Early and accurate prognostic assessment is crucial to avoid serious disease progression in patients with liver failure. Thyroid hormone is an important metabolic regulator involved in hepatic function. This review examines in detail the pathophysiological regulation of the hypothalamic-pituitary-thyroid axis in patients with liver failure and emphasizes the importance of thyroid profiling (thyroid-stimulating hormone, T3, and T4) in prognostic assessment and risk stratification. T3 can enhance liver regeneration. The clinical application of thyroid hormone replacement therapy in patients with acute-on-chronic liver failure complicated by non-thyroidal illness syndrome is controversial. This review aims to inform clinical practice regarding the relevance of TH level assessment in liver failure and to provide novel insights into the prognostic evaluation and comprehensive care of liver failure complicated by thyroid dysfunction.

Perioperative anaphylaxis is a rare, life-threatening, iatrogenic condition that predominantly arises following anesthesia. The unique context of this condition, characterized by the concurrent administration of multiple drugs, patient draping, and altered physiological states, presents significant diagnostic and therapeutic challenges, contributing to a higher mortality rate compared to anaphylaxis in other settings. This narrative review synthesizes the evidence to delineate the evolving etiology, pathophysiology, atypical clinical presentation, evidence-based immediate management, and strategic prevention of perioperative anaphylactic reactions. The primary causative agents include neuromuscular blocking agents, antibiotics, and latex, with emerging culprits such as chlorhexidine, dyes, and novel agents like remimazolam. Diagnosis is complicated by the paucity of cutaneous signs; thus, cardiovascular collapse combined with a low end-tidal carbon dioxide level has emerged as a useful supportive diagnostic indicator that requires integration with the clinical context. Immediate management prioritizes the prompt administration of epinephrine and aggressive fluid resuscitation. Subsequent allergological investigations, primarily via skin testing and serum tryptase/histamine measurement, are paramount for identifying the causative agent and preventing its recurrence. Prevention strategies emphasize meticulous history-taking, risk stratification, and the creation of latex-free environments. Future directions must focus on establishing global surveillance networks, exploring novel biomarkers and risk factors such as the circulating microbiome—a preliminary but promising area of research—and enhancing team preparedness through simulation training to improve patient safety outcomes.

Chronic stress-induced hypercortisolism causes diminished ovarian reserve (DOR), contributing to infertility and miscarriage. Androgen supplementation is an emerging therapeutic approach for DOR. The traditional Chinese herbal decoction modified Gengnianchun formula (MGNC) has shown clinical efficacy in treating DOR. This study aimed to compare the effectiveness of MGNC with that of androgens in a stress-induced DOR mouse model.

Sexually mature female C57 mice aged six weeks were randomly assigned to six groups (n = 10 per group, with 3 independent replicates per group), including the control, model, low-dose testosterone (LT), medium-dose testosterone (MT), high-dose testosterone (HT), and MGNC groups. This sample size and study design were determined based on preliminary experimental data. Chronic stress was induced in mice, except for the control group, by daily glucocorticoid injection, and the mice in the LT, MT, HT, and MGNC groups were treated at the same time with testosterone (low, medium, or high dose) or MGNC for six weeks. Body weight, estrous cycles, ovarian follicle counts, hormone profiles, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and testosterone, and in vitro preantral follicle growth rates (via MGNC-enriched or androgen-treated serum) were assessed.

All groups presented stable body weights. MGNC ameliorated estrous cycle irregularities caused by stress, while testosterone exacerbated the abnormality. Moreover, MGNC outperformed LT in improving primordial/primary/antral follicle counts and corpus luteum formation, while MT and HT did not improve ovarian follicle reserve. LT was associated with the highest serum estradiol level, but none of the testosterone doses reduced FSH levels or the FSH/LH ratio, whereas MGNC lowered FSH and the FSH/LH ratio. Additionally, MGNC-enriched serum significantly enhanced the in vitro follicular growth rate in corticosterone-supplemented culture medium, and this effect was superior to that observed with testosterone-pretreated serum.

