BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal ...BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension(PH).AIM To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure(PVP).METHODS This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024.Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs.All patients'angiographic images were collected for analysis.The associations between WHVP and PVP in each group were analyzed via linear regression analysis,and a predictive model was established.RESULTS The 877 patients had a mean age of 52.6±13.0 years,with 582 males and 295 females.Patients were categorized into four groups on the basis of their anatomical structure.All groups showed strong correlations between WHVP and PVP.The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884(P<0.05);in the hepatic right vein-accessory hepatic venous angiography group,it was 0.721(P<0.05);in the hepatic right vein-middle hepatic venous angiography group,it was 0.344(P<0.05);and in the hepatic right vein-nonangiography group,it was 0.293(P<0.05).CONCLUSION The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP.Based on the different anatomical classifications of hepatic veins,WHVP can be used to estimate PVP,improving the accuracy of PVP prediction.展开更多
In this article,we provide commentary on the recent article by Zhao et al.We focus on the shifts in the gut microbiota of patients with hepatitis B virus(HBV)-associated cirrhosis/portal hypertension(PH)following tran...In this article,we provide commentary on the recent article by Zhao et al.We focus on the shifts in the gut microbiota of patients with hepatitis B virus(HBV)-associated cirrhosis/portal hypertension(PH)following transjugular intrahepatic portosystemic shunt(TIPS)and the implications for understanding the mechanisms,diagnosis,and treatment.By comparing the gut microbiota composition and dynamic changes before and after TIPS in patients with and without hepatic encephalopathy,the authors found an increase in non-probiotic bacteria in those who developed hepatic encephalopathy post-TIPS,with Morganella species present only in the hepatic encephalopathy group.The gut microbiota changes post-TIPS among patients without the occurrence of hepatic encephalopathy suggest potential therapeutic benefits through prophylactic microbiome therapies.Furthermore,the specific gut microbiota alterations may hold promise to predict the risk of hepatic encephalopathy in individuals undergoing TIPS for HBVrelated PH.Despite these promising findings,future studies are needed to address limitations,including a small sample size,a relatively short evaluation period for gut microbiota alterations,the absence of data on dynamic alterations in gut microbiota post-TIPS and their correlation with blood ammonia levels,and the lack of validation in animal models.In conclusion,Zhao et al's study has shed new light on the link of gut microbiota with post-TIPS hepatic encephalopathy,potentially through the intricate gut-liver axis,and has important clinical implications for improving the management of patients with HBV-related PH.展开更多
Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.De...Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.Despite hepatic vein complic-ations following LT occurring at a relatively low frequency,ranging between 2%to 11%,delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality.Clinical manifestations of hepatic vein complications are often subtle and nonspecific,posing challenges for early diagnosis.Signs may initially present as mild abnormalities in liver function,delayed recovery of liver function,unexplained ascites,lower limb edema,and perineal edema.Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion.Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness.Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging,these findings lack specificity.Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can,however,significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.展开更多
BACKGROUND Portal hypertension(PHT),a complication of liver cirrhosis,is sometimes managed with transjugular intrahepatic portosystemic shunt(TIPS)to reduce portal pressure.Although effective,TIPS poses risks,includin...BACKGROUND Portal hypertension(PHT),a complication of liver cirrhosis,is sometimes managed with transjugular intrahepatic portosystemic shunt(TIPS)to reduce portal pressure.Although effective,TIPS poses risks,including hepatic enceph-alopathy(HE).This study investigates whether a significant reduction in the portal pressure gradient(PPG)after TIPS improves outcomes in PHT patients.AIM To evaluate the impact of post-TIPS PPG reduction on clinical outcomes and explore the relationship between PPG reduction and portal vein diameter.METHODS This retrospective cohort study included 815 patients with PHT who underwent TIPS at two tertiary hospitals between 2014 and 2022.Patients were categorized based on whether they achieved a 50%reduction in PPG.Propensity score matching was applied to balance baseline characteristics.Kaplan-Meier analysis assessed clinical outcomes,including rebleeding,HE,liver failure,and hepato-cellular carcinoma.Cox regression identified risk factors,and Spearman correlation analyzed the relationship between PPG reduction and portal vein diameter.RESULTS Patients with a PPG reduction>50%had significantly lower risks of rebleeding(P=0.004),shunt dysfunction(P=0.002),and mortality(P=0.024)compared to those with a PPG reduction≤50%.However,these patients faced higher risks of HE(P<0.001)and liver failure(P=0.003).A significant negative correlation was observed between the percentage of PPG reduction and portal vein diameter(ρ=-0.632,P<0.001),suggesting that patients with smaller portal vein diameters may achieve greater PPG reductions.CONCLUSION A significant PPG reduction following TIPS is associated with improved clinical outcomes,including reduced risks of rebleeding,shunt dysfunction,hepatocellular carcinoma,and mortality,though it increases HE and liver failure risks.The observed correlation between portal vein diameter and PPG reduction highlights the potential role of portal vein anatomy in predicting TIPS efficacy,warranting further investigation.展开更多
This is a narrative review in which the advances in technical aspects,the main indications,limitations and clinical results of the transjugular intrahepatic portosystemic shunt(TIPS)in portal hypertension(PH)are addre...This is a narrative review in which the advances in technical aspects,the main indications,limitations and clinical results of the transjugular intrahepatic portosystemic shunt(TIPS)in portal hypertension(PH)are addressed.With the emergence of the coated prosthesis,a better shunt patency,a lower incidence of hepatic encephalopathy(HE)and better survival when compared to TIPS with the conventional prosthesis are demonstrated.The main indications for TIPS are refractory ascites,acute variceal bleeding unresponsive to pharmacological/endoscopic therapy and,lastly,patients considered at high risk for rebleeding preemptive TIPS(pTIPS).Absolute contraindications to the use of TIPS are severe uncontrolled HE,systemic infection or sepsis,congestive heart failure,severe pulmonary arterial hypertension,and biliary obstruction.The control of hemorrhage due to variceal rupture can reach up to 90%-100%of cases,and 55%in refractory ascites.Despite evidences regarding pTIPS in patients at high risk for rebleeding,less than 20%of eligible patients are treated.TIPS may also decrease the incidence of future decompensation in cirrhosis and increase survival in selected patients.In conclusion,TIPS is an essential treatment for patients with PH,but is often neglected.It is important for the hepatologist to form a multidisciplinary team,in which the role of the radiologist with experience in interventional procedures is prominent.展开更多
BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is an effective intervention for managing complications of portal hypertension,particularly acute variceal bleeding(AVB).While effective in reducing portal...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is an effective intervention for managing complications of portal hypertension,particularly acute variceal bleeding(AVB).While effective in reducing portal pressure and preventing rebleeding,TIPS is associated with a considerable risk of overt hepatic encephalopathy(OHE),a complication that significantly elevates mortality rates.AIM To develop a machine learning(ML)model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.METHODS This retrospective single-center study included 218 patients with AVB who underwent TIPS.The dataset was divided into training(70%)and testing(30%)sets.Critical features were identified using embedded methods and recursive feature elimination.Three ML algorithms-random forest,extreme gradient boosting,and logistic regression-were validated via 10-fold cross-validation.SHapley Additive exPlanations analysis was employed to interpret the model’s predictions.Survival analysis was conducted using Kaplan-Meier curves and stepwise Cox regression analysis to compare overall survival(OS)between patients with and without OHE.RESULTS The median OS of the study cohort was 47.83±22.95 months.Among the models evaluated,logistic regression demonstrated the highest performance with an area under the curve(AUC)of 0.825.Key predictors identified were Child-Pugh score,age,and portal vein thrombosis.Kaplan-Meier analysis revealed that patients without OHE had a significantly longer OS(P=0.005).The 5-year survival rate was 78.4%,with an OHE incidence of 15.1%.Both actual OHE status and predicted OHE value were significant predictors in each Cox model,with model-predicted OHE achieving an AUC of 88.1 in survival prediction.CONCLUSION The ML model accurately predicts post-TIPS OHE and outperforms traditional models,supporting its use in improving outcomes in patients with AVB.展开更多
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
BACKGROUND Hepatic alveolar echinococcosis(HAE)is a chronic parasitic disease caused by the larval stage of Echinococcus multilocularis.Although significant research has been conducted on the pathogenesis and immunolo...BACKGROUND Hepatic alveolar echinococcosis(HAE)is a chronic parasitic disease caused by the larval stage of Echinococcus multilocularis.Although significant research has been conducted on the pathogenesis and immunological aspects of HAE,comprehensive bibliometric analyses in this area are still lacking.This study sought to fill this gap by systematically analyzing the immunological literature on HAE using bibliometric methods.AIM To identify research trends,key contributors,and emerging developments and offer insights to guide future research in this field.METHODS Research articles on HAE published between 1983 and 2023 were retrieved from the Web of Science Core Collection database.A total of 319 articles were selected for bibliometric analysis,which was conducted using the CiteSpace and VOSviewer software.The analysis focused on key variables such as publication volume,authors,journals,countries,references,and keywords.RESULTS The analysis revealed a significant increase in research on HAE over the past four decades,particularly after 1995.China and Switzerland emerged as the leading countries in terms of publication volume,with Bruno Gottstein and Vuitton DA identified as the most influential authors in this field.Key research areas include the interaction between the pathogen and the host immune system,as well as advances in disease diagnosis and treatment strategies.The keyword co-occurrence analysis highlighted the primary themes and identified emerging trends within the research landscape.CONCLUSION This study provides a comprehensive framework for understanding HAE immunology and highlights research hotspots,future directions,key contributors,and the importance of international cooperation.展开更多
Hepatic encephalopathy,defined as neuropsychiatric dysfunction secondary to liver disease,is a frequent decompensating event in cirrhosis.Its clinical impact is highlighted by a notable increase in patient mortality r...Hepatic encephalopathy,defined as neuropsychiatric dysfunction secondary to liver disease,is a frequent decompensating event in cirrhosis.Its clinical impact is highlighted by a notable increase in patient mortality rates and a concomitant reduction in overall quality of life.Systemically,liver disease,liver function failure,portosystemic shunting,and associated multi-organ dysfunction result in the increase of disease-causing neurotoxins in the circulation,which impairs cerebral homeostasis.Key circulating neurotoxins are ammonia and inflammatory mediators.In the brain,pathophysiology is less well understood,but is thought to be driven by glial cell dysfunction.Astrocytes are the only brain resident cells that have ammonia-metabolizing machinery and are therefore putatively most susceptible to ammonia elevation.Based on a large body of mostly in vitro evidence,ammonia-induced cellular and molecular disturbances include astrocyte swelling and oxidative stress.Microglia,the brain resident macrophages,have been linked to the translation of systemic inflammation to the brain microenvironment.Recent evidence from animal studies has provided novel insights into old and new downstream effects of astrocyte and microglial dysfunction such as toxin clearance disruption and myeloid cell attraction to the central nervous system parenchyma.Furthermore,state of the art research increasingly implicates neuronal dysfunction and possibly even irreversible neuronal cell death.Cell-type specific investigation in animal models highlights the need for critical revision of the contribution of astrocytes and microglia to well-established and novel cellular and molecular alterations in hepatic encephalopathy.In this review,we therefore give a current and comprehensive overview of causes,features,and consequences of astrocyte and microglial dysfunction in hepatic encephalopathy,including areas of interest for future investigation.展开更多
Antipalu is a phytomedicinal medicinal beverage that is popular in the District of Abidjan, particularly for the treatment of malaria. However, Antipalu could present potential health effects on patients, and few toxi...Antipalu is a phytomedicinal medicinal beverage that is popular in the District of Abidjan, particularly for the treatment of malaria. However, Antipalu could present potential health effects on patients, and few toxicological studies have been conducted before its use. In order to determine the cytotoxicity of Antipalu, two complementary tests, LDH activity and the MTT cell proliferation assay, were used using Vero cells. Vero cells were exposed to increasing concentrations of Antipalu and incubated for 24, 48 and 72 hours. In addition, forty (40) rats distributed randomly into 4 groups, including 10 animals per group (5 males and 5 females) were used for the potential hepatoxic effects. Animals in group 1 received distilled water and were used as a control group. On the other hand, Lot I, II and III received by gavage a volume of the Antipalu extract corresponding to 1 ml/100 g of body weight at 200 mg/kg, 400 mg/kg, 800 mg/kg, respectively. The extract was administered daily at the same time for 28 days and serum was collected once a week to evaluate hepatic