After 3-years (144 week) of double-blind treatment in Chinese chronic hepatitis B patients in two ongoing phase 3 studies, tenofovir alafenamide (TAF) showed similar efficacy to tenofovir disoproxil fumarate (TDF), with improved renal and bone safety. In this study, we aimed to report the 5-year results from 2 years into the open-label TAF treatment phase.

All participants completing the 144-week double-blind treatment were eligible to receive open-label TAF 25 mg once daily up to week 384. Serial analysis of viral suppression (hepatitis B virus DNA <29 IU/mL), alanine aminotransferase normalization, serological responses, and safety outcomes at year 5 (week 240) was performed.

The open-label phase included 93% (311/334) of the enrolled participants, which included 212 who switched from double-blind TAF to open-label TAF (TAF-TAF) and 99 who switched from double-blind TDF to open-label TAF (TDF-TAF). Baseline characteristics were comparable. Week 240 viral suppression rates were similar between groups [93.4% vs. 93.9%; difference: −1.5%, (95% CI: −6.4 to −3.5), p=0.857]. Alanine aminotransferase normalization and serological response rates were higher in the TAF-TAF group than in the TDF-TAF group. The frequencies of adverse events and laboratory abnormalities were low and similar between groups. Both groups had similar small numerical declines from baseline in estimated glomerular filtration rate at year 5 (week 240, −2.85 mL/min vs. −3.29 mL/min, p=0.910). The greater declines in renal and bone parameters in the TDF-TAF group through week 144 improved after switching to TAF.

The 5-year TAF treatment efficacy was high and similar to that of 3-year TDF followed by 2-year TAF in Chinese chronic hepatitis B patients. Favorable effects on bone and renal parameters were sustained with TAF treatment alone and were observed following the switch from TDF to TAF.

Breast cancer (BC) is the type of cancer with the highest incidence and mortality rates in women in the world. In the treatment of this neoplasia, several therapies are applied, including radiotherapy, hormonal therapy, chemotherapy, and biological therapy. Although most patients respond to these types of therapy, some patients over time, develop resistance or eventually relapse. Considering the above, future therapeutic concepts in BC are being directed at individualization of therapy and escalation of treatment based on tumor biology through the use of gene therapy. In this regard, a new genomic engineering technology, called the clustered regularly interspaced short palindromic repeat (CRISPR)-associated protein-9 (Cas9), has acquired great importance in recent years, as a potential gene editing tool, extensively applied in human cancer research and cancer treatment. The aim of this review was to describe the advantages, limitations, and applications of CRISPR gene editing technology in BC treatment. Our review emphasizes the innovative facets and profound importance of CRISPR gene editing technology within the BC treatment landscape. Additionally, it provides valuable information to consider when evaluating the risks associated with the implementation of CRISPR-Cas9 technology in BC therapy.

Parkinson’s disease (PD) is a common neurodegenerative disorder with unclear molecular mechanisms. Noncoding RNAs, such as microRNAs (miRNAs) and long noncoding RNAs (lncRNAs), have been identified as critical regulators of gene expression. This study aimed to investigate the triple network of lncRNA-miRNA-mRNA, known as competing endogenous RNAs (ceRNAs), and to identify essential lncRNAs that regulate PD-related gene expression through their target miRNAs. The study also identified a common triple network between COVID-19 and PD that may contribute to exacerbating PD symptoms.

A bioinformatics approach was employed to construct a PD ceRNA network using common PD genes, miRNAs and lncRNAs with the highest interaction with their targets. Also, a PD-COVID-19 triple network was constructed by integrating PD network nodes into the COVID-19 network.

The PD ceRNA network comprised 34 nodes, including 12 lncRNAs, 16 miRNAs with interconnections and six mRNAs, some of which were related to COVID-19. The network showed parallel expression of the SNCA and PARK7 genes as well as the NEAT1 and MALAT1 lncRNAs in both PD and COVID-19.

