A recent study by Sala-Miquel et al investigated the diagnostic effectiveness of follow-up strategies in patients with non-metastatic colorectal cancer(CRC)after surgical resection.This research highlighted the signif...A recent study by Sala-Miquel et al investigated the diagnostic effectiveness of follow-up strategies in patients with non-metastatic colorectal cancer(CRC)after surgical resection.This research highlighted the significance of using computed tomography(CT),colonoscopy,and tumor markers for the early detection of recurrence or metastasis.The findings indicated that strict adherence to follow-up protocols can contribute to decreased mortality rates among these patients.However,the study has several limitations that must be considered.It was retrospective and conducted at a single center,which may affect the generalizability of the results.Further,the absence of a control group and the exclusion of stage IV patients limit the study's applicability.Methodological issues,including insufficient adjustment for confounding variables,a lack of sensitivity analyses,and limitations in time-dependent covariate analysis,further constrain the conclusions'robustness.Moreover,while the study emphasizes the role of CT scans,it does not adequately address their potential risks and underrepresents the importance of colonoscopy.Future research should focus on multicenter,prospective studies that integrate personalized follow-up approaches and explore innovative technologies to enhance the efficacy of follow-up strategies in CRC management.By addressing these limitations,researchers can improve the applicability and impact of follow-up strategies in the care of CRC patients.展开更多
A recent study by Lu et al examined the potential benefits of postoperative combined therapy(PCT)using anti-programmed cell death protein-1/PD-ligand-1 and anti-vascular endothelial growth factor agents for patients w...A recent study by Lu et al examined the potential benefits of postoperative combined therapy(PCT)using anti-programmed cell death protein-1/PD-ligand-1 and anti-vascular endothelial growth factor agents for patients with hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC).At the same time,the findings offer important insights;however,several methodological and statistical limitations should be noted.These limitations include selection bias from the study’s retrospective design,variability in treatment regimens,a small sample size,and inadequate monitoring of hepatitis B virus(HBV)reactivation.The study’s conclusions about PCT efficacy warrant cautious interpretation due to unresolved biases.Prospective trials with biomarker stratification are critical to confirm these preliminary findings.These findings underscore the need for prospective,biomarker-driven trials to validate the efficacy of PCT.Future research should prioritize standardized regimens,HBV reactivation monitoring,and global collaborations to optimize therapeutic strategies for HBV-HCC.展开更多
The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our unde...The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our understanding of the limitations of current biopsy protocols,it raises several concerns about the generalizability of its findings,sample size,and methodology.One major limitation was the exclusion of patients with ileal strictures,ileostomies,or J-pouches,which reduced the applicability of the results to the wider CD population.Furthermore,the biopsy protocol's focus on single biopsies from specific locations may inadequately capture the patchy inflammation characteristic of CD.The study also uses histologic indices primarily developed for ulcerative colitis,which may not be suitable for assessing CD.It is recommended that multi-center studies be conducted and histologic indices specific to CD be developed to improve the relevance of future research.Additionally,researchers should consider the influence of treatment regimens on the findings.Addressing these limitations would enhance the clinical significance of the study and inform better diagnostic and therapeutic approaches for CD.展开更多
A recent study by Qin et al emphasized the potential of zinc finger protein 71(ZNF71)as a promising biomarker for hepatocellular carcinoma(HCC).The authors offered valuable insights into the relationship between ZNF71...A recent study by Qin et al emphasized the potential of zinc finger protein 71(ZNF71)as a promising biomarker for hepatocellular carcinoma(HCC).The authors offered valuable insights into the relationship between ZNF71 and various clinical and pathological stages of HCC.However,several limitations are required to be addressed to improve the findings.These limitations include concerns regarding patient selection,the generalizability of the results,and the necessity for functional validation to establish ZNF71’s specific role in the progression of HCC.Furthermore,statistical issues related to multiple comparisons,confounding variables,and the inherent heterogeneity of high-throughput datasets warrant careful consideration.Future research should focus on multi-institutional cohorts,utilize in vivo models,and compare ZNF71 with established biomarkers to strengthen the clinical relevance of ZNF71.展开更多