MGNC demonstrates superior efficacy over androgen therapy in treating chronic stress-induced DOR in mice, supporting further investigations into its clinical potential and mechanisms.

The history of screening for cervical cancer is rich with implementing cutting-edge ideas and technologies. From the very first “Pap smear” to the semi-automated and computerized systems of today, the way we screen for cervical cancer has changed dramatically in the past 75 years. With the advent of new techniques and more advanced machine learning algorithms, we sought to understand the current and future applications of artificial intelligence in clinical pathology around cervical cancer screening, diagnosis, and treatment.

A structured narrative review was conducted to examine the historical evolution and contemporary advances in cervical cancer screening, diagnosis, excisional management, and artificial intelligence applications. Peer-reviewed articles, consensus guidelines, and global policy documents published between January 1990 and March 2025 were identified through targeted searches of PubMed and review of reference lists from relevant publications. Search terms included combinations of “cervical cancer screening,” “Papanicolaou test,” “liquid-based cytology,” “HPV testing,” “colposcopy,” “loop electrosurgical excision procedure,” “digital pathology,” “deep learning,” and “artificial intelligence.” Emphasis was placed on multi-center validation studies, systematic reviews, regulatory and implementation guidance, and global health frameworks. Publications lacking methodological transparency or direct relevance to clinical or translational practice were excluded.

Through a review of the literature, we describe how innovations in conventional and liquid-based cytology, human papillomavirus testing, and organized screening programs established the current prevention framework. Building on this foundation, recent studies demonstrate promising performance of deep learning algorithms applied to conventionally prepared cervical cytology slides, with systems capable of binary normal versus abnormal classification as well as more granular diagnostic categorization. Artificial intelligence-assisted colposcopy and computer-vision approaches have also shown improved diagnostic concordance, workflow efficiency, and potential to expand screening capacity in resource-limited environments.

There has been much work done in the past several years surrounding the implementation of deep learning algorithms in regard to cervical cancer screening. The work in this field shows promise in enhancing diagnostic accuracy, streamlining diagnostic workflow, and decreasing turnaround times from specimen collection to rendering a diagnosis. However, there are still many technical, legal, and ethical questions that must be answered prior to widespread adoption of these algorithms for patient care.

Comparative data on sequential transarterial chemoembolization (TACE) after stereotactic body radiation therapy (SBRT) in recurrent hepatocellular carcinoma (HCC) remain limited. This study aimed to evaluate the efficacy of this combination.

We retrospectively reviewed 152 patients with recurrent HCC who met predefined eligibility criteria; 109 received SBRT alone and 43 received SBRT plus TACE. To minimize selection bias, a 2:1 propensity score matching was performed, resulting in 68 patients in the SBRT-alone group and 36 in the SBRT plus TACE group for the final comparative analysis. Overall survival, progression-free survival, and local control were assessed using the Kaplan-Meier method.

The SBRT plus TACE group was associated with numerically higher survival rates, although this difference did not reach statistical significance. The cumulative one-, three-, and five-year overall survival rates were 91.2%, 76.3%, and 61.8% for SBRT alone, compared to 100.0%, 86.1%, and 77.5% for the combination therapy ( p = 0.069). The corresponding progression-free survival rates were 73.1%, 51.1%, and 32.3% versus 88.9%, 58.1%, and 52.3% ( p = 0.091). No acute grade ≥3 toxicities were observed in either group.

In this exploratory analysis of recurrent HCC, the combination of SBRT and TACE demonstrated a favorable trend toward improved survival compared with SBRT alone, without an increase in severe toxicity. While these findings did not reach statistical significance, they establish the safety profile of the combined approach and provide preliminary evidence supporting its potential therapeutic role. This hypothesis-generating study justifies and informs the design of larger, prospective trials to definitively evaluate the efficacy of this regimen.

