Cirrhosis is a common chronic progressive liver disease with complex pathogenesis and high mortality, which is the leading cause of liver-related death in the world and China. The combination of traditional Chinese and Western medicine is the main strategy to block the process of cirrhosis in China. In recent years, TCM has made great progress in preventing and reversing liver cirrhosis and demonstrated its unique advantages in promoting liver cirrhosis decompensation and recompensation. Relevant research results have also been recognized internationally, but there are still many challenges.

Objective: To explore factors of the occurrence of hepatocarcinogenesis in patients with hepatitis B virus-related compensated cirrhosis, and to evaluate the efficacy of traditional Chinese medicine on the prevention of hepatocarcinogenesis. Methods: A retrospective cohort study was conducted to include 528 patients with hepatitis B virus-related compensated cirrhosis who were followed up for 10 years. Clinical data such as general information, personal history, treatment history, biochemical examination, and imaging examination were collected. The occurrence of hepatocarcinogenesis was estimated as the endpoint event. Patients were divided into TCM cohort and non-TCM cohort according to whether they had received TCM treatment during the follow-up period. The life table method and Kaplan-Meier method were used to calculate the hepatocarcinogenesis-free survival time and the 1-,3-,5-,7-, and 10-year hepatocarcinogenesis-free survival rates. The Log-Rank test was used for univariate analysis. COX regression was used to screen the independent factors and to determine the influence of TCM on hepatocarcinogenesis. Results: A total of 528 patients who met the inclusion and exclusion criteria were screened, including 157 in the non-TCM cohort and 371 in the TCM cohort. After 1∶2 propensity score, they were divided into the new non-TCM cohort of 157 cases and the new TCM cohort of 314 cases. The incidence of hepatocarcinogenesis in the TCM cohort was lower than in the non-TCM cohort (26.1% vs 47.8%, P<0.001). The 1-,3-,5-,7-, and 10-year hepatocarcinogenesis-free survival rates were higher than those in the non-TCM cohort, and the hepatocarcinogenesis-free survival time was longer (103.4 months vs 84.7 months). The differences were all statistically significant (P<0.001). The results of multivariate regression analysis showed that age, TCM treatment, antiviral treatment, smoking history, family history of liver disease, PLT level, AFP level, HBV DNA response, and intrahepatic nodules were independent factors for the occurrence of hepatocarcinogenesis. Among them, accepting TCM treatment and antiviral treatment were protective factors, while the rest were all risk factors. Conclusion: The occurrence of hepatocarcinogenesis in patients with hepatitis B virus-related compensated cirrhosis was related to multiple factors. Traditional Chinese medicine treatment could reduce the incidence of hepatocarcinogenesis, prolong the hepatocarcinogenesis-free survival time, and improve the hepatocarcinogenesis-free survival rate, which had better long-term clinical efficacy.

Liver cirrhosis is a chronic and progressive liver disease caused by various etiologies, posing a significant burden on healthcare in China. This article explores the clinical experience of Professor Gao Yueqiu in treating liver cirrhosis. During the compensated stage, the treatment emphasizes disease differentiation, focusing on kidney tonification, spleen strengthening, blood activation, and anti-fibrosis strategies. For cases with cirrhotic nodules, the therapeutic approach is guided by the "Jueyin Organ Nodules" theory, emphasizing the combination of strengthening the body′s defenses and utilizing agents to dispel pathogenic factors and resolve nodules. In the decompensated stage, characterized by complex complications and impaired water metabolism, the treatment advocates for regulating the triple burner to restore balance. Professor Gao′s clinical experience employs tailored formulations, including the Rou Gan Recipe, Xiao Ji Recipe and Xiao Zhang Recipe, emphasizing a dual approach of reinforcing the body′s vitality while eliminating pathogens, yielding satisfactory outcomes. A representative case study is included to illustrate the effectiveness of this approach.

