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Review Article Open Access
Zixin Liang, Shanshan Li, Zhiyu Wang, Junting Zhou, Ziyue Huang, Jiehan Li, Haolin Bao, Judy Wai Ping Yam, Yi Xu
Published online January 14, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00401
Abstract
Hepatocellular carcinoma (HCC) is one of the deadliest malignant tumors in the world, and its incidence and mortality have increased year by year. HCC research has increasingly [...] Read more.

Hepatocellular carcinoma (HCC) is one of the deadliest malignant tumors in the world, and its incidence and mortality have increased year by year. HCC research has increasingly focused on understanding its pathogenesis and developing treatments.The Wnt signaling pathway, a complex and evolutionarily conserved signal transduction system, has been extensively studied in the genesis and treatment of several malignant tumors. Recent investigations suggest that the pathogenesis of HCC may be significantly influenced by dysregulated Wnt/β-catenin signaling. This article aimed to examine the pathway that controls Wnt signaling in HCC and its mechanisms. In addition, we highlighted the role of this pathway in HCC etiology and targeted treatment.

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Review Article Open Access
Weizheng Zhang
Published online January 2, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00199
Abstract
Hyperuricemia (HU), characterized by elevated uric acid (UA) levels in the blood, is a global health concern associated with various conditions, including cardiovascular diseases, [...] Read more.

Hyperuricemia (HU), characterized by elevated uric acid (UA) levels in the blood, is a global health concern associated with various conditions, including cardiovascular diseases, gout, hypertension, metabolic syndrome, renal dysfunction, and neurodegenerative diseases. Recent studies highlight the multifaceted origins of HU, implicating genetic predisposition, dietary patterns, lifestyle choices, and environmental influences. Genetic variations affecting enzymes and transporters involved in purine metabolism and UA excretion have been identified, paving the way for personalized treatment strategies. Advances in diagnostic imaging and omics technologies provide enhanced precision in detecting and evaluating risks. While pharmacological interventions remain central to managing HU, persistent challenges such as treatment resistance necessitate the exploration of novel drug targets and lifestyle modifications. Chinese herbal medicines present a potential alternative with fewer side effects. Emerging research on the impact of gut microbiota on UA metabolism opens new therapeutic avenues. Despite progress, challenges such as optimizing treatment duration and understanding long-term effects remain. Collaborative efforts are essential to address these challenges and advance our comprehension of HU. Integrating precision medicine and holistic patient care approaches holds promise for improving outcomes and enhancing the quality of life for individuals with HU. This review provided a contemporary analysis of HU, covering its causes, associated health risks, diagnosis, treatment, and future outlook.

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Original Article Open Access
Huizhong Ji, Bin Song, Xuehui Li, Hui Chen, Xueli Sun, Tian Tian, Yang Geng, Xin Wang, Hengzhong Zhang, Yumei Wu, Yan Liu, Changjun Pei, Ling Cao
Published online December 31, 2024
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00400
Abstract
Waist circumference (WC) is closely associated with metabolic diseases, including diabetes mellitus (DM), metabolic syndrome, and mortality. However, the correlation between WC [...] Read more.

Waist circumference (WC) is closely associated with metabolic diseases, including diabetes mellitus (DM), metabolic syndrome, and mortality. However, the correlation between WC and mortality varies across populations and has rarely been examined specifically in patients with DM. In this study, we explored the relationships between WC and both all-cause and cardiovascular mortalities among individuals with DM.

Participants from the National Health and Nutrition Examination Survey 2003–2018 included 3,151 women and 3,473 men with DM who had baseline WC measurements. Survival data were collected from enrollment until December 31, 2019. Cox proportional hazard models were adjusted for demographic features and other confounders. Restricted cubic spline curves and threshold effect analyses were performed separately for men and women. Sensitivity analyses were conducted to minimize reverse causality.

