1.Correlation between the serum levels of aminotransferases and liver inflammation activity in pediatric chronic hepatitis B patients: An analysis of 1 267 cases
Dan ZHAO ; Lina JIANG ; Shuhong LIU ; Haiyan WEI ; Chunmei BAO ; Jingmin ZHAO
Journal of Clinical Hepatology 2025;41(6):1062-1067
ObjectiveTo investigate the correlation of the serum levels of aminotransferases and their ratios with liver inflammation activity in pediatric chronic hepatitis B (pCHB) patients, and to provide a basis for selecting the dominant population for treatment. MethodsThis study was conducted among 1 267 pCHB patients who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to August 2022 and these patients did not receive antiviral therapy. The patients were analyzed in terms of demographic features, blood routine, blood biochemistry, HBV serological markers, and liver biopsy data. According to liver inflammation activity based on liver biopsy, the patients were divided into no or mild inflammation activity (G0 — G1) group and significant inflammation activity (G2 — G4) group. The serum levels of aminotransferases and their ratios were compared between groups, and their correlation with liver inflammation activity in pCHB patients was analyzed. Additionally, the patients were stratified by the age, and the relationship between serum aminotransferase levels and liver inflammation activity was analyzed in each age group. For comparison of continuous data between two groups, the independent samples t-test was used when the data were normally distributed, while the Mann-Whitney U test was used when the data were not normally distributed; the chi-square test was employed for comparison of categorical data between two groups. A Spearman’s correlation analysis was performed for correlation assessment. ResultsAmong the 1 267 pCHB patients, there were 468 (36.9%) in the G0 — G1 group and 799 (63.1%) in the G2 — G4 group, and there were significant differences between the two groups in the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, gamma-glutamyl transpeptidase (GGT), total bilirubin, direct bilirubin, HBeAg quantification, low-density lipoprotein, and platelet count (PLT) (all P<0.05). The correlation analysis showed that liver inflammation activity was negatively correlated with PLT and low-density lipoprotein (both P<0.05) and was positively correlated with GGT, total bilirubin, direct bilirubin, and HBeAg titer (all P<0.05), while it was not significantly correlated with ALT, AST, and AST/ALT ratio (all P>0.05). In the 0 — 12 years group, the 13 — 18 years male group, and the 13 — 18 years female group, liver inflammation activity aggravated with the increases in the serum levels of ALT and AST, and there were significant differences between groups (all P<0.05). In the 0 — 12 years group, there was a significant difference in significant liver inflammation activity between the AST/ALT ratio >1 group and the AST/ALT ratio ≤1 group (P<0.001). Among the 1 267 patients, 447 (35.28%) had an ALT level of <2×upper limit of normal (ULN), among whom 196 (43.85%) had G≥2 liver inflammation, accounting for 15.47% of all children enrolled. ConclusionLiver inflammation activity is not significantly correlated with ALT, AST, and AST/ALT ratio in pCHB patients, suggesting that the serum levels of aminotransferases cannot truly reflect liver inflammation activity in pCHB patients with an aminotransferase level of <2×ULN. In clinical practice, liver biopsy should be performed for children with an aminotransferase level of <2×ULN to clarify whether antiviral therapy should be performed.
2.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
3.Pathological mechanism of multi-organ injuries in metabolic dysfunction-associated fatty liver disease
Journal of Clinical Hepatology 2025;41(9):1729-1736
Metabolic dysfunction-associated fatty liver disease (MAFLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), have emerged as significant types of chronic liver disease worldwide and are closely associated with metabolic syndrome. The liver-extrahepatic organ/tissue axis and the “spill-over effect” of intrahepatic inflammation play pivotal roles in the pathogenesis and progression of MAFLD/MASH, significantly impacting multi-organ metabolic homeostasis and leading to various extrahepatic injuries. These include cardiovascular diseases, sarcopenia, chronic kidney disease, non-alcoholic fatty pancreas disease, polycystic ovary syndrome, hepatocellular carcinoma, and various related solid tumors. There is a notable epidemiological link between MAFLD and the development of both liver cancer and extrahepatic malignancies. The risk of associated tumorigenesis is related to multiple factors, including persistent metabolic disorders, chronic low-grade inflammation, and gut microbiota dysbiosis. Recent research perspectives have shifted from focusing solely on hepatic pathology to recognizing systemic metabolic dysregulation, emphasizing the central role of liver-extrahepatic organ interactions in disease progression. This article aims to explore the pathogenesis of MAFLD/MASH and to review the mechanisms underlying related multi-organ extrahepatic injuries.