Objective: To explore the distribution and characteristics of common basic syndromes in metabolic associated fatty liver disease (MAFLD), and provide diagnostic and therapeutic basis for standardized syndrome differentiation and evaluation of syndrome efficacy. Methods: Retrieving literature related to MAFLD syndrome from inception in Chinese databases until August 31, 2023. Using SPSS 20.0 software, establish a database and conduct statistical descriptive analysis. Using SPSS Modeler 18.0 software and Apriori algorithm, conduct association rule analysis on evidence elements. Using Latern 5.0 software and LTM-EAST algorithm, construct a symptom hidden structure model and perform a comprehensive clustering analysis. Results: (1) A total of 203 MAFLD syndrome related literature were included, involving 16 basic syndromes, 16 syndrome elements, and 85 symptoms. (2) The basic syndromes with a frequency of ≥ 10% and a cumulative composition ratio of ≥75% include: phlegm dampness syndrome, spleen qi deficiency syndrome, liver depression and qi stagnation syndrome, and blood stasis syndrome. (3) Analyzing the association rules of syndrome elements, 32 strong association rules were obtained, and four basic syndromes were inferred, including spleen qi deficiency syndrome, liver depression and qi stagnation syndrome, phlegm dampness syndrome, and blood stasis syndrome Perform hidden structure analysis on symptoms with a frequency of ≥5%, resulting in 13 hidden variables and 26 hidden classes. Five comprehensive clustering models were obtained through comprehensive clustering, and five basic syndromes were inferred, including spleen qi deficiency syndrome, liver depression, and qi stagnation syndrome, phlegm dampness syndrome, blood stasis syndrome, and dampness (phlegm) heat syndrome. Based on the above methods, four common basic syndromes were ultimately identified. Conclusion: The common basic syndromes of MAFLD include spleen qi deficiency syndrome, liver depression and qi stagnation syndrome, phlegm dampness syndrome, and blood stasis syndrome, which belong to a combination of deficiency and excess.

Objective: Objective Based on the literature data, this paper explores the classification and characteristics of common syndromes of alcoholic liver disease (ALD), to provide a reference for clinical syndrome differentiation and pattern standardization research. Methods: Literature related to ALD syndromes in the China National Knowledge Infrastructure, Wanfang Data, and VIP Database for Chinese Technical Periodicals were searched from January 2013 to January 2024. The literature that meets the requirements was screened out and a database was constructed, and the statistical description, association rule network, and hidden structure model were used to analyze the data frequency and correlation to determine the common syndromes and symptom characteristics of ALD. Results: There were 149 papers that met the requirements, the syndromes that constituted ≥5% were liver, spleen, stomach, and gallbladder; pathological syndromes include dampness, qi stagnation, qi deficiency, heat, phlegm, and blood stasis; the basic syndromes include spleen qi deficiency pattern, damp-heat accumulation pattern, liver stagnation pattern, phlegm-dampness pattern, qi stagnation pattern, and blood stasis pattern; symptoms include flank pain, abdominal distention, eat less, fatigue and fatigue. Pattern element association rule analysis and hidden structure cluster analysis deduced five syndromes:spleen qi deficiency pattern, liver depression and spleen deficiency pattern, damp-heat accumulation pattern, blood stasis pattern, and kidney yin deficiency pattern. Conclusion: ALD is mainly located in the liver and spleen. The main symptoms of ALD are flank pain, abdominal distention, lack of appetite, fatigue, and fatigue; the main pathological syndromes are dampness, heat, qi stagnation, and qi deficiency; and the basic syndromes are damp-heat accumulation pattern, liver depression and spleen deficiency pattern, and spleen qi deficiency pattern.

