1.Research advances in liver venous deprivation
Bensong HE ; Ming XIAO ; Qijia ZHANG ; Canhong XIANG ; Yanxiong WANG ; Yingbo LI ; Zhishuo WANG
Journal of Clinical Hepatology 2025;41(1):183-188
Portal vein embolization (PVE) can induce atrophy of the embolized lobe and compensatory regeneration of the non-embolized lobe. However, due to inadequate regeneration of future liver remnant (FLR) after PVE, some patients remain unsuitable for hepatectomy after PVE. In recent years, liver venous deprivation (LVD), which combines PVE with hepatic vein embolization (HVE), has induced enhanced FLR regeneration. Compared with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), LVD triggers faster and more robust FLR regeneration, with lower incidence rate of postoperative complications and mortality rate. By reviewing related articles on LVD, this article introduces the effectiveness of LVD and analyzes the differences and safety of various technical paths, and it is believed that LVD is a safe and effective preoperative pretreatment method.
2.Patients with chronic hepatitis B under nucleos(t)ide analog therapy with Omicron BA.5 infection:A retrospective study in South China
Peipei WANG ; Junjian CHEN ; Dabiao CHEN ; Ziying LEI ; Zhishuo MO ; Ying ZHANG
Liver Research 2025;9(1):66-73
Background and aims:Clinical data regarding patients with chronic hepatitis B(CHB)after Omicron BA.5 infection are currently limited.This study aimed to assess the clinical characteristics of patients with CHB and Omicron BA.5 infection in South China.Methods:This retrospective study was conducted from January to March 2023 in a cohort of 485 healthy individuals and 553 patients with CHB.Clinical features,encompassing COVID-19-related symptoms,levels of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)antibodies,vaccination status,liver functions,and virological markers of hepatitis B virus(HBV)infection were measured.Results:COVID-19-related symptom patterns were similar in both groups,except for fever,which was notably less prevalent(85.4%vs.90.4%,P=0.047)among patients with CHB who experienced a significantly shorter duration of fever(median 2.2(25th-75th percentile,1.0-3.0)days vs.2.3(1.0-3.0)days,P=0.048)and a shorter time for symptom relief(9.2(5.0-14.0)vs.11.1(5.0-14.0)days,P=0.015).The levels of SARS-CoV-2 antibodies were comparable between the two groups but increased after booster vaccinations.In patients with CHB,globulin(GLB)and hepatitis B envelope antibody levels were significantly increased after Omicron BA.5 infection,regardless of nucleos(t)ide analog regimens comparing entecavir(ETV)with tenofovir(TFV).Patients with CHB treated with TFV had significantly higher levels of SARS-CoV-2 antibodies than those treated with ETV(1065.1(346.9-1188.5)COI vs.765.5(24.5-1119.1)COI,P=0.025).Conclusions:No significant exacerbation of COVID-19 symptoms was observed in conjunction with the efficacy of COVID-19 booster vaccinations.There were no notable alterations in liver functions except for GLB.HBV reactivation,as evidenced by increased HBV DNA,was observed among patients with CHB after Omicron BA.5 infection.These changes were not affected by ETV versus TFV administration;however,TFV resulted in a significant increase in SARS-CoV-2 antibody levels.Further studies are required to improve care and therapeutics for patients with CHB who contracted COVID-19.
3.Thinking and Practice of Clinical Evidence-based Evaluation in TCM with Disease-syndrome Diagnostic System
Tengwen LIU ; Yifan SHI ; Tianyuan WANG ; Qian LIU ; Zhishuo FAN ; Guozhen ZHAO ; Jing HU ; Dong WANG ; Bo LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):127-136
In recent years, there have been both achievements and criticisms in using the methods of evidence-based medicine to evaluate the efficacy of traditional Chinese medicine (TCM), which is mainly due to the differences between TCM and Western medicine. To facilitate the clinical evidence-based evaluation in TCM, this paper analyzes the challenges faced in TCM clinical evaluation, particularly in the diagnosis, clinical intervention, and efficacy assessment methods. Considering the current state of TCM clinical evaluation and our clinical research experience, we believe that establishing and refining the TCM disease-syndrome diagnostic system is a prerequisite for the practice of clinical evidence-based evaluation in TCM. Furthermore, this paper discusses the specific connotation, development, and challenges of the disease-syndrome diagnostic system, especially the choice of TCM disease name or modern medical disease name in this system. Then, the clinical application scenarios are expounded from ''TCM disease name + syndrome differentiation'' and ''Western medicine disease name + syndrome differentiation''. Moreover, this paper proposed solutions for practical issues such as the standardization of disease and syndrome diagnosis, selection of clinical evaluation methods, and application of evidence-based approaches in clinical evaluation. Establishing the criteria for the disease-syndrome diagnostic system is crucial for the determination of clinical intervention regimen, the selection of clinical research methods, and the establishment of evaluation indicators, which are essential for generating high-quality clinical evidence. To sum up, this paper reviews the development and current situation of the disease-syndrome diagnostic system and proposes an exploratory approach for the standardization and application of this system in clinical evidence-based evaluation. This approach aims to facilitate the integration of TCM with modern clinical practice, thereby achieving standardized evaluation of TCM efficacy and deepening the integration of TCM with evidence-based medicine.

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