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Review Article Open Access
Ciro Comparetto, Franco Borruto
Published online March 30, 2025
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Cancer Screening and Prevention. doi:10.14218/CSP.2024.00032
Abstract
Breast cancer remains one of the leading causes of cancer-related deaths worldwide. Early detection of breast cancer significantly improves outcomes and survival rates, minimizing [...] Read more.

Breast cancer remains one of the leading causes of cancer-related deaths worldwide. Early detection of breast cancer significantly improves outcomes and survival rates, minimizing treatments. Imaging techniques are critical in identifying abnormalities and diagnosing breast cancer at its earliest stages, often before clinical symptoms emerge. Mammography remains standard for screening in average-risk women, while supplementary methods like ultrasound, magnetic resonance imaging, and tomosynthesis enhance detection rates, particularly in women with dense breasts or those at high risk. Given that certain factors, such as family history, age, genetic mutations, and breast density, affect the risk of developing breast cancer, some women may benefit from earlier or more frequent screenings. Personalized screening protocols are becoming more common, tailoring the type and frequency of imaging to the individual’s risk profile. Newer technologies, such as molecular breast imaging and contrast-enhanced mammography show promise but require further validation for widespread use. In conclusion, imaging techniques including mammography, ultrasound, magnetic resonance imaging, and newer technologies like three-dimensional mammography and molecular breast imaging are essential tools in the early detection of breast cancer, leading to better outcomes for patients. This literature review provides an overview of current breast cancer imaging methods, their role in early diagnosis, and their effectiveness and limitations.

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Consensus Open Access
Xiaoyuan Xu, Yujuan Guan, Jinghang Xu, Song Yang, Yifan Han, Jidong Jia, Yuemin Nan, Lai Wei, Zhongping Duan, Hui Zhuang, Liver Fibrosis, Cirrhosis and Portal Hypertension Group, Chinese Society of Hepatology, Chinese Medical Association
Published online April 24, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00105
Abstract
Thrombocytopenia in cirrhosis presents significant challenges in clinical practice. To help clinicians rapidly understand and standardize the diagnosis and treatment of this condition, [...] Read more.

Thrombocytopenia in cirrhosis presents significant challenges in clinical practice. To help clinicians rapidly understand and standardize the diagnosis and treatment of this condition, the Liver Fibrosis, Cirrhosis, and Portal Hypertension Group under the Chinese Society of Hepatology, Chinese Medical Association, convened experts across relevant fields to formulate the Expert Consensus for the Management of Thrombocytopenia in Cirrhosis. This consensus aimed to provide evidence-based guidance for clinical diagnosis and treatment.

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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
Prithvi S. Prabhu, Rija Kalita, Vanshika Sharma, Tulika Prakash
Published online March 25, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2024.00030
Abstract
Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and primarily includes ulcerative colitis and Crohn’s disease. As the number [...] Read more.

Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and primarily includes ulcerative colitis and Crohn’s disease. As the number of patients suffering from IBD increases, diagnosis and treatment have become pressing yet challenging tasks. A major challenge is that patients with IBD often do not exhibit characteristic symptoms, making it difficult to distinguish IBD from other intestinal abnormalities. Endoscopy is the most conventional method used to diagnose IBD; however, this technique is invasive and costly. Therefore, there is a need to develop affordable, non-invasive diagnostic methods, which underscores the importance of identifying biomarkers specific to IBD. It is now well established that the gut microbiome plays a significant role in the development of IBD, and changes in the abundance of various gut organisms have been widely studied to identify microbial signatures associated with the disease. This review discusses the current state of knowledge regarding biomarkers in IBD, with a primary focus on the gut microbiome, associated metabolic signatures, and their links with immunological biomarkers. These biomarkers will help propose an integrative model to better understand the pathophysiology of this complex disease. Such an integrated approach also offers insights into potential therapeutic targets for designing more effective treatment strategies for patients.

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Review Article Open Access
Swarup K. Chakrabarti, Dhrubajyoti Chattopadhyay
Published online September 16, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00029
Abstract
Type 1 diabetes (T1D) develops when the immune system targets and destroys pancreatic β-cells responsible for insulin production, ultimately resulting in reduced insulin levels. [...] Read more.

Type 1 diabetes (T1D) develops when the immune system targets and destroys pancreatic β-cells responsible for insulin production, ultimately resulting in reduced insulin levels. Islet transplantation has garnered significant attention as a potential treatment, but it presents numerous challenges that hinder its effectiveness for T1D patients. A primary issue is the immune system’s tendency to reject transplanted islets, leading to a gradual decline in their functionality. Furthermore, many individuals remain reliant on additional insulin therapy. These challenges are exacerbated by the global shortage of organ donors, which limits the availability of pancreata for transplantation. This review outlines several innovative strategies to regenerate insulin-producing β-cells for the treatment of T1D, with a primary focus on pancreatic progenitor and stem cells. The strategy of converting non-β cells, particularly pancreatic α-cells, into functional β-cells continues to show promise. Moreover, α-cells, which are less vulnerable to autoimmune attacks, present a distinct opportunity for β-cell regeneration in individuals with T1D. While the use of progenitor or stem cells for β-cell regeneration appears encouraging, various hurdles, such as immune rejection, suboptimal differentiation, and other challenges, still impede the implementation of this strategy. Nonetheless, this approach may ultimately pave the way for long-lasting treatment and potential cures for T1D.