Metabolic-associated fatty liver disease(MAFLD),formerly known as nonalcoho-lic fatty liver disease,is an increasing global health challenge with substantial implications for metabolic and cardiovascular health(CVH).A...Metabolic-associated fatty liver disease(MAFLD),formerly known as nonalcoho-lic fatty liver disease,is an increasing global health challenge with substantial implications for metabolic and cardiovascular health(CVH).A recent study by Fu et al investigated the relationship between CVH metrics,specifically Life’s Simple 7 and Life’s Essential 8,and the prevalence of MAFLD.While this study offered important insights into the relationship between CVH and MAFLD,several me-thodological limitations,unaddressed confounding factors,and potential biases that could impact the interpretation of their findings should be considered.The study’s cross-sectional nature restricted the ability to draw causal conclusions,and it did not fully account for potential confounding factors such as dietary habits,genetic predispositions,and medication use.Furthermore,relying on tran-sient elastography to diagnose MAFLD introduces certain diagnostic limitations.Longitudinal study designs,advanced statistical modeling techniques,and diverse population groups should be utilized to strengthen future research.Exploring the mechanistic pathways that link CVH metrics to MAFLD through multi-omics approaches and interventional studies will be essential in formulating targeted prevention and treatment strategies.Structural equation modeling and machine learning techniques could provide a more refined analysis of these interrelated factors.Additionally,future research should employ longitudinal study designs and explore genetic and epigenetic influences to enhance our un-derstanding of CVH and MAFLD interactions.展开更多
BACKGROUND Celiac disease(CD)is an autoimmune disorder associated with an increased risk of pancreatitis,yet large-scale studies examining long-term risk and specific etiologies in CD patients are scarce.AIM To assess...BACKGROUND Celiac disease(CD)is an autoimmune disorder associated with an increased risk of pancreatitis,yet large-scale studies examining long-term risk and specific etiologies in CD patients are scarce.AIM To assess the long-term risk of pancreatitis in CD patients.METHODS We conducted a population-based cohort study with consecutive patients diagnosed with CD using the TriNeTx research network.Each patient was matched to a patient in the control group using a 1:1 propensity score matching to minimize confounding effects.The primary outcomes were the incidence of acute pancreatitis and chronic pancreatitis,and the secondary outcome was to assess the etiologies of pancreatitis.The incidence was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 160228 patients were identified to have CD,and the remaining 250725 individuals without CD were considered as controls.At 7-year follow-up,CD patients exhibited a significantly higher risk of acute pancreatitis(HR=2.05;95%CI:1.93-2.17)and chronic pancreatitis(HR=1.42;95%CI:1.31-1.54)compared to controls.Elevated risks for alcohol-induced(HR=1.35),biliary(HR=1.37),and idiopathic pancreatitis(HR=1.49)were also observed.Findings remained robust across all follow-up intervals and sensitivity analyses.CONCLUSION Patients with CD have a substantially increased long-term risk of acute and chronic pancreatitis,including alcoholrelated,biliary,and idiopathic subtypes.These findings support the routine surveillance of pancreatitis in CD management and highlight the need for further research into disease-specific risk factors and mitigation approaches.展开更多
Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Re...Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.展开更多
Metabolic dysfunction-associated steatotic liver disease,previously known as nonalcoholic fatty liver disease(NAFLD),is becoming increasingly common and is associated with significant morbidity and mortality related t...Metabolic dysfunction-associated steatotic liver disease,previously known as nonalcoholic fatty liver disease(NAFLD),is becoming increasingly common and is associated with significant morbidity and mortality related to both liver and non-liver issues.In its early stages,NAFLD is characterized by immune cell dysregulation,which suggests that immune-targeted therapies could be a viable treatment option for nonalcoholic steatohepatitis.A recent study by Zhu et al.investigated the role of autoantibodies in metabolic dysfunction-associated stea-totic liver disease at various histological stages.While the research provided valuable insights,several methodological concerns are noted,which include the study’s retrospective design,a limited panel of autoantibodies,and a lack of a prospective study design that adequately controls for confounding factors such as age,comorbidities and lifestyle.Furthermore,the interpretation of positive antinuclear antibodies as evidence of autoimmune involvement in NAFLD is questioned due to the possibility of nonspecific immune responses.Recommend-ations to improve the study’s design include conducting prospective studies,implementing more detailed antibody profiling,and adjusting for demographic and clinical factors.Future studies should address these issues to improve the clinical relevance and credibility of findings related to autoimmunity in NAFLD.展开更多
