BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly dev...BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.展开更多
Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resu...Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resulting from nonalcoholic causes and closely linked to metabolic dysfunction[1].It is strongly associated with metabolic abnormalities,including type 2 diabetes,overweight,and obesity.The global prevalence of MASLD is estimated to be approximately 25%−33%,and its incidence is rising rapidly,particularly among younger populations,due to increasingly prevalent unhealthy lifestyle behaviors such as sleep deprivation,sedentary habits,and diets rich in calories.展开更多
Objective:To evaluate the hepatoprotective effects of skate-derived bioactives-collagen peptides(CPs)and chondroitin-against ethanol(EtOH)-induced liver injury and to elucidate their underlying mechanisms.Methods:The ...Objective:To evaluate the hepatoprotective effects of skate-derived bioactives-collagen peptides(CPs)and chondroitin-against ethanol(EtOH)-induced liver injury and to elucidate their underlying mechanisms.Methods:The protective effects of CPs and chondroitin were assessed in different in vitro and in vivo EtOH-induced injury models.Oxidative stress was evaluated by measuring reactive oxygen species production and antioxidant markers(NRF2 and GCLC).EtOH metabolism was examined by measuring alchohol-metabolizing enzymes(alcohol dehydrogenase and aldehyde dehydrogenase)and cytochrome P450 enzymes.Furthermore,lipid dysregulation was assessed by Oil Red O staining and determination of lipogenic markers(SREBP-1 and FAS).Liver injury was also evaluated by measuring serum glutamate oxaloacetate transaminase and glutamate pyruvate transaminase,and performing histological analysis.Results:In hepatocytes and zebrafish,both CPs and chondroitin reduced oxidative stress,downregulated cytochrome P450 enzymes and lipogenic markers,and enhanced antioxidant defenses,with chondroitin showing the strongest hepatoprotection.In EtOH-fed mice,chondroitin significantly improved liver enzyme profiles,reduced hepatic lipid accumulation and inflammation,and restored antioxidant and metabolic homeostasis.Conclusions:Skate-derived chondroitin significantly attenuates EtOH-induced liver injury by modulating oxidative stress,EtOH metabolism,and lipid regulation.These findings demonstrate the hepatoprotective potential of chondroitin in different preclinical models of alcohol-induced liver damage.展开更多
Background:High-mobility group box 1(HMGB1)is a critical damage-associated molecular pattern protein that participates in diverse physiological and pathological processes.However,its relevance to the prognosis of arti...Background:High-mobility group box 1(HMGB1)is a critical damage-associated molecular pattern protein that participates in diverse physiological and pathological processes.However,its relevance to the prognosis of artificial liver support therapy in patients with acute liver injury(ALF)remains unclear.Methods:Bioinformatics analyses were performed to identify HMGB1-interacting proteins and associated inflammatory signaling pathways.Peripheral blood samples were collected from ALF patients before and after artificial liver support therapy,and serum HMGB1 concentrations were quantified using ELISA.Primary mouse hepatocytes were stimulated with lipopolysaccharide(LPS)in vitro and HMGB1 expression was verified by western blot.Results:Single-cell transcriptomic profiling showed that HMGB1 is widely expressed across tissues and predominantly localized in the nucleus.In the liver,HMGB1 was primarily expressed in hepatocytes and hepatic stellate cells.STRING database analysis revealed that human HMGB1 interacts with multiple proteins,including TLR4,TP53,and BECN1.The constructed interaction network comprised 11 nodes with an average local clustering coefficient of 0.888,and the protein–protein interaction enrichment P-value was 1.42×10^(-5),indicating significant enrichment.Gene Ontology and KEGG pathway enrichment analyses demonstrated that HMGB1 is closely linked to inflammatory and injury-related signaling pathways,including the TLR and NLR pathways.Metabolomic profiling revealed significant metabolic alterations between patients with ALF and healthy controls under both positive and negative ion modes and functional analysis showed necroptosis was activated.The cell viability gradually decreased with time and dose under LPS treatment and extracellular HMGB1 was upregulated in LPS induced ALF model and patients(P<0.05).Serum HMGB1/RIPK3/MLKL levels were markedly elevated in ALF patients compared with controls(P<0.05)and progressively declined following artificial liver support therapy.Furthermore,elevated HMGB1 concentrations were positively correlated with unfavorable clinical outcomes.Conclusion:Peripheral blood HMGB1 levels are significantly increased in patients with acute liver failure,decrease following artificial liver support therapy,and are positively associated with poor clinical prognosis.展开更多
Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the ...Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the aggressive nature of thedisease and the significant burden it places on globalhealthcare systems. Although primary preventionremains the cornerstone of liver cancer control,improving outcomes for patients already diagnosedis equally critical for mitigating the impact of thedisease.展开更多
Background and AimsHepatic iron deposition(HID)in the reticuloendothelial system(RES)is associated with histological severity in metabolic dysfunction-associated steatotic liver disease(MASLD).This study aimed to asse...Background and AimsHepatic iron deposition(HID)in the reticuloendothelial system(RES)is associated with histological severity in metabolic dysfunction-associated steatotic liver disease(MASLD).This study aimed to assess the interaction between the transferrin(TF)-rs1049296 C>T variant and HID patterns on the risk of significant liver fibrosis in MASLD.MethodsWe analyzed 406 adults with liver biopsy-confirmed MASLD.HID was categorized as hepatocellular,RES,or mixed,based on Perl's iron staining.The association between iron-related genetic variants and significant liver fibrosis(fibrosis stage≥F2)was analyzed,focusing on the interactions between single-nucleotide polymorphism genotypes and iron deposition patterns.Multivariable logistic