中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Vol.41 No.3 (293 in total) Mar. 2025

Theme Issue: Clinical Application and Research Progress of Albumin in Liver Disease 

Chief Editor: JIA Jidong

Beijing Friendship Hospital, Capital Medical University
Cover Content

 Previous Issue

column
Display Method:
Editorial
Driving innovation and fostering collaboration to advance the development and clinical research of next-generation human serum albumin
Jidong JIA, Junqi NIU
2025, 41(3): 401-403. DOI: 10.12449/JCH250301
Abstract(1880) HTML (105) PDF (508KB)(62)
Abstract:
Albumin is the most abundant protein in human plasma， and in addition to the function of maintaining plasma colloid osmotic pressure， it also has the functions of material transport， detoxification， maintaining vascular integrity， antioxidation， anti-inflammation， and immune modulation. In the field of liver disease， albumin is mainly used to prevent circulatory dysfunction after large-volume paracentesis and treat cirrhotic hypoalbuminemia and ascites， spontaneous bacterial peritonitis， and hepatorenal syndrome. The development of recombinant human serum albumin helps to reduce the potential biosafety risks of human serum albumin products and the disadvantages of relying heavily on import. Due to the lack of reference to the results of pivotal clinical trials of marketed human albumin products， there are still various challenges in the design， implementation， and evaluation of clinical trials of human albumin. Therefore， experts in pharmaceutical enterprises， clinical medicine， methodology， and evaluation/supervision are needed to be pragmatic， innovative and collaborative.
Expert Forum
A re-understanding of the physiological function of albumin
Jingjing WANG, Ligai LIU, Wen XIE
2025, 41(3): 404-408. DOI: 10.12449/JCH250302
Abstract(1310) HTML (105) PDF (580KB)(82)
Abstract:
As an important protein synthesized by the liver， albumin is one of the most important markers for liver function， and its structure and function change with the progression of liver injury. Latest studies have shown that albumin in the disease state is not only reduced in quantity， but also damaged in quality， and thus the concept of “effective albumin” was proposed. This article elaborates on the research advances in the physiological structure and function of albumin， the changes of physiological function in the disease state， and the research advances in effective albumin， so as to explore precise strategies for the clinical application of albumin.
The application of human serum albumin in liver cirrhosis and its complications
Yaxin LI, Huiguo DING
2025, 41(3): 409-414. DOI: 10.12449/JCH250303
Abstract(1589) HTML (108) PDF (607KB)(79)
Abstract:
Albumin is synthesized in the liver， and in case of severe liver injury， albumin synthesis is reduced with structural alterations （such as an increase in methylation and glycosylation）， leading to a significant reduction in effective albumin in circulation. Albumin not only maintains plasma oncotic pressure， but also has the functions of antioxidation， anti-inflammation， immunomodulation， and transport. Current guidelines recommend the short-term application of human serum albumin in the treatment of large-volume paracentesis， hepatorenal syndrome， and spontaneous bacterial peritonitis in patients with liver cirrhosis， as it is shown that human serum albumin can help to reduce mortality. In addition， human serum albumin may improve the prognosis of cirrhotic patients with hyponatremia， non-SBP infections， and hepatic encephalopathy. However， there are still controversies over the application of human serum albumin in liver cirrhosis and related complications in terms of optimal dose and long-term efficacy.
The development and application of genetically engineered human serum albumin
Yanhang GAO, Junqi NIU
2025, 41(3): 415-419. DOI: 10.12449/JCH250304
Abstract(1779) HTML (100) PDF (600KB)(39)
Abstract:
Human serum albumin （HSA） is the most abundant protein in plasma and has many biological functions and clinical applications. An adequate and stable supply of functional HSA molecules that are easy to store and have a long half-life is still an unmet clinical need. Therefore， it is extremely necessary to develop alternative methods for large-scale production of HSA. Genetic engineering techniques can clone the HSA gene into microorganism， animal， and plant hosts for efficient expression， which provides new possibilities for the large-scale production of HSA. This article reviews the advances in recombinant HSA （rHSA） in different expression systems and the production of rHSA by xenogeneic animals such as pigs and cattle， in order to draw attention to the application potential of genetic engineering techniques in HSA production and the importance of rHSA in the biomedical field in future.
Statistical considerations in the design of albumin clinical trials
Yuanyuan KONG, Chen YAO, Jidong JIA
2025, 41(3): 420-423. DOI: 10.12449/JCH250305
Abstract(1354) HTML (80) PDF (496KB)(39)
Abstract:
Albumin is widely used in clinical practice， and the rationality of trial design directly affects the reliability of research findings and clinical application value. This article reviews the key statistical considerations in the design of albumin clinical trials， including the selection of primary endpoints， the establishment of statistical hypotheses and non-inferiority margins， clinical evaluation criteria for ascites improvement， sample size， and interim analyses， in order to provide methodological guidance for clinical researchers to optimize clinical trial design and enhance its scientific rigor and feasibility.
Guideline
Guidelines for fecal microbiota transplantation therapy in patients with liver cirrhosis
Viral Hepatitis Group of Professional Committee of Liver Disease （combined traditional Chinese and western medicine） of Chinese Research Hospital Association, Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Diseases
2025, 41(3): 424-431. DOI: 10.12449/JCH250306
Abstract(1970) HTML (106) PDF (979KB)(71)
Abstract:
Expert consensus on precision detection of intrahepatic cholangiocarcinoma （2024 edition）
Pathology Group, Chinese Society of Liver Cancer of Chinese Anti-Cancer Association, Liver Pathology Group
2025, 41(3): 432-441. DOI: 10.12449/JCH250307
Abstract(1352) HTML (122) PDF (1128KB)(80)
Abstract:
Intrahepatic cholangiocarcinoma （ICC） is a highly heterogeneous tumor， and molecular profiling serves as the foundation for personalized treatment of ICC. Accurate detection methods are clinically significant for comprehensively screening patients suitable for targeted therapies. This consensus is based on clinical practice data from both domestic and international sources， tailored to the Chinese context， and focuses on key targets for ICC. We present 15 recommendations aimed at guiding the precision detection of ICC.
Guideline Interpretation
Interpretation of metabolic dysfunction and alcohol-related liver disease： Position statement by an expert panel on alcohol-related liver disease （2024 edition）
Zhenyao JIANG, Binbin ZHANG, Jie LI, Junping SHI
2025, 41(3): 442-445. DOI: 10.12449/JCH250308
Abstract(1414) HTML (106) PDF (575KB)(45)
Abstract:
In November 2024， the Expert Group on Alcohol-related Liver Disease released a position statement on metabolic dysfunction and alcohol-related liver disease （MetALD）. MetALD is a new subtype of steatotic liver disease and refers to MASLD patients with a relatively large amount of alcohol consumption. The position statement points out the importance of accurate evaluation of alcohol consumption and recommends to quantify alcohol consumption using standard methods and alcohol biomarkers， and a comprehensive diagnosis should be made based on metabolic risk factors. In addition， the position statement analyzes the influence of drinking pattern on the diagnosis of MetALD and recommends to consider long-term drinking history during typing. The position statement also discusses the complex association between drinking and the diseases including metabolic syndrome， hepatic steatosis， fibrosis， and type 2 diabetes mellitus， and it is pointed out that the hierarchical management of patients should be optimized based on liver histological models and noninvasive models. The position statement elaborates on the definition of MetALD， drinking assessment， the interaction between alcohol use and metabolic dysfunction， and the methods for comprehensive management of MetALD， in order to facilitate learning and provide guidance for clinicians and researchers in clinical practice.
