Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

Objective To evaluate the radiation impact of a self-developed digital miniature CT on the human body and the environment under simulated scanning conditions, and verify its safety and regulatory compliance. Methods Under typical head scanning conditions with the digital miniature CT (70 kV/10 mA), the equivalent doses received at the body surface sites corresponding to the thyroid, breast, stomach, liver, kidney, and gonads of the phantom were measured without protection and with 0.5 mmPb equivalent protection using LiF (Mg, Cu, P) thermoluminescent dosimeters. The ambient dose equivalent rates at the bed level inside the CT room at different directions and distances from the scanning center were measured using a model AT1121 X/γ dosimeter. The equivalent doses of organs on both sides of the phantom and the ambient equivalent dose rates on the left and right sides of the longitudinal axis of the bed in the CT room were compared. The Mann-Whitney test was used at a significance level of P < 0.05. Results During a single scan of the head with the digital miniature CT, the equivalent doses at the body surface sites corresponding to the thyroid, breast, stomach, liver, kidney, and gonads without protection were 1.04, 0.95, 0.55, 0.57, 0.40, and 0.12 mSv, respectively, which were only 0.84% to 8.24% of the doses inside the irradiation field. With 0.5 mm Pb equivalent protection, the equivalent dose of the thyroid decreased from 8.24 mSv to 3.27 mSv with a reduction of 60.3%, and the doses of the other organs were reduced to 1.5-11.5 μSv with the maximum reduction of 14 times. In the longitudinal axis direction of the CT bed, the ambient dose equivalent rate at a distance of 2 m from the scanning center was reduced to 0.066 mSv/h, which was only 9.6% of the ambient equivalent dose rate at a distance of 50 cm from the scanning center. Conclusion The digital miniature CT has advantages in ensuring patient safety, optimizing imaging quality, and promoting technological development, demonstrating promising application potential. However, the radiation protection of personal and CT room should not be ignored.

Objective: To investigate the association between overweight, obesity, central obesity and hypertension, so as to provide the basis for formulating targeted hypertension prevention and control strategies. Methods: Permanent residents aged ≥18 years were selected in Wenzhou City, Zhejiang Province from June 2023 to August 2024 by a multistage cluster random sampling method. Data on demographic information, lifestyle, height, weight, waist circumference (WC), blood pressure, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. The prevalence of hypertension was calculated and standardized using the data of the Sixth National Population Census in 2010. Body mass index (BMI) was calculated to determine overweight and obesity, while WC was used to identify central obesity. The association between overweight, obesity, central obesity and hypertension were analyzed using multivariable logistic regression models. Results: A total of 38 593 residents were surveyed, including 19 481 (50.48%) males and 19 112 (49.52%) females. The median age was 46.00 (interquartile range, 26.00) years. The rates of overweight, obesity, and central obesity were 32.74% (12 634 individuals), 10.27% (3 963 individuals), and 27.87% (10 755 individuals), respectively. There were 11 813 cases of hypertension, with a prevalence and standardized prevalence of 30.61% and 24.41%, respectively. Multivariable logistic regression analysis showed that after adjusting for demographic information, lifestyle, diabetes and dyslipidemia, the likelihood of hypertension in the overweight and obesity groups was 1.927 (95%CI: 1.815-2.045) times and 3.724 (95%CI: 3.404-4.073) times that of the normal BMI group, respectively. The likelihood of hypertension in the central obesity group was 2.346 (95%CI: 2.214-2.486) times that of the normal WC group. The likelihood of hypertension in the central obesity only, overweight only, overweight with central obesity, obesity only and obesity with central obesity groups was 1.586 (95%CI: 1.391-1.809), 1.704 (95%CI: 1.582-1.835), 2.433 (95%CI: 2.254-2.626), 1.768 (95%CI: 1.424-2.194), and 4.466 (95%CI: 4.053-4.921) times that of the normal BMI and WC group, respectively. Conclusions Overweight, obesity and central obesity were all associated with hypertension among adult residents. The highest likelihood of hypertension was observed among adult residents with both general obesity and central obesity.