Among 6,624 participants with DM, 621 women and 871 men died during median follow-ups of 6.8 and 6.3 years, respectively. WC demonstrated a U-shaped association with all-cause and cardiovascular mortalities in women, and a J-shaped trend in men. The optimal WC thresholds for minimizing mortality risk were 107.0 cm for women and 89.0 cm for men. For women, adjusted hazard ratios for all-cause mortality were 0.97 (95% confidence interval (CI): 0.96–0.98, P < 0.001) for WC below 107.0 cm and 1.04 (95% CI: 1.02–1.05, P < 0.001) for WC above 107.0 cm. In men, the corresponding ratios were 0.94 (95% CI: 0.90–0.97, P < 0.001) for WC below 89.0 cm and 1.03 (95% CI: 1.02–1.05, P < 0.001) for WC above 89.0 cm.

WC showed a U-shaped association with all-cause and cardiovascular mortalities in women and a J-shaped association in men among U.S. adults with DM from the National Health and Nutrition Examination Survey. Further research is needed to explore the underlying mechanisms rather than promoting preconceived notions about an optimal WC.

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Original Article Open Access
Yali Wan, Yuxin Zhan, Yuanjue Wu, Ping Yao, Yi Chen, Zhaoyu Xiong, Jiaohua Yu, Rong Yan, Suyun Li
Published online December 31, 2024
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Neurosurgical Subspecialties. doi:10.14218/NSSS.2024.00005
Abstract
Proper nutritional management has been shown to reduce complications and lead to better clinical outcomes. However, inaccurate nutritional screening and assessment, inappropriate [...] Read more.

Proper nutritional management has been shown to reduce complications and lead to better clinical outcomes. However, inaccurate nutritional screening and assessment, inappropriate nutrition support, and deviations from suggested guidelines were observed in clinical practice. We aimed to investigate the nutritional status and support of hospitalized patients with neurological diseases to identify deficiencies in nutritional assessment and treatment.

A self-designed questionnaire, developed through a literature review, group discussions, and expert consultation, was converted into an electronic form to conduct a cross-sectional survey in a tertiary-level general hospital. The patients’ basic information and the first nutrition assessment were filled out upon admission. The final nutrition assessment were logged at discharge, transfer out, or death. Two-person cross-entry was used to ensure the accuracy of data input.

A total of 620 patients were enrolled in this study. Of these, 24.4% were at nutritional risk upon admission, and 22.7% were identified as at nutritional risk in the final assessment. There were no statistically significant differences in nutritional status between the first and final assessments, except for serum albumin concentration. A total of 118 patients (19.0%) received nutrition therapy. Complications occurred in 35 (45.5%) patients treated with enteral nutrition and 29 (30.5%) patients treated with parenteral nutrition.

The incidence of nutritional risk in inpatients with neurological diseases enrolled in this study was relatively low. However, nutritional treatment in this study was not sufficiently standardized. Nurses are needed to receive relevant professional training to improve quality of nutritional interventions.

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Mini Review Open Access
Jixiang Li, Liang Zeng, Tong Feng
Published online January 7, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00048
Abstract
Patients with obstructive sleep apnea (OSA) and metabolic syndrome (MetS) have a higher prevalence and mortality rate of cardiovascular diseases, posing a significant burden on [...] Read more.

Patients with obstructive sleep apnea (OSA) and metabolic syndrome (MetS) have a higher prevalence and mortality rate of cardiovascular diseases, posing a significant burden on both individuals and society. Although the precise pathophysiological relationship between OSA and MetS remains unclear, their bidirectional interaction may create a harmful cycle of mutual reinforcement. This review explored the current treatment progress for OSA and MetS, including continuous positive airway pressure therapy, weight management, and metabolic surgeries. Studies indicate that while continuous positive airway pressure therapy effectively alleviates OSA symptoms, its impact on metabolic markers is limited, emphasizing the importance of long-term weight control. Metabolic surgeries, such as gastric bypass and sleeve gastrectomy, significantly reduce weight and directly improve metabolic abnormalities associated with MetS, such as insulin resistance and dyslipidemia, thereby lowering the risk of cardiovascular diseases. In contrast, mandibular advancement devices primarily improve symptoms of OSA and indirectly enhance metabolic function by improving sleep quality and reducing intermittent hypoxemia. Although mandibular advancement devices have a limited direct impact on metabolic parameters, they may offer potential benefits in lowering blood pressure and managing MetS. Understanding and breaking the cycle between OSA and MetS can significantly reduce the associated cardiovascular risks.

