1.Dissecting antibody-mediated natural killer cell effects reveals a cytotoxic CX3CR1+KLRC2–CD16hi subset linked to hepatitis B virus outcomes
Libo TANG ; Yuhao WANG ; Zihan JIN ; Yurong GU ; Zhaofeng ZENG ; Linnan SONG ; Xuan YI ; Lingtao ZHANG ; Yujing ZHANG ; Weiying HE ; Liping WANG ; Weixin HE ; Jianru SUN ; Xiaoqin LAN ; Xiangyong LI ; Shihong ZHONG ; Yongyin LI
Clinical and Molecular Hepatology 2026;32(2):683-705
Background/Aims:
Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment.
Methods:
A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets.
Results:
The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals.
Conclusions
Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.
2.Analysis of the development course and trends of pharmacovigilance in China
Hongling LI ; Yurong ZHANG ; Zhengbi QIN ; Mingjie ZHENG ; Li ZHAO
China Pharmacy 2026;37(17):2327-2331
Pharmacovigilance runs through the whole life cycle of drugs. This paper systematically sorts out the development course of pharmacovigilance in China, from the initial establishment of the adverse drug reaction reporting system to the gradual construction of a complete pharmacovigilance system aligned with international standards. It focuses on analyzing the evolutionary features of the organizational system, legal system and monitoring system during this process. On this basis, this paper further discusses the future development trends of pharmacovigilance in China. In general, remarkable progress has been achieved in both regulatory construction and practical implementation of China’s pharmacovigilance system. In the future, efforts should be continuously made to improve the pharmacovigilance system, such as accelerating the implementation of the “one-body with two-wings” working framework and strengthening the primary responsibility of marketing authorization holders. It is also necessary to cultivate and reserve professional talents and promote information-based construction, including optimizing the spontaneous reporting system and establishing active monitoring systems. These measures can provide more solid support for ensuring public drug safety and facilitating high-quality development of the pharmaceutical industry.
3.Huashi Baidu Granules Treat Influenza Viral Pneumonia by Regulating Gut-Lung Axis
Qijing LI ; Hanhui HUANG ; Yurong DENG ; Ao'ao WANG ; Jianliang LI ; Jianhui SUN ; Liyu HAO ; Zongyuan LI ; Guimin LIU ; Hongmei LI ; Luqi HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):59-69
ObjectiveTo explore the mechanism of Huashi Baidu granules in treating influenza A (H1N1) virus infection based on the gut-lung axis. MethodsBALB/c mice were randomly assigned into a blank control group, a model control group, a positive control (oseltamivir phosphate capsules, 19.5 mg·kg-1) group, and a Huashi Baidu granules (17.81 g·kg-1) group. Mice in other groups except the blank control group were instilled nasally by H1N1 viral fluid for the modeling of influenza viral pneumonia and treated with corresponding drugs once daily by gavage for 5 consecutive days. The mouse lung index was calculated, and pathological changes in the lung and colon tissue were observed. Western blot was employed to quantify the expression levels of nucleotide-binding oligomeric domain-like receptor protein 3 (NLRP3), cysteinyl aspartate-specific proteinase -1 (Caspase-1), apoptosis-associated Speck-like protein containing a CARD (ASC), gasdermin D (GSDMD), interleukin-18 (IL-18), IL-1β, and colonic tight junction protein 1 (CLDN1), and Occludin in the lung and colon tissue. Non-targeted metabolomics was employed to analyze the metabolic profiles of the lung tissue and intestinal contents. The 16S rRNA sequencing was performed to analyze the gut microbiota structure in intestinal contents. