1.O-GlcNAcylation participates in initiation of SHH-type medulloblastoma by regulating Rack1 protein stability
Luo JINGYA ; Gao TANGQING ; Yang MENGMENG ; Yang HAIHONG
Chinese Journal of Clinical Oncology 2025;52(2):55-63
Objective:To investigate the role of O-GlcNAcylation in the regulation of the stability of receptor for activated C kinase 1(Rack1)during SHH-type medulloblastoma(SHH-MB)initiation.Methods:SHH-MB tumors and adjacent tissues were selected from the clinical tu-mor specimen library of the Department of Pathology at The General Hospital of Western Theater Command.Rack1 expression and O-GlcNAcylation(O-GlcNAc)levels in these tumor tissues were analyzed.The human medulloblastoma cell line Daoy was treated with a glyc-osyltransferase(OGT)inhibitor(OSMI-1)and adeglycosyltransferase(OGA)inhibitor(TM-G),and their impact on tumor cell proliferation was assessed using a Cell Counting Kit-8(CCK-8)and immunofluorescence staining.The O-GlcNAc enzyme labeling system co-immunoprecipita-tion(Co-IP)and Western blot were used to correlate Rack1 protein levels with O-GlcNAc levels.The impact of O-GlcNAcon Rack1 stability was confirmed using cycloheximide(CHX)and ubiquitination modification experiments.In a medulloblastoma mouse model with Rack1 knockdown,tumor cell proliferation was detected using a Cell Counting Kit-8(CCK-8),immunofluorescence staining,and a scratch assay.Xenograft tumors were transplanted into immunodeficient mice and SHH signaling was detected by Western blot in the obtained tissue samples(sh-NC and sh-Rack1)to verify the role of Rack1 protein in SHH-MB.Results:Rack1 and O-GlcNAcylation levels were significantly in-creased in SHH-MB tumor samples,and a negative correlation was observed between Rack1 levels and patient survival rates.Treatment of Daoy cells with OGT and TM-G revealed that O-GlcNAc significantly promotes Daoy cell proliferation,while inhibiting O-GlcNAc impedes tu-mor cell proliferation.Molecular experiments have confirmed that O-GlcNAc modification of Rack1 protein can regulate tumor cell stability,thereby promoting tumor cell proliferation.When Rack1 expression was knocked down in Daoy cells,cell proliferation was significantly re-duced relative to control cells.Accordingly,proliferation was significantly inhibited in tumor tissues with Rack1 protein knockdown in mouse models,suggesting that Rack1 can participate in the initiation of SHH-MB by regulating SHH signaling.Conclusions:O-GlcNAcylation particip-ates in SHH-MB initiation by regulating Rack1 stability.
2.Effect of benzoapyrene exposure during pregnancy on learning and memory functions of rat offspring and expression levels of related genes
Jingya SHI ; Siyu WANG ; Xutao GAO ; Jisheng NIE
Journal of Environmental and Occupational Medicine 2025;42(10):1234-1239
Background Polycyclic aromatic hydrocarbons represented by benzo[a]pyrene are among the most significant occupational and environmental pollutants. Exposure to benzo[a]pyrene during pregnancy can cause delayed intellectual development in offspring, and the mechanism may be related to the expression of protocadherin (Pcdh), a key molecule for learning and memory. Objective To explore the possible role of Pcdh in impaired learning and memory function of pups caused by benzo[a]pyrene exposure during pregnancy by establishing an animal model of cognitive impairment in pups caused by benzo[a]pyrene exposure during pregnancy, and detecting the expression of Pcdh and its transcription-related factors in the hippocampal tissues of pups at different developmental stages. Methods Sixty female and male SPF-grade rats were caged in a 1:1 ratio overnight, and the successfully mated female mice were randomly divided into blank control, 0 mg·kg−1, 10 mg·kg−1, 20 mg·kg−1, and 40 mg·kg−1 groups, with 6 mice in each group. They were intraperitoneally injected with benzo[a]pyrene from the 17th to the 19th day of pregnancy to establish an exposure model. Learning and memory functions of the offspring were tested through Morris water maze on the 45th day after the birth (PND) of the pups. On the PND45 and PND75 of the pups, hippocampal tissues of 6 pups (per group) were collected respectively. The expression levels of PcdhαC1 and wings apart-like homolog (WAPL) genes and proteins were detected by fluorescence quantitative polymerase chain reaction (PCR) and Western blotting. Results The results of Morris water maze showed that there was no interaction between the escape latency time of the pups and the dose groups of 0 mg·kg−1, 10 mg·kg−1, 20 mg·kg−1, and 40 mg·kg−1 (F time × group=0.515, P>0.05). The escape latency of pups decreased with increase of training time (F time=24.678, P<0.001, F group=12.803, P<0.001). The PCR results showed that at PND45, compared with the blank group, the relative expression levels of PcdhαC1 mRNA in the 10 mg·kg−1, 20 mg·kg−1, and 40 mg·kg−1 groups decreased (P<0.05), and the relative expression levels of WAPL mRNA increased (P<0.05). At PND75, compared with the blank group, the relative expression levels of PcdhαC1 mRNA in the 20 mg·kg−1 and 40 mg·kg−1 groups decreased (P<0.05), and the relative expression levels of WAPL mRNA increased (P<0.05). The Western blotting results showed that at PND45, compared with the blank group, the expression levels of PcdhαC1 protein in the 10 mg·kg−1, 20 mg·kg−1, and 40 mg·kg−1 groups decreased (P<0.05), and the expression levels of WAPL protein increased (P<0.05). At PND75, compared with the blank group, the expression levels of PcdhαC1 protein in the 10 mg·kg−1, 20 mg·kg−1, and 40 mg·kg−1 groups decreased (P<0.05), and the expression levels of WAPL protein increased (P<0.05). Conclusion Exposure to benzo[a]pyrene during pregnancy can cause impairment in the learning and memory abilities of PND45 offspring and may alter the expression of PcdhαC1 and WAPL genes and proteins.
