1.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
2.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
3.Survey on the awareness and clinical application of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians
Yuanyuan KONG ; Yujie GUO ; Yujuan GUAN ; Xuan LIANG ; Zhongjie HU ; Xiaobo LU ; Mingqin LU ; Yongfeng YANG ; Meifang HAN ; Hong YOU ; Zhiyun YANG ; Jidong JIA
Journal of Clinical Hepatology 2025;41(6):1068-1074
ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. MethodsFrom July 19 to December 31, 2024, a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide, including their awareness and practice based on 18 questions regarding testing and referral, diagnosis and treatment, and follow-up. ResultsAmong all respondents, only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B, with an overall awareness rate of 22.0%. Only 20% — 40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy, while 80% — 100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year, 3 years, and 5 years were 67.5% 57.5% and 47.5%,respectively, showing a trend of gradual reduction, which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians, insufficient awareness of the disease among patients, and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection, diagnosis, treatment, and management” for patients with chronic hepatitis B in healthcare institutions, in order to promote the implementation of the guidelines.
4.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
5.Safety and efficacy of mitoxantrone liposome combined chemotherapy in the treatment of mixed phenotype acute leukemia
Huiwen JIANG ; Cong LU ; Jing HE ; Qiuzhe WEI ; Meifang SU ; Yaohui WU ; Junbin HU
Chinese Journal of Hematology 2025;46(1):64-69
Objective:To evaluate the safety and efficacy of mitoxantrone liposome (MIT-LIP) combined chemotherapy in treating mixed phenotype acute leukemia (MPAL) .Methods:December 2021 to November 2024, MPAL patients who underwent the MAED (MIT-LIP + cytarabine + etoposide + dexamethasone) regimen were retrospectively analyzed. Data on clinical characteristics, adverse reactions, therapeutic outcomes, and long-term prognoses were collected.Results:A total of 7 MPAL patients who received MAED regimen were admitted. Among them, two patients were initially diagnosed with T-ALL or B-ALL, respectively, and transformed into AML after treatment. Three patients were initially diagnosed as MPAL (B/myeloid), one as MPAL (T/myeloid), and one with MPAL (myeloid/plasmacytoid dendritic cell). Among the 7 patients, there were 3 males and 4 females, 1 chromosome abnormalities and 6 gene abnormalities, including 1 case with BCR∷ABL fusion gene. The median age was 38 years (range: 16–58 years). There was no clear related drug allergy and organ toxicity during MAED regimen, and the main adverse effect was hematological toxicity. After induced chemotherapy, all patients achieved complete remission (CR), 2 maintained MRD-negative CR and 1 maintained MRD-positive CR. The other 4 patients underwent allogeneic hematopoietic stem cell transplantation, 2 maintained MRD-negative CR, and 2 relapsed. The current median follow-up time was 12 months, the overall survival (OS) rate was 100%, the relapse-free survival (RFS) rate was 60%, and the median OS time and median RFS time were not reached.Conclusion:The MAED regimen demonstrates high safety and a favorable CR rate in MPAL treatment.
6.Multicenter survey on the current status of pediatric life support training
Xin QIAN ; Xiaodi CAI ; Quan WANG ; Meifang LIN ; Qian WANG ; Tingting XUE ; Biru LI ; Quelan HUANG ; Yi WANG ; Yunxia HONG ; Zhixu CHEN ; Guoping LU ; Ye CHENG ; Hongyang HU
Chinese Pediatric Emergency Medicine 2025;32(11):827-831
Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country,covering basic institutional information,training capacity and training faculty,training program funding,as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center,an online questionnaire was distributed,and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey,including 19 children's hospitals,14 general hospitals,6 maternal and child health hospitals,2 women and children’s hospitals,and 1 training institution.The distribution of training centers showed a concentration in coastal areas,with the top three provinces/municipalities being Guangdong(7/42,16.7%),Zhejiang(6/42,14.3%),and Shanghai(4/42,9.5%).As of December 31 2023,the 42 institutions had an annual basic life support(BLS)training volume of 8 587 individuals,the median was 120 (100,200),and an annual pediatric advanced life support(PALS)training volume of 2 448 individuals,the median was 30 (20,50).Among the 42 institutions,there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions,24(24/42,57.1%)reported BLS instructor teams comprising fewer than 10 members,and 33(33/42,78.6%)reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%)reported having dedicated funding support.The top three challenges were:training sessions occupying instructors’personal time(27/42,64.3%),low instructor compensation(16/42,38.1%),and issues with the data submission system(16/42,38.1%).Conclusion:Pediatric life support training centers in China are primarily children’s hospitals,with a geographical concentration in coastal areas,which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity,with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.