4.Influencing factors for carotid plaque among perimenopausal women
ZHANG Lina ; CAO Lan ; GU Yanan ; ZHAO Jianying
Journal of Preventive Medicine 2025;37(5):507-511
Objective:
To investigate the factors affecting carotid plaques among perimenopausal women, so as to provide the basis for the prevention and early intervention of cardiovascular diseases in perimenopausal women.
Methods:
Perimenopausal women aged 40-60 who underwent health check-ups at Xingtai People's Hospital from January 2022 to January 2023 were selected as subjects by convenient sampling method. Demographic information, lifestyle, waist-to-hip ratio, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. Carotid plaques were detected using a Doppler ultrasound diagnostic instrument. Factors affecting carotid plaques among perimenopausal women were identified using a multivariable logistic regression model.
Results:
Totally 2 146 perimenopausal women were surveyed, with an age of (50.04±5.82) years. Carotid plaques were detected in 525 cases, with a detection rate of 24.46%. Multivariable logistic regression analysis showed that older age (45-<50 years old, OR=1.474, 95%CI: 1.062-2.047; 55-60 years old, OR=1.779, 95%CI: 1.276-2.481), residing in urban areas (OR=1.601, 95%CI: 1.079-2.376), drinking (OR=1.805, 95%CI: 1.108-2.941), hypertension (OR=1.815, 95%CI: 1.290-2.553), abnormal waist-to-hip ratio (OR=2.479, 95%CI: 1.982-3.101), and abnormal atherogenic index of plasma (OR=1.325, 95%CI: 1.064-1.650) were associated with a higher risk of carotid plaques. College degree or above (college, OR=0.659, 95%CI: 0.502-0.865; bachelor's degree or above, OR=0.517, 95%CI: 0.397-0.673), physical exercise (OR=0.621, 95%CI: 0.494-0.781) were associated with a lower risk of carotid plaques.
Conclusion
The carotid plaques among perimenopausal women mainly affected by age, place of residence, educational level, alcohol consumption, physical exercise, hypertension, waist-to-hip ratio and atherogenic index of plasma.
5.LIU Fengbin's Experience in Treating Autoimmune Liver Disease with the Method of Nourishing Yin and Removing Stasis Based on Stage
Xiling YANG ; Qiuhong YONG ; Chaoyuan HUANG ; Lina ZHAO ; Yiyuan ZHENG ; Chong PENG ; Kunhai ZHUANG ;
Journal of Traditional Chinese Medicine 2025;66(7):674-679
This paper summarizes Professor LIU Fengbin's clinical experience in treating autoimmune liver disease (AILD) using the method of nourishing yin and removing stasis based on stage differentiation. He believes that the pathogenesis of AILD generally involves both deficiency in essence and excess in manifestation, with essence deficiency often presenting as liver and kidney yin deficiency, which may progress to spleen deficiency and yang deficiency over time. The excess manifestation commonly includes qi stagnation, blood stasis, damp-heat, and phlegm toxicity. Clinically, he advocates for the treatment principle of nourishing yin and removing stasis. On the foundation of nourishing liver and kidney yin, different pathological factors causing stasis are eliminated according to their nature. Treatment is also tailored to different stages of AILD. In the early and asymptomatic stages, liver qi stagnation and spleen deficiency are prominent, warranting a therapeutic approach of soothing the liver, regulating qi and strengthening the spleen. The modified Chaishao Qizhi Decoction (柴芍气滞汤) is used. During the symptomatic stage, pathogenic factors become more pronounced, often accompanied by a significant deficiency of vital qi, with damp-heat, water retention, and phlegm toxicity as key pathological features. The treatment should focus on strengthening the spleen and dispelling dampness, using modified Sijunzi Decoction (四君子汤) combined with Yinchen Wuling Powder (茵陈五苓散). In the liver function decompensation stage, vital qi is severely deficient while pathogenic factors persist, with damp-heat, phlegm toxicity, and blood stasis obstructing the liver collaterals. Treatment should focus on nourishing blood, softening the liver, strengthening the spleen, and resolving stasis, using the modified Ruangan Yangxue Decoction (软肝养血汤). Throughout the treatment process, emphasis is placed on tonifying the liver and kidneys while protecting yin fluids.
