine populations in Jilin Province,China,277 nasopharyngeal swabs were collected from livestock exhibiting influ-enza-like symptoms for IDV detection.Virus isolation was performed using swine testicular(ST)cells for PCR-positive samples,followed by comprehensive analyses including whole-genome se-quencing,phylogenetic analysis,electron microscopic observation of viral morphology,and glycosy-lation site prediction.Two IDV strains were successfully isolated from bovine samples,designated as D/bovine/China/JL22/2024(JL22)and D/bovine/China/JL34/2024(JL34).These strains were demonstrated to have specific hemagglutination activity against turkey red blood cells,while no he-magglutination to chicken,rabbit,or guinea pig erythrocytes.Virus-inoculated ST cells exhibited distinct cytopathic effects(CPE)within 48 h,with a hemagglutination titer of 4 log2 in the culture supernatant.Phylogenetic analysis of the hemagglutinin-esterase-fusion(HEF)gene indicated that these strains were most closely related to the Japanese isolate D/Yamagata2019,belonging to the YAMA2019 lineage.Genomic sequence analysis showed the absence of genetic reassortment in these isolates.In this study,two IDV strains were successfully isolated and characterized,which provides preliminary insights into their genomic sequences and biological properties.The findings confirm the presence of IDV in bovine populations in Jilin Province and provide the fundamental data for future epidemiological surveillance and control strategies of IDV.
3.Isolation,identification and biological characterization of influenza D viruses in Jilin region
Hongjin LI ; Hailin JIN ; Xinxin LIU ; Weiwen YAN ; Xianwen LIN ; Yue YIN ; Bing GAO ; Xianyuan KONG ; Che SONG ; Guang WANG ; Renfu YIN
Chinese Journal of Veterinary Science 2025;45(11):2405-2410
To investigate the prevalence of influenza D virus(IDV)in cattle and swine populations in Jilin Province,China,277 nasopharyngeal swabs were collected from livestock exhibiting influ-enza-like symptoms for IDV detection.Virus isolation was performed using swine testicular(ST)cells for PCR-positive samples,followed by comprehensive analyses including whole-genome se-quencing,phylogenetic analysis,electron microscopic observation of viral morphology,and glycosy-lation site prediction.Two IDV strains were successfully isolated from bovine samples,designated as D/bovine/China/JL22/2024(JL22)and D/bovine/China/JL34/2024(JL34).These strains were demonstrated to have specific hemagglutination activity against turkey red blood cells,while no he-magglutination to chicken,rabbit,or guinea pig erythrocytes.Virus-inoculated ST cells exhibited distinct cytopathic effects(CPE)within 48 h,with a hemagglutination titer of 4 log2 in the culture supernatant.Phylogenetic analysis of the hemagglutinin-esterase-fusion(HEF)gene indicated that these strains were most closely related to the Japanese isolate D/Yamagata2019,belonging to the YAMA2019 lineage.Genomic sequence analysis showed the absence of genetic reassortment in these isolates.In this study,two IDV strains were successfully isolated and characterized,which provides preliminary insights into their genomic sequences and biological properties.The findings confirm the presence of IDV in bovine populations in Jilin Province and provide the fundamental data for future epidemiological surveillance and control strategies of IDV.
4.Application Value Research and Detection of RF after RF-CIC Dissociation in the Serum of Rheumatoid Arthritis Patients
Guiqi HU ; Mengyu LYU ; Qingyang SUN ; Yue WANG ; Rui SONG ; Yuzhu DAI ; Jun CHENG ; Feihu CHE
Journal of Modern Laboratory Medicine 2025;40(6):181-184,189
Objective To detect the content of rheumatoid factor(RF)after RF-CIC dissociation using serum circulating immune complexes(CIC)dissociation technology and evaluate its diagnostic and clinical value in rheumatic arthritis(RA).Methods 55 RA patients diagnosed and treated in the 903rd Hospital of the People's Liberation Army from January 2024 to December 2024 were selected as the RA disease group,and 20 healthy individuals were selected as the control group.In addition,57 non RA pa-tients with symptoms resembling RA[patients with systemic lupus erythematosus(SLE),gout,ankylosing spondylitis(AS),osteo-arthritis,etc)]as the non RA disease group.Using CIC dissociation technology,RF content after RF-CIC dissociation was detect-ed in the serum of all three groups of study subjects,and C-reactive protein(CRP)and RF levels in all subjects were detected using a biochemical analyzer.Analyzed and compared the differences in the positive rate and levels of RF-CIC among three groups object of study.In addition,analyze and compare the correlation between RF-CIC and inflammatory index CRP.Results The positive rates of RF-CIC in the serum of RA disease group,non RA disease group,and control group were 87.27%(48/55),10.53%(6/57)and 0.0%(0/20),respectively,and the differences between the three groups was statistically significant(χ2=84.520,P<0.05).Further subgroup analysis showed that the RF-CIC positivity rate in the RF negative subgroup of RA disease patients[61.11%(11/18)]higher than that in the non RA disease group[1.92%(1/52)]and the control group[0%(0/20)],and the differ-ences were statistically significant(χ2=44.493,21.671,all P<0.05).The RF-CIC positivity rate was higher in RF positive pa-tients than in RF negative patients in the RA disease group(100%vs 61.11%),and the difference was statistically significant(χ2=16.487,P<0.05).The RF-CIC content in the serum of RF positive patients in the RA disease group was higher than that of RF negative patients[16.35(10.53,26.49)vs 3.57(2.53,3.89)],and the difference was statistically significant(Z=-4.243,P<0.05).Correlation analysis showed that the levels of CRP and RF in the serum of RA patients were positively correlated with the levels of RF-CIC(r=0.490,0.970,all P<0.05).Conclusion RF-CIC demonstrates high positivity even in RF-negative RA patients,and their levels correlate with CRP.RF-CIC shows potential as a serological indicator for early diagnosis and disease activity assess-ment in RA.
