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Review Article Open Access
Fanyang Kong, Rui Dong, Gong Chen, Song Sun, Yifan Yang, Jingying Jiang, Lingdu Meng, Huifen Chen, Jiajie Zhu, Shan Zheng
Published online January 30, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00260
Abstract
Biliary atresia (BA) is a congenital cholestatic disease that can seriously damage children’s liver function. It is one of the main reasons for liver transplantation in children. [...] Read more.

Biliary atresia (BA) is a congenital cholestatic disease that can seriously damage children’s liver function. It is one of the main reasons for liver transplantation in children. Early diagnosis of BA is crucial to the prognosis of patients, but there is still a lack of reliable non-invasive diagnostic methods. Additionally, as some children are in urgent need of liver transplantation, evaluating the stage of liver fibrosis and postoperative native liver survival in children with BA using a straightforward, efficient, and less traumatic method is a major focus of doctors. In recent years, an increasing number of BA-related biomarkers have been identified and have shown great potential in the following three aspects of clinical practice: diagnosis, evaluation of the stage of liver fibrosis, and prediction of native liver survival. This review focuses on the pathophysiological function and clinical application of three novel BA-related biomarkers, namely MMP-7, FGF-19, and M2BPGi. Furthermore, progress in well-known biomarkers of BA such as gamma-glutamyltransferase, circulating cytokines, and other potential biomarkers is discussed, aiming to provide a reference for clinical practice.

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Research Letter Open Access
Ruoqi Zhou, Yuwei Wang, Xinxin Liu, Xia Yu, Dajing Xia, Yihua Wu, Yu Shi
Published online September 29, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00186
Review Article Open Access
Paolo Gallo, Valentina Flagiello, Andrea Falcomatà, Giulia Di Pasquale, Giorgio D’Avanzo, Francesca Terracciani, Antonio Picardi, Umberto Vespasiani-Gentilucci
Published online January 26, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00207
Abstract
Sarcopenia is a well-known complication of chronic liver disease (CLD), and it is almost always observed in patients with cirrhosis, at least in those with decompensated disease. [...] Read more.

Sarcopenia is a well-known complication of chronic liver disease (CLD), and it is almost always observed in patients with cirrhosis, at least in those with decompensated disease. Since nonalcoholic fatty liver disease (NAFLD), recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), is becoming the leading cause of end-stage liver disease, a new scenario characterized by the frequent coexistence of NAFLD, obesity, and sarcopenia is emerging. Although it is not yet resolved whether the bidirectional relationship between sarcopenia and NAFLD subtends causal determinants, it is clear that the interaction of these two conditions is associated with an increased risk of poor outcomes. Notably, during the course of CLD, deregulation of the liver-muscle-adipose tissue axis has been described. Unfortunately, owing to the lack of properly designed studies, specific therapeutic guidelines for patients with sarcopenia in the context of NAFLD-related CLD have not yet been defined. Strategies aimed to induce the loss of fat mass together with the maintenance of lean body mass seem most appropriate. This can be achieved by properly designed diets integrated with specific nutritional supplementations and accompanied by adequate physical exercise. Future studies aiming to add to the knowledge of the correct assessment and approach to sarcopenia in the context of NAFLD-related CLD are eagerly awaited.

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Original Article Open Access
Xufan Cai, Fang Xu, Zhaohong Wang, Hui Chen, Shengzhang Lin
Published online February 9, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00457
Abstract
Targeted therapy and immunotherapy have emerged as treatment options for hepatocellular carcinoma (HCC) in recent years. The significance of serine and glycine metabolism in various [...] Read more.

Targeted therapy and immunotherapy have emerged as treatment options for hepatocellular carcinoma (HCC) in recent years. The significance of serine and glycine metabolism in various cancers is widely acknowledged. This study aims to investigate their correlation with the prognosis and tumor immune microenvironment (TIME) of HCC.

Based on the public database, different subtypes were identified by cluster analysis, and the prognostic model was constructed through regression analysis. The gene expression omnibus (GEO) data set was used as the validation set to verify the performance of the model. The survival curve evaluated prognostic ability. CIBERSORT was used to evaluate the level of immune cell infiltration, and maftools analyzed the mutations. DsigDB screened small molecule compounds related to prognostic genes.

HCC was found to have two distinct subtypes. Subsequently, we constructed a risk score prognostic model through regression analysis based on serine and glycine metabolism-related genes (SGMGs). A nomogram was constructed based on risk scores and other clinical factors. HCC patients with a higher risk score showed a poor prognosis, and there were significant differences in immune cell infiltration between the high- and low-risk groups. In addition, three potential drugs associated with prognostic genes, streptozocin, norfloxacin, and hydrocotarnine, were identified.

