Hepatocellular carcinoma(HCC)has become the second leading cause of cancer-related death worldwide,ranking 6th among all tumors.Due to the lack of obvious early symptoms,most patients are diagnosed in the advanced stage,and the clinical benefits of surgical resection and hepatic artery chemoembolization and radiofrequency ablation are very limited.In recent years,the advent of immune-targeted therapies has revolutionized the systemic and systemic treatment of patients with advanced HCC,however,there is a lack of strong clinical evidence on the safety and efficacy of immune and targeted therapies for special populations,including patients with human immunodeficiency virus(HIV)infection,active autoimmune disease,decompensated cirrhosis(Child B or C),patients with diabetes-associated metabolic syndrome,patients with portal hypertension,vascular invasion,or portal vein thrombosis(PVT),and patients with liver transplantation(LT).This article reviews the current research progress of immune and targeted drugs in special populations.

Objective To report a case of synovial sarcoma of the liver and review the literature for improving the understanding of the disease.Methods The clinical data of a patient with liver synovial sarcoma admitted to the First Affiliated Hospital of Henan University were analyzed retrospectively.The imaging,pathological features,treatment and prognosis of this disease were summarized by searching the database(CNKI,Wanfang Data,PubMed,untill July 2022)and the literature results analyzed comprehensively.Results The patient was a 71-year-old female who was admitted to the hospital due to abdominal pain.Computed tomography(CT)scan showed a mass with mixed density in the right lobe and caudate lobe of the liver.The large cross section size was about 115 mm×87 mm and the mass showed continuous heterogeneous enhancement,being considered as malignant hepatic tumors with multiple metastasis of the liver and lung.Ultrasound-guided needle biopsy was performed,and microscopy showed the tumor cells were obvious atypical,and some were spindle-shaped.Immunohistochemistry showed that the patient was positive for vimentin(VIM),epithelial membrane antigen(EMA),methylation of histone at lysine 27(H3K27Me3),and negative for pan cytokeratin(CK-pan)and S-100,and pathological diagnosis of synovial sarcoma was made.The patient did not undergo subsequent treatment and was lost to follow-up after discharge.A total of 12 cases of hepatic synovial sarcoma were reported after searching the database.The clinical manifestations were abdominal pain or distention.The lesions were mostly located in the right lobe of the liver,usually large,heterogeneous density,and heterogeneous enhancement on enhanced CT or magnetic resonance imaging(MRI).Spindle-shaped cells were found at histopathologic examination.Immunohistochemistry showed the patient was positive for VIM,EMA,H3K27Me,B-cell leukemia/lymphoma-2(BCL-2)and transducer-like enhancer of split 1(TLE1).SS18-SSX fusion gene or SS18 gene isolation were detected.Eleven patients received surgical treatment,5 received adjuvant chemotherapy,and 4 had recurrence or metastasis during the follow-up period.Conclusions Synovial sarcoma of the liver is a rare malignant tumor of the liver.The clinical and imaging features are not specific.The diagnosis depends on pathology.At present,the main treatment is surgery,and comprehensive treatment such as adjuvant chemotherapy can be performed.The prognosis of the patient is poor.

Dual-tracer PET imaging can provide more comprehensive clinical information for disease diagnosis. How to achieve dual-tracer imaging through single imaging session is one of the hot topics in the field of nuclear medicine. The key issues in achieving dual-tracer imaging with a single scan is the accurate separation of single-tracer information from the mixed tracer signal. In the last two decades, separation methods for different tracers have been proposed, and the injection interval between two tracers was reduced. This paper summarizes recent dual-tracer separation methods. The basic principles, features and advantages of separation methods are analyzed. Besides, the outlook on the future development of dual-tracer separation is also discussed in the present review.

Objective To propose a motion performance-based adaptive assistance strategy to balance the differences in movement intensity caused by varying motor abilities in dual-person upper limb rehabilitation training. Methods A competitive interactive task suitable for dual-person rehabilitation training was designed.Two kinematic evaluation metrics were introduced,and fuzzy logic was applied to comprehensively assess the patients'motor performance.An adaptive control system framework was constructed to dynamically adjust the robot's assistance level through a difference-based adaptive step-size piecewise function.Four healthy persons were recruited ran-domly to test the system. Results The proposed strategy could adaptively adjust the level of assistance based on the participants'motor perfor-mance,balancing the differences in motor abilities between them and enabling both parties to engage at a similar competitive level. Conclusion The motion performance-based adaptive assistance strategy and adaptive control system framework may bal-ance the skill levels between participants with different motor abilities,avoiding the imbalance of training intensi-ty during dual-person interactive rehabilitation.

