The Baveno Cooperation is a consortium of internationally renowned experts committed to setting standards for the clinical management of patients with advanced chronic liver disease, with a particular emphasis on complications related to portal hypertension. Updated every five years and endorsed by major scientific societies, the Baveno recommendations have significantly influenced clinical practice and improved patient outcomes worldwide. The latest Baveno consensus, Baveno VII, provided a series of recommendations that have shifted our understanding of chronic liver disease and portal hypertension and profoundly shaped clinical practice. However, many areas of research remain to be explored in the short to intermediate term to enable a more personalized medicine approach. This review highlights some of the most relevant advancements introduced in Baveno VII and discusses future challenges.
Hypertension, Portal/therapy* ; Humans

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Oligodendrocyte lineage cells, including oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs), are essential in establishing and maintaining brain circuits. Autophagy is a conserved process that keeps the quality of organelles and proteostasis. The role of autophagy in oligodendrocyte lineage cells remains unclear. The present study shows that autophagy is required to maintain the number of OPCs/OLs and myelin integrity during brain aging. Inactivation of autophagy in oligodendrocyte lineage cells increases the number of OPCs/OLs in the developing brain while exaggerating the loss of OPCs/OLs with brain aging. Inactivation of autophagy in oligodendrocyte lineage cells impairs the turnover of myelin basic protein (MBP). It causes MBP to accumulate in the cytoplasm as multimeric aggregates and fails to be incorporated into integral myelin, which is associated with attenuated endocytic recycling. Inactivation of autophagy in oligodendrocyte lineage cells impairs myelin integrity and causes demyelination. Thus, this study shows autophagy is required to maintain myelin quality during aging by controlling the turnover of myelin components.
Animals ; Autophagy/physiology* ; Oligodendroglia/metabolism* ; Myelin Sheath/physiology* ; Aging/pathology* ; Myelin Basic Protein/metabolism* ; Cell Lineage/physiology* ; Mice ; Oligodendrocyte Precursor Cells ; Mice, Inbred C57BL ; Brain/cytology* ; Cells, Cultured ; Cell Count

Objective:To explore the evaluation value of shear wave elastography(SWE)parameters combined with gamma-Glutamyltransferase(GGT)and aspartate aminotransferase(AST)/alanine aminotransferase(ALT)for the severity of cirrhosis patients.Methods:96 cirrhosis patients who were admitted to Dafang County People's Hospital from January 2022 to October 2024 were selected,they were divided into control group(n=65,Child-Push A and B-grade)and an observation group(n=31,Child-Push c-grade)according to Child-Push grade.All cirrhosis patients underwent SWE examination,serum GGT levels,AST/ALT in cirrhosis patients were detected.SWE parameters(shear wave velocity,elastic modulus)and serum GGT levels,AST/ALT were compared between two groups,Pearson correlation analysis was applied to investigate the correlation between SWE parameters,serum GGT,AST/ALT,and the severity of cirrhosis.The receiver operating characteristic(ROC)curve was used to analyze the value of SWE parameters,serum GGT,AST/ALT individual and combined assessment for evaluating Child-Push c-grade cirrhosis.Delong test was used to compare the area under the ROC curve(AUC)of SWE parameter combination,serum GGT and AST/ALT combination,and SWE parameter and serum GGT,AST/ALT combination in evaluating Child-Push c-grade cirrhosis.Results:Compared with the control group,the observation group had faster shear wave velocity and higher elastic modulus(P＜0.05).The AUC values of shear wave velocity and elastic modulus individual and combined assessment were 0.712,0.739,and 0.845,respectively.Compared with the control group,the observation group had higher serum GGT,AST,ALT levels,and AST/ALT(P＜0.05).The AUC values of serum GGT,AST/ALT individual and combined assessment were 0.664,0.714,and 0.790,respectively.SWE parameters,serum GGT levels,AST/ALT were positively correlated with the severity of cirrhosis(P＜0.05).The AUC of SWE parameter combined with serum GGT and AST/ALT assessment was 0.923,significantly higher than SWE parameter combined and serum GGT and AST/ALT combined(z=2.731,2.924,both P＜0.05).Conclusion:Patients with more severe cirrhosis has a faster shear wave velocity,higher elastic modulus,and higher serum GGT levels and AST/ALT.The combined detection above indicators has good application value in evaluating the degree of cirrhosis.

