Liver biopsy in the post-hepatitis C virus era in Japan

In Japan,liver biopsies were previously crucial in evaluating the severity of hepatitis caused by the hepatitis C virus(HCV)and diagnosing HCV-related hepatocellular carcinoma(HCC).However,due to the development of effective antiviral treatments and advanced imaging,the necessity for biopsies has significantly decreased.This change has resulted in fewer chances for diagnosing liver disease,causing many general pathologists to feel less confident in making liver biopsy diagnoses.This article provides a comprehensive overview of the challenges and potential solutions related to liver biopsies in Japan.First,it highlights the importance of considering steatotic liver diseases as independent conditions that can coexist with other liver diseases due to their increasing prevalence.Second,it emphasizes the need to avoid hasty assumptions of HCC in nodular lesions,because clinically diagnosable HCCs are not targets for biopsy.Third,the importance of diagnosing hepatic immune-related adverse events caused by immune checkpoint inhibitors is increasing due to the anticipated widespread use of these drugs.In conclusion,pathologists should be attuned to the changing landscape of liver diseases and approach liver biopsies with care and attention to detail.

Clinical Observation of the Effect of Xuesaitong Soft Capsule (血塞通软胶囊) on Post-hepatitis Fibrosis

Objective: To study the effect of Xuesaitong soft capsule (血塞通软胶囊, XST) on liver fibrosis criteria in patients with post-hepatitis fibrosis. Methods: Sixty-four patients with such fibrosis were randomly divided into the treated group and control group. They were treated with XST and Dahuang Zhechong pill (大黄NFDA1虫丸) for 3 months respectively. Their liver fibrosis criteria were examined before and after treatment. Results: The levels of serum procollagen Ⅲ, hyaluronic acid, collagen Ⅳ, laminin in the two groups were significantly lower ( P <0.01) than those before treatment. The differences between the two groups were insignificant ( P >0.05). Conclusion: XST could recover liver dysfunction and had anti-liver fibrosis function.

Influence of Fuzheng Huayu Tablet(扶正化瘀片) on Mental State and Social Function of Patients with Post-Hepatitis B Liver Cirrhosis

Objective： To observe the influence of Fuzheng Huayu Tablet （扶正化瘀片, FZHYT） on mental state and social activity of patients with post-hepatitis B liver cirrhosis （LC-HB）. Methods： Adopting grouped randomized double-blinded control method, 180 LC-HB patients in 3 research centers were distributed to 2 groups, the treated group and the control group, 90 in each group. Patients in the treated group were administered with FZHYT; while those in the control group treated with conventional therapy combined with placebo, the course for all patients were 6 months. Their mental state and social activity were evaluated before treatment, after 3 months＇ treatment and at terminal of the 6-month therapeutic course by estimating with Zung self-rating anxiety scale （SAS）, self-rating depression scale （SDS） and social deficit screening scale （SDSS）. Additionally, the basic demographic materials, liver function, cirrhosis index, hepatic and splenic images, blood coagulation function, etc. in the patients were tested and compared as well. Results： As compared with before treatment, the normal rate of SAS and SDS scores increased and the social deficit rate decreased in the treated group significantly after treatment, showing statistical significance （P〈0.05 or P〈0.01）; while in the control group, change was only shown in the social deficit （P〈0.01）, inter-group comparisons after treatment showed significant differences in all the three indexes （P〈0.05 or P〈0.01）. Additionally, after treatment, levels of liver function, cirrhosis, blood coagulation function and splenomegaly in the treated group were all improved significantly （P〈0.05 or P〈0.01）, and the improvements were better than those in the control group （P〈0.01） in levels of total bilirubin （TBIL）, albumin （ALB）, type 1V collagen （1V-C）, prothrombin time （PT）, prothrombin activity （PTA）. Conclusion： Most patients of LC-HB have mental disturbance and social activity deficit, which could definitely be improved by intervention with Chinese FZHYT.