Objective:To investigate the correlation between the expression of GLI1 and im-mune invasion and clinical prognosis in gastric cancer.To study the effect of GLI1 expression on drug resistance in gastric cancer.Methods:The expression difference of GLI1 in gastric cancer and normal tissues was analyzed by using TCGA database,and the effect of clinical features and GLI1 gene ex-pression level on prognosis of patients with gastric cancer was analyzed.The correlation between GLI1 gene expression and tumor immune cell infiltration in gastric cancer tissues was analyzed to explore its influence on drug resistance of chemotherapy drugs and targeted drugs.Clinical samples were collect-ed to analyze the difference of GLI1 expression in gastric cancer and paracancer tissues.Results:The expression of GLI1 in gastric cancer tissues was 1.7 times that in normal tissues,and the overall sur-vival and disease-free survival of patients with high expression are shorter than those with low ex-pression(P＜0.05).The interstitial score,immune score and abundance of immunoinfiltrating cells were higher in the high expression of GLI1 in gastric cancer tissues.High expression of GLI1 reduces drug sensitivity and is positively correlated with the expression of immune checkpoint markers PDCD1(P＜0.05).GLI1 expression was significantly increased in patients with subdifferentiated gastric cancer.Conclusions:GLI1 expression is associated with the prognosis and immune infiltration of patients with gastric cancer,and it may lead to poor prognosis of patients by regulating chemotherapy resis-tance,which may be a potential therapeutic target and molecular marker for gastric cancer.

AIM:To investigate the application of virtual reality(VR)technology in ocular trauma teaching for medical students.METHODS: A total of 90 medical students who participated in the Ophthalmology teaching program between November 2022 and April 2024 were recruited as subjects. Using a case-control method, 45 students in the case group attended traditional ocular trauma teaching program combined with VR virtual simulation experiments, and 45 students in the control group solely attended traditional ocular trauma teaching program. After the teaching practice, the two groups were compared in terms of their examination performance of theoretical knowledge and case analysis, learning ability(evaluated by the Self-Directed Learning Rating Scale), and the satisfaction survey on the quality of teaching; the statistical analyses were performed using t-test or Chi-square test.RESULTS: The scores of theoretical knowledge and case analysis examinations of the case group were significantly higher than those of the control group, and the differences were statistically significant(scores of theoretical knowledge examination: 57.27±2.78 vs 53.91±3.20; scores of case analysis examination: 35.71±3.73 vs 32.67±5.52, both P<0.05). The scores of the Self-Directed Learning Rating Scale of the case group were significantly higher than those of the control group(P<0.05), and the satisfaction with teaching quality of the case group was significantly higher than that of the control group(P<0.05).CONCLUSION: VR-enabled teaching of ocular trauma can effectively improve medical students' mastery of theoretical knowledge and practical skills, enhance students' self-directed learning ability and improve teaching satisfaction.

Objective To analyze the characteristics of platelet changes and their influencing factors during postoperative hospitalization in patients who underwent transcatheter aortic valve implantation (TAVI). Methods The patients who underwent TAVI at Beijing Anzhen Hospital Valve Surgery Center between March 2017 and October 2021 were retrospectively selected. The patients were divided into a self-limiting group and a non-self-limiting group according to the characteristics of postoperative platelet decline. In addition, the general preoperative data, preoperative and postoperative ultrasound data, intraoperative data, and the use of anticoagulant drugs during the postoperative stay in the hospital were compared between the two groups. Results A total of 249 patients were enrolled in this study. There were 175 (70.3%) patients in the self-limiting group, including 100 males and 75 females, and there were 74 (29.7%) patients in the non-self-limiting group, including 43 males and 31 females, with no statistical difference between the two groups (P=0.863). The mean age of patients was 73.11±8.88 years in the self-limiting group and 71.54±10.39 years in the non-self-limiting group (P=0.231). The decline of platelets in the self-limiting group generally occurred on the postoperative day 2 and reached the lowest count on the postoperative day 4, and returned to the baseline level on the postoperative day 5-7, while the platelets in the non-self-limiting group changed by simple rise, fall or irregular fluctuation. Patients in the self-limiting group had severer preoperative aortic stenosis (P<0.001) and used more extracorporeal circulation assistance during surgery (P<0.001). Postoperatively, patients in the self-limiting group were more likely to have periaortic valve leakage than those in the non-self-limiting group (P=0.013). Conclusion Platelet changes in most patients after TAVI show a self-limiting decline, which may be related to the severity of patients’ preoperative aortic stenosis, intraoperative extracorporeal circulation device use, and postoperative perivalvular leakage.