This study aims to understand the epidemic distribution characteristics,antimicrobial resistance,virulence genes,and biofilm adhesion ability of Enterococcus in yaks on the Tibetan plateau.Three hundred and forty-six fresh yak fecal samples and 311 milk samples were collected from four provinces on the Tibetan plateau(Xizang,Sichuan,Gansu,Qinghai),totaling 657 sam-ples.Bacterial isolation and identification were conducted,followed by 16S rDNA gene detection and the construction of a systematic evolutionary tree.The isolated strains were tested for antimi-crobial resistance and virulence genes using PCR,and sensitivity tests were performed using 18 types of antibiotics.The biofilm adhesion ability of the isolated bacteria was determined using an improved semi-quantitative crystal violet staining method.The results showed that the total isola-tion rate of Enterococcus was 32.27％,with Sichuan having the highest at 60.23％,followed by Gansu,Qinghai,and Tibet autonomous region at 42.70％,23.47％,and 18.31％respectively.In terms of sample types,the isolation rate in fecal samples was 36.71％,and in milk samples,it was 27.33％.Through PCR amplification,bands of approximately 1 400 bp were obtained,and 5 strains were selected for evolutionary analysis,forming a separate cluster.Among the 212 isolated strains,a high resistance to clindamycin,quinupristin-dalfopristin,linezolid,levofloxacin,and erythromycin was observed,with various resistance phenomena,accounting for 60.85％.Only 5 out of 12 resist-ant genes were detected,namely erm(B),tet(L),tet(O),tet(M),and ant(6)-Ia.All 13 virulence genes were detected in Enterococcus,with detection rates in the range of 5.19％to 95.76％,where cpd was 95.75％,gelE was 91.98％,efaA was 86.79％,asal was 86.32％,and the rest ranged from 5.19％to 55.66％.The fsr virulence gene was not detected in Enterococcus from milk sources.Among the isolated strains,3.30％showed medium adhesive ability,48.58％showed weak adhesive ability,and 48.11％showed no adhesive ability.The above research revealed the preva-lence of yak derived Enterococcus,the carrying status of resistance and virulence genes,and the correlation between biofilm phenotypes,laying the foundation for mastering research data on yak-derived Enterococcus in the Tibetan plateau.

Objective:To explore the evaluation value of shear wave elastography(SWE)parameters combined with gamma-Glutamyltransferase(GGT)and aspartate aminotransferase(AST)/alanine aminotransferase(ALT)for the severity of cirrhosis patients.Methods:96 cirrhosis patients who were admitted to Dafang County People's Hospital from January 2022 to October 2024 were selected,they were divided into control group(n=65,Child-Push A and B-grade)and an observation group(n=31,Child-Push c-grade)according to Child-Push grade.All cirrhosis patients underwent SWE examination,serum GGT levels,AST/ALT in cirrhosis patients were detected.SWE parameters(shear wave velocity,elastic modulus)and serum GGT levels,AST/ALT were compared between two groups,Pearson correlation analysis was applied to investigate the correlation between SWE parameters,serum GGT,AST/ALT,and the severity of cirrhosis.The receiver operating characteristic(ROC)curve was used to analyze the value of SWE parameters,serum GGT,AST/ALT individual and combined assessment for evaluating Child-Push c-grade cirrhosis.Delong test was used to compare the area under the ROC curve(AUC)of SWE parameter combination,serum GGT and AST/ALT combination,and SWE parameter and serum GGT,AST/ALT combination in evaluating Child-Push c-grade cirrhosis.Results:Compared with the control group,the observation group had faster shear wave velocity and higher elastic modulus(P＜0.05).The AUC values of shear wave velocity and elastic modulus individual and combined assessment were 0.712,0.739,and 0.845,respectively.Compared with the control group,the observation group had higher serum GGT,AST,ALT levels,and AST/ALT(P＜0.05).The AUC values of serum GGT,AST/ALT individual and combined assessment were 0.664,0.714,and 0.790,respectively.SWE parameters,serum GGT levels,AST/ALT were positively correlated with the severity of cirrhosis(P＜0.05).The AUC of SWE parameter combined with serum GGT and AST/ALT assessment was 0.923,significantly higher than SWE parameter combined and serum GGT and AST/ALT combined(z=2.731,2.924,both P＜0.05).Conclusion:Patients with more severe cirrhosis has a faster shear wave velocity,higher elastic modulus,and higher serum GGT levels and AST/ALT.The combined detection above indicators has good application value in evaluating the degree of cirrhosis.

