Liver biopsy is a crucial diagnostic tool for chronic liver diseases, allowing for direct observation of lesion morphology and aiding in precise evaluation. It is especially valuable in cases of autoimmune hepatitis, which exhibits complex morphological characteristics. This includes assessing grading and staging criteria, recognizing overlap syndrome, and considering the morphological features of immune-mediated hepatitis and post-COVID-19 vaccination autoimmune hepatitis. Furthermore, significant morphological differences exist between type 1 and type 2 autoimmune pancreatitis, necessitating further research into type 3 autoimmune pancreatitis.
Alcoholic liver disease (ALD) is a liver disease caused by long-term heavy drinking. With the improvement in the living standard of Chinese people, the incidence rate of ALD tends to increase significantly. The typical pathological patterns of ALD include alcoholic steatosis, alcoholic steatohepatitis, liver fibrosis, and alcoholic cirrhosis. The diverse and complex pathological morphology of ALD and its similarities with other liver diseases pose a great challenge to pathologists. This article reviews the histopathological morphology, grading and staging systems, and differential diagnosis of ALD.
Autoimmune hepatitis (AIH) is an immune-mediated inflammatory disease of the liver parenchyma, which is characterized by hypergammaglobulinemia, the presence of autoantibodies, and typical abnormalities in liver histology; however, the diverse clinical manifestations of AIH and the lack of specific serological markers have brought difficulties and challenges in the diagnosis of AIH. Although portal lymphoplasmacytic infiltration, interface hepatitis, lymphocyte emperipolesis, and hepatocyte rosettes are the typical histological features of AIH, many other histological features can also be observed in AIH, including centrilobular necrosis and Kupffer cell hyaline globules. Therefore, no single histological feature can be used for the diagnosis of AIH, and a confirmed diagnosis should be made with reference to clinical and laboratory examinations, with the exclusion of liver diseases due to other causes. This article summarizes the histological features of AIH, different histopathological spectrum, common clinical issues, differential diagnosis, and recent advances.
In recent years, new advances have been achieved for the research on the pathogenesis, diagnosis, and treatment of primary biliary cholangitis (PBC). Accurate diagnosis, prognosis assessment, and risk stratification based on the clinicopathological features of patients are important for the treatment of PBC. This article summarizes the advances in the clinicopathological features and treatment of PBC.
Cholestatic liver disease (CLD) is a group of liver diseases caused by various reasons, such as abnormal bile metabolism, blocked outflow, and bile duct injury, and the major causes of CLD include drugs, poisons, immunity, genetics, obstruction, infection, and tumor. Cholestasis is a common pathological change in CLD; however, the site, histopathology, and ultrastructure of cholestasis due to different etiologies are relatively specific. According to the etiology, this article elaborates on the pathological characteristics of CLD such as autoimmune cholangitis, inherited metabolic liver disease, and large bile duct disease and introduces the differential diagnosis of other types of CLD, in order to improve the understanding of CLD pathology and facilitate accurate diagnosis and treatment.
Autoimmune pancreatitis (AIP) is a rare disease, and its diagnosis should be made based on a comprehensive evaluation of clinical, radiological, serological, and pathological findings. At present, AIP is classified into two subtypes of type 1 (identified as the pancreatic manifestation of IgG4-related disease) and type 2 (identified as the pancreas-specific disorder independent of IgG4). Although type 1 and type 2 AIP seem to have different pathogeneses, they tend to have similar radiological findings and exhibit a good response to corticosteroid therapy. This article mainly reviews the histopathological features of the two subtypes of AIP, especially the diagnostic challenges encountered in the interpretation of specimens obtained through endoscopic ultrasound-guided fine needle aspiration/biopsy, to as to help pathologists enhance the accuracy of the diagnosis of AIP.
Severe acute pancreatitis (SAP) is characterized by rapid onset and progression, complex clinicopathological changes, and a mortality rate of as high as 20% — 30%. Long-term clinical practice and basic research have shown that relying solely on Western medicine for the treatment of SAP may not achieve satisfactory outcomes, and integrated traditional Chinese and Western medicine therapy has a marked clinical effect and significant advantages. Based on evidence-based medicine and with reference to related guidelines and clinical practice in China and globally, these guidelines summarize 28 clinical questions after widely soliciting opinions and suggestions from experts. This document specifically elaborates on the etiology, pathogenesis, and diagnostic criteria of SAP, as well as the key points of integrated traditional Chinese and Western medicine typing, disease staging, treatment methods, and therapies, so as to standardize the integrated traditional Chinese and Western medicine diagnostic criteria and treatment principles of SAP.
The prevalence rate of nonalcoholic fatty liver disease (NAFLD) reaches up to 30% around the world, and the disease has a serious impact on human health and constitutes a public health burden. Due to difficulties in the diagnosis and monitoring of NAFLD, it is important to identify potential drug targets and biomarkers, and multi-omics techniques hold great promise in the search for early diagnostic markers, therapeutic targets, and outcome and prognostic assessment of NAFLD. This article reviews the research advances in multi-omics techniques in the field of NAFLD in recent years, in order to provide a richer theoretical basis and new strategies for the prevention and treatment of NAFLD.
