To investigate the effectiveness and safety of coblopasvir hydrochloride combined with sofosbuvir （CLP/SOF） in the treatment of patients with chronic hepatitis C （CHC） and those with genotype 3b in terms of virologic response rate，changes in liver and renal function parameters，and adverse events，and to provide a reference for clinical diagnosis and treatment.

The patients with CHC who were admitted to Maanshan Fourth People’s Hospital from March 1，2023 to July 31，2024 were enrolled and treated with CLP/SOF for a course of 12 weeks. Follow-up assessments were conducted at weeks 4，8，and 12 of treatment and at 12 weeks after the end of treatment，and related data were collected，including HCV RNA，routine blood test results，and liver and renal function parameters. Sustained virologic response at 12 weeks after treatment （SVR12） and safety profile were evaluated. The Friedman test was used for comparison of liver and renal function parameters，routine blood test results，and liver fibrosis score at different time points.

A total of 107 CHC patients treated with CLP/SOF were enrolled，with an age of 22 — 92 years，and there were 55 male patients. The predominant genotypes were 1b （46.73%） and 3b （28.97%）. Comorbidities mainly included liver cirrhosis （15 patients），fatty liver disease （27 patients），syphilis （15 patients），HBV infection （8 patients），and HIV infection （2 patients）. The overall SVR12 rate was 100% （107/107），with an SVR12 rate of 100% for subgroups with different genotypes and those with liver cirrhosis，fatty liver disease，syphilis，HBV infection，or HIV infection. The patients with HCV genotype 3b comorbid with liver cirrhosis，fatty liver disease，syphilis，HBV infection，hypertension or diabetes also achieved an SVR12 rate of 100%. After CLP/SOF treatment，the patients showed significant reductions in the levels of the liver function parameters alanine aminotransferase，aspartate aminotransferase，total bilirubin，and hemoglobin （all P<0.001） and significant reductions in the liver fibrosis scores fibrosis-4 and aspartate aminotransferase-to-platelet ratio index （both P<0.001）. The median creatinine level was 66 μmol/L before treatment，which decreased to 52 μmol/L at week 12 of treatment （P<0.001）. No adverse events were reported.

Patients with CHC achieve a high SVR12 rate and significant improvements in liver function parameters and liver fibrosis markers after treatment with the CLP/SOF regimen，and this regimen has no significant impact on renal function and shows a favorable safety profile. Therefore，it holds promise for clinical application.

To construct a machine learning model combining two-dimensional shear wave elastography （2D-SWE） and serological markers，and to investigate its clinical value in differentiating primary biliary cholangitis （PBC） from overlap syndrome （OS）.

A total of 199 patients with pathologically confirmed PBC or OS in Nantong Third People’s Hospital from January 2021 to December 2025 were retrospectively enrolled，with 125 patients in the PBC group and 74 in the OS group. The patients were randomly divided into a training set with 139 patients and a test set with 60 patients at a ratio of 7∶3. Related data were collected，including serological markers，conventional two-dimensional ultrasound parameters，and 2D-SWE parameters （including velocity of shear wave ［VS］ and liver fibrosis index ［LFI］）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups，and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Logistic regression analyses were used to identify independent predictive factors，which were then incorporated into six machine learning models，and 5-fold cross-validation was used for optimization of parameters. The indicators including the area under the receiver operating characteristic curve （AUC） were compared in the test set to determine the best model，and the SHapley additive exPlanations （SHAP） analysis was used for model interpretation.

Female patients accounted for 87.8% in the OS group and 79.2% in the PBC group. Compared with the PBC group，the OS group had significantly higher age，VS，LFI，splenic area，aspartate aminotransferase，total bilirubin，prothrombin time，immunoglobulin G （IgG），and immunoglobulin M （Z=-2.883，-6.524，-4.000，-3.061，-2.194，-2.372，-4.079，-6.964，and -2.709，all P<0.05） and a significantly lower platelet count （Z=4.098，P<0.001），and there were also significant differences between the two groups in the proportion of patients with positive anti-nuclear antibody，fibrosis stage，and inflammation grade （χ²=3.458，63.198，and 101.038，all P<0.05）. Variables without multicollinearity were included in the regression analysis，and the multivariate Logistic regression analysis showed that VS （odds ratio ［OR］=4.503，95% confidence interval ［CI］：1.698 — 11.943，P=0.003），LFI （OR=1.813，95%CI：1.050 — 3.132，P=0.033），and IgG （OR=1.121，95%CI：1.026 — 1.226，P=0.012） were independent predictive factors for differentiating PBC from OS. Six machine learning models were constructed based on these variables，among which the logistic regression model showed the best predictive performance in the test set，with an AUC of 0.881 （95%CI：0.788 — 0.974），a sensitivity of 0.731，and a specificity of 0.794. The SHAP analysis showed that IgG contributed the most to model prediction.