This study aims to understand the epidemic distribution characteristics,antimicrobial resistance,virulence genes,and biofilm adhesion ability of Enterococcus in yaks on the Tibetan plateau.Three hundred and forty-six fresh yak fecal samples and 311 milk samples were collected from four provinces on the Tibetan plateau(Xizang,Sichuan,Gansu,Qinghai),totaling 657 sam-ples.Bacterial isolation and identification were conducted,followed by 16S rDNA gene detection and the construction of a systematic evolutionary tree.The isolated strains were tested for antimi-crobial resistance and virulence genes using PCR,and sensitivity tests were performed using 18 types of antibiotics.The biofilm adhesion ability of the isolated bacteria was determined using an improved semi-quantitative crystal violet staining method.The results showed that the total isola-tion rate of Enterococcus was 32.27％,with Sichuan having the highest at 60.23％,followed by Gansu,Qinghai,and Tibet autonomous region at 42.70％,23.47％,and 18.31％respectively.In terms of sample types,the isolation rate in fecal samples was 36.71％,and in milk samples,it was 27.33％.Through PCR amplification,bands of approximately 1 400 bp were obtained,and 5 strains were selected for evolutionary analysis,forming a separate cluster.Among the 212 isolated strains,a high resistance to clindamycin,quinupristin-dalfopristin,linezolid,levofloxacin,and erythromycin was observed,with various resistance phenomena,accounting for 60.85％.Only 5 out of 12 resist-ant genes were detected,namely erm(B),tet(L),tet(O),tet(M),and ant(6)-Ia.All 13 virulence genes were detected in Enterococcus,with detection rates in the range of 5.19％to 95.76％,where cpd was 95.75％,gelE was 91.98％,efaA was 86.79％,asal was 86.32％,and the rest ranged from 5.19％to 55.66％.The fsr virulence gene was not detected in Enterococcus from milk sources.Among the isolated strains,3.30％showed medium adhesive ability,48.58％showed weak adhesive ability,and 48.11％showed no adhesive ability.The above research revealed the preva-lence of yak derived Enterococcus,the carrying status of resistance and virulence genes,and the correlation between biofilm phenotypes,laying the foundation for mastering research data on yak-derived Enterococcus in the Tibetan plateau.

Background/Aims: Oral EDP-514 is a potent core protein inhibitor of hepatitis B virus (HBV) replication, which produced a >4-log viral load reduction in HBV-infected chimeric mice with human liver cells. This study evaluated the safety, pharmacokinetics, and antiviral activity of three doses of EDP-514 in treatment-naive viremic patients with HBeAgpositive or -negative chronic HBV infection. Methods: Patients with HBsAg detectable at screening and at least 6 months previously were eligible. HBeAg-positive and -negative patients had a serum/plasma HBV DNA level ≥20,000 and ≥2,000 IU/mL, respectively. Twenty-five patients were randomized to EDP-514 200 (n=6), 400 (n=6) or 800 mg (n=7) or placebo (n=6) once daily for 28 days. Results: A dose-related increase in EDP-514 exposure (AUClast and Cmax) was observed across doses. At Day 28, mean reductions in HBV DNA were –2.9, –3.3, –3.5 and –0.2 log10 IU/mL with EDP-514 200 mg, 400 mg, 800 mg, and placebo groups, respectively. The corresponding mean change from baseline for HBV RNA levels was –2.9, –2.4, –2.0, and –0.02 log10 U/mL. No virologic failures were observed. No clinically meaningful changes from baseline were observed for HBsAg, HBeAg or HBcrAg. Nine patients reported treatment emergent adverse events of mild or moderate severity with no discontinuations, serious AEs or deaths. Conclusions In treatment-naïve viremic patients, oral EDP-514 was generally safe and well-tolerated, displayed PK profile supportive of once-daily dosing, and markedly reduced HBV DNA and HBV RNA.

Objective:To examine the application of a novel pedagogical approach multidimensional supportive psychological intervention(MSPI)in the clinical practice teaching of andrological nursing care.Methods:Using the Hamilton Depression Scale(HAMD),we assessed the psychology of 100 nursing interns about to enter clinical practice in the Department of Andrology from De-cember 2021 to December 2022.We equally randomized the subjects into an experimental and a control group,the former receiving MSPI and the latter trained on the conventional teaching model without any psychological support intervention.Results:Compared with the baseline,the HAMD scores were significantly decreased in the experimental group after intervention(12.4±2.1 vs 8.9±2.4,P＜0.01),but increased in the controls(13.1±1.8 vs 14.7±1.9,P＜0.01);the skill scores dramatically increased in the experimental group(82.6±4.7 vs 91.2±2.4,P＜0.01),but decreased in the control group after intervention(81.0±3.5 vs 80.4±2.7,P=0.28).Conclusion:MSPI can significantly enhance the learning enthusiasm of nursing students in a short period,re-duce their psychological stress and improve teaching outcomes.This approach,combining psychology with teaching,can also strength-en the mental resilience of nursing students and better confront them with future professional challenges.