Fatty Liver Disease
Quality assessment of guidelines/consensuses on traditional Chinese medicine/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease
Ruimin JIAO, Jingjie ZHAO, Juanjuan LI, Wei CHEN, Chaoru HAN, Li LI, Chunjun XU, Hong YOU
2025, 41(3): 446-452. DOI: 10.12449/JCH250309
Abstract(1719) HTML (96) PDF (936KB)(26)
Abstract:
  Objective  To evaluate the methodological quality and reporting quality of published guidelines/consensuses on traditional Chinese medicine （TCM）/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease （NAFLD）， and to provide a basis for formulating guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD in the future.  Methods  Databases including PubMed， Embase， Web of Science， CNKI， Wanfang Data， and CBM and the websites of China Association of Chinese Medicine and China Association of Integrative Medicine were searched for related articles published up to September 1， 2024. Two clinical researchers independently assessed the methodological quality and reporting quality of the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD by using Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ） and Reporting Items for Practice Guidelines in Healthcare （RIGHT）.  Results  A total of nine guidelines/consensuses were included after literature screening， with four guidelines and five expert consensuses. The scores of different domains assessed by AGREE Ⅱ for the nine guidelines/consensuses were as follows： scope and purpose （47.1%）， stakeholder involvement （41.0%）， rigor of development （21.6%）， clarity of presentation （40.2%）， applicability （19.0%）， and editorial independence （19.6%）. The recommendation level of the articles was B level （recommended after revision） for four articles and C level （not recommended） for five articles. The RIGHT assessment showed high reporting rates for “Basic Information” and “Background”， while other areas needed to be improved. Currently， there was no international standard for the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and the quality of these guidelines/consensuses needed to be enhanced to ensure comprehensiveness and credibility.  Conclusion  There is still potential for improving the quality of guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and AGREE Ⅱ and RIGHT checklists should be strictly followed to ensure the fairness， scientific rigor， and transparency of these guidelines/consensuses.
Diagnostic value of miR-128-3p， SIRT1， and AMPK in patients with type 2 diabetes mellitus comorbid with nonalcoholic fatty liver disease
Juyi LI, Yingqun NI, Yuanyuan ZHANG, Huaizhen LIU
2025, 41(3): 453-460. DOI: 10.12449/JCH250310
Abstract(172) HTML (79) PDF (1188KB)(17)
Abstract:
  Objective  To investigate the expression levels of miR-128-3p， SIRT1， and AMPK in the peripheral blood of patients with type 2 diabetes mellitus （T2DM） comorbid with nonalcoholic fatty liver disease （NAFLD）， as well as the role of miR-128-3p in predicting NAFLD in T2DM patients.  Methods  A total of 80 patients with T2DM who were hospitalized in The First Affiliated Hospital of Anhui University of Chinese Medicine from September 2022 to August 2023 were enrolled and divided into T2DM group with 40 patients and NAFLD group with 40 patients， and according to the NAFLD fibrosis score （NFS）， the patients were further divided into progressive liver fibrosis group with 16 patients and non-progressive liver fibrosis group with 64 patients. General data and biochemical parameters were collected； quantitative real-time PCR was used to measure the mRNA expression levels of miR-128-3p， SIRT1， and AMPK in peripheral blood， and Western blot was used to measure the protein expression levels of SIRT1 and AMPK. The independent-samples t test was used for comparison of normally distributed data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. The logistic regression analysis was used to identify the influencing factors for the presence of NAFLD and progressive liver fibrosis， and the receiver operating characteristic （ROC） curve analysis was used to determine the optimal cut-off value of miR-128-3p for predicting NAFLD.  Results  There were significant differences between the NAFLD group and the non-NAFLD group in body mass index， fasting plasma glucose， glycated hemoglobin， fasting insulin， fasting C-peptide， alanine aminotransferase （ALT）， aspartate aminotransferase， gamma-glutamyl transpeptidase， alkaline phosphatase， fibronectin， triglycerides， high-density lipoprotein cholesterol， total triiodothyronine （TT3）， Homeostasis Model Assessment of Insulin Resistance （HOMA-IR）， and NFS （all P<0.05）. Compared with the non-NAFLD group， the NAFLD group had a significantly higher mRNA expression level of miR-128-3p in peripheral blood （t=-8.765， P<0.001） and significant reductions in the mRNA and proteins expression levels of SIRT1 and AMPK （P<0.001）. There were significant differences between the progressive liver fibrosis group and the non-progressive liver fibrosis group in age， ALT， free triiodothyronine， TT3， superoxide dismutase， and miR-128-3p （all P<0.05）. The logistic regression analysis showed that miR-128-3p was an independent risk factor for the development of NAFLD （odds ratio ［OR］=8.221， 95% confidence interval ［CI］： 2.735 — 24.714， P<0.001） and progressive liver fibrosis （OR=1.493， 95%CI： 1.117‍ ‍—‍ ‍1.997， P=0.007）. The ROC curve analysis showed that miR-128-3p had an area under the ROC curve of 0.890 （95%CI： 0.829 — 0.950）， with an optimal cut-off value of 13.165， a sensitivity of 89.3%， and a specificity of 72.7%.  Conclusion  There is an increase in the expression of miR-128-3p in peripheral blood of T2DM patients with NAFLD， while there are reductions in the expression levels of SIRT1 and AMPK， suggesting that miR-128-3p has a certain diagnostic value in identifying NAFLD and liver fibrosis in such population.
