The incidence and mortality of hepatocellular carcinoma (HCC) in China are among the highest in the world, imposing a heavy social burden. Liver resection and liver transplantation are the primary radical treatments for HCC, although most patients are no longer able to meet the surgical requirements at initial diagnosis. Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) has the advantages of shrinking tumors, enlarging residual liver, regressing portal vein tumor thrombus and improving the quality of life, which can be used for conversion, downstaging and bridging therapy for HCC before surgical treatment, enabling patients regain the chance of radical treatment and reducing the postoperative recurrence rate. This review focuses on the clinical application and progress of ⁹⁰Y-SIRT in this field.

Objective:To investigate the prevalence and determinants of dry eye syndrome among civil aviation flight attendants.Methods:Data from 1 201 civil aviation flight attendants across 6 airlines, along with their eye examination and general health records from the previous year, were collected and analyzed between January and March 2024. A self-designed questionnaire was designed to assess risk factors to dry eye syndrome. The severity of dry eye syndrome of these civil aviation flight attendants was assessed using the Ocular Surface Disease Index (OSDI) scale before they were grouped based on OSDI scores. The Fatigue Assessment Scale and Pittsburgh Sleep Quality Index were used to evaluate levels of fatigue and sleep quality. Multivariable Logistic regression was employed to identify factors associated with the severity of dry eye syndrome.Results:A total of 1 201 flight attendants were enrolled in this study. Questionnaires were distributed to all the participants, and 1 021 valid responses were collected, yielding a response rate of 85.0%. All flight attendants experienced dry eye syndrome. Among these cases, 657 cases were classified as moderate and 364 as severe. Logistic regression analysis showed that flying hours in the previous year ( OR=1.001, 95% CI: 1.001-1.002), a history of eyelid disease ( OR=2.059, 95% CI: 1.311-3.232), fatigue ( OR=2.438, 95% CI: 1.633-3.640), use of preservative-containing eye drops ( OR=3.034, 95% CI: 1.800-5.113), use of artificial tears ( OR=2.431, 95% CI: 1.544-3.827), use of contact lenses ( OR=2.095, 95% CI: 1.381-3.179), refractive progression of <-0.50 D ( OR=3.102, 95% CI: 1.955-4.920) and -0.50 to <-1.00 D ( OR=3.846, 95% CI: 1.845-8.018), sleep scale scores of 6-10 ( OR=1.940, 95% CI: 1.258-2.993), 11-15 ( OR=2.730, 95% CI: 1.564-4.768), and 16-21 ( OR=6.010, 95% CI: 1.752-20.614) were determinants of the severity of dry eye syndrome. Conclusions:Dry eye symptoms are generally severe among civil aviation flight attendants. Priority should be given to monitoring sleep quality and fatigue levels, with particular emphasis on individuals exceeding 713 flying hours in the previous year for early detection of dry eye syndrome.

Objective:To investigate the efficacy and safety of lenvatinib plus drug-eluting bead transarterial chemoembolization (DEB-TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (Len+DEB-TACE+HAIC) versus lenvatinib plus DEB-TACE (Len+DEB-TACE) for hepatocellular carcinoma (HCC) larger than 7 cm with portal vein tumor thrombosis (PVTT).Methods:The data from patients diagnosed with HCC (>7 cm) and PVTT who received either Len+DEB-TACE+HAIC ( n=99) or Len+DEB-TACE ( n=102) between July 2019 and June 2021 at six institutions in China were collected and retrospectively analyzed. Tumor responses were evaluated based on modified Response Evaluation Criteria in Solid Tumors. Objective response rate (ORR), disease control rate (DCR), time to progression (TTP), overall survival (OS), and treatment-related adverse event (TRAE) were compared between the two groups by propensity score matching. Subgroup analyses were performed for TTP and OS. Results:After propensity score matching, 83 pairs of patients were included in the study cohorts. The ORR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 66.3% and 38.6% ( χ2=12.78, P<0.001), respectively. The DCR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 91.6% and 79.5% ( χ2=4.87, P=0.027), respectively. The median TTP and median OS for the Len+DEB-TACE+HAIC group were significantly longer than those for the Len+DEB-TACE group (TTP, 10.1 months vs. 6.1 months, χ2=35.28, P<0.001; OS, 17.3 months vs. 12.9 months, χ2=16.84, P<0.001). The incidence of ≥grade 3 TRAEs was 38.6% in the Len+DEB-TACE+HAIC group and 33.7% in the Len+DEB-TACE group ( χ2=0.42, P=0.518). Conclusion:Compared with Len+DEB-TACE, Len+DEB-TACE+HAIC led to improved tumor response, TTP and OS with an acceptable safety profile in patients with large HCC and PVTT.