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the 5-hydroxytryptamine (5-HT) levels in the serum, lung tissue, and colon tissue. ResultsCompared with the blank control group, the model control group showed elevated lung index, marked inflammatory cell infiltration and alveolar structural destruction in the lung tissue, obvious inflammatory cell infiltration and mucosal epithelial damage in the colon tissue, upregulated protein levels of NLRP3 inflammasome pathway proteins NLRP3, Caspase-1, GSDMD, IL-1β, and IL-18 in the lung and colon tissue (P<0.05, P<0.01), downregulated protein levels of CLDN1 and Occludin in the colon tissue (P<0.05, P<0.01). Compared with the model control group, Huashi Baidu Granules reduced the lung index (P<0.01), alleviated pathological damage in the lungs and colon, inhibited the expression of NLRP3, Caspase-1, GSDMD, IL-1β, and IL-18 in lung and colon tissue (P<0.05, P<0.01), and upregulated the expression of CLDN1 and Occludin in the colon tissue (P<0.05, P<0.01). Metabolomics analysis showed that Huashi Baidu Granules downregulated the 5-HT pathway and arachidonic acid metabolism pathway in the lung and colon tissue, while upregulating nucleotide metabolism and TCA cycle. Compared with the blank control group, the model control group exhibited elevated levels of 5-HT in the serum, lung tissue, and colon tissue (P<0.01). The intervention with Huashi Baidu Granules lowered the levels of 5-HT in the serum (P<0.05) and the lung and colon tissue (P<0.01). Huashi Baidu Granules increased the diversity of gut microbiota, enriched beneficial bacteria such as Blautia, and inhibited pathogenic bacteria such as Desulfovibrio. ConclusionHuashi Baidu Granules significantly alleviate lung inflammation and pathological damage in mice infected with influenza A (H1N1) virus, reshape the intestinal microecology, and repair the intestinal barrier. It may exert cross-organ regulation by inhibiting the cascade of "gutogenic 5-HT release-circulatory transport-pulmonary 5-HT receptor activation-NLRP3 inflammasome assembly." It exerts therapeutic effects on influenza viral pneumonia through the gut-lung axis. This study provides a modern biological interpretation for the TCM theories of interior-exterior relationship between the lung and large intestine and simultaneous treatment of the lung and intestine.
4.Trend in incidence of colorectal cancer in Xiaoshan District from 2010 to 2024
LI Yurong ; WANG Dongfei ; GAO Yuanyuan ; JIANG Yuanyuan ; LIN Junying ; XIAO Duanduan
Journal of Preventive Medicine 2025;37(9):927-931,936
Objective:
To analyze the incidence trend of colorectal cancer in Xiaoshan District, Hangzhou City from 2010 to 2024, and predict the incidence of colorectal cancer from 2025 to 2027, so as to provide the evidence for improving the prevention and control strategies of colorectal cancer.
Methods:
Colorectal cancer incidence data from 2010 to 2024 in Xiaoshan District were collected through the Hangzhou Municipal Chronic Disease Monitoring Management System. The crude incidence of colorectal cancer was calculated, and standardized using the data from the Sixth National Population Census in 2010 (Chinese standardized rate) and the Segi's world standard population (world standardized rate). The trend of colorectal cancer incidence from 2010 to 2024 was analyzed using the average annual percent change (AAPC). An exponential smoothing state space model with trigonometric seasonality, box-cox transformation, ARMA errors, trend and seasonal components (TBATS) was established to forecast the crude incidence of colorectal cancer from 2025 to 2027.
Results:
There were 10 726 new cases of colorectal cancer in Xiaoshan District from 2010 to 2024. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer were 59.25/100 000, 38.62/100 000 and 29.50/100 000, respectively. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer in males were 70.56/100 000, 44.44/100 000and 35.58/100 000, respectively, while those in females were 48.37/100 000, 32.69/100 000 and 23.70/100 000, respectively. The Chinese standardized rate of colorectal cancer was significantly higher in males than in females (P<0.05). The crude incidence of colorectal cancer in males, females and the whole population showed upward trends from 2010 to 2024 (AAPC=4.916%, 3.795% and 4.442%, all P<0.05). The crude incidence of colorectal cancer in the groups of 0-<35, 35-<50, 50-<75 and ≥75 years were 1.75/100 000, 19.86/100 000, 112.28/100 000 and 272.99/100 000, respectively, showing an increasing trend with age (P<0.05). From 2010 to 2024, the crude incidence of colorectal cancer in the ≥75 years group showed an increasing trend (AAPC=4.470%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). TBATS model demonstrated good fitting (predictive) performance, indicating a year-by-year increase in the crude incidence of colorectal cancer across the whole population from 2025 to 2027, with an estimated rate reaching 70.45/100 000 in 2027.