regression analysis was used to adjust for potential confounders.ResultsHID was detected in 271(66.7%)patients,with hepatocellular,RES,and mixed patterns accounting for 11.1%,18.0%,and 37.7%,respectively.A significant interaction was observed between HID and the TF-rs1049296 genotype(P=0.035 for interaction).In multivariable analysis,male sex,hypertension,severe lobular inflammation,and mixed hepatocellular/RES iron deposition were independent predictors of significant liver fibrosis.RES deposition markedly increased the risk of significant liver fibrosis(adjusted odds ratio:6.65;95%confidence interval:1.84-23.97,p<0.05),particularly in men with isolated RES iron deposition(adjusted odds ratio:5.26;95%confidence interval:1.21-22.81,p<0.05).ConclusionsThe TF-rs1049296 T allele interacts with RES iron deposition to identify a MASLD subpopulation at elevated risk of progressive liver disease,providing opportunities for refined risk stratification and personalized management.展开更多
BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or ga...BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or gastric varices.While rare,omental varices pose a risk for hemoperitoneum if ruptured,which is a lifethreatening complication with high mortality rates despite surgical intervention.CASE SUMMARY This report reviews the case of a patient 36-year-old female with alcohol related cirrhosis decompensated by ascites,but no history of varices admitted for hemorrhagic shock from spontaneous rupture of omental varices requiring emergency surgery.She underwent the first documented successful orthotopic liver transplantation the same admission.CONCLUSION This case report and literature review stresses the importance of early consideration and identification of intraabdominal variceal sources in cirrhotic patients with refractory shock.展开更多
Fatty liver hemorrhagic syndrome(FLHS)in laying hens is a metabolic disorder characterized by excessive hepatic lipid accumulation,inflammation,and hemorrhage,bearing pathological similarities to human non-alcoholic f...Fatty liver hemorrhagic syndrome(FLHS)in laying hens is a metabolic disorder characterized by excessive hepatic lipid accumulation,inflammation,and hemorrhage,bearing pathological similarities to human non-alcoholic fatty liver disease.With the rise of intensive poultry farming,the incidence of FLHS has markedly increased,resulting in significant economic losses in the poultry industry.The gut microbiota plays a crucial role in host digestion,metabolism,and immune regulation,particularly in liver diseases.Gut microbiota and its metabolites influence liver health via the gut-liver axis.This review aims to explore metabolite-mediated interactions between the laying hens and the gut microbiota,elucidating their role in the pathogenesis of FLHS.Host-derived metabolites,such as lipids,bile acids,amino acids,and carbohydrates,regulate the structure and function of the gut microbiota through the gut-liver axis,playing a role in FLHS progression.Concurrently,microbial metabolites,including short-chain fatty acids,bile acids,and amino acid derivatives,influence hepatic lipid metabolism,inflammation,and oxidative stress,driving the development of FLHS.Key microbes,such as Bacteroides,Lactobacillus,and Akkermansia muciniphila,are considered potential therapeutic targets due to their involvement in metabolite production.By integrating multi-omics data and mechanistic studies,this review highlights the central role of host–gut microbiota communication in FLHS and provides a theoretical basis and research direction for the development of microbiota-based intervention strategies.展开更多
Inborn errors of metabolism(IEM)are rare disorders,most are liver-based with liver transplantation(LT)emerging as an effective cure in the pediatric population.LT has been shown to offer a cure or deter disease progre...Inborn errors of metabolism(IEM)are rare disorders,most are liver-based with liver transplantation(LT)emerging as an effective cure in the pediatric population.LT has been shown to offer a cure or deter disease progression and provide symptomatic improvement in patients with IEM.Each metabolic disorder is unique,with the missing enzyme or transporter protein causing substrate deficiency or toxic byproduct production.Knowledge about the distribution of deficient enzymes,the percentage of enzymes replaced by LT,and the extent of extrahepatic involvement helps anticipate and manage complications in the perioperative period.Most patients have multisystem involvement and can be on complex dietary regimens.Metabolic decompensation can be triggered due to the stress response to surgery,fasting and other unanticipated complications perioperatively.Thus,a multidisciplinary team’s input including those from metabolic specialists is essential to develop disease and patient-specific strategies for the perioperative management of these patients during LT.In this review,we outline the classification of IEM,indications for LT along with potential benefits,basic metabolic defects and their implications,details of extrahepatic involvement and perioperative management strategies for LT in children with some of the commonly presenting IEM,to assist anesthesiologists handling this cohort of patients.展开更多
MASLD in China:an under-recognized public health problem Epidemic characteristics of metabolic dysfunction-associated steatotic liver disease(MASLD)in China As one of the most common chronic non-infectious liver disea...MASLD in China:an under-recognized public health problem Epidemic characteristics of metabolic dysfunction-associated steatotic liver disease(MASLD)in China As one of the most common chronic non-infectious liver diseases,metabolic dysfunction-associated steatotic liver disease(MASLD),previously known as non-alcoholic fatty liver disease(NAFLD),affects one quarter of the world’s population,is closely related to diabetes and obesity[1,2].展开更多
