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While some studies have not found a similar effect in Hepatitis B surface antigen (HBsAg)-seropositive patients regarding ALT levels, other research indicates an increased risk of cirrhosis in HBV carriers who smoke 20 or more cigarettes per day, an effect that is particularly pronounced when combined with habitual alcohol consumption [85, 86]

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pSS was diagnosed according to the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria ( Histological staining The LSG samples were fixed in fresh 4% neutral formaldehyde overnight, placed into an automatic tissue dehydrator for dehydration, embedded in paraffin, and cut into 5-mm-thick serial sections for haematoxylin and eosin (HE) and immunohistochemical (IHC) staining

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