Conclusions
The crude incidence of colorectal cancer in Xiaoshan District showed an increasing trend from 2010 to 2024, and it is predicted to continue to increase from 2025 to 2027. Males and the elderly are the key populations for colorectal cancer prevention and control.
5.Identification of the sugarcane β-1,3-glucanase gene family and analysis of their expression under various stress conditions.
Tingchen HUANG ; Yifei XIA ; Yurong LUO ; Shoujian ZANG ; Yan CHEN ; Qinghong LIU ; Yingying LI ; Yue ZHANG ; Wenyue ZHANG ; Yachun SU ; Chuihuai YOU
Chinese Journal of Biotechnology 2025;41(7):2913-2933
Sugarcane (Saccharum spp.) is an important sugar crop. Biotic and abiotic stresses such as diseases, cold, and drought are major factors limiting sugarcane production. β-1,3-glucanase (EC 3.2.1.39), a member of the pathogenesis-related protein family, plays an essential role not only in the plant defenses against pathogens but also in plant growth, development, and abiotic stress responses. To systematically investigate the sugarcane β-1,3-glucanase gene family, 132 glycoside hydrolase (GH) 17 family members were identified in the genomes of the sugarcane wild species Saccharum spontaneum 'Np-X', the tropical species S. officinarum 'LA-Purple', and the Saccharum spp. hybrid cultivar 'R570'. The results of the phylogenetic analysis categorized them into four subfamilies, of which subfamily Ⅳ had the largest proportion of members (102). The members of the sugarcane GH17 gene family contained five conserved motifs and 0-16 introns. The majority of the GH17 genes exhibited a genome-wide replication pattern, with 89.50% originating from S. spontaneum 'Np-X' and S. officinarum 'LA-Purple', while 58.10% of them in the Saccharum spp. hybrid cultivar 'R570' belonged to the discrete replication type. Four major classes of cis-acting elements were identified in the promoters, including the elements related to plant growth, development, and tissue-specific expression (14.21%), light-responsive elements (38.24%), biotic or abiotic stress-responsive elements (9.18%), and hormone-responsive elements (38.37%), which suggested that this gene family was involved in plant growth, development, hormone responses, and stress responses. Transcriptome and quantitative real-time PCR (RT-qPCR) analyses showed that the sugarcane GH17 genes exhibited tissue-specific expression and were differentially expressed under low temperature, drought, and hormone treatments, as well as during the interactions between different sugarcane genotypes and Sporisorium scitamineum, suggesting their potential roles in plant defenses. In addition, some SsGlu genes (SsGlu5, SsGlu20, SsGlu21, SsGlu25, SsGlu28, and SsGlu39) were expected to serve as candidate stress-related genes. This study lays a foundation for further revealing the molecular mechanisms of the stress resistance of sugarcane via β-1,3-glucanase genes.
Saccharum/physiology*
;
Stress, Physiological/genetics*
;
Glucan 1,3-beta-Glucosidase/metabolism*
;
Multigene Family
;
Phylogeny
;
Gene Expression Regulation, Plant
;
Plant Proteins/genetics*
6.CD69 Expression is Negatively Associated With T-Cell Immunity and Predicts Antiviral Therapy Response in Chronic Hepatitis B
Yurong GU ; Yanhua BI ; Zexuan HUANG ; Chunhong LIAO ; Xiaoyan LI ; Hao HU ; Huaping XIE ; Yuehua HUANG
Annals of Laboratory Medicine 2025;45(2):185-198
Background:
The function of CD69 expressed on T cells in chronic hepatitis B (CHB) remains unclear. We aimed to elucidate the roles of CD69 on T cells in the disease process and in antiviral therapy for CHB.
