1.Construction of gene recombinant IgG1 κ anti-P plasmids and their expression in HEK293T Cells
Zhonghui GUO ; Jiamin ZHANG ; Xinyi ZHU ; Ying YANG ; Ziyan ZHU
Chinese Journal of Blood Transfusion 2026;39(3):317-322
Objective: To construct gene recombinant expression plasmids of human anti-P antibody with IgG1 and kappa chain based on the human hybridoma cell line. Methods: Starting from the specific RT-PCR products encoding the variable regions of the IgH chain and IgL chain of the anti-P monoclonal cell line, appropriate restriction enzyme digestion sites were introduced at both ends of the VH and VL fragments through nested PCR. The plasmids carrying the antibody constant region and the nested PCR products of VH and VL were ligated by the action of T4 ligase and subsequently transferred into competent E. coli DH5ɑ, and positive clones were selected in the antibiotic resistant LB medium. After sequence confirmation, recombinant plasmids DNA were transfected into HEK293T cells, and the recombinant antibody obtained in the culture supernatant. The characteristics of recombinant expression antibodies were determined by using rapid antibody isotying kit, serological agglutination tests and flow cytometry. Results: Recombinant gene expression vectors, pFUSEss-CHIg-hG1+VH, pFUSE2ss-CLIg-hκ+VL, were successfully constructed. Human IgG1 kappa light chain antibodies were detected in the supernatant of HEK293T cells transient transfected with recombinant plasmids. After the supernatant was ultra-filtered and concentrated, it could cause agglutination reactions with P antigen-positive red blood cells. The mean fluorescence intensity (MFI) of the reaction between recombinant antibodies and antigen-positive red blood cells in flow cytometry experiments was higher than that of antigen-negative red blood cells. Conclusion: The experimental study on the conversion of red blood group antibody types by genetic engineering technology represents a beneficial exploration towards establishing a feasible technical route for the development of genetic recombination and modification of antibodies reagent.
2.Empirical study of input, output, outcome and impact of community-based rehabilitation stations
Xiayao CHEN ; Ying DONG ; Xue DONG ; Zhongxiang MI ; Jun CHENG ; Aimin ZHANG ; Didi LU ; Jun WANG ; Jude LIU ; Qianmo AN ; Hui GUO ; Xiaochen LIU ; Zefeng YU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(1):83-89
ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.
3.Research progress on mechanism of active ingredients of traditional Chinese medicine in ameliorating skeletal muscle atrophy
Qin JIANG ; Wenya GUO ; Ying ZHOU ; Jian ZHOU ; Zhenyu ZHANG ; Yanchun GONG ; Lihua YAO ; Yuhua LI
China Pharmacy 2026;37(15):2057-2062
Skeletal muscle atrophy refers to a pathological condition characterized by muscle fiber atrophy as well as decreased muscle mass and muscle strength induced by various predisposing factors. It falls under the category of “flaccidity syndrome” in traditional Chinese medicine, and its pathogenesis is mainly associated with disturbed protein homeostasis, mitochondrial dysfunction and oxidative stress injury. Active ingredients of traditional Chinese medicine exerts synergistic regulatory effects via multiple pathways, thus possessing unique advantages in the clinical prevention and treatment of skeletal muscle atrophy. This paper reviews the mechanisms by which active ingredients of traditional Chinese medicine alleviate skeletal muscle atrophy. Existing studies have demonstrated that such active ingredients can ameliorate skeletal muscle atrophy through multiple approaches: regulating protein metabolic balance (geniposide, matrine, schisandrin A, etc.) and oxidative stress (astragaloside Ⅳ, Gastrodia elata polysaccharide, Angelica sinensis polysaccharide, etc.), improving mitochondrial function (parthenolide, berberine, curcumin, etc.), facilitating myogenesis and myogenic differentiation (cucurbitacin Ⅱb, saikosaponin A, saikosaponin D, etc.), suppressing inflammatory response (ursolic acid, triptolide, emodin, etc.), ameliorating insulin resistance (akebiasaponin D, etc.). In the future, active ingredients of traditional Chinese medicine are expected to achieve breakthroughs in clinical treatment for skeletal muscle atrophy, providing novel ideas and strategies for the prevention and treatment of degenerative disorders.