Objective To evaluate the inhibitory effects of prophylactic administration of α-zearalanol(α-ZAL)on bone microarchitecture and bone resorption activity in ovariectomized osteoporotic rats,and to investigate its regulatory effects on the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells(BMSCs).Methods A total of 606-month-old unmated female Sprague-Dawley(SD)rats weighing(300±20)g were randomly divided into the sham surgery group(Sham group),ovariectomy group(OVX group),solvent group(Oil group),estradiol benzoate treatment group(Post-E2 group),α-ZAL prevention group(Pre-ZAL group),and α-ZAL treatment group(Post-ZAL group),with 10 rats in each group.An osteoporosis rat model was established using the ovariectomy method.Rats in the Sham group underwent the same surgical procedures except for ovarian removal.Seventy-two hours after ovarian removal,the Oil group received intramuscular injections of 0.5 mL of oil solvent,and the Pre-ZAL group received intramuscular injections of α-ZAL(1.5 mg·kg-1),administered every 3 days for 120 consecutive days.The Post-E2 group and Post-ZAL group began intramuscular injections of estradiol benzoate(1.5 mg·kg-1)and α-ZAL(1.5 mg·kg-1),respectively,90 days after ovariectomy,administered every 3 days for 120 consecutive days.After drug administration,bone density and bone tissue microstructure morphology were analyzed using a micro-CT small animal in vivo imaging system and staining methods.Osteoclasts were isolated and their activity was detected.Femoral BMSCs were obtained to assess their osteoblast and adipocyte differentiation capabilities,and uterine tissue morphological changes were observed via histological sections.Results Compared with the OVX group,BMD in the Sham group,Post-E2 group,Pre-ZAL group,and Post-ZAL group increased by 133.12%,75.97%,69.64%,and 24.69%,respectively(all P<0.01).BMD in the Pre-ZAL group was 36.09%higher than in the Post-ZAL group(P<0.01),and there was no significant difference in BMD between the Post-E2 and Pre-ZAL groups(P>0.05).Tb.N in the Sham group,Post-E2 group,Pre-ZAL group,and Post-ZAL group increased by 160.08%,118.14%,94.76%,and 46.76%,respectively,compared with the OVX group(all P<0.01).Tb.Ar increased by 324.21%,203.83%,177.99%,and 82.71%,respectively(all P<0.01).Tb.N in the Pre-ZAL group increased by 32.71%compared to the Post-ZAL group(P<0.05),while Tb.Ar increased by 52.15%(P<0.01).Tb.Sp in the Sham,Post-E2,and Pre-ZAL groups decreased by 58.53%,42.18%,and 35.61%,respectively,compared with the OVX group(all P<0.01).The MAR of the upper tibial cancellous bone in the Sham,Post-E2,and Pre-ZAL groups increased by 257.81%,156.72%,and 142.63%,respectively,compared with the OVX group(all P<0.01),BFR increased by 192.19%,137.23%,and 88.13%,respectively(all P<0.01).MAR and BFR in the Pre-ZAL group increased by 58.10%and 43.63%,respectively,compared with the Post-ZAL group(both P<0.01).There were no significant differences in MAR and BFR between the Post-E2 group and the Pre-ZAL group(P>0.05).MMP-9,TRAP,and CK mRNA expression was significantly downregulated in both the Post-E2 group and the Pre-ZAL group(P<0.01).The osteoblast differentiation capacity of BMSCs in the Post-E2 group and all Post-ZAL groups was enhanced,with a significant increase in the number of mineralized nodules,and the expression levels of OCN,COL1,and OPN mRNA were significantly increased(P<0.01),while the ability to differentiate into adipocytes was weakened.The number of intracellular lipid droplets in BMSCs was significantly reduced,the lipid droplet volume was smaller,and the expression levels of PPAR-γ2 and aP2 mRNA were decreased(P<0.05).There were no significant differences between the Post-E2 group and the Pre-ZAL group(P>0.05).There was no significant increase in body weight in the Post-E2,Pre-ZAL,and Post-ZAL groups,but uterine weight significantly increased in the Post-E2 group(P<0.05),with marked uterine epithelial hyperplasia.Uterine weight in the Pre-ZAL and Post-ZAL groups showed no significant difference compared to the OVX group(P>0.05),and no significant changes were observed in uterine epithelium.Conclusion α-ZAL can effectively protect bone mass,improve bone microstructure,and reduce estrogen-related uterine adverse reactions by regulating the osteogenic/adipogenic differentiation balance of BMSCs,providing a potential new therapeutic strategy for the prevention and treatment of postmenopausal osteoporosis.