Methods:
We enrolled 335 treatment-naive patients with CHB and 93 patients with CHB on antiviral therapy. CD69, antiviral cytokine production by T cells, T-helper (Th) cells, and inhibitory molecules of T cells were measured using flow cytometry, and clinical-virological characteristics were examined dynamically during antiviral therapy.
Results:
CD69 expression on CD3+, CD4+, and CD8+ T cells was the lowest in the immune-active phase and was negatively correlated with liver transaminase activity, fibrosis features, inflammatory cytokine production by T cells, and Th-cell frequencies but positively with inhibitory molecules on T cells. CD69 expression on CD3+, CD4+, and CD8+ T cells decreased after 48 weeks of antiviral therapy, and patients with hepatitis B e antigen (HBeAg) seroconversion in week 48 showed lower CD69 expression on T cells at baseline and week 48. The area under the ROC curve of CD69 expression on T cells at baseline for predicting HBeAg seroconversion in week 48 was 0.870, the sensitivity was 0.909, and the specificity was 0.714 (P = 0.002).
Conclusions
CD69 negatively regulates T-cell immunity during CHB, and its expression decreases with antiviral therapy. CD69 expression predicts HBeAg seroconversion in week 48. CD69 may play an important negative role in regulating T cells and affect the efficacy of antiviral therapy.
7.The incidence and mortality trend of breast cancer among women with registered residence in Xiaoshan District of Hangzhou City in Zhejiang Province from 2014 to 2023
Junying LIN ; Yuanyuan GAO ; Dongfei WANG ; Yurong LI
Shanghai Journal of Preventive Medicine 2025;37(12):998-1002
ObjectiveTo analyze the trend of incidence, mortality rate and survival rate of breast cancer among women with registered residence in Xiaoshan District of Hangzhou City in Zhejiang Province from 2014 to 2023, and to provide a basis for improving breast cancer prevention and control strategies. MethodsData on the incidence and mortality of breast cancer among women with registered residence in Xiaoshan District from 2014 to 2023 were collected through Zhejiang Chronic Disease Monitoring and Management System. The crude incidence and mortality rate, as well as the age-standardized incidence and mortality rate using both the 2000 Chinese standard population (abbreviated as “Chinese ASR”) and Segi’s 1960 world standard population (“world ASR”) were calculated. Joinpoint model was employed to analyze the trends in incidence and mortality rate, while R software (version 4.1.1) was used to analyze the 5-year relative survival rate to assess the survival status of breast cancer patients. ResultsFrom 2014 to 2023, the crude incidence rate, the Chinese age-standardized incidence rate (ASIRC) and the world age-standardized incidence rate (ASIRW) of breast cancer among women with registered residence in Xiaoshan District were from 70.00/100 000 to 128.35/100 000, from 52.92/100 000 to 94.29/100 000, and from 40.82/100 000 to 72.07/100 000, respectively, with the corresponding average annual percentage changes (AAPC) of 5.80%, 4.63% and 4.71%, respectively, showing a significant increasing trend over the decade (all P<0.05). The incidence rate of breast cancer among people aged 30‒<40 years old or 50‒<75 years old exhibited a significant increase trend from 2014 to 2023 (all P<0.05). The crude mortality rate of breast cancer in female was from 7.75/100 000 to 12.34/100 000, the ASMRC of breast cancer in female was from 4.62/100 000 to 7.53/100 000, and the ASMRW of breast cancer in female was from 3.58/100 000 to 5.71/100 000, and the AAPC had no statistically significance. However, the mortality rate of breast cancer was increased with age (P<0.001). The 5-year age-standardized relative survival rate of breast cancer in female in Xiaoshan District was significantly higher in the 2016‒2018 period (94.46%) compared to the 2013‒2015 period (91.02%) (P<0.05). ConclusionFrom 2014 to 2023, the annual incidence of breast cancer among women with registered residence in Xiaoshan District of Hangzhou City in Zhejiang Province showed an increasing trend, while the change in mortality rate was not statistically significant. The 5-year survival rate of breast cancer in female was at a high level, indicating notable achievements in comprehensive prevention and control efforts. It is essential to continue to strengthen public awareness campaigns for breast cancer prevention and control, control breast cancer risk factors, actively carry out early diagnosis and treatment of breast cancer among target groups, and improve the quality of life for breast cancer patients.