5.Application Value Research and Detection of RF after RF-CIC Dissociation in the Serum of Rheumatoid Arthritis Patients
Guiqi HU ; Mengyu LYU ; Qingyang SUN ; Yue WANG ; Rui SONG ; Yuzhu DAI ; Jun CHENG ; Feihu CHE
Journal of Modern Laboratory Medicine 2025;40(6):181-184,189
Objective To detect the content of rheumatoid factor(RF)after RF-CIC dissociation using serum circulating immune complexes(CIC)dissociation technology and evaluate its diagnostic and clinical value in rheumatic arthritis(RA).Methods 55 RA patients diagnosed and treated in the 903rd Hospital of the People's Liberation Army from January 2024 to December 2024 were selected as the RA disease group,and 20 healthy individuals were selected as the control group.In addition,57 non RA pa-tients with symptoms resembling RA[patients with systemic lupus erythematosus(SLE),gout,ankylosing spondylitis(AS),osteo-arthritis,etc)]as the non RA disease group.Using CIC dissociation technology,RF content after RF-CIC dissociation was detect-ed in the serum of all three groups of study subjects,and C-reactive protein(CRP)and RF levels in all subjects were detected using a biochemical analyzer.Analyzed and compared the differences in the positive rate and levels of RF-CIC among three groups object of study.In addition,analyze and compare the correlation between RF-CIC and inflammatory index CRP.Results The positive rates of RF-CIC in the serum of RA disease group,non RA disease group,and control group were 87.27%(48/55),10.53%(6/57)and 0.0%(0/20),respectively,and the differences between the three groups was statistically significant(χ2=84.520,P<0.05).Further subgroup analysis showed that the RF-CIC positivity rate in the RF negative subgroup of RA disease patients[61.11%(11/18)]higher than that in the non RA disease group[1.92%(1/52)]and the control group[0%(0/20)],and the differ-ences were statistically significant(χ2=44.493,21.671,all P<0.05).The RF-CIC positivity rate was higher in RF positive pa-tients than in RF negative patients in the RA disease group(100%vs 61.11%),and the difference was statistically significant(χ2=16.487,P<0.05).The RF-CIC content in the serum of RF positive patients in the RA disease group was higher than that of RF negative patients[16.35(10.53,26.49)vs 3.57(2.53,3.89)],and the difference was statistically significant(Z=-4.243,P<0.05).Correlation analysis showed that the levels of CRP and RF in the serum of RA patients were positively correlated with the levels of RF-CIC(r=0.490,0.970,all P<0.05).Conclusion RF-CIC demonstrates high positivity even in RF-negative RA patients,and their levels correlate with CRP.RF-CIC shows potential as a serological indicator for early diagnosis and disease activity assess-ment in RA.
6.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
7.Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Journal of Korean Medical Science 2025;40(3):e8-
Background:
Identifying factors associated with early post-discharge outpatient care is crucial to prevent relapse and suicide in patients with schizophrenia. This study aimed to investigate factors associated with receiving follow-up care within seven days after hospital discharge among patients with schizophrenia.
Methods:
This nationwide population-based study was conducted using data from the National Health Insurance Claim Database of South Korea. All patients aged ≥ 18 years, newly admitted to the hospital with schizophrenia between January 1, 2017, and December 31, 2018, were included. The outcome of interest was the receipt of outpatient follow-up care within seven days of hospital discharge. Patients’ general characteristics and healthcare services were included as independent variables. A generalized estimating equation model was used to examine factors associated with the outcome.
Results:
Of 17,565 patients with schizophrenia, 37.6% received outpatient follow-up care within seven days after hospital discharge. Patients who were older and male were less likely to receive follow-up care seven days after discharge. Patients with prior psychiatric outpatient care to their index admission were more likely to receive follow-up care than those without prior outpatient care. A longer hospital stay significantly decreased the likelihood of receiving outpatient follow-up. However, comorbid alcohol use disorder was not associated with receiving follow-up care within seven days of discharge.
Conclusion
This study highlights the need to ensure continuity of care for patients with schizophrenia during discharge planning, with particular attention to vulnerable patients.