Artificial intelligence (AI) translation in genitourinary (GU) pathology has progressed unevenly across organs and tasks. This review addresses a central clinical question: which GU pathology AI applications are deployment-ready, which require further validation, and what frameworks can guide safe implementation? We synthesize evidence across GU organs and introduce pragmatic translation frameworks to guide deployment and prioritize translational research.

Narrative review integrating foundational literature with targeted 2023–2025 publications, emphasizing regulatory milestones, external validation, and prospective studies. Literature was identified through PubMed, Embase, and conference proceedings using structured search terms for AI, digital pathology, and GU organ-specific queries. For each organ/task, we mapped evidence strength, regulatory maturity, generalizability, workflow integration, safety, and feasibility to a Translational Readiness Index (TRI) rubric (0–30 scale).

Prostate biopsy AI demonstrates the strongest maturity (TRI 26/30), supported by U.S. Food and Drug Administration-cleared systems, multi-site validation, and prospective implementations showing efficiency gains and reduced ancillary testing. Bladder cytology shows moderate readiness (TRI 19/30), with commercial offerings supporting pilotable prescreening workflows aligned with the Paris System when paired with uncertainty-aware deferral. Bladder histology, renal neoplasia, and low-prevalence domains (testis, penis) remain emerging (TRI 6–15/30), constrained by label variability, rare subtype underrepresentation, and limited external validation.

The TRI rubric, SURE-Path safety bundle, and VALIDATED/ORCHESTRATE implementation pathway provide a practical template for evidence-based deployment in GU pathology. Clinically defensible translation requires matching intended use to validation evidence, with explicit safeguards for emerging applications.

Micro- and nanoplastics (MNPs) are pervasive environmental contaminants with growing recognition as potential contributors to human disease. Widespread human exposure occurs primarily through ingestion of contaminated food and water, and MNPs have been detected in multiple human tissues, including the gastrointestinal tract. Experimental evidence provides a plausible biological basis for disease associations, including impairment of intestinal barrier integrity, activation of mucosal immune pathways, and alteration of gut microbial communities caused by MNP exposure. Although human data remain limited, early studies demonstrate MNP detection in stool and suggest potential correlations with inflammatory biomarkers such as fecal calprotectin. These findings, together with mechanistic data from in vitro and animal models, raise concern that MNP exposure represents a paradigm shift in the pathogenesis or modulation of inflammatory bowel disease (IBD); however, methodological variability, small sample sizes, and contamination challenges currently limit definitive conclusions. The aim of this review is to evaluate the current understanding of MNP exposure and its impact on intestinal health, particularly in relation to IBD. We synthesize mechanistic and early clinical evidence linking MNPs to IBD and highlight critical research gaps. Future standardized exposure assessment, mechanistic validation in human systems, and longitudinal studies are essential to clarify causal relationships. Given the modifiable nature of environmental plastic exposure, advancing this field may offer new opportunities for IBD prevention and intervention.

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by intermittent hypoxia and sleep fragmentation, which may contribute to lung cancer development and progression. This review synthesizes epidemiological evidence on the association between OSA and lung cancer incidence and mortality, highlighting inconsistencies due to study design, population differences, and confounding factors such as smoking and obesity. While some studies report an increased lung cancer risk, particularly with severe nocturnal hypoxemia, others suggest no significant association or a potential protective effect. Pathophysiologically, OSA promotes oncogenesis through hypoxia-inducible factor activation, tumor immune microenvironment remodeling, exosome-mediated signaling, nuclear factor κB pathway activation, and enhanced cancer stem cell properties. Continuous positive airway pressure therapy may mitigate these effects, with evidence suggesting reduced lung cancer incidence and improved prognosis in adherent patients. This review underscores the need for standardized studies using objective diagnostics and robust confounder adjustment to clarify the OSA–lung cancer link and optimize clinical management.