4.Pathogenesis Evolution of Atherosclerosis Induced by Novel Turbid-toxin Microplastics from Perspective of "Body Fluids and Blood Stasis Mixing"
He GUO ; Ying YANG ; Yi ZHENG ; Zhichao CHEN ; Huan ZHANG ; Ying ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):253-260
From the theoretical perspective of "body fluids and blood stasis mixing", environmental microplastics (MPs) are conceptualized as a "novel turbid-toxin". This study aims to elucidate the complete pathogenic pathway through which MPs act as a key driving force (the "crucible" of pathogenesis) in the initiation and progression of atherosclerosis (AS). By tracing the classical theories in the Chapter The Occurrence of All Diseases of Miraculous Pivot (Ling Shu), this paper clarifies the core connotations of "body fluids"-it not only refers to endogenous pathological fluids and lipid turbidity but also provides a theoretical basis for incorporating "exogenous turbid fluids", thereby laying a logical foundation for conceptualizing MPs as a "novel turbid-toxin". Meanwhile, the implications of "blood" (encompassing both blood quality abnormalities and blood stasis) and the dynamic process of "mixing" are elucidated. Drawing upon modern toxicological evidence, this paper demonstrates the high homology between MPs and "exogenous turbid-fluids" from three aspects: Morphology, toxicity, and invasion routes. The micro/nano-scale particle morphology of MPs enables mobility within the bloodstream. The multiple exposure pathways of MPs correspond to the traditional Chinese medicine understanding of pathogens invading through the mouth, nose, and skin. The characteristics of accumulating in vivo while inducing oxidative stress and inflammatory responses of MPs fully embody the pathogenic features-adhesion, binding, and vessel damage-of "turbid-toxin". On this basis, the dynamic pathogenesis of MP-induced AS is systematically interpreted. Initially, MPs with the "turbid-toxin" nature impair nutrient-defense harmony and cause endothelial dysfunction. Subsequently, as the core of "mixing", they interact with blood lipids and immune cells, generating heat and phlegm to form a major pathological hub of chronic inflammation. Ultimately, this process drives the coalescence of phlegm, stasis, and turbid-toxin into tangible plaques, evolving from stable lesions to vulnerable masses and accumulations. By integrating classical pathogenic model with contemporary environmental medicine, this study establishes an analytical framework that bridges macro-theory and micro-mechanisms for understanding the cardiovascular risks of MPs through an integrative Chinese-Western medicine lens.
5.Effect of Yiqi Yangyin Huoxue Formula(益气养阴活血方)on Oxidative Stress and Inflammatory Injury in Membranous Nephropathy Model Rats:Based on the NOX4-mediated SDF-1α/CXCR4 Signaling Pathway
Xiaoxiao GUO ; Chundong SONG ; Hanhan ZHANG ; Ke SONG ; Chenchen CHEN ; Haoran JIANG ; Ying DING
Journal of Traditional Chinese Medicine 2026;67(13):1431-1439
ObjectiveTo investigate the potential mechanism of Yiqi Yangyin Huoxue Formula (益气养阴活血方, YYHF) in the treatment of membranous nephropathy (MN) based on the NOX4-mediated stromal cell-derived factor-1α(SDF-1α)/CXC chemokine receptor 4 (CXCR4) signaling pathway. MethodsA total of 42 male SD rats were randomly divided into blank group (n=6) and modeling group (n=36). The modeling rats were given a single injection of sheep antirat Fx1A (6 ml/kg) serum into the tail vein to establish MN model. Thirty-six rats with successful modeling were further divided into model group (normal saline, 10 ml/kg), benazepril group (10 mg·kg-1·d-1), the medium-dose YYHF group (11.0 g·kg-1·d-1) and high-dose YYHF group (22.0 g·kg-1·d-1), with 9 rats in each group. All groups received daily intragastric administration for 6 consecutive weeks. During the experimental period, the general condition of rats in each group was observed. After gavage administration finished, a fully automated biochemical analyzer was used to measure the 24-hour urine total protein (24 h-UTP) and serum biochemical parameters, including albumin (ALB), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TC), and triglyceride (TG). Hematoxylin-eosin (HE) staining and periodic acid-silver metheramine (PASM) staining were used to observe the histopathological changes of renal tissues in each group of rats. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in renal tissues were detected by ELISA. The protein expression levels of NOX4, SDF-1α, CXCR4, Nrf2, nuclear factor kappa B subunit p65 (NF-κB p65) and podocyte slit diaphragm protein nephrin in rat renal tissues were detected by Western Blotting. The mRNA expressions of NOX4, SDF-1α, CXCR4, Nrf2, NF-κB p65 and Nephrin in renal tissues were detected by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). ResultsCompared to the blank group, rats in the model group exhibited typical features of MN, including lethargy, reduced activity, dull and coarse fur, marked edema, and massive proteinuria. Compared to the model group, these abnormal conditions were improved to varying degrees in all treatment groups. The high-dose YYHF group showed a level of improvement comparable to that of the benazepril group, with overall recovery superior to that of the medium-dose YYHF group. Compared to the blank group, the model group showed increased levels of 24 h-UTP, BUN, SCr, TC and TG, decreased level of ALB, increased levels of MDA and protein and mRNA expressions of NOX4, SDF-1α, CXCR4 and NF-κB p65 in renal tissue, along with decreased levels of SOD and protein and mRNA expressions of Nrf2, Nephrin (P<0.01), accompanied by severe renal pathological damage. Compared to the model group, the benazepril and the medium- and high-dose YYHF groups showed significant improvements in the above indicators (P<0.01), along with alleviation of renal pathological injury. The 24 h-UTP level in the high-dose YYHF group was lower than that in the medium-dose group (P<0.01), while no statistically significant difference was observed among the other treatment groups (P>0.01). ConclusionYYHF may alleviate oxidative stress and inflammatory responses by down-regulating the expression of NOX4 and inhibiting the SDF-1α/CXCR4-Nrf2 signaling pathway, thereby improving podocyte damage and protecting renal function.
