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.

With the widespread application of systemic treatments for hepatocellular carcinoma, liver injury caused by molecular targeted drugs and immune checkpoint inhibitors has become a common clinical problem. The Chinese Society of Hepatology, Chinese Medical Association, organized domestic experts to summarize and analyze adverse liver reactions, as well as advances in the diagnosis and treatment related to systemic therapy for liver cancer, both domestically and internationally. Based on this work, we formulated the “Consensus on the Management of Liver Injury Associated with Targeted Drugs and Immune Checkpoint Inhibitors for Hepatocellular Carcinoma”, aiming to provide practical recommendations and decision-making guidance for clinicians in hepatology and related specialties. This guidance focuses on the monitoring, diagnosis, prevention, and treatment of liver injury during targeted and immune checkpoint inhibitor therapy, ultimately helping more liver cancer patients benefit from targeted immunotherapy.

Gastric cancer remains a significant global health burden, with limited therapeutic options and poor clinical outcomes. Although conventional treatments such as surgery and chemotherapy are widely used, their effectiveness is often hindered by adverse effects and high recurrence rates, highlighting the urgent need for safer and more effective alternatives. Scleromitrion diffusum (Willd.) (S. diffusum), a well-established anticancer herb in traditional Chinese medicine, has demonstrated promising clinical potential against gastric cancer. This review systematically examines the bioactive components of S. diffusum and their multi-target mechanisms of action against gastric cancer. Key active compounds, including flavonoids, anthraquinones, and terpenoids, have been identified as exerting synergistic anti-gastric cancer effects. These compounds collectively target critical pathways in gastric cancer pathogenesis, including apoptosis induction, suppression of proliferation and angiogenesis, and immune modulation. The mechanistic elucidation presented in this review not only validates the traditional use of S. diffusum in cancer management but also provides a molecular basis for its potential application in precision medicine strategies for gastric cancer. Beyond summarizing existing evidence, this work highlights critical gaps in current knowledge and proposes essential directions for future research, providing important references for integrating traditional medicine with modern oncology approaches.

Regular exercise is fundamental for people with metabolic dysfunction-associated steatotic liver disease (MASLD), yet exercise maintenance is generally poor. This generative co-design process aimed to embed the voices and opinions of people with lived experience of MASLD and their care stakeholders to (i) frame barriers and enablers to exercise maintenance and (ii) highlight priorities for exercise-focused research agendas in MASLD.

A generative co-design framework was applied. Two virtual co-design sessions were undertaken: Session 1 – Framing the issue, where initial discovery was conducted with people with lived experience of MASLD; and Session 2 – Generative design and sharing ideas with lived experience partners and healthcare stakeholders. Sessions were audio-recorded and transcribed, and key determinants and considerations were discerned by two independent researchers.

Lived experience partners (n = 5, 53 ± 16 years, 40% male) ranked five equally important barriers to exercise maintenance: musculoskeletal and pain issues, lack of access to exercise equipment/facilities, cost, competing priorities, and low energy levels, which influenced core positive and negative determinants. Alongside lived experience partners, healthcare stakeholders (hepatologists [n = 3], exercise professionals [n = 3], 67% male) identified three core needs with eight considerations. Some disconnects in priorities were observed. Lived experience partners emphasized affordability, accessibility, and considerations for comorbidities, while healthcare partners advocated for research on natural history, prevention, behavior change, cost-effectiveness, and health system change.

This co-design methodology highlights unique consumer-informed research questions. Exercise interventions and their associated implementation trials will benefit from being co-designed with both people with MASLD and care stakeholders.

Infection control is essential for the success of prosthodontic and oral implant procedures, as microbial contamination can lead to serious complications such as denture stomatitis and peri-implantitis. While synthetic disinfectants like chlorhexidine are commonly used, they may cause side effects including irritation, toxicity, and the development of microbial resistance over time. Natural products derived from plants, animals, and minerals are currently being explored as safer alternatives. Compounds such as epigallocatechin gallate from green tea; eugenol from clove oil; quercetin, thymol, cinnamaldehyde, and flavonoids from propolis; and terpinen-4-ol from tea tree oil have shown strong antimicrobial and anti-biofilm properties. These natural agents are not only effective against harmful oral bacteria but also promote healing, are more biocompatible, environmentally friendly, and are often preferred by patients. However, challenges remain regarding their routine clinical use. The strength and composition of natural agents can vary, and there is a lack of consistent product standards, clinical trials, and comprehensive safety data. Currently, these products are not approved by the U.S. Food and Drug Administration for dental use and are only available as over-the-counter remedies. Production costs and scalability must also be evaluated in comparison with synthetic alternatives. Emerging technologies, such as nanocarriers and targeted delivery systems, are being developed to enhance the effectiveness of natural agents in dental applications. Further clinical research and the establishment of clear regulatory guidelines are necessary to support their integration into clinical practice. Natural disinfectants hold significant potential to become valuable, safe, and sustainable tools for maintaining hygiene in prosthodontics and oral implantology.

Amyotrophic lateral sclerosis (ALS) and other motor neuron diseases (MNDs) are major global causes of death. However, their global incidence, mortality, and disability-adjusted life years remain largely unknown, despite their importance for disease prevention and resource allocation. We therefore examined the global epidemiology of ALS/MNDs.

This study analyzed data from the Global Burden of Disease 2021 database for 204 regions (1990–2021), focusing on ALS/MNDs. Data from the world, China, and the G8 countries were analyzed separately. Age-standardized incidence rates were reported for the 1990s, 2000s, 2010s, and 2020s.

A rising global burden of ALS/MNDs, with significant variations across regions and levels of the social development index, was observed in the Global Burden of Disease database. A significant overlap of etiology between neurological diseases and ALS was also identified. Among the G8 countries and China, China and the USA exhibited the highest prevalence rates in the 1990s, 2000s, 2010s, and 2020s, with China showing 3.3 per 10,000 and the USA 4.0 per 10,000 in the 2020s.

Understanding the common etiologies of ALS/MNDs is key to their effective control. Recommended strategies include pollution control, chemical and radiation safety management, disease monitoring, public health education, multi-departmental collaboration, and scientific research.