This study investigated the expression patterns of SGMGs and their relationship with tumor characteristics, resulting in the development of a novel model for predicting the prognosis of HCC patients. The study provides a reference for clinical prognosis prediction and treatment of HCC patients.

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Review Article Open Access
Huisen Hu, Yonglei Zhao, Chengbin He, Lujie Qian, Pintong Huang
Published online April 30, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00018
Abstract
Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis [...] Read more.

Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis and patient survival. Ultrasound technology, serving has undergone substantial advances as the primary method of HCC surveillance and has broadened its scope in recent years for effective management of HCC. This article is a comprehensive overview of ultrasound technology in the treatment of HCC, encompassing early detection, diagnosis, staging, treatment evaluation, and prognostic assessment. In addition, the authors summarized the application of contrast-enhanced ultrasound in the diagnosis of HCC and assessment of prognosis. Finally, the authors discussed further directions in this field by emphasizing overcoming existing obstacles and integrating cutting-edge technologies.

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Review Article Open Access
Xiaofeng Feng, Nafei Huang, Yuqin Wu, Fei Gao, Xiaomei Chen, Chenyi Zhang, Bing Zhang, Tao Sun
Published online May 31, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00034
Abstract
Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. It manifests initially as marked hepatocellular steatosis and can progress [...] Read more.

Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. It manifests initially as marked hepatocellular steatosis and can progress to steatohepatitis, liver fibrosis, and cirrhosis. With China’s rapid economic growth, coupled with a complex social background and the influence of a deleterious wine culture, the number of patients with ALD in China has increased significantly; the disease has become a social and health problem that cannot be ignored. In this review, we briefly described the social factors affecting ALD in China and elaborated on differences between alcoholic and other liver diseases in terms of complications (e.g., cirrhosis, upper gastrointestinal bleeding, hepatic encephalopathy, hepatocellular carcinoma, addiction, and other extrahepatic diseases). We also emphasized that ALD was more dangerous and difficult to treat than other liver diseases due to its complications, and that precise and effective treatment measures were lacking. In addition, we considered new ideas and treatment methods that may be generated in the future.

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Original Article Open Access
Xiaoxiao Wang, Huixin Liu, Jinlei Qi, Lijun Wang, Peng Yin, Feng Liu, Lai Wei, Yu Wang, Maigeng Zhou, Huiying Rao
Published online January 22, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00454
Abstract
China accounts for 14.9% of total cirrhosis deaths worldwide. A detailed and comprehensive understanding of the contemporary status of cirrhosis mortality in China is crucial for [...] Read more.

China accounts for 14.9% of total cirrhosis deaths worldwide. A detailed and comprehensive understanding of the contemporary status of cirrhosis mortality in China is crucial for establishing strategies for intervention and decreasing the disease burden of cirrhosis worldwide. The study aimed to report the cirrhosis mortality rates in our whole country or province over time.

Mortality data from 2008 to 2020 were retrieved from the Disease Surveillance Point System (DSPs) of the Chinese Center for Disease Control and Prevention. The crude mortality rate and age-standardized mortality rate of patients with cirrhosis were stratified by sex, residential location, and region. The average annual percentage change (AAPC) in cirrhosis mortality rates from 2008 to 2020 was also calculated.

The crude mortality rate of cirrhosis was 4.57/100,000 people in 2020. Compared with females and individuals living in urban areas, males and people living in rural areas had greater age-standardized mortality. The crude mortality rate and age-standardized mortality rate in provinces in Southwest China (Guangxi, Yunnan, Guizhou, and Qinghai) were greater than those in other provinces. Moreover, with increasing age, the age-specific mortality rate increased significantly. From 2008 to 2020, the mortality rate of cirrhosis in China decreased except for in males aged 50–59 years, females aged 45–49 years and females aged 80–84 years.

The mortality rate of patients with cirrhosis in China decreased from 2008 to 2020. In the future, interventions of cirrhosis mortality control need to pay more attention to all males, females aged 45–49 and 80–84 years, and people living in rural areas and in provinces in Southwest China.

