ObjectiveTo investigate the effects of rhizosphere organic acids secreted by the roots of Salvia miltiorrhiza on continuous cropping obstacles. MethodsThe mixed solution of organic acids in the rhizosphere of S. miltiorrhiza in continuous cropping and rotation cropping was added to the hairy roots subcultured for 21 days， and samples were collected on days 0， 2， 4， 6， 8， and 10. The changes of biomass， effective components， primary metabolites， secondary metabolites， antioxidant enzymes， and hormones in hairy roots of S. miltiorrhiza were observed and determined. ResultsCompared with the rotation cropping group and the blank control group， the simulation of organic acid secretion from the roots of S. miltiorrhiza had a significant inhibitory effect on the growth of hairy roots and decreased the content of effective components as well as total sugar and total protein in primary metabolites. Compared with the blank control group， the rotation cropping group and the continuous cropping group showed total sugar and total protein content decreases of 33.9% and 5.1%， respectively. On the other hand， the secretion of organic acids from S. miltiorrhiza roots significantly promoted the accumulation of total phenolic acids and total tanshinone， which showed increases of 14.6% and 1.6%， respectively， in continuous cropping group and rotation cropping group compared with the blank control group. ConclusionThe organic acid environment under continuous cropping significantly inhibited the growth of hairy roots and the accumulation of primary metabolites， while promoting the synthesis and accumulation of secondary metabolites of S. miltiorrhiza.

Although there are several risk classification and management guidelines for invasive procedures in cirrhotic patients,consensus on the bleeding risk and thresholds of hemostatic parameters has not been achieved.The purpose of this consensus is to establish an expert opinion on the bleeding risk associated with invasive procedures in cirrhotic patients,categorizing 80 procedures as"high risk"and"low risk".The consensus also informs physicians of the laboratory thresholds for platelet count,international normalized ratio,fibrinogen,and activated partial thromboplastin time that experts consider acceptable for elective invasive procedures in patients with cirrhosis.This experience-based classification may help refine future research design and guide clinical decision-making for invasive procedures in cirrhotic patients.

Resmetirom received accelerated approval from the United States Food and Drug Administration (FDA) in March 2024 for the treatment of metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver fibrosis (stages F2 to F3 fibrosis). This article is excerpted from the Resmetirom therapy for metabolic dysfunction- associated steatotic liver disease: October 2024 updates to AASLD practice guidance. The purpose of this article is to provide medication guidance to clinicians.

In recent years, owing to advances in understanding of hepatocarcinogenesis, the treatment of primary liver cancer (PLC), including hepatocellular-cholangio-carcinoma, fibrolamellar carcinoma, and hepatic epithelioid hemangioendothelioma have garnered increased attention. In this position paper, an international panel of experts representing oncology, hepatology, pathology, radiology, and surgery has systematically summarised the available information and evidence on the pathogenesis, diagnosis, and treatment of rare PLC. While clinical trials of systemic treatments are underway for some rare PLC—more researches, involving national and international collaboration—are required.

This position statement explores the intricate relationship between alcohol intake and metabolic dysfunction in the context of the 2023 nomenclature for steatotic liver disease (SLD). Recent and lifetime alcohol use should be accurately assessed in all patients with SLD to facilitate classification of alcohol use in grams of alcohol per week. Alcohol biomarkers (phosphatidylethanol), use of validated questionnaires, and collateral information from friends and relatives could help facilitate differentiation between alcohol-related liver disease per se and liver disease with both metabolic and alcohol-related liver disease. Heavy alcohol use can contribute to cardiometabolic risk factors such as high blood pressure, hypertriglyceridemia, and hyperglycemia. As a result, caution should be exercised in the application of only one metabolic dysfunction criterion to diagnose metabolic dysfunction-associated steatotic liver disease, as suggested in the 2023 nomenclature document, particularly in individuals exceeding weekly alcohol use thresholds of 140 g for women and 210 g for men. Additionally, metabolic dysfunction and alcohol use should be reassessed over time. This approach could ensure a more accurate prognosis and effective management of SLD addressing both metabolic and alcohol-related factors.