We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study of...We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study offers valuable mechanistic insights into local ablation,enhancing the efficacy of immune checkpoint blockade.However,critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation.We recommend clarifying experimental details,optimizing murine models,applying more robust statistical analyses,and tempering conclusions to reflect the correlative nature of the findings.Further work should investigate immune mechanisms,durability of response,and safety in clinically relevant models to maximize translational potential.These refinements will strengthen the study’s impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.展开更多
BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated fro...BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large populations.AIM To assess the risk of PC in CD patients.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform.We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this study.Among them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control cohort.The mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,respectively.During the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.CONCLUSION Patients with CD are at increased risk of PC.Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.展开更多
BACKGROUND Patients with autoimmune hepatitis(AIH)require life-long immunosuppressive agents that may increase the risk of poor coronavirus disease 2019(COVID-19)outcomes.There is a paucity of large data at the popula...BACKGROUND Patients with autoimmune hepatitis(AIH)require life-long immunosuppressive agents that may increase the risk of poor coronavirus disease 2019(COVID-19)outcomes.There is a paucity of large data at the population level to assess whether patients with AIH have an increased risk of severe diseases.AIM To evaluate the impact of pre-existing AIH on the clinical outcomes of patients with COVID-19.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive adult patients(≥18 years)diagnosed with COVID-19 using the TriNeTx research network platform.The outcomes of patients with AIH(main group)were compared to a propensity score-matched cohort of patients:(1)Without chronic liver disease(CLD);and(2)Patients with CLD except AIH(non-AIH CLD)control groups.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The primary outcome was all-cause mortality,and secondary outcomes were hospitalization rate,need for critical care,severe disease,mechanical ventilation,and acute kidney injury(AKI).For each outcome,the risk ratio(RR)and confidence intervals(CI)were calculated to compare the association of AIH with the outcome.RESULTS We identified 375 patients with AIH,1647915 patients with non-CLD,and 15790 patients with non-AIH CLD with COVID-19 infection.Compared to non-CLD patients,the AIH cohort had an increased risk of all-cause mortality(RR=2.22;95%CI:1.07-4.61),hospitalization rate(RR=1.78;95%CI:1.17-2.69),and severe disease(RR=1.98;95%CI:1.19-3.26).The AIH cohort had a lower risk of hospitalization rate(RR=0.72;95%CI:0.56-0.92),critical care(RR=0.50;95%CI:0.32-0.79),and AKI(RR=0.56;95%CI:0.35-0.88)compared to the non-AIH CLD patients.CONCLUSION Patients with AIH are associated with increased hospitalization risk,severe disease,and all-cause mortality compared to patients without pre-existing CLD from the diagnosis of COVID-19.However,patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD.展开更多
The global incidence of oral cancer has steadily increased in recent years and is associated with high morbidity and mortality.Oral cancer is the most common cancer in the head and neck region,and is predominantly of ...The global incidence of oral cancer has steadily increased in recent years and is associated with high morbidity and mortality.Oral cancer is the most common cancer in the head and neck region,and is predominantly of epithelial origin(i.e.squamous cell carcinoma).Oral cancer treatment modalities mainly include surgery with or without radiotherapy and chemotherapy.Though proven effective,chemotherapy has significant adverse effects with possibilities of tumor resistance to anticancer drugs and recurrence.Thus,there is an imperative need to identify suitable anticancer therapies that are highly precise with minimal side effects and to make oral cancer treatment effective and safer.Among the available adjuvant therapies is curcumin,a plant polyphenol isolated from the rhizome of the turmeric plant Curcuma longa.Curcumin has been demonstrated to have antiinfectious,antioxidant,anti-inflammatory,and anticarcinogenic properties.Curcumin has poor bioavailability,which has been overcome by its various analogues and nanoformulations,such as nanoparticles,liposome complexes,micelles,and phospholipid complexes.Studies have shown that the anticancer effects of curcumin are mediated by its action on multiple molecular targets,including activator protein 1,protein kinase B(Akt),nuclear factorκ-light-chainenhancer of activated B cells,mitogen-activated protein kinase,epidermal growth factor receptor(EGFR)expression,and EGFR downstream signaling pathways.These targets play important roles in oral cancer pathogenesis,thereby making curcumin a promising adjuvant treatment modality.This review aims to summarize the different novel formulations of curcumin and their role in the treatment of oral cancer.展开更多