biochemical markers. After 28 days of study, all rats were euthanized by an overdose of ether and the liver of the rats was removed for gross morphological and histopathological analysis. The results of the cell supernatant assay showed an increasing extracellular LDH enzyme activity with lethal concentrations at 10% and 50% (LC10 = 111 µg/mL and LC50 = 555 µg/mL, respectively). In addition, the MTT assay showed a decrease in mitochondrial activity and thus cell proliferation after 24, 48 and 72 H of incubation. Our study showed that Antipalu caused alterations in the plasma membranes of the cells, resulting in the release of lactase dehydrogenase (LDH) into the external environment and a decrease in the mitochondrial activity of the Vero cells. The biochemical parameters ALT, ASAT, ALPs, and GGT showed no significant change (P > 0.05) in the group of treated rats compared to the controls. However, these variations were moderate and transient, with values remaining almost within their standard limits. Microscopic observations of liver tissue sections from rats treated with the Antipalu showed no lesions, edema and necrosis. These results suggest that the Antipalu did not interfere with the functioning or alter the integrity of the liver.展开更多
By summarizing the pharmacological effects of pomegranate extract and its active components,such as punicalagin,punicalin,gallic acid,ellagic acid,caffeic acid,and chlorogenic acid,it is found that the extract exhibit...By summarizing the pharmacological effects of pomegranate extract and its active components,such as punicalagin,punicalin,gallic acid,ellagic acid,caffeic acid,and chlorogenic acid,it is found that the extract exhibits therapeutic effects on liver injury,viral hepatitis,metabolic dysfunction-associated fatty liver disease,liver fibrosis,and liver cancer.Emerging evidence suggests that these natural products may alleviate liver diseases through multi-targeted therapeutic mechanisms,including anti-inflammation,anti-oxidative stress,immunoregulation,and anti-steatosis.The underlying mechanisms by which pomegranate exerts hepatoprotective activities may be attributed to the regulation of multiple signaling pathways,including P62/Nrf2,TGF-β1/Smad7,Wnt/β-catenin,MAPK/Nrf2,Nrf2/Keap1,Akt/FOXO3a,MAPK/NF-κB,etc.Consequently,pomegranate can serve as a functional food,nutritional supplement,or adjuvant in the modern treatment of liver diseases.展开更多
BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs interve...BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.展开更多
The liver performs multiple life-sustaining functions.Hepatic diseases,including hepatitis,cirrhosis,and hepatoma,pose significant health and economic burdens globally.Along with the advances in nanotechnology,mesopor...The liver performs multiple life-sustaining functions.Hepatic diseases,including hepatitis,cirrhosis,and hepatoma,pose significant health and economic burdens globally.Along with the advances in nanotechnology,mesoporous silica nanoparticles(MSNs)exhibiting diversiform size and shape,distinct morphological properties,and favorable physico-chemical features have become an ideal choice for drug delivery systems and inspire alternative thinking for the management of hepatic diseases.Initially,we introduce the physiological structure of the liver and highlight its intrinsic cell types and correlative functions.Next,we detail the synthesis methods and physicochemical properties of MSNs and their capacity for controlled drug loading and release.Particularly,we discuss the interactions between liver and MSNs with respect to the passive targeting mechanisms of MSNs within the liver by adjusting their particle size,pore diameter,surface charge,hydrophobicity/hydrophilicity,and surface functionalization.Subsequently,we emphasize the role of MSNs in regulating liver pathophysiology,exploring their value in addressing liver pathological states,such as tumors and inflammation,combined with multi-functional designs and intelligent modes to enhance drug targeting and minimize side effects.Lastly,we put forward the problems,challenges,opportunities,as well as clinical translational issues faced by MSNs in the management of liver diseases.展开更多
This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incid...This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incidence rate in Europe is lower than in developing countries,but it is a major complication with high morbidity,particularly in immunocompromised patients.They are most frequently caused by Enterobacterales infections,but hypervirulent Klebsiella strains are an emerging problem in Western countries.Amoebiasis has been a public health problem in Europe,primarily imported from other endemic foci.At the same time,this infection is becoming an emerging disease,as the number of infected patients who have not traveled to endemic areas is rising.Treatment options for hydatid liver cyst include chemotherapy,open or laparoscopic surgery,percutaneous treatment(percutaneous aspiration,re-aspiration and injection and its modification)and“wait and watch”strategy.Most hydatid liver cyst patients in Pillay et al’s study received surgical treatment,but several studies have confirmed the safety and efficacy of percutaneous aspiration,re-aspiration and injection.展开更多
The role of the gut microbiota in the pathogenesis and treatment of hepatic encephalopathy (HE) has garnered increasing attention due to significant advancements in understanding the gut microbiota over recent years. ...The role of the gut microbiota in the pathogenesis and treatment of hepatic encephalopathy (HE) has garnered increasing attention due to significant advancements in understanding the gut microbiota over recent years. A growing body of evidence from laboratory and clinical studies highlights a substantial relationship between gut microbiota and HE. Identifying the role of gut microbiota in maintaining normal cognitive function, including its influence on the gut barrier and immune cells, is essential to elucidate the mechanisms underlying the development of HE. This understanding offers novel perspectives for its prevention and treatment. This paper provides a comprehensive review of the research progress concerning the gut microbiota, HE, and their interrelationship, along with current treatment methods for HE. Furthermore, it outlines the limitations and challenges associated with microbiota-based therapeutic research.展开更多
Objective:To investigate the effects of a crude extract from Gnetum montanum Markgr.on ethanol-induced hepatotoxicity and metabolic disorders.Methods:Alcoholic liver disorder was induced in mice by administering incre...Objective:To investigate the effects of a crude extract from Gnetum montanum Markgr.on ethanol-induced hepatotoxicity and metabolic disorders.Methods:Alcoholic liver disorder was induced in mice by administering increasing doses of ethanol via oral gavage.Biomarkers of liver injury and oxidative stress were assessed at the end of the study.Liver tissue damage and fat deposition were evaluated using hematoxylin and eosin and oil red O staining,respectively.In addition,key biomarkers were examined in acetaldehyde-treated HepG2 cells.Results:Ethanol consumption induced characteristic pathological changes,including elevated serum markers of liver injury,hepatic lipid accumulation,and oxidative stress in liver tissues.Oral administration of Gnetum montanum extract(175 and 350 mg/kg)decreased serum aspartate aminotransferase,alanine aminotransferase,γ-glutamyl transferase,and bilirubin levels in ethanol-treated mice.The extract also lowered triglyceride levels in serum and liver tissue in a dose-dependent manner.Furthermore,it mitigated malondialdehyde levels,preserved reduced glutathione levels,and enhanced catalase activity and total antioxidant capacity in liver tissue homogenates.Additionally,ethanol-induced hyperuricemia was suppressed by Gnetum montanum extract by inhibiting xanthine oxidase activity.Similar effects were observed in Gnetum montanum extract-treated HepG2 cells.Conclusions:This study demonstrates that Gnetum montanum extract alleviates ethanol-induced hepatic injury by alleviating oxidative stress and inhibiting xanthine oxidase activity.展开更多