6.Reconsideraton of Stroke with Syndrome of Combined Blood Stasis and Toxin from the Perspective of Xiang Thinking
Yunfan ZHANG ; Di ZHAO ; Lina MIAO ; Hongxi LIU ; Jingjing WEI ; Xiao LIANG ; Liuding WANG ; Xueru ZHANG ; Yunmeng CHEN ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2025;66(13):1305-1310
Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy, reasoning, deduction, and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind, fire, phlegm, and blood stasis" in stroke, thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile, the article traced the construction process of xiang thinking, and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives, state, attribute, origin, and law. Furthermore, the relationship between the process of constructing xiang thinking and the origin of etiology, identification methods, pathogenesis evolution, and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored, so as to provide insights into research on the etiology and pathogenesis of stroke, as well as clinical diagnosis and treatment approaches.
7.Analysis of the timeliness of anti-retroviral therapy among newly reported HIV/AIDS cases
SU Dehua ; CHEN Xiangyang ; LI Jun ; ZHAO Lina ; ZHANG Hemei ; ZHU Tingting ; HU Wenxue ; LAI Jiangyi
Journal of Preventive Medicine 2025;37(8):804-808
Objective:
To analyze the timeliness of antir-etroviral therapy (ART) and its influencing factors among newly reported HIV/AIDS cases in Wenzhou City, Zhejiang Province from 2016 to 2023, so as to provide a reference for improving the ART effect of HIV/AIDS cases.
Methods:
Newly reported HIV/AIDS cases in Wenzhou City from 2016 to 2023 were selected as the research subjects. Demographic information, the situation of the first CD4+ T lymphocyte (CD4 cell) test, baseline CD4 cell count, and ART situation were collected through the Chinese Disease Prevention and Control Information System. The timely rate of ART was analyzed, and the influencing factors for timely ART among HIV/AIDS cases were analyzed using a multivariable logistic regression model.
Results:
A total of 4 500 newly reported HIV/AIDS cases in Wenzhou City from 2016 to 2023 were included, among which 3 679 were males, accounting for 81.76%, and 821 were females, accounting for 18.24%. The median age was 46.24 (interquartile range, 26.23) years. Among these cases, 3 606 received timely ART, with a timely rate of 80.13%. The timely rate of ART increased from 57.54% in 2016 to 91.97% in 2023 (P<0.05). Multivariable logistic regression analysis showed that unmarried/divorced/widowed (OR=0.769, 95%CI: 0.641-0.922), detainees (OR=0.492, 95%CI: 0.269-0.900), untimely first CD4 cell test (OR=0.278, 95%CI: 0.234-0.330), baseline CD4 cell count ≥200 cells/µL (OR=0.709, 95%CI: 0.595-0.843) or undetected (OR=0.131, 95%CI: 0.080-0.213) were associated with a lower timeliness for ART among HIV/AIDS cases.
Conclusion
From 2016 to 2023, the timely rate of ART among newly reported HIV/AIDS cases in Wenzhou City showed an upward trend, which was mainly affected by marital status, case source, timeliness of the first CD4 cell test, and baseline CD4 cell count.
8.Humanistic Care for the Prevention of Perioperative Hypothermia in the Elderly
Na LI ; Liyan ZHAO ; Lina WU ; Xiongtao LIU ; Ru GU ; Wei PENG ; Xiali SHI ; Dan LEI ; Jing ZHANG ; Weiling LUO
Chinese Medical Ethics 2024;35(3):350-352
The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.
