Hepatic sinusoidal obstruction syndrome (SOS) is characterized by hepatic sinusoidal endothelial cell injury and detachment, hepatic sinusoidal congestion, and hepatic cell necrosis. Currently, limited data exist concerning changes during the recovery period, especially histopathological changes. The purpose of this study was to investigate the evolution of pathology in patients with pyrrolizidine alkaloid (PA)-induced SOS and in a monocrotaline-induced SOS rat model.

Patients diagnosed with PA-induced SOS who underwent liver biopsy after achieving clinical remission were consecutively enrolled in this retrospective study. To compare the clinical and pathological differences between patients with acute and convalescent SOS, a 2:1 matched analysis was performed based on age, sex, treatment regimen, and baseline Drum Tower Severity Scoring (DTSS) during the acute phase. Additionally, an animal model of PA-induced SOS was established through the administration of monocrotaline.

Fourteen consecutive patients with SOS who had adequate liver biopsy specimens obtained during recovery were identified. During convalescence, most laboratory and imaging findings, such as the map-like enhancement observed on computed tomography, also disappeared. However, histopathological analysis revealed a distinct shift from hepatic sinusoidal endothelial cell injury in the acute phase to portal tract abnormalities, primarily characterized by portal vein stricture, in the recovery phase. These pathological changes were corroborated in our animal model.

Our study suggests that both patients with PA-induced SOS and rats in the convalescent stage may exhibit porto-sinusoidal vascular disease-like changes. Regular follow-up and dynamic pathological assessment are therefore recommended to facilitate the early detection of potential signs of portal hypertension.

Standardized pathologic sampling and reporting are essential for pancreatic cancer staging, prognosis assessment, and comparable clinical data. This guideline aimed to develop evidence-based recommendations for standardized pathologic sampling and diagnostic reporting of pancreatic cancer in China. Literature searches were conducted in English and Chinese databases, guideline websites, Google, and reference lists for records published before December 31, 2023. Two investigators screened and extracted the evidence; methodological quality and certainty were assessed using AMSTAR/AGREE II and GRADE, respectively; and recommendations were formulated through two rounds of modified Delphi consultations, with an agreement threshold of ≥ 75% for consensus. The final guideline includes 11 recommendations, including six strong and five weak recommendations, addressing margin and surface assessment, sampling methods, histologic classification and grading, lymphovascular and perineural invasion, TNM staging, tumor regression grading after neoadjuvant therapy, background lesions, and structured reporting. These recommendations provide a standardized framework for pathologic assessment and reporting of pancreatic cancer resection specimens and may support more consistent prognostic evaluation and clinical decision-making.

Balloon-occluded transarterial chemoembolization (B-TACE) has emerged as a significant advancement in the locoregional treatment of hepatocellular carcinoma. This technique utilizes a balloon microcatheter selectively placed in target hepatic arteries to occlude blood flow and enhance drug accumulation within tumors while minimizing systemic exposure. The feasibility, safety, and effectiveness of the balloon occlusion technique have been verified. Recent studies have demonstrated that B-TACE achieves superior tumor response rates and potentially improves survival outcomes compared with conventional transarterial chemoembolization (C-TACE) techniques, particularly in cases with complex tumor vasculature or C-TACE-refractory disease. However, determining which patients would benefit from B-TACE requires comprehensive assessment. It remains to be determined in clinical practice whether this technique increases the risk of liver function impairment or is associated with specific complications. Further research is needed to better understand the technical conditions required for its clinical application, prognostic factors, and how it can be combined with other interventional techniques. This review summarizes the current literature on B-TACE, focusing on its technical principles, clinical efficacy, safety profile, and evolving role within the contemporary treatment landscape for advanced hepatocellular carcinoma, including its integration with systemic therapies.

Viral hepatitis caused by A to E imposes a substantial global burden of liver disease. Despite US control strategies, long-term national data covering serologic markers of all five hepatitis viruses remain limited. In this study, we analyzed epidemiologic trends from 2011 to 2023 and aimed to identify prevention gaps.

We analyzed National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2023 using weighted logistic regression, with stratification by age, sex, and race/ethnicity.

