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Original Article Open Access
Protection against Endothelial Injury Mediates the Anti-thrombotic Effect of Danggui Buxue Decoction in a Rat Model of Cirrhotic Portal Vein Thrombosis
Yanan Guo, Sisi Dong, Meng Li, Yanyan Tao, Jing Lv, Chenghai Liu
Published online December 5, 2025
Gastroenterology & Hepatology Research. doi:10.14218/GHR.2025.00001
Abstract
PVT is a harmful event in cirrhosis, and the prevention and treatment of PVT are important in the management of cirrhosis and portal hypertension. The study aimed to observe the [...] Read more.

PVT is a harmful event in cirrhosis, and the prevention and treatment of PVT are important in the management of cirrhosis and portal hypertension. The study aimed to observe the efficacy of Danggui Buxue Decoction (DBD) on portal vein thrombosis (PVT) in cirrhosis and to elucidate the related mechanism using a modified animal model.

A model of PVT in cirrhosis was established by partial portal vein ligation and intraperitoneal injection of CCl4 in rats, which showed obvious PVT with intra- and extravenous thrombosis as well as liver cirrhosis. Rats were randomly assigned into four groups and received intragastric administration of DBD (12 g/kg/day) or rivaroxaban (20 mg/kg/day) for 6 weeks.

DBD attenuated collagen deposition and reduced thrombus formation in model livers, increased portal vein blood flow, expanded the portal vein diameter, and reduced prothrombin time and international normalized ratio in the model rats. In addition, DBD reduced hepatic von Willebrand factor and plasminogen activator inhibitor-1 expression and increased hepatic fibrin degradation product content in the liver tissues of model rats.

We modified a model of cirrhotic PVT in rats and found that DBD had a good effect on PVT and liver fibrosis, with the mechanisms related to the enhancement of portal vein blood flow and the protection against endothelial cell injury.

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Review Article Open Access
Regulatory Mechanisms of NKG2DL Expression and Clinical Significance in Hepatocellular Carcinoma Cells
Qiqun Gu, Mei Wu, Chengyi Wan
Published online December 5, 2025
Gastroenterology & Hepatology Research. doi:10.14218/GHR.2025.00002
Abstract
Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates worldwide, in which immune evasion mechanisms play a crucial role in its progression [...] Read more.

Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates worldwide, in which immune evasion mechanisms play a crucial role in its progression and treatment. Natural killer group 2D ligands (NKG2DL), as key molecules activating immune cells, significantly influence the immune evasion of liver cancer through their regulatory mechanisms. This review summarizes the regulatory mechanisms of NKG2DL expression, including genetic, signaling pathway, non-coding RNA, and stress response modulation, and discusses their expression patterns and clinical relevance in HCC. Studies have shown that the expression status of NKG2DL not only impacts patient prognosis and therapeutic response but also provides potential targets for HCC immunotherapy. Future research should focus on the molecular networks regulating their expression and their synergy with immunotherapy to provide a theoretical basis for developing more precise diagnostic and personalized treatment strategies for HCC.

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Illuminating and Instructive Clinical Case Open Access
Human Albumin-enriched Peritoneal Dialysis: A Novel Approach to Manage Refractory Ascites and Kidney Dysfunction in Decompensated Advanced Chronic Liver Disease
Mario Romeo, Silvio Borrelli, Marcello Dallio, Carlo Garofalo, Fiammetta Di Nardo, Paolo Vaia, Carmine Napolitano, Luca De Nicola, Alessandro Federico
Published online December 2, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00404
Abstract
For individuals with decompensated advanced chronic liver disease (dACLD), the onset of refractory ascites (RA) represents a dramatic event. In this setting, a relevant proportion [...] Read more.

For individuals with decompensated advanced chronic liver disease (dACLD), the onset of refractory ascites (RA) represents a dramatic event. In this setting, a relevant proportion of RA patients develop kidney dysfunction, as well as hepatorenal syndrome-acute kidney injury, with limited therapeutic and survival chances. An 81-year-old woman with dACLD-RA was admitted with severe ascites and stage IV chronic kidney dysfunction. On the second day, hepatorenal syndrome-acute kidney injury occurred, requiring standard medical therapy. Intravenous human albumin (HA) and terlipressin administration were compromised by poor venous access and severe respiratory dysfunction. After excluding transjugular intrahepatic portosystemic shunt and transplantation due to age and comorbidities, peritoneal dialysis (PD) was initiated, leading to renal recovery and ascites resolution. Two weeks later, she was readmitted due to the unfeasibility of accessing peripheral veins for the intravenous administration of HA, which was essential to support circulatory function, preserve oncotic balance, and properly manage both RA and chronic kidney dysfunction. A novel PD+HA protocol was therefore started, with intraperitoneal infusion of HA-enriched dialysate to allow a positive albumin gradient from dialysate to blood. Over 12 months, serum albumin levels increased, and clinical stability and improved nutritional status were observed, with no additional hospitalizations or complications. This is the first case describing the application of HA-enriched PD in managing a dACLD patient with RA and kidney dysfunction. HA-enriched PD may represent a promising strategy in complex dACLD care by guaranteeing frequent and small-volume paracentesis and preservation of oncotic pressure without dialytic albumin loss.