Characteristics of T cells in the liver tissues of mice with nonalcoholic steatohepatitis
Ting MAO, Mingyi XU, Jiayi WANG
2025, 41(3): 461-468. DOI: 10.12449/JCH250311
Abstract(197) HTML (82) PDF (3813KB)(13)
Abstract:
  Objective  To investigate the heterogeneity and transcriptomic characteristics of T-cell subsets in the liver of mice with nonalcoholic steatohepatitis （NASH） at the single-cell level using single-cell RNA sequencing （scRNA-seq）， and to provide a reference for studying the mechanism of action of T cells in NASH.  Methods  Six male C57BL/6 mice were randomly divided into control group fed with regular diet and NASH group fed with methionine-choline-deficient （MCD） diet， with three mice in each group， and liver tissue was collected for scRNA-seq after 6 weeks of modeling. Specific differentially expressed genes were analyzed between T-cell subsets， and related analyses were performed， including dimension clustering， cell type annotation， t-distributed stochastic neighbor embedding （t-SNE）， violin plot， gene ontology （GO） functional enrichment analysis， and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. Immunofluorescent staining was used to observe the expression of the T cell marker Tcrα and the specific marker genes Tcf7 and Cxcr6 in the liver of mice in the two groups. The independent-samples t test was used for comparison of continuous data between two groups.  Results  Two T cell subsets were identified in the liver of mice， and the percentage of cluster 6 decreased from 58.5% in the control group to 48.7% in the NASH group. The top four specific genes were Nsg2， Cd8b1， Cd8a， and Tcf7. Tcf7， a characteristic marker gene for cluster 6， was expressed in 65% of cells in cluster 6， and therefore， cluster 6 was defined as Tcf7+ T cells. The GO and KEGG enrichment analyses showed that the differentially expressed genes of cluster 6 were involved in T cell activation， leukocyte adhesion， binding ubiquitin-like protein ligase， and the signaling pathways for Th17， Th1， and Th2 cell differentiation. The percentage of cluster 7 increased from 41.5% in the control group to 51.3% in the NASH group. The top four specific genes of cluster 7 were Cd40lg， Tcrg-C1， Il2rα， and Cxcr6. Cxcr6 was expressed in 90% of cells in cluster 7， and therefore， cluster 7 was defined as Cxcr6+ T cells. The GO and KEGG enrichment analyses showed that cluster 7 was involved in T cell activation， cytokine production， the T cell receptor signaling pathway， and the Th17 cell differentiation and MAPK signaling pathway. Immunofluorescence assay showed that compared with the control group， the NASH group showed a significant reduction in the area with positive co-expression of Tcf7 protein and Tcrα protein （1.80%±0.67% vs 0.33%±0.13%， P<0.05） and a significant increase in the area with positive co-expression of Cxcr6 protein and Tcrα protein （0.50%±0.09% vs 2.66%± 0.33%， P<0.001）.  Conclusion  There is a reduction in the percentage of Tcf7+ T cells and an increase in the percentage of Cxcr6+ T cells in NASH mice， revealing the characteristics and differences of T cells in the liver of NASH mice.
Liver Fibrosis and Liver Cirrhosis
Effect of Yiqi Yangyin Jiedu Huayu prescription on intestinal metabolites in liver cirrhosis with minimal hepatic encephalopathy： A study based on metabolomics
Tingting JIANG, Qun ZHANG, Xianbo WANG, Yuyong JIANG, Xiaoli LIU, Hao YU, Zhiyun YANG
2025, 41(3): 469-477. DOI: 10.12449/JCH250312
Abstract(1391) HTML (83) PDF (5152KB)(14)
Abstract:
  Objective  To investigate the effect of Yiqi Yangyin Jiedu Huayu prescription on minimal hepatic encephalopathy in liver cirrhosis based on intestinal metabolomics.  Methods  A total of 11 patients with liver cirrhosis who were hospitalized in Beijing Ditan Hospital， Capital Medical University， from March to May 2024， and were diagnosed with MHE based on psychometric hepatic encephalopathy score were enrolled as subjects， and 11 healthy family members of the patients were enrolled as control group. Fecal samples were collected for metabolomics analysis from the control group and the patients with MHE before and after treatment with Yiqi Yangyin Jiedu Huayu prescription， and a population cohort study was conducted to investigate the effect of Yiqi Yangyin Jiedu Huayu prescription on intestinal metabolism of patients with MHE. The Fisher’s exact test was used for categorical data between two groups； the independent samples t-test was used for comparison of normally distributed continuous data between two groups， the paired t-test was used for comparision before and after treatment within the same group， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups.  Results  A total of 29 differentially expressed metabolites were detected between the MHE group and the control group， mainly amino acids， organic acids， organic amines， carbohydrates， fatty acids， and vitamins， and there were 12 upregulated metabolites and 17 downregulated metabolites in the MHE group， which were mainly enriched in the metabolic pathways of ornithine， branched-chain amino acid， and aromatic amino acid. After the treatment with Yiqi Yangyin Jiedu Huayu prescription， 80 differentially expressed metabolites were detected in the patients with MHE， mainly carbohydrates， organic acids， and amino acids， and there were 56 upregulated metabolites and 24 downregulated metabolites， which were mainly enriched in the metabolic pathways of ornithine， branched-chain amino acid， and aromatic amino acid.  Conclusion  Yiqi Yangyin Jiedu Huayu prescription can exert a therapeutic effect on patients with MHE by regulating intestinal metabolism.
Liver Neoplasm
Effect of the nitroglycerin-controlled low central venous pressure technique on cerebral metabolic markers and cerebral blood oxygen saturation in patients undergoing laparoscopic hepatectomy for liver cancer
Bo WANG, Xia FU, Conghai LYU, Chunfang YIN, Qiyuan WU
2025, 41(3): 478-484. DOI: 10.12449/JCH250313
Abstract(1219) HTML (69) PDF (743KB)(16)
Abstract:
  Objective  To investigate the effect of the nitroglycerin-controlled low central venous pressure （CLCVP） technique on brain metabolic markers and cerebral blood oxygen saturation in patients undergoing laparoscopic hepatectomy for liver cancer， and to reduce the risk of neurological complications.  Methods  A total of 105 patients who underwent elective laparoscopic hepatectomy for liver cancer in Haikou Hospital Affiliated to Xiangya Hospital of Central South University from April 2020 to May 2023 were enrolled and randomly divided into CLCVP group with 54 patients and non-CLCVP group with 51 patients. The patients in the CLCVP group were treated with the nitroglycerin CLCVP technique during surgery， while those in the non-CLCVP group were given conventional surgical treatment. The two groups were compared in terms of the following indicators： perioperative indicators； hemodynamic parameters and cerebral oxygen metabolism before anesthesia induction （T0）， at 5 minutes after anesthesia induction （T1）， at 5 minutes after the beginning of liver parenchyma dissection （T2）， at 5 minutes after the end of hepatectomy （T3）， and immediately after the end of surgery （T4）； the changes in liver function parameters after surgery； the incidence rate of adverse reactions. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups； the analysis of variance with repeated measures was used for comparison between multiple time points.  Results  Compared with the non-CLCVP group， the CLCVP group had significantly lower intraoperative blood loss and intraoperative fluid infusion volume （t=5.408 and 7.220， both P<0.05）， while there were no significant differences between the two groups in time of operation， anesthesia time， extubation time， resuscitation time and intraoperative urine volume （all P>0.05）. Compared with the data at T0， both groups had significant reductions in mean arterial pressure， heart rate， and central venous pressure during surgery （all P<0.05）， and compared with the non-CLCVP group， the CLCVP group had significantly lower mean arterial pressure and central venous pressure （P<0.05） and a significantly higher heart rate （P<0.05） at T2 and T3. Compared with the data at T0， both groups had a significant reduction in Ca-jvDO2 at T2‍ ‍—‍ ‍T4 time points （all P<0.05）， while there was no significant difference in Ca-jvDO2 between the two groups at each time point （all P>0.05）. Compared with the data at T0， the CLCVP group had a significant reduction in rSO2 at T2‍ ‍—‍ ‍T4 time points （all P<0.05）， and the CLCVP group had a significantly lower level of rSO2 than the non-CLCVP group at T2‍ ‍—‍ ‍T3 time points （both P<0.05）； there were no significant changes in CERO2 and Djv-aBL in either group at each time point （all P>0.05）. At 3 and 7 days after surgery， both groups had significant increases in the liver function parameters of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， and total bilirubin （TBil） （all P<0.05）， and the CLCVP group had significantly lower levels of AST and ALT than the non-CLCVP group （all P<0.05）； there was no significant difference in TBil between the two groups at each time point （all P>0.05）. There was no significant difference in the incidence rate of perioperative complications between the two groups （χ2=0.729， P=0.394）.  Conclusion  The application of the nitroglycerin CLCVP technique in laparoscopic hepatectomy for liver cancer can reduce the amount of intraoperative blood loss in patients， but it is necessary to further enhance the monitoring of cerebral blood oxygen saturation during surgery， so as to reduce the risk of neurological complications as much as possible.