The prevalence rate of nonalcoholic fatty liver disease (NAFLD) in postmenopausal women is significantly higher than that in premenopausal women and even exceeds that in men of the same age group, and exercise intervention remains an effective method for the prevention and treatment of NAFLD in postmenopausal women. In addition, postmenopausal women with NAFLD often have comorbidities such as sarcopenia, osteoporosis, cardiovascular diseases, and diabetes, which requires targeted exercise prescriptions and proactive intervention for potential comorbidities. Through a literature review, this article provides targeted recommendations for exercise intervention prescriptions in postmenopausal women with NAFLD and related comorbidities.
Drug-induced autoimmune-like hepatitis (DI-ALH) is a special clinical phenotype of drug-induced liver injury and has similar clinical features and laboratory test results to autoimmune hepatitis, and it is often difficult to distinguish them through liver biopsy. Therefore, correct differential diagnosis DI-ALH and autoimmune hepatitis is a crucial and difficult point in clinical practice. This article analyzes the research advances in the pathogenesis, clinical features, diagnosis and treatment, and prognosis of DI-ALH, in order to provide ideas for the diagnosis and treatment of such diseases among clinicians.
Hepatitis C is one of the main causes of liver cancer. With the application of direct-acting antiviral agents, more than 95% of patients can achieve the eradication of hepatitis C virus and obtain sustained virologic response (SVR). Effective antiviral therapy can change the natural course of hepatitis C and reduce the risk of liver cancer; however, some patients are still affected by age, sex, liver fibrosis, diabetes, hepatic steatosis, alcohol consumption, and genetic factors and become the high-risk population of liver cancer. Therefore, it is needed to further clarify and improve the identification and prediction of high-risk populations of liver cancer after SVR of hepatitis C. This article reviews the risk factors and predictive models for liver cancer after SVR in patients with hepatitis C, in order to provide a basis for identifying the high-risk population of liver cancer after SVR of hepatitis C in clinical practice.
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third leading cause of cancer-related deaths, and it is a serious threat to human health and has become a clinical problem that needs to be solved urgently. Extracellular vesicles (EV) are membrane vesicles containing multiple components and play an important role in the development and progression of HCC. This article summarizes the effect of EVs of different origins on HCC and analyzes the mechanism of action of EV on HCC, so as to provide new perspectives for the diagnosis and treatment of HCC.
Caveolin-1 (CAV1) is a structural protein of caveolae on the plasma membrane and is an important regulatory factor for liver function. CAV1 regulates hepatic lipid deposition, lipid and glucose metabolism, mitochondrial function, and hepatocyte proliferation through various molecular pathways. Therefore, CAV1 plays a crucial role in maintaining liver physiology during the metabolic regulatory processes such as hepatic steatosis and hepatocyte proliferation. Furthermore, CAV1 is also involved in the development and progression of different types of liver injury, hepatitis, and liver cirrhosis. This article reviews the role of CAV1 in liver-related diseases and its mechanism in the regulation of liver macrophages, so as to provide a theoretical basis for targeting CAV1 in the treatment of liver-related diseases.
T-cell immunoglobulin and mucin domain-containing molecule-3 (Tim-3) is a member of the Tim family and has been a research hotspot in recent years. As a negative regulatory factor, Tim-3 exerts different effects by binding to different ligands. Tim-3 is expressed in various types of immune cells, such as natural killer cells, dendritic cells, and monocytes, and Tim-3 has a regulatory effect on the functions of these immune cells. In recent years, a large number of studies have shown that Tim-3 is closely associated with the development and progression of liver diseases. This article reviews the studies on the role and mechanism of Tim-3 in different liver diseases and cells in recent years, in order to provide richer perspectives and ideas for the clinical diagnosis and treatment of liver diseases.
Acute liver failure (ALF) is one of the most critical liver diseases in clinical practice and seriously affects the life and health of Chinese people. Due to its high morbidity and mortality rates, unclear pathogenesis, and limited treatment methods, ALF has become a major problem that needs to be solved urgently in the field of liver diseases. In recent years, more and more studies have shown that endoplasmic reticulum stress is a key biological process in the progression of ALF, and the IRE1α/TRAF2/JNK pathway, as a part of endoplasmic reticulum stress signaling, plays a role in amplifying inflammatory response, promoting hepatocyte apoptosis, and inhibiting liver regeneration ability during the progression of diseases. As a traditional treasure of China, traditional Chinese medicine has become a research hotspot in search for effective prevention and treatment drugs for ALF from monomers of Chinese herbs. This article elaborates on the mechanism of action of the IRE1α/TRAF2/JNK pathway in the progression of ALF and summarizes the potential value of several monomers of Chinese herbs in regulating this pathway, such as salidroside, Fructus Broussonetiae, Fructus Psoraleae+Schisandra chinensis, baicalein, genipin, kaempferol, resveratrol, sea buckthorn polysaccharide extract, and luteol, in order to provide a reference for further research and clinical practice of ALF.
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- 1Current situation in the research of Gilbert’s syndrome
- 2Review of acute pancreatitis scoring systems
- 3Clinical value of 13C-methacetin breath test for assessing liver function in patients with cirrhosis
- 4Studies on relevant gactors of Child-Pugh grading in hepatic cirrhosis
- 5Meta-analysis of 111 patients with nonalcoholic steatohepatitis-associated hepatocellular carcinoma
- 6Research state and prospect of hyponatremia in cirrhosis
- 7Relationship between Epstein-Barr virus infection and hepatic lesions in children
- 8Congenital bile acid synthesis defect and cholestatic liver disease
- 9Interventional treatment for Budd-Chiari syndrome:reports of 883 cases
- 10
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