Objective:To systematically evaluate the effect of virtual reality exercise training on gait performance in older adults.Methods:Randomized controlled trials on the rehabilitation effects of virtual reality exercise training on gait performance in older adults were electronically searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from establishing of the database to January 10, 2025. Version 2 of the Cochrane risk of bias tool for randomized trials (RoB 2) was used to evaluate the methodological quality of the included literature. Meta-analysis was performed using RevMan 5.4.Results:A total of 27 articles were included. Meta-analysis showed that the effect of virtual reality exercise on improving the functional walking ability of older adults was better than traditional exercise [ WMD=-0.83, 95% CI (-1.31, -0.36) , P<0.01]. However, virtual reality exercise did not improve step speed, stride length, step frequency, and dynamic gait indices in older adults ( P>0.05) . Subgroup analysis showed that virtual reality exercise was more effective than traditional exercise in improving step speed in older adults when the length of the weekly intervention was≥120 min [ SMD=0.48, 95% CI (0.04, 0.92) , P=0.03]. Conclusions:Virtual reality exercise training effectively improves walking ability in older adults but has no advantage in improving refined gait-related indicators. Future interventions in the form of virtual reality exercise training combined with traditional exercise rehabilitation are recommended for older adults.

Objective:To systematically evaluate the effect of virtual reality exercise training on gait performance in older adults.Methods:Randomized controlled trials on the rehabilitation effects of virtual reality exercise training on gait performance in older adults were electronically searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from establishing of the database to January 10, 2025. Version 2 of the Cochrane risk of bias tool for randomized trials (RoB 2) was used to evaluate the methodological quality of the included literature. Meta-analysis was performed using RevMan 5.4.Results:A total of 27 articles were included. Meta-analysis showed that the effect of virtual reality exercise on improving the functional walking ability of older adults was better than traditional exercise [ WMD=-0.83, 95% CI (-1.31, -0.36) , P<0.01]. However, virtual reality exercise did not improve step speed, stride length, step frequency, and dynamic gait indices in older adults ( P>0.05) . Subgroup analysis showed that virtual reality exercise was more effective than traditional exercise in improving step speed in older adults when the length of the weekly intervention was≥120 min [ SMD=0.48, 95% CI (0.04, 0.92) , P=0.03]. Conclusions:Virtual reality exercise training effectively improves walking ability in older adults but has no advantage in improving refined gait-related indicators. Future interventions in the form of virtual reality exercise training combined with traditional exercise rehabilitation are recommended for older adults.

Objective:To investigate the prevalence and determinants of dry eye syndrome among civil aviation flight attendants.Methods:Data from 1 201 civil aviation flight attendants across 6 airlines, along with their eye examination and general health records from the previous year, were collected and analyzed between January and March 2024. A self-designed questionnaire was designed to assess risk factors to dry eye syndrome. The severity of dry eye syndrome of these civil aviation flight attendants was assessed using the Ocular Surface Disease Index (OSDI) scale before they were grouped based on OSDI scores. The Fatigue Assessment Scale and Pittsburgh Sleep Quality Index were used to evaluate levels of fatigue and sleep quality. Multivariable Logistic regression was employed to identify factors associated with the severity of dry eye syndrome.Results:A total of 1 201 flight attendants were enrolled in this study. Questionnaires were distributed to all the participants, and 1 021 valid responses were collected, yielding a response rate of 85.0%. All flight attendants experienced dry eye syndrome. Among these cases, 657 cases were classified as moderate and 364 as severe. Logistic regression analysis showed that flying hours in the previous year ( OR=1.001, 95% CI: 1.001-1.002), a history of eyelid disease ( OR=2.059, 95% CI: 1.311-3.232), fatigue ( OR=2.438, 95% CI: 1.633-3.640), use of preservative-containing eye drops ( OR=3.034, 95% CI: 1.800-5.113), use of artificial tears ( OR=2.431, 95% CI: 1.544-3.827), use of contact lenses ( OR=2.095, 95% CI: 1.381-3.179), refractive progression of <-0.50 D ( OR=3.102, 95% CI: 1.955-4.920) and -0.50 to <-1.00 D ( OR=3.846, 95% CI: 1.845-8.018), sleep scale scores of 6-10 ( OR=1.940, 95% CI: 1.258-2.993), 11-15 ( OR=2.730, 95% CI: 1.564-4.768), and 16-21 ( OR=6.010, 95% CI: 1.752-20.614) were determinants of the severity of dry eye syndrome. Conclusions:Dry eye symptoms are generally severe among civil aviation flight attendants. Priority should be given to monitoring sleep quality and fatigue levels, with particular emphasis on individuals exceeding 713 flying hours in the previous year for early detection of dry eye syndrome.