Effect of Go-Ichi-Ni-San complex subunit 1 on disease progression and chemotherapy resistance in hepatocellular carcinoma
Yishan HUO, Dawei LI, Xiangbing DUAN, Yuyu MA, Guojun ZHANG, Kainan ZHANG, Xiumin MA
2025, 41(3): 485-492. DOI: 10.12449/JCH250314
Abstract(152) HTML (75) PDF (3409KB)(12)
Abstract:
  Objective  To investigate the role and mechanism of Go-Ichi-Ni-San complex subunit 1 （GINS1） in the progression of hepatocellular carcinoma （HCC） and the development of chemotherapy resistance.  Methods  The tumor database GEPIA2 was used to analyze the differential expression of GINS1 between HCC patients and healthy individuals， and pathological tissue samples were collected from 40 HCC patients who were admitted to The Affiliated Tumor Hospital of Xinjiang Medical University and the First Affiliated Hospital of Xinjiang Medical University from May 2017 to January 2021. Immunohistochemical staining was used to measure the difference in the expression of GINS1 between HCC tissue and corresponding adjacent tissue， and the correlation between the expression level of GINS1 and the clinical TNM stage of HCC was analyzed. Western blot was also used to measure the difference in the expression of GINS1 between HCC Huh7/Hep3B/Li-7/MHCC97H cell lines and normal human QSG7701 hepatocytes. The method of lentivirus transfection was used to establish the MHCC97H cell line with stable GINS1 knockdown and its negative control cell line. CCK-8 assay and colony formation assay were used to measure cell proliferative capacity； scratch assay was used to measure cell migration ability； Transwell assay was used to measure cell invasion ability； cells were treated with oxaliplatin to measure their sensitivity to chemotherapy drugs. Nude mice were used to establish a tumor-bearing model and observe the effect of GINS1 knockdown on the growth of HCC in vivo. Western Blot was used to measure the expression levels of the proteins associated with the Notch pathway and the JAK/STAT pathway. The cells were treated with the Notch receptor agonist Jagged-1 to analyze the association between GINS1 and the Notch/JAK/STAT pathway. The independent-samples t test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups.  Results  The expression of GINS1 was upregulated in HCC patients， HCC tissue， and HCC cell lines （all P<0.05）， and the expression level of GINS1 was positively correlated with the clinical TNM stage of HCC （r=0.822， P=0.011）. Compared with the negative control cells， the GINS1-knockdown MHCC97H cells showed significant reductions in proliferation， migration， and invasion activities （all P<0.01） and a significantly enhanced sensitivity to oxaliplatin （P<0.01）. Compared with the nude mice in the control group， GINS1 knockdown caused significant inhibition of tumor weight and volume in vivo in nude mice （all P<0.001）. Compared with the negative control cells， the GINS1-knockdown MHCC97H cells showed significant reductions in the expression levels of Notch1， Notch3， p-JAK2， and p-STAT3 （all P<0.05）， while there were no significant differences in the overall expression levels of JAK2 and STAT3 （P>0.05）. After Jagged-1 treatment， the GINS1-knockdown MHCC97H cells showed significant increases in proliferation， migration， and invasion activities and a significant reduction in sensitivity to oxaliplatin， as well as significant increases in the levels of p-JAK2 and p-STAT3 （all P<0.05）.  Conclusion  GINS1 is upregulated in HCC and can promote HCC progression and chemotherapy resistance through the Notch/JAK2/STAT3 pathway.
Effect and mechanism of gallic acid on the proliferation， migration， invasion， and apoptosis of human hepatocellular carcinoma HepG2 cells
Zhiru WANG, Wenjing ZHAO, Xi CHEN
2025, 41(3): 493-498. DOI: 10.12449/JCH250315
Abstract(175) HTML (79) PDF (3143KB)(13)
Abstract:
  Objective  To investigate the effect of gallic acid （GA） on the proliferation， migration， invasion， and apoptosis of human hepatocellular carcinoma HepG2 cells and its mechanism.  Methods  HepG2 cells were treated with different concentrations of GA （0， 5， 10， 20， 30， 40， and 50 μg/mL） for 24 and 48 hours， and CCK8 assay was used to measure cell viability and calculate IC50. The experiment was divided into control group （HepG2 cells）， 5 μg/mL GA group， 10 μg/mL GA group， and 20 μg/mL GA group. Plate colony formation assay was used to evaluate the effect of GA on cell proliferation； wound healing assay and Transwell chamber assay were used to observe the effect of GA on cell migration and invasion； flow cytometry was used to observe the effect of GA on cell apoptosis； Western blot was used to measure the expression of matrix metallopeptidase-2 （MMP-2）， matrix metallopeptidase-9 （MMP-9）， and apoptosis-related proteins. A one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups.  Results  The mean IC50 value of GA on HepG2 cells was 38.02±2.58 μg/mL at 24 hours and 18.36±1.54 μg/mL at 48 hours. The number of cell colonies was 239.00±29.45 in the control group， 210.00±19.00 in the 5 μg/mL GA group， 144.33±16.03 in the 10 μg/mL GA group， and 57.00±9.55 in the 20 μg/mL GA group， suggesting that compared with the control group， each GA group had a significant reduction in cell colony formation ability （all P<0.05）. After 24 hours of treatment， the cell migration rate was 42.62%± 7.82% in the control group， 35.34%±6.42% in the 5 μg/mL GA group， 21.85%±4.42% in the 10 μg/mL GA group， and 12.57%± 3.54% in the 20 μg/mL GA group， respectively， in these four groups， and the number of transmembrane cells in these four groups was 230.30±15.30， 182.12±12.60， 137.20±7.50， and 124.40±6.80， respectively， suggesting that compared with the control group， each GA group had significant reductions in migration rate and the number of transmembrane cells （all P<0.05）. After 48 hours of treatment， the cell apoptotic rate was 0.67%±0.08% in the control group， 13.27%±1.07% in the 5 μg/mL GA group， 20.94%± 2.45% in the 10 μg/mL GA group， and 40.74%±2.63% in the 20 μg/mL GA group， and compared with the control group， each GA group had a significant increase in cell apoptosis rate （all P<0.05）. Compared with the control group， each GA group had significant reductions in the protein expression levels of MMP-2 and MMP-9 （all P<0.05） and significant increases in the protein expression levels of Bax and cleaved caspase-3 （all P<0.05）.  Conclusion  GA can inhibit the proliferation， migration， and invasion of HepG2 cells and promote the apoptosis of HepG2 cells， possibly by regulating MMP-2， MMP-9， and the apoptosis-related proteins Bax/Bcl-2.