Transjugular intrahepatic portosystemic shunt (TIPS) is a proven procedure therapy for complications in cirrhotic portal hypertension (PH). In recent years, there has been a lot of progress in the field of TIPS, especially in terms of technical operation, prognostic models, and indication expansion. Therefore, the guidelines aim to provide a comprehensive overview of all aspects of the use of TIPS in patients with cirrhosis while separating sections pertaining to other specialized subjects (e.g., the usage of TIPS in surgical procedures and hepatovascular disorders).

Objective:To analyze the scientific research projects of health management disciplines in medical institutions in Beijing.Methods:This study was an observational study, and data was retrieved through computer between 2014 and 2023 from the scientific research data filling system of health management disciplines in medical institutions in Beijing region, which recorded the project name, project category, scientific research funding, institution, discipline, field, etc.. Excel 2016 was used to analyze the scientific research projects of health management disciplines in medical institutions in the Beijing region.Results:From 2014 to 2023, a total of 1 848 scientific research projects of health management disciplines in medical institutions in the Beijing region were initiated, with research funding of 1 204.775 million yuan. In terms of institutional categorization, they were mainly concentrated on central and municipal medical institutions, and in terms of research fields, there were 1 577 projects in Western medicine, with research funding of 1 133.240 million yuan, and 271 projects in Chinese medicine/combination of Chinese and Western medicine, with research funding of 71.535 million yuan. Cardiovascular diseases ranked first in the sub-discipline of Western medicine, and Chinese internal medicine ranked first in the sub-discipline of Chinese medicine.Conclusions:The scientific research projects of health management disciplines in medical institutions in Beijing are characterized by an imbalance in the distribution of institutions and the classification of funded sub-disciplines. The research innovation of health management in medical institutions needs to strengthen multidisciplinary cooperation and talent cultivation.

Liver transplantation (LT) is a kind of effective life-saving rescue procedure. Numerous changes have occurred in the field of LT over the past decade, including expanded indications, transplantation for patients with acute-on-chronic liver failure, advances in transplant oncology, the use of donors after cardiac death, new surgical techniques, and prioritization of recipients on the waiting list. Furthermore, advances in organ perfusion techniques and the identification of novel rejection syndromes have impacted the management of LT recipients. The European Association for the study of the Liver Guidelines aims to focus on new developments since the previous version of the guidelines was released in 2016 rather than comprehensively covering all aspects of liver transplantation. Herein, certain content has been excerpted for readers' reference.

Objective To explore the relationship between the digital transformation of public hospitals and hospital quality and safety management,providing evidence for hospital digital transformation development and policy formulation.Methods Hospital management data from Shanghai municipal hospitals were collected,and a questionnaire was used to assess the current state of digital transformation.A panel regression of time-fixed effects analysis was performed to examine the correlation between various digital transformation variables and quality and safety performance in 8 Shanghai municipal hospitals from January 2023 to May 2024.Results Hospital digital system construction,digital service level,digital investment and digital research are significantly positively correlated with patient safety and service efficiency,and negatively correlated with the incidence of negative safety events in readmissions,venous thromboembolism and unplanned reoperation.The level of digital services was associated with a reduction in average length of stay.Increased digital investment was associated with not only decreased proportion of medication costs,but also an increase in the proportion of consumable costs,other categories of expenditures,and finally average costs.Conclusion While digital transformation improves hospital quality and safety,it also leads to an increased disease burden for patients.Therefore,further evidence is needed to analyze the cost-effectiveness of different digital transformation pathways.

Resmetirom received accelerated approval from the United States Food and Drug Administration (FDA) in March 2024 for the treatment of metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver fibrosis (stages F2 to F3 fibrosis). This article is excerpted from the Resmetirom therapy for metabolic dysfunction- associated steatotic liver disease: October 2024 updates to AASLD practice guidance. The purpose of this article is to provide medication guidance to clinicians.