3.Characteristics of psoriatic arthritis: a cross-sectional study based on a cohort of 530 patients
Jingya GAO ; Yiyi WANG ; Hongxiang HU ; Xiya PENG ; Min YANG ; Lingyan ZHANG ; Jing TANG ; Yue XIAO ; Dan HAO ; Xingli ZHOU ; Wei YAN ; Wei LI
Chinese Journal of Dermatology 2025;58(11):1053-1058
Objective:To investigate disease characteristics of patients with psoriatic arthritis (PsA) based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation.Methods:A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed.Results:A total of 530 PsA patients were included, of whom 332 (62.6%) were males and 198 (37.4%) were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients (85.3%), with time intervals ( M [ Q1, Q3]) of 8.0 (3.0, 15.0) years. Overweight or obesity was observed in 319 patients (60.2%), and 188 (35.5%) had comorbid fatty liver. Peripheral joint involvement was common (485 cases, 91.5%), with the proximal interphalangeal joints being most frequently affected by tenderness (172 cases, 35.5%) and swelling (119 cases, 24.5%) ; the number of enthesitis cases identified by ultrasonography (116 cases, 23.9%) was significantly higher than that by clinical examination (82 cases, 15.5%) ; axial joint involvement was observed in 258 patients (48.7%), with the sacroiliac joints most commonly affected (201 cases, 77.9%). Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 (63.0%), with interleukin-17 inhibitors being the most common (140 cases, 26.4%), followed by tumor necrosis factor-α inhibitors (106 cases, 20.0%) and Janus kinase inhibitors (39 cases, 7.4%) . Conclusions:PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.
4.Characteristics of psoriatic arthritis: a cross-sectional study based on a cohort of 530 patients
Jingya GAO ; Yiyi WANG ; Hongxiang HU ; Xiya PENG ; Min YANG ; Lingyan ZHANG ; Jing TANG ; Yue XIAO ; Dan HAO ; Xingli ZHOU ; Wei YAN ; Wei LI
Chinese Journal of Dermatology 2025;58(11):1053-1058
Objective:To investigate disease characteristics of patients with psoriatic arthritis (PsA) based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation.Methods:A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed.Results:A total of 530 PsA patients were included, of whom 332 (62.6%) were males and 198 (37.4%) were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients (85.3%), with time intervals ( M [ Q1, Q3]) of 8.0 (3.0, 15.0) years. Overweight or obesity was observed in 319 patients (60.2%), and 188 (35.5%) had comorbid fatty liver. Peripheral joint involvement was common (485 cases, 91.5%), with the proximal interphalangeal joints being most frequently affected by tenderness (172 cases, 35.5%) and swelling (119 cases, 24.5%) ; the number of enthesitis cases identified by ultrasonography (116 cases, 23.9%) was significantly higher than that by clinical examination (82 cases, 15.5%) ; axial joint involvement was observed in 258 patients (48.7%), with the sacroiliac joints most commonly affected (201 cases, 77.9%). Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 (63.0%), with interleukin-17 inhibitors being the most common (140 cases, 26.4%), followed by tumor necrosis factor-α inhibitors (106 cases, 20.0%) and Janus kinase inhibitors (39 cases, 7.4%) . Conclusions:PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.
5.Progress in the Diagnosis and Treatment of Steroid-Unrespon-sive Pneumonitis Related to Immune Checkpoint Inhibitors
Xiangran FENG ; Yongfeng GAO ; Xiaofei LAN ; Xianwen SUN ; Jun ZHOU ; Jingya ZHAO ; Zhiyao BAO ; Yi XIANG
China Cancer 2025;34(3):244-250
Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70%~80%of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.