The rapid evolution of systemic therapies for hepatocellular carcinoma(HCC),one of the most common types of liver cancer,has attracted significant attention especially to hepatic arterial infusion chemotherapy(HAIC)as...The rapid evolution of systemic therapies for hepatocellular carcinoma(HCC),one of the most common types of liver cancer,has attracted significant attention especially to hepatic arterial infusion chemotherapy(HAIC)as a highly promising treatment approach.This method,which delivers chemotherapy directly into the liver's arterial supply,is designed to maximize the concentration of anti-cancer drugs at the tumor site while minimizing systemic side effects.Despite the potential and the encouraging results observed in various studies,HAIC has not yet achieved widespread acceptance and utilization.Sorafenib is a widely used systemic therapy that targets multiple pathways involved in tumor growth and angiogenesis,while transarterial chemoembolization(TACE)is a locoregional therapy that combines arterial embolization with chemotherapy.These treatments have been the mainstay of HCC management,yet they have limitations that HAIC may potentially overcome.This article specifically comments on the network meta-analysis that examined the current research status of HAIC,highlighting its effectiveness and safety profile in comparison to established standard treatments such as Sorafenib and TACE.Through an extensive review of existing studies,the authors conclude that patients receiving HAIC often experience better survival rates and longer periods without disease progression compared to those receiving Sorafenib or TACE.展开更多
Background Energy deficiency is a leading cause of the high pre-weaning mortality of neonatal piglets in the swine industry.Thus,optimal energy metabolism is of crucial importance for improving the survivability of ne...Background Energy deficiency is a leading cause of the high pre-weaning mortality of neonatal piglets in the swine industry.Thus,optimal energy metabolism is of crucial importance for improving the survivability of neonatal piglets.The effective utilization of milk fat as primary energy is indispensably required.Methods Pregnant sows(n=27)were randomly assigned into 3 treatments.Each treatment received a standard diet(3,265 kcal ME/kg)supplemented with either 0,0.25%or 0.5%clofibrate(w/w)from d 107 of gestation to d 7 of lacta-tion.The effects of maternal clofibrate on their milk fatty acid(FA)and performance of the piglets were evaluated.The evaluations were performed via measuring sow productive performance,milk FA composition,and hepatic FA oxida-tion of the piglets at birth and d 1,7,14 and 19 after birth.Results Maternal supplementation of clofibrate had no effect on reproductive performance of the sows at farrowing and weaning(P>0.05).However,the mortality at weaning was reduced for piglets from sows with 0.25%of clofi-brate,and the average weekly(and daily)gain was higher in piglets from sows that received clofibrate than sows without clofibrate in the first week(P<0.0001).Maternal clofibrate increased percentage of milk C12:0 and C14:0 FAs but decreased C18:2 and n-6 polyunsaturated FAs.Maternal clofibrate also increased plasma ketone body levels and hepatic FA oxidation measured at the first day of birth,but the increase was not detected in piglets on d 7,14 or 19.Clofibrate was not detected in milk collected from the clofibrate-treated sows.The percentage of FA oxidation decreased,and the percentage of FA esterification increased with increasing in postnatal age.Supplemental carni-tine increased FA oxidation regardless of succinate dehydrogenase inhibition,and the increase had no effect on FA esterification.Conclusions Maternal supplementation of clofibrate during late gestation and early lactation increases hepatic FA oxidative metabolism at birth and improves growth performance of newborn piglets.Maternal clofibrate transfer to suckling piglets via milk was not detected.Carnitine availability is critical for piglets to maintain a high FA oxidation rate during the suckling period.展开更多
This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-inva...This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-invasive method to measure LS,which correlates with the degree of liver fibrosis,and SPA,an indicator of portal hypertension,2D-SWE offers a comprehensive evaluation of a patient’s hepatic status.These advancements are particularly crucial in hepatic surgery,where accurate preoperative assessments are essential for optimizing surgical outcomes and minimizing complications.This letter highlights the prac-tical implications of integrating 2D-SWE into clinical practice,emphasizing its potential to improve patient safety and surgical precision by enhancing the ability to predict PHLF and tailor surgical approaches accordingly.展开更多
BACKGROUND Hepatic organoid-based modelling,through the elucidation of a range of in vivo biological processes and the recreation of the intricate liver microenvironment,is yielding groundbreaking insights into the pa...BACKGROUND Hepatic organoid-based modelling,through the elucidation of a range of in vivo biological processes and the recreation of the intricate liver microenvironment,is yielding groundbreaking insights into the pathophysiology and personalized medicine approaches for liver diseases.AIM This study was designed to analyse the global scientific output of hepatic organoid research and assess current achievements and future trends through bibliometric analysis.METHODS Articles were retrieved from the Web of Science Core Collection,and CiteSpace 6.3.R1 was employed to analyse the literature,including outputs,journals,and countries,among others.RESULTS Between 2010 and 2024,a total of 991 articles pertaining to hepatic organoid research were published.The journal Hepatology published the greatest number of papers,and journals with an impact factor greater than 10 constituted 60%of the top 10 journals.The United States and Utrecht University were identified as the most prolific country and institution,respectively.Clevers H emerged as the most prolific author,whereas Huch M had the highest number of cocitations,suggesting that both are ideal candidates for academic collaboration.Research on hepatic organoids has exhibited a progressive shift in focus,evolving from initial investigations into model building,differentiation research in stem cells,bile ducts,and progenitor cells,to a broader spectrum encompassing lipid metabolism,single-cell RNA sequencing,and therapeutic applications.The phrases exhibiting citation bursts from 2022 to 2024 include“drug resistance”,“disease model”,and“patient-derived tumor organoids”.CONCLUSION Research on hepatic organoids has increased over the past decade and is expected to continue to grow.Key research areas include applications for liver diseases and drug development.Future trends likely to gain focus include patient-derived tumour organoids,disease modelling,and personalized medicine.展开更多
基金Supported by Capital Medical University Affiliated Beijing Shijitan Hospital Talent Development Program during the 14th Five-Year Plan,No.2023 LJRCLFQ.
