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Mini Review Open Access
Hongyu Mu, Jiangning Peng, Ling Yao, Lin Tang, Tianqi Wang
Published online September 4, 2025
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Future Integrative Medicine. doi:10.14218/FIM.2025.00027
Abstract
Ginseng, a traditional Chinese medicinal herb, has been used for centuries to enhance vitality and overall well-being. This review synthesizes multiple studies to summarize the [...] Read more.

Ginseng, a traditional Chinese medicinal herb, has been used for centuries to enhance vitality and overall well-being. This review synthesizes multiple studies to summarize the latest discoveries on the immunoregulatory effects of ginseng, its role in improving patients’ quality of life, and new evidence of its antitumor properties. It concludes that ginseng and its extracts can improve patients’ quality of life and may have the potential to target tumor cells. Meanwhile, ginseng extracts significantly improve sub-health status, with an 85% improvement rate observed in young adults after 30 days of intervention. This review provides valuable new evidence for ongoing research on ginseng and its extracts.

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Review Article Open Access
Houyan Zhang, Dongjie Wu, Qingjuan Wu, Yanxuan Wu, Ziwei Guo, Li Wang, Yi Wang, Qian Zeng, Liang Shi, Bin Shi, Gongchang Yu, Wenliang Lv
Published online September 3, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00259
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), the most common chronic liver disorder worldwide, results from multidimensional network dysregulation involving [...] Read more.

Metabolic dysfunction-associated steatotic liver disease (MASLD), the most common chronic liver disorder worldwide, results from multidimensional network dysregulation involving lipid metabolism imbalance, insulin resistance, oxidative stress, chronic inflammation, and gut-liver axis disruption. Silent information regulator 1 (SIRT1), an NAD+-dependent deacetylase, functions as a central regulator of metabolic homeostasis and a key mediator in immune microenvironment remodeling and inter-organ communication. This review systematically describes the multi-target mechanisms of SIRT1 in MASLD pathogenesis through its regulation of critical factors, including peroxisome proliferator-activated receptor gamma coactivator 1-α, Forkhead Box O, and nuclear factor kappa-light-chain-enhancer of activated B cells, which govern hepatocyte lipid remodeling, mitochondrial quality control, autophagy–endoplasmic reticulum stress balance, and Kupffer cell/T cell polarization. This work introduces, for the first time, the concept that SIRT1 mediates systemic regulation of MASLD via coordinated “metabolism–inflammation–organ axis” interactions. Recent studies indicate that natural compounds (e.g., resveratrol, curcumin) improve gut-liver barrier function through microbiota–SIRT1 interactions, while synthetic activators (SRT1720) and NAD+ precursors (NMN) enhance hepatocyte antioxidant capacity and fatty acid β-oxidation. This innovative analysis highlights the spatiotemporal specificity of various SIRT1 activators, emphasizing that tissue-selective delivery and dynamic dosage optimization are crucial for overcoming clinical translation challenges. By integrating mechanistic and translational insights, this review provides a novel foundation for precision intervention strategies targeting SIRT1 network reprogramming.

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Mini Review Open Access
Valeria M. Fernández-Garibay, Mariana M. Ramírez-Mejia, Guadalupe Ponciano-Rodriguez, Ran Wang, Xingshun Qi, Nahum Méndez-Sánchez
Published online September 3, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00279
Abstract
Persistent liver injury halts the regenerative capacity of hepatocytes and activates mechanisms that result in the replacement of normal hepatic parenchyma with extracellular matrix [...] Read more.