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Short Communication Open Access
Formulation of a Novel Emulgel Incorporated with Alpinia calcarata Essential Oil and Assessment of Its Anti-inflammatory Activity
W.J.A. Banukie N. Jayasuriya, L.D.A. Menuka Arawwawala, N.T. Bhavantha Dias, K. Pararamasingam, N.M.M. Fazlan, K.A. Samarasinghe, T. Sugandhika Suresh
Published online November 28, 2025
Future Integrative Medicine. doi:10.14218/FIM.2025.00029
Abstract
Alpinia calcarata (A. calcarata) Roscoe (Family: Zingiberaceae) is a rhizomatous perennial herb used in traditional medicine to treat inflammatory conditions. This study aimed to [...] Read more.

Alpinia calcarata (A. calcarata) Roscoe (Family: Zingiberaceae) is a rhizomatous perennial herb used in traditional medicine to treat inflammatory conditions. This study aimed to develop a topical emulgel dosage form by incorporating the essential oil of A. calcarata rhizome and to investigate it’s in vitro anti-inflammatory activity. A thin-layer chromatographic fingerprint of the essential oil of A. calcarata rhizome was developed. Then, an emulsion base containing plant oil was formulated and incorporated within a Carbopol gel base. The physical characteristics of this formulation were evaluated subsequently. The anti-inflammatory mechanism of the emulgel was determined by in vitro blood cell membrane stabilization assay and thrombolytic activity assay. The results were statistically analyzed by one-way analysis of variance. The thin-layer chromatographic fingerprint of the test oil demonstrated several bands with unique retention factor values. The formulated herbal emulgel was white, viscous, and homogeneous in appearance. The spreadability was 118 g·cm/M, and the pH of the emulgel was 6.30 at 25°C. The A. calcarata emulgel significantly (p < 0.05) inhibited heat-induced in vitro hemolysis, with the highest activity at a 50 µg/mL dose (87.68 ± 0.35%) compared to the placebo. Furthermore, this activity was found to be dependent on the essential oil concentration (r2 = 0.99) of the emulgel. Therefore, it was concluded that the essential oil of A. calcarata rhizome is an effective active ingredient to be used in a topical emulgel formulation, whereas the diverse phytochemicals present in the essential oil would be the underlying source of its anti-inflammatory activity.

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Original Article Open Access
Establishment of the Traditional Chinese Medicine Nursing Assessment Form Based on the Delphi Method for Chronic Wounds
Lina Yue, Xuying Xu, Shujie Cui, Ran Xie, Conghui Shi, Changyue Wang, Guangyu Wang, Shidong An, Shurui Xie, Shuo Wang, Xiaolu Pei
Published online November 27, 2025
Future Integrative Medicine. doi:10.14218/FIM.2025.00037
Abstract
The existing wound assessment tools, which are based on modern medical theory, limit the clinical application of traditional Chinese medicine (TCM) nursing. This research aimed [...] Read more.

The existing wound assessment tools, which are based on modern medical theory, limit the clinical application of traditional Chinese medicine (TCM) nursing. This research aimed to develop a scientific, standardized, and characteristic TCM nursing evaluation form for chronic wounds.

Based on a literature review and research group discussions, an initial draft of an expert consultation questionnaire, based on literature from the past five years (2017–2021) from databases such as CNKI, Wanfang, VIP, and SinoMed, was formulated. The authority of the experts was expressed using the authority coefficient, derived from self-evaluations, which is critical for ensuring the scientific validity and rationality of the indicator system. After three rounds of Delphi expert consultation, the TCM nursing assessment form for wound surfaces was finalized.

The effective response rate for the three rounds of expert consultation questionnaires was 100%. The judgment coefficient was 0.85, the familiarity coefficient was 0.89, and the authority coefficient was 0.87. The coefficients of variation for the three rounds were 0.172, 0.044, and 0.013, respectively, while the Kendall’s coefficients of concordance were 0.406, 0.269, and 0.502, respectively, with statistically significant differences (p < 0.001). The final TCM nursing assessment form for wound surfaces included four basic information items, two primary indicators, 17 secondary indicators, and 13 tertiary indicators.

The TCM nursing assessment form integrates TCM syndrome differentiation principles and provides a standardized tool for the assessment of chronic wounds.