9.Molecular mechanism of adipose tissue inflammation induced by acute exposure to cooking oil fumes
Ge WANG ; Biao WU ; Jianshu GUO ; Dongxia FAN ; Lu YU ; Chihang ZHANG ; Lan MI ; Lina WANG ; Jinzhuo ZHAO
Journal of Environmental and Occupational Medicine 2024;41(4):349-355
Background Cooking oil fumes are closely related to immune response, and adipose tissue also plays an important role in immune regulation. At present, the biological effect and mechanism of inflammation of adipose tissue induced by oil fume exposure are not clear yet. Objective To investigate the inflammatory effect of different exposure duration of cooking fumes on adipose tissue in mice and explore the role of Nod-like receptor pyrin domain 3 (NLRP3)/cysteinyl aspartate specific proteinase 1 (Caspase 1)/interleukin (IL)-1β signaling pathway. Methods Forty 8-week-old female C57BL/6J mice were randomly divided into 3-day control group (CON3 group), 7-day control group (CON7 group), 3-day oil fume exposure group (COF3 group), and 7-day oil fume exposure group (COF7 group), with 10 mice in each group. The mice were exposed to oil fumes in a cooking oil fume formation and exposure equipment (COFFEE) for 20 min, followed by a 10-min pause, 1 h a day for consecutive 3 d or 7 d. General condition of mice was observed and body weight was measured every day. After exposure, blood was sampled from the eyeball. Serum levels of IL-6, IL-27, and IL-1β were detected by enzyme-linked immunosorbent assay (ELISA). The adipose tissue of mice was collected and observed after hematoxylin-eosin (HE) staining. The percentages of CD4+ and CD8+T cells in adipose tissue were detected by flow cytometry. Real-time quantitative PCR (RT-qPCR) was used to detect the expression levels of nuclear factor-κB (NF-κB), NLRP3, Caspase 1, and IL-1β in adipose tissue. Western blot was used to detect the expression levels of NLRP3, Caspase 1, and IL-1β in adipose. Results Compared with the corresponding control group, serum IL-6, IL-27, and IL-1β contents in the COF3 group and the COF7 group were significantly increased (P<0.05) except IL-6 in the COF3 group, and the levels in the COF7 group were significantly higher than those in the COF3 group (P<0.05). Vacuolar lipid droplets in adipocytes decreased, cytoplasm shrank, and inflammatory cells infiltrated in the COF7 group after HE staining. The flow cytometry results showed that the proportions of CD4+ and CD8+T cells in adipocytes of the COF3 group and the COF7 group were increased compared to the corresponding control group, with a significant increase in the COF7 group (P<0.05), and the CD4+/CD8+T ratio also significantly increased progressively in the two groups (P<0.05). The results of RT-qPCR showed that compared with the corresponding control group, the mRNA expression levels of NF-κB, NLRP3, Caspase 1, and IL-1β in adipose tissue of mice in the COF3 group and the COF7 group were significantly increased (P<0.05, P<0.01). The mRNA expression levels of mice in each exposure group gradually increased over time. The Western blot results showed that compared with the corresponding control group, the protein expressions of NLRP3 and Caspase 1 in the COF3 group were significantly increased (P<0.01), and the expression of IL-1β protein also increased but without statistical significance. The protein expressions of NLRP3, Caspase 1, and IL-1β in the COF7 group were significantly higher than those in the CON7 group (P<0.05, P<0.01). Conclusion Acute exposure to cooking oil fumes can induce significant inflammatory response in adipose tissue, and the effect gradually increases with the extension of exposure time. The mechanism of action may be related to the activation of NLRP3 inflammasome signaling pathway.
10.Expert consensus on the workflow of digital aesthetic design in prosthodontics
Zhonghao LIU ; Feng LIU ; Jiang CHEN ; Cui HUANG ; Xianglong HAN ; Wenjie HU ; Chun XU ; Weicai LIU ; Lina NIU ; Chufan MA ; Yijiao ZHAO ; Ke ZHAO ; Ming ZHENG ; Yaming CHEN ; Qingfeng HUANG ; Yi MAN ; Mingming XU ; Xuliang DENG ; Ti ZHOU ; Xiaorui SHI
Journal of Practical Stomatology 2024;40(2):156-163
In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.


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