Objective: The study aimed to investigate the impact of Qinggan Huatan Huoxue formula on cirrhosis development in non-alcoholic steatohepatitis (NASH) patients over a five-year period. Methods: A total of 427 NASH patients were collected between January 2015 and January 2018. All patients underwent a five-year follow-up during which independent risk factors for liver cirrhosis were analyzed using logistic regression. The study observed the effect of Qinggan Huatan Huoxue formula in preventing NASH patients from progressing to liver cirrhosis. Results: the use of Qinggan Huatan Huoxue formula was identified as an independent risk factor for NASH patients progressing to cirrhosis within five years. The incidence of liver cirrhosis was 5.7% in the TCM recipe group compared to 13.3% in the control group with a 1∶one propensity score (P<0.001). The time from follow-up to cirrhosis was 4.0±0.2 years in the TCM group and 3.5±0.3 years in the control group (P<0.001). Conclusion: Qinggan Huatan Huoxue formula demonstrated efficacy in reducing the risk of liver cirrhosis in NASH patients over a five-year period and effectively delayed the onset of cirrhosis.

Objective: To explore the expression levels and clinical significance of BCL2 and SOX11 in HCC. Methods: A total of 72 HCC patients admitted to the Department of Spleen, Stomach, Liver and Gallbladder at The First Affiliated Hospital of Henan University of CM from October 2020 to October 2021 were selected as the research subjects.ELISA kit was used to detect the expression levels of BCL2 and SOX11 in the patient serum. The SPSS 25.0 was used to statistically analyze the correlation between BCL2/SOX11 and the clinical indicators of patients, as well as the role of BCL2 and SOX11 expression in evaluating the prognosis of HCC. Results: There is a negative correlation between serum BCL2 and Child Pugh grading, AST, ALT, ALP, GGT, and the difference is statistically significant (P<0.05). There is a negative correlation between serum SOX11 and ALT, ALP, GGT, and the difference is statistically significant (P<0.05). The progression-free survival rate and overall survival rate of HCC patients in the BCL2 high expression group were higher than those in the low expression group, with statistical significance (P<0.05), while there was no significant difference in the SOX11 high and low expression group (P>0.05). Conclusion: The BCL2 and SOX11 are both highly expressed in the serum of HCC patients and can serve as effective indicators for predicting liver function in HCC patients. In addition, BCL2 can serve as a molecular marker for evaluating the prognosis of HCC patients.

Objective: To explore the detection rate of fatty liver of different severity and its correlation with traditional Chinese medicine physique in a community in Beijing. Methods: Based on the data of elderly people who underwent physical examination in 2023 in Cuigezhuang Township, Chaoyang District, Beijing, the correlation between TCM constitution and fatty liver of different severity was analyzed by logistic regression. Results: A total of 1590 patients were included, and the total detection rate of fatty liver was 44.8%. There were significant differences in sex, age, BMI, waist circumference, smoking history, drinking history, diabetes, hypertension, abdominal obesity, SBP, AST, ALT, TBiL, HDL-C, TG, CR, FPG, and phlegm-dampness constitution in different severity of fatty liver (P<0.05). The risk of mild fatty liver (OR=1.689), moderate fatty liver (OR=1.499), and severe fatty liver (OR=2.198) was higher in people with phlegm-dampness constitution. Stratified analysis showed that the effect was more pronounced for gender, age, smoking history, drinking history, and exercise. BMI (OR=1.19), waist circumference (OR=1.053), and TG (OR=2.897) were independent risk factors for the formation of moist heated fatty liver. Conclusion: The phlegm-dampness constitution is associated with a higher risk of fatty liver, and the risk is higher in different severity of fatty liver. Adjusting the traditional Chinese medicine constitution can provide more ideas and methods for the prevention and treatment of fatty liver.

