Humans ; COVID-19 ; SARS-CoV-2

Liver cirrhosis, characterized by diffuse hepatocytes necrosis, insufficient regeneration of hepatocytes, angiogenesis, severe fibrosis and the formation of pseudolobules, is a progressive chronic hepatic disease induced by a variety of causes. It is clinically characterized by liver function damage and portal hypertension, and many complications may occur in the late stage. Based on the update relevant guidelines, experts' consensus, and research advances on the diagnosis and treatment of cirrhosis, Chinese Society of Gastroenterology of Chinese Medical Association established a consensus aiming to standardize the clinical diagnosis and treatment of liver cirrhosis and guide clinical practice. This consensus contains 43 statements on the etiology, pathology and pathogenesis, clinical manifestations, major complications, diagnosis, treatment, prognosis and chronic disease management of liver cirrhosis. Since several guidelines and experts' consensus on the complications of liver cirrhosis have been published, this consensus focuses on the research progress of liver cirrhosis itself.

Due to the difficult eradication of Helicobacter pylori caused by gradual increase of antibiotic resistance, the widespread use of nonsteroidal anti‑inflammatory drugs, and the common use of antithrombotic therapy in the aging population, the diagnosis and treatment of peptic ulcer are more challenging than ever. To further explore a new model of diagnosis and treatment of peptic ulcer in accordance with our national conditions, the Editorial Board of Chinese Journal of Digestion organized an expert committee to develop a new version of the consensus based on "Standardized diagnosis and treatment of peptic ulcer (2016, Xi′an)". The consensus has 30 statements, divided into 9 parts, covering the definition, clinical manifestations, pharmacological treatment, treatment of complications, and prevention of peptic ulcer.

Recently,Chinese Society of Gastroenterology of Chinese Medical Association organized the experts to formulate the Chinese consensus on clinical diagnosis and management of covert hepatic encephalopathy.The consensus was developed based on a review of recent domestic and foreign guidelines,a summary of the new achievements in the field,and a consideration of the practice of China.The consensus updated the concept and epidemiological characteristics,explained the risk factors,pathogenesis,and hazards of covert hepatic encephalopathy,and provided recommendations for its diagnosis,treatment,and chronic disease management.This paper interpreted the key points of this consensus,to provide reference and guidance for clinical practice.

Recently, Chinese Society of Gastroenterology of Chinese Medical Association organized the experts to formulate the Chinese consensus on clinical diagnosis and management of covert hepatic encephalopathy. The consensus was developed based on a review of recent domestic and foreign guidelines, a summary of the new achievements in the field, and a consideration of the practice of China. The consensus updated the concept and epidemiological characteristics, explained the risk factors, pathogenesis, and hazards of covert hepatic encephalopathy, and provided recommendations for its diagnosis, treatment, and chronic disease management. This paper interpreted the key points of this consensus, to provide reference and guidance for clinical practice.

Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis-related complications has been recognized during recent years. This paper aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis-related complications. Hepatobiliary Study Group of Chinese Society of Gastroenterology and Hepatology Committee of Chinese Research Hospital Association invited gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists to formulate the clinical practice guidance based on comprehensive literature review and experts' clinical experiences. Overall, 10 major statements regarding efficacy and safety of terlipressin in liver cirrhosis - related complications were proposed. Terlipressin can be beneficial for the management of cirrhotic patients with acute gastroesophageal variceal bleeding and hepatorenal syndrome (HRS). However, the evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction and bacterial infections, as well as in those undergoing hepatic resection and liver transplantation remains insufficient. Terlipressin - related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored. The current clinical practice guidance supports the use of terlipressin for gastroesophageal variceal bleeding and HRS in liver cirrhosis. High-quality studies are needed to further clarify its potential effects in other liver cirrhosis-related complications.

Portal hypertension is one of the most serious complications in patients with liver cirrhosis, and its prevention and treatment are essential to improve patient outcomes. The main pathophysiological basis of cirrhotic portal hypertension is increased intrahepatic vascular resistance and/or increased portal blood flow. In recent years, studies have suggested that liver sinusoid endothelial cells dysfunction, hepatic microvascular thrombosis, pathological angiogenesis, and gut-liver axis imbalance play critical roles in the development of portal hypertension. With respect to this, targeted therapy drugs have made significant advances. This article discusses the cirrhotic portal hypertension reversal mechanism and the current status of its treatment.

The modification of proteins with ubiquitination is closely related to the occurrence and development of chronic liver disease and hepatocellular carcinoma. The tripartite motif (TRIM) family of proteins is one of the E3 ubiquitin ligase subfamily, which participates in various biological processes such as intracellular signal transduction, apoptosis, autophagy, and immunity by regulating the ubiquitination of target proteins. A growing body of research shows that the TRIM family of proteins plays an important role in chronic liver disease. This article systematically reviews the role and molecular mechanism of TRIM protein in the process of chronic liver disease, with the aim of exploring its potential application in the clinical diagnosis and treatment.

Objective:To evaluate the effectiveness of interventional treatment for neonatal critical pulmonary stenosis(NCPS).Methods:Clinical data of 12 neonates with NCPS who received percutaneous balloon pulmonary valvuloplasty (PBPV) from January 2016 to December 2019 in Department of Cardiology, Shenzhen Children′s Hospital were summarized and analyzed.The collected data included transthoracic echocardiography (TTE), percutaneous oxygen saturation (SPO 2), relevant data on interventional surgery, and follow-up results. Results:All 12 neonates with NCPS received PBPV successfully.The postoperative pressure difference between the right ventricle and the pulmonary artery ranged from 8 to 35 mmHg[(20±7) mmHg, 1 mmHg=0.133 kPa]. The postoperative SPO 2 ranged from 74%-100%[(93.0±5.9)%]. Three neonates with NCPS received Blalock-Taussig (B-T) shunt.One neonate with NCPS developed supraventricular tachycardia during the operation.There was no death for these 12 neonates with NCPS. Conclusions:Interventional treatment of neonates with NCPS could achieve a better effect and be employed as the first treatment option.Some neonates with NCPS would require cardiac B-T shunt or patent ductus arteriosus stent implantation.

In recent years, as a new treatment method developed on the basis of traditional acupuncture, electrical stimulation, including electroacupuncture and transcutaneous electrical acustimulation, has shown great potential in the treatment of various gastrointestinal diseases. Because of the characteristics of family therapy, it can greatly reduce the cost of treatment and has a comparative advantage over drug therapy, however, it has not been widely used in clinical practice. This article reviewed the advantages and disadvantages of electrical stimulation, stimulation parameters, mechanism, and research progress of the treatment.