文摘A recent study by Sala-Miquel et al investigated the diagnostic effectiveness of follow-up strategies in patients with non-metastatic colorectal cancer(CRC)after surgical resection.This research highlighted the significance of using computed tomography(CT),colonoscopy,and tumor markers for the early detection of recurrence or metastasis.The findings indicated that strict adherence to follow-up protocols can contribute to decreased mortality rates among these patients.However,the study has several limitations that must be considered.It was retrospective and conducted at a single center,which may affect the generalizability of the results.Further,the absence of a control group and the exclusion of stage IV patients limit the study's applicability.Methodological issues,including insufficient adjustment for confounding variables,a lack of sensitivity analyses,and limitations in time-dependent covariate analysis,further constrain the conclusions'robustness.Moreover,while the study emphasizes the role of CT scans,it does not adequately address their potential risks and underrepresents the importance of colonoscopy.Future research should focus on multicenter,prospective studies that integrate personalized follow-up approaches and explore innovative technologies to enhance the efficacy of follow-up strategies in CRC management.By addressing these limitations,researchers can improve the applicability and impact of follow-up strategies in the care of CRC patients.
文摘A recent study by Lu et al examined the potential benefits of postoperative combined therapy(PCT)using anti-programmed cell death protein-1/PD-ligand-1 and anti-vascular endothelial growth factor agents for patients with hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC).At the same time,the findings offer important insights;however,several methodological and statistical limitations should be noted.These limitations include selection bias from the study’s retrospective design,variability in treatment regimens,a small sample size,and inadequate monitoring of hepatitis B virus(HBV)reactivation.The study’s conclusions about PCT efficacy warrant cautious interpretation due to unresolved biases.Prospective trials with biomarker stratification are critical to confirm these preliminary findings.These findings underscore the need for prospective,biomarker-driven trials to validate the efficacy of PCT.Future research should prioritize standardized regimens,HBV reactivation monitoring,and global collaborations to optimize therapeutic strategies for HBV-HCC.
文摘The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our understanding of the limitations of current biopsy protocols,it raises several concerns about the generalizability of its findings,sample size,and methodology.One major limitation was the exclusion of patients with ileal strictures,ileostomies,or J-pouches,which reduced the applicability of the results to the wider CD population.Furthermore,the biopsy protocol's focus on single biopsies from specific locations may inadequately capture the patchy inflammation characteristic of CD.The study also uses histologic indices primarily developed for ulcerative colitis,which may not be suitable for assessing CD.It is recommended that multi-center studies be conducted and histologic indices specific to CD be developed to improve the relevance of future research.Additionally,researchers should consider the influence of treatment regimens on the findings.Addressing these limitations would enhance the clinical significance of the study and inform better diagnostic and therapeutic approaches for CD.
文摘A recent study by Qin et al emphasized the potential of zinc finger protein 71(ZNF71)as a promising biomarker for hepatocellular carcinoma(HCC).The authors offered valuable insights into the relationship between ZNF71 and various clinical and pathological stages of HCC.However,several limitations are required to be addressed to improve the findings.These limitations include concerns regarding patient selection,the generalizability of the results,and the necessity for functional validation to establish ZNF71’s specific role in the progression of HCC.Furthermore,statistical issues related to multiple comparisons,confounding variables,and the inherent heterogeneity of high-throughput datasets warrant careful consideration.Future research should focus on multi-institutional cohorts,utilize in vivo models,and compare ZNF71 with established biomarkers to strengthen the clinical relevance of ZNF71.