Tezepelumab(AMG 157/MEDI9929)is a human monoclonal antibody against the epithelial cell-derived cytokine thymic stromal lymphopoietin(TSLP).It is primarily used to treat moderate to severe asthma,particularly in patients with a non-eosinophilic inflammatory phenotype,whose asthma remains uncontrolled despite the use of long-acting beta-agonists and moderate to high doses of inhaled glucocorticoids.This article will summarise the mechanism of action,clinical trial efficacy and safety and tolerability of Tezepelumab in order to provide a comprehensive understanding of the drug and inform clinical work.

Objective To observe the effects of dexmedetomidine combined with esketamine on early postoperative pain and cognitive function in elderly patients undergoing spinal surgery.Methods The aged spinal surgery patients were divided into control group and treatment group by random number table method.Both groups were anesthetically induced by intramuscular injection of esketamine 3 mg·kg-1,while the control group was anesthetically induced by intravenous injection of propofol 4 mg·kg-1 with constant velocity pump.The treatment group was given 1 μg·kg-1 dexmedetomidine by intravenous pump for 10 min,and then continued pumping at 0.5 μg·kg-1 rate.The changes of vital signs 5 min before surgery(T1),5 min after surgery(T2),at the end of surgery(T3),at the time of recovery(T4),early postoperative pain,cognitive function,the time of the first patient control analgesia(PC A),the cumulative dosage of sufentanil in different time periods within 48 h and the occurrence of adverse drug reactions were observed in the 2 groups.Results 44 patients were included in the control group and 45 patients in the treatment group,respectively.At T2,T3 and T4,the heart rate of treatment group were(82.51±3.05),(80.15±3.21)and(81.51±3.04)beat·min-1,and that of control group were(92.54±3.10),(93.52±3.05)and(88.45±3.51)beat·min-1,respectively.The mean arterial pressure(MAP)of the treatment group were(54.51±3.58),(55.25±3.21)and(60.25±3.24)mmHg;and that of the control group were(73.25±3.54),(70.52±3.20)and(68.51±3.05)mmHg,respectively.The blood oxygen saturation(SPO2)of treatment groups were(98.56±0.38)％,(98.25±0.35)％and(99.02±0.14)％;and the SPO2 of control group were(94.52±0.35)％,(95.25±0.25)％and(96.25±0.32)％,respectively.Visual analogue pain(VAS)scores were(5.69±1.12),(5.02±0.89),(4.52±0.65)and(4.01±0.45)scores at 2,4,6 and 8 h after operation,respectively;the control group were(6.25±1.35),(5.46±1.12),(4.98±0.84)and(4.25±0.52)scores,respectively.24,36 and 72 h after operation,the scores of MMSE in treatment group were 24.25±1.15,26.25±1.14,27.25±0.89 and 28.86±0.62,respectively;the control group were 22.52±1.02,24.25±1.12,26.58±0.87 and 28.78±0.52,respectively.Compared with the control group,there were statistically significant differences in the above indexes of treatment groups(all P＜0.05).The adverse drug reactions in the control group were mainly lethargy,respiratory depression,nausea and vomiting,and the adverse drug reactions in the treatment group were mainly lethargy,nausea and vomiting,and the incidence of total adverse drug reactions in the treatment group and the control group was 6.67％and 22.73％,respectively,with statistical significance(P＜0.05).Conclusion Dexmedetomidine combined with esketamine is safe and effective in elderly patients undergoing spinal surgery.It can effectively reduce early postoperative pain and quickly restore cognitive function.