Background Perilla frutescens seeds(PFS)are gaining recognition as a natural alternative to antibiotics in livestock,supporting sustainable farming and animal health.However,the underlying molecular mechanisms through...Background Perilla frutescens seeds(PFS)are gaining recognition as a natural alternative to antibiotics in livestock,supporting sustainable farming and animal health.However,the underlying molecular mechanisms through which PFS influence host immune function and antioxidant capacity,especially via the gut-liver-muscle axis,remain largely unknown.This study employed an integrative multi-omics approach to elucidate how PFS supplementation modulates the microbiota-gut-liver-muscle axis and enhances immune and antioxidant functions in lambs.Results PFS supplementation markedly improved immune and antioxidant profiles,demonstrated by elevated serum levels of IL-10,IgM,IgG,GSH-PX,and SOD,and reductions in IL-1β,TNF-α,and MDA.Microbial analysis revealed elevated abundances of ruminal and intestinal taxa commonly associated with gut homeostasis and metabolic health(Christensenellaceae_R-7_group)and reduced levels of species with pathogenic or pro-inflammatory potential(Bacillus cereus and Clostridioides)in the ileum.Transcriptomic and metabolomic profiling of liver tissue indicated modulation of key inflammatory and bile acid signaling pathways,including the downregulation of TLR4,NLRP3,ATF3,CYP2J2,and LXR-α.PFS also increased hepatic concentrations of anti-inflammatory metabolites such as chlorquinaldol and indole-3-carboxaldehyde,while reducing levels of LysoPC(20:4)and phosphatidic acid.Correlation and mediation analyses revealed strong interconnections among gut microbiota,hepatic gene expression,lipid metabolites in liver and muscle,and systemic immune-antioxidant markers.Conclusion These findings highlight the microbiota-gut-liver-muscle axis as a central mechanism through which PFS enhances immune function and antioxidant capacity in lambs.PFS supplementation represents a promising nutritional strategy to improve healthy lamb production,supporting the development of antibiotic-free and sustainable livestock systems.展开更多
Twelve new diterpenoids,euphorwallnoids A-L(1-12),comprising five rhamnofolanes(1-5),five tiglianes(6-10),and two daphnanes(11 and 12),along with six known analogues(13-18),were isolated from the whole plants of Eupho...Twelve new diterpenoids,euphorwallnoids A-L(1-12),comprising five rhamnofolanes(1-5),five tiglianes(6-10),and two daphnanes(11 and 12),along with six known analogues(13-18),were isolated from the whole plants of Euphorbia wallichii(E.wallichii).Their structures were determined using spectroscopic analysis,computational methods,chemical derivatization,and single-crystal X-ray diffraction.Euphorwallnoid A(1)features an unusual 5/7/6/5-tetracyclic scaffold,whereas 2-5 represent a rare subclass of 4-deoxygenated rhamnofolanes and 6-8 constitute 13-deoxygenated tiglianes.Notably,compound 1 demonstrated promising anti-liver fibrosis activity by significantly inhibiting the expression of fibronectin(FN),α-smooth muscle actin(α-SMA),and collagen I in transforming growth factorβ1(TGF-β1)-stimulated LX-2 cells at micromolar concentrations.展开更多
Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—com...Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—comprised of interacting endothelial,stromal,and immune cells—plays a critical role in creating a supportive niche for tumor cell colonization and immune evasion and,thus,the establishment of metastases.The liver’s intrinsic nature further facilitates the development of immune tolerance,mediated by regulatory T cells,myeloid-derived suppressor cells,and soluble factors such as anti-inflammatory cytokines,which together dampen antitumor immune responses.This immunosuppressive milieu contributes significantly to resistance to immune checkpoint inhibitors,limiting the efficacy of immunotherapy in metastatic CRC.Deciphering the complex crosstalk between metastatic CRC cells and TME within the liver is essential for developing novel,effective immunotherapeutic approaches.Several strategies to overcome this lack of response are under research,including combination therapies,novel compounds,and approaches that target TME components.The scope of this review is to synthesize recent advances in the characterization of the hepatic metastatic microenvironment and emerging therapeutic approaches aimed at overcoming immune resistance in CRC liver metastases.展开更多
Background:Local treatments(including cryoablation)for liver tumors adjacent to the pericardium carry relatively high risks,and the safety,efficacy,and risk-benefit ratio of cryoablation specifically for tumors at thi...Background:Local treatments(including cryoablation)for liver tumors adjacent to the pericardium carry relatively high risks,and the safety,efficacy,and risk-benefit ratio of cryoablation specifically for tumors at this location all lack sufficient clinical validation.Methods:A retrospective case series was conducted involving 41 patients(20 males and 21 females)with a total of 45 liver tumors who underwent percutaneous CT-guided cryoablation between July 1,2021,and March 31,2025.The median age of the patients was 61 years(range:30-81 years).Tumor diameters were classified as≤10 mm(n=9),>10 to≤30 mm(n=25),and>30 to≤50 mm(n=11).All lesions were located within 10 mm of the pericardium.The technical success rate,local progression-free survival(LPFS),procedure-related adverse events,and risk-benefit analysis of this treatment were evaluated.Results:The technical success rate was 100%(45/45).The LPFS rates at 3,6,12,and 24 months were 95.56%,92.83%,77.12%,and 67.48%,respectively.No procedure-related mortality or major complications were observed.A total of 11(26.8%,11/41)minor complications requiring medical intervention were observed,including pneumothorax(n=2,5.3%),infection(n=2,5.3%),persistent vomiting(n=2,5.3%),postoperative fever(n=3,7.9%),and transient hepatic dysfunction(n=2,5.3%).The mean intraoperative visual analog scale pain score was 2.8±0.9.The average procedural duration was 60.8±14.1 min,with a mean cumulative dose length product of 3,058.9±1,725.4 mGy·cm.Conclusion:Preliminary research data suggest that CT-guided percutaneous cryoablation is technically feasible and demonstrates an acceptable safety profile for the treatment of liver tumors adjacent to the pericardium when the minimum distance exceeds 10 mm.展开更多
Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have signi...Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.展开更多