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Original Article Open Access
Oxytocin Attenuates Metabolic Dysfunction-associated Steatotic Liver Disease via AMPK/SREBP1c/FAS-mediated Suppression of Hepatic Lipogenesis
Yue Xu, Siqian Lu, Hongpei Wu, Haifeng Wu, Ming Li, Meng Zhou, Ting Chen, Xun Wang, Lishuai Qu, Qin Jin, Jinxia Liu
Published online November 26, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00213
Abstract
As the leading cause of chronic liver disease globally, metabolic dysfunction-associated steatotic liver disease (MASLD) lacks effective therapies. This study aimed to investigate [...] Read more.

As the leading cause of chronic liver disease globally, metabolic dysfunction-associated steatotic liver disease (MASLD) lacks effective therapies. This study aimed to investigate the therapeutic potential and molecular mechanisms of oxytocin (OXT) in MASLD.

Integrated bioinformatics analysis of MASLD datasets was carried out to identify OXT-related metabolic disturbances. Serum OXT levels were quantified using an enzyme-linked immunosorbent assay in 113 MASLD patients and 63 healthy controls. Mechanistic assays were conducted using oleic acid (OA)-induced, lipid-loaded HepG2 cells and high-fat diet-fed C57BL/6 mice, and OXT was administered intraperitoneally in vivo and supplemented in vitro.

Bioinformatics analysis revealed significant changes in OXT expression levels, particularly in fatty acid metabolism. Elevated OXT expression levels in MASLD patients were identified as an independent prognostic factor. In vitro, OXT significantly reduced OA-induced lipid accumulation in HepG2 cells, while in vivo, it decreased body weight, liver injury, and serum cholesterol levels in high-fat diet-fed mice. Mechanistically, OXT enhanced the expression level of phosphorylated AMP-activated protein kinase (AMPK) and suppressed the levels of sterol regulatory element-binding protein-1c (SREBP1c) and fatty acid synthase (FAS). Blockade of AMPK with the chemical inhibitor Compound C reversed the ability of OXT to suppress the SREBP1c/FAS axis and reduce lipid accumulation in hepatocytes. Additionally, OXT inhibited the nuclear translocation of SREBP1c in OA-treated cells.

The findings demonstrate that OXT may serve as a potential therapeutic agent for MASLD by regulating the AMPK/SREBP1c/FAS pathway in lipid metabolism.

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Original Article Open Access
PDK4 Regulates Inflammatory Injury in Acute-on-chronic Liver Failure by Phosphorylating STAT1-mediated M1 Polarization of Macrophages
Shilong Dong, Luyuan Ma, Chuan Shen, Ruolan Gu, Xinyang Li, Ying Xiao, Caiyan Zhao
Published online November 26, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00343
Abstract
Acute-on-chronic liver failure (ACLF) is a life-threatening syndrome characterized by systemic inflammation and immune dysregulation, in which macrophages play a key role in organ [...] Read more.

Acute-on-chronic liver failure (ACLF) is a life-threatening syndrome characterized by systemic inflammation and immune dysregulation, in which macrophages play a key role in organ injury. This study aimed to investigate the role and mechanism of pyruvate dehydrogenase kinase 4 (PDK4) in ACLF to identify therapeutic targets that modulate macrophage function and mitigate ACLF progression.

Single-cell RNA sequencing data from healthy and ACLF liver tissues were analyzed from the Sequence Read Archive database. Transcriptomic data of peripheral blood mononuclear cells from ACLF patients (GSE168048) were also examined. In vitro experiments assessed PDK4 expression and macrophage polarization, and conditioned-medium studies evaluated effects on LO2 hepatocytes. In vivo validation was performed in ACLF mouse models treated with a PDK4 inhibitor.

Single-cell analysis revealed a predominance of M1-polarized hepatic macrophages in ACLF with marked upregulation of PDK4. Peripheral blood mononuclear cell transcriptomics showed that higher PDK4 expression correlated with 28-day mortality. In vitro, PDK4 expression increased in M1 macrophages; PDK4 inhibition attenuated M1 polarization and reduced cytotoxic effects on LO2 cells. In vivo, pharmacologic inhibition of PDK4 suppressed M1 polarization in macrophages, alleviated liver inflammation, and reduced tissue injury. Mechanistically, PDK4 promoted M1 polarization via activation of signal transducer and activator of transcription 1 signaling.

PDK4 is a key pro-inflammatory regulator in ACLF by promoting M1 macrophage polarization. Targeting PDK4 may be a promising strategy to attenuate inflammation and improve clinical outcomes in ACLF.