Study on the protective efect and mechanism of paeoniflorin on palmitic acid-induced HepG2 cells
Tong LIU, Shanzheng LI, Cheng ZHOU, Sutong LIU, Lihui ZHANG, Wenxia ZHAO
2025, 41(3): 499-505. DOI: 10.12449/JCH250316
Abstract(1495) HTML (78) PDF (2930KB)(10)
Abstract:
  Objective  To investigate the role and mechanism of action of paeoniflorin （PF） in protecting HepG2 cells induced by palmitic acid （PA）.  Methods  HepG2 cells were stimulated with PA at a concentration of 250 μmol/L to establish a NAFLD model. Compound C at a concentration of 10 μmol/L was used as an inhibitor， and PF at a concentration of 25 μmol/L was used for intervention. The experiment was divided into normal group （CON group） treated with complete culture medium， model group （MOD group） treated with PA， PF treatment group （MOD+PF group） treated with PA and PF， model+inhibitor group （MOD+COM group） treated with PA and Compound C， and model+inhibitor+PF group （MOD+COM+PF group） treated with PA， Compound C， and PF. Kits were used to measure lipid deposition indicators， liver function parameters， oxidative stress indicators， and inflammation indicators； oil red O staining was used to observe lipid deposition； Western Blot was used to measure the protein expression levels of AMPK， SIRT1， PGC-1α， mTOR， Beclin-1， LC3， and P62 in cells. The one-way analysis of variance was used for comparison of quantitative data between groups， while the Tukey’s test was used for comparison between two groups.  Results  Compared with the MOD group， PF improved the levels of TC and TG （P<0.05）， reduced the levels of ALT， AST， CRP， TNF-α， IL-1β， and IL-6 （P<0.05）， increased the activity of SOD and CAT and the level of GSH， and reduced the level of MDA in cells （all P<0.05）. Oil red O staining showed that PF alleviated lipid deposition in cells. Western blot results showed that compared with the MOD group， PF increased the protein expression levels of p-AMPK， SIRT1， PGC-1α， LC3Ⅱ/LC3Ⅰ， and Beclin-1 and reduced the protein expression levels of p-mTOR and P62 （all P<0.05）.  Conclusion  PF can inhibit PA-induced oxidative stress and inflammatory response in HepG2 cells， improve lipid deposition， and promote autophagy via the AMPK/SIRT1/PGC-1α/mTOR signaling pathway.
Other Liver Disease
Influencing factors for meropenem-related liver injury and their predictive value
Yan HE, Hongqin KE, Hongliang LI, Jianyong ZHU, Lijun ZHAO, Huibin YU
2025, 41(3): 506-512. DOI: 10.12449/JCH250317
Abstract(194) HTML (97) PDF (1170KB)(31)
Abstract:
  Objective  To analyze the factors influencing meropenem-related liver injury （MRLI） and to explore their clinical predictive value.  Methods  A retrospective case-control study was conducted， and the Chinese Hospital Pharmacovigilance System （CHPS） was used to establish a retrieval scheme. A total of 1 625 hospitalized cases using meropenem from January 2018 to December 2022 were collected. Patients were divided into case group （n=62） and control group （n=1 563） based on the presence or absence of liver injury. Clinical data and laboratory indicators from both groups were collected and analyzed. The t-test was used for comparison of normally distributed continuous data between the two groups， while the Mann-Whitney U test was used for comparison of continuous data not conforming to a normal distribution. The chi-square test was used for comparison of categorical data between the two groups. A multivariate Logistic regression analysis was performed to identify the influencing factors for MRLI. A Logistic regression equation was established， and the predictive value of these factors was assessed using the receiver operating characteristic （ROC） curve.  Results  The results of univariate analysis indicated that the rates of male patients， hypoproteinemia， shock， intensive care unit （ICU） admissions， sepsis， and liver， gallbladder， and cardiovascular diseases， the levels of alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， gamma-glutamyl transpeptidase （GGT）， aspartate aminotransferase （AST）， creatinine （CREA）， and procalcitonin （PCT）， and the number of hospitalization days were significantly higher in the case group than in the control group （P<0.05）， and that the platelet levels in the case group were significantly lower than those in the control group （P<0.05）. The multivariate Logistic regression analysis showed that male sex （odds ratio ［OR］=2.080， 95% confidence interval ［CI］： 1.050 — 4.123， P=0.036）， admission to the ICU （OR=8.207， 95%CI： 4.094‍ ‍—‍ ‍16.453， P<0.001）， comorbidity with gallbladder disease （OR=8.240， 95%CI： 3.605‍ ‍—‍ ‍18.832， P<0.001）， ALP （OR=1.012， 95%CI： 1.004‍ ‍—‍ ‍1.019， P=0.004）， GGT （OR=1.010， 95%CI： 1.005‍ ‍—‍ ‍1.015， P<0.001）， and PLT （OR=0.997， 95%CI： 0.994‍ ‍—‍ ‍0.999， P=0.020） were the influential factors for MRLI. The areas under the ROC curve of ALP， GGT， and PLT were 0.589， 0.637， and 0.595， respectively， and the AUC of them combined was 0.837.  Conclusion  Male sex， ICU admission， comorbidity with gallbladder disease， increased ALP， increased GGT， and decreased PLT were influencing factors for MRLI， and a combination of factors has a better predictive value for the occurrence of MRLI.
Biliary Disease
Efficacy and safety of endoscopic retrograde cholangiopancreatography combined with oral cholangiopancreatography in the treatment of duodenal papilla cholecystectomy
Liying TAO, Hongguang WANG, Qingmei GUO, Xiang GUO, Lianyu PIAO, Muyu YANG, Yong YU, Libin RUAN, Jianbin GU, Si CHEN, Yingting DU, Xiuying GAI, Sijie GUO
2025, 41(3): 513-517. DOI: 10.12449/JCH250318
Abstract(169) HTML (83) PDF (1711KB)(19)
Abstract:
  Objective  To investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps.  Methods  A retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications.  Results  Both the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed.  Conclusion  Oral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.