Objective To compare the inhibitory effects of remimazolam and dexmedetomidine on cough during emergence from general anesthesia after thyroid surgery.Methods Patients with 111 cases of thyroid surgery were randomly divided into 3 groups,37 in each group.Group A was given a bolus of 0.1 mg·kg-1 and 0.05 mg·kg-1·h-1 remimazolam intravenous infusion until extubation,group B was given 0.5 μg·kg-1 of the dexmedetomidine over 10 minutes,and group C was given same dose of normal saline.The incidence of cough during emergence from general anesthesia,the moderate and severe cough,the recovery time and extubation time,the Ramsay Sedation Scale(RSS)score,and the heart rate(HR),and mean arterial pressure(MAP)at different time points before and after intervention and before and after extubation were recorded and compared.Results There were significant differences in the incidence of coughing among group A,B and C(37.84％vs.67.57％vs.91.89％,adjusted P＜0.016 7,respectively).The incidence of moderate and severe cough was also lower in group A than in group B and C(8.11％vs.35.14％vs.67.57％,adjusted P＜0.001).The recovery time and extubation time were longer in group B than those of group A and C(adjusted P＜0.001).The RSS scores at the time of extubation and after extubation were higher in group B than in group A and C(adjusted P=0.002 and P=0.007,respectively).After intervention,compared with group C,the HR of group A and B decreased to different degree,and different drugs interacted with time,and the HR of group B patients decreased to a greater extent.Conclusion Remimazolam suppresses the occurrence and reduces the severity coughing during emergence from general anesthesia,and reduce the severity in patients treated with thyroid surgeries.Compared with dexmedetomidine,remimazolam did not prolong recovery time and extubation time,remaining more stable haemodynamics.

MHNTs@PDA@ZIF-8 with rod-shaped core-shell structures was synthesized and used as sorbent in magnetic solid phase extraction(MSPE).MHNTs@PDA@ZIF-8-MSPE method coupled with gas chromatography-mass spectrometry(GC-MS)was employed to analyze sixteen kinds of polycyclic aromatic hydrocarbons(PAHs)in tea beverages.Vibrating sample magnetometer(VSM),Fourier transform infrared spectroscopy(FT-IR),X-ray diffraction(XRD),scanning electron microscopy(SEM)and nitrogen adsorption-desorption techniques were used to characterize the MHNTs@PDA@ZIF-8.The results demonstrated that the MHNTs@PDA@ZIF-8 exhibited significant magnetic properties and a large specific surface area.The experimental conditions that could affect MSPE were investigated,including adsorbent dosage,extraction time,desorption time,ionic strength,desorption solvent type,and desorption solvent volume.The optimal conditions were 10 mg of MHNTs@PDA@ZIF-8 as adsorbent,90 s under vortex extraction,and ultrasonic desorption for 60 s with 1 mL ofn-hexane.The sixteen kinds of PAHs showed good linearity in the concentration range of 5-500 μg/L(r2≥0.995).The limits of detection(S/N=3)and quantitation(S/N=10)were in the range of 0.1-0.8 μg/L and 0.3-2.6 μg/L,respectively.The recoveries of the method ranged from 60.9%to 114.7%,with relative standard deviations(n=3)ranging from 0.2%to 9.2%when the addition levels of sixteen kinds of PAHs were 10,50,and 100 μg/L.The method was simple,fast,sensitive and environmentally friendly,and suitable for detecting sixteen kinds of PAHs in tea beverages.

Heme oxygenase-1(HO-1)is an inducible heme oxygenase and a catalytic enzyme for heme decomposition reactions,which can catalyze the heme decomposition into CO,biliverdin and Fe2+.HO-1 and its metabolites have anti-inflammatory,antioxidant and anti-apoptotic effects in human body,and play an important role in neurodegenerative diseases such as Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,and Huntington's disease.This article will review the production,distribution,and gene structure of HO-1,the biological characteristics of its metabolites,and the role and mechanism of HO-1 in neurodegenerative diseases,in order to provide a theoretical basis for the clinical application of HO-1.