Objective: To explore the efficacy of Shenmai Sanjie capsule combined with microwave ablation in the treatment of senile small liver cancer and analyze its effects on tumor markers, functional status, and survival rate. Methods: A total of 98 elderly patients with small liver cancer treated in Kunming Third People's Hospital from January 2021 to January 2023 were selected and divided into control group and study group with 49 cases each by random number table method. The control group was treated with microwave ablation, and the study group was treated with Shenmai Sanjie capsule combined with microwave ablation. The short-term efficacy, TCM syndrome scores, serum tumor markers [abnormal prothrombin Ⅱ (PIVKA-Ⅱ), alpha-fetoprotein (AFP), phosphatidylinositol proteoglycan 3 (CPC3)], inflammatory factors [C-reactive protein/albumin ratio (CAR), tumor necrosis factor α (TNF-α), interleukin-10 (IL-10)], Functional status, hepatic pain and survival rate were compared between the two groups. Results: The total effective rate of the study group was higher than that of the control group (83.67% vs. 61.22%, P<0.05). The TCM syndrome score of the study group was lower than that of the control group (P<0.05). The levels of PIVKA-Ⅱ, AFP and CPC3 after treatment were (285.76±55.18) U/L, (539.64±75.23) μg/L and (2.90±0.86) μg/L, respectively. Lower than that of control group (359.81±67.24) U/L, (608.41±87.54) μg/L, (3.85±1.04) μg/L (P<0.05); The levels of CAR, TNF-α and IL-10 in serum after treatment were (0.18±0.05), (0.71±0.19) ng/ml and (55.91±16.20) pg/ml, respectively. It was lower than that of control group (0.25±0.07), (0.83±0.21) ng/ml, (70.84±18.41) pg/ml (P<0.05). After treatment, the KPS score of the study group was higher than that of the control group [(81.46±4.29) points vs. (75.31±4.70) points], and the VAS score was lower than that of the control group [(2.41±0.73) points vs. (2.95±0.81) points, (P<0.05)]. The 12-month survival rate of the study group was higher than that of the control group (100.00% vs. 86.67%, P<0.05). Conclusion: Shenmai Sanjie capsule combined with microwave ablation is effective in the treatment of senile small liver cancer, which can improve clinical symptoms, control tumor progression, inhibit inflammatory response, improve functional status, reduce the degree of liver pain and increase the survival rate.

Objective: To investigate and analyze the relationship between the changes of serum signal transduction and transcription activator 3 (STAT3) and sex-determining region Y-box 4 (SOX4) proteins and the degree of liver fibrosis in patients with chronic hepatitis B (CHB). Methods: A total of 118 CHB patients admitted to First Affiliated Hospital of Air Force Military Medical University from October 2022 to October 2023 were selected as the case group, another 118 healthy people in the same period were selected as the control group, the general data of the two groups were compared. The degree of liver fibrosis in the case group was observed and divided into S1-S4 stages. Western blot was used to detect the expression of STAT3 and SOX4 proteins in serum. Pearson method was used to analyze the correlation between serum STAT3 and SOX4 levels, the correlation between serum STAT3 and SOX4 protein expression levels and the degree of liver fibrosis. The ROC curve was used to analyze the diagnostic value of serum STAT3 and SOX4 protein levels for liver fibrosis in patients with CHB. Results: The serum STAT3(1.4±0.3) and SOX4(1.2±0.2) levels in CHB patients were obviously higher than those in the control group(1.0±0.1), (0.9±0.1) (P<0.05). Among 118 patients with CHB, 19 cases were in S1 of liver fibrosis, 30 cases were in S2, 32 cases were in S3, and 37 cases were in S4. There were 19 non significant patients and 99 significant patients. The expression levels of STAT3 (1.4±0.3) and SOX4 (1.3±0.3) in significance were significantly higher than those in non-significance (1.01±0.3), (1.0±0.1) (P<0.05). Pearson correlation analysis showed that serum STAT3 and SOX4 levels were positively correlated (r=0.3, P<0.05), and there was a positive correlation between the expression levels of both and the degree of liver fibrosis (r=0.4, 0.5, P<0.001). The ROC curve showed that the AUC of STAT3 in the diagnosis of S2S3S4, SS3S4, and S4 in patients with CHB was 0.877, 0.823, and 0.937 respectively, and the cut-off value was 1.070, 1.239, and 1.411 respectively. The AUC of SOX4 in the diagnosis of S2S3S4, SS3S4, and S4 in patients with liver fibrosis was 0.819, 0.950, and 0.989 respectively, and the cut-off value was 1.103, 1.210, and 1.267 respectively. Conclusion: The expression levels of STAT3 and SOX4 proteins in the serum of patients with CHB increase with the aggravation of liver fibrosis. The expression levels of STAT3 and SOX4 proteins have certain diagnostic value for the degree of liver fibrosis.