Objective:To investigate the efficacy and safety of lenvatinib plus drug-eluting bead transarterial chemoembolization (DEB-TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (Len+DEB-TACE+HAIC) versus lenvatinib plus DEB-TACE (Len+DEB-TACE) for hepatocellular carcinoma (HCC) larger than 7 cm with portal vein tumor thrombosis (PVTT).Methods:The data from patients diagnosed with HCC (>7 cm) and PVTT who received either Len+DEB-TACE+HAIC ( n=99) or Len+DEB-TACE ( n=102) between July 2019 and June 2021 at six institutions in China were collected and retrospectively analyzed. Tumor responses were evaluated based on modified Response Evaluation Criteria in Solid Tumors. Objective response rate (ORR), disease control rate (DCR), time to progression (TTP), overall survival (OS), and treatment-related adverse event (TRAE) were compared between the two groups by propensity score matching. Subgroup analyses were performed for TTP and OS. Results:After propensity score matching, 83 pairs of patients were included in the study cohorts. The ORR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 66.3% and 38.6% ( χ2=12.78, P<0.001), respectively. The DCR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 91.6% and 79.5% ( χ2=4.87, P=0.027), respectively. The median TTP and median OS for the Len+DEB-TACE+HAIC group were significantly longer than those for the Len+DEB-TACE group (TTP, 10.1 months vs. 6.1 months, χ2=35.28, P<0.001; OS, 17.3 months vs. 12.9 months, χ2=16.84, P<0.001). The incidence of ≥grade 3 TRAEs was 38.6% in the Len+DEB-TACE+HAIC group and 33.7% in the Len+DEB-TACE group ( χ2=0.42, P=0.518). Conclusion:Compared with Len+DEB-TACE, Len+DEB-TACE+HAIC led to improved tumor response, TTP and OS with an acceptable safety profile in patients with large HCC and PVTT.

【Objective】 To investigate the condition of confidential unit exclusion(CUE) in Guangzhou, so as to ensure blood safety. 【Methods】 The number of CUE donors, demographic characteristics of CUE donors, reasons for CUE, and response time of CUE after blood donation in Guangzhou from 2009 to 2022 were statistically analyzed. 【Results】 From 2009 to 2022, the response ratios of CUE was 0.006 2% (260/4 170 984) and the ratios had statistically significant difference between different years(P<0.05). For the response ratios of CUE, no statistically significant difference was noticed in gender and occupation (P>0.05), but statistically significant differences were found in age, number of blood donations, education background, and marital status (P<0.05). Blood donors aged 18~30 (0.007 3%, P<0.05) and first-time blood donors (0.010 8%, P<0.05) were the main groups of CUE. High risk sexual behavior (28.46%, 74/260) was the primary reason for CUE. The CUE response peak was within 72 hours after blood donation, and the response ratios within 24-72 hours after blood donation was the highest (68.46%, 178/260). 【Conclusion】 CUE is a crucial measure to ensure blood safety. Detailed pre-donation health consultations are suggested for blood donors aged 18-30 and first-time blood donors so as to better excluding high-risk blood donors. Strengthening the publicity of CUE response and process, registering and classifying the reasons for CUE are also important.

OBJECTIVE: Anemoside B4 (AB4), the most abundant triterpenoidal saponin isolated from Pulsatilla chinensis, inhibited influenza virus FM1 or Klebsiella pneumoniae-induced pneumonia. However, the anti-SARS-CoV-2 effect of AB4 has not been unraveled. Therefore, this study aimed to determine the antiviral activity and potential mechanism of AB4 in inhibiting human coronavirus SARS-CoV-2 in vivo and in vitro. METHODS: The cytotoxicity of AB4 was evaluated using the Cell Counting Kit-8 (CCK8) assay. SARS-CoV-2 infected HEK293T, HPAEpiC, and Vero E6 cells were used for in vitro assays. The antiviral effect of AB4 in vivo was evaluated by SARS-CoV-2-infected hACE2-IRES-luc transgenic mouse model. Furthermore, label-free quantitative proteomics and bioinformatic analysis were performed to explore the potential antiviral mechanism of action of AB4. Type I IFN signaling-associated proteins were assessed using Western blotting or immumohistochemical staining. RESULTS: The data showed that AB4 reduced the propagation of SARS-CoV-2 along with the decreased Nucleocapsid protein (N), Spike protein (S), and 3C-like protease (3CLpro) in HEK293T cells. In vivo antiviral activity data revealed that AB4 inhibited viral replication and relieved pneumonia in a SARS-CoV-2 infected mouse model. We further disclosed that the antiviral activity of AB4 was associated with the enhanced interferon (IFN)-β response via the activation of retinoic acid-inducible gene I (RIG-1) like receptor (RLP) pathways. Additionally, label-free quantitative proteomic analyses discovered that 17 proteins were significantly altered by AB4 in the SARS-CoV-2 coronavirus infections cells. These proteins mainly clustered in RNA metabolism. CONCLUSION Our results indicated that AB4 inhibited SARS-CoV-2 replication through the RLR pathways and moderated the RNA metabolism, suggesting that it would be a potential lead compound for the development of anti-SARS-CoV-2 drugs.