This study provide insights into the molecular mechanisms underlying the worsening of symptoms in PD patients with COVID-19. The PD and COVID-19 ceRNA network indicates that coronavirus could worsen PD symptoms by altering the expression of some genes related to PD. Therefore, COVID-19 could dysregulate the common RNAs involved in PD through lncRNAs, miRNAs.

Autoimmune hepatitis is an inflammatory liver disease primarily mediated by T cell. It has not been fully elucidated about the pathogenesis, and it is presently thought to be related to genetic susceptibility, infection and environmental triggers, and abnormal autoimmune regulation. Recent studies have found that traditional Chinese medicine can improve the biochemical indicators and clinical symptoms of patients with autoimmune hepatitis. This article reviews the specific mechanism of traditional Chinese medicine on treating autoimmune hepatitis in order to propose new ideas for its clinical diagnosis and treatment.

Cervical cancer is a significant public health concern worldwide. Current screening approaches include Pap smears, human papillomavirus testing, visual inspections, and emerging molecular techniques, aimed at enhancing precision and accessibility. The landscape also includes the increasing prominence of self-sampling and telemedicine, which broaden the reach of screening services. Human papillomavirus vaccination programs targeting young girls have the potential to significantly reduce long-term risk. These evolving strategies are supported by global initiatives such as the World Health Organization’s Cervical Cancer Elimination Initiative, aiming to increase screening efforts and reduce the global impact of cervical cancer. The key findings of this study suggested that current methodologies for the detection and prevention of cervical cancer are a little beneficial and there is a pressing need to use advanced technologies such as highly sophisticated equipment integrated with artificial intelligence. In addition, the detection of cervical cancer screening provides insights into evolving methodologies, promising prospects, and nuanced challenges that must be addressed to prevent this condition in females worldwide. Looking forward, future cervical cancer screening involves further refinements in molecular testing, expanded vaccine coverage, and the integration of telehealth solutions, promising increased accessibility and improved early detection to overcome insightful challenges.

Esophageal tuberculosis (ET) is a relatively rare clinical condition, characterized by often atypical clinical features. The lack of specificity in diagnostic methods, such as esophagogastroduodenoscopy and various imaging techniques, frequently leads to misdiagnosis and inappropriate treatments. Compared to esophagogastroduodenoscopy, endoscopic ultrasonography (EUS) offers a more comprehensive examination of esophageal tuberculosis lesions, including the extent of wall layer involvement and the internal structure characteristics of the lesions. Furthermore, when necessary, endoscopic ultrasonography-guided fine-needle aspiration can be employed to acquire deeper pathological tissue, significantly aiding diagnosis. When combined with the patient's clinical presentation, endoscopic findings, and pathological features, EUS plays a crucial role in the definitive diagnosis of ET and in the differential diagnosis process. This article meticulously reviews both national and international literature to summarize the relevant features of ET, with a focus on its appearance under EUS, and to highlight the clinical value of EUS in enhancing the diagnosis of ET and in distinguishing it from other conditions. The aim is to offer guidance for the accurate diagnosis of ET.

About 30% of lung cancer patients are accessible to targeted therapy or immunotherapy based on the current criteria. In this study, a novel gene cluster expression analysis was introduced with a goal to potentially expand the treatments to more patients based on the proposed criteria.

Selected gene expression omnibus data sets were downloaded, normalized, and analyzed. A univariate recurrence prediction model was built based on the receiver operating characteristic, for which an optimal cutoff was determined to set abnormality status, called the gene cluster expression index (GCEI). Recurrence and survival risks were calculated and compared between two subgroups indexed by the GCEI. Moreover, a combinatory GCEI was also introduced and its performance was analyzed for combined multiple cluster statuses.

The recurrence risks of the patient subgroups with abnormally expressed clusters with GCEI = 1 were much higher than for the corresponding normal subgroup with GCEI = 0. The higher risks ranged from 120–300% that of the corresponding lower-risk group.

