Chikungunya virus (CHIKV), an emerging mosquito-borne alphavirus, poses an escalating global public health threat due to its rapid geographic expansion and increasing outbreak frequency. While most infections present with acute fever and severe polyarthralgia, a significant proportion of patients develop chronic, disabling joint symptoms. Recent local transmission in subtropical urban regions of China, and particularly Guangdong Province, where over 4,800 cases were reported in Foshan alone by July 2025, highlights the virus's adaptability to new environments. Globally, over 220,000 cases and 80 deaths were reported in the first half of 2025 across 14 countries, with Brazil accounting for the majority of the reported cases. Climate factors, viral evolution, and human mobility are major drivers of the virus’ spread. Despite the growing threat, no specific antiviral treatment or licensed vaccine is currently available. An effective response requires integrated strategies combining vaccine development, vector control, early warning systems, and climate-adaptive public health planning to mitigate further transmission and its health and socioeconomic impact.

Surgical resection of the caudate lobe of the liver remains the final hurdle for liver surgeons, not only in open hepatectomy but also in recent minimally invasive hepatectomy. In the dawn of liver surgery, Prof. Kumon made hepatic casts and showed the anatomy of the caudate lobe of the liver based on the portal segmentation in the National Cancer Center Hospital, Tokyo. Meanwhile, liver surgeons in the center successfully performed isolated caudate lobectomy of the liver for liver cancers one after another. Prof. Kumon is still dissecting hepatic casts to demonstrate the right border of the paracaval portion of the caudate lobe against segment VIII of the liver. An approach to right hemihepatectomy preserving the paracaval portion of the caudate lobe was developed thanks to the detailed anatomical knowledge of the liver based on hepatic casts.

Hilar cholangiocarcinoma (hCCA) is a malignant tumor originating from the epithelial cells of the bile ducts, and it is characterized by an aggressive nature, complex surgical management, high mortality, and poor prognosis. Despite recent advances in surgical techniques, medical devices, and related technologies, there remains a pressing need to standardize diagnostic and therapeutic pathways to improve treatment outcomes and extend long-term patient survival. To better integrate and refine these standards, this consensus was reached through a national conference held in Changsha, Hunan Province, involving multidisciplinary experts from various regions across China. This collaborative effort, drawing from various medical facilities and academic organizations nationwide, resulted in the reaching of the "Chinese Multicenter Expert Consensus on the Diagnosis and Treatment of Hilar Cholangiocarcinoma: 2025 Edition" based on current clinical studies and over 40 years of clinical practice experience in managing hCCA. The consensus provides a comprehensive overview of hCCA, including its epidemiological characteristics, diagnostic and screening methods, pathological features, staging and classification systems, and various treatment modalities, while offering specific and actionable recommendations for clinical practice that highlight well-defined indications for surgical, local, and systemic therapies and that emphasize the importance of multidisciplinary approaches to both diagnostic and therapeutic workflows.

Chikungunya fever is a mosquito-borne disease caused by an RNA virus of the Alphavirus genus and is characterized by fever and severe joint pain. The disease is primarily transmitted by Aedes aegypti and Ae. albopictus mosquitoes. Since its re-emergence in 2005, chikungunya has spread extensively, affecting more than 2.8 billion people across 119 countries worldwide. This article reviews the global epidemiological features of chikungunya, with a focus on its transmission dynamics, the characteristics of the virus and its vectors, as well as the influence of ecological and climatic factors. The article also discusses public health response measures, including the Wolbachia strategy, vaccine development, and integrated vector management. Despite China being a non-epidemic area, imported cases have led to localized outbreaks, prompting the implementation of the 'Four Pests-free Village' initiative to reduce mosquito density and improve public health. Notably, as of July 31, 2025, Guangdong Province in China has reported over 5,158 chikungunya cases and has initiated a Level 3 emergency response in the City of Foshan. In the face of global challenges such as climate change and the spread of invasive species, establishing a normalized rapid response system and enhancing monitoring, early warning, and inter-departmental collaboration are crucial to controlling the spread of mosquito-borne diseases and protecting public health.