Objective: Analyze the risk factors for liver damage in children with mycoplasma pneumoniae pneumonia (MPP). Methods: Selecting clinical data of 107 children with MPP complicated with liver damage admitted to our hospital from January 2020 to August 2023. Then, we selected 110 children without MPP complicated with liver damage admitted during the same period as the control group, conducting univariate and multivariate analysis of clinical related data of the two groups of children, and drawing ROC curves to analyze the predictive efficacy of risk factors for MPP complicated with liver damage. Results: In terms of hospitalization time, fever duration, fever peak(≥39.0℃), hormone application time, LYM%, RDW, Hb, CRP, ALP, TP, Alb, LDH, CK-MB α-There were statistically significant differences (P<0.05) in HBDH, occurrence of lung consolidation, and involvement of lung lobes by ≥2 lesions. Conclusion: The causes of liver damage in children with MPP are complex, including heat duration, heat peak(≥39.0℃), LYM%, RDW, LDH, and involvement of more than two lobes of the lungs. Clinical needs to develop scientific prevention and treatment plans in advance based on the patient's clinical symptoms, laboratory, and imaging indicators to improve prognosis.

Objective: To explore the influence of Quzhuo Jiangzhi decoction on therapeutic efficacy, blood lipids, insulin resistance, and serum leptin in patients with non-alcoholic fatty liver disease (NAFLD). Methods: A total of 102 patients who were treated in our hospital were included from June 2022 to December 2023. According to the random number table method, they were classified into study group (51 cases) and control group (51 cases). The total score of TCM syndromes, blood lipids [cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), apolipoprotein B], glucose metabolism indicators [fasting plasma glucose (FPG), 2h postprandial blood glucose (2 h-PG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)], serum leptin and related indicators[glutamic-oxalacetic transaminase, albumin, controlled attenuation parameter (CAP)] and adverse reactions were compared between groups before and after treatment. Results: After treatment, the total score of TCM syndromes with (10.08±2.07) points in study group was lower than(12.25±2.31) points in control group (P<0.05). The levels of cholesterol, triglyceride, and apolipoprotein B with (4.25±0.31) mmol/L, (1.17±0.22) mmol/L and (0.95±0.11) g/L in study group after treatment were lower than those in control group, the level of HDL-C with (2.76±0.19) mmol/L in study group were higher than that in control group (all P<0.05). After treatment, the FPG, 2 h-PG, FINS and HOMA-IR with (4.58±0.62) mmol/L, (7.06±1.15) mmol/L, (6.21±1.16) mIU/mL and (1.26±0.03) in study group were lower than (4.89±0.77) mmol/L, (7.51±1.03) mmol/L, (6.95±1.35) mIU/mL and (1.51±0.05) in control group (all P<0.05). After treatment, the levels of serum leptin, glutamic-oxalacetic transaminase and albumin in study group with (10.25±2.56) ng/L, (61.36±13.45) U/L and (3.52±0.62) g/dL were lower than (14.67±2.49) ng/L, (68.69±13.77) U/L and (3.88±0.55) g/dL in control group (all P<0.05). After treatment, the CAP with (247.51±39.27) dB/m in study group was lower than (273.19±41.16) dB/m in control group (P<0.05). There were no obvious differences in the incidence rates of adverse reactions between study group and control group (P>0.05). Conclusion: Quzhuo Jiangzhi decoction can improve the therapeutic efficacy of non-alcoholic fatty liver disease, and can reduce blood lipids and serum leptin, lower liver fat content and improve insulin resistance.