6.Visualization of Wallerian Degeneration of The Corticospinal Tract and Glial Pathological Changes After Ischemic Stroke in Mice
Meng MENG ; Jiao MU ; Mei-Yu LI ; Jun-Yan GAO ; Xiao-Min ZHU ; Liang-Liang LIU ; Ying GUO ; Guo-Hui ZHANG
Progress in Biochemistry and Biophysics 2026;53(10):2808-2819
ObjectiveStroke remains the leading cause of acquired disability in adults worldwide, imposing a substantial socioeconomic burden on patients, families, and healthcare systems. Among the various neurological deficits caused by stroke, motor dysfunction——particularly contralateral hemiplegia——is the most common and debilitating consequence, and it predominantly results from damage to the cortical motor conduction pathways. When motor cortex neurons or their projecting fibers are damaged, the distal axons and their associated myelin sheaths undergo a series of progressive, programmed degeneration, fragmentation, and eventual phagocytic clearance. This pathological process is termed Wallerian degeneration (WD). However, the temporal progression of WD following ischemic stroke and the associated alterations in the local glial microenvironment remain incompletely understood. The present study was designed to systematically elucidate the time course of corticospinal tract (CST) axonal WD after ischemic stroke in mice, and to simultaneously characterize the dynamic pathological changes of astrocytes, microglia, oligodendrocyte lineage cells, and myelinating oligodendrocytes during the WD process. MethodsEight-week-old male C57BL/6J mice were randomly assigned to control and ischemic stroke groups. A focal cortical ischemic stroke model was established in the right sensorimotor cortex using the photothrombotic method. This method induces localized intravascular thrombosis in the target cortical region through precisely controlled interaction between the photosensitizer and laser light of specific wavelength. At day 1 post‑surgery, 2,3,5-triphenyltetrazolium chloride (TTC) staining was performed to evaluate infarct volume, hematoxylin and eosin (HE) staining for histopathological examination, and Nissl staining for assessment of neuronal injury. For axonal degeneration time-course analysis, rAAV-CAG-mCherry anterograde viral tracing was employed to specifically label CST neurons. Cervical spinal cord sections at the CST region were collected at day 3, 5, 7, 14, and 60 post-injury. Morphological changes of mCherry-positive CST fibers were observed under fluorescence microscopy, and the fluorescence signal area fraction within the defined region was quantitatively analyzed to evaluate the dynamic process of axonal degeneration. For glial response assessment, immunofluorescence staining against Iba1 (microglia), GFAP (astrocytes), Olig2 (oligodendrocyte lineage cells), and APC (myelinating oligodendrocytes) was performed at day 7, 14, and 60 post‑surgery. The numbers of positive cells were counted to quantitatively analyze the dynamic changes in each glial population at different time points after ischemia, thereby revealing the evolution of the glial microenvironment during WD. ResultsThe photothrombotic method stably and reliably established an ischemic brain injury model confined to the sensorimotor cortex. Viral tracing revealed that the proportion of mCherry‑positive CST fibers was significantly reduced at day 7 after ischemic injury to the neuronal soma. Immunofluorescence staining demonstrated that during WD, the numbers of microglia and astrocytes in the CST region were significantly increased, whereas the numbers of oligodendrocyte lineage cells and myelinating oligodendrocytes showed no significant changes. ConclusionWD of CST axons is observed at day 7 post-ischemic stroke in a delayed manner. This degenerative process selectively activates microglia and astrocytes, while leaving the number of oligodendrocyte lineage cells largely unaffected.
