Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease that can lead to hepatocyte destruction, inflammation, liver fibrosis, cirrhosis, and liver failure. The diagnosis of AIH requires the identification of lymphoblast cell interface hepatitis and serum biochemical abnormalities, as well as the exclusion of related diseases. According to different specific autoantibodies, AIH can be divided into AIH-1 and AIH-2. The first-line treatment for AIH is a corticosteroid and azathioprine regimen, and patients with liver failure require liver transplantation. However, the long-term use of corticosteroids has obvious side effects, and patients are prone to relapse after drug withdrawal. Autoimmune diseases are characterized by an imbalance in immune tolerance of self-antigens, activation of autoreactive T cells, overactivity of B cells, and increased production of autoantibodies. CD4⁺ T cells are key players in adaptive immunity and can secrete cytokines, activate B cells to produce antibodies, and influence the cytotoxicity of CD8⁺ T cells. According to their characteristics, CD4⁺ T cells can be divided into different subsets. In this review, we discuss the changes in T helper (Th)1, Th2, Th17, Th9, Th22, regulatory T cell, T follicular helper, and T peripheral helper cells and their related factors in AIH and discuss the therapeutic potential of targeting CD4⁺ T-cell subsets in AIH.

Objective: This study aimed to systematically assess the efficacy and complications of radiofrequency thermocoagulation (RFT) and percutaneous balloon compression (PBC) for treating trigeminal neuralgia (TN).Methods: Chinese and English studies on RFT and PBC in the treatment of TN were systematically searched using CNKI, Wanfang Data, VIP, PubMed, EMBASE, Cochrane Library, and until December 31, 2022. Further, the literature was strictly screened using specific inclusion and exclusion criteria. The RevMan 5.4 software was used for data processing and meta-analysis.Results: Overall, 16 studies with 3,326 patients were included. The results of meta-analysis revealed that no significant difference was present between the two groups in terms of the rate of efficacy immediately after surgery, 1 month after surgery, and 3 months after surgery (odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.35–1.54, p = 0.41; OR = 0.41, 95% CI 0.13–1.32, p = 0.13; OR = 0.40, 95% CI 0.10–1.60, p = 0.20); however, at 12 months after surgery, the difference was statistically significant (OR = 0.27, 95% CI 0.10–0.75, p = 0.01). Notably, there was no significant difference in the postoperative sleep quality index between the two groups immediately after surgery and 1 month after surgery (SMD = −0.01, 95% CI −2.47 to 2.44, p = 0.99; SMD = 0.14, 95% CI −3.95 to 4.22, p = 0.95). Further, statistically significant differences were observed between the two groups in the incidence of postoperative masticatory muscle strength decline and oral herpes (OR = 0.37; 95% CI 0.21–0.63, p = 0.0003; OR = 0.25, 95% CI 0.10–0.61, p = 0.003). In addition, a statistically significant difference was found in the recurrence rate at 1-year follow-up (OR = 2.23, 95% CI 1.03–4.81, p = 0.04); however, no statistically significant differences were found in the recurrence rate at the 2-year follow-up (OR = 1.95, 95% CI 0.33–11.59, p = 0.46).Conclusion: In the treatment of TN, both RFT and PBC can achieve good short-term efficacy, and no significant differences were noted between the outcomes of the two approaches. Compared with RFT, PBC may result in a lower pain score and recurrence rate in the medium and long terms, but it is a higher incidence of cold sores, and the decrease of masticatory muscle strength is more obvious.

Objectives: This study aimed to investigate the differences in the effectiveness of percutaneous radiofrequency thermocoagulation (PRT) and microvascular decompression (MVD) in treating glossopharyngeal neuralgia (GPN). Methods: Medical records of patients were reviewed to investigate their baseline characteristics and immediate postoperative prognosis. Long-term outcomes of these patients were obtained through telephone interviews. Visual analog scale (VAS) and Pittsburgh sleep quality index (PSQI) scores at 1 day and 1, 4, 12, 24, and 48 weeks after surgery were compared between the MVD and PRT groups, in addition to complete pain relief rate, effective rate, adverse reactions, length of hospital stay, and economic indicators. Results: The VAS and PSQI scores of the two groups at 1 day and 1, 4, 12, 24, and 48 weeks after surgery were significantly lower (P < 0.05) than those before surgery. At 48 weeks, the complete remission rate was significantly higher (P < 0.05) in the MVD group than in PRT group. No significant difference in adverse reactions was observed between the two groups. The length of hospital stay, operative time, and cost were significantly higher (P < 0.05) in the MVD group than in the PRT group. Conclusions: Both PRT and MVD can significantly reduce patients’ degree of pain and improve their sleep quality. In the medium term, MVD is better than PRT in terms of the complete curative effect. In young patients with GPN, MVD is more often recommended than PRT; however, MVD is costlier than PRT.

We conducted a systematic review and meta-analysis of all published data to determine the impact of estradiol pretreatment on reproductive outcomes and ovary stimulation characteristics for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment with gonadotropin-releasing hormone (GnRH) antagonist protocol. MEDLINE, EMBASE, Cochrane Library, Web of Science, and China National Knowledge Infrastructure were searched, and any randomized controlled trials associated with estradiol pretreatment in GnRH antagonist protocol were included. Seven studies (1,236 patients) were included in the present study. The pooled data from the meta-analysis demonstrated no significant difference in ongoing pregnancy rate (odds ratio (OR): 0.92 (95% CI: 0.69–1.21; P = 0.53) and live birth rate OR: 0.98 (95% CI: 0.74–1.30; P = 0.90) between patients with and those without estradiol pretreatment in GnRH antagonist protocol. Duration of gonadotropin exposure, gonadotropin consumption, and the number of cumulus–oocyte complexes were not significantly different between groups. Luteal estradiol pretreatment in IVF/ICSI cycles with GnRH antagonist protocol in normal ovary responding population does not affect the reproductive outcomes. It is an encouraging option to facilitate cycle scheduling in GnRH antagonist protocol, for luteal estradiol pretreatment does not increase the duration of gonadotropin exposure or gonadotropin consumption.