The liver,a critical metabolic organ,is particularly vulnerable to damage upon aluminum exposure.However,the precise molecular mechanisms through which aluminum induces hepatotoxicity remain to be fully elucidated.Thi...The liver,a critical metabolic organ,is particularly vulnerable to damage upon aluminum exposure.However,the precise molecular mechanisms through which aluminum induces hepatotoxicity remain to be fully elucidated.This study aimed to investigate the adverse effects of aluminum exposure on mouse liver tissue.The results indicated that AlCl_(3) exposure induced significant liver dysfunction,characterized by reduced adenosine triphosphate levels,elevated plasma alanine aminotransferase and aspartate aminotransferase.Histopathological analysis of liver tissue revealed marked histological damage,accompanied by substantial iron deposition.Further examinations demonstrated elevated hepatic levels of malondialdehyde,4-hydroxynonenal,and reactive oxygen species,decreased levels of glutathione(GSH)and superoxide dismutase,increased levels of oxidized glutathione(GSSG),and a reduced GSH/GSSG ratio.The mRNA and protein expression of ferroptosis-related molecules,including downregulated glutathione peroxidase 4 and solute carrier family 7 member 11,were significantly downregulated,while acyl-CoA synthetase long-chain family member 4,ferritin heavy chain 1,and iron regulatory protein 1 levels were significantly upregulated.Treatment with Ferrostatin-1 markedly ameliorated liver dysfunction and histopathological damage,attenuating signs of ferroptosis.These findings highlight the potential of ferroptosis-targeted therapies as a viable treatment strategy for aluminum exposure-induced hepatocyte injury.展开更多
Liver transplantation(LT)remains the optimal life-saving intervention for patients with end-stage liver disease.Despite the recent advances in LT several barriers,including organ allocation,donor-recipient matching,an...Liver transplantation(LT)remains the optimal life-saving intervention for patients with end-stage liver disease.Despite the recent advances in LT several barriers,including organ allocation,donor-recipient matching,and patient education,persist.With the growing progress of artificial intelligence,particularly large language models(LLMs)like ChatGPT,new applications have emerged in the field of LT.Current studies demonstrating usage of ChatGPT in LT include various areas of application,from clinical settings to research and education.ChatGPT usage can benefit both healthcare professionals,by decreasing the time spent on non-clinical work,but also LT recipients by providing accurate information.Future potential applications include the expanding usage of ChatGPT and other LLMs in the field of LT pathology and radiology as well as the automated creation of discharge summaries or other related paperwork.Additionally,the next models of ChatGPT might have the potential to provide more accurate patient education material with increased readability.Although ChatGPT usage presents promising applications,there are certain ethical and practical limitations.Key concerns include patient data privacy,information accuracy,misinformation possibility and lack of legal framework.Healthcare providers and policymakers should collaborate for the establishment of a controlled framework for the safe use of ChatGPT.The aim of this minireview is to summarize current literature on ChatGPT in LT,highlighting both opportunities and limitations,while also providing future possible applications.展开更多
BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically...BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.展开更多
Selective internal radiation therapy using yttrium-90 has been used to treat hepatocellular carcinoma,intrahepatic cholangiocarcinoma,and other malignant tumors that have spread to the liver locally.The authors used t...Selective internal radiation therapy using yttrium-90 has been used to treat hepatocellular carcinoma,intrahepatic cholangiocarcinoma,and other malignant tumors that have spread to the liver locally.The authors used the bibliometric approach in response to the neoplasms,using the keyword“Yttrium 90 AND Liver Neoplasms”as a search parameter and then looked up pertinent English-language literature in the Web of Science core collection database’s selfbuilt database through November 30,2025.For statistical analysis and literature management,EndNote and Excel tools were utilized.In addition to co-citation and emergent keyword analysis of authors,VOSviewer and CiteSpace were utilized for social network and chronological order of countries,institutions,authors,and keywords.The aim of this study was to serve as a reference for future research by methodically sorting through the international research literature on Yttrium 90 treatment of liver neoplasms and summarizing the research status and hot trends in this field.In recent years,research focus has increasingly shifted toward high-quality,multi-center clinical trials that combine SIRT-targeted systemic therapy with hepatectomy following the descending stage.This approach is likely to remain a significant research trend in the field.展开更多
For early hepatocellular carcinoma(HCC),curative therapies include surgical excision and radiofrequency ablation.Other treatment modes for advanced HCC involve transarterial chemoembolization.For HCC patients who do n...For early hepatocellular carcinoma(HCC),curative therapies include surgical excision and radiofrequency ablation.Other treatment modes for advanced HCC involve transarterial chemoembolization.For HCC patients who do not fit the Milan criteria or are waiting for liver transplantation(LT),studies of transarterial radioembolization with Yttrium-90(Y-90)demonstrated that Y-90 may accomplish a good downstaging or bridging effect before LT and can even achieve complete pathological necrosis.The present review discussed Y-90 radioembolization as a local regional treatment option for advanced and unresectable HCC,with a focus on neoadjuvant intervention before LT.展开更多
文摘BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.
文摘Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resulting from nonalcoholic causes and closely linked to metabolic dysfunction[1].It is strongly associated with metabolic abnormalities,including type 2 diabetes,overweight,and obesity.The global prevalence of MASLD is estimated to be approximately 25%−33%,and its incidence is rising rapidly,particularly among younger populations,due to increasingly prevalent unhealthy lifestyle behaviors such as sleep deprivation,sedentary habits,and diets rich in calories.
基金supported by the National Research Foundation of Korea grant funded by the Korean government(Grant no.:RS-2022-NR070862).