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Review Article Open Access
Acharya Balkrishna, Deepika Srivastava, Razia Parveen, Ankita Kukreti, Nidhi Sharma
Published online November 6, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2025.00030
Abstract
Gastrointestinal (GI) health is essential for maintaining systemic balance, influencing digestion, immunity, and neuroendocrine signaling. However, GI disorders such as irritable [...] Read more.

Gastrointestinal (GI) health is essential for maintaining systemic balance, influencing digestion, immunity, and neuroendocrine signaling. However, GI disorders such as irritable bowel syndrome, inflammatory bowel disease, gastroesophageal reflux disease, peptic ulcers, and constipation are increasingly prevalent, significantly affecting global health and healthcare economics. Although conventional pharmacological treatments offer symptomatic relief, their long-term use is often associated with adverse effects, resistance, and limited efficacy, prompting a shift toward alternative and complementary therapies. Traditional systems of medicine, such as Ayurveda, Traditional Chinese Medicine, Unani, and Siddha, emphasize holistic approaches, including herbal formulations that target underlying causes rather than just symptoms. This review provides a comprehensive analysis of the role of natural products and traditional herbals in GI health. It discusses key bioactive constituents, flavonoids, alkaloids, terpenoids, and polyphenols, known for their anti-inflammatory, antimicrobial, gastroprotective, and prebiotic properties. Widely used herbal remedies such as Triphala, licorice root, peppermint oil, turmeric, and psyllium are highlighted for their proven therapeutic actions. Additionally, the review documents more than 300 medicinal plants traditionally used in diverse cultures worldwide for managing GI conditions, based on ethnopharmacological evidence. While the therapeutic promise is substantial, challenges such as formulation standardization, herb-drug interactions, and limited clinical data remain. The review underscores the need for integrating traditional wisdom with modern scientific validation, offering a path forward for safe, effective, and personalized GI healthcare.

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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
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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Review Article Open Access
Yike Tian, Haibo Yu, Juan Chen
Published online July 22, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00064
Abstract
Chronic hepatitis B virus (HBV) infection remains a major cause of liver diseases, including cirrhosis and hepatocellular carcinoma. Reliable biomarkers for assessing viral replication, [...] Read more.

Chronic hepatitis B virus (HBV) infection remains a major cause of liver diseases, including cirrhosis and hepatocellular carcinoma. Reliable biomarkers for assessing viral replication, liver damage, and predicting clinical outcomes are essential for effective patient management. This review focuses on two promising biomarkers: serum HBV RNA and hepatitis B core-related antigen, both of which show strong correlations with viral replication and disease progression. Serum HBV RNA levels reflect the quantity and transcriptional activity of intrahepatic covalently closed circular DNA, providing insights into viral replication. They also correlate with other markers of replicative activity and have predictive value for key clinical outcomes, including hepatitis B e antigen and hepatitis B surface antigen seroconversion, relapse after therapy cessation, and liver fibrosis. Similarly, hepatitis B core-related antigen is closely associated with covalently closed circular DNA levels, correlates with markers of viral replication, and shows promise in predicting liver fibrosis, cirrhosis, and the risk of hepatocellular carcinoma. This review highlights the potential of both biomarkers for monitoring disease progression and guiding therapeutic decisions, particularly in the context of personalized treatment strategies and risk assessment for liver-related complications.

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Original Article Open Access
Biwu Wu, Haoyue Yuan, Qiang Yuan, Gang Wu, Jin Hu
Published online April 3, 2025
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Neurosurgical Subspecialties. doi:10.14218/NSSS.2025.00006
Abstract
Surgical management of supratentorial spontaneous intracerebral hemorrhage (sICH) remains controversial. Craniotomy (CT) reduces mortality but offers limited functional benefits. [...] Read more.

Surgical management of supratentorial spontaneous intracerebral hemorrhage (sICH) remains controversial. Craniotomy (CT) reduces mortality but offers limited functional benefits. Neuroendoscopic surgery (NE) has emerged as a viable alternative, providing improved outcomes. Recent randomized controlled trials (RCTs) strengthen ongoing comparisons between these approaches. This meta-analysis systematically evaluates the efficacy and safety of NE versus CT for supratentorial sICH.

RCTs comparing NE versus CT for supratentorial sICH were systematically identified through comprehensive searches of PubMed, Embase, Cochrane Library, and Web of Science databases. Evaluated outcomes included functional outcome (favorable or unfavorable), hematoma evacuation rate, mortality, intraoperative blood loss, operation time, rebleeding, infection (including pulmonary and intracranial), and total complications. Cochrane’s Risk of Bias-2 tool was employed to assess the risk of bias across the included studies.

Eight RCTs were included, comprising 1,354 patients. NE demonstrated a significant advantage in achieving a favorable functional outcome (risk ratio: 1.43; 95% confidence interval (CI) 1.22, 1.68; p < 0.001) and a notably higher hematoma evacuation rate (mean difference (MD): 7.60; 95% CI 3.59, 11.61; p < 0.001). Additionally, NE was associated with a marked reduction in intraoperative blood loss (MD: −152.95; 95% CI −261.68, −44.22; p = 0.006) and a substantial reduction in operative time (MD: −118.49; 95% CI −147.30, −89.67; p < 0.001). The incidences of unfavorable functional outcome and total complications, including pulmonary infection, were significantly lower in the NE group. However, NE did not lead to an improvement in the mortality rate, and there were no significant differences in the incidences of postoperative rebleeding or intracranial infection between the two groups.

These findings suggest that NE offers distinct advantages in terms of functional outcomes and surgical efficiency for patients with supratentorial sICH. Future studies should involve larger, higher-quality RCTs, and neuroendoscopic techniques should be continuously optimized.

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