8.Trends in incidence and mortality of acute myocardial infarction in Xiaoshan District, Hangzhou City from 2017 to 2023
Yuanyuan GAO ; Fenjuan WANG ; Dongfei WANG ; Yurong LI ; Yuanyuan JIANG ; Fangfang ZHAO ; Duanduan XIAO ; Junying LIN
Shanghai Journal of Preventive Medicine 2025;37(3):249-254
ObjectiveTo analyze the incidence rate and mortality of acute myocardial infarction (AMI) and their changing trends among the registered residents in Xiaoshan District, Hangzhou City from 2017 to 2023, so as to provide references for formulating policies related to AMI prevention. MethodsThe morbidity and mortality data of AMI among the registered residents in Xiaoshan District from 2017 to 2023 were collected through the Hangzhou Chronic Disease and Death Cause Monitoring System. Software such as Excel 2019, SPSS 25.0 and Joinpoint 4.9.1.0 were used to calculate the incidence rate, mortality, and average annual percentage change (AAPC) of AMI. ResultsFrom 2017 to 2023, the average annual crude incidence rate, age-standardized incidence rate using China standard population (ASIRC), and the age-standardized incidence rate using World standard population (ASIRW) of AMI in Xiaoshan District were 48.25/100 000, 29.14/100 000, and 21.64/100 000, respectively, and, from which the AAPCs were 5.495%, 6.010%, and 6.533%, respectively, all showing an upward trend. The average annual crude mortality rate, the age-standardized mortality rate using China standard population (ASMRC), and the age-standardized mortality rate using World standard population (ASMRW) were 11.76/100 000, 6.52/100 000, and 4.71/100 000, respectively, from which the AAPCs were -9.669%, -10.433% and -9.615%, respectively, all showing a downward trend. The average annual crude incidence rate of AMI was higher in males (65.87/100 000) than that in females (31.31/100 000). Moreover, the average annual crude mortality rate of AMI was higher in males (14.08/100 000) than that in females (9.52/100 000), and the difference was statistically significant (all P<0.001) .After age grouping, the crude incidence rate of AMI among the residents aged 35-, 45-, 55-, and 65- years in Xiaoshan District from 2017 to 2023 showed an upward trend over time, with AAPCs of 16.993%, 17.149%, 8.523%, and 5.002%, respectively. While the crude mortality rate in residents aged 35-, 75-, and 85-102 years showed an decreasing trend over time, with AAPCs of -23.977%, -15.467%, and -17.415%, respectively, but there was no statistically significant difference in the trends in incidence rate and mortality of other age groups (all P>0.05). ConclusionThe situation of AMI prevention and control among the registered residents in Xiaoshan District is not optimistic, and targeted measures should be strengthened for the male residents aged ≥35 years old.