The GCEI can be used to classify lung cancers with dramatically different recurrence risks and may be used to guide targeted therapy or immunotherapy for patients who are in a high-risk group but do not qualify for such treatment according to conventional companion tests.

Breast cancer is one of the greatest global health concerns for women, with rising incidence rates and mortality projections, while affordability and access to mammography screening and diagnosis, especially in low- and middle-income countries, remain a challenge. This retrospective clinical validation study evaluated a breast cancer pre-screening solution (BCPS) based on a commercially available smartphone with a thermal imaging sensor powered by artificial intelligence. The purpose was to measure the performance of the BCPS tool compared to mammography, the gold standard for first-pass examination in breast cancer screening.

The evaluation was conducted in the Erebouni Medical Center Breast Unit in Armenia over a period of six months. We tested a cohort of 478 women of whom 45 were finally diagnosed with breast cancer after biopsy. Participants were first screened with the BCPS before undergoing the standard breast screening pathway. After studying the mammography results, if malignancy was discovered, a biopsy was performed and taken as the ground truth when comparing with BCPS artificial intelligence results.

When combined with patient-reported or clinical symptoms, the BCPS tool achieved a sensitivity of 89% and a specificity of 83% compared to mammography. When clinical or patient-reported symptoms were not taken into account, sensitivity was considerably lower (60%), while specificity was higher (88.2%).

The BCPS tool, in combination with basic clinical exams and patient-reported symptoms, may serve as a robust triaging tool for breast cancer detection where mammography is not available or affordable, identifying the majority of women who need further diagnostic assessment.

Currently, the mechanism of occurrence and development of colonic polyps and colonic cancer has not been fully elucidated. Previous studies have shown a certain relationship between bile acid (BA) profile and the development of colonic cancer. Through an analysis of the relationship between alterations in the serum BA profile and colonic neoplasms, this study sought to develop new biomarkers for assessing the risk of colon illnesses and offer fresh perspectives for identifying treatment targets.

The study encompassed 135 individuals who showed no abnormalities during colonoscopy, 204 patients with colonic polyps, and 92 patients with colonic cancer, all diagnosed and treated at Zhongda Hospital, Southeast University, from January 1, 2022, to June 1, 2023. Serum BA profiles, liver function, and clinical data were collected for statistical analysis.

The concentration of deoxycholic acid in patients with colonic neoplasms was lower than that in the control group, whereas levels of taurocholic acid, taurochenodeoxycholic acid, and glycochenodeoxycholic acid were significantly higher in the colonic neoplasms group than in the control group (P < 0.05). Subgroup analysis revealed that there were statistical differences in the content of cholic acid, ursodeoxycholic acid, and glycoursodeoxycholic acid among different pathological types of colonic neoplasms. Logistic regression analysis indicated a negative correlation between the concentration of glycodeoxycholic acid and the risk of developing colonic neoplasms.

Compared with the normal population, the serum BA profile of colonic neoplasms patients has changed. Patients with colonic neoplasms exhibit elevated levels of primary conjugated BAs and decreased levels of secondary free BA (deoxycholic acid).

Wilms tumor is the most common renal malignancy in children. miR-146a, a highly conserved small noncoding RNA, plays a critical role in various human diseases. Increasing studies have suggested that rs2910164 C>G polymorphism in miR-146a is associated with susceptibility to cancers. However, miR-146a rs2910164 C>G polymorphism influence on Wilms tumor remains unknown. The aim of this study was to evaluate the relationship between miR-146a rs2910164 C>G polymorphism and Wilms tumor susceptibility in Chinese children.

In the six-center case-control study, we enrolled 1,352 subjects from East China (416 cases and 936 healthy controls). The TaqMan method was adopted to genotype the miR-146a rs2910164 C>G polymorphism. Logistic regression models were utilized to assess the correlation between this polymorphism and the risk of Wilms tumor.

No significant association was observed between miR-146a rs2910164 C>G polymorphism and the susceptibility to Wilms tumor. Further stratification analysis also did not detect a significant relationship.