Cancer remains a major threat to human health, with the incidence of hepatobiliary tumors consistently high. Treatment methods for hepatobiliary tumors include surgical intervention, ablation, embolization, and pharmacological treatments, with surgery being a critical component of systemic treatment for patients with hepatobiliary tumors. Compared to other methods, surgery is the most effective way to remove tumors and improve survival rates, serving as the cornerstone of various treatment strategies. However, the large patient population sometimes burdens traditional surgical oncology. In recent years, rapidly advancing artificial intelligence (AI) technologies, characterized by efficiency, precision, and personalization, align well with the treatment philosophy of oncologic surgery. Increasing studies have shown that AI-assisted surgical oncology outperforms traditional approaches in many aspects. This review, based on machine learning, neural networks, and other AI techniques, discusses the various applications of AI throughout the entire process of hepatobiliary tumor surgical treatment, including diagnostic assistance, surgical decision-making, intraoperative support, postoperative monitoring, risk assessment, and medical education. It offers new insights and directions for the integration and application of AI in oncologic surgery.

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare malignancy with poor prognosis and unclear benefit from adjuvant chemotherapy. To identify the appropriate candidates for postoperative adjuvant chemotherapy in cHCC-CCA, we developed a prognostic model to predict patient outcomes and stratify populations accordingly. This retrospective study included 75 cHCC-CCA patients treated at Tianjin Medical University Cancer Institute and Hospital from 2009 to 2019. Prognostic factors were identified via univariate and multivariate Cox regression. Model performance was assessed using ROC curves, calibration plots, and decision curve analysis. Propensity score matching (PSM) was applied to reduce bias. Adjuvant chemotherapy significantly improved overall survival (OS) in Kaplan–Meier (p = 0.029) and PSM analyses (p = 0.0011). Five independent prognostic factors were identified: macrovascular invasion, lymph node metastasis, the largest tumor size >5 cm, the high expression of CD8, and the high expression of FOXP3. The nomogram showed good predictive performance. Among high-risk patients stratified by the nomogram, those receiving adjuvant chemotherapy had longer OS (p = 0.013), while no significant benefit was observed in the low-risk group (p = 0.084). Adjuvant chemotherapy improves postoperative survival in cHCC-CCA. The nomogram provides individualized risk stratification and may inform treatment decisions.

Conversion therapy with a combination of tyrosine kinase inhibitor and anti-programmed death-1 antibody sequential surgery and postoperative adjuvant therapy has shown improved survival benefits in patients with Barcelona C stage (BCLC-C) hepatocellular carcinoma (HCC). We aimed to compare the survival benefits in a retrospective cohort of patients with BCLC-C HCC who underwent surgery after conversion therapy with adjuvant therapy and surgery alone. The conversion therapy group was derived from a prospective clinical study, and from January 2015 to September 2023, we selected patients diagnosed with BCLC-C HCC who underwent liver resection at Chinese PLA General Hospital as the surgical group. The primary endpoint in the comparison of survival benefits between conversion therapy and surgery-alone groups was recurrence-free survival. Propensity score matching was applied to reduce any potential bias in the study. By the end of follow-up, the conversion therapy group mRFS was 37.8 months, with postoperative 1-, 2- and 3-year RFS rates of 66.8%, 54.6%, and 48.3%. In the surgery group, the mRFS was 3.0 months, and postoperative 1- , 2- and 3-year RFS rates of 22.4%, 17.5%, and 15.0%, respectively. On multivariable Cox regression analyses, conversion therapy significantly reduced HCC-related mortality and HCC recurrence rates compared with surgery alone. For BCLC-C HCC patients, conversion therapy with adjuvant therapy is in relationship with increased survival in comparison with surgery alone.