9.Prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome
Jie LI ; Yurong MA ; Wanjun HU ; Na HAN ; Songhong YUE ; Tiejun GAN ; Guangyao LIU ; Shuai YUAN ; Jing ZHANG
Chinese Journal of Medical Imaging Technology 2025;41(10):1641-1645
Objective To investigate the value of prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome(OTCS).Methods A total of 67 children with suspected tethered cord syndrome(TCS)and confirmed OTCS by surgery were prospectively enrolled as OTCS group,while 73 healthy subjects were recruited as control group.Supine-and prone-position lumbar MR examinations were performed in both groups.The position of filum terminale on prone axial T2WI and the presence or absence of"sunset sign"(i.e.filum terminale located within the dorsal 1/2 of spinal canal on prone axial T2WI)were observed,spinal cord conus mobility was calculated.The efficacy of"sunset sign"for diagnosing OTCS in children was calculated through comparison between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of spinal cord conus mobility.Results On prone-position axial T2WI,"sunset sign"was found in 58 cases(58/67,86.57%)but not in 9 cases(9/67,13.43%)in OTCS group,which was not even observed in control group.The sensitivity of"sunset sign"for diagnosing pediatric OTCS was 86.57%(58/67),with specificity of 100%(73/73),positive predictive value of 100%(58/58)and negative predictive value of 89.02%(73/82).The spinal cord conus mobility was(19.30±5.89)%in OTCS group and(31.71±6.58)%in control group,being statistically different between groups(t=-11.722,P<0.001).The sensitivity,specificity and AUC of spinal cord conus mobility for diagnosing pediatric OTCS was 80.60%,90.41%and 0.920,respectively.Conclusion Prone-position MRI of lumbar spine could be used in diagnosing pediatric OTCS.
10.Characteristics and risk factors of portal hypertensive colopathy in patients with liver cirrhosis
Zhihui DUAN ; Shubo CHEN ; Tianyou SUN ; Yabing LIU ; Xiaolin JI ; Zheng QI ; Yurong MA ; Cuiping HAN ; Hui LI
Chinese Journal of General Surgery 2025;34(7):1421-1429
Background and Aims:Portal hypertensive colopathy(PHC)is a common complication of portal hypertension in patients with liver cirrhosis.It may lead to gastrointestinal bleeding,yet its underlying pathogenesis remains unclear,and systematic research in China is limited.This study aimed to analyze the colonoscopic features in cirrhotic patients and to explore their associations with relevant clinical factors.Methods:A retrospective analysis was conducted on 99 cirrhotic patients who underwent colonoscopy at Xingtai People's Hospital between July 2020 and December 2024.Colonoscopy,gastroscopy,and clinical data were reviewed.Differences between patients with PHC and those without were compared in terms of sex,Child-Pugh classification,platelet count,presence of ascites,and hepatic encephalopathy.Multivariate logistic regression was used to identify independent risk factors for PHC.Additionally,colorectal lesion detection rates were compared with those of a contemporaneous cohort of 444 participants undergoing national colorectal cancer(CRC)screening at the same center.Results:Among the 105 patients with cirrhosis,the detection rates of PHC,adenomatous polyps,and CRC were 32.32%,28.28%,and 3.03%,respectively,while only 37.37%had no abnormal findings.No serious colonoscopy-related complications were observed.The proportion of males in the PHC group was significantly higher than in the non-PHC group(78.13%vs.50.75%,P=0.009).The PHC group also showed significantly higher rates of Child-Pugh class B/C,and lower platelet count(all P<0.05).There was no statistically significant difference in the incidence of ascites and hepatic encephalopathy between the two groups(P>0.05).Multivariate analysis identified that male gender(OR=3.307,95%CI=1.219-8.971)and Child-Pugh class B/C(OR=2.867,95%CI=1.046-7.861)were independent risk factors for PHC.Compared to the CRC screening cohort,cirrhotic patients had a similar adenoma detection rate(28.28%vs.25.00%,P=0.499),and a slightly higher colorectal cancer detection rate that did not reach statistical significance(3.03%vs.0.68%,P=0.135).Conclusion:Colonoscopy revealed a high rate of abnormalities in cirrhotic patients,with PHC and adenomatous polyps being the most common findings.Routine colonoscopy is recommended for cirrhotic patients without contraindications,especially males,and patients with Child-Pugh class B/C,to facilitate early detection of PHC and precancerous lesions,thereby reducing the risk of lower gastrointestinal bleeding and missed diagnoses of malignancy.


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