The noninvasive multimodal machine learning model combining 2D-SWE parameters （VS，LFI） and serum IgG can effectively differentiate PBC from OS，providing a reference for clinical decision-making regarding the need for liver biopsy.

To investigate the risk factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients，to construct a clinical predictive model，and to provide a reference for predicting rebleeding in the early stage，reducing the incidence rate of rebleeding，and improving the clinical outcome of patients.

A retrospective analysis was performed for the clinical data of 194 liver cirrhosis patients with gastroesophageal variceal bleeding who received initial endoscopic therapy at Department of Gastroenterology，The Second People’s Hospital of Lanzhou，from January 1，2021 to May 31，2025. According to whether rebleeding occurred within 1 year after endoscopic therapy，the patients were divided into rebleeding group and non-rebleeding group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups，and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The patients enrolled were randomly divided into a training set and a validation set at a ratio of 7∶3. In the training set，the Lasso regression analysis was used to obtain optimal predictive variables，and the factors that might affect prognosis were included in the univariate and multivariate Logistic regression analyses to identify independent predictive factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients，which were used to construct a nomogram model. In both the training set and the validation set，the receiver operating characteristic （ROC） curve and the calibration curve were used to assess the discriminatory ability and calibration of the model，and decision curve analysis and the clinical impact curve were used to assess the clinical practicability of the model.

Among the 194 liver cirrhosis patients with esophageal and gastric varices，116 （59.79%） experienced rebleeding within 1 year after endoscopic therapy，with 76 patients in the training set and 40 patients in the validation set. In the training set，the Lasso regression analysis and the univariate and multivariate Logistic regression analyses showed that etiology of liver cirrhosis （odds ratio ［OR］=3.540，95% confidence interval ［CI］：1.520 — 7.150，P<0.001），Child-Pugh class （OR=3.560，95%CI：1.380 — 9.500，P=0.019），severity of esophageal and gastric varices （OR=8.190，95%CI：3.568 — 17.850，P=0.026），and main portal vein diameter （OR=2.954，95%CI：1.349 — 15.030，P=0.044） were independent predictive factors for rebleeding of esophageal and gastric varices in liver cirrhosis patients. A nomogram model was constructed based on the above independent predictive factors. The ROC curve analysis showed that this model had an area under the ROC curve of 0.845 （95%CI：0.778 — 0.912） in the training set and 0.801 （95%CI：0.798 — 0.868） in the validation set. The model had an index of concordance of 0.832 in the training set and 0.820 in the validation set，suggesting that the model had a good discriminatory ability. The Hosmer-Lemeshow test showed P values of 0.320 and 0.550 in the training set and validation set，respectively，the calibration curve indicated that the predicted probabilities of the nomogram model were in good concordance with the actual observed probabilities，suggesting that the model had good calibration. The decision curve analysis and the clinical impact curve showed that the model had good clinical utility.

The nomogram model based on etiology of liver cirrhosis，Child-Pugh class，severity of esophageal and gastric varices，and main portal vein diameter has a certain clinical value in predicting the risk of rebleeding from esophageal and gastric varices in liver cirrhosis.

To investigate the therapeutic effect of Bazhen Lihe Kangxian prescription on rats with liver fibrosis induced by carbon tetrachloride （CCl₄），and to explore its mechanism of action against liver fibrosis.