Development of a predictive model and application for spontaneous passage of common bile duct stones based on automated machine learning
Jian CHEN, Kaijian XIA, Fuli GAO, Luojie LIU, Ganhong WANG, Xiaodan XU
2025, 41(3): 518-527. DOI: 10.12449/JCH250319
Abstract(1474) HTML (82) PDF (3367KB)(17)
Abstract:
  Objective  To develop a predictive model and application for spontaneous passage of common bile duct stones using automated machine learning algorithms given the complexity of treatment decision-making for patients with common bile duct stones， and to reduce unnecessary endoscopic retrograde cholangiopancreatography （ERCP） procedures.  Methods  A retrospective analysis was performed for the data of 835 patients who were scheduled for ERCP after a confirmed diagnosis of common bile duct stones based on imaging techniques in Changshu First People’s Hospital （dataset 1） and Changshu Traditional Chinese Medicine Hospital （dataset 2）. The dataset 1 was used for the training and internal validation of the machine learning model and the development of an application， and the dataset 2 was used for external testing. A total of 22 potential predictive variables were included for the establishment and internal validation of the LASSO regression model and various automated machine learning models. The area under the receiver operating characteristic curve （AUC）， sensitivity， specificity， and accuracy were used to assess the performance of models and identify the best model. Feature importance plots， force plots， and SHAP plots were used to interpret the model. The Python Dash library and the best model were used to develop a web application， and external testing was conducted using the dataset 2. The Kolmogorov-Smirnov test was used to examine whether the data were normally distributed， and the Mann-Whitney U test was used for comparison between two groups， while the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups.  Results  Among the 835 patients included in the study， 152 （18.20%） experienced spontaneous stone passage. The LASSO model achieved an AUC of 0.875 in the training set （n=588） and 0.864 in the validation set （n=171）， and the top five predictive factors in terms of importance were solitary common bile duct stones， non-dilated common bile duct， diameter of common bile duct stones， a reduction in serum alkaline phosphatase （ALP）， and a reduction in gamma-glutamyl transpeptidase （GGT）. A total of 55 models were established using automated machine learning， among which the gradient boosting machine （GBM） model had the best performance， with an AUC of 0.891 （95% confidence interval： 0.859‍ ‍—‍ ‍0.927）， outperforming the extreme randomized tree mode， the deep learning model， the generalized linear model， and the distributed random forest model. The GBM model had an accuracy of 0.855， a sensitivity of 0.846， and a specificity of 0.857 in the test set （n=76）. The variable importance analysis showed that five factors had important influence on the prediction of spontaneous stone passage， i.e.， were solitary common bile duct stones， non-dilated common bile duct， a stone diameter of <8 mm， a reduction in serum ALP， and a reduction in GGT. The SHAP analysis of the GBM model showed a significant increase in the probability of spontaneous stone passage in patients with solitary common bile duct stones， non-dilated common bile duct， a stone diameter of <8 mm， and a reduction in serum ALP or GGT.  Conclusion  The GBM model and application developed using automated machine learning algorithms exhibit excellent predictive performance and user-friendliness in predicting spontaneous stone passage in patients with common bile duct stones. This application can help avoid unnecessary ERCP procedures， thereby reducing surgical risks and healthcare costs.
Pancreatic Disease
Distribution pattern of traditional Chinese medicine syndromes and analysis of influencing factors in pancreatic cancer
Zhiyao SHI, Shiyu WU, Shaojian REN, Yichan LIU, Yijie YIN, Yu GAO, Xixing WANG
2025, 41(3): 528-535. DOI: 10.12449/JCH250320
Abstract(192) HTML (97) PDF (750KB)(10)
Abstract:
  Objective  To investigate the influencing factors for traditional Chinese medicine （TCM） syndromes in pancreatic cancer by analyzing 608 cases， and to provide a theoretical reference for TCM syndrome differentiation and standardized treatment of pancreatic cancer.  Methods  A total of 608 patients with a pathological or clinical diagnosis of pancreatic cancer who were admitted to Shanxi Institute of Traditional Chinese Medicine， The Affiliated Hospital of Shanxi University of Chinese Medicine， and Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2023 were enrolled， and TCM syndrome differentiation was performed. The chi-square test was used for comparison of categorical data between groups. The clinical data with statistical significance between groups were included in the regression analysis， and the unordered polytomous logistic regression model was used to investigate the influencing factors for the TCM syndrome of pancreatic cancer.  Results  For the 608 patients with pancreatic cancer， common initial symptoms included abdominal pain （32.40%）， abdominal distension （23.85%）， fatigue （16.12%）， and emaciation （10.03%）， and the main clinical symptoms included poor appetite （75.97%）， abdominal pain （67.27%）， fatigue （61.84%）， abdominal distension （57.40%）， and emaciation （53.62%）. There were significant differences between the patients with different TCM syndromes of pancreatic cancer in sex （χ2=62.823， P<0.001）， disease duration （χ2=14.868， P=0.011）， clinical stage （χ2=21.006， P<0.001）， lymph node metastasis （χ2=2.205， P=0.032）， surgery （χ2=38.008， P<0.001）， chemotherapy （χ2=21.384， P<0.001）， radiotherapy （χ2=17.510， P=0.004）， and immunotherapy （χ2=18.573， P=0.002）. The logistic regression analysis showed that male sex was a protective factor against Qi and blood deficiency syndrome （odds ratio ［OR］=0.081， 95% confidence interval ［CI］： 0.031‍ ‍—‍ ‍0.213， P<0.001）， Qi stagnation and blood stasis syndrome （OR=0.100， 95%CI： 0.041‍ ‍—‍ ‍0.247， P<0.001）， and syndrome of Yin deficiency with internal heat （OR=0.158， 95%CI： 0.057‍ ‍—‍ ‍0.444， P<0.001）， while it was a risk factor for the syndrome of damp-heat accumulation （OR=2.378， 95%CI： 1.074‍ ‍—‍ ‍5.266， P=0.033）； the course of the disease of<1 year was a protective factor against Qi and blood deficiency syndrome （OR=0.167， 95%CI： 0.073‍ ‍—‍ ‍0.383， P<0.001）， syndrome of spleen-kidney Yang deficiency （OR=0.183， 95%CI： 0.089‍ ‍—‍ ‍0.378， P<0.001）， and syndrome of Yin deficiency and internal heat （OR=0.164， 95%CI： 0.070‍ ‍—‍ ‍0.385， P<0.001）； clinical stage Ⅰ/Ⅱ/Ⅲ was a risk factor for damp-heat accumulation （OR=2.793， 95%CI： 1.259‍ ‍—‍ ‍6.196， P=0.012） and Qi stagnation and blood stasis syndrome （OR=7.863， 95%CI： 2.808‍ ‍—‍ ‍22.020， P<0.001）； lymph node metastasis was a risk factor for Qi and blood deficiency syndrome （OR=4.005， 95%CI： 1.477‍ ‍—‍ ‍10.861， P=0.006）； surgical treatment was a risk factor for Qi and blood deficiency syndrome （OR=4.151， 95%CI： 1.916‍ ‍—‍ ‍8.995， P<0.001）， syndrome of spleen-kidney yang deficiency （OR=5.352， 95%CI： 2.436‍ ‍—‍ ‍11.759， P<0.001）， Qi stagnation and blood stasis syndrome （OR=2.334， 95%CI： 1.071‍ ‍—‍ ‍5.088， P=0.033）， and syndrome of Yin deficiency and internal heat （OR=4.167， 95%CI： 1.789‍ ‍—‍ ‍9.707， P<0.001）； chemotherapy was a protective factor against damp-heat accumulation （OR=0.188， 95%CI： 0.082‍ ‍—‍ ‍0.428， P<0.001）； radiotherapy was a risk factor for damp-heat accumulation （OR=2.571， 95%CI： 1.151‍ ‍—‍ ‍5.746， P=0.021） and syndrome of Yin deficiency with internal heat （OR=8.384， 95%CI： 3.348‍ ‍—‍ ‍20.997， P<0.001）； immunotherapy was a risk factor for Qi and blood deficiency syndrome （OR=2.114， 95%CI： 1.021‍ ‍—‍ ‍4.379， P=0.044）.  Conclusion  Sex， course of the disease， clinical stage， presence or absence of lymph node metastasis， surgery， chemotherapy， radiotherapy， and immunotherapy are the main influencing factors for the TCM syndrome of pancreatic cancer.