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Original Article Open Access
Shaotian Qiu, Qian Zhang, Jiaxuan Hu, Lewei Wang, Rui Chen, Yingying Cao, Fang Liu, Zhenjun Yu, Caiyan Zhao, Liaoyun Zhang, Wanhua Ren, Shaojie Xin, Yu Chen, Zhongping Duan, Tao Han
Published online January 31, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00379
Abstract
The impact of the characteristics of extrahepatic organ failure (EHOF) including the onset time, number, type, and sequence on the prognosis of acute-on-chronic liver failure (ACLF) [...] Read more.

The impact of the characteristics of extrahepatic organ failure (EHOF) including the onset time, number, type, and sequence on the prognosis of acute-on-chronic liver failure (ACLF) patients remains unknown. This study aimed to identify the association between the characteristics of EHOF and the prognosis of ACLF patients.

ACLF subjects enrolled at six hospitals in China were included in the analysis. The risk of mortality based on the characteristics of EHOF was evaluated. Survival of study groups was compared by Kaplan–Meier analysis and log-rank tests.

A total of 736 patients with ACLF were included. EHOF was observed in 402 patients (54.6%), of which 295 (73.4%) developed single EHOF (SEHOF) and 107 (26.6%) developed multiple EHOF (MEHOF). The most commonly observed EHOF was coagulation failure (47.0%), followed by renal (13.0%), brain (4.9%), respiratory (4.3%), and circulatory (2.3%) failure. Survival analysis found that MEHOF or SEHOF patients with brain failure had a worse prognosis. However, no significant outcome was found in the analysis of the effect of onset time and sequence of failed organs on prognosis. Patients were further divided into three risk subgroups by the EHOF characteristics. Kaplan–Meier analysis showed that risk stratification resulted in the differentiation of patients with different risks of mortality both in the training and validation cohorts.

The mortality of ACLF patients was determined by the number and type, but not the onset time and sequence of EHOF. Risk stratification applicable to clinical practice was established.

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Review Article Open Access
Megh R. Goyal, Anamika Chauhan
Published online September 2, 2024
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Future Integrative Medicine. doi:10.14218/FIM.2023.00089
Abstract
In recent years, there has been a notable shift towards a holistic approach to human health, recognizing the importance of integrating essential nutrients with traditional natural [...] Read more.

In recent years, there has been a notable shift towards a holistic approach to human health, recognizing the importance of integrating essential nutrients with traditional natural medicines. This review article examines the potential synergy between nutrition and traditional healing practices in promoting well-being and disease prevention. It explores the diverse landscape of traditional medicine systems worldwide, highlighting their cultural significance and accumulated wisdom over generations. Moreover, it sheds light on the scientific foundations of these traditional remedies, showcasing their relevance in modern healthcare. Traditional natural medicines, often sourced from plants, animals, or minerals, offer a wide array of therapeutic options addressing root causes rather than symptoms alone. This enduring wisdom has sparked interest in complementing modern healthcare with traditional practices, aiming for a harmonious integration of tradition and evidence-based medicine. Furthermore, the article underscores the critical role of nutrients in maintaining overall health and preventing chronic diseases. It emphasizes the holistic perspective of health, encompassing mental, emotional, and physical well-being. The relationship between nutrition and health is also explored, emphasizing the importance of a balanced diet. The synergy between traditional natural medicines and nutritional interventions presents a promising avenue for a comprehensive approach to healthcare. The article advocates for collaborative research, interdisciplinary dialogue, and cross-cultural exchanges to harness the collective wisdom of the past and present. By embracing both nutrients and traditional medicines, we can move towards achieving optimal health and wellness, recognizing the profound interconnectedness between humans and the natural world.

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Illuminating and Instructive Clinical Case Open Access
Xuemei Zhang, Kun Liu, Xiaona Lu, Wenlan Zheng, Jia Shi, Shihan Yu, Hai Feng, Zhuo Yu
Published online February 19, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00464
Abstract
Hepatocyte nuclear factor 1β (HNF1β) is essential for biliary development, while its genetic defect triggers the dysplasia of interlobular bile ducts, leading to life-threatening [...] Read more.

Hepatocyte nuclear factor 1β (HNF1β) is essential for biliary development, while its genetic defect triggers the dysplasia of interlobular bile ducts, leading to life-threatening hepatitis and cholestasis. To date, this disorder has mainly been documented in neonates. Here, we report a case of cholestasis in an adult patient caused by a de novo HNF1β mutation. A liver biopsy revealed remarkable shrinkage of the portal area accompanied by a decrease or absence of interlobular bile ducts, veins, and arteries in the portal area. Our case showed that an HNF1β defect could induce late-onset cholestasis with paucity of the portal area in adulthood.

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