A total of 50 male Sprague-Dawley rats were randomly divided into blank group，model group，silybin group （43.19 mg/kg），and low-，middle-，and high-dose Bazhen Lihe Kangxian prescription groups （7.96，15.93，and 31.86 g/kg，respectively）. Subcutaneous injection of 40% CCl₄-olive oil solution （twice a week for 8 consecutive weeks） was performed to establish a model of liver fibrosis. After successful modeling，the rats in the blank group and the model group were given normal saline by gavage，while those in the treatment groups were given the corresponding drug by gavage，once a day for 4 consecutive weeks. HE staining and Masson staining were used to observe liver histopathological changes； an automatic biochemical analyzer was used to measure the serum levels of albumin （Alb），aspartate aminotransferase （AST），and alanine aminotransferase （ALT）； ELISA was used to measure the serum levels of hyaluronic acid （HA），collagen Ⅳ （Col-Ⅳ），procollagen Ⅲ N-terminal peptide （PⅢNP），and laminin （LN）； Western blotting was used to measure the protein expression levels of phosphoinositide 3-kinase （PI3K），phosphorylated PI3K （p-PI3K），protein kinase B （Akt），phosphorylated Akt （p-Akt），mammalian target of rapamycin （mTOR），and phosphorylated mTOR （p-mTOR） in liver tissue； RT-qPCR was used to measure the mRNA expression levels of collagen Ⅰ （Col-Ⅰ） and α-smooth muscle actin （α-SMA） in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups，and the least significant difference t-test was used for further comparison between two groups.

Compared with the blank group，the model group had disrupted hepatic lobular structure，disordered arrangement of hepatic cell cords，hepatocyte fatty degeneration，severe inflammatory cell infiltration，and deposition of massive blue collagen fibers，as well as significant increases in the levels of AST，ALT，HA，LN，Col‑Ⅳ，and PⅢNP and a significant reduction in the level of Alb （all P<0.01）. Compared with the model group，the silybin group and the three Bazhen Lihe Kangxian prescription groups had varying degrees of improvement in inflammatory cell infiltration，hepatocyte fatty degeneration，and collagen deposition in liver tissue，as well as significant reductions in the levels of AST，ALT，HA，LN，Col‑Ⅳ，and PⅢNP and a significant increase in the level of Alb （all P<0.01）. Compared with the blank group，the model group had significant increases in the protein expression levels of p‑PI3K/PI3K，p-Akt/Akt，and p‑mTOR/mTOR and the mRNA expression levels of Col-I and α-SMA in liver tissue （all P<0.01）； compared with the model group，the silybin group and the high- and middle-dose Bazhen Lihe Kangxian prescription groups had significant reductions in the protein expression levels of p-PI3K/PI3K （all P<0.01），and the silybin group and the three Bazhen Lihe Kangxian prescription groups had significant reductions in the protein expression levels of p-Akt/Akt and p-mTOR/mTOR and the mRNA expression levels of Col-Ⅰ and α-SMA in liver tissue （all P<0.01）.

Bazhen Lihe Kangxian prescription can improve CCl₄-induced liver fibrosis in rats and alleviate liver injury，possibly by inhibiting the PI3K/Akt/mTOR pathway.

To investigate the therapeutic effect of Biejiajian Pills on rats with carbon tetrachloride （CCl₄）-induced hepatic fibrosis and its mechanism based on the bile acid （BA）-short-chain fatty acid （SCFA） metabolic axis.

