Effect of chronic hepatitis B virus DNA negative transformation and HBsAg clearance on the occurrence of hepatocellular carcinoma / 中华肝脏病杂志

Achieving HBV DNA negative transformation and HBsAg clearance with effective antiviral therapy can reduce the incidence of HCC, but some patients are still at risk of developing HCC. Therefore, screening high-risk patients for close monitoring is essential to reduce the incidence of HCC. This paper reviews the occurrence of HCC, risk factors and risk prediction models of HBV DNA negative transformation and HBsAg clearance, and provides a basis for screening and follow-up management of high-risk group of HCC with chronic hepatitis B.

Application value of imaging diagnosis in nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) is a chronic disease with complex lesions, and it is difficult to determine the clinical stage. Liver biopsy is still the gold standard for the diagnosis of NAFLD; however, its clinical application is limited by various factors. Therefore, noninvasive methods for the accurate diagnosis of NAFLD are research hotspots at present. Imaging examinations help to achieve qualitative and quantitative evaluations of hepatic steatosis and fibrosis and thus has a promising future in clinical practice. This article summarizes the research advances in the imaging diagnosis of nonalcoholic fatty liver disease in recent years.

Progress in Diagnosis and Treatment of Primary Biliary Cholangitis / 胃肠病学

In the past 40 years,patients with primary biliary cholangitis (PBC)have benefited from the extensive use of ursodeoxycholic acid (UDCA),resulting in increase of response rate and survival rate. The prognosis of PBC patients was significantly improved. However,some patients responded poorly to UDCA and with poor long-term outcome. Therefore,accurate diagnosis,evaluation and risk stratification based on serological and pathological characteristics of the patients are very important for the treatment of PBC. This article summarized the progress in diagnosis and treatment of PBC.

Risk factors and therapeutic strategies for primary biliary cholangitis patients with poor prognosis / 中华肝脏病杂志

With the progress in detection methods and the update of diagnostic and therapeutic concepts, more and more patients with primary biliary cholangitis (PBC) have been diagnosed and treated. A high proportion of PBC patients, however, progress to liver decompensation, with an increased risk of liver transplantation and death and a significant reduction in long-term survival. These patients need early diagnosis and urgent treatment. This article discusses how to identify the PBC patients with poor prognosis early from the aspects of biochemical response, disease features, and biomarkers, and reviews the progress in related complementary therapies and new drugs including Ocaliva, Fibrates, UDCA-derived drugs, and molecular targeted drugs.

Therapeutic strategies for patients with primary biliary cholangitis and suboptimal response to ursodeoxycholic acid / 临床肝胆病杂志

In recent years,ursodeoxycholic acid is commonly used for the treatment of primary biliary cholangitis (PBC);however,the growing number of PBC patients and the occurrence of suboptimal response and treatment intolerance pose a great challenge to treatment regimens.The approval of the new drug obeticholic acid brings hope to PBC patients,and a combination of fibrates also has a promising future.More studies are in progress.Although new drugs,such as monoclonal antibody,fibroblast growth factor 19,and sodium-dependent bile acid transporter inhibitor,have limited efficacy data,they provide new directions for the treatment of PBC.With the help of individualized follow-up and stratified therapy,the management of PBC patients will enter a new stage.