Hepatocellular carcinoma (HCC) is well characterized as a heterogeneous disease. Its late-stage diagnosis and chemotherapy resistance make it one of the refractory tumors in China. Natural killer (NK) cells play a significant role in immune surveillance. However, NK cells become dysfunctional in the progression of HCC, leading to tumor immune escape. This article reviews the recent progress on different strategies of NK cell-based immunotherapy in treating HCC, including direct adoptive NK cell transfer, gene engineering in NK cell, NK cell receptor targeting, immunosuppressive microenvironment modification, and tumor toxicity enhancement by cytokines or traditional Chinese medicine. These NK cell-based strategies have shown promising therapeutic potential.
Humans ; Carcinoma, Hepatocellular/therapy* ; Liver Neoplasms/therapy* ; Immunotherapy ; Killer Cells, Natural ; Receptors, Natural Killer Cell ; Tumor Microenvironment

According to the International League Against Epilepsy (ILAE) standards, the Newborn Working Group of the ILAE put forward 6 necessary questions about the management of neonatal anti-seizure medication and gave evidence-based recommendations in 2023. The basic framework is systematic review+expert consensus. The clinical recommendations of ILAE guidelines 2023 and the similarities and differences between ILAE guidelines 2023 and ILAE guidelines 2011 were analyzed and interpreted in this paper, in order to provide reference for colleagues involved in neonatal convulsion management in China.

Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Objective:To investigate the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) with the aid of neurophysiological monitoring under general anesthesia.Methods:From August 2016 to October 2019, 58 patients underwent PELD under general anesthesia were selected in our hospital; 30 were via transformational approach and 28 were via interlaminar approach. The whole operative procedures were performed under continuous monitoring of spontaneous electromyography (SEMG), and the peak value, waveform and motor unit of SEMG at the surgical side were observed. The clinical outcomes were evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI).Results:PELD was successfully performed in all 58 patients. Abnormal SEMG reactions were recorded in 8 patients (13.8%), manifested as clustered or frequent high amplitude action potentials; 5 patients (16.7%, 5/30) were via transformational approach and 3 (10.7%, 3/28) were via interlaminar approach. Two patients relapsed at 3 and 6 weeks after surgery, respectively; one was treated with PELD again and the other one was treated with lumbar fusion and instrument fixation. The pain at the lumbago and leg was alleviated obviously after surgery in the 56 patients; the VAS scores were 7.43±1.32, 2.55±0.87 and 1.59±0.87 before surgery, and 3 d and 3 months after surgery, respectively, with significant differences ( P<0.05); the mean ODI before surgery and 3 months after surgery were 67.36±7.13 and 12.39±5.48, respectively, with significant difference ( P <0.05). Conclusion:PELD with the aid of neurophysiological monitoring under general anesthesia is safe and reliable, which can achieve good clinical efficacy.

Objective The aim of this study was to inve-stigate the associations between genetic variants in interleukin (IL)-33 and susceptibility to gout.Methods The genetic distributions of rs3939286 were detected in 1 100 men with gout and 1 227 ethnically matched controls using Taqman allelic discrimination real-time polymerase chain reaction (PCR).Hardy-Weinberg was used to verify the representativeness of the samples.Differences in genetic distributions between groups were investigated using x2 tests.The genotypephenotype relationship among gout patients was tested by analysis of variance.Results The frequencies of AA,AG and GG genotypes were1,101 and 998 (0.1％,9.2％ and 90.7％) among gout patients,while they were 1 132 and 1 094 (0.1％,10.7％ and 89.2％) among the controls.There were no significant differences in genetic distributions of IL-33 rs3939286 polymorphism between gout patients and controls (P=0.478 by genotype,x2=1.46,P=0.309 by allele).Conclusion Our results have revealed that the rs3939286 variant in IL-33 gene may be not involved in the development of gout in male gout patients of Shandong.However,further studies in other ethnic groups are needed to confirm the results.

