International Hepatology

With the increasing aging population in China, major chronic diseases have become the leading cause of death and the most significant disease burden for Chinese residents. As an essential means of treating chronic diseases, medications urgently require scientific, rational, and precise usage and management. At a domestic academic conference, Professor Houwen Lin from Shanghai Jiao Tong University School of Medicine, gave a remarkable academic report titled "The Role of Clinical Pharmacy in the Diagnosis and Treatment of Major Chronic Diseases." He provided a detailed introduction of how the clinical pharmacy team at Renji Hospital, driven by clinical needs, established key technologies for precise medication and new drug clinical positioning for major chronic diseases such as cardiovascular metabolism, rheumatology, and oncology. This article summarizes the report's content for the readers of Hepatology Digest.

Diabetes and liver disease are prevalent chronic conditions in China. They often interact in terms of pathogenesis, clinical manifestations, and treatment targets, acting as mutual risk factors. Joint management can alleviate the disease burden. To support the development of co-management of diabetes and liver disease in China, this journal, in collaboration with the CDL (China Diabetes and Liver Disease Co-management Action Plan), launches the CDL Literature Monthly Review column. Each month, we share relevant research on the mechanisms and treatment advancements of diabetes combined with liver disease, inviting experts in the field to provide commentary. This aims to offer insights and assistance to researchers and frontline medical professionals in scientific research and clinical practice.

Hepatic sinusoidal obstruction syndrome (HSOS), also known as hepatic veno-occlusive disease, is a common secondary vascular liver disease caused by various factors leading to damage to sinusoidal endothelial cells, resulting in sinusoidal obstruction and hepatic congestion. Clinically, it primarily presents with abdominal distension, liver pain, rapid ascites accumulation, hepatomegaly, and jaundice, which can lead to severe liver dysfunction, multi-organ failure, and even death. Professor Qingchun Fu's team from the Shanghai Public Health Clinical Center shares a clinical case and their experience in diagnosing and treating a patient with HSOS induced by combined drug and alcohol use.

Recently, the 25th National Conference on Traditional Chinese Medicine and Hepatobiliary Diseases organized by the Chinese Association of Traditional Chinese Medicine was successfully held in Chongqing. The conference invited distinguished TCM masters, academicians, renowned TCM experts, and hepatology specialists from across the country to deliver academic reports, focusing on the hot and challenging issues in the diagnosis and treatment of liver diseases with TCM. At the conference, Professor Li Li from Beijing Hospital of Traditional Chinese Medicine, presented a report titled "Latest Advances in the Clinical Cure of Chronic Hepatitis B." The following is a summary of the report for our readers.

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have brought transformative breakthroughs to the clinical treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer patients. The combination of CDK4/6 inhibitors and endocrine therapy has become the standard regimen for HR+/HER2- locally advanced and metastatic breast cancer. In the adjuvant treatment phase for early-stage breast cancer, CDK4/6 inhibitors have also shown positive results and have been approved for indications. The 2024 ASCO conference presented multiple advancements in the adjuvant treatment of HR+/HER2- early-stage breast cancer with CDK4/6 inhibitors. At the recent 5th Comprehensive Cancer Treatment Academic Conference of the Xinghai Medical Forum, Oncology Frontier invited Professor Yang Zhang from The Second Hospital of Dalian Medical University, Professor Kejing Zhang from Xiangya Hospital of Central South University to elaborate on and discuss the research progress of CDK4/6 inhibitors in adjuvant therapy for HR+ early-stage breast cancer.

According to the World Health Organization, there are currently about 257 million chronic hepatitis B (CHB) patients worldwide, with approximately 70 million HBV (hepatitis B virus) carriers in China, making it one of the countries with a high prevalence of chronic HBV infection. Due to factors such as viral characteristics, immune status, and environmental influences, domestic and international guidelines typically classify the natural history of chronic HBV infection into four phases: immune tolerance, immune active, immune control, and reactivation. Identifying these phases is crucial for predicting patient prognosis and guiding intervention strategies. However, recent studies have shown that a considerable number of chronic HBV infection patients cannot be categorized into any of these four phases based on existing guidelines or natural history criteria, leaving them in an indeterminate phase or gray zone, which is not covered by international and domestic clinical guidelines. Recently, at the 17th National Clinical Conference on Liver Diseases in 2024, Professor Peng Hu presented a report titled "Related Research on Indeterminate Phase of Chronic Hepatitis B." Hepatology Digest conducted an interview with Professor Peng Hu regarding CHB's indeterminate phase. Here is the summarized interview for our readers.

Liver fibrosis is the result of damage to the liver by pathogenic factors, leading to chronic, repeated abnormalities in liver function and the deposition of collagen and other proteins. It is a crucial factor influencing the prognosis of chronic liver disease and a necessary stage in the progression to cirrhosis. Recently, at the 25th National Conference on Traditional Chinese Medicine and Hepatobiliary Diseases organized by the Chinese Association of Traditional Chinese Medicine, Professor Jingtao Li from the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine presented the latest clinical research advancements in the prevention and treatment of liver fibrosis using Traditional Chinese Medicine (TCM). The multi-component, multi-target therapeutic features of TCM, along with the significant efficacy of several representative drugs, provide strong scientific support for the application of TCM in combating liver fibrosis.

Hepatitis B virus (HBV), a hepatotropic DNA virus, is the causative agent of hepatitis B. HBV-infected individuals have three types of particles in their blood: Dane particles, spherical particles, and tubular particles. The characteristics of these particles can be used to detect evidence of HBV infection through immunological methods. Recently, at the 17th National Conference on Clinical Hepatology, Professor Ailong Huang, President of Chongqing Medical University, delivered a report titled "Mechanisms of Persistent HBV Infection." This report provides an in-depth analysis of the mechanisms behind persistent HBV infection, revealing the relationship between abnormal host immune responses and viral evasion of host antiviral effects, offering new perspectives for understanding HBV persistence and developing treatment strategies.

Cholestatic drug-induced liver injury (DILI) is a drug-induced condition characterized primarily or prominently by intrahepatic cholestasis, featuring clinical, biochemical, and histopathological evidence. It is a relatively common and serious adverse drug reaction that can lead to acute liver failure and even death, affecting the clinical application of medications. In recent years, significant breakthroughs in targeted and immunotherapy for cancer have markedly improved the prognosis and survival of patients with malignancies. However, liver injury caused by antitumor drugs, particularly cholestatic DILI, has become a major clinical concern. Recently, at the 8th International Forum on Drug-Induced Liver Injury and the 9th National Conference on Drug-Induced Liver Injury, Professor Enqiang Chen from West China Hospital of Sichuan University, delivered an outstanding report on cholestatic DILI, which is summarized below for our readers.

Cholangiocarcinoma (BTC), often called the "silent killer," constitutes less than 1% of adult cancers and has a poor prognosis with limited patient survival. Current treatments primarily involve surgery and chemotherapy, but their efficacy is limited. Recently, various targeted drugs and immune checkpoint inhibitors (ICIs) have provided new therapeutic options for BTC patients. The 2024 American Society of Clinical Oncology (ASCO) Annual Meeting presented several new drug research updates on BTC. Here, we summarize three oral presentation studies.