Background and aims:Advanced hepatocellular carcinoma(HCC)with pulmonary metastasis(PM)has a poor prognosis,and optimal treatment strategies remain controversial.This study aimed to compare the long-term outcomes of patients with advanced HCC with PM who were treated with resection of pul-monary metastases versus those treated with targeted therapies combined with immunotherapy.Methods:A retrospective analysis was conducted on the medical records of HCC patients with PM who underwent either pulmonary metastasectomy or immunotherapy combined with targeted therapies at the Eastern Hepatobiliary Surgery Hospital,Changhai Hospital of Shanghai,Fujian Provincial Hospital,and West China Hospital of Sichuan University from September 2013 to October 2022.One-to-one propensity score matching(PSM)was employed to control the influence of potential confounders,and the survival outcomes were compared.Results:A total of 119 HCC patients with PM were included in this study.The overall survival(OS)of patients who underwent pulmonary metastasectomy was significantly longer than that of patients who received immunotherapy targeted combinations(OS:1-year,80.0％vs.59.3％;2-year,31.7％vs.20.3％;3-year,20.0％vs.0;P＜0.001).After PSM,the long-term prognosis of the pulmonary metastasectomy group remained significantly better than that of the immunotherapy combination group(OS:1-year,87.0％vs.69.6％;2-year,34.8％vs.30.4％;3-year,21.7％vs.0;P=0.005).Multivariate analysis revealed that treat-ment allocation(hazard ratio(HR)=2.177,95％confidence interval(CI)=1.068-4.439)and hepatic tumor T stage(HR=2.342,95％CI=1.209-4.538)were independent risk factors for OS.Conclusions:Pulmonary metastasectomy was associated with improved survival compared to immu-notherapy combined with targeted therapies and may represent an optimal treatment option for highly selected HCC patients with resectable PM.

Spinal cord injury (SCI) represents a complex pathophysiological process involving the interaction of multiple cell types. Conventional sequencing methods can only detect the average gene expression level of the damaged local cell populations, which is difficult to reflect its heterogeneity. Therefore, new technologies are needed to reveal the intercellular heterogeneity and the complex intercellular interactions of the damaged lesions. The single-cell RNA sequencing (scRNA-seq) technique facilitates high-resolution profiling of gene expression at the single-cell level, providing insights into cellular heterogeneity and function, potential molecular pathways, cell fate transitions, and the intercellular interactions pertinent to disease progression. This technology generates valuable gene expression data that support both basic and translational research efforts aiming at the identification of therapeutic targets for intervention. The scRNA-seq technique and its multifaceted application in the local immune microenvironment of injury after SCI were discussed, which will contribute to a more comprehensive understanding of the pathophysiological processes in the immune microenvironment of SCI.
Spinal Cord Injuries/genetics* ; Humans ; Single-Cell Analysis/methods* ; Sequence Analysis, RNA/methods* ; Animals ; Gene Expression Profiling/methods* ; Cellular Microenvironment/genetics*

Objective To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)for the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.Methods Thirty-one pa-tients with histopathologically proved adenoid cystic carcinoma and pleomorphic adenoma were examined with DCE-MRI,in which 10 cases were benign and 21 cases were malignant.The data of the conventional 3.0T DCE-MRI were improved by the 3D fast spoiled gradient-echo sequence (FSPGR)method.Z-test was performed on the quantitative parameters for benign and malignant le-sions,including volume transfer constant (Ktrans ),rate constant (Kep )and extravascular extracellular space fraction (Ve ).The re-ceiver operating characteristic (ROC)curves were plotted to investigate the diagnosis.Results The mean Ktranss of the adenoid cystic carcinoma group and pleomorphic adenoma group were (0.266 ± 0.103 )min-1 and (0.1 55 ± 0.080)min-1 respectively,and the difference between them were statistically significant (Z =-2.699,P < 0.05).The difference between the keps of the aforementioned two groups was of statistical significance (Z =-2.263,P < 0.05),while that of the ves is without statistical significance (Z =-1.132, P >0.05).The areas under the ROC curves of the Ktrans and kep were 0.813 and 0.763 respectively.Choosing the optimal diagnostic cut-off points corresponding to the maximum Youden indexes 0.173 min-1 and 0.818 min-1 ,the sensitivities of Ktrans and kep for identifying the adenoid cystic carcinoma and pleomorphic adenoma were 90.9% and 81.8%,and the specificities were 77.8% and 66.7%.Ktrans was of the highest sensitivity and specificity for the identification of the adenoid cystic carcinoma and pleomorphic adenoma.Conclu-sion The dynamic contrast-enhanced parameter Ktrans plays a certain role in the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.