文摘BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension(PH).AIM To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure(PVP).METHODS This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024.Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs.All patients'angiographic images were collected for analysis.The associations between WHVP and PVP in each group were analyzed via linear regression analysis,and a predictive model was established.RESULTS The 877 patients had a mean age of 52.6±13.0 years,with 582 males and 295 females.Patients were categorized into four groups on the basis of their anatomical structure.All groups showed strong correlations between WHVP and PVP.The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884(P<0.05);in the hepatic right vein-accessory hepatic venous angiography group,it was 0.721(P<0.05);in the hepatic right vein-middle hepatic venous angiography group,it was 0.344(P<0.05);and in the hepatic right vein-nonangiography group,it was 0.293(P<0.05).CONCLUSION The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP.Based on the different anatomical classifications of hepatic veins,WHVP can be used to estimate PVP,improving the accuracy of PVP prediction.
基金Supported by Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province,No.2023GBYJ-YL-1.
文摘In this article,we provide commentary on the recent article by Zhao et al.We focus on the shifts in the gut microbiota of patients with hepatitis B virus(HBV)-associated cirrhosis/portal hypertension(PH)following transjugular intrahepatic portosystemic shunt(TIPS)and the implications for understanding the mechanisms,diagnosis,and treatment.By comparing the gut microbiota composition and dynamic changes before and after TIPS in patients with and without hepatic encephalopathy,the authors found an increase in non-probiotic bacteria in those who developed hepatic encephalopathy post-TIPS,with Morganella species present only in the hepatic encephalopathy group.The gut microbiota changes post-TIPS among patients without the occurrence of hepatic encephalopathy suggest potential therapeutic benefits through prophylactic microbiome therapies.Furthermore,the specific gut microbiota alterations may hold promise to predict the risk of hepatic encephalopathy in individuals undergoing TIPS for HBVrelated PH.Despite these promising findings,future studies are needed to address limitations,including a small sample size,a relatively short evaluation period for gut microbiota alterations,the absence of data on dynamic alterations in gut microbiota post-TIPS and their correlation with blood ammonia levels,and the lack of validation in animal models.In conclusion,Zhao et al's study has shed new light on the link of gut microbiota with post-TIPS hepatic encephalopathy,potentially through the intricate gut-liver axis,and has important clinical implications for improving the management of patients with HBV-related PH.
基金Supported by The Shenzhen Science and Technology Research and Development Fund,No.JCYJ20220530163011026 and No.JCYJ20210324131809027Shenzhen Medical Key Discipline Project,No.G2021008 and No.G2022008.
文摘Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.Despite hepatic vein complic-ations following LT occurring at a relatively low frequency,ranging between 2%to 11%,delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality.Clinical manifestations of hepatic vein complications are often subtle and nonspecific,posing challenges for early diagnosis.Signs may initially present as mild abnormalities in liver function,delayed recovery of liver function,unexplained ascites,lower limb edema,and perineal edema.Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion.Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness.Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging,these findings lack specificity.Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can,however,significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.
基金Supported by the“14th Five-Year”Talent Training Program of Beijing Shijitan Hospital,Capital Medical University,No.2023 LJRCLFQ.
文摘BACKGROUND Portal hypertension(PHT),a complication of liver cirrhosis,is sometimes managed with transjugular intrahepatic portosystemic shunt(TIPS)to reduce portal pressure.Although effective,TIPS poses risks,including hepatic enceph-alopathy(HE).This study investigates whether a significant reduction in the portal pressure gradient(PPG)after TIPS improves outcomes in PHT patients.AIM To evaluate the impact of post-TIPS PPG reduction on clinical outcomes and explore the relationship between PPG reduction and portal vein diameter.METHODS This retrospective cohort study included 815 patients with PHT who underwent TIPS at two tertiary hospitals between 2014 and 2022.Patients were categorized based on whether they achieved a 50%reduction in PPG.Propensity score matching was applied to balance baseline characteristics.Kaplan-Meier analysis assessed clinical outcomes,including rebleeding,HE,liver failure,and hepato-cellular carcinoma.Cox regression identified risk factors,and Spearman correlation analyzed the relationship between PPG reduction and portal vein diameter.RESULTS Patients with a PPG reduction>50%had significantly lower risks of rebleeding(P=0.004),shunt dysfunction(P=0.002),and mortality(P=0.024)compared to those with a PPG reduction≤50%.However,these patients faced higher risks of HE(P<0.001)and liver failure(P=0.003).A significant negative correlation was observed between the percentage of PPG reduction and portal vein diameter(ρ=-0.632,P<0.001),suggesting that patients with smaller portal vein diameters may achieve greater PPG reductions.CONCLUSION A significant PPG reduction following TIPS is associated with improved clinical outcomes,including reduced risks of rebleeding,shunt dysfunction,hepatocellular carcinoma,and mortality,though it increases HE and liver failure risks.The observed correlation between portal vein diameter and PPG reduction highlights the potential role of portal vein anatomy in predicting TIPS efficacy,warranting further investigation.
文摘This is a narrative review in which the advances in technical aspects,the main indications,limitations and clinical results of the transjugular intrahepatic portosystemic shunt(TIPS)in portal hypertension(PH)are addressed.With the emergence of the coated prosthesis,a better shunt patency,a lower incidence of hepatic encephalopathy(HE)and better survival when compared to TIPS with the conventional prosthesis are demonstrated.The main indications for TIPS are refractory ascites,acute variceal bleeding unresponsive to pharmacological/endoscopic therapy and,lastly,patients considered at high risk for rebleeding preemptive TIPS(pTIPS).Absolute contraindications to the use of TIPS are severe uncontrolled HE,systemic infection or sepsis,congestive heart failure,severe pulmonary arterial hypertension,and biliary obstruction.The control of hemorrhage due to variceal rupture can reach up to 90%-100%of cases,and 55%in refractory ascites.Despite evidences regarding pTIPS in patients at high risk for rebleeding,less than 20%of eligible patients are treated.TIPS may also decrease the incidence of future decompensation in cirrhosis and increase survival in selected patients.In conclusion,TIPS is an essential treatment for patients with PH,but is often neglected.It is important for the hepatologist to form a multidisciplinary team,in which the role of the radiologist with experience in interventional procedures is prominent.