The method of CCl₄ induction was used to establish a rat model of hepatic fibrosis，and 32 male Sprague-Dawley rats were randomly divided into control group，model group，Biejiajian Pills group （2.2 g/kg），and silymarin group （43.19 mg/kg），with 8 rats in each group. All rats except those in the control group were given intraperitoneal injection of CCl₄ （diluted with corn oil at a ratio of 4∶6，2 mL/kg） to induce a model of hepatic fibrosis for 8 consecutive weeks，and the rats in the drug administration groups were given the corresponding drug by gavage. An automatic biochemical analyzer was used to measure the serum levels of alanine aminotransferase （ALT），aspartate aminotransferase （AST），total bilirubin （TBil），and albumin （Alb）； chloramine-T colorimetry was used to measure the content of hydroxyproline （HYP） in liver tissue； HE staining and Masson staining were used to observe liver histopathological changes； UPLC-MS/MS and GC-MS were used to measure the levels of BAs and SCFAs. The Shapiro-Wilk test and the Levene test were performed for all data to determine normality and homogeneity of variance； a one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups，and the least significant difference t-test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of Ishak score between groups，and the Dunn’s test was used for further comparison between two groups. The Benjamini-Hochberg method was used for multiple comparison correction in the screening of differentially expressed metabolites in metabolomics data. The variable importance in projection （VIP） values were obtained in combination with the orthogonal partial least squares-discriminant analysis （OPLS-DA） model，and metabolites with VIP>1 and P<0.05 were selected as significantly differentially expressed metabolites between groups. The robustness of the OPLS-DA model was evaluated through 200 permutation tests，and the main parameters of the model were reported，including the interpretation rate of the model for categorical variables （R²Y） and the predictive ability of the model （Q²）. A Spearman’s rank correlation analysis was performed.

The results of staining showed ordered arrangement of hepatocytes in the Biejiajian Pills group，with significant alleviation of inflammatory cell infiltration and collagen fiber deposition. Compared with the control group，the model group had significant increases in the serum levels of TBil and HYP and a significant reduction in the serum level of Alb （all P<0.05）. Compared with the control group，the Biejiajian Pills group had significant increases in the serum levels of AST，ALT，TBil，and HYP and a significant reduction in the serum level of Alb （all P<0.05），and the silymarin group had significant increases in the serum levels of ALT，TBil，and HYP and a significant reduction in the serum level of Alb （all P<0.05）. Compared with the model group，the Biejiajian Pills group had significant reductions in the serum levels of ALT，AST，TBil，and HYP （all P<0.05），and the silymarin group had significant reductions in the serum levels of ALT，TBil，HYP，and AST and a significant increase in the serum level of Alb （all P<0.05）. Mechanism studies showed that compared with the control group，the model group had significant reductions in the levels of taurolithocholic acid，tauro-α-muricholic acid，taurocholic acid，glycodeoxycholic acid，taurohyocholic acid，chenodeoxycholic acid，glycohyodeoxycholic acid，7，12-diketolithocholic acid，taurochenodeoxycholic acid，and glycochenodeoxycholic acid and significant increases in the levels of hyodeoxycholic acid，norcholic acid，β-muricholic acid，and cholic acid （all P<0.05）. Compared with the model group，the Biejiajian Pills group had significant increases in the levels of the protective BAs taurolithocholic acid，chenodeoxycholic acid，taurocholic acid，taurohyocholic acid，and taurodeoxycholic acid and significant reductions in the levels of tauro-α-muricholic acid，tauro-β-muricholic acid，taurohyodeoxycholic acid+tauroursodeoxycholic acid，α-muricholic acid，glycoursodeoxycholic acid，and norcholic acid （alll P<0.05）. As for SCFAs，compared with the model group，the Biejiajian Pills group had significant increases in the levels of acetic acid，propionic acid，isobutyric acid，butyric acid，isopentanoic acid，pentanoic acid，and hexanoic acid （all P<0.05）. Compared with the model group，the silymarin group had significant reductions in the levels of taurolithocholic acid，tauro-α-muricholic acid，norcholic acid，glycocholic acid，deoxycholic acid，tauro-β-muricholic acid，taurodeoxycholic acid，taurohyodeoxycholic acid+tauroursodeoxycholic acid，and α-muricholic acid and significant increases in the levels of taurocholic acid and chenodeoxycholic acid，as well as significant increases in the levels of the SCFAs acetic acid，propionic acid，pentanoic acid，and hexanoic acid （all P<0.05）. The correlation analysis showed that the metabolism of BAs and SCFAs was correlated with the changes in serum indicators.

Biejiajian Pills can alleviate CCl₄-induced hepatic fibrosis in rats by regulating the BA/SCFA metabolic axis.

To assess the performance of preoperative serum Golgi protein 73 （GP73） in diagnosing liver fibrosis degree in patients with resectable hepatocellular carcinoma （HCC），to investigate its value in predicting postoperative survival，and to provide a basis for risk stratification and individualized decision-making in this population.