8.Exploration of an Intelligent Evidence Achieve Mode of Evidence-Based Chinese Medicine:Take Systematic Review of Coronary Heart Disease Syndrome Research as an Example
Qianzi CHE ; Qingyang ZENG ; Tian SONG ; Lin CHEN ; Jing WAN ; Nannan SHI
Journal of Traditional Chinese Medicine 2025;66(15):1597-1603
ObjectiveTo construct an intelligent model for literature screening, retrieval, and data extraction with a systematic review of coronary heart disease syndromes as an example, so as to improve the efficiency of evidence-based Chinese medicine research. MethodsBased on China National Knowledge Infrastructure (CNKI), VIP and Wanfang Data Resource System, the articles related to coronary heart disease syndrome research published from January 1, 2000 to December 31, 2023 were retrieved. Automated tools were used to batch retrieve paper metadata. Using text similarity algorithms, papers were merged, deduplicated, and subjected to preliminary screening based on titles and abstracts. Further screening was performed using object detection and image processing technologies on the full texts and statistical tables. Natural language processing (NLP) techniques and pre-trained models were applied to extract information. ResultsThe initial search retrieved 56 255 coronary heart disease syndrome-related articles. By artificial intelligence-assisted preliminary and secondary screening, the manual verification scope was narrowed to 1075 articles. Ultimately, 646 coronary heart disease syndrome related studies were included manually. With accuracy verification showing over 90% consistency in semantic recognition and element decomposition processes, we achieved data extraction and standardization processing for both basic literature information and 38 syndrome element statistics. ConclusionBy incorporating natural language processing, pre-trained models, artificial intelligence image processing and other technologies, this study enabled efficient retrieval, screening and standardized data extraction of Chinese medicine research literature.
9.Role of noninvasive tests in the prognostication of metabolic dysfunction-associated steatotic liver disease
Yue WANG ; Sherlot Juan SONG ; Yichong JIANG ; Jimmy Che-To LAI ; Grace Lai-Hung WONG ; Vincent Wai-Sun WONG ; Terry Cheuk-Fung YIP
Clinical and Molecular Hepatology 2025;31(Suppl):S51-S75
In managing metabolic dysfunction-associated steatotic liver disease, which affects over 30% of the general population, effective noninvasive biomarkers for assessing disease severity, monitoring disease progression, predicting the development of liver-related complications, and assessing treatment response are crucial. The advantage of simple fibrosis scores lies in their widespread accessibility through routinely performed blood tests and extensive validation in different clinical settings. They have shown reasonable accuracy in diagnosing advanced fibrosis and good performance in excluding the majority of patients with a low risk of liver-related complications. Among patients with elevated serum fibrosis scores, a more specific fibrosis and imaging biomarker has proved useful to accurately identify patients at risk of liver-related complications. Among specific fibrosis blood biomarkers, enhanced liver fibrosis is the most widely utilized and has been approved in the United States as a prognostic biomarker. For imaging biomarkers, the availability of vibration-controlled transient elastography has been largely improved over the past years, enabling the use of liver stiffness measurement (LSM) for accurate assessment of significant and advanced fibrosis, and cirrhosis. Combining LSM with other routinely available blood tests enhances the ability to diagnose at-risk metabolic dysfunction-associated steatohepatitis and predict liver-related complications, some reaching an accuracy comparable to that of liver biopsy. Magnetic resonance imaging-based modalities provide the most accurate quantification of liver fibrosis, though the current utilization is limited to research settings. Expanding their future use in clinical practice depends on factors such as cost and facility availability.
10.Role of noninvasive tests in the prognostication of metabolic dysfunction-associated steatotic liver disease
Yue WANG ; Sherlot Juan SONG ; Yichong JIANG ; Jimmy Che-To LAI ; Grace Lai-Hung WONG ; Vincent Wai-Sun WONG ; Terry Cheuk-Fung YIP
Clinical and Molecular Hepatology 2025;31(Suppl):S51-S75
In managing metabolic dysfunction-associated steatotic liver disease, which affects over 30% of the general population, effective noninvasive biomarkers for assessing disease severity, monitoring disease progression, predicting the development of liver-related complications, and assessing treatment response are crucial. The advantage of simple fibrosis scores lies in their widespread accessibility through routinely performed blood tests and extensive validation in different clinical settings. They have shown reasonable accuracy in diagnosing advanced fibrosis and good performance in excluding the majority of patients with a low risk of liver-related complications. Among patients with elevated serum fibrosis scores, a more specific fibrosis and imaging biomarker has proved useful to accurately identify patients at risk of liver-related complications. Among specific fibrosis blood biomarkers, enhanced liver fibrosis is the most widely utilized and has been approved in the United States as a prognostic biomarker. For imaging biomarkers, the availability of vibration-controlled transient elastography has been largely improved over the past years, enabling the use of liver stiffness measurement (LSM) for accurate assessment of significant and advanced fibrosis, and cirrhosis. Combining LSM with other routinely available blood tests enhances the ability to diagnose at-risk metabolic dysfunction-associated steatohepatitis and predict liver-related complications, some reaching an accuracy comparable to that of liver biopsy. Magnetic resonance imaging-based modalities provide the most accurate quantification of liver fibrosis, though the current utilization is limited to research settings. Expanding their future use in clinical practice depends on factors such as cost and facility availability.

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