基金Natural Science Foundation of Guangdong Province,No.2024A1515013069.
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is an effective intervention for managing complications of portal hypertension,particularly acute variceal bleeding(AVB).While effective in reducing portal pressure and preventing rebleeding,TIPS is associated with a considerable risk of overt hepatic encephalopathy(OHE),a complication that significantly elevates mortality rates.AIM To develop a machine learning(ML)model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.METHODS This retrospective single-center study included 218 patients with AVB who underwent TIPS.The dataset was divided into training(70%)and testing(30%)sets.Critical features were identified using embedded methods and recursive feature elimination.Three ML algorithms-random forest,extreme gradient boosting,and logistic regression-were validated via 10-fold cross-validation.SHapley Additive exPlanations analysis was employed to interpret the model’s predictions.Survival analysis was conducted using Kaplan-Meier curves and stepwise Cox regression analysis to compare overall survival(OS)between patients with and without OHE.RESULTS The median OS of the study cohort was 47.83±22.95 months.Among the models evaluated,logistic regression demonstrated the highest performance with an area under the curve(AUC)of 0.825.Key predictors identified were Child-Pugh score,age,and portal vein thrombosis.Kaplan-Meier analysis revealed that patients without OHE had a significantly longer OS(P=0.005).The 5-year survival rate was 78.4%,with an OHE incidence of 15.1%.Both actual OHE status and predicted OHE value were significant predictors in each Cox model,with model-predicted OHE achieving an AUC of 88.1 in survival prediction.CONCLUSION The ML model accurately predicts post-TIPS OHE and outperforms traditional models,supporting its use in improving outcomes in patients with AVB.
文摘This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
基金Supported by National Natural Science Foundation of China,No.82270632 and No.82260411.
文摘BACKGROUND Hepatic alveolar echinococcosis(HAE)is a chronic parasitic disease caused by the larval stage of Echinococcus multilocularis.Although significant research has been conducted on the pathogenesis and immunological aspects of HAE,comprehensive bibliometric analyses in this area are still lacking.This study sought to fill this gap by systematically analyzing the immunological literature on HAE using bibliometric methods.AIM To identify research trends,key contributors,and emerging developments and offer insights to guide future research in this field.METHODS Research articles on HAE published between 1983 and 2023 were retrieved from the Web of Science Core Collection database.A total of 319 articles were selected for bibliometric analysis,which was conducted using the CiteSpace and VOSviewer software.The analysis focused on key variables such as publication volume,authors,journals,countries,references,and keywords.RESULTS The analysis revealed a significant increase in research on HAE over the past four decades,particularly after 1995.China and Switzerland emerged as the leading countries in terms of publication volume,with Bruno Gottstein and Vuitton DA identified as the most influential authors in this field.Key research areas include the interaction between the pathogen and the host immune system,as well as advances in disease diagnosis and treatment strategies.The keyword co-occurrence analysis highlighted the primary themes and identified emerging trends within the research landscape.CONCLUSION This study provides a comprehensive framework for understanding HAE immunology and highlights research hotspots,future directions,key contributors,and the importance of international cooperation.
基金supported by grants from the Research Foundation–Flanders(11A6420N,1268823N to WC and LVH)a FWO Junior Research Project Grant(G055121N to REV)VIB.AG is a senior clinical researcher of the Research Foundation–Flanders(1805718N)。
文摘Hepatic encephalopathy,defined as neuropsychiatric dysfunction secondary to liver disease,is a frequent decompensating event in cirrhosis.Its clinical impact is highlighted by a notable increase in patient mortality rates and a concomitant reduction in overall quality of life.Systemically,liver disease,liver function failure,portosystemic shunting,and associated multi-organ dysfunction result in the increase of disease-causing neurotoxins in the circulation,which impairs cerebral homeostasis.Key circulating neurotoxins are ammonia and inflammatory mediators.In the brain,pathophysiology is less well understood,but is thought to be driven by glial cell dysfunction.Astrocytes are the only brain resident cells that have ammonia-metabolizing machinery and are therefore putatively most susceptible to ammonia elevation.Based on a large body of mostly in vitro evidence,ammonia-induced cellular and molecular disturbances include astrocyte swelling and oxidative stress.Microglia,the brain resident macrophages,have been linked to the translation of systemic inflammation to the brain microenvironment.Recent evidence from animal studies has provided novel insights into old and new downstream effects of astrocyte and microglial dysfunction such as toxin clearance disruption and myeloid cell attraction to the central nervous system parenchyma.Furthermore,state of the art research increasingly implicates neuronal dysfunction and possibly even irreversible neuronal cell death.Cell-type specific investigation in animal models highlights the need for critical revision of the contribution of astrocytes and microglia to well-established and novel cellular and molecular alterations in hepatic encephalopathy.In this review,we therefore give a current and comprehensive overview of causes,features,and consequences of astrocyte and microglial dysfunction in hepatic encephalopathy,including areas of interest for future investigation.
文摘Antipalu is a phytomedicinal medicinal beverage that is popular in the District of Abidjan, particularly for the treatment of malaria. However, Antipalu could present potential health effects on patients, and few toxicological studies have been conducted before its use. In order to determine the cytotoxicity of Antipalu, two complementary tests, LDH activity and the MTT cell proliferation assay, were used using Vero cells. Vero cells were exposed to increasing concentrations of Antipalu and incubated for 24, 48 and 72 hours. In addition, forty (40) rats distributed randomly into 4 groups, including 10 animals per group (5 males and 5 females) were used for the potential hepatoxic effects. Animals in group 1 received distilled water and were used as a control group. On the other hand, Lot I, II and III received by gavage a volume of the Antipalu extract corresponding to 1 ml/100 g of body weight at 200 mg/kg, 400 mg/kg, 800 mg/kg, respectively. The extract was administered daily at the same time for 28 days and serum was collected once a week to evaluate hepatic biochemical markers. After 28 days of study, all rats were euthanized by an overdose of ether and the liver of the rats was removed for gross morphological and histopathological analysis. The results of the cell supernatant assay showed an increasing extracellular LDH enzyme activity with lethal concentrations at 10% and 50% (LC10 = 111 µg/mL and LC50 = 555 µg/mL, respectively). In addition, the MTT assay showed a decrease in mitochondrial activity and thus cell proliferation after 24, 48 and 72 H of incubation. Our study showed that Antipalu caused alterations in the plasma membranes of the cells, resulting in the release of lactase dehydrogenase (LDH) into the external environment and a decrease in the mitochondrial activity of the Vero cells. The biochemical parameters ALT, ASAT, ALPs, and GGT showed no significant change (P > 0.05) in the group of treated rats compared to the controls. However, these variations were moderate and transient, with values remaining almost within their standard limits. Microscopic observations of liver tissue sections from rats treated with the Antipalu showed no lesions, edema and necrosis. These results suggest that the Antipalu did not interfere with the functioning or alter the integrity of the liver.