A total of 631 patients with HCC who underwent liver resection at The First Hospital of Jilin University from March 1，2009 to December 31，2022 were enrolled. The demographic，pathological，and serological features of the patients were collected，and the serum level of GP73 was measured before surgery. Scheuer score determined by liver biopsy was used as the gold standard for diagnosing liver fibrosis； the Spearman correlation analysis was used to investigate the correlation between GP73 and liver fibrosis； the receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC） were used to assess the value of serum GP73 and compound serological markers in the diagnosis of liver fibrosis，and the Delong test was used for comparison of AUC. With all-cause mortality as the outcome，X-Tile 3.6.1 software was used to determine the optimal cut-off value of GP73； the univariate and multivariate Cox regression analyses were used to identify independent influencing factors for prognosis，and a nomogram model was constructed. Ten-fold cross-validation was used for internal validation； index of concordance （C-index），integrated discrimination improvement （IDI） index，and net reclassification improvement （NRI） index were calculated； calibration curve and decision curve analysis were used to assess the predictive performance of the model.

The serum level of GP73 was positively correlated with Scheuer liver fibrosis stage （r_s=0.255，P<0.001）. Serum GP73 had a significantly higher AUC than gamma-glutamyl transferase-to-platelet ratio （0.704 vs 0.634，Z=2.00，P=0.046） and S index （0.704 vs 0.637，Z=1.98，P=0.048） in the diagnosis of significant liver fibrosis，with no significant difference compared with aspartate aminotransferase-to-platelet ratio index （AUC=0.722） and fibrosis-4 index （AUC=0.695） （both P>0.05）. During a median follow-up time of 48.66 months，239 patients （37.9%） died. GP73 had an optimal cut-off value of 65 ng/mL in predicting postoperative mortality in patients with resectable HCC，and high GP73 expression （≥65 ng/mL） alone achieved a C-index of 0.617 for predicting the prognosis of HCC patients，which was better than the C-index of 0.551 for Barcelona Clinic Liver Cancer （BCLC） stage （P<0.001）. The multivariate Cox regression analysis showed that serum GP73 （hazard ratio ［HR］=2.56，95% confidence interval ［CI］：1.86 — 3.52，P<0.001），sex （HR=1.58，95%CI：1.10 — 2.28，P=0.014），vascular invasion （HR=1.69，95%CI：1.30 — 2.21，P<0.001），total bilirubin （HR=1.49，95%CI：1.16 — 1.93，P=0.002），and maximum tumor diameter （HR=1.07，95%CI：1.04 — 1.11，P<0.001） were independent risk factors for all-cause mortality after hepatectomy in patients with HCC. In order to assess whether the addition of GP73 to the other four variables could further improve model performance，the model based on GP73，sex，vascular invasion，total bilirubin，and maximum tumor diameter was defined as the GP73-included model，and the model based on all five variables except GP73 was defined as the GP73-excluded model. The GP73-included model achieved an AUC of 0.704 （95%CI：0.656 — 0.753） for predicting 5-year survival rate after surgery，and ten-fold cross-validation showed that this model had a mean C-index of 0.716 （95%CI：0.682 — 0.750），which was higher than the C-index of the GP73-excluded model （C-index=0.682，95%CI：0.645 — 0.719，P=0.008） and BCLC stage （C-index=0.551，95%CI：0.523 — 0.580，P<0.001）. Compared with the GP73-excluded model，the GP73-included model yielded an IDI index of 0.039 （95%CI：0.016 — 0.069，P<0.001） and an NRI index of 0.259 （95%CI：0.179 — 0.335，P<0.001），and compared with BCLC stage，the GP73-included model had an IDI index of 0.112 （95%CI：0.069 — 0.163，P<0.001） and an NRI index of 0.272 （95%CI：0.169 — 0.380，P<0.001）. Calibration curve and decision curve analyses showed that the GP73-included model had good calibration and net clinical benefit.

GP73 can be used as a serological biomarker for diagnosing liver fibrosis in patients with resectable HCC，and preoperative GP73 level has a certain value in predicting the survival of these patients after hepatectomy. The integrated prognostic model incorporating GP73 can help to optimize postoperative risk stratification，thereby providing a basis for decision-making in precise treatment of HCC.