The present study showed no association of miR-146a rs2910164 C>G polymorphism with the risk of Wilms tumor in the Eastern Chinese population. Subsequent studies with a larger sample size will be required to validate these results.

The government of Bangladesh adopted visual inspection of the cervix with acetic acid method for cervical cancer screening in the majority of the district and sub-district hospitals. Before alternative screening methods are adopted, the prevalence of high-risk human papillomavirus (HPV) genotypes among various geographical regions must be determined. Therefore, we aimed to determine the prevalence of high-risk HPV genotypes in urban and rural areas of Bangladesh.

This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2021 to June 2022. Using a multistage sampling method, cervical samples (N = 3,856) were collected from women aged 30–49 years attending visual inspection of the cervix with acetic acid at 16 centers (eight districts and eight sub-districts). HPV tests were performed by real-time PCR amplification. Descriptive analysis and Chi-square test/Fisher’s exact test were performed for associations, and a P value <0.05 was considered significant.

Among the 3,856 women, the overall prevalence of high-risk HPV was 3.6%, with 49 (1.3%) women testing positive for HPV16, 12 (0.3%) women testing positive for HPV18, and 65 (1.7%) testing positive for other high-risk HPV genotypes. There was a significant variation in the prevalence of high-risk HPV among the divisions (P = 0.001), with the highest infection rate (7.1%) observed among women in rural Sylhet and the lowest in rural Mymensingh (0.5%). No significant difference in high-risk HPV prevalence was found between the urban and rural women, except in Mymensingh.

The low prevalence of high-risk HPV (3.6%) among Bangladeshi women with regional variation should be considered by policymakers during the development of cervical cancer prevention policies.

With the development of gene editing technology, its application in tumor diagnosis is becoming increasingly widespread. The CRISPR/Cas system is an important gene editing tool that can significantly improve the early detection rate and precision diagnosis level, enabling high-throughput and high-sensitivity detection of tumors. This article focuses on CRISPR/Cas system for detecting various tumor-related targets and elaborates on its applications in tumor diagnosis from five aspects: (1) detection of tumor-derived exosomes: by recognizing the surface proteins or nucleic acids of exosomes secreted by tumor cells into blood or other samples through adaptors, the CRISPR system is activated, achieving non-invasive liquid biopsy of tumors; (2) detection of circulating tumor DNA tumor cells disseminate DNA into the circulatory system to trigger nucleic acid reactions involving gene editing enzymes, enabling the monitoring of tumor dynamic states; (3) detection of circulating tumor cells (CTCs): by using aptamers to recognize surface proteins of tumor cells or directly detecting tumor-related nucleic acids, the integrated CRISPR system allows for the detection of circulating tumor cells even in trace amounts, achieving precise diagnosis; (4) detection of tumor markers: high sensitivity is achieved through the coupling of various tumor marker aptamers and gene editing systems; (5) detection and identification of tumor microenvironments: by activating gene editing enzyme activity through differential factors in the tumor tissue microenvironment and triggering nucleic acid reactions, the diagnosis and dynamic monitoring of tumors can be achieved. The progress and bottlenecks of the CRISPR/Cas system in tumor diagnosis in the future are also discussed.

Alcohol-related liver disease (ALRD) has emerged as a significant global health concern, primarily attributed to the overconsumption of alcohol. While alcoholism has the potential to impact various organs, it is the liver that is especially vulnerable.

This review comprehensively examines the challenges encountered during the pre-transplant, intra-transplant, and post-transplant phases, a significant number of which are attributable to alcohol misuse. Historically, liver transplant (LT) programmes have excluded patients with alcohol-related liver disease (ARLD) due to mandatory abstinence requirements and apprehensions regarding potential graft shortages for other hepatic diseases. This review counters these concerns by highlighting the minimal usage of grafts for early liver transplantation. It strongly advocates for the incorporation of severe alcoholic hepatitis into the model for end-stage liver disease allocation, devoid of any stigmatization. The selection of ARLD individuals for LT necessitates the critical involvement of a multidisciplinary team, inclusive of addiction specialists.