6.Progress in the Diagnosis and Treatment of Steroid-Unrespon-sive Pneumonitis Related to Immune Checkpoint Inhibitors
Xiangran FENG ; Yongfeng GAO ; Xiaofei LAN ; Xianwen SUN ; Jun ZHOU ; Jingya ZHAO ; Zhiyao BAO ; Yi XIANG
China Cancer 2025;34(3):244-250
Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70%~80%of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.
7.O-GlcNAcylation participates in initiation of SHH-type medulloblastoma by regulating Rack1 protein stability
Luo JINGYA ; Gao TANGQING ; Yang MENGMENG ; Yang HAIHONG
Chinese Journal of Clinical Oncology 2025;52(2):55-63
Objective:To investigate the role of O-GlcNAcylation in the regulation of the stability of receptor for activated C kinase 1(Rack1)during SHH-type medulloblastoma(SHH-MB)initiation.Methods:SHH-MB tumors and adjacent tissues were selected from the clinical tu-mor specimen library of the Department of Pathology at The General Hospital of Western Theater Command.Rack1 expression and O-GlcNAcylation(O-GlcNAc)levels in these tumor tissues were analyzed.The human medulloblastoma cell line Daoy was treated with a glyc-osyltransferase(OGT)inhibitor(OSMI-1)and adeglycosyltransferase(OGA)inhibitor(TM-G),and their impact on tumor cell proliferation was assessed using a Cell Counting Kit-8(CCK-8)and immunofluorescence staining.The O-GlcNAc enzyme labeling system co-immunoprecipita-tion(Co-IP)and Western blot were used to correlate Rack1 protein levels with O-GlcNAc levels.The impact of O-GlcNAcon Rack1 stability was confirmed using cycloheximide(CHX)and ubiquitination modification experiments.In a medulloblastoma mouse model with Rack1 knockdown,tumor cell proliferation was detected using a Cell Counting Kit-8(CCK-8),immunofluorescence staining,and a scratch assay.Xenograft tumors were transplanted into immunodeficient mice and SHH signaling was detected by Western blot in the obtained tissue samples(sh-NC and sh-Rack1)to verify the role of Rack1 protein in SHH-MB.Results:Rack1 and O-GlcNAcylation levels were significantly in-creased in SHH-MB tumor samples,and a negative correlation was observed between Rack1 levels and patient survival rates.Treatment of Daoy cells with OGT and TM-G revealed that O-GlcNAc significantly promotes Daoy cell proliferation,while inhibiting O-GlcNAc impedes tu-mor cell proliferation.Molecular experiments have confirmed that O-GlcNAc modification of Rack1 protein can regulate tumor cell stability,thereby promoting tumor cell proliferation.When Rack1 expression was knocked down in Daoy cells,cell proliferation was significantly re-duced relative to control cells.Accordingly,proliferation was significantly inhibited in tumor tissues with Rack1 protein knockdown in mouse models,suggesting that Rack1 can participate in the initiation of SHH-MB by regulating SHH signaling.Conclusions:O-GlcNAcylation particip-ates in SHH-MB initiation by regulating Rack1 stability.
8.Diagnostic evaluation of non-invasive liver fibrosis models and establishment of a new model in chronic hepatitis B patients complicated with nonalcoholic fatty liver disease
Yinghui GAO ; Mingyue DENG ; Ruirui ZHU ; Zhixian GUO ; Jingya YAN ; Xuemeng ZHAO ; Zhiqin LI
Chinese Journal of Digestion 2024;44(10):686-692
Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.
9.Structural Characteristics and Antioxidant Activity Analysis of Polysaccharides from Pinelliae Rhizoma and Its Processed Products Before and After Hydrolysis (Enzymolysis) by Sugar Spectrum
Meibian HU ; Kuixu GAO ; Yao WANG ; Xi PENG ; Jingya WANG ; Xianglong MENG ; Shuosheng ZHANG ; Jianghua LI ; Yujie LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):192-201
ObjectiveThe glycosidic linkage structural characteristics of polysaccharides from Pinelliae Rhizoma(PR) and its processed products were analyzed by sugar spectrum, high performance thin layer chromatography(HPTLC), fluorescence-assisted carbohydrate gel electrophoresis(PACE) based on partial acid hydrolysis and specific glycosidase hydrolysis, and the antioxidant activities of polysaccharides before and after hydrolysis(enzymolysis
10.Diagnostic evaluation of non-invasive liver fibrosis models and establishment of a new model in chronic hepatitis B patients complicated with nonalcoholic fatty liver disease
Yinghui GAO ; Mingyue DENG ; Ruirui ZHU ; Zhixian GUO ; Jingya YAN ; Xuemeng ZHAO ; Zhiqin LI
Chinese Journal of Digestion 2024;44(10):686-692
Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.

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