基金Supported by the National Natural Science Foundation of China(81573563)Scientific and Technological Innovation Team for Qinghai-Tibetan Plateau Research in Southwest Minzu University(2024CXTD16)the Sichuan Provincial Administration of Traditional Chinese Medicine Innovation Team Project(2023ZD05).
文摘By summarizing the pharmacological effects of pomegranate extract and its active components,such as punicalagin,punicalin,gallic acid,ellagic acid,caffeic acid,and chlorogenic acid,it is found that the extract exhibits therapeutic effects on liver injury,viral hepatitis,metabolic dysfunction-associated fatty liver disease,liver fibrosis,and liver cancer.Emerging evidence suggests that these natural products may alleviate liver diseases through multi-targeted therapeutic mechanisms,including anti-inflammation,anti-oxidative stress,immunoregulation,and anti-steatosis.The underlying mechanisms by which pomegranate exerts hepatoprotective activities may be attributed to the regulation of multiple signaling pathways,including P62/Nrf2,TGF-β1/Smad7,Wnt/β-catenin,MAPK/Nrf2,Nrf2/Keap1,Akt/FOXO3a,MAPK/NF-κB,etc.Consequently,pomegranate can serve as a functional food,nutritional supplement,or adjuvant in the modern treatment of liver diseases.
文摘BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.
基金supported by the National Natural Science Foundation of China(No.82472136).
文摘The liver performs multiple life-sustaining functions.Hepatic diseases,including hepatitis,cirrhosis,and hepatoma,pose significant health and economic burdens globally.Along with the advances in nanotechnology,mesoporous silica nanoparticles(MSNs)exhibiting diversiform size and shape,distinct morphological properties,and favorable physico-chemical features have become an ideal choice for drug delivery systems and inspire alternative thinking for the management of hepatic diseases.Initially,we introduce the physiological structure of the liver and highlight its intrinsic cell types and correlative functions.Next,we detail the synthesis methods and physicochemical properties of MSNs and their capacity for controlled drug loading and release.Particularly,we discuss the interactions between liver and MSNs with respect to the passive targeting mechanisms of MSNs within the liver by adjusting their particle size,pore diameter,surface charge,hydrophobicity/hydrophilicity,and surface functionalization.Subsequently,we emphasize the role of MSNs in regulating liver pathophysiology,exploring their value in addressing liver pathological states,such as tumors and inflammation,combined with multi-functional designs and intelligent modes to enhance drug targeting and minimize side effects.Lastly,we put forward the problems,challenges,opportunities,as well as clinical translational issues faced by MSNs in the management of liver diseases.
文摘This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incidence rate in Europe is lower than in developing countries,but it is a major complication with high morbidity,particularly in immunocompromised patients.They are most frequently caused by Enterobacterales infections,but hypervirulent Klebsiella strains are an emerging problem in Western countries.Amoebiasis has been a public health problem in Europe,primarily imported from other endemic foci.At the same time,this infection is becoming an emerging disease,as the number of infected patients who have not traveled to endemic areas is rising.Treatment options for hydatid liver cyst include chemotherapy,open or laparoscopic surgery,percutaneous treatment(percutaneous aspiration,re-aspiration and injection and its modification)and“wait and watch”strategy.Most hydatid liver cyst patients in Pillay et al’s study received surgical treatment,but several studies have confirmed the safety and efficacy of percutaneous aspiration,re-aspiration and injection.
基金supported by the Health Commission of Sichuan Province(Popularization of Application Project,Grant No.21PJ182).
文摘The role of the gut microbiota in the pathogenesis and treatment of hepatic encephalopathy (HE) has garnered increasing attention due to significant advancements in understanding the gut microbiota over recent years. A growing body of evidence from laboratory and clinical studies highlights a substantial relationship between gut microbiota and HE. Identifying the role of gut microbiota in maintaining normal cognitive function, including its influence on the gut barrier and immune cells, is essential to elucidate the mechanisms underlying the development of HE. This understanding offers novel perspectives for its prevention and treatment. This paper provides a comprehensive review of the research progress concerning the gut microbiota, HE, and their interrelationship, along with current treatment methods for HE. Furthermore, it outlines the limitations and challenges associated with microbiota-based therapeutic research.
基金funded by Vietnam National Foundation for Science and Technology Development under grant number 108.05-2023.23.
文摘Objective:To investigate the effects of a crude extract from Gnetum montanum Markgr.on ethanol-induced hepatotoxicity and metabolic disorders.Methods:Alcoholic liver disorder was induced in mice by administering increasing doses of ethanol via oral gavage.Biomarkers of liver injury and oxidative stress were assessed at the end of the study.Liver tissue damage and fat deposition were evaluated using hematoxylin and eosin and oil red O staining,respectively.In addition,key biomarkers were examined in acetaldehyde-treated HepG2 cells.Results:Ethanol consumption induced characteristic pathological changes,including elevated serum markers of liver injury,hepatic lipid accumulation,and oxidative stress in liver tissues.Oral administration of Gnetum montanum extract(175 and 350 mg/kg)decreased serum aspartate aminotransferase,alanine aminotransferase,γ-glutamyl transferase,and bilirubin levels in ethanol-treated mice.The extract also lowered triglyceride levels in serum and liver tissue in a dose-dependent manner.Furthermore,it mitigated malondialdehyde levels,preserved reduced glutathione levels,and enhanced catalase activity and total antioxidant capacity in liver tissue homogenates.Additionally,ethanol-induced hyperuricemia was suppressed by Gnetum montanum extract by inhibiting xanthine oxidase activity.Similar effects were observed in Gnetum montanum extract-treated HepG2 cells.Conclusions:This study demonstrates that Gnetum montanum extract alleviates ethanol-induced hepatic injury by alleviating oxidative stress and inhibiting xanthine oxidase activity.