Persistent liver injury halts the regenerative capacity of hepatocytes and activates mechanisms that result in the replacement of normal hepatic parenchyma with extracellular matrix deposits. As liver fibrosis develops, the liver undergoes architectural changes and alterations in microcirculation that lead to increased intrahepatic vascular resistance and portal hypertension. Thrombocytopenia is a prevalent condition in patients with chronic liver disease and portal hypertension. Multiple mechanisms related to increased platelet destruction or decreased platelet production contribute to thrombocytopenia. Increased platelet destruction occurs due to splenic sequestration caused by hypersplenism or immune-mediated conditions. Decreased platelet production results from a decline in thrombopoietin production, bone marrow suppression by medications, or toxic insults. Therapies aimed at improving thrombocytopenia are controversial, and individual factors must be considered. Although hepatic venous pressure gradient measurement is the gold standard for diagnosing portal hypertension, non-invasive tests show adequate correlation with hepatic venous pressure gradients. Various clinical risk scores consider platelet counts as independent predictors of adverse liver outcomes, such as the development of esophageal varices and the presence of advanced fibrosis. Nonselective beta-blockers are the cornerstone of long-term management for clinically significant portal hypertension. Indications for transjugular intrahepatic portosystemic shunt placement include failure to control portal hypertension-related bleeding, early rebleeding, and refractory or recurrent ascites. Ultimately, liver transplantation is the only definitive cure for portal hypertension and its major complications, including thrombocytopenia. Understanding the mechanisms underlying thrombocytopenia in patients with portal hypertension and chronic liver disease is essential for accurate diagnosis and effective patient management. This review aimed to evidence on the pathophysiological mechanisms linking chronic liver disease, portal hypertension, and thrombocytopenia, and to discuss their diagnostic and therapeutic implications.

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Review Article Open Access
Xiansong Zhu, Jingmin Cheng, Tao Yang, Kexia Fan, Yuan Ma, Yongxiang Yang
Published online September 25, 2025
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Neurosurgical Subspecialties. doi:10.14218/NSSS.2025.00023
Abstract
Chronic subdural hematoma (CSDH) is a common disease in neurosurgery, with epidemiological characteristics showing an overall annual incidence of 1.7–20.6 per 100,000 people and [...] Read more.

Chronic subdural hematoma (CSDH) is a common disease in neurosurgery, with epidemiological characteristics showing an overall annual incidence of 1.7–20.6 per 100,000 people and a higher prevalence in the elderly. However, despite the increased disease burden, there have been limited breakthroughs in treatment options over the past 20 years. A significant gap exists in our understanding of the exact pathophysiological mechanism of CSDH, leading to a lack of specific clinical treatment options based on a clear pathological mechanism. Current research suggests that the development of CSDH involves dual mechanisms of trauma and inflammation, and that these pathologic processes together promote pathological changes such as angiogenesis, inflammatory response, and neovascularization. Therapies for CSDH encompass both surgical (e.g., twist-drill drainage, burr-hole drainage, craniotomy) and non-surgical approaches (e.g., clinical observation, medication, intracranial pressure monitoring, anticoagulation). Meanwhile, middle meningeal artery embolization, as an emerging minimally invasive interventional technique, has shown good prospects for clinical application. This review aims to bridge the gap between current treatment options and the need for effective strategies by providing a comprehensive summary of the epidemiological trends, pathophysiological advances, and optimization of therapeutic strategies for CSDH.

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Review Article Open Access
Pavel Ivanov, Natalia Todosenko, Kristina Yurova, Olga Khaziakhmatova, Larisa Litvinova
Published online October 30, 2025
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Gene Expression. doi:10.14218/GE.2025.00058
Abstract
Characteristic signs of alopecia are gradual thinning, disruption of structural features, and the hair development cycle (anagen, catagen, telogen) against the background of miniaturization [...] Read more.

Characteristic signs of alopecia are gradual thinning, disruption of structural features, and the hair development cycle (anagen, catagen, telogen) against the background of miniaturization of hair follicles, which leads to baldness and psychological stress in patients. Despite the rapid development and clinical application of synthetic pharmacological, cellular/acellular, and molecular drugs, no effective therapeutic agent against alopecia has yet been developed. Great hopes are pinned on the improvement of therapeutic strategies with the introduction of exosomes into practical application, which contain a wide array of active substances for the targeted stimulation of hair follicle activity (anagen inducers) through the regulation of intracellular signaling cascades, growth factors, and microRNAs. The review discusses in detail the microRNAs and their intracellular targets that control hair follicle morphogenesis. It also focuses on the prospects of using stem cell exosomes from various sources for the treatment of alopecia, providing a clinical rationale for potential benefits and risks.

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Review Article Open Access
Swarup K. Chakrabarti, Dhrubajyoti Chattopadhyay
Published online July 1, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00018
Abstract
Type 2 diabetes (T2D) is a metabolic disorder characterized by insulin resistance (IR), inflammation, and dysregulation in glucose metabolism. The disease is spreading globally, [...] Read more.