Case Report
Rare giant hepatic angiomyolipoma with subcapsular rupture misdiagnosed as hepatocellular carcinoma： A case report
Zhiwei ZHANG, Feng LIU, Hezhao ZHANG, Qinying WANG, Zhiyong SHI
2025, 41(3): 536-541. DOI: 10.12449/JCH250321
Abstract(161) HTML (84) PDF (3282KB)(24)
Abstract:
Hepatic angiomyolipoma （HAML） is a rare benign mesenchymal tumor frequently observed in middle-aged women. Due to the absence of prominent symptoms in the early stage and the lack of specific imaging findings， the diagnosis of this disease can be challenging， leading to a high rate of misdiagnosis. This article reports a case of giant HAML with subcapsular rupture that was misdiagnosed as hepatocellular carcinoma and introduces the characteristics of the case and its diagnosis and treatment process， in order to provide a reference for the diagnosis and treatment of this type of disease.
Review
Clinical diagnosis of drug-induced autoimmune-like hepatitis
Yongping LIU, Yaojie SHEN
2025, 41(3): 542-546. DOI: 10.12449/JCH250322
Abstract(186) HTML (88) PDF (640KB)(39)
Abstract:
Some patients with drug-induced liver injury （DILI） may present with similar features to patients with autoimmune hepatitis （AIH）， and such cases are defined as drug-induced autoimmune-like hepatitis （DI-ALH）. In 2022， the European Association for the Study of the Liver discussed the nomenclature， diagnosis， and treatment of DI-ALH and put forward expert opinions to establish the criteria for clinical diagnosis. However， the clinical diagnosis of DI-ALH remains complex and difficult， and there is no direct evidence for the link between drug intake and the body’s immune progression. Therefore， this article reviews the research advances in the diagnosis of DI-ALH from the four aspects of clinical phenotype， pathological diagnosis， diagnostic score， and clinical prognosis.
Role of amino acid metabolism in autoimmune hepatitis and related therapeutic targets
Peipei GUO, Yang XU, Jiaqi SHI, Yang WU, Lixia LU, Bin LI, Xiaohui YU
2025, 41(3): 547-551. DOI: 10.12449/JCH250323
Abstract(168) HTML (90) PDF (595KB)(21)
Abstract:
Autoimmune hepatitis （AIH） is a chronic inflammatory liver disease. The pathogenesis of AIH remains unclear， but it is mainly autoimmune injury caused by the breakdown of autoimmune tolerance due to the abnormal activation of the immune system， while the specific molecular mechanism remains unknown. Recent studies have shown that abnormal amino acid metabolism plays an important role in the development and progression of AIH. This article reviews the research advances in amino acid metabolic reprogramming in AIH， in order to provide a theoretical basis for amino acid metabolism as a new target for the clinical diagnosis and treatment of AIH.
Gut microbiota in hepatitis B cirrhosis
Yannan LI, Changzheng LI
2025, 41(3): 552-555. DOI: 10.12449/JCH250324
Abstract(194) HTML (85) PDF (554KB)(33)
Abstract:
Hepatitis B cirrhosis is the most significant component of liver cirrhosis in China， and there is a significant increase in the mortality rate of patients after progression from hepatitis to liver cirrhosis. A large number of studies have shown that gut microbiota may influence the progression of hepatitis B cirrhosis， including the impact on the regulation of inflammatory response and intestinal immunity， the inhibition of HBV， and the production of ammonia-like substances. This article reviews the research advances in the changes in gut microbiota in hepatitis B cirrhosis patients and explores new ideas for the treatment of hepatitis B cirrhosis by intervening in gut microbiota.
Application of Model for End-Stage Liver Disease score in end-stage liver disease
Rigan XIGU, Ya SU, Jing TONG, Bingyuan WANG
2025, 41(3): 556-560. DOI: 10.12449/JCH250325
Abstract(1347) HTML (83) PDF (583KB)(39)
Abstract:
The Model for End-Stage Liver Disease （MELD） score is currently used to prioritize liver allocation for cirrhotic patients awaiting liver transplantation in the world. With the application of MELD score in transplantation for patients with severe conditions， several models have been proposed to refine and improve MELD score. MELD score has also been used for the management of non-transplantation patients with chronic liver disease. This article briefly reviews the background of these models and believes that the original intention of MELD is to determine the priority of organ allocation for liver transplantation. The expanded application of MELD score beyond liver transplantation assessment should be performed with reference to clinical practice， and different MELD models should be selected rationally based on individual conditions， in order to help patients achieve optimal prognosis assessment， intervention measures， and benefits.
Influencing factors for the homing ability of mesenchymal stem cells in end-stage liver disease and optimization measures
Yuxin LIU, Liaoyun ZHANG
2025, 41(3): 561-567. DOI: 10.12449/JCH250326
Abstract(161) HTML (103) PDF (761KB)(15)
Abstract:
Mesenchymal stem cells （MSCs） have emerged as a promising cellular therapy for end-stage liver disease （ESLD） due to their robust self-regenerative， paracrine， and immunomodulatory characteristics， providing new directions for the treatment of advanced liver disease. However， the clinical application of MSCs is significantly limited by the fact that only a small number of MSCs can reach the liver due to massive apoptosis or necrosis during the homing process caused by the influence of the complex microenvironment （inflammation， oxidative stress， and hypoxia） of the injured liver and the fact that a substantial proportion of MSCs become trapped in the pulmonary capillaries following intravenous administration with a lack of sufficient homing receptors or adhesion molecules. Various strategies have been developed to optimize the proliferation， migration， and homing abilities of MSCs， including preconditioning， gene modification， and nanoencapsulation technology. This article elaborates on the influencing factors for the homing ability of MSCs， the strategies to optimize their homing in ESLD， and the mechanism of the homing of MSCs， in order to improve cell transplantation efficiency， promote liver repair and regeneration， and pave the way for the application of MSCs in the treatment of ESLD.
Effect of intestinal flora and metabolites on the development and progression of acute-on-chronic liver failure
Ke SHI, Qun ZHANG, Xianbo WANG, Ying FENG
2025, 41(3): 568-573. DOI: 10.12449/JCH250327
Abstract(1712) HTML (84) PDF (680KB)(24)
Abstract:
Acute-on-chronic liver failure （ACLF） is a dangerous disease with severe conditions， rapid progression， and high short-term mortality. Intestinal flora and metabolites are closely associated with the development， progression， and pathogenesis of ACLF. During the development of ACLF， the destruction of intestinal integrity and the dysregulation of intestinal microecology and its metabolites mediate immune disturbance and thus aggravate systemic inflammatory response. This article elaborates on the role of intestinal flora and metabolites in the development and progression of ACLF and related therapeutic strategies.
