[Research progress on pyroptosis in liver diseases]

Pyroptosis is a newly discovered kind of cell death modality that, due to its association with innate immunity, plays a crucial role in cytolysis and inflammatory cytokine release during host defense against infection. In recent years, studies have shown that pyroptosis plays an important role in the occurrence and development of liver diseases. This article introduces and elaborates on the most recent research progress on pyroptosis in liver diseases based on the morphological features, molecular and pathophysiological mechanisms.

[Fatty liver disease's renaming impacts on drug clinical trials]

Fatty liver disease has undergone a major name change, with metabolic dysfunction-associated fatty liver disease (MASLD) replacing nonalcoholic fatty liver disease. The definition of MASLD no longer requires the exclusion of other co-existing liver diseases but instead associates hepatic steatosis with overweight/obesity, type 2 diabetes mellitus, or metabolic disorders and clearly defines the amount of alcohol consumption. The new definition also introduces the concepts of metabolic-related alcoholic liver disease and cryptogenic fatty liver disease. These changes will bring new challenges and opportunities for the design of clinical trials of fatty liver disease drugs and the selection of target populations.

[Interpretation of the important update of the Guideline for the prevention and treatment of hepatitis C (2022 edition)]

In the past 20 years, Chinese Medical Association had issued several versions of hepatitis C prevention and treatment guidelines. In the latest guidelines published in 2022, the Chinese Society of Hepatology and the Society of Infectious Diseases for the Chinese Medical Association organized experts to update their recommendations for hepatitis C screening and treatment. The updated key points on prevention, diagnosis, and treatment proposed in the guidelines are now interpreted, aiming to provide reference for more effective clinical application of the guidelines.

[Evolution of clinical outcomes following hepatitis C virus clearance]

As hepatitis C treatment entered the era of direct-acting antiviral drugs, an increasing number of patients received treatment and achieved virus clearance, but virus clearance is merely a relative endpoint. Future emphasis will be placed on post-treatment benefits and the evolution of clinical outcomes. This article aims to describe the improvement in all-cause mortality and hepatic and extrahepatic-related diseases following virus clearance, particularly in patients treated with direct-acting antiviral drugs.

[New advances of artificial intelligence in the diagnosis of non-alcoholic fatty liver disease]

Artificial intelligence (AI) refers to the use of computer programs to simulate and extend human intelligence, and has application prospects in the diagnosis and treatment of diseases. This review focuses on the research status of the screening and diagnosis of NAFLD and nonalcoholic steatohepatitis using artificial intelligence technology, electronic health record data, multi-omics prediction models, image recognition technology based on liver imaging and pathological biopsy, and new drugs research and development, with a view to provide new ideas for the diagnosis and treatment.

[From treatable to curable to eliminated ---- a decade of research progress in the diagnosis and treatment of hepatitis C]

Hepatitis C is the first chronic viral infection that can be cured, and it has taken only 30 years from the discovery of the hepatitis C virus genome to the ability to eliminate the public health threat posed by hepatitis C virus. In the past ten years, the etiological detection of hepatitis C has experienced the development from sensitive and quantitative to rapid, convenient, automatic and point of care testing. With the continuous introduction of direct antiviral drugs, all types of hepatitis C patients, including special populations, can be safely and effectively cured by short courses of all-oral drugs. Progress in the diagnosis and treatment of hepatitis C is an important basis for eliminating the public health threat of hepatitis C. China has published the Planning of prevent and treatment for viral hepatitis in China (2017-2020). We look forward to achieving WHO's goal of eliminating viral hepatitis as a public health threat at an early date through effective screening, diagnosis and treatment.

[Elimination of hepatitis C, our progress, challenges and hopes]

Hepatitis C infection is a serious public health threat, and the World Health Organization has recommended the elimination of public health threats from viral hepatitis, including hepatitis C, by 2030. Many countries and regions are actively exploring strategies and models to eliminate the public health threat of hepatitis C. It is estimated that there are at least 7.6 million cases of chronic hepatitis C in China, with both diagnosis and treatment rates far away to 2030 target. China's government, social organizations and doctors at different levels are also actively exploring the mode of eliminating the public health threat of hepatitis C in China, including the main mode supported by national standards, government-led mode, social institution undertaking and government-supported mode, medical alliance mode, screening in high-prevalence areas and services contracted with family doctors. China can have a lessons learning from international and ourselves experience, particularly as "Test and treat all based on needs and demand" strategy in Covid-19 control, finally achieve eliminate the public health threat of hepatitis C as soon as possible.

[Assessment methods and research status of quality of life in patients with nonalcoholic fatty liver disease]

Over the past two decades, the incidence of non-alcoholic fatty liver disease (NAFLD) has risen sharply and has become the most common chronic liver disease, placing a heavy burden on patients and their families. A comprehensive assessment of the quality of life (QoL) of NAFLD patients is necessary to develop and implement more effective intervention strategies. Currently, the disease-specific scales commonly used to assess the quality of life of NAFLD patients include the 36-Item Short-Form Health Survey questionnaire (SF-36), Chronic Liver Disease Questionnaire (CLDQ), and so on. The research results of home and abroad showed that the quality of life of NAFLD patients is significantly lower than that of healthy people, and with the aggravation of the disease, the quality of life of such patients decreases, and may even be lower than other patients with chronic liver disease, and the reason for this may be related to factors such as body mass index (BMI) and complications. In clinical practice, the assessment of quality of life can fully reflect the health status of NAFLD patients, thereby helping to establish the personalized treatment goals to comprehensively assess the impact of disease on patients with clinical interventions.