The role of laparoscopy for complex resections like right hemihepatectomy for hepatocellular carcinoma (HCC) remains contentious, and its assessment is often hampered by traditional metrics that fail to reflect the comprehensive quality of perioperative management. Therefore, this study used the textbook outcome (TO), a composite endpoint, to compare the laparoscopic (LRH) and open (ORH) approaches for HCC within a propensity score-matched (PSM) analysis. We retrospectively analyzed 435 patients who underwent curative-intent right hemihepatectomy. After 1:3 PSM, a final cohort of 121 patients who underwent LRH and 242 who underwent ORH was included for analysis. Results indicated that the rate of TO achievement was comparable between the LRH and ORH groups (62.0% vs. 65.3%, p = 0.563), with intraoperative complications (17.4%), post-hepatectomy liver failure (14.9%), and major postoperative complications (13.5%) as the primary barriers to achieving a TO. No significant differences in overall survival (OS) or disease-free survival (DFS) were observed, although the LRH group had a significantly shorter duration of hospitalization (p = 0.006). In multivariable Cox regression models, achieving a TO was confirmed as an independent protective factor for both OS (HR: 0.46, 95% CI: 0.34-0.63, p < 0.001) and DFS (HR: 0.44, 95% CI: 0.33-0.58, p < 0.001). For right hemihepatectomy, clinical practice should focus on maximizing the rate of TO achievement through systematic perioperative management, as a key strategy to improve long-term prognosis.

Laparoscopic anatomical right hemihepatectomy (LARH) is a highly challenging procedure due to the lack of an appropriate surgical approach. This study aimed to investigate the safety and efficacy of LARH via a hepatic parenchymal transection-first approach (HPF) guided by the middle hepatic vein (MHV) (HPFM) to treat hepatocellular carcinoma (HCC) by comparison with the extrahepatic Glissonian approach (EG). Between January 2017 and December 2019, a total of 105 HCC patients who underwent LARH, of whom 48 underwent HPFM, were included in this study. After a 1:1 propensity score matching, 41 LARH-HPFM were compared to 41 LARH-EG. We have analyzed perioperative and oncologic outcomes of the two different operative approaches for HCC treatments. Quality of two operative approaches was defined by textbook outcome (TO). The LARH-HPF group was associated with shorter mean operative time (P = 0.029) and less blood loss (P = 0.023). The LARH-HPFM did not increase the postoperative overall complication rates (P = 0.248) when compared with the LARH-EG. The results of univariable and multivariable analyses indicated that LARH-HPFM provided a clinical benefit for operative time and blood loss. In addition, patients who received LARH-HPFM cumulated more TO criteria (P = 0.017), and achieved higher rate of TO (46.3% vs. 24.4%; 2.68, 95% CI 1.05 - 6.86, P = 0.040) compared with those who received LARH-EG. These findings indicate LARH-HPFM is safe and feasible for HCC with certain advantages over LARH-EG, but there are still many problems worth further exploration.

Triple therapy (TT), consisting of transarterial chemoembolization, immune checkpoint inhibitors, and tyrosine kinase inhibitors, is recommended as a conversion therapy for patients with unresectable hepatocellular carcinoma (uHCC). However, patients with uHCC with portal vein tumor thrombosis (PVTT) have a limited response to TT alone. This study evaluated whether combining TT with radiotherapy (TTR) could increase conversion resection rates and improve the prognosis of uHCC with PVTT. A total of 123 patients treated at our institution from 2020-2024 were retrospectively analyzed, comprising 103 patients receiving TT and 20 receiving TTR. The overlap weighting (OW) method was used to minimize bias. Compared with the TT group, patients in the TTR group had a significantly greater early tumor shrinkage rate (85.0% vs. 59.2%, p = 0.029). Moreover, conversion resection rates were significantly higher in the TTR group (65.0% vs. 35.0%, p = 0.012), and the median overall survival (OS) was notably prolonged (median OS not reached vs. 31.9 months, p = 0.031). Following OW adjustment of the data, we obtained similar results. Multivariate analysis confirmed TTR as an independent protective factor for both OS (HR = 0.354, 95% CI = 0.127-0.984, p = 0.046) and the conversion resection rate (OR = 0.261, 95% CI = 0.081-0.838, p = 0.024). Treatment-related adverse events were manageable. Thus, TTR offers an improved conversion resection rate and survival outcomes compared with TT alone in patients with uHCC with PVTT and represents a promising therapeutic strategy.