Association between intestinal barrier disruption in liver failure and the cGAS-STING signaling pathway
Qiao TANG, Chao ZHOU, Ning ZHANG, Man GONG
2025, 41(3): 574-579. DOI: 10.12449/JCH250328
Abstract(150) HTML (81) PDF (937KB)(14)
Abstract:
Liver failure is a common severe syndrome of liver diseases with high mortality. The function and structural integrity of the intestinal barrier as an entity are closely associated with the development and progression of liver failure. The cGAS-STING signaling pathway can participate in innate immune response by recognizing DNA produced by pathogen invasion and host cell damage and inducing the production of type I interferon. Numerous studies have shown that activation of the cGAS-STING pathway can significantly impact the cellular structure， mucosal components， and commensal bacteria of the intestinal barrier. This article reviews the interplay between the cGAS-STING signaling pathway and intestinal barrier disruption in liver failure， in order to provide novel insights for the clinical management of liver failure.
Risk factors， diagnosis and treatment of perforation after endoscopic retrograde cholangiopancreatography
Wenyu ZHAO, Yan FU, Yajiao DUAN, Juan TANG, Jing NI
2025, 41(3): 580-587. DOI: 10.12449/JCH250329
Abstract(170) HTML (73) PDF (806KB)(20)
Abstract:
After 50 years of clinical development， endoscopic retrograde cholangiopancreatography （ERCP） has become the preferred method for the clinical diagnosis and treatment of cholangio-pancreatic duct diseases； however， the major postoperative complications of ERCP， such as pancreatitis， hemorrhage， and perforation， are still a difficult issue faced by clinicians， and postoperative perforation is associated with an extremely high risk of death. Therefore， it is very important to explore the risk factors for perforation after ERCP， make a definite diagnosis of perforation in a timely manner， and formulate precise prevention and treatment measures. By reviewing a large number of articles， this article summarizes the influencing factors for perforation after ERCP and related diagnosis and treatment measures.
Mechanism of action of bile-gut axis in the development and progression of intrahepatic cholangiocarcinoma
Xue YU, Tianhao SHEN, Cheng ZHOU, Yu LIU, Wei LI, Tinghui JIANG, Yongqiang ZHU, Yan LIU
2025, 41(3): 588-593. DOI: 10.12449/JCH250330
Abstract(167) HTML (87) PDF (1044KB)(18)
Abstract:
Intrahepatic cholangiocarcinoma is a malignant tumor with an extremely poor prognosis， and its pathogenesis is complex and remains unclear. In recent years， more and more studies have focused on the role of bile-gut axis in the development and progression of intrahepatic cholangiocarcinoma. Bile-gut axis refers to the complex interaction between bile and gut microbiota， including bile salt metabolism， dynamic changes of microbiota， inflammatory response， and immune system regulation. This article elaborates on the potential mechanisms of bile-gut axis in intrahepatic cholangiocarcinoma， especially gut microbiota dysbiosis， abnormal bile salt metabolism， chronic inflammatory response， and immune system interaction， this article aims to provide new perspectives and possible therapeutic targets for future research and promote the early diagnosis and effective treatment of intrahepatic cholangiocarcinoma.
Components of tumor stroma-immune microenvironment and their interactions in intrahepatic cholangiocarcinoma
Qiulu ZHANG, Zhuo LI, Congrong LIU, Limei GUO
2025, 41(3): 594-600. DOI: 10.12449/JCH250331
Abstract(162) HTML (76) PDF (1621KB)(18)
Abstract:
Intrahepatic cholangiocarcinoma （ICC） is a highly malignant liver tumor， and due to the absence of symptoms in its early stage and the lack of effective treatment measures， patients tend to have an extremely low 5-year survival rate. The tumor stroma-immune microenvironment （TSIME） is a complex ecosystem that changes dynamically during tumorigenesis and evolution and consists of a variety of cellular and non-cellular components， and it plays an important role in the development， proliferation， invasion， and progression of ICC and determines the heterogeneity and malignancy of ICC to a certain degree. This article reviews the cellular components （such as T cells， B cells， natural killer cells， dendritic cells， neutrophils， macrophages， myeloid-derived suppressor cells） and non-cellular components （such as chemokines and cytokines） within the ICC TSIME， as well as the complex mechanisms of interaction between these components， and it also reviews the spatial interactions between immune cells and tumor cells， in order to provide potential research directions for ICC immunotherapy and new ideas for the effective and precise treatment of ICC in the future.
Introduction of High - quality Articles in Foreign Journals
Gut｜E-twenty-six-specific sequence variant 5 (ETV5) facilitates hepatocellular carcinoma progression and metastasis through enhancing polymorphonuclear myeloid-derived suppressor cell (PMN-MDSC)-mediated immunosuppression
2025, 41(3): 484-484. DOI: 10.12449/JCH2503.gwqkjpwzjj1
Abstract(150) HTML (76) PDF (891KB)(20)
Abstract:
Hepatology International｜Non-canonical Wnt signaling pathway activated NFATC3 promotes GDF15 expression in MASH: prospective analyses of UK biobank proteomic data
2025, 41(3): 541-541. DOI: 10.12449/JCH2503.gwqkjpwzjj2
Abstract(117) HTML (79) PDF (904KB)(7)
Abstract:
Hepatology｜Genomic and the tumor microenvironment heterogeneity in multifocal hepatocellular carcinoma
2025, 41(3): 546-546. DOI: 10.12449/JCH2503.gwqkjpwzjj3
Abstract(120) HTML (66) PDF (891KB)(9)
Abstract:
Hepatology International｜Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis and non-alcoholic fatty liver disease, 1990—2021: a multi-model trend analysis and forecasting study
2025, 41(3): 567-567. DOI: 10.12449/JCH2503.gwqkjpwzjj4
Abstract(141) HTML (68) PDF (888KB)(19)
Abstract:
Journal of Hepatology｜TGM2-mediated histone serotonylation promotes HCC progression via MYC signalling pathway
2025, 41(3): 587-587. DOI: 10.12449/JCH2503.gwqkjpwzjj5
Abstract(125) HTML (67) PDF (903KB)(8)
Abstract:
Acknowledgements
Current reviewers
2025, 41(3): 306-306. DOI: 10.12449/JCH2503.zhixie
Abstract(110) HTML (68) PDF (1045KB)(10)
Abstract:
    

The first journal specializing in hepatobiliary and pancreatic diseases in China

Supervisor：Ministry of Education of the People's Republic of China

Sponsor：Jilin University

Academic Support: Chinese Society of Hepatology，Chinese Medical Association

Address: 461 Xinjiang Road, Changchun

Submit：0431-88782044

Peer review：0431-88783542

Email：lcgdb@vip.163.com

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd