1.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
2.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
3.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
4.Effect of knockdown of ARHGAP30 on proliferation and apoptosis of Siha cells
Ya-Ting PENG ; Duan LIU ; Jie MENG ; Wen-Chao LI ; Hui-Qi LI ; Hua GUO ; Mei-Lan NIU ; Qiao-Hong QIN
Chinese Pharmacological Bulletin 2024;40(5):847-853
Aim To investigate the changes in the proliferation and apoptosis of Siha cells after knocking down Rho GTPase-activating protein 30(ARHGAP30).Methods After designing specific shARHGAP30 primers and connecting them to the pLKO.1 vector,we transformed them into Escherichia coli competent cells,then co-transfecting them with lentiviral helper plasmids into HEK-293T cells.We collected and filtered cell supernatant to obtain the vi-rus to infect Siha cells.RT-qPCR and Western blot were used to detect knockdown efficiency,as well as changes in the expression of Bax and Bcl-2 after trans-fection.The CCK-8 method was employed to measure the proliferation level of cells after knockdown.Results After successful construction of a lentiviral plasmid with knockdown of the ARHGAP30 gene and establish-ment of stably transfected Siha cells,ARHGAP30 tran-scription and translation(P<0.01)in Siha cells de-creased,Bax/Bcl-2 significantly decreased(P<0.01),indicating decreased apoptosis and increased cell proliferation(P<0.01).Conclusions This study suggests the involvement of ARHGAP30 in the proliferation and apoptosis of Siha cells,and regulating the ARHGAP30 gene may interfere with the occurrence and development of cervical cancer.
5.Research progress in regulatory mechanism and traditional Chinese medicine intervention of circular RNA for coronary atherosclerotic heart disease
Lan-Tian HU ; Xue-Na XIE ; Yu-Ying WANG ; Mei LIU ; Hong-Ai GUO ; Rong YUAN ; Qi-Qi XIN ; Yu MIAO ; Wei-Hong CONG
Chinese Pharmacological Bulletin 2024;40(11):2014-2019
Coronary atherosclerotic heart disease(CHD)is an ischemic cardiovascular condition caused by the narrowing or blockage of the vascular lumen due to coronary atherosclerosis.Clinically,it presents as angina pectoris,heart failure,or sud-den cardiac death,and stands as one of the primary causes of mortality among both urban and rural populations in China.Cir-cRNA,classified as non-coding RNAs,can function as upstream regulatory molecules for miRNA or RNA-binding proteins.They actively participate in various pathological processes associated with CHD,including endothelial cell dysfunction,smooth mus-cle cell migration,macrophage-derived foam cell formation,an-giogenesis,myocardial injury,and repair,as well as post-in-farction heart failure.The expression pattern of these molecules is highly specific to the illness and tissue,indicating their poten-tial as therapeutic targets for disease management and as biomar-kers.Furthermore,they also open up new avenues for drug tar-get development in the field of traditional Chinese medicine.This article aims to provide an overview of the recent research progress on circRNA in the regulation of coronary heart disease,as well as the mechanisms involved in traditional Chinese medi-cine.It serves as a valuable reference for future research on cor-onary heart disease.
6.Construction of a predictive model of death for sepsis-associated acute kidney injury
Xiaohan LI ; Changju ZHU ; Chao LAN ; Qi LIU
Chinese Critical Care Medicine 2024;36(4):381-386
Objective:To establish a predictive model nomogram for 30-day death in patients with sepsis-associated acute kidney injury (SA-AKI) by using the data from the large international database, the Electronic Intensive Care Unit-Collaborative Research Database (eICU-CRD), and to validate its predictive performance.Methods:A retrospective cohort study was conducted using data from the eICU-CRD. Data of SA-AKI patients were screened from the eICU-CRD database, including demographic characteristics, medical history, SA-AKI type, Kidney Disease: Improving Global Outcomes (KDIGO)-AKI staging, severity of illness scores, vital signs, laboratory indicators, and treatment measures; with admission time as the observation start point, death as the outcome event, and a follow-up time of 30 days. Relevant variables of patients with different 30-day prognoses were compared. Univariate Logistic regression analysis and multivariate Logistic regression forward likelihood ratio analysis were used to screen for risk factors associated with 30-day death in SA-AKI patients, and a predictive model nomogram was constructed. Receiver operator characteristic curve (ROC curve), calibration curve, and Hosmer-Lemeshow test were used to validate the predictive performance of the model.Results:A total of 201 SA-AKI patients' data were finally enrolled, among which 51 survived for 30 days and 150 died, with a mortality of 74.63%. Compared with the survival group, patients in the death group were older [years old: 68 (60, 78) vs. 59 (52, 69), P < 0.01], had lower body weight, proportion of transient SA-AKI, platelet count (PLT) and blood glucose [body weight (kg): 79 (65, 95) vs. 91 (71, 127), proportion of transient SA-AKI: 61.33% (92/150) vs. 82.35% (42/51), PLT (×10 9/L): 207 (116, 313) vs. 260 (176, 338), blood glucose (mmol/L): 5.5 (4.4, 7.1) vs. 6.4 (5.1, 7.6), all P < 0.05] and higher proportion of persistent SA-AKI, sequential organ failure assessment (SOFA) score, lactic acid (Lac), and total bilirubin [TBil; proportion of persistent SA-AKI: 38.67% (58/150) vs. 17.65% (9/51), SOFA score: 7 (5, 22) vs. 5 (2, 7), Lac (mmol/L): 0.4 (0.2, 0.7) vs. 0.3 (0.2, 0.4), TBil (μmol/L): 41.0 (17.1, 51.3) vs. 18.8 (17.1, 34.2), all P < 0.05]. Univariate Logistic regression analysis showed that age [odds ratio ( OR) = 1.035, 95% confidence interval (95% CI) was 1.013-1.058, P = 0.002], body weight ( OR = 0.987, 95% CI was 0.977-0.996, P = 0.007), persistent SA-AKI ( OR = 2.942, 95% CI was 1.333-6.491, P = 0.008), SOFA score ( OR = 1.073, 95% CI was 1.020-1.129, P = 0.006), PLT ( OR = 0.998, 95% CI was 0.996-1.000, P = 0.034), Lac ( OR = 1.142, 95% CI was 1.009-1.292, P = 0.035), TBil ( OR = 1.422, 95% CI was 1.070-1.890, P = 0.015) were associated with 30-day death risk in SA-AKI patients. Multivariate Logistic regression forward likelihood ratio analysis showed that age ( OR = 1.051, 95% CI was 1.023-1.079, P = 0.000), body weight ( OR = 0.985, 95% CI was 0.974-0.995, P = 0.005), cardiovascular disease ( OR = 9.055, 95% CI was 1.037-79.084, P = 0.046), persistent SA-AKI ( OR = 3.020, 95% CI was 1.258-7.249, P = 0.013), SOFA score ( OR = 1.076, 95% CI was 1.013-1.143, P = 0.017), and PLT ( OR = 0.997, 95% CI was 0.995-1.000, P = 0.030) were independent risk factors for 30-day death in SA-AKI patients. Based on the above risk factors, a predictive model nomogram for 30-day death in SA-AKI patients was constructed. ROC curve analysis showed that the area under the ROC curve (AUC) of the model was 0.798 (95% CI was 0.722-0.873), with a sensitivity of 86.7% and a specificity of 62.7%. Calibration curve showed that the fitted curve was close to the standard line, indicating that the predicted probability was close to the actual probability, suggesting good predictive performance of the model. Hosmer-Lemeshow test showed χ 2 = 6.393, df = 8, P = 0.603 > 0.05, suggesting that the model could fit the observed data well. The quality of model fitting was judged by the accuracy of model prediction. The results showed that the prediction accuracy rate of the model was 95.3%, and the overall prediction accuracy rate of the model was 81.6%, indicating good model fitting. Conclusion:A predictive model for 30-day death in SA-AKI patients based on risk factors can be successfully constructed, and the model has high accuracy, sensitivity, reliability, and certain specificity, which can help to early identify high-risk patients for death and adopt more proactive treatment strategies.
7.Research progress of fluorescent probes in uric acid detection
Di-Di XING ; Ruo-Jin LIU ; Jia-Yu QI ; Ning MA ; Ya-Kun JI ; Jia-Xin ZHOU ; Yu-Shan XING ; Xiao-Lan ZHEN
Chinese Medical Equipment Journal 2024;45(6):93-104
The advantages of fluorescence detection of uric acid were introduced compared to the traditional detection methods.The preparation process,detection principle and performance of organic,inorganic and organic-inorganic hybrid fluorescent probes were reviewed.The advantages and disadvantages of kinds of fluorescent probes were analyzed when used for uric acid detection,and the futural directions were pointed out for related research.[Chinese Medical Equipment Journal,2024,45(6):93-104]
8.Simulation study of musculoskeletal system of lower limbs based on synergistic effects of stress and electromagnetic fields
Ruo-Bing LIU ; Qi-Lin PEI ; Xi SHAO ; Dan WANG ; Yu-Lan TIAN ; Ze-Dong YAN ; Da JING
Chinese Medical Equipment Journal 2024;45(9):21-26
Objective To apply a COMSOL-based finite element analysis method to investigating the electric field effects produced by the human lower limb musculoskeletal system under the synergistic effects of stress field and electromagnetic field.Methods Firstly,a 3D human body model was constructed by Maxon Cinema 4D R21 software,and then imported into COMSOL 6.1 software in STL format.Secondly,an electromagnetic field intervention and stress loading model for the left lower limb of the human body was designed and constructed,in which 15 Hz quasi-pulse group current signals were used for electromagnetic field excitation and the stress field was realized by applying a vibration load with an average compressive force of about 90 N/cm2 to the left foot of the human body.Finally,the electromagnetic properties of human tissue were simulated by numerical simulation,and then the effects of stress field or elecromagnetic field or combined stress field and electromagnetic field on human bioelectric field were compared.Results