[Situation analysis of timing of first visit of anti-mitochondrial antibody-positive patients]

Objective: To understand the basic information of anti-mitochondrial antibody (anti-AMA)-positive patients after initial diagnosis, and to set groundwork for further exploring the clinical significance of AMA in various diseases. Methods: Demographic data and related clinical information recorded through the Information System of Peking University People's Hospital from January 2013 to December 2016 were collected. Patients whose AMA and/or AMA-M2 first- tested as positive were recorded. Complications were classified according to the International Classification of Diseases. Results: A total of 1323 AMA positive cases were discovered for the first time. Among them, 78.0% were women, and the age of initial diagnosis was 56.8 ± 16.0 years. The first three initially diagnosed departments were rheumatology and immunology (37.4%), liver Disease (15.9%) and hematology (15.9%) relevant to musculoskeletal and connective tissue diseases (45.2%), hematology and hematopoietic organs and immune diseases (30.6%) and circulatory system diseases (29.7%). There were 297 newly confirmed cases of primary biliary cholangitis (PBC); accounting for 89.2% of women, and the age of initial diagnosis was 60.1 ± 12.4 years. The top three departments of initially diagnosed as PBC were liver disease (37.7%), rheumatology (33.0%) and gastroenterology (15.2%), of which 39.7% had musculoskeletal and connective tissue diseases, 27.9% had circulatory diseases, and 24.9 % were combined with endocrine and metabolic diseases. Conclusion: Besides PBC and other autoimmune diseases, AMA and / or AMA-M2 positivity can be observed in a variety of diseases in several clinical departments, and its clinical significance remains to be further clarified.

[Clinical analysis of cerebral venous sinus thrombosis in six children]

Objective: To summarize the clinical features of cerebral venous sinus thrombosis (CVST) in 6 children, and to improve the understanding of CVST in children. Methods: The risk factors, clinical presentations, laboratory findings, imaging manifestations, treatments and outcomes of 6 children (3 males, 3 females) with CVST admitted to the Department of Pediatrics, First Affiliated Hospital of Zhengzhou University from January 2012 to December 2017 were analyzed retrospectively. Results: The risk factors of disease were found in 5 cases, including 3 cases of infection, 1 case of L-asparaginase and dexamethasone chemotherapy and 1 case of oral prednisone alone. No definite risk factor was found in 1 case. The clinical presentations were headache in all cases, vomiting in 3 cases, convulsion in 2 cases, hemiplegia, photophobia, phonophobia and limitation of eyeball abduction in 1 case respectively. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed 2 cases of intracranial hemorrhage, 2 cases of cerebral parenchymal infarction and 2 cases of abnormal signal in venous sinus. Thrombus located in superior sagittal sinus in 4 cases, transverse sinus in 4 cases, sigmoid sinus in 3 cases and straight sinus in 1 case. After anticoagulation treatment, headache and vomiting were alleviated, and veins were recanalized in 6 cases. Two cases were diagnosed with eyeball abduction limitation and hemiplegia but did not improve in the short term after treatment. Conclusions: Infection is the main risk factor of CVST in children and headache is often the cause of medical consultation. Brain MRI and MRV are helpful in diagnosis and timely treatment can improve prognosis.

[Incidence of depressive disorders and related independent risk factors in patients with chronic hepatitis C]

Objective: To investigate the incidence and related independent risk factors of depression in treatment-naïve Han ethnic Chinese patients with chronic hepatitis C. Methods: Nine hundred and ninety-seven Han Chinese patients with confirmed chronic HCV infection were enrolled. Beck's depression inventory scale was used to assess depression score. Patients were divided into two groups according to the score: score≥17, depression group (16.85%, 168/997); score <17, no depression group (83.15%, 829/997). Multivariate logistic regression was used to analyze independent risk factors related with the onset of depression in patients with chronic hepatitis C. Results: There was a statistically significant difference between the two groups in terms of gender distribution, marital status, education level, income level and smoking status (P < 0.05). Independent risk factors were female [odds ratio (OR) = 3.85; 95% CI: 2.28-6.50, P = 0.001], decompensated cirrhosis [OR = 2.31; 95% CI: 1.20-4.48, P = 0.013], unmarried [OR = 2.01; 95% CI: 1.12-3.60, P = 0.019], separated [OR = 17.39; 95% CI: 1.64-184.47, P = 0.018], divorced [OR = 3.82; 95% CI: 1.36-10.74, P = 0.011], without higher education [OR = 2.04; 95% CI: 1.22-3.42, P = 0.007], low income [OR = 3.94; 95% CI: 1.38-11.28, P = 0.011], middle income [OR = 2.96; 95% CI: 1.02-8.62, P = 0.047], uninterrupted smoking [OR = 3.67; 95% CI: 2.13-6.31, P = 0.001], and previously smoked [OR = 3.33, 95% CI: 1.66-6.68, P = 0.001]. Conclusion: The incidence of depression in patients with chronic hepatitis C is relatively high. The independent risk factors related with depression include female, unmarried, separated, and divorced, without higher education, low and middle-income level, smoking and disease progression to decompensated cirrhosis, but no significant correlation between hepatitis C virus genotypes and viral load.

