Hepatocellular carcinoma (HCC) frequently presents as advanced stage with poor prognosis and high mortality. Systemic treatment is the treatment of choice for advanced disease. In 2007, the first multi-kinase inhibitor (MKI) sorafenib was approved and shown to modestly prolong overall survival (OS). The progress of systemic therapy has been slow afterwards until 2018 when lenvatinib, another MKI, was shown to be non-inferior to sorafenib on median OS as the first-line therapy for HCC. Since then, remarkable progress has been achieved on the treatment of advanced HCC, including the development of second-line targeted treatment, including regorafenib, cabozantinib and ramucirumab from 2017 to 2019. A growing focus has been placed on immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1), its ligand PD-L1, and cytotoxic T-lymphocyte-associated protein 4. These ICIs have proven their potency in treating HCC as both initial and subsequent line of therapy. At present, both regimens of atezolizumab combined with bevacizumab, as well as the combination of tremelimumab and durvalumab, are recommended as the first-line treatments based on positive phase III clinical trials. With the advancement of ICIs, it is anticipated that the role of MKIs in the treatment of HCC will evolve. In this article, lenvatinib, one of the most commonly used MKIs in HCC, is chosen to be reviewed.

Background:In the 2022-2023 global outbreak,the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox(Mpox)cases respectively as of November 2023.This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes. Methods:Houston Health Department received reports of suspected Mpox cases via electronic case reports and laboratory reports from healthcare providers within Houston.These were then investigated and reclassified as either positive or negative using DNA polymerase chain reaction tests.All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods.Descriptive statistics using frequency distribution was used to analyze the sociodemographic,clinical features and travel history of the cases.A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P＜0.05.Other infection control measures such as community engagement,health education,tracking and contact tracing,vaccination,referrals and laboratory sample logistics support were implemented by the health department. Results:Out of the total of 1,625 suspected persons investigated for Mpox,724(44.6％)tested positive.Among the 724 confirmed cases,male was 700(96.7％),females 20(2.8％),transgender male 1(0.1％),transgender female 3(0.4％).Age groups 30-39 years constituted 43.6％,18-29 years 27.4％,40-49 years 18.2％,50-59 years was 8％.Race distribution of positive cases was Whites 43.4％,African American 38.7％,Asian 1.4％.Risk factors with P＜0.05 included male gender,age groups 30-39 years and 40-49 years,travel history to Mpox endemic areas,recent sexual contact with known or suspected Mpox cases,human immunodeficiency virus seropositivity.Identifying as gay and bisexual were also statistically significant risk factors for Mpox infection. Conclusion:The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.

OBJECTIVE: Considering the different prevalence rates of diseases such as asthma and chronic obstructive pulmonary disease in Asians relative to other races, Koreans may have unique airway structure and lung function. This study aimed to investigate unique features of airway structure and lung function based on quantitative computed tomography (QCT)-imaging metrics in the Korean Asian population (Koreans) as compared with the White American population (Whites). MATERIALS AND METHODS: QCT data of healthy non-smokers (223 Koreans vs. 70 Whites) were collected, including QCT structural variables of wall thickness (WT) and hydraulic diameter (Dh) and functional variables of air volume, total air volume change in the lung (ΔVair), percent emphysema-like lung (Emph%), and percent functional small airway disease-like lung (fSAD%). Mann-Whitney U tests were performed to compare the two groups. RESULTS: As compared with Whites, Koreans had smaller volume at inspiration, ΔVair between inspiration and expiration (p < 0.001), and Emph% at inspiration (p < 0.001). Especially, Korean females had a decrease of ΔVair in the lower lobes (p < 0.001), associated with fSAD% at the lower lobes (p < 0.05). In addition, Koreans had smaller Dh and WT of the trachea (both, p < 0.05), correlated with the forced expiratory volume in 1 second (R = 0.49, 0.39; all p < 0.001) and forced vital capacity (R = 0.55, 0.45; all p < 0.001). CONCLUSION: Koreans had unique features of airway structure and lung function as compared with Whites, and the difference was clearer in female individuals. Discriminating structural and functional features between Koreans and Whites enables exploration of inter-racial differences of pulmonary disease in terms of severity, distribution, and phenotype.
Asian Continental Ancestry Group ; Asthma ; Continental Population Groups ; Female ; Forced Expiratory Volume ; Humans ; Lung ; Lung Diseases ; Phenotype ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Thorax ; Trachea ; Vital Capacity