Despite the complexities associated with LT for patients with ARLD, this review underscores its therapeutic advantages, particularly for those anticipated to experience severe adverse effects. This review accentuates the necessity of ensuring equitable access to medical interventions for all patients, irrespective of their lifestyle choices.

The examination of genetic and epigenetic variables that play a role in the onset and advancement of ALD. The identification of potential therapy strategies is also an important area of study. The formulation of intricate eligibility rules for LT in patients with a past of alcohol abuse needs essential interactions between medical practitioners and researchers. The use of new technologies such as genomics and epigenomics could boost the accuracy of ALD diagnostic and prognostic approaches. These targeted investigations could potentially lead to major improvements in the management and treatment results of ALD.

Shaoyao decoction (SYD) has been found widespread clinical use in treating ulcerative colitis (UC). However, the mechanism underlying SYD impact on UC remains elusive.

We preliminarily evaluated the therapeutic effect of SYD intervention in a dextran sulfate sodium-induced UC mouse model by analyzing the body weight change, disease activity index score, colon length, and HE staining results of colon tissue in each group of mice. Subsequently, we determined pro-inflammatory cytokines level and blood coagulation markers in the colon tissues of mice in each group to evaluate the effect of SYD intervention on colonic inflammatory response and coagulation function in UC mice.

Our findings emphasize the significant therapeutic effect of SYD on UC, including slowed down body weight loss, reduced disease activity index score, increased colon length, and reduced inflammatory infiltration in colon tissue. Moreover, SYD intervention significantly downregulated the levels of pro-inflammatory cytokines IL-1β, IL-6, and IL-17A in the colon. Furthermore, SYD intervention reversed the coagulation-related indicators such as prothrombin time, fibrinogen, P-selectin, D-dimer, and platelet glycomembrane protein IIb/IIIa.

Our results elucidate the substantial therapeutic impact of SYD on UC mice. Importantly, the therapeutic mechanism of SYD in addressing UC potentially involves the inhibiting of inflammatory response mediated by hypercoagulability.

This review explores the convergence of traditional wisdom and modern science in the realm of herbal medicines, focusing on the safety, efficacy, and bioactivity of these natural remedies in contemporary healthcare. The rich history of herbal medicines, deeply embedded in cultural traditions, is witnessing a resurgence as the quest for holistic and personalized healthcare gains momentum. Herbal medicine, a time-honored practice passed down through generations, is experiencing renewed interest amid the growing acknowledgment of its potential benefits. This review delves into the safety profiles of herbal remedies, subjecting them to rigorous scientific scrutiny. Additionally, it investigates the efficacy of herbal interventions, aiming to bridge the gap between historical anecdotes and empirical research. The complex bioactivity of herbal compounds, often containing numerous active ingredients, is a focal point, unraveling the mechanisms through which these natural substances interact with the human body. In a world where the synthesis of traditional wisdom and modern science holds promise for advancing healthcare, this review contributes to the ongoing dialogue. By critically examining the safety, efficacy, and bioactivity of herbal remedies, it aims to illuminate the evolving landscape of herbal medicine. The goal is to integrate the best of both worlds to enhance global well-being, acknowledging the potential of herbal medicine as a valuable complement to modern healthcare practices.

With the highest incidence rate and death rate among malignant tumors, lung cancer is the most prevalent malignant tumor worldwide. Tumor-node-metastasis (TNM) staging provides a basis for clinical therapy and prognosis while the fundamental principle of traditional Chinese medicine (TCM) is the syndrome differentiation and treatment. This study offers an objective foundation for the distinction and classification of TCM syndromes by methodically assessing the relationship between TNM staging indicators and the various types of the syndrome in lung cancer.

To find pertinent material, we searched a number of databases, including CNKI, PubMed, VIP, and Wanfang. Literature on the relationship between TCM syndrome categories and TNM staging indexes of lung cancer published from the database’s inception until May 2023 was gathered. The meta-analysis was carried out using Rev Man 5.4.