OBJECTIVE To evaluate the quality of guidelines/consensus on therapeutic drug monitoring （TDM） of anti-tumor necrosis factor-α （TNF-α） in patients with inflammatory bowel disease （IBD） in China and globally. METHODS PubMed， Embase， CNKI， Wanfang data， VIP， and release websites of guidelines/consensus in China and globally were searched to collect guidelines/expert consensus on TDM with anti-TNF-α for IBD patients. The search period was from database establishment to June 2023. After two investigators independently screened the literature and extracted the data， the methodological quality of the included guidelines/consensuses was evaluated using the Appraisal of Guidelines for Research and Evaluation Ⅱ. The main recommendations of the included guidelines/consensuses were summarized. RESULTS A total of 9 articles were included， 3 were guidelines and 6 were expert consensus. The standardized percentages of the 9 guidelines/consensus in the 6 dimensions （scope and aims， participants， rigor of formulation， clarity of expression， application， and editorial independence） were 90.43%， 41.98%， 52.55%， 85.49%， 19.00%， and 76.85%， respectively. Eight guidelines/consensus had a recommendation of grade B and one consensus of grade C. The main recommendations involve TDM application scenarios， threshold ranges， strategy adjustments， detection methods， and interpretation of results. Most guidelines/consensus recommend passive TDM for non-responders. It is recommended to set the TDM concentration range according to the expected treatment results and make strategy adjustments in combination with the disease condition and TDM results. Additionally， the same test method is recommended for the same patient. Some guidelines/consensus hold that no differences were noted in the interpretation of results between biosimilar and original drug. CONCLUSIONS The overall quality of the included guidelines/consensus was fair， with relatively consistent recommendation. Clinicians need to understand the characteristics and limitations of TDM with this class of drugs， and interpret and apply results of TDM in combination with specific clinical treatment goals.

Volume electron microscopy (vEM) imaging technology was rapidly developed in recent years. It has been the advanced technology to solve high-resolution three-dimensional structures of biological samples. Much wonderful work has revealed the fine structure and interactions of intracellular organelles, the ultrastructure of tissues, and even the three-dimensional structure of entire small biological organisms. With the continuous improvement of resolution, scale and throughput, vEM is becoming more and more widely used in medicine, life sciences, clinical diagnostics and other fields. As a result, this technology has been rated by Nature as one of the seven most noteworthy frontier technologies to watch in 2023. However, the development and application of vEM-related technologies started late in China and need to be further promoted. We write this review to introduce all related vEM technologies, covering the development history of vEM, technology classification, sample preparation, data collection, image processing, etc., which is convenient for people in various fields to understand, learn, apply and further develop this technology.

OBJECTIVE To study effects of Jinshui Liujun decoction(JLD) on pulmonary water metabolism and TNF-α/NF-κB signaling pathway in asthmatic mice. METHODS After 1 week of acclimatization, 10 mice were randomly selected by body weight as a blank control group, and the rest of the mice were sensitized by intraperitoneal and subcutaneous injections of ovalbumin sensitizing solution on the 1st, 8th, and 15th day of the experiment. On the 22nd day, they were randomly divided into model control group, positive control group and JLD low, medium and high dose(4.1, 8.2, 16.4 g·kg−1) group, and replicated the asthma mouse model by inhaling nebulized excitation solution(1% ovalbumin) once every other day for 2 consecutive weeks, and at the same time, were given atomized excitation solution(1% ovalbumin) every other day for two weeks to replicate the asthmatic mouse model, and were given the test drug by gavage daily. The effects of JLD on the behavior, lung wet-dry weight ratio, AQP1, AQP5, TNF-α, NF-κB, and NF-κB mRNA expression in asthmatic mice were observed. RESULTS JLD reduced the number of animals with asthma attacks, alleviated asthma symptoms, decreased the lung index and lung wet-to-dry weight ratio, increased the expression level of AQP1 and AQP5 in lung tissues, reduced the content of TNF-α in bronchoalveolar lavage fluid and lung tissues, and down-regulated the expression level of NF-κB and its genes in lung tissues(P<0.05 or P<0.01). CONCLUSION JLD has an anti-asthma effect and its mechanism of action is partially due to its inhibition of the TNF-α/NF-κB signaling pathway, upregulation of AQP1 and AQP5, and improvement of pulmonary water metabolism.