Simulation results showed that the electric field intensity peaked at the leg joints under both electromagnetic and stress fields acting alone or synergistically,the bioelectric field intensity generated by the human body was related to the distance from the exogenous excitation loading location,and the electric field generated under synergistic action was equivalent to the linear superposition of the bioelectric field in the tissue induced by the electromagnetic field and the stress field acting alone.Conclusion Data supplement is provided for predicting bioelectric field changes within the musculoskeletal tissue,and theoretical foundation is laid for the development and application of multi-physics field synergistic intervention therapy for treating the disorders of the lower limb musculos-keletal system.[Chinese Medical Equipment Journal,2024,45(9):21-26]
9.Clinical characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis
Jing-Qi LIU ; Yong-Zhen LI ; Lan-Jun SHUAI ; Yan CAO ; Xiao-Yan LI ; Ying WANG ; Tian SHEN ; Shuang-Hong MO ; Xiao-Jie HE ; Xiao-Chuan WU
Chinese Journal of Contemporary Pediatrics 2024;26(8):823-828
Objective To study the clinical characteristics of children with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV).Methods A retrospective analysis was conducted on the clinical data of 25 children diagnosed with AAV at the Second Xiangya Hospital of Central South University from January 2010 to June 2022.Results Among the AAV children,there were 5 males and 20 females,with a median age of onset of 11.0 years.Involvement of the urinary system was seen in 18 cases(72%);respiratory system involvement in 10 cases(40%);skin involvement in 6 cases(24%);eye,ear,and nose involvement in 5 cases(20%);joint involvement in 4 cases(16%);digestive system involvement in 2 cases(8%).Eleven cases underwent kidney biopsy,with 5 cases(46%)showing focal type,2 cases(18%)showing crescentic type,2 cases(18%)showing mixed type,and 2 cases(18%)showing sclerotic type.Immune complex deposits were present in 5 cases(45%).Seven cases reached chronic kidney disease(CKD)stage Ⅴ,with 2 cases resulting in death.Two cases underwent kidney transplantation.At the end of the follow-up period,2 cases were at CKD stage Ⅱ,and 1 case was at CKD stage Ⅲ.Of the 16 cases of microscopic polyangiitis(MPA)group,13(81%)involved the urinary system.Of the 9 cases of granulomatosis with polyangiitis(GPA),6 cases(66%)had sinusitis.Serum creatinine and uric acid levels were higher in the MPA group than in the GPA group(P<0.05),while red blood cell count and glomerular filtration rate were lower in the MPA group(P<0.05).Conclusions AAV is more common in school-age female children,with MPA being the most common clinical subtype.The onset of AAV in children is mainly characterized by renal involvement,followed by respiratory system involvement.The renal pathology often presents as focal type with possible immune complex deposits.Children with MPA often have renal involvement,while those with GPA commonly have sinusitis.The prognosis of children with AAV is poor,often accompanied by renal insufficiency.
10.Meta-analysis on the incidence of long COVID in Omicron-infected pa-tients
Li-Yu WANG ; Shi-Wei WU ; Meng-Qi XU ; Bao-Guang LIU ; Lan-Ying PEI ; Guo-Li YAN ; Guan-Min ZHENG
Chinese Journal of Infection Control 2024;23(11):1384-1390
Objective To explore the incidence of long CO VID symptoms in patients infected with Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods According to the inclusion and exclu-sion criteria of literatures,relevant studies without language restrictions published up to 2024 were retrieved from both Chinese and English databases.The Chinese databases were China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP databases,and the foreign databases were PubMed,Embase,and Web of Science.Three-step screening was used to select literatures,and Stata 17.0 software was used for analysis.Results The incidence of at least one sequelae in patients infected with Omicron variant was 29.62%.The most common symptoms included fatigue(19.10%),joint or muscle pain(11.06%),memory loss(9.71%),brain fog(8.80%),cough(8.42%),headache(7.26%),and sore throat(6.68%).Subgroup analysis results showed that with the extension of follow-up(3 months vs 6 months),the incidence of smell or taste changes was significantly re-duced(7.22%vs 0.78%).The higher the proportion of women(<50%vs 50%-65%vs>65%),the higher the incidence of joint or muscle pain(1.09%vs 4.62%vs 19.53%);the greater the median age(≥45 years vs<45 years),the higher the incidence of chest pain or chest distress(0.90%vs 3.86%),all with statistically significant differences(all P<0.05).Conclusion Incidence of long COVID in Omicron-infected patients is high and can cause various symptoms.Follow-up time,median age and gender proportion have significant impacts on the incidence of some symptoms.

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