文摘Objective:To evaluate the hepatoprotective effects of skate-derived bioactives-collagen peptides(CPs)and chondroitin-against ethanol(EtOH)-induced liver injury and to elucidate their underlying mechanisms.Methods:The protective effects of CPs and chondroitin were assessed in different in vitro and in vivo EtOH-induced injury models.Oxidative stress was evaluated by measuring reactive oxygen species production and antioxidant markers(NRF2 and GCLC).EtOH metabolism was examined by measuring alchohol-metabolizing enzymes(alcohol dehydrogenase and aldehyde dehydrogenase)and cytochrome P450 enzymes.Furthermore,lipid dysregulation was assessed by Oil Red O staining and determination of lipogenic markers(SREBP-1 and FAS).Liver injury was also evaluated by measuring serum glutamate oxaloacetate transaminase and glutamate pyruvate transaminase,and performing histological analysis.Results:In hepatocytes and zebrafish,both CPs and chondroitin reduced oxidative stress,downregulated cytochrome P450 enzymes and lipogenic markers,and enhanced antioxidant defenses,with chondroitin showing the strongest hepatoprotection.In EtOH-fed mice,chondroitin significantly improved liver enzyme profiles,reduced hepatic lipid accumulation and inflammation,and restored antioxidant and metabolic homeostasis.Conclusions:Skate-derived chondroitin significantly attenuates EtOH-induced liver injury by modulating oxidative stress,EtOH metabolism,and lipid regulation.These findings demonstrate the hepatoprotective potential of chondroitin in different preclinical models of alcohol-induced liver damage.
基金supported by the National Natural Science Foundation of China(No.82360120)the Kunming Medical University Joint Special Project on Applied Basic Research(202401AY070001-134),and project iGandanF-1082022-RGG049+2 种基金the Open Project of Yunnan Provincial Clinical Medical Center for Digestive System Diseases(2022LCZXXF-XH07/17)the 14th Undergraduate Scientific Research Project of Mudanjiang Medical University(2024057)Yunnan Provincial Key Laboratory of Clinical Virology(No.2023A4010403-04).
文摘Background:High-mobility group box 1(HMGB1)is a critical damage-associated molecular pattern protein that participates in diverse physiological and pathological processes.However,its relevance to the prognosis of artificial liver support therapy in patients with acute liver injury(ALF)remains unclear.Methods:Bioinformatics analyses were performed to identify HMGB1-interacting proteins and associated inflammatory signaling pathways.Peripheral blood samples were collected from ALF patients before and after artificial liver support therapy,and serum HMGB1 concentrations were quantified using ELISA.Primary mouse hepatocytes were stimulated with lipopolysaccharide(LPS)in vitro and HMGB1 expression was verified by western blot.Results:Single-cell transcriptomic profiling showed that HMGB1 is widely expressed across tissues and predominantly localized in the nucleus.In the liver,HMGB1 was primarily expressed in hepatocytes and hepatic stellate cells.STRING database analysis revealed that human HMGB1 interacts with multiple proteins,including TLR4,TP53,and BECN1.The constructed interaction network comprised 11 nodes with an average local clustering coefficient of 0.888,and the protein–protein interaction enrichment P-value was 1.42×10^(-5),indicating significant enrichment.Gene Ontology and KEGG pathway enrichment analyses demonstrated that HMGB1 is closely linked to inflammatory and injury-related signaling pathways,including the TLR and NLR pathways.Metabolomic profiling revealed significant metabolic alterations between patients with ALF and healthy controls under both positive and negative ion modes and functional analysis showed necroptosis was activated.The cell viability gradually decreased with time and dose under LPS treatment and extracellular HMGB1 was upregulated in LPS induced ALF model and patients(P<0.05).Serum HMGB1/RIPK3/MLKL levels were markedly elevated in ALF patients compared with controls(P<0.05)and progressively declined following artificial liver support therapy.Furthermore,elevated HMGB1 concentrations were positively correlated with unfavorable clinical outcomes.Conclusion:Peripheral blood HMGB1 levels are significantly increased in patients with acute liver failure,decrease following artificial liver support therapy,and are positively associated with poor clinical prognosis.
基金National Key Project of Research and Development Program of China[2021YFC2500404].
文摘Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the aggressive nature of thedisease and the significant burden it places on globalhealthcare systems. Although primary preventionremains the cornerstone of liver cancer control,improving outcomes for patients already diagnosedis equally critical for mitigating the impact of thedisease.
基金funded by grants from the National Natural Science Foundation of China(82070588)High-Level Creative Talents from the Department of Public Health in Zhejiang Province(S2032102600032)+2 种基金the Project of New Century 551 Talent Nurturing in WenzhouGT is supported in part by grants from the School of Medicine,University of Verona,Verona,Italy.CDB is supported in part by the Southampton NIHR Biomedical Research Centre(NIHR203319),UKCDB has received research grant support from Echosens,the manufacturer of the Fibroscan device used to assess liver fat and fibrosis in chronic liver diseases.
