Guangming Li

The rising incidence of liver cirrhosis among women of childbearing age is associated with increased maternal morbidity and potential adverse maternal health outcomes. This study aimed to analyze temporal trends of cirrhosis incidence and project future epidemiological patterns to guide targeted prevention and control strategies. We extracted liver cirrhosis incidence data from the Global Burden of Disease Study 2021, covering 204 countries and territories from 1992 to 2021. The analytical population included females aged 15 to 49 years. Trends across age groups, periods, and birth cohorts were analyzed using the age-period-cohort model. The Bayesian age-period-cohort model was utilized to forecast epidemiological trends through 2030. Between 1992 and 2021, global cirrhosis trends varied by etiology: alcohol-related cases increased (14,566.88–19,340.29) despite declining age-standardized incidence rates (1.22–0.94 per 100,000), while nonalcoholic fatty liver disease-related cirrhosis showed a continuous upward trend in both case counts and age-standardized incidence rate between 1992 and 2021 (reaching 16,095,135.50 cases and 831.02 per 100,000 population in 2021), with projections indicating it may rise to approximately 19.63 million cases (95% uncertainty interval = 16.36 million–22.89 million) by 2030. Low socio-demographic index regions bore the highest burden. Projections through 2030 suggest a potential rising global burden, particularly for alcohol-related cases, with divergent trends projected for China (decreasing) and India (increasing). The global incidence of liver cirrhosis among women of childbearing age is rising, in population-level correlation with the growing burden of nonalcoholic fatty liver disease and regional gaps in viral and alcohol-related cirrhosis etiologies. These findings highlight the potential need for region-specific prevention strategies. Limitations include Global Burden of Disease data quality, ecological bias, and insufficient pregnancy-specific data for detailed incidence trend analysis.

Capsular invasion independently predicts poor prognosis after primary liver cancer (PLC). While maximum tumor diameter (MTD) informs staging systems, its p

Background Hepatocellular carcinoma (HCC) is the fifth most common malignant tumor and the third leading cause of cancer-related death worldwide. Despite the significance of multifocality in HCC (M-HCC), most studies have predominantly treated it as a prognostic factor, lacking in-depth investigation into its prognostic implications. This retrospective study aims to integrate clinical and laboratory examinations to construct a predictive model that more accurately forecasts the prognosis of patients with M-HCC. This aims to guide personalized treatment strategies and improve overall survival rates. Methods We applied the Lasso and cross-validated Lasso (CV-Lasso) combined with Random Forest analysis to explore the prognostic factors influencing M-HCC. Simultaneously, we utilized the identified prognostic factors to construct a Nomogram. This Nomogram assigns scores based on the magnitude of the impact of each factor on prognosis, enabling the prediction of postoperative survival rates for patients. Subsequently, the model-derived risk scores categorized patients into low-risk and high-risk groups, and Kaplan–Meier curves were generated. Results The patients, who were enrolled, were divided into training and validation sets. Factors influencing the prognosis of M-HCC were identified through Lasso, cross-validated Lasso, and Random Forest analyses, revealing seven key factors: Age, Antiviral, Child–Pugh, Cirrhosis, White Blood Cell (WBC), Platelets (PLT), and Thrombin Time (TT). Nomograms were constructed based on these factors to predict 3-year, 5-year, and 8-year survival rates. ROC curves confirmed the predictive capability of various factors, with larger areas under the curve at 5 (AUC = 0.653) and 8 years (AUC = 0.733). Kaplan–Meier curves stratified patients into low-risk and high-risk groups, showing significantly higher survival times in the low-risk group (p < 0.0001). Conclusions Postoperative antiviral treatment for patients with M-HCC, aimed at enhancing immune function and protecting liver function, has been shown to extend patient survival. Simultaneously, factors such as Child–Pugh, age, and Cirrhosis in patients with M-HCC have been associated with a decrease in postoperative survival time.

Emerging evidence links gut microbiota (GM) to venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE), but causal insights are limited. Using two-sample Mendelian randomization (MR), we assessed causal effects of 211 GM taxa and 489 plasma metabolites on VTE/DVT/PE. Genetic instruments (single nucleotide polymorphism) for GM and metabolites were leveraged to infer causality, complemented by mediation and pathway analyses. Sixteen GM taxa (e.g., protective Firmicutes, Clostridia; risk-enhancing Bacteroidetes, Desulfovibrionaceae) and 40 metabolites showed causal associations with VTE/DVT/PE. Reverse MR identified 11 GM changes secondary to thrombosis. No pleiotropy or heterogeneity was detected. Ten metabolite-mediated pathways (e.g., arginine biosynthesis) bridged GM to thrombosis, suggesting GM-metabolite interactions as potential biomarkers for thrombotic risk stratification and prognosis.

Background: Hepatitis E virus (HEV) infection poses a significant health risk across diverse demographic groups, particularly among pregnant women, immunocompromised individuals, patients with chronic liver disease, and the elderly. The global epidemiology of HEV reveals distinct patterns of prevalence, transmission, and disease severity among these populations, necessitating targeted vaccination strategies. The licensing of the Hecolin (HEV 239) vaccine offers promise, but gaps in clinical trial data and varying immune responses in high-risk groups challenge its widespread applicability. Scope: This review synthesizes data on HEV’s epidemiology, discusses the susceptibility of vulnerable populations, evaluates the efficacy and safety of HEV 239, and highlights the urgent need for clinical research tailored to these groups. Key findings underscore the complexity of vaccine response influenced by immunological, physiological, and environmental factors. Additionally, potential advancements in vaccine technology, including the development of broad-spectrum vaccines and innovative delivery systems, are discussed as future directions. Strategies: Addressing regulatory, economic, and logistical barriers remains crucial for effective HEV vaccination programs. A multidisciplinary approach integrating public health policy, rigorous clinical evaluations, and collaborative frameworks is essential to ensure equitable access to HEV vaccination, ultimately improving health outcomes on a global scale.