Type 2 diabetes (T2D) is a metabolic disorder characterized by insulin resistance (IR), inflammation, and dysregulation in glucose metabolism. The disease is spreading globally, partly due to aging, which can damage the immune system and speed up the progression of the metabolic disorder. This review primarily delves into the triggers for T2D within the framework of the ominous octet, which emphasizes 8 principal factors under the “ominous octet” framework that contribute to high blood glucose and associated metabolic disorders. The article studies the interplay of hyperinsulinemia, mitochondrial dysfunction (MD), and endoplasmic reticulum (ER) stress with immune aging in driving disease progression affecting each component of the octet. MD and ER stress can result in defects in insulin signaling, ultimately leading to β-cell death. Chronic inflammation associated with aging, also known as inflammaging, especially affects older adults by worsening IR and glucose regulation, which creates a continuous sequence of metabolic problems. Thus, the “ominous octet” framework provides fundamental knowledge to develop personalized treatment approaches that target metabolic dysfunction together with ER stress, MD, and immune system imbalances. These strategies show promising potential to improve treatments for T2D and may lead to better health outcomes for older adults dealing with this condition.

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Review Article Open Access
Narmadhaa Sivagurunathan, Latchoumycandane Calivarathan
Published online July 21, 2025
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Gene Expression. doi:10.14218/GE.2025.00001
Abstract
Acetaminophen (APAP) is one of the most commonly used analgesic and antipyretic medications and is generally considered safe at therapeutic doses. However, overdose remains a leading [...] Read more.

Acetaminophen (APAP) is one of the most commonly used analgesic and antipyretic medications and is generally considered safe at therapeutic doses. However, overdose remains a leading cause of acute liver failure, primarily characterized by centrilobular (zone 3) hepatic necrosis, oxidative stress, mitochondrial dysfunction, and sterile inflammation. The hepatotoxic effects of APAP are localized to the centrilobular region, where cytochrome P450 2E1 is highly expressed. Cytochrome P450 2E1 catalyzes the conversion of APAP to a toxic metabolite, N-acetyl-p-benzoquinone imine. During overdose, the liver’s detoxification capacity is overwhelmed and excess N-acetyl-p-benzoquinone imine binds to cellular proteins, initiating oxidative stress and mitochondrial injury that culminate in hepatocyte death. A central component of APAP-induced hepatotoxicity is the activation of innate immune responses, particularly via inflammasome pathways. Inflammasomes are cytosolic multiprotein complexes that detect cellular damage and trigger inflammation. Among these, the NOD-, LRR-, and pyrin domain-containing 3 (NLRP3) inflammasome plays a significant role in APAP-induced liver injury. Upon activation, the NLRP3 inflammasome promotes autocatalytic cleavage of procaspase-1 into its active form, caspase-1, which subsequently processes the pro-inflammatory cytokines pro-interleukin-1β and pro-interleukin-18 into their mature forms. These cytokines recruit additional immune cells and amplify liver inflammation, exacerbating tissue injury. Thus, the NLRP3 inflammasome serves as a key mechanistic link between the initial toxic insult and the ensuing inflammatory response in APAP hepatotoxicity. This review aimed to explore the molecular mechanisms underlying APAP-induced liver injury, particularly inflammasome activation, and evaluate the current and emerging therapeutic strategies.

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Review Article Open Access
Jin Zhang, Rong Li, Xueqin Tan, Chuang Wang
Published online August 7, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00099
Abstract
Recent advancements in cancer immunotherapy have highlighted glypican-3 (GPC3) as a prominent target for treating hepatocellular carcinoma (HCC). However, approximately 10% to 30% [...] Read more.

Recent advancements in cancer immunotherapy have highlighted glypican-3 (GPC3) as a prominent target for treating hepatocellular carcinoma (HCC). However, approximately 10% to 30% of HCC patients exhibit low or absent GPC3 expression on the surface of tumor cells, which limits the feasibility of GPC3-targeted therapies. Consequently, it is essential for patients to undergo pre-diagnostic assessments of GPC3 expression in tumor cells to evaluate their suitability for GPC3-directed therapy. Although various methods have been developed to specifically detect GPC3 as a biomarker for treatment and prognosis, the diagnostic approaches currently employed in clinical studies remain relatively limited. Here, we provide a comprehensive overview of the clinical development of GPC3-targeted therapeutics, clinical trials in GPC3-positive HCC, and current methods for detecting GPC3 expression, highlighting their advantages and limitations. Furthermore, we explore the potential of integrating targeted therapy with various GPC3 detection modalities tailored to different pathological stages. This integration not only provides insights into the selection of effective methods for detecting GPC3 expression but also has the potential to significantly improve the clinical outcomes of patients with liver cancer. By simultaneously assessing the advantages and disadvantages of these methods, this review aims to establish a theoretical foundation for the clinical selection of appropriate GPC3 detection strategies for targeted therapy.