文摘Background and AimsHepatic iron deposition(HID)in the reticuloendothelial system(RES)is associated with histological severity in metabolic dysfunction-associated steatotic liver disease(MASLD).This study aimed to assess the interaction between the transferrin(TF)-rs1049296 C>T variant and HID patterns on the risk of significant liver fibrosis in MASLD.MethodsWe analyzed 406 adults with liver biopsy-confirmed MASLD.HID was categorized as hepatocellular,RES,or mixed,based on Perl's iron staining.The association between iron-related genetic variants and significant liver fibrosis(fibrosis stage≥F2)was analyzed,focusing on the interactions between single-nucleotide polymorphism genotypes and iron deposition patterns.Multivariable logistic regression analysis was used to adjust for potential confounders.ResultsHID was detected in 271(66.7%)patients,with hepatocellular,RES,and mixed patterns accounting for 11.1%,18.0%,and 37.7%,respectively.A significant interaction was observed between HID and the TF-rs1049296 genotype(P=0.035 for interaction).In multivariable analysis,male sex,hypertension,severe lobular inflammation,and mixed hepatocellular/RES iron deposition were independent predictors of significant liver fibrosis.RES deposition markedly increased the risk of significant liver fibrosis(adjusted odds ratio:6.65;95%confidence interval:1.84-23.97,p<0.05),particularly in men with isolated RES iron deposition(adjusted odds ratio:5.26;95%confidence interval:1.21-22.81,p<0.05).ConclusionsThe TF-rs1049296 T allele interacts with RES iron deposition to identify a MASLD subpopulation at elevated risk of progressive liver disease,providing opportunities for refined risk stratification and personalized management.
文摘BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or gastric varices.While rare,omental varices pose a risk for hemoperitoneum if ruptured,which is a lifethreatening complication with high mortality rates despite surgical intervention.CASE SUMMARY This report reviews the case of a patient 36-year-old female with alcohol related cirrhosis decompensated by ascites,but no history of varices admitted for hemorrhagic shock from spontaneous rupture of omental varices requiring emergency surgery.She underwent the first documented successful orthotopic liver transplantation the same admission.CONCLUSION This case report and literature review stresses the importance of early consideration and identification of intraabdominal variceal sources in cirrhotic patients with refractory shock.
基金supported by the Science Research Project of Hebei Education Department(BJK2024077)Key Research and Development Projects of Hebei Province(22326619D)the National Natural Science Foundation of China(No.32473073 and No.32503085)。
文摘Fatty liver hemorrhagic syndrome(FLHS)in laying hens is a metabolic disorder characterized by excessive hepatic lipid accumulation,inflammation,and hemorrhage,bearing pathological similarities to human non-alcoholic fatty liver disease.With the rise of intensive poultry farming,the incidence of FLHS has markedly increased,resulting in significant economic losses in the poultry industry.The gut microbiota plays a crucial role in host digestion,metabolism,and immune regulation,particularly in liver diseases.Gut microbiota and its metabolites influence liver health via the gut-liver axis.This review aims to explore metabolite-mediated interactions between the laying hens and the gut microbiota,elucidating their role in the pathogenesis of FLHS.Host-derived metabolites,such as lipids,bile acids,amino acids,and carbohydrates,regulate the structure and function of the gut microbiota through the gut-liver axis,playing a role in FLHS progression.Concurrently,microbial metabolites,including short-chain fatty acids,bile acids,and amino acid derivatives,influence hepatic lipid metabolism,inflammation,and oxidative stress,driving the development of FLHS.Key microbes,such as Bacteroides,Lactobacillus,and Akkermansia muciniphila,are considered potential therapeutic targets due to their involvement in metabolite production.By integrating multi-omics data and mechanistic studies,this review highlights the central role of host–gut microbiota communication in FLHS and provides a theoretical basis and research direction for the development of microbiota-based intervention strategies.
文摘Inborn errors of metabolism(IEM)are rare disorders,most are liver-based with liver transplantation(LT)emerging as an effective cure in the pediatric population.LT has been shown to offer a cure or deter disease progression and provide symptomatic improvement in patients with IEM.Each metabolic disorder is unique,with the missing enzyme or transporter protein causing substrate deficiency or toxic byproduct production.Knowledge about the distribution of deficient enzymes,the percentage of enzymes replaced by LT,and the extent of extrahepatic involvement helps anticipate and manage complications in the perioperative period.Most patients have multisystem involvement and can be on complex dietary regimens.Metabolic decompensation can be triggered due to the stress response to surgery,fasting and other unanticipated complications perioperatively.Thus,a multidisciplinary team’s input including those from metabolic specialists is essential to develop disease and patient-specific strategies for the perioperative management of these patients during LT.In this review,we outline the classification of IEM,indications for LT along with potential benefits,basic metabolic defects and their implications,details of extrahepatic involvement and perioperative management strategies for LT in children with some of the commonly presenting IEM,to assist anesthesiologists handling this cohort of patients.
基金funded by the Program of China Scholarships Council(No.202206785007)“Four New”Experimental Teaching Curriculum Reform Project of Jinan University in China(SYJG202235),the Teaching QualityTeaching Reform Project of Undergraduate University of Guangdong in China(2020).
文摘MASLD in China:an under-recognized public health problem Epidemic characteristics of metabolic dysfunction-associated steatotic liver disease(MASLD)in China As one of the most common chronic non-infectious liver diseases,metabolic dysfunction-associated steatotic liver disease(MASLD),previously known as non-alcoholic fatty liver disease(NAFLD),affects one quarter of the world’s population,is closely related to diabetes and obesity[1,2].