[Proper patient education improves hepatitis C patients' disease-related knowledge and antiviral treatment acceptance in rural China]

Objective: To evaluate the affect of hepatitis C virus (HCV) education in chronic hepatitis C patients' disease related knowledge and antiviral treatment acceptance in rural china. Methods: Rural HCV patients of attended CHC project of HCV education. Doctor delivered subsequent interactive lecture, and patients completed pre- and post-education questionnaires before and after taking the lectures. Results: 151 CHC patients were included. Mean age was 57.3 years old, 50.3% were male, 51.0% of the students had primary school education or illiterate, and 76.2% had a monthly income below RMB 3,000. 98.0% of patients defined their baseline HCV knowledge as "nothing" or "a little bit". A multivariate analysis reveled baseline knowledge scores were associated with age and household income. After education, mean knowledge score (range: 0-28) increased from 13.1 to 23.0 (P < 0.001) and average percent of patients with correct answers from the topic rose from 46.8% to 82.1% (P < 0.001), and patients' antiviral treatment acceptance increased from 33.9% to 65.6% (P < 0.001). Conclusion: A rural Chinese patients had less education, HCV education delivered on the preferred format of patients substantially improved hepatitis C patients' disease-related knowledge and antiviral treatment acceptance in rural china.

[Algorithmic analysis of potential drug-drug interactions using direct-acting antiviral agents and concomitant medications in chronic hepatitis C]

Direct acting antiviral agents (DAAs) metabolism and pharmacokinetics of concomitant medications data were extracted and analyzed from the database of Chinese Health Insurance between 2013 and 2015. A potential drug-drug interactions (DDI) were calculated by integration of extracted data and confirmed by using Liverpool website (https: //www.hep-druginteractions.org/). A new algorithm is suggested for management of DDI between DAAs and concomitant medications.

[Comorbidities and concomitant medication use in adult patients with chronic hepatitis C: a descriptive epidemiological analysis]

Objective: To analyze the comorbidity and concomitant medications use in adult patients with chronic hepatitis C. Methods: A descriptive epidemiological methods was carried out in adult patients with chronic hepatitis C and data from 2013 to 2015 were accessed through the China Medical Insurance database. Results: Among a chronic HCV cohort of 2 958 cases, the top five comorbidities were diabetes, hypertension, ischemic heart disease, gastroduodenitis, and co-infection with HBV and HCV. The three most common concomitant medications prescribed for mentioned comorbidities were acarbose, metformin and repaglinide (Diabetes), nifedipine, amlodipine and metoprolol (Hypertension), aspirin, nifedipine and amlodipine (Ischemic heart disease), omeprazole, pantoprazole and levolfoxacin (Gastroduodenitis), ribavirin, pegylated interferon alpha-2a and alpha-2b ( Co- infected with hepatitis B and C virus). Conclusion: The five most frequent comorbidities in adult patients with chronic hepatitis C are diabetes, hypertension, ischemic heart disease, gastroduodenitis, and co-infection with HBV and HCV. A concomitant medication use in those patients with comorbidities causes potential drug-drug interactions.

[Effectiveness and safety of direct-acting antiviral agents for treatment of patients with chronic hepatitis C virus infection]

Hepatitis C is one of the major causes of liver disease worldwide. Chronic hepatitis C can cause liver fibrosis and cirrhosis leading to end-stage liver disease. Antiviral therapy can clear the virus, stop the progress of the disease, thereby reducing the incidence of advanced liver disease. This article aims to discuss the effects and safety of antiviral treatments, including direct- acting antiviral agents, on patients with chronic hepatitis C with fibrosis and compensated and decompensated liver cirrhosis.

[Insect-resistant transgenic poplar expressing AaIT gene]

Insect-specific scorpion neurotoxin AaIT gene inserted into a binary vector was transferred into a hybrid poplar clone N-106(P. deltoides x P. simonii) growing in the Southern of China. We obtained sixty-two regenerated plants by Agrobacterium tumefaciens transferring system. PCR and PCR-Southern analysis showed that AaIT gene was incorporated into the genome of some recovered poplar plants. One of the transformed plants named A5 was significantly resistant to feeding by first instar larvae of Lymantria dispar, compared with the untransformed control plant. It caused a decrease in leaf consumption by larvae, a lower larval weight gain and a higher larval motality rate of Lymantria dispar. ELISA analysis proved that AaIT gene was expressed in this transfomed poplar plant.