Current hepatitis B virus (HBV) infection remained stable at 0.3%, while HBV susceptibility was 71.3%. Among individuals born in 1991 or later, HBV vaccination coverage declined from 90.0% to 83.6% during 2011–2020 (P for trend = 0.012); 57.0% of participants reporting vaccination were serologically susceptible. Anti-HDV positivity among participants with current HBV infection was 1.3%. Anti-hepatitis C virus (HCV) seroprevalence remained 1.6%, while active HCV viremia decreased from 0.8% to 0.4%, and viremia among anti-HCV-positive participants fell from 65.5% to 31.3% (P = 0.004). Hepatitis A virus antibody seroprevalence increased from 41.6% to 48.0% (P < 0.001) with stable vaccination coverage. Anti-HEV IgM positivity increased from 1.6% to 1.7% (P = 0.004).

US viral hepatitis trends diverged from 2011 to 2023. The decrease in detectable HCV RNA was consistent with progress in HCV control, whereas persistent HBV susceptibility, declining vaccination coverage in younger birth cohorts, and increasing hepatitis A virus seroprevalence and hepatitis E virus IgM positivity indicate ongoing prevention and surveillance needs.

Traumatic brain injury (TBI) induces neuroimmune activation and metabolic reprogramming in microglia, but the transcriptional regulators underlying these responses remain unclear. This study aimed to integrate single-cell and bulk transcriptomic datasets to identify microglia-associated regulatory genes and characterize their potential roles in post-TBI neuroinflammatory and immunometabolic dysregulation.

We integrated single-cell RNA sequencing data (GSE101901) with a bulk training dataset (GSE58485) and an independent bulk validation dataset (GSE242025) from murine TBI models. hdWGCNA, differential expression, pseudotime, CIBERSORT, and in silico transcription factor binding-site analyses were performed to identify and characterize candidate genes. Key-gene expression was additionally validated by RT-qPCR in male C57BL/6 mice assigned to Sham and TBI groups (n = 5 per group). The Drug Gene Interaction Database was used for exploratory drug-gene prediction.

Single-cell profiling suggested descriptive shifts in the proportions of microglia, astrocytes, and neurons after TBI. hdWGCNA identified 90 microglia-associated genes, 43 of which overlapped with nominally differentially expressed genes; 89 genes met the Benjamini–Hochberg-adjusted P < 0.05 threshold in the bulk analysis. Cross-dataset validation identified increased Ccl4 and Lgals3 expression and decreased Egr1 expression. Motif scanning identified four predicted EGR1 motif occurrences in the Ccl4 promoter and six occurrences at three unique locations in the Lgals3 promoter. RT-qPCR in TBI and Sham mice (n = 5 per group) supported the same directional expression changes in Ccl4, Lgals3, and Egr1.

A candidate Ccl4/Lgals3/Egr1 expression pattern characterized by Ccl4 and Lgals3 upregulation and Egr1 downregulation was associated with post-TBI neuroinflammatory and immunometabolic changes. Further mechanistic validation is required.

Endovascular embolization is a cornerstone treatment for intracranial aneurysms, and transfemoral access (TFA) has traditionally been the default vascular route. Transradial access (TRA) is increasingly used in neurointervention because it may reduce clinically important access-site complications, improve postprocedural comfort, and facilitate earlier ambulation. This narrative review aims to summarize direct and indirect evidence comparing TRA and TFA for intracranial aneurysm embolization, with attention to technical feasibility, access conversion, puncture-site complications, neurological events, radiation exposure, procedure duration, recovery, and cost considerations. Direct comparative evidence specific to aneurysm embolization remains limited and is mainly observational; some supporting data come from diagnostic cerebral angiography, mixed therapeutic neurointervention, and cardiovascular access literature. Available data suggest that TRA may be a safe and feasible option for selected patients when performed by experienced operators, particularly when radial anatomy is favorable and the intended device strategy is compatible with upper-extremity access. TFA remains essential for complex anatomy, large-bore device requirements, or insufficient TRA expertise. Access selection should therefore be individualized rather than based on a presumption of universal superiority. Well-designed multicenter studies are needed to define aneurysm-specific outcomes, long-term angiographic durability, patient-reported outcomes, and cost-effectiveness.