基金supported by the Central Government-Guided Local Science and Technology Development Fund Project(2025ZY0108)Bayannaoer Research Institute Young Scientist Project(2024BYNECAU002)+1 种基金Hainan Provincial Natural Science Foundation of China(324QN289)the China Agriculture Research System(CARS-38)。
文摘Background Perilla frutescens seeds(PFS)are gaining recognition as a natural alternative to antibiotics in livestock,supporting sustainable farming and animal health.However,the underlying molecular mechanisms through which PFS influence host immune function and antioxidant capacity,especially via the gut-liver-muscle axis,remain largely unknown.This study employed an integrative multi-omics approach to elucidate how PFS supplementation modulates the microbiota-gut-liver-muscle axis and enhances immune and antioxidant functions in lambs.Results PFS supplementation markedly improved immune and antioxidant profiles,demonstrated by elevated serum levels of IL-10,IgM,IgG,GSH-PX,and SOD,and reductions in IL-1β,TNF-α,and MDA.Microbial analysis revealed elevated abundances of ruminal and intestinal taxa commonly associated with gut homeostasis and metabolic health(Christensenellaceae_R-7_group)and reduced levels of species with pathogenic or pro-inflammatory potential(Bacillus cereus and Clostridioides)in the ileum.Transcriptomic and metabolomic profiling of liver tissue indicated modulation of key inflammatory and bile acid signaling pathways,including the downregulation of TLR4,NLRP3,ATF3,CYP2J2,and LXR-α.PFS also increased hepatic concentrations of anti-inflammatory metabolites such as chlorquinaldol and indole-3-carboxaldehyde,while reducing levels of LysoPC(20:4)and phosphatidic acid.Correlation and mediation analyses revealed strong interconnections among gut microbiota,hepatic gene expression,lipid metabolites in liver and muscle,and systemic immune-antioxidant markers.Conclusion These findings highlight the microbiota-gut-liver-muscle axis as a central mechanism through which PFS enhances immune function and antioxidant capacity in lambs.PFS supplementation represents a promising nutritional strategy to improve healthy lamb production,supporting the development of antibiotic-free and sustainable livestock systems.
基金supported by the National Natural Science Foundation of China (Nos.82404454,22407144,and 82304322)the China Postdoctoral Science Foundation (No.2024M753800)+1 种基金the Postdoctoral Fellowship Program of CPSF (No.GZC20242113)the Open Program of Shenzhen Bay Laboratory(No.SZBL2021080601007)
文摘Twelve new diterpenoids,euphorwallnoids A-L(1-12),comprising five rhamnofolanes(1-5),five tiglianes(6-10),and two daphnanes(11 and 12),along with six known analogues(13-18),were isolated from the whole plants of Euphorbia wallichii(E.wallichii).Their structures were determined using spectroscopic analysis,computational methods,chemical derivatization,and single-crystal X-ray diffraction.Euphorwallnoid A(1)features an unusual 5/7/6/5-tetracyclic scaffold,whereas 2-5 represent a rare subclass of 4-deoxygenated rhamnofolanes and 6-8 constitute 13-deoxygenated tiglianes.Notably,compound 1 demonstrated promising anti-liver fibrosis activity by significantly inhibiting the expression of fibronectin(FN),α-smooth muscle actin(α-SMA),and collagen I in transforming growth factorβ1(TGF-β1)-stimulated LX-2 cells at micromolar concentrations.
基金funded by the Italian Ministry of Health through the grant“PRIN 2022 PNRR”entitled“Landscape ANalyses of immune CEll signatures associated with early Liver metastatic cOlorecTal cancer”(LANCELOT),P2022N3NC4,which has received funding from European Commission—NextGeneration for the salary of the researcher Candela Cives-Losada.
文摘Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—comprised of interacting endothelial,stromal,and immune cells—plays a critical role in creating a supportive niche for tumor cell colonization and immune evasion and,thus,the establishment of metastases.The liver’s intrinsic nature further facilitates the development of immune tolerance,mediated by regulatory T cells,myeloid-derived suppressor cells,and soluble factors such as anti-inflammatory cytokines,which together dampen antitumor immune responses.This immunosuppressive milieu contributes significantly to resistance to immune checkpoint inhibitors,limiting the efficacy of immunotherapy in metastatic CRC.Deciphering the complex crosstalk between metastatic CRC cells and TME within the liver is essential for developing novel,effective immunotherapeutic approaches.Several strategies to overcome this lack of response are under research,including combination therapies,novel compounds,and approaches that target TME components.The scope of this review is to synthesize recent advances in the characterization of the hepatic metastatic microenvironment and emerging therapeutic approaches aimed at overcoming immune resistance in CRC liver metastases.
基金supported by the Medical Research Project of Shanghai Hongkou District Health Commission(Grant No.2303-23).
文摘Background:Local treatments(including cryoablation)for liver tumors adjacent to the pericardium carry relatively high risks,and the safety,efficacy,and risk-benefit ratio of cryoablation specifically for tumors at this location all lack sufficient clinical validation.Methods:A retrospective case series was conducted involving 41 patients(20 males and 21 females)with a total of 45 liver tumors who underwent percutaneous CT-guided cryoablation between July 1,2021,and March 31,2025.The median age of the patients was 61 years(range:30-81 years).Tumor diameters were classified as≤10 mm(n=9),>10 to≤30 mm(n=25),and>30 to≤50 mm(n=11).All lesions were located within 10 mm of the pericardium.The technical success rate,local progression-free survival(LPFS),procedure-related adverse events,and risk-benefit analysis of this treatment were evaluated.Results:The technical success rate was 100%(45/45).The LPFS rates at 3,6,12,and 24 months were 95.56%,92.83%,77.12%,and 67.48%,respectively.No procedure-related mortality or major complications were observed.A total of 11(26.8%,11/41)minor complications requiring medical intervention were observed,including pneumothorax(n=2,5.3%),infection(n=2,5.3%),persistent vomiting(n=2,5.3%),postoperative fever(n=3,7.9%),and transient hepatic dysfunction(n=2,5.3%).The mean intraoperative visual analog scale pain score was 2.8±0.9.The average procedural duration was 60.8±14.1 min,with a mean cumulative dose length product of 3,058.9±1,725.4 mGy·cm.Conclusion:Preliminary research data suggest that CT-guided percutaneous cryoablation is technically feasible and demonstrates an acceptable safety profile for the treatment of liver tumors adjacent to the pericardium when the minimum distance exceeds 10 mm.