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Original Article Open Access
Lotfi Salhi, Khawla Moussa, Ridha Ben Salah
Published online January 15, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00032
Abstract
Lung cancer remains the leading cause of cancer-related mortality worldwide. Early detection of pulmonary nodules is crucial for timely diagnosis and effective treatment. Conventional [...] Read more.

Lung cancer remains the leading cause of cancer-related mortality worldwide. Early detection of pulmonary nodules is crucial for timely diagnosis and effective treatment. Conventional computer-aided detection systems have shown limitations, including high false-positive rates and low sensitivity. Recent advances in deep learning, particularly convolutional neural networks (CNNs), have shown great potential in improving the accuracy and reliability of nodule detection and classification. This study aimed to develop and evaluate an automatic method for lung nodule detection and classification using a CNN-based architecture applied to computed tomography images from the publicly available LIDC-IDRI database.

This retrospective study was conducted on 82 patients (10,496 computed tomography slices) selected from the LIDC-IDRI database. The proposed method consists of five main steps: image preprocessing, lung parenchyma segmentation using Otsu’s thresholding and morphological operations, detection of nodule candidates, feature extraction, and classification using a CNN model. The CNN architecture includes two convolutional layers (20 and 30 filters, 3×3 kernel), ReLU activation, max-pooling layers, and a Softmax output layer. The network was trained with a mini-batch size of 32 for 50 epochs using the Stochastic Gradient Descent with Momentum optimizer (learning rate = 0.001, momentum = 0.9). Model performance was evaluated in terms of sensitivity, specificity, precision, and accuracy.

The proposed CNN model successfully detected pulmonary nodules and achieved accurate classification between benign and malignant nodules. On the LIDC-IDRI dataset, the model achieved a sensitivity of 98.7%, specificity of 97.5%, precision of 97.9%, and accuracy of 98.4%. Comparative analysis with recent studies, including hybrid CNN-long short-term memory and ResNet-based models, demonstrated that the proposed method provides competitive performance while maintaining lower computational complexity. The classification of nodule subtypes (solid, partially frosted, totally frosted) showed satisfactory discrimination results.

The proposed CNN-based system demonstrates the feasibility and robustness of deep learning for automatic lung nodule detection and classification. Despite strong results, the study acknowledges limitations such as single-database validation and a relatively small training size. Future work will focus on validating the model across other datasets (e.g., ELCAP, NELSON) and optimizing multi-class classification performance to enhance generalizability and clinical applicability.

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Consensus Open Access
Suxian Zhao, Jie Li, Lingdi Liu, Sha Huang, Yanhang Gao, Mei Liu, Yu Chen, Lai Wei, Jidong Jia, Hong You, Zhongping Duan, Hui Zhuang, Jingfeng Liu, Xiaoyuan Xu, Yuemin Nan, Chinese Society of Hepatology, Chinese Medical Association
Published online September 12, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00228
Abstract
With the widespread application of systemic treatments for hepatocellular carcinoma, liver injury caused by molecular targeted drugs and immune checkpoint inhibitors has become [...] Read more.

With the widespread application of systemic treatments for hepatocellular carcinoma, liver injury caused by molecular targeted drugs and immune checkpoint inhibitors has become a common clinical problem. The Chinese Society of Hepatology, Chinese Medical Association, organized domestic experts to summarize and analyze adverse liver reactions, as well as advances in the diagnosis and treatment related to systemic therapy for liver cancer, both domestically and internationally. Based on this work, we formulated the “Consensus on the Management of Liver Injury Associated with Targeted Drugs and Immune Checkpoint Inhibitors for Hepatocellular Carcinoma”, aiming to provide practical recommendations and decision-making guidance for clinicians in hepatology and related specialties. This guidance focuses on the monitoring, diagnosis, prevention, and treatment of liver injury during targeted and immune checkpoint inhibitor therapy, ultimately helping more liver cancer patients benefit from targeted immunotherapy.

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