In the end, seven pieces of literature totaling 264 patients were included. Lung cancer is mainly characterized by phlegm dampness syndrome, Qi Yin deficiency syndrome, Yin deficiency internal heat syndrome, and Qi stagnation and blood stasis syndrome. In stage I and II, phlegm dampness syndrome > Yin deficiency internal heat syndrome (p < 0.5), phlegm dampness syndrome > Qi Yin deficiency syndrome (p < 0.5), phlegm dampness syndrome > Qi stagnation and blood stasis syndrome (p < 0.5). In stages III and IV, Qi Yin deficiency syndrome > Qi stagnation and blood stasis syndrome > Yin deficiency internal heat syndrome > phlegm dampness syndrome (p < 0.5).

Phlegm dampness syndrome is the main syndrome in stages I and II of lung cancer, while Qi and Yin deficiency syndromes are the main syndromes in stages III and IV of lung cancer.

The global burden of colorectal cancer (CRC) is a pressing concern, with a substantial impact on public health. Despite advancements in understanding the molecular mechanisms of CRC development, challenges remain in translating this knowledge into effective clinical interventions. Key genetic mutations, notably in the adenomatous polyposis coli (APC) and Kirsten rat sarcoma virus (KRAS) genes, are central to CRC initiation and progression. Current CRC treatments include surgery and chemotherapy, often combined with targeted agents. However, resistance and heterogeneity within CRC patients limit the effectiveness of these therapies. Promisingly, research has focused on targeting APC and KRAS mutations for therapy. Small molecules inhibiting the Wnt pathway and antibodies targeting specific components are under investigation. Targeting KRAS itself is challenging due to its conserved structure, but disrupting its membrane interactions and subcellular localization are potential therapeutic strategies. To address the limitations of single-drug therapy, combination approaches are gaining traction. Combination therapy not only minimizes off-target effects but also tackles drug resistance and diverse genetic alterations within tumors. The intricate interplay of mutations and pathways in CRC necessitates multifaceted therapeutic strategies. Although progress has been made in understanding CRC genetics and developing targeted therapies, there is still work to be done to translate these insights into effective clinical treatments for CRC patients. This review provides crucial information for novel combination treatments for CRC.

The application of antifibrotic drugs to treat patients with chronic liver diseases who are receiving antiviral therapies for hepatocellular carcinoma (HCC) has not been established. Here, we aimed to assess the impact of the Traditional Chinese Medicine Fuzheng Huayu (FZHY) on the occurrence of HCC in patients with hepatitis B virus-related compensated cirrhosis receiving the antiviral drug entecavir (ETV).

A multicenter retrospective cohort study was performed. Compensated liver cirrhosis patients were divided into the ETV+FZHY group or the ETV group according to treatment. The cumulative incidence of HCC was analyzed using Kaplan-Meier and log-rank tests. Propensity score matching was used for confounding factors. Stratified analysis and Cox regression were used to determine the effects of FZHY on the occurrence of HCC and liver function decompensation.

Out of 910 chronic hepatitis B patients, 458 were in the ETV+FZHY group and 452 were in the ETV group. After propensity score matching, the 5-year cumulative incidence of HCC was 9.8% in the ETV+FZHY group and 21.8% in the ETV group (p<0.01). The adjusted hazard ratio for HCC was 0.216 (0.108, 0.432) when FZHY treatment was >36 months. Age, diabetes, alanine aminotransferase, γ-glutamyl transpeptidase, albumin, hepatitis B e-antigen, and fibrosis 4 score were associated with the occurrence of HCC. FZHY decreased the risk of HCC in patients aged >45 years with a hepatitis B virus DNA level of ≥2,000 IU/l.

Adjunctive FZHY treatment reduced HCC occurrence in patients with hepatitis B virus cirrhosis who were treated with ETV, possibly due to the antifibrotic properties of FZHY.