文摘Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.
基金supported by the Central Guided Local Development Fund Special Project(No.ZY23055039)the Natural Science Foundation of Guangxi Province(No.2025GXNSFHA069061)+5 种基金Baise City Scientific Research and Technology Development Plan Self-Funded Project(No.Encyclopedia 20241590)Baise City Scientific Research and Technol-ogy Development Plan Project(No.Encyclopedia 20232083)Guangxi Zhuang Autonomous Region Traditional Chinese Medicine Management Bureau Self-Funded Scientific Research Project(No.GZZC2020248)Guangxi Zhuang Autonomous Region Health Commission Self-Funded Scientific Research Project(No.Z20201416)2024 Innovation Project of Youjiang Medical University for Nationalities Graduate Education(No.YXCXJH2024004)the Natural Science Foundation of Guangxi Province(No.GUIKEAB24010060).
文摘The liver,a critical metabolic organ,is particularly vulnerable to damage upon aluminum exposure.However,the precise molecular mechanisms through which aluminum induces hepatotoxicity remain to be fully elucidated.This study aimed to investigate the adverse effects of aluminum exposure on mouse liver tissue.The results indicated that AlCl_(3) exposure induced significant liver dysfunction,characterized by reduced adenosine triphosphate levels,elevated plasma alanine aminotransferase and aspartate aminotransferase.Histopathological analysis of liver tissue revealed marked histological damage,accompanied by substantial iron deposition.Further examinations demonstrated elevated hepatic levels of malondialdehyde,4-hydroxynonenal,and reactive oxygen species,decreased levels of glutathione(GSH)and superoxide dismutase,increased levels of oxidized glutathione(GSSG),and a reduced GSH/GSSG ratio.The mRNA and protein expression of ferroptosis-related molecules,including downregulated glutathione peroxidase 4 and solute carrier family 7 member 11,were significantly downregulated,while acyl-CoA synthetase long-chain family member 4,ferritin heavy chain 1,and iron regulatory protein 1 levels were significantly upregulated.Treatment with Ferrostatin-1 markedly ameliorated liver dysfunction and histopathological damage,attenuating signs of ferroptosis.These findings highlight the potential of ferroptosis-targeted therapies as a viable treatment strategy for aluminum exposure-induced hepatocyte injury.
文摘Liver transplantation(LT)remains the optimal life-saving intervention for patients with end-stage liver disease.Despite the recent advances in LT several barriers,including organ allocation,donor-recipient matching,and patient education,persist.With the growing progress of artificial intelligence,particularly large language models(LLMs)like ChatGPT,new applications have emerged in the field of LT.Current studies demonstrating usage of ChatGPT in LT include various areas of application,from clinical settings to research and education.ChatGPT usage can benefit both healthcare professionals,by decreasing the time spent on non-clinical work,but also LT recipients by providing accurate information.Future potential applications include the expanding usage of ChatGPT and other LLMs in the field of LT pathology and radiology as well as the automated creation of discharge summaries or other related paperwork.Additionally,the next models of ChatGPT might have the potential to provide more accurate patient education material with increased readability.Although ChatGPT usage presents promising applications,there are certain ethical and practical limitations.Key concerns include patient data privacy,information accuracy,misinformation possibility and lack of legal framework.Healthcare providers and policymakers should collaborate for the establishment of a controlled framework for the safe use of ChatGPT.The aim of this minireview is to summarize current literature on ChatGPT in LT,highlighting both opportunities and limitations,while also providing future possible applications.
基金Supported by National Natural Science Foundation of China,No.82303672Zhejiang Provincial Health Commission and Zhejiang Provincial Administration of Traditional Chinese Medicine through the Targeted Project for Medical and Health Research,No.2025ZL017and China Primary Health Care Foundation,No.ZLMY20240311001ZJ.
文摘BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.
文摘Selective internal radiation therapy using yttrium-90 has been used to treat hepatocellular carcinoma,intrahepatic cholangiocarcinoma,and other malignant tumors that have spread to the liver locally.The authors used the bibliometric approach in response to the neoplasms,using the keyword“Yttrium 90 AND Liver Neoplasms”as a search parameter and then looked up pertinent English-language literature in the Web of Science core collection database’s selfbuilt database through November 30,2025.For statistical analysis and literature management,EndNote and Excel tools were utilized.In addition to co-citation and emergent keyword analysis of authors,VOSviewer and CiteSpace were utilized for social network and chronological order of countries,institutions,authors,and keywords.The aim of this study was to serve as a reference for future research by methodically sorting through the international research literature on Yttrium 90 treatment of liver neoplasms and summarizing the research status and hot trends in this field.In recent years,research focus has increasingly shifted toward high-quality,multi-center clinical trials that combine SIRT-targeted systemic therapy with hepatectomy following the descending stage.This approach is likely to remain a significant research trend in the field.
文摘For early hepatocellular carcinoma(HCC),curative therapies include surgical excision and radiofrequency ablation.Other treatment modes for advanced HCC involve transarterial chemoembolization.For HCC patients who do not fit the Milan criteria or are waiting for liver transplantation(LT),studies of transarterial radioembolization with Yttrium-90(Y-90)demonstrated that Y-90 may accomplish a good downstaging or bridging effect before LT and can even achieve complete pathological necrosis.The present review discussed Y-90 radioembolization as a local regional treatment option for advanced and unresectable HCC,with a focus on neoadjuvant intervention before LT.