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Review Article Open Access
Weiqiang Zhao
Published online December 30, 2024
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2024.00042
Abstract
The number of molecular abnormalities identified in hematopoietic and lymphocytic neoplasms has grown exponentially over the past decades. Patients with genetic biomarker-matched [...] Read more.

The number of molecular abnormalities identified in hematopoietic and lymphocytic neoplasms has grown exponentially over the past decades. Patients with genetic biomarker-matched targeted therapies have experienced significantly improved survival rates. Modern molecular laboratories, equipped with advanced technologies such as next-generation sequencing, can simultaneously test hundreds of genes and thousands of hotspots in a single run with multiple samples analyzed side by side. Bioinformatics tools provide seamless, evidence-based information to determine whether the detected mutations are benign or pathogenic, somatic or germline, druggable or diagnostic. This review is divided into five sections, each aiming to provide a comprehensive overview of the genetic landscape of myeloid and lymphocytic neoplasms. It highlights the challenges and proposes potential solutions to facilitate interpretation and maximize the clinical utility of molecular profiling results.

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Commentary Open Access
Lei Huang, Tong Feng
Published online January 2, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00700
Original Article Open Access
Ceren Utku, Deniz Nart, Gurdeniz Serin, Duygu Doga Ekizalioglu, Tufan Gumus, Alper Uguz, Funda Yilmaz
Published online December 30, 2024
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2024.00045
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by distinct histological subtypes and a poor prognosis. Among these, the micropapillary pattern, [...] Read more.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by distinct histological subtypes and a poor prognosis. Among these, the micropapillary pattern, typically observed focally, has been associated with worse outcomes in various cancers. This study aimed to evaluate the prognostic significance of the micropapillary pattern in PDAC, focusing on its percentage within the tumor and its impact on overall survival.

A retrospective analysis was conducted on 71 patients with surgically resected PDAC. Micropapillary patterns were categorized based on their percentage within the tumor (≥20%) and compared to non-micropapillary cases. Demographic, clinical, and histological data, including tumor nodule metastasis stage, tumor grade, peripancreatic fat tissue invasion, and resection margin status, were analyzed. Survival data were assessed using Kaplan-Meier and Cox proportional hazards models. A p-value < 0.05 was considered statistically significant.

The cohort included 28 female and 43 male patients, with a mean age of 63.25 years. Of the 71 cases, 23.9% (n = 17) exhibited a micropapillary pattern. The median overall survival for the micropapillary group was eight months, compared to 18 months for the non-micropapillary group (p = 0.017). Multivariate analysis revealed that the micropapillary group had an increased risk of mortality (hazard ratio = 1.892, p = 0.042), independent of tumor nodule metastasis stage.

Our findings indicate that the micropapillary pattern, even when present in as little as 20% of the tumor, serves as an independent prognostic factor for decreased survival in PDAC. Incorporating the percentage of the micropapillary pattern into pathology reports could provide valuable insights into the tumor’s biological behavior, potentially enhancing patient management strategies.

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Editorial Open Access
Amancio Carnero, Hua Wang
Published online January 15, 2025
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Gene Expression. doi:10.14218/GE.2025.00000
Review Article Open Access
Xin-Lei Li, Gang Zhou
Published online December 30, 2024
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Cancer Screening and Prevention. doi:10.14218/CSP.2024.00025
Abstract
Oral potentially malignant disorders (OPMDs), characterized by a wide variety of types and diverse clinical manifestations, have always been difficult to diagnose and differentiate. [...] Read more.

Oral potentially malignant disorders (OPMDs), characterized by a wide variety of types and diverse clinical manifestations, have always been difficult to diagnose and differentiate. All of them carry a risk of malignant transformation. In addition to pathological examination, which remains the gold standard, various auxiliary diagnostic tests are used in clinical practice. Deep learning, a branch of artificial intelligence, has been applied to medical image analysis. Among deep learning techniques, convolutional neural networks are commonly used for image segmentation, detection, classification, and computer-aided diagnosis. We reviewed several image analysis methods based on deep learning neural networks for the diagnosis and prognosis of OPMDs, including photographic images, autofluorescence images, exfoliative cytology images, histopathological images, and optical coherence tomography images. Additionally, we assessed the current limitations and challenges in applying deep learning to the diagnosis of OPMDs.

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