7.The impact of smart healthcare-based full-cycle healthcare management on patients with mitral regurgitation undergoing TEER
Meifang DAI ; Ran LIU ; Ruoyun LIU ; Yang LI ; Yutong KE ; Jing HE ; Chunli LIU ; Zhinan LU ; Li ZHAO ; Guangyuan SONG ; Chengqian YIN
Chinese Journal of Cardiology 2025;53(8):913-921
Objective:To explore the advantages of internet-based smart healthcare for full-cycle transcatheter edge-to-edge repair (TEER) management in reducing postoperative adverse events rate, improving cardiac function, and enhancing quality of life.Methods:This retrospective study enrolled patients with mitral regurgitation who underwent transcatheter TEER at Beijing Anzhen Hospital Valve Intervention Center between June 2021 and September 2023. Patients were classified into degeneration mitral regurgitation (DMR) and functional mitral regurgitation (FMR) according to etiology, with further stratification by enrollment period into usual care group (June 2021 to October 2022) and full-cycle management group (November 2022 to September 2023). The 1-year postoperative follow-up data were collected and compared between subgroups with the same etiology. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare the differences in major endpoint event-free survival rates between the two groups. Univariate and multivariate Cox regression and logistic regression analyses were performed to evaluate the impact of the full-cycle management system on patients′ outcomes.Results:A total of 130 patients were included, aged (72.0±8.6) years, including 82 (63%) males. DMR was identified in 84 cases (40 in the usual care group and 44 in the full-cycle management group), while FMR was observed in 46 cases (27 in the usual care group and 19 in the full-cycle management group). Kaplan-Meier analysis demonstrated higher 1-year major endpoint event-free survival rates in the full-cycle management group compared to the usual care group, though the difference was not statistically significant (log-rank P>0.05). Compared to the usual care group, the full-cycle management group showed significantly higher proportions of New York Heart Association classification Ⅰ-Ⅱ patients (DMR: 67% vs. 52%, P=0.031; FMR: 68% vs. 52%, P=0.021), greater 6-minute walking distances (DMR: (346.39±70.41) m vs. (294.11±60.47) m, P=0.012; FMR: (356.60±54.68) m vs. (318.55±39.02) m, P=0.004), and superior Kansas City Cardiomyopathy Questionnaire scores (DMR: 81.50 (74.50, 85.00) points vs. 71.00 (66.00, 82.25) points, P=0.014; FMR: 83.00 (76.00, 85.00) points vs. 74.00 (70.75, 80.00) points, P=0.030). Multivariate logistic regression confirmed the full-cycle management system as an independent predictor for the above improved outcomes (all P<0.05). Conclusion:Smart healthcare-based full-cycle management improves cardiac function and quality of life in mitral regurgitation patients after TEER, demonstrating lower rates of major endpoint events compared to usual care.
8.Safety and efficacy of mitoxantrone liposome combined chemotherapy in the treatment of mixed phenotype acute leukemia
Huiwen JIANG ; Cong LU ; Jing HE ; Qiuzhe WEI ; Meifang SU ; Yaohui WU ; Junbin HU
Chinese Journal of Hematology 2025;46(1):64-69
Objective:To evaluate the safety and efficacy of mitoxantrone liposome (MIT-LIP) combined chemotherapy in treating mixed phenotype acute leukemia (MPAL) .Methods:December 2021 to November 2024, MPAL patients who underwent the MAED (MIT-LIP + cytarabine + etoposide + dexamethasone) regimen were retrospectively analyzed. Data on clinical characteristics, adverse reactions, therapeutic outcomes, and long-term prognoses were collected.Results:A total of 7 MPAL patients who received MAED regimen were admitted. Among them, two patients were initially diagnosed with T-ALL or B-ALL, respectively, and transformed into AML after treatment. Three patients were initially diagnosed as MPAL (B/myeloid), one as MPAL (T/myeloid), and one with MPAL (myeloid/plasmacytoid dendritic cell). Among the 7 patients, there were 3 males and 4 females, 1 chromosome abnormalities and 6 gene abnormalities, including 1 case with BCR∷ABL fusion gene. The median age was 38 years (range: 16–58 years). There was no clear related drug allergy and organ toxicity during MAED regimen, and the main adverse effect was hematological toxicity. After induced chemotherapy, all patients achieved complete remission (CR), 2 maintained MRD-negative CR and 1 maintained MRD-positive CR. The other 4 patients underwent allogeneic hematopoietic stem cell transplantation, 2 maintained MRD-negative CR, and 2 relapsed. The current median follow-up time was 12 months, the overall survival (OS) rate was 100%, the relapse-free survival (RFS) rate was 60%, and the median OS time and median RFS time were not reached.Conclusion:The MAED regimen demonstrates high safety and a favorable CR rate in MPAL treatment.