Objective To investigate the clinical efficiency of Huayu Xiaozhong Decoction (HXD) on preventing peri-operative deep venous thrombosis (DVT) in lower limbs following artificial total hip replacement. Methods Ninety cases following artificial total hip replacement were randomized into blank control group, Rivaroxaban group and HXD group, 30 cases in each group, and were treated with brown sugar water, Rivaroxaban, HXD respectively. Before operation, and one, 3 and 14 days after operation, we monitored the changes of bleeding volume, DVT incidence, hemoglobin, prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , international normalized ratio (INR), and D-dimer (DD) in the three groups. Results (1) Fifteen cases had DVT, with a total incidence rate of 16.67%. Of the 15 cases, 10 were from blank control group, 2 from Rivaroxaban group, and 3 from HXD group. ( 2) The amount of bleeding volume of Rivaroxaban group was larger than that of the blank control group and HXD group (P<0.05), but the bleeding was mild. (3) One, 3 and 14 days after operation, PT and APTT were shortened in blank control group (P<0.01 compared with those before operation). PT, APTT and INR were prolonged, and coagulation function was improved in Rivaroxaban group and HXD group, the differences being significant as compared with the blank control group ( P<0.05). HXD group had better effect on improving INR than Rivaroxaban group ( P<0.05). ( 4) In the three groups, hemoglobin level began to decrease on postoperative day one, arrived to the bottom on postoperative day 3 (P<0.05), and rose up near to the normal level on postoperative day 14; HXD group had higher hemoglobin level than blank control group and Rivaroxaban group on postoperative day 3 and 14 ( P<0.05). The 3 groups had higher plasma DD level than the normal level before the operation, arrived to the highest level on postoperative day one and 3 ( P<0.05) , and fell down near to the normal level on postoperative day 14. The inter-group comparison results showed that Rivaroxaban group and HXD group had lower DD level than the blank control group on postoperative day 3 and 14 ( P<0.05). Conclusion HXD is effective on preventing DVT in the peri-operation period through reducing bleeding, increasing hemoglobin level and improving postoperative anemia. The efficiency and safety of HXD are similar to Rivaroxaban.

BACKGROUND:Now, domestic total knee arthroplasty surgeries mainly use medial parapatel ar approach, with the disadvantages of large trauma and slower recovery. The quadriceps sparing approach is more accorded with normal anatomy, which can keep the knee extension system intact. The clinical comparison between quadriceps sparing approach and medial parapatel ar approach is rare.
OBJECTIVE:To compare the early effect of total knee arthroplasty through quadriceps sparing approach and medial parapatel ar approach.
METHODS:From January 2009 to January 2010, 55 patients (70 knees) were randomly divided into quadriceps sparing approach group (n=26, 35 knees) and medial parapatel ar approach group (n=29, 35 knees). Patients in two groups received total knee arthroplasty through quadriceps sparing approach and medial parapatel ar
approach respectively. The incision length, operative time, postoperative drainage volume, additional amount of etoricoxib tablets, pain degree, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint, Hospital for Special Surgery Knee Score, radiographic alignment of al components and complications were compared between two groups. Al the prostheses used in this study were the Sigma type prostheses
provided by the rotation platform of Johnson&Johnson Company.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months without infections, deep vein thrombosis, neurovascular injury, prosthesis instability, prosthesis loosening or displacement. Position of al the
prostheses was normal in patients. The operative time in the quadriceps sparing approach group was longer than that in the medial parapatel ar approach group (P=0.00), while the incision length, postoperative drainage volume, additional
amount of etoricoxib tablets, visual analog scale, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score in the quadriceps
sparing approach group were better than those in the medial parapatel ar approach group (P<0.05). There were no
significant differences in range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score between two groups. The early effect of total knee arthroplasty through quadriceps sparing approach is better than the medial parapatel ar approach, and there is no significant difference in prosthesis alignment between two methods.

Objective To investigate whether polymorphism of 102 T/C in 5-HTR2A (serotonin receptor 2A) are associated with Tourette syndrome (TS) in Chinese Han population or none.Methods A total of 101 TS patients and their parents were recruited for the study.The genetic contributions of the 5-HTR-2A 102 T/C polymorphism in 5HTR2A were evaluated using polymerase chain reaction and restriction enzyme digestion (PCRRFLP) and haplotype relative risk (HRR) and transmission disequilibrium test (TDT) statistics.Results The results revealed no significant associations between the 5-HTR-2A 102 T/C polymorphism and TS (HTR-2A 102T/C,TDT =0.353,df=1,P =0.621 ;HRR =1.127,x2 =0.358,P =0.550,95％ CI:0.762-1.666).Conclusion The data suggest that the HTR-2A 102 T/C polymorphism may not be associated with susceptibility to TS in the Chinese Han population.However,these results need to be replicated using larger datasets collected from different populations.

Sample size estimation is necessary for any experimental or survey research. An appropriate estimation of sample size based on known information and statistical knowledge is of great significance. This article introduces methods of sample size estimation of difference test for data with the design of one factor with two levels, including sample size estimation formulas and realization based on the formulas and the POWER procedure of SAS software for quantitative data and qualitative data with the design of one factor with two levels. In addition, this article presents examples for analysis, which will play a leading role for researchers to implement the repetition principle during the research design phase.

ABSTRACT: Estimation of sample size and testing power is an important component of research design. This article introduced methods for sample size and testing power estimation of difference test for quantitative and qualitative data with the single-group design, the paired design or the crossover design. To be specific, this article introduced formulas for sample size and testing power estimation of difference test for quantitative and qualitative data with the above three designs, the realization based on the formulas and the POWER procedure of SAS software and elaborated it with examples, which will benefit researchers for implementing the repetition principle.