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Systematic Review Open Access
Safety and Efficacy of Stereoelectroencephalography-guided Resection and Responsive Neurostimulation in Drug-resistant Temporal Lobe Epilepsy: A Systematic Review
Muaz Ali, Abdaal Munir, Jamal Montaser, Srihas Tumu, Venkata Yashashwini Maram Reddy, Navod Jayasuriya, Iana Malasevskaia
Published online November 26, 2025
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00035
Abstract
Temporal lobe epilepsy (TLE) is the most common focal epilepsy, with many patients developing drug-resistant epilepsy. Surgical interventions, including stereoelectroencephalography [...] Read more.

Temporal lobe epilepsy (TLE) is the most common focal epilepsy, with many patients developing drug-resistant epilepsy. Surgical interventions, including stereoelectroencephalography (SEEG)-guided temporal lobe resection (TLR) and SEEG-guided responsive neurostimulation (RNS), are key treatment options. This systematic review compares the efficacy and safety of these interventions in drug-resistant TLE.

A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. A comprehensive search of multiple databases was performed (January 23–February 14, 2025). Eligible studies included adult patients with drug-resistant TLE undergoing SEEG-guided TLR or RNS (where SEEG was used pre-implant for localization). Primary outcomes assessed included seizure freedom, seizure reduction, adverse events, and quality of life (QoL) improvements. Quality assessments were performed using appropriate tools for randomized and observational studies.

Fifteen studies met the inclusion criteria, with sample sizes ranging from 10 to 440 participants. SEEG-guided TLR achieved an average seizure freedom rate of 58.5% (range: 32–85%) and a mean seizure reduction of 75% (range: 60–90%). SEEG-guided RNS resulted in an average seizure freedom rate of 12.85% and seizure reduction of 63.2%, with variability across studies. QoL improvements were reported in 80–82% of patients. Adverse events were infrequent but varied between interventions.

This review highlights the effectiveness of SEEG-guided TLR and RNS in managing drug-resistant TLE. While both interventions reduce seizure burden and improve QoL, seizure freedom rates are higher with resection. However, gaps remain in understanding long-term cognitive outcomes and demographic influences on treatment response. Future research should address these factors to refine patient selection and optimize epilepsy care.

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Commentary Open Access
Insights into Advantages and Limitations of Network Pharmacology in Traditional Chinese Medicine
Xu Zhao, Jingyi Chen, Haowen Zhang, Mengyuan Li
Published online November 26, 2025
Future Integrative Medicine. doi:10.14218/FIM.2025.00043
Original Article Open Access
Bioactive Polyphenolic Compounds and In Vitro Anti-degenerative Property-based Pharmacological Propensities of Some Promising Germplasms of Amaranthus hypochondriacus L.
Manashi Aditya, Silpa Gangopadhyay, Soumen Bhattacharjee
Published online November 26, 2025
Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2025.00037
Abstract
Amaranth is conventionally consumed as a significant source of nutrients and bioactive compounds and is a potential alternate crop. The present study aimed to validate the folklore [...] Read more.

Amaranth is conventionally consumed as a significant source of nutrients and bioactive compounds and is a potential alternate crop. The present study aimed to validate the folklore and ethnomedicinal claims regarding the utilization of foliar tissues of the pseudocereal Amaranthus hypochondriacus L. for their pharmacological propensities, primarily focusing on bioactive polyphenolic compounds and associated anti-degenerative properties, in view of the scarce evidence available on the same.

Reverse-phase high-performance liquid chromatography coupled with a photodiode array assay of nineteen significant bioactive polyphenolic compounds, along with their in vitro antioxidant-based pharmacological properties (superoxide and hydroxyl radical scavenging properties, metal-chelating and reducing properties, radical scavenging properties, anti-lipid peroxidation and protein coagulation properties, and α-glucosidase and α-amylase inhibitory activities), were assessed and compared for foliar extracts of ten promising experimental accessions of Amaranthus hypochondriacus, grown in two different seasons (summer and winter).

The results exhibited germplasm-specific variations in the pharmacological potential of foliar tissues of the experimental amaranths, which can be substantiated by data showing a close correlation between the abundance of bioactive polyphenolic compounds (naringin, myricetin, naringenin, apigenin, rutin, catechin, quercetin) and in vitro antioxidant (2,2-diphenyl-1-picrylhydrazyl, 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assay, hydroxyl radical scavenging, reducing, and metal-chelating) properties, as well as anti-diabetic (inhibition of α-glucosidase and α-amylase activities) and anti-inflammatory (anti-lipid peroxidation) attributes. Accessions IC107144 and IC47434 stood out as the most promising medicinal crops based on overall in vitro anti-degenerative properties and the bioavailability of polyphenolic compounds.

Overall, the results validated the traditional ethnomedicinal claim regarding the utilization of foliar tissues of the underutilized pseudocereal Amaranthus hypochondriacus L., and identified lead germplasms (IC107144 and IC47434) as low-cost natural sources of bioactive compounds, potentially promoting their pharmacological utilization.

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