9.Multicenter survey on the current status of pediatric life support training
Xin QIAN ; Xiaodi CAI ; Quan WANG ; Meifang LIN ; Qian WANG ; Tingting XUE ; Biru LI ; Quelan HUANG ; Yi WANG ; Yunxia HONG ; Zhixu CHEN ; Guoping LU ; Ye CHENG ; Hongyang HU
Chinese Pediatric Emergency Medicine 2025;32(11):827-831
Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country,covering basic institutional information,training capacity and training faculty,training program funding,as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center,an online questionnaire was distributed,and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey,including 19 children's hospitals,14 general hospitals,6 maternal and child health hospitals,2 women and children’s hospitals,and 1 training institution.The distribution of training centers showed a concentration in coastal areas,with the top three provinces/municipalities being Guangdong(7/42,16.7%),Zhejiang(6/42,14.3%),and Shanghai(4/42,9.5%).As of December 31 2023,the 42 institutions had an annual basic life support(BLS)training volume of 8 587 individuals,the median was 120 (100,200),and an annual pediatric advanced life support(PALS)training volume of 2 448 individuals,the median was 30 (20,50).Among the 42 institutions,there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions,24(24/42,57.1%)reported BLS instructor teams comprising fewer than 10 members,and 33(33/42,78.6%)reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%)reported having dedicated funding support.The top three challenges were:training sessions occupying instructors’personal time(27/42,64.3%),low instructor compensation(16/42,38.1%),and issues with the data submission system(16/42,38.1%).Conclusion:Pediatric life support training centers in China are primarily children’s hospitals,with a geographical concentration in coastal areas,which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity,with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.
10.The impact of smart healthcare-based full-cycle healthcare management on patients with mitral regurgitation undergoing TEER
Meifang DAI ; Ran LIU ; Ruoyun LIU ; Yang LI ; Yutong KE ; Jing HE ; Chunli LIU ; Zhinan LU ; Li ZHAO ; Guangyuan SONG ; Chengqian YIN
Chinese Journal of Cardiology 2025;53(8):913-921
Objective:To explore the advantages of internet-based smart healthcare for full-cycle transcatheter edge-to-edge repair (TEER) management in reducing postoperative adverse events rate, improving cardiac function, and enhancing quality of life.Methods:This retrospective study enrolled patients with mitral regurgitation who underwent transcatheter TEER at Beijing Anzhen Hospital Valve Intervention Center between June 2021 and September 2023. Patients were classified into degeneration mitral regurgitation (DMR) and functional mitral regurgitation (FMR) according to etiology, with further stratification by enrollment period into usual care group (June 2021 to October 2022) and full-cycle management group (November 2022 to September 2023). The 1-year postoperative follow-up data were collected and compared between subgroups with the same etiology. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare the differences in major endpoint event-free survival rates between the two groups. Univariate and multivariate Cox regression and logistic regression analyses were performed to evaluate the impact of the full-cycle management system on patients′ outcomes.Results:A total of 130 patients were included, aged (72.0±8.6) years, including 82 (63%) males. DMR was identified in 84 cases (40 in the usual care group and 44 in the full-cycle management group), while FMR was observed in 46 cases (27 in the usual care group and 19 in the full-cycle management group). Kaplan-Meier analysis demonstrated higher 1-year major endpoint event-free survival rates in the full-cycle management group compared to the usual care group, though the difference was not statistically significant (log-rank P>0.05). Compared to the usual care group, the full-cycle management group showed significantly higher proportions of New York Heart Association classification Ⅰ-Ⅱ patients (DMR: 67% vs. 52%, P=0.031; FMR: 68% vs. 52%, P=0.021), greater 6-minute walking distances (DMR: (346.39±70.41) m vs. (294.11±60.47) m, P=0.012; FMR: (356.60±54.68) m vs. (318.55±39.02) m, P=0.004), and superior Kansas City Cardiomyopathy Questionnaire scores (DMR: 81.50 (74.50, 85.00) points vs. 71.00 (66.00, 82.25) points, P=0.014; FMR: 83.00 (76.00, 85.00) points vs. 74.00 (70.75, 80.00) points, P=0.030). Multivariate logistic regression confirmed the full-cycle management system as an independent predictor for the above improved outcomes (all P<0.05). Conclusion:Smart healthcare-based full-cycle management improves cardiac function and quality of life in mitral regurgitation patients after TEER, demonstrating lower rates of major endpoint events compared to usual care.

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