Hepatocellular carcinoma cells interact with tumor microenvironment, and exhibits There are temporal and spatial heterogeneity of hepatocellular carcinoma which interacts with tumor microinvironment. In this paper, we summarized the characteristics of hepatocellular carcinoma heterogeneity, the mechanism of heterogeneity, and the impact of hepatocellular carcinoma heterogeneity on diagnosis and treatment, so as to provide a new thinking direction for the diagnosis and treatment of hepatocellular carcinoma.

BACKGROUNDPrimary open angle glaucoma (POAG) is a common cause of irreversible blindness. The variable etiology of POAG poses significant challenges for treatment and rehabilitation. We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder, assess vision-related quality of life (VRQL), and to evaluate the efficacy of rehabilitative treatments.

METHODSWe analyzed the visional disturbances in 500 POAG patients (890 eyes) by regular ophthalmic examination and visual field examination using Humphrey 30° perimetry. Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia, health education, counseling, and the fitting of typoscopes. VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire.

RESULTSScores on the VRQL self-assessment were significantly lower compared to healthy controls. The primary cause of the vision disturbances was ametropia (97.99%), and 51.61% of the ametropia eyes had not received appropriate correction. The secondary causes of visual impairment were glaucomatous neurodegeneration (26.29%), complicated cataract, or other accompanying eye diseases. The causes of the clinical low vision (44 patients) were glaucomatous neurodegeneration (32 eyes), fundus diseases (23 eyes), keratopathy (11 eyes), and other eye diseases (10 eyes). The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia (P < 0.01). Twenty-five patients with low vision were provided with typoscopes, and 21 (84%) experienced significant functional recovery, while the remaining low vision patients could see letter lines two or more levels lower (smaller) on visual charts in a near vision test.

CONCLUSIONSVision disorders in POAG patients are common and severe. Appropriate rehabilitation, especially the correction of ametropia, can significantly improve VRQL as revealed by the self-assessment of POAG patients.

Adult ; Aged ; Female ; Glaucoma, Open-Angle ; complications ; rehabilitation ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Vision Disorders ; etiology ; rehabilitation