文摘The rapid evolution of systemic therapies for hepatocellular carcinoma(HCC),one of the most common types of liver cancer,has attracted significant attention especially to hepatic arterial infusion chemotherapy(HAIC)as a highly promising treatment approach.This method,which delivers chemotherapy directly into the liver's arterial supply,is designed to maximize the concentration of anti-cancer drugs at the tumor site while minimizing systemic side effects.Despite the potential and the encouraging results observed in various studies,HAIC has not yet achieved widespread acceptance and utilization.Sorafenib is a widely used systemic therapy that targets multiple pathways involved in tumor growth and angiogenesis,while transarterial chemoembolization(TACE)is a locoregional therapy that combines arterial embolization with chemotherapy.These treatments have been the mainstay of HCC management,yet they have limitations that HAIC may potentially overcome.This article specifically comments on the network meta-analysis that examined the current research status of HAIC,highlighting its effectiveness and safety profile in comparison to established standard treatments such as Sorafenib and TACE.Through an extensive review of existing studies,the authors conclude that patients receiving HAIC often experience better survival rates and longer periods without disease progression compared to those receiving Sorafenib or TACE.
基金Animal Nutrition,Growth and Lactation(grant no.2015–67015-23245/project accession no.1005855)Animal Health and Production and Animal Products(grant no.2023–67015-39663/1030033)from the USDA National Institute of Food and AgricultureNorth Carolina Agricultural Research Hatch projects 1016618 and 02780.
文摘Background Energy deficiency is a leading cause of the high pre-weaning mortality of neonatal piglets in the swine industry.Thus,optimal energy metabolism is of crucial importance for improving the survivability of neonatal piglets.The effective utilization of milk fat as primary energy is indispensably required.Methods Pregnant sows(n=27)were randomly assigned into 3 treatments.Each treatment received a standard diet(3,265 kcal ME/kg)supplemented with either 0,0.25%or 0.5%clofibrate(w/w)from d 107 of gestation to d 7 of lacta-tion.The effects of maternal clofibrate on their milk fatty acid(FA)and performance of the piglets were evaluated.The evaluations were performed via measuring sow productive performance,milk FA composition,and hepatic FA oxida-tion of the piglets at birth and d 1,7,14 and 19 after birth.Results Maternal supplementation of clofibrate had no effect on reproductive performance of the sows at farrowing and weaning(P>0.05).However,the mortality at weaning was reduced for piglets from sows with 0.25%of clofi-brate,and the average weekly(and daily)gain was higher in piglets from sows that received clofibrate than sows without clofibrate in the first week(P<0.0001).Maternal clofibrate increased percentage of milk C12:0 and C14:0 FAs but decreased C18:2 and n-6 polyunsaturated FAs.Maternal clofibrate also increased plasma ketone body levels and hepatic FA oxidation measured at the first day of birth,but the increase was not detected in piglets on d 7,14 or 19.Clofibrate was not detected in milk collected from the clofibrate-treated sows.The percentage of FA oxidation decreased,and the percentage of FA esterification increased with increasing in postnatal age.Supplemental carni-tine increased FA oxidation regardless of succinate dehydrogenase inhibition,and the increase had no effect on FA esterification.Conclusions Maternal supplementation of clofibrate during late gestation and early lactation increases hepatic FA oxidative metabolism at birth and improves growth performance of newborn piglets.Maternal clofibrate transfer to suckling piglets via milk was not detected.Carnitine availability is critical for piglets to maintain a high FA oxidation rate during the suckling period.
基金Supported by Guangdong Medical Science and Technology Research Fund Project,No.A2024475.
文摘This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-invasive method to measure LS,which correlates with the degree of liver fibrosis,and SPA,an indicator of portal hypertension,2D-SWE offers a comprehensive evaluation of a patient’s hepatic status.These advancements are particularly crucial in hepatic surgery,where accurate preoperative assessments are essential for optimizing surgical outcomes and minimizing complications.This letter highlights the prac-tical implications of integrating 2D-SWE into clinical practice,emphasizing its potential to improve patient safety and surgical precision by enhancing the ability to predict PHLF and tailor surgical approaches accordingly.
基金Supported by National Natural Science Foundation of China,No.81630080,No.82305179,and No.82374181The China Postdoctoral Science Foundation Grant,No.2019M650600+1 种基金The Beijing University of Chinese Medicine“Decoding Traditional Chinese Medicine”Project,No.2023-JYB-JBZD-036The Hefei National Research Center for Physical Sciences at the Microscale,No.KF2021104.
文摘BACKGROUND Hepatic organoid-based modelling,through the elucidation of a range of in vivo biological processes and the recreation of the intricate liver microenvironment,is yielding groundbreaking insights into the pathophysiology and personalized medicine approaches for liver diseases.AIM This study was designed to analyse the global scientific output of hepatic organoid research and assess current achievements and future trends through bibliometric analysis.METHODS Articles were retrieved from the Web of Science Core Collection,and CiteSpace 6.3.R1 was employed to analyse the literature,including outputs,journals,and countries,among others.RESULTS Between 2010 and 2024,a total of 991 articles pertaining to hepatic organoid research were published.The journal Hepatology published the greatest number of papers,and journals with an impact factor greater than 10 constituted 60%of the top 10 journals.The United States and Utrecht University were identified as the most prolific country and institution,respectively.Clevers H emerged as the most prolific author,whereas Huch M had the highest number of cocitations,suggesting that both are ideal candidates for academic collaboration.Research on hepatic organoids has exhibited a progressive shift in focus,evolving from initial investigations into model building,differentiation research in stem cells,bile ducts,and progenitor cells,to a broader spectrum encompassing lipid metabolism,single-cell RNA sequencing,and therapeutic applications.The phrases exhibiting citation bursts from 2022 to 2024 include“drug resistance”,“disease model”,and“patient-derived tumor organoids”.CONCLUSION Research on hepatic organoids has increased over the past decade and is expected to continue to grow.Key research areas include applications for liver diseases and drug development.Future trends likely to gain focus include patient-derived tumour organoids,disease modelling,and personalized medicine.
