Bile duct injuries can be classified into iatrogenic and non-iatrogenic categories.Non-iatrogenic bile duct injuries include immune,infectious,vascular,ischemic,genetic,idiopathic,and neoplastic causes.After injury,the biliary epithelial cells undergo closely linked pathological processes,such as inflammatory repair,epithelial regeneration,and fibrous repair.These processes interact with inflammatory and stromal cells through autocrine and paracrine mechanisms,coordinating the repair process to maintain the structural and functional integrity of the bile ducts.In the absence of effective intervention,bile duct injuries can lead to bile leakage,biliary strictures,and even progress to cirrhosis,severely affecting the patient's quality of life.Currently,treating bile duct injuries is no longer limited to traditional surgical methods but also includes non-surgical treatments such as immune modulation,bile acid regulation,and gut microbiota adjustment.With the development of medical technology,novel treatments such as gene therapy,stem cell/organoid technology,and endoscopic retrograde cholangiopancreatography/tissue-engineered scaffolds are gaining attention and are expected to become effective treatment options for bile duct injuries in the future.This review focuses on the etiology and pathological mechanisms during the repair process of bile duct injuries and summarizes existing and potential treatment approaches,providing a reference for future research and clinical management of bile duct injuries.

Bile duct injuries can be classified into iatrogenic and non-iatrogenic categories.Non-iatrogenic bile duct injuries include immune,infectious,vascular,ischemic,genetic,idiopathic,and neoplastic causes.After injury,the biliary epithelial cells undergo closely linked pathological processes,such as inflammatory repair,epithelial regeneration,and fibrous repair.These processes interact with inflammatory and stromal cells through autocrine and paracrine mechanisms,coordinating the repair process to maintain the structural and functional integrity of the bile ducts.In the absence of effective intervention,bile duct injuries can lead to bile leakage,biliary strictures,and even progress to cirrhosis,severely affecting the patient's quality of life.Currently,treating bile duct injuries is no longer limited to traditional surgical methods but also includes non-surgical treatments such as immune modulation,bile acid regulation,and gut microbiota adjustment.With the development of medical technology,novel treatments such as gene therapy,stem cell/organoid technology,and endoscopic retrograde cholangiopancreatography/tissue-engineered scaffolds are gaining attention and are expected to become effective treatment options for bile duct injuries in the future.This review focuses on the etiology and pathological mechanisms during the repair process of bile duct injuries and summarizes existing and potential treatment approaches,providing a reference for future research and clinical management of bile duct injuries.

Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.