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Original Article Open Access
m1A Epitranscriptomic Control of NUPR1 by YTHDF1 Exacerbates Metabolic Dysregulation in Nonalcoholic Fatty Liver Disease
Nan Luo, Zhihai Xu, Dongmei Zhao, Xue Yang, Yu Tian, Rongkuan Li
Published online April 2, 2026
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00570
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder with a complex pathogenesis. Although epitranscriptomic modifications such as N6-methyladenosine (m6A) [...] Read more.

Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder with a complex pathogenesis. Although epitranscriptomic modifications such as N6-methyladenosine (m6A) have been implicated in NAFLD, the role of N1-methyladenosine (m1A) and its regulators is largely unexplored. Recently, YTHDF1, a well-characterized m6A reader, was also shown to recognize m1A; however, the functional consequences of this dual specificity are unknown. This study aimed to investigate the role of YTHDF1 in NAFLD pathogenesis and to explore whether its function is mediated through recognition of RNA methylation modification on specific target mRNAs.

Expression of YTHDF1 in NAFLD was analyzed in the GEO database. Loss-of-function studies for YTHDF1 were conducted in vivo (high-fat diet-fed mice) and in vitro (free fatty acid-treated HepG2 cells) in models of NAFLD. We employed RNA-seq and m1A-MeRIP-seq to identify key targets, followed by mechanistic validation of the YTHDF1–m1A–NUPR1 axis using biochemical, histological, and mRNA stability assays.

We identified a critical role for YTHDF1 in promoting hepatic steatosis. NUPR1, a stress-induced transcriptional regulator, undergoes m1A modification. YTHDF1 directly binds to m1A-modified NUPR1 mRNA, enhancing its stability, thereby leading to elevated NUPR1 protein levels. Functionally, upregulated NUPR1 acts as a core driver of NAFLD pathogenesis by activating lipogenic and suppressing fatty acid β-oxidation genes, thereby exacerbating hepatic lipid accumulation.

Our study unveils a novel epitranscriptomic mechanism in which YTHDF1, functioning as a dual-specificity reader, governs NAFLD progression through the m1A-NUPR1 axis. This not only expands the understanding of RNA modification recognition but also establishes the YTHDF1–m1A–NUPR1 pathway as a promising therapeutic target for metabolic liver disease.

Full article
Review Article Open Access
Fecal Microbiota Transplantation as a Therapeutic Adjuvant in Gastrointestinal Cancers: Potential Mechanisms, Therapeutic Applications, and a Functional Donor Screening Strategy
Yang Wang, Zhaoshen Li, Xiangyu Kong
Published online June 26, 2026
Cancer Screening and Prevention. doi:10.14218/CSP.2026.00033
Abstract
Gastrointestinal (GI) cancers account for approximately one-third of annual cancer-related deaths globally, while outcomes remain poor despite advances in surgery, chemotherapy, [...] Read more.

Gastrointestinal (GI) cancers account for approximately one-third of annual cancer-related deaths globally, while outcomes remain poor despite advances in surgery, chemotherapy, radiotherapy, and immunotherapy. Given the challenges of persistent resistance and treatment-related toxicities in current therapies, the pivotal roles of the gut microbiota and fecal microbiota transplantation (FMT) in GI cancer therapy are increasingly recognized. This review aims to explore the potential and mechanisms of FMT as a therapeutic adjuvant in the treatment of GI cancers. FMT may enhance antitumor treatment efficacy and reduce treatment-related toxicity through multiple mechanisms, including enhancing antigen presentation, reshaping the tumor microenvironment, and preserving intestinal barrier function. Preliminary clinical evidence indicates that FMT combined with immune checkpoint inhibitors, chemotherapy, or radiotherapy can improve treatment response rates in some trials and may reverse resistance and alleviate associated intestinal toxicities in selected cases. However, clinical application is hindered by donor microbiota functional heterogeneity, substantial interindividual variability in engraftment, and the absence of validated predictive models. To advance FMT toward precision intervention, we propose a functional screening framework: the Healthy Donor-derived Microbiota Xenograft model as a preclinical functional screening platform and its subsequent clinical application, Xenograft-screened FMT, which links donor-level functional validation with personalized microbiota delivery. By integrating mechanistic insights, emerging preclinical and clinical evidence, and a functional screening framework, this review contributes to advancing FMT from an empirical intervention toward a precision adjuvant strategy and offers insights into future clinical investigation of FMT as a therapeutic approach in GI oncology.

Full article
Review Article Open Access
Advances in Lipid Metabolism Reprogramming in Hepatocellular Carcinoma
Weiqi Duan, Qian Jian, Bo Sun, Hong Yang, Youcai Deng, Yu Peng, Sulai Liu
Published online June 26, 2026
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00055
Abstract
Lipid metabolism reprogramming drives malignant proliferation and invasiveness in hepatocellular carcinoma (HCC). Beyond supplying energy and membrane components, lipids function [...] Read more.

Lipid metabolism reprogramming drives malignant proliferation and invasiveness in hepatocellular carcinoma (HCC). Beyond supplying energy and membrane components, lipids function as signaling molecules that modulate tumor cell epigenetics and the microenvironment. Accumulating research has clarified the implications of these metabolic alterations in HCC, providing a rationale for targeted therapies. This review summarizes key alterations in lipid metabolism within HCC and explores their mechanistic contributions to tumor progression. It further examines how lipid metabolic shifts in immune and stromal cells of the tumor microenvironment promote HCC advancement. Finally, we discuss the therapeutic potential of targeting lipid metabolism in liver cancer treatment.

Full article
Original Article Open Access
Core Active Ingredients and Therapeutic Targets of Yiguanjian for Liver Fibrosis: A Computational and Genetic Inference-based Study
Yikun Jiang, Jiahui Wang, Lei Wang, Yang Zheng, Tiejian Zhao, Rongwu Zhang, Huaye Xiao
Published online May 15, 2026
Gastroenterology & Hepatology Research. doi:10.14218/GHR.2026.00001
Abstract
Studies suggest that Yiguanjian (YGJ) may exert a therapeutic effect on liver fibrosis. However, the active components and molecular targets responsible for its action remain unclear. [...] Read more.

Studies suggest that Yiguanjian (YGJ) may exert a therapeutic effect on liver fibrosis. However, the active components and molecular targets responsible for its action remain unclear. This study aimed to systematically evaluate the active ingredients and potential targets of YGJ in the treatment of liver fibrosis.

Active compounds and corresponding targets of YGJ were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Encyclopedia of Traditional Chinese Medicine (ETCM) databases. Liver fibrosis-related datasets were obtained from the Gene Expression Omnibus (GEO) database and divided into training and validation sets. Differentially expressed genes (DEGs) from the training set were subsequently analyzed using network pharmacology, molecular dynamics simulations, and immune infiltration analysis. Three machine learning models were employed to screen for core targets, followed by Gene Set Enrichment Analysis (GSEA) and Mendelian randomization (MR) analysis. The validation set was used to assess the expression levels and diagnostic potential of core targets.

A total of 2,887 liver fibrosis-related targets and 1,198 YGJ-related targets were identified. Three hundred and three putative targets for YGJ in the treatment of liver fibrosis were identified. Three machine learning methods further narrowed these down to five core targets. Immune infiltration analysis revealed an increase in effector B cells, resting CD4+ memory T cells, γδ T cells, and M1 macrophages during liver fibrosis progression. MR analysis showed that all five core targets (FABP4, MDM2, AKR1B1, PDGFRB, and NR1H4) had odds ratios greater than 1, indicating that they function as risk factors. Expression analyses in both the training and validation sets consistently validated the MR results, demonstrating strong diagnostic potential. GSEA revealed that the core targets were enriched in key signaling pathways, including Wnt, PPAR, and MAPK. Molecular docking and molecular dynamics simulations showed that the active compounds of YGJ exhibited strong binding affinity and stability with the core targets.

YGJ exerts its potential antifibrotic effects by downregulating or antagonizing the risk-associated targets (FABP4, MDM2, AKR1B1, PDGFRB, and NR1H4). These findings provide new insights into the potential of YGJ for treating liver fibrosis, while offering a scientific reference for the prevention and treatment of chronic liver diseases.

Full article
Guideline Open Access
Evidence-based Guideline on the Standardized Diagnostic Imaging Report for Pancreatic Solid Tumors in China
Yun Bian, Jing Li, Zhaoshen Li, Jianping Lu, Chengwei Shao, Shiyuan Liu, Min Chen, Xun Li, on behalf of the Professional Committee of Pancreatic Diseases, Chinese Medical Doctor Association; the Radiology Branch of the Chinese Medical Association; the National Clinical Research Center for Digestive Diseases (Shanghai); and the Shanghai Medical Association Radiology Quality Control Center
Published online March 28, 2026
Cancer Screening and Prevention. doi:10.14218/CSP.2025.00029
Abstract
Pancreatic solid tumors encompass diverse pathological subtypes. Objective, accurate, and comprehensive imaging examinations and diagnostic reports are essential for preoperative [...] Read more.

Pancreatic solid tumors encompass diverse pathological subtypes. Objective, accurate, and comprehensive imaging examinations and diagnostic reports are essential for preoperative staging, treatment planning, and prognostic evaluation. Currently, China lacks corresponding guidelines or consensus documents, leading to prominent issues including subjective diagnostic reports, incomplete descriptions, and inconsistent terminology. The present guideline was developed to standardize diagnostic imaging reporting of pancreatic solid tumors in China. Relevant domestic and international evidence on imaging examination techniques, key reporting elements, and diagnostic criteria was systematically reviewed and synthesized. This guideline was developed by a multidisciplinary expert panel through systematic evidence retrieval and appraisal, GRADE-based recommendation grading, modified Delphi consensus, and external review. A total of 20 evidence-based recommendations, 13 strong and 7 weak, were formulated, in aspects of imaging examination and diagnostic reporting standards, including the measurement of the tumor size of pancreatic solid tumors, assessment of the obstruction of the main pancreatic duct and common bile duct, definition, assessment, and clinical significance of pancreatic parenchymal atrophy, the assessment of obstructive acute pancreatitis, pseudocysts/retention cysts, and peripancreatic vessels, criteria for resectability, regional lymph node assessment, criteria for suspicious lymph nodes and descriptions of their specific location, and detection of hepatic and peritoneal metastases. Implementation of this guideline in clinical practice will help standardize the accuracy and consistency of diagnostic imaging reports for pancreatic solid tumors in China, thereby advancing standardized imaging diagnosis and informing clinical treatment decisions.