7.Treadmill Exercise Attenuates Hippocampal Neuroinflammation and Ameliorates Cognitive Dysfunction in Methamphetamine-Addicted Mice: Transcriptomic Screening Identifies NLRC5 as a Candidate Molecule
Guo-Si YING ; Qiu-Yue HUANG ; Ji-Sheng XU ; Xue-Jie ZHANG ; Ya-Rui DANG ; Xue LI
Progress in Biochemistry and Biophysics 2026;53(10):2820-2834
ObjectiveTreadmill exercise intervention was evaluated for its effects on addictive behavior, learning and memory, and hippocampal neuroinflammation in methamphetamine (MA)-addicted mice, and transcriptomic screening was performed to identify candidate molecules involved in exercise-mediated attenuation of MA-related neuronal injury. MethodsTwo-month-old male C57BL/6 mice were randomly assigned to four groups: control (C), exercise control (CE), methamphetamine (M), and methamphetamine plus exercise (ME). Mice in the M and ME groups received intraperitoneal injections of MA (1 mg/kg) once daily for 7 consecutive days to establish the addiction model, whereas mice in the C and CE groups received equal volumes of saline. Subsequently, mice in the CE and ME groups underwent treadmill exercise at 12 m/min for 60 min/d for 2 weeks. Conditioned place preference (CPP), the Y-maze, and the Morris water maze (MWM) were used to assess addictive behavior, spatial recognition memory, and spatial learning and memory, respectively. Hippocampal neuronal ultrastructure was examined by transmission electron microscopy (TEM), and microglia-related responses were evaluated by immunofluorescence staining for ionized calcium-binding adapter molecule 1 (Iba-1) in the hippocampal CA1 region. Previously generated and publicly available RNA-seq data from brain tissue of the C, M, and ME groups were reanalyzed, with three biological samples per group. Differentially expressed genes (DEGs) were re-screened using the criteria of P<0.05 and fold change>1.5 or <0.67, followed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. NLR family CARD domain containing 5 (Nlrc5) was further validated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and Western blot was used to determine the protein expression of NLRC5, nuclear factor kappa B (NF‑κB), interleukin-1β (IL-1β), postsynaptic density-95 (PSD-95), and synaptophysin. ResultsTreadmill exercise significantly attenuated MA-induced conditioned place preference and improved learning and memory performance in both the Y-maze and MWM tests. Exercise increased exploration time and distance in the novel arm of the Y-maze, shortened escape latency, and increased the number of platform crossings in the MWM. Average swimming speed during the probe trial did not differ significantly among groups, suggesting that the MWM differences were not attributable to obvious differences in swimming performance. TEM revealed that MA exposure induced mitochondrial swelling, disrupted cristae, reduced organelle abundance, and nuclear envelope abnormalities in hippocampal neurons, whereas these ultrastructural changes were alleviated after exercise. Immunofluorescence staining showed that MA increased Iba-1 fluorescence intensity in the hippocampal CA1 region, while treadmill exercise significantly reduced this change. Transcriptomic analysis identified 160 DEGs associated with MA exposure and 58 DEGs associated with exercise intervention, with 9 overlapping DEGs. KEGG enrichment analysis showed that MA-related DEGs were enriched in the NOD-like receptor signaling pathway. Among the overlapping DEGs, Nlrc5, which was downregulated after MA exposure and restored following exercise intervention, was selected as a candidate gene for further validation. RT-qPCR confirmed that treadmill exercise reversed the MA-induced decrease in Nlrc5 mRNA expression. Western blot analysis further showed that treadmill exercise increased NLRC5, PSD-95, and synaptophysin protein expression while reducing NF-κB and IL-1β expression. ConclusionTwo weeks of treadmill exercise attenuated MA-induced conditioned place preference and ameliorated learning and memory impairment, alleviated hippocampal neuroinflammation and neuronal ultrastructural damage, and restored the expression of synapse-related proteins. Transcriptomic screening combined with molecular validation demonstrated that exercise intervention was accompanied by restoration of NLRC5 expression, reduced NF‑κB and IL-1β expression, and increased PSD-95 and synaptophysin expression. These findings suggest that NLRC5 may represent a candidate molecule involved in exercise-mediated amelioration of MA-related neuronal injury. However, the present results mainly demonstrate coordinated changes in NLRC5 expression, inflammatory indicators, and cognitive outcomes rather than a direct causal relationship, and the specific role of NLRC5 requires further functional validation.
