Extragonadal Seminoma: Simultaneous Involvement of the Anterior Mediastinum and Central Nervous System.

Non-alcoholic fatty liver disease (NAFLD) is a type of metabolic stress-induced liver injury associated with insulin resistance and genetic susceptibility. Its disease spectrum encompasses non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), liver cirrhosis, and hepatocellular carcinoma (HCC). NAFLD not only leads to liver-related disabilities and mortalities but is also closely associated with the high prevalence of metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and atherosclerotic cardiovascular diseases. The global prevalence of NAFLD is on the rise. Abnormal accumulation of liver lipids is one of its main etiological factors, yet the specific pathogenesis has not been fully elucidated. Lifestyle intervention serves as the fundamental treatment, and novel metabolic drugs such as peroxisome proliferator-activated receptor (PPAR) agonists and farnesoid X receptor (FXR) agonists are currently in the clinical trial stage. Insulin resistance is a core factor in the occurrence and development of NAFLD. It exacerbates hepatic steatosis in hepatocytes through various pathways, including increasing lipolysis, inhibiting the activity of lipoprotein lipase, affecting glucose metabolism, promoting the synthesis of very low-density lipoprotein, and inducing oxidative stress and inflammatory responses. Regulating glucose and lipid metabolism is the key to the treatment of NAFLD. In recent years, studies have found that the EGFR/AKT/ESR1 signaling pathway plays a crucial role in regulating liver metabolic homeostasis and inflammatory responses, and it may become an important molecular regulatory target for NAFLD. In traditional Chinese medicine (TCM) theory, NAFLD mostly falls into the categories of “Gan Pi“(liver-spleen disharmony) and “Ji Ju” (accumulation). The key pathogenesis is closely related to liver qi stagnation and spleen deficiency, internal obstruction of phlegm-turbidity, and deficiency of the liver and kidney. The liver is responsible for regulating the flow of qi, and the spleen is in charge of transportation and transformation. If emotions are not smooth or the diet is improper, it can lead to the liver failing to regulate the flow of qi and the spleen failing to perform its transportation function. Nutrients from food and water fail to be metabolized properly, instead accumulating as phlegm-dampness that obstructs the liver collaterals. Over time, this results in fatty liver. Furthermore, the kidney is the root of congenital endowment, with the liver and kidney being closely interconnected.. If there is a deficiency of kidney essence and the liver loses nourishment, it can also accelerate the abnormal metabolism of liver lipids.