Full article
Editorial Open Access
Original Article Open Access
Chronic Hepatitis B in the Asia-Pacific Region: Results of the 2023 Global Burden of Disease Study
Zhengzhao Lu, Dong Xu, Wei Ji, Jingjie Zhao, Tingting Xiao, Dongxu Wang, Yuanyuan Kong, Jidong Jia, Hong You, Xinyu Zhao
Published online June 26, 2026
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00114
Abstract
The Asia-Pacific region accounts for a larger share of the hepatitis B burden than any other regions of the world, presenting a challenge to meeting the World Health Organization [...] Read more.

The Asia-Pacific region accounts for a larger share of the hepatitis B burden than any other regions of the world, presenting a challenge to meeting the World Health Organization (WHO) 2030 elimination targets. In this study, we aimed to quantify the burden of chronic hepatitis B (CHB) and project its trends through 2030 using the Global Burden of Disease 2023 framework, thereby identifying gaps and priorities for the Asia-Pacific region to achieve WHO 2030 targets.

Using data from the Global Burden of Disease Study 2023, we analyzed CHB prevalence, mortality, and disability-adjusted life years. We evaluated temporal trends (1990–2023) using average annual percent changes and projected the 2024–2030 burden using Bayesian age-period-cohort models.

In 2023, the Asia-Pacific region accounted for 63% of global CHB cases (178.0 million), 66% of deaths (259.1 thousand), and 65% of disability-adjusted life years (8.4 million). Regional prevalence and mortality rates exceeded global averages, although childhood (<5 years) prevalence was comparatively lower (590.3 vs. 1,325.3 per 100,000). East Asia bore the highest absolute burden (99.2 million cases), and South Asia had the largest pediatric caseload. Between 1990 and 2023, Western Asia showed the steepest decline in adult prevalence (−1.99%), whereas Southeast and Central Asia exhibited upward mortality trends. Projections indicate that the Asia-Pacific region is off track to meet the WHO 2030 disease elimination targets, as the prevalence rate in children under five years remains above the 0.1% target threshold and absolute mortality is projected to increase.

The Asia-Pacific region continues to contribute the largest share of the global CHB burden and now faces persistent gaps despite progress. Although substantial progress has been made in reducing prevalence through immunization, the region is currently off track to meet the WHO 2030 targets for both incidence and mortality.

Full article
Letter to the Editor Open Access
Original Article Open Access
Evidence Summary for Blood Pressure Management in Patients with Ruptured Intracranial Aneurysms: Implications for Clinical Nursing Practice
Huan Wang, Juanfang Zhang, Xuan Tan, Li Sun, Lianlian Qu, Yuxin Zhan, Sisi Zhang, Danfeng Li, Qiong He, Xiaomei Wei, Hailan Peng
Published online June 29, 2026
Neurosurgical Subspecialties. doi:10.14218/NSSS.2026.00007
Abstract
Given that hemodynamic fluctuations acutely escalate the risk of devastating rebleeding and secondary neurological deficits in unsecured ruptured intracranial aneurysms, this study [...] Read more.

Given that hemodynamic fluctuations acutely escalate the risk of devastating rebleeding and secondary neurological deficits in unsecured ruptured intracranial aneurysms, this study aimed to synthesize the best available evidence for blood pressure management in this population and to provide an evidence-based foundation for clinical nursing practice.

A systematic search was conducted in domestic and international databases and relevant websites for evidence pertaining to blood pressure management in patients with ruptured intracranial aneurysms, including clinical practices, guidelines, expert consensuses, evidence summaries, and systematic reviews/meta-analyses. The search period covered database inception up to June 2025. Two researchers independently performed literature quality assessments and evidence extraction, with particular attention to nursing-relevant evidence on hemodynamic monitoring, bedside assessment, complication prevention, fluid management, and follow-up coordination.

A total of 17 studies were included, comprising 11 guidelines, 4 expert consensuses, and 2 clinical decision entries. The synthesized evidence yielded 32 recommendations, structured into 6 core clinical domains: personnel and environmental configuration, individualized blood pressure targeting, precision hemodynamic monitoring, complication prevention, fluid therapy strategy, and longitudinal follow-up protocols. These recommendations further clarified key nursing responsibilities in triage coordination, continuous blood pressure surveillance, neurological assessment, delayed cerebral ischemia surveillance, fluid balance monitoring, and long-term follow-up.

Blood pressure management in patients with ruptured intracranial aneurysms should be individualized and multidisciplinary. The synthesized evidence highlights key nursing priorities in hemodynamic monitoring, delayed cerebral ischemia surveillance, fluid management, and follow-up coordination, and may inform standardized clinical nursing protocols.

Full article
Letter to the Editor Open Access
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