Objective: To study the efficacy of YGXJ on mice with early cirrhosis and its mechanism of action in regulating the balance of Ly6Chi/Ly6Clo macrophages. Methods: The C57BL/6 mice were divided into blank group, model group, and traditional Chinese medicine intervention group (YGXJ low, medium, and high dose group), and the early cirrhosis model was induced by intraperitoneal injection of carbon tetrachloride for nine weeks. The treatment group was given three doses of traditional Chinese medicine YGXJ low, medium, and high by gavage for four weeks. HE staining and Masson staining were used to observe the pathological staining of liver tissue in each group of mice, to detect the ALT and AST levels of mouse liver function, Western-blot assay to detect the expression level of liver type I collagen, immunohistochemistry to detect the expression of liver F4/80 and LY6C, and qRT-PCR to detect the levels of TNF-α, IL1-β, MMP9 and MMP12 mRNA levels in the liver. Results: After four weeks of YGXJ intervention, compared with the model group, the hepatic inflammatory cell infiltration and collagen fiber deposition in the YGXJ dose groups were significantly reduced. The degree of cirrhosis was reversed, and the hepatic function levels of ALT and AST in each dose group had a downward trend, and the therapeutic effect was most obvious in the medium-dose group of YGXJ. The expression of hepatic Collagen Ⅰ in the medium-dose group of YGXJ had a downward trend compared with that of the model control group. The hepatic Collagen Ⅰ expression of YJXJ medium dose intervention group had a decreasing trend compared with the model control group. Immunohistochemistry showed that the expression of F4/80 and LY6C was significantly reduced in the YGXJ medium-dose group compared with that in the model group, and the mRNA levels of TNF-α and IL1-β were decreased, and the mRNA levels of MMP9 and MMP12 were increased. Conclusion: The YGXJ improved the degree of cirrhosis and liver injury in mice, and its mechanism of action may be related to the regulation of Ly6Chi/Ly6Clo macrophage balance.

Objective: To investigate the mechanism of Sco on the liver inflammatory microenvironment of rats with liver failure by observing the changes of relevant indexes of Yinchen's active ingredient 6,7-dimethoxycoumarin (Scoparone/Sco) before and after intervention in a rat model of liver failure. Methods: Sixty SD rats were randomly divided into three groups: blank group, model group, and Sco group, with twenty 20 rats in each group. The Sco group is treated with 5ml/kg DMSO solution and 60mg/kg Scoparone, and the rats in the blank group and model group are treated with the same amount of normal saline, both of which are continuously intervened for seven days. The model group and the Sco group were modeled with D-aminogalactose combined with lipopolysaccharide, and intraperitoneal injection was used once. The abdominal aortic blood and liver tissues of rats in each group were collected for the detection of liver function ALT, AST, TBil, inflammatory cytokines IL-6, IL-17 and IL-21, and the expressions of p38 MAPK, IL-17 and AP-1 proteins and genes were detected by Western blotting and fluorescence quantitative qPCR. Results: Compared with the blank group, ALT, AST, TBil, IL-6, IL-17, and IL-21 were significantly increased in the model group (P＜0.05), and compared with the model group, ALT, AST, TBil, IL-6, IL-17, and IL-21 in the Sco group were significantly decreased (P＜0.05). Compared with the blank group, the expressions of p38 MAPK, IL-17, and AP-1 protein and mRNA in the model group were significantly increased (P＜0.05), and compared with the model group, the expressions of p38 MAPK, IL-17 and AP-1 protein and mRNA in the Sco group were significantly decreased (P＜0.05). Conclusion: Sco may regulate the p38 MAPK/IL-17 signaling pathway, down-regulate the expression of p38 MAPK, IL-17, and AP-1, and then inhibit the inflammatory response of liver failure.