文摘Metabolic-associated fatty liver disease(MAFLD),formerly known as nonalcoho-lic fatty liver disease,is an increasing global health challenge with substantial implications for metabolic and cardiovascular health(CVH).A recent study by Fu et al investigated the relationship between CVH metrics,specifically Life’s Simple 7 and Life’s Essential 8,and the prevalence of MAFLD.While this study offered important insights into the relationship between CVH and MAFLD,several me-thodological limitations,unaddressed confounding factors,and potential biases that could impact the interpretation of their findings should be considered.The study’s cross-sectional nature restricted the ability to draw causal conclusions,and it did not fully account for potential confounding factors such as dietary habits,genetic predispositions,and medication use.Furthermore,relying on tran-sient elastography to diagnose MAFLD introduces certain diagnostic limitations.Longitudinal study designs,advanced statistical modeling techniques,and diverse population groups should be utilized to strengthen future research.Exploring the mechanistic pathways that link CVH metrics to MAFLD through multi-omics approaches and interventional studies will be essential in formulating targeted prevention and treatment strategies.Structural equation modeling and machine learning techniques could provide a more refined analysis of these interrelated factors.Additionally,future research should employ longitudinal study designs and explore genetic and epigenetic influences to enhance our un-derstanding of CVH and MAFLD interactions.
文摘BACKGROUND Celiac disease(CD)is an autoimmune disorder associated with an increased risk of pancreatitis,yet large-scale studies examining long-term risk and specific etiologies in CD patients are scarce.AIM To assess the long-term risk of pancreatitis in CD patients.METHODS We conducted a population-based cohort study with consecutive patients diagnosed with CD using the TriNeTx research network.Each patient was matched to a patient in the control group using a 1:1 propensity score matching to minimize confounding effects.The primary outcomes were the incidence of acute pancreatitis and chronic pancreatitis,and the secondary outcome was to assess the etiologies of pancreatitis.The incidence was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 160228 patients were identified to have CD,and the remaining 250725 individuals without CD were considered as controls.At 7-year follow-up,CD patients exhibited a significantly higher risk of acute pancreatitis(HR=2.05;95%CI:1.93-2.17)and chronic pancreatitis(HR=1.42;95%CI:1.31-1.54)compared to controls.Elevated risks for alcohol-induced(HR=1.35),biliary(HR=1.37),and idiopathic pancreatitis(HR=1.49)were also observed.Findings remained robust across all follow-up intervals and sensitivity analyses.CONCLUSION Patients with CD have a substantially increased long-term risk of acute and chronic pancreatitis,including alcoholrelated,biliary,and idiopathic subtypes.These findings support the routine surveillance of pancreatitis in CD management and highlight the need for further research into disease-specific risk factors and mitigation approaches.
文摘Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.
文摘Metabolic dysfunction-associated steatotic liver disease,previously known as nonalcoholic fatty liver disease(NAFLD),is becoming increasingly common and is associated with significant morbidity and mortality related to both liver and non-liver issues.In its early stages,NAFLD is characterized by immune cell dysregulation,which suggests that immune-targeted therapies could be a viable treatment option for nonalcoholic steatohepatitis.A recent study by Zhu et al.investigated the role of autoantibodies in metabolic dysfunction-associated stea-totic liver disease at various histological stages.While the research provided valuable insights,several methodological concerns are noted,which include the study’s retrospective design,a limited panel of autoantibodies,and a lack of a prospective study design that adequately controls for confounding factors such as age,comorbidities and lifestyle.Furthermore,the interpretation of positive antinuclear antibodies as evidence of autoimmune involvement in NAFLD is questioned due to the possibility of nonspecific immune responses.Recommend-ations to improve the study’s design include conducting prospective studies,implementing more detailed antibody profiling,and adjusting for demographic and clinical factors.Future studies should address these issues to improve the clinical relevance and credibility of findings related to autoimmunity in NAFLD.
