ABSTRACT
In 2022, the European Association for the Study of the Liver issued Clinical practice guidelines on sclerosing cholangitis. With reference to the 2017 edition of Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline (2017) and in comparison to the corresponding contents in Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021) issued by Chinese Society of Hepatology, Chinese Medical Association, in 2021, this article summarizes the updates in diagnosis, treatment, monitoring, and management of special populations and analyzes the basis for updated recommendations and their guiding significance in optimizing the clinical management of primary sclerosing cholangitis (PSC). The comparative analysis shows that the new version of the guidelines is similar to the Chinese guidelines in terms of diagnosis, treatment, and follow-up, and it is worth learning from the technical details such as the recommended dose of ursodeoxycholic acid and long-term follow-up plan. Since PSC is a chronic refractory disease, the drugs recommended by current guidelines cannot delay or reverse disease progression, and there is still a lack of consensus statements on immunotherapy and screening protocols for end-stage complications, which might be the directions for further research.
ABSTRACT
Chronic hepatitis B and its related diseases remain important public health problems and tough medical issues in China and even around the world, and now there is still a lack of effective radical treatment methods. This article reviews the traditional Chinese Medicine treatment regimens, the integrated traditional Chinese and Western Medicine treatment regimens, and related research highlights formed for hepatitis B (including various disease stages such as HBV carriers, chronic hepatitis B, liver fibrosis, liver cirrhosis, precancerous lesions of hepatocellular carcinoma, liver cancer, and liver failure) under the support of National Science and Technology Major Project from "The 11th Five-Year Plan" to "The 13th Five-Year Plan" (Prevention and Treatment of Major Infectious Diseases such as AIDS and Viral Hepatitis), and it also summarizes the role of traditional Chinese Medicine in the comprehensive prevention and treatment of chronic hepatitis B and its related diseases.
ABSTRACT
Exosomes (EXOs) are formed by intracellular multivesicular bodies and carry a variety of biomacromolecules such as lipids, proteins, encoding and non-coding RNAs, and mitochondrial DNA. EXOs can be released in vivo by different cell types, including hepatocytes, hepatic stellate cells, and immune cells and play the role of intercellular communication. More and more studies have shown that EXOs are involved in the development, progression, and prognosis of chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC) caused by hepatitis B virus (HBV) infection and are expected to become potential biomarkers for the early diagnosis and prognostic evaluation of HBV-related HCC. This article reviews the role of EXOs in the host infection process of HBV and the importance of EXOs in the development, progression, and prognosis of CHB and HCC, in order to provide new ideas for the basic and clinical research in this field.
ABSTRACT
Intestinal flora is closely associated with chronic hepatitis B (CHB). Recent studies have shown that the imbalance of intestinal flora is associated with the development, progression, and prognosis of CHB, and the environment of intestinal flora may also change with disease progression, suggesting that intestinal flora and CHB interact with each other. This article reviews the influence of intestinal flora on the progression of CHB and related liver diseases and the role of intestinal flora regulation in the diagnosis and treatment of CHB and related liver diseases, in order to provide new ideas for the clinical treatment of CHB.
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Hypoxic microenvironment is a common phenomenon of liver diseases and runs through the whole process of the development and progression of liver diseases. In recent years, the research on liver fibrosis and hypoxic microenvironment of hepatocellular carcinoma has attracted more and more attention. Hypoxia-inducible factor (HIF) is the most important hypoxic stress factor found at present. This article reviews the characteristics of hypoxic microenvironment in the liver and liver diseases and further elaborates on the association of HIF overexpression with hepatocyte damage, formation of fibrosis, and malignant transformation of hepatocytes.
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Objective To explore the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis. Methods The study overall collected and discussed the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis patients by adopting the principles and methods of clinical epidemiology based on the previous research of TCM syndrome characteristics. Results The important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis were total alcohol intakes and the total alcohol intakes under family alcoholism history condition. Conclusion The degree of viscera damage by alcohol is closely related to the distribution of TCM syndrome characteristics of alcoholic hepatic fibrosis and its pathogenesis evolution. The genetic constitution is one of the important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis.
ABSTRACT
Objective To investigate the correlation between the distribution of the charactcristics of TCM syndrome of alcoholic liver fibrosis and alcoholic consumption. Methods Our group studied clinical cases in multi-center prospective method. In virtue of Factor Analysis, we explored the characteristics of TCM syndrome of alcoholic liver fibrosis, and the forming characteristics of alcoholic liver fibrosis in inland. Rerults Among the subjects, the characteristics of TCM syndrome of alcoholic liver fibrosis mainly manifested excess syndrome with the common manifestations of deficiency and excess. The visceral position was mainly in liver and spleen, related to gallbladder and stomach. The result suggested that stagnation of Qi stagnation, blood stasis, damp heat, with deficiency of genuine Qi were the interpretation of the causes of alcoholic liver fibrosis. The total alcoholic consumption was one of the important factors which effected on the distribution of thecharacteristics of TCM syndrome of alcoholic liver fibrosis. Total bilirubin had mostly striking effect on the distribution of the characteristics of TCM syndrome. Conclusions The total alcoholic consumption was one of the important factors which effected on the distribution of the characteristics of TCM syndrome of alcoholic liver fibrosis.