8.Feasibility of deep learning technique based on CT radiomics in improving the diagnostic accuracy for pulmonary nodules
Xianhu ZHANG ; Zhigang ZHANG ; Fang LIU ; Ying GUO ; Fan LI ; Chong LIU
China Medical Equipment 2025;22(9):12-16
Objective:To investigate the feasibility of deep learning based on computed tomography(CT)radiomics in improving diagnostic accuracy for pulmonary nodules.Methods:A total of 500 patients with pulmonary nodules who admitted to our hospital from January 2023 to January 2024 were selected as study subjects,and they were randomly divided into a training set(350 patients)and a test set(150 patients)as 7:3 ratio.All patients underwent CT examination,and pathological diagnosis was used as gold standard to record pulmonary nodules that were judged by clinical judgment.The radiomics features were screened from the CT images of the patients,and these features were used to construct multiple machine learning models.The predictive value of different models in diagnosing pulmonary nodules was analyzed through confusion matrices and receiver operating characteristic(ROC)curve.Results:A total of 1,594 radiomics features,including 1,195 texture features(74.97%)that was the largest ratio,334 first-order histograms(20.95%),and 65 second-order histograms(4.08%),were extracted in this study.After least absolute shrinkage and selection operator(LASSO)regression analysis and ten-fold cross-validation processing,a total of six radiomics features were screened out.The screened radiomics features were incorporated respectively into four assembled models with machine learning,including ResNet50,DenseNet121,Inception_V3 and VGG19.The constructed models were evaluated respectively using the training set and the test set.The results showed that the assembled model had the highest accuracies in both training set and the test set(96.57%and 95.33%),which area under curve(AUC)values were 0.934 and 0.923,and specificities were 81.64%and 80.52%,and sensitivities were 90.25%and 88.71%,respectively.The results of consistency test indicated that the assembled model had the best classification consistency(Kappa=0.856,P<0.001)in the constructed diagnostic model for pulmonary nodule,which was the best-performing model.Conclusion:The deep learning technique based on CT radiomics has a certain feasibility in improving the diagnostic accuracy for pulmonary nodules,and the machine learning model that is included in this study has favorable predictive value in diagnosing pulmonary nodules.In them,the assembled model that is constructed on the basis of ResNet50,DenseNet121,Inception_V3,and VGG19 has better classification ability.
9.Therapeutic value of visual endoscopic retrograde appendicitis therapy in children with acute suppurative appendicitis
Anding ZHANG ; Na FAN ; Mingzhong WANG ; Lingchao ZENG ; Chunhui WANG ; Yan LIN ; Jiaren ZHOU ; Yaping SONG ; Nini ZHANG ; Haiyan WANG ; Hongwei GUO ; Ying ZHOU ; Baoxi WANG ; Xun JIANG
Chinese Journal of Pediatrics 2025;63(7):754-758
Objective:To investigate the therapeutic value of visual endoscopic retrograde appendicitis therapy (vERAT) in pediatric patients with acute suppurative appendicitis (ASA).Methods:This was a retrospective cohort study. A total of 55 ASA patients who underwent vERAT at the Pediatric Department of the Tangdu Hospital of Air Force Medical University between November 2023 and January 2025 were selected and divided into groups based on the presence or absence of fecaliths: fecalith group and non-fecalith group. The baseline characteristics, initial treatment success rates, treatment costs, hospital stay duration, procedure time, and recurrence rates between two groups were compared. Mann-Whitney U test and χ2 test were used to evaluate group differences. Results:A total of 55 ASA patients were enrolled, including 38 males and 17 females, with the age of 11.2 (9.2, 13.1) years. Based on the presence of fecaliths, patients were divided into two groups: fecalith group (32 cases) and non-fecalith group (23 cases). No statistically significant differences were observed between the two groups in terms of age, gender, duration of abdominal pain, white blood cell count, neutrophil percentage, diameter of appendix, thickness of appendix clinical symptoms or signs (all P>0.05). The initial treatment success rates were 91% (29/32) in fecalith group and 96% (22/23) in non-fecalith group, with no statistically significant difference ( P=0.632). However, significant differences were noted in stent placement ( χ2=5.85, P=0.026) and procedure time ( Z=4.75, P<0.001). The follow-up duration time was 6.0 (2.0, 12.0) and 7.0 (2.0, 8.5) months for the fecalith and non-fecalith groups, respectively, with no significant difference ( Z=0.05, P=0.962). The recurrence rates were 14% (4/29) in fecalith group and 5% (1/22) in non-fecalith group, with no statistically significant difference ( P=0.375). Conclusions:vERAT can safely and effectively treat pediatric ASA, regardless of the presence or absence of fecaliths. It can provide a new treatment option for ASA.
10.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.

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