文摘We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study offers valuable mechanistic insights into local ablation,enhancing the efficacy of immune checkpoint blockade.However,critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation.We recommend clarifying experimental details,optimizing murine models,applying more robust statistical analyses,and tempering conclusions to reflect the correlative nature of the findings.Further work should investigate immune mechanisms,durability of response,and safety in clinically relevant models to maximize translational potential.These refinements will strengthen the study’s impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.
文摘BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large populations.AIM To assess the risk of PC in CD patients.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform.We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this study.Among them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control cohort.The mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,respectively.During the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.CONCLUSION Patients with CD are at increased risk of PC.Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.
文摘BACKGROUND Patients with autoimmune hepatitis(AIH)require life-long immunosuppressive agents that may increase the risk of poor coronavirus disease 2019(COVID-19)outcomes.There is a paucity of large data at the population level to assess whether patients with AIH have an increased risk of severe diseases.AIM To evaluate the impact of pre-existing AIH on the clinical outcomes of patients with COVID-19.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive adult patients(≥18 years)diagnosed with COVID-19 using the TriNeTx research network platform.The outcomes of patients with AIH(main group)were compared to a propensity score-matched cohort of patients:(1)Without chronic liver disease(CLD);and(2)Patients with CLD except AIH(non-AIH CLD)control groups.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The primary outcome was all-cause mortality,and secondary outcomes were hospitalization rate,need for critical care,severe disease,mechanical ventilation,and acute kidney injury(AKI).For each outcome,the risk ratio(RR)and confidence intervals(CI)were calculated to compare the association of AIH with the outcome.RESULTS We identified 375 patients with AIH,1647915 patients with non-CLD,and 15790 patients with non-AIH CLD with COVID-19 infection.Compared to non-CLD patients,the AIH cohort had an increased risk of all-cause mortality(RR=2.22;95%CI:1.07-4.61),hospitalization rate(RR=1.78;95%CI:1.17-2.69),and severe disease(RR=1.98;95%CI:1.19-3.26).The AIH cohort had a lower risk of hospitalization rate(RR=0.72;95%CI:0.56-0.92),critical care(RR=0.50;95%CI:0.32-0.79),and AKI(RR=0.56;95%CI:0.35-0.88)compared to the non-AIH CLD patients.CONCLUSION Patients with AIH are associated with increased hospitalization risk,severe disease,and all-cause mortality compared to patients without pre-existing CLD from the diagnosis of COVID-19.However,patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD.
文摘The global incidence of oral cancer has steadily increased in recent years and is associated with high morbidity and mortality.Oral cancer is the most common cancer in the head and neck region,and is predominantly of epithelial origin(i.e.squamous cell carcinoma).Oral cancer treatment modalities mainly include surgery with or without radiotherapy and chemotherapy.Though proven effective,chemotherapy has significant adverse effects with possibilities of tumor resistance to anticancer drugs and recurrence.Thus,there is an imperative need to identify suitable anticancer therapies that are highly precise with minimal side effects and to make oral cancer treatment effective and safer.Among the available adjuvant therapies is curcumin,a plant polyphenol isolated from the rhizome of the turmeric plant Curcuma longa.Curcumin has been demonstrated to have antiinfectious,antioxidant,anti-inflammatory,and anticarcinogenic properties.Curcumin has poor bioavailability,which has been overcome by its various analogues and nanoformulations,such as nanoparticles,liposome complexes,micelles,and phospholipid complexes.Studies have shown that the anticancer effects of curcumin are mediated by its action on multiple molecular targets,including activator protein 1,protein kinase B(Akt),nuclear factorκ-light-chainenhancer of activated B cells,mitogen-activated protein kinase,epidermal growth factor receptor(EGFR)expression,and EGFR downstream signaling pathways.These targets play important roles in oral cancer pathogenesis,thereby making curcumin a promising adjuvant treatment modality.This review aims to summarize the different novel formulations of curcumin and their role in the treatment of oral cancer.
