Radiological findings in non-surgical recurrent hepatocellular carcinoma:From locoregional treatments to immunotherapy

Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.

Clinical benefits of rational-emotive stress management therapy for job burnout and dysfunctional distress of special education teachers

It has been observed that managing job burnout and dysfunctional distress constitute part of the major challenges among special educators,and that empirical data on the management of burnout and dysfunctional distress associated with the job of special education teachers are lacking in the literature.The current article discusses the clinical benefits of a rational-emotive stressmanagement therapy program in reducing the level of job burnout symptoms and dysfunctional distress in special education teachers,using evidence from a 2018 clinical trial study that reported the efficacy of this intervention.Results show the clinical benefits and implications of conducting a rational-emotive stress management intervention,and recommendations are made for future research.

Management about intravesical histological transformation of prostatic mucinous carcinoma after radical prostatectomy:A case report

BACKGROUND Prostatic mucinous carcinoma(MC)and prostatic signet ring cell carcinoma are two variants of prostate cancer.MC has a higher overall survival time among all variants,while signet ring cell carcinoma is associated with lower survival time relative to other carcinomas.Only a small proportion of prostatic MC may contain signet ring cells.Over the last several decades there were only 12 patients that were documented in two studies.CASE SUMMARY We report on a 64-year-old man who was diagnosed with prostatic MC after he received a robotic-assisted laparoscopic radical prostatectomy in the West China Hospital.After robotic-assisted laparoscopic radical prostatectomy,the patient underwent three successive transurethral resections of bladder tumors.Pathological examination of the first transurethral resection of bladder tumors specimen indicated that the neoplasm was prostatic MC that had metastasized to the urinary bladder.The subsequent two transurethral resections of bladder tumors indicated the presence of prostatic mucinous carcinoma with signet ring cells.CONCLUSION This case report aimed to share the management experience,raise awareness,and highlight the importance of multidisciplinary cooperation of prostatic mucinous carcinoma with signet ring cells.

Demand analysis of an intelligent medication administration system for older adults with chronic diseases based on the Kano model

Objectives Gerontechnology has great potential in promoting older adults’well-being.With the accelerated aging process,gerontechnology has a promising market prospect.However,most technological developers and healthcare professionals attached importance to products’effectiveness,and ignored older adults’demands and user experience,which reduced older adults'adoption intention of gerontechnology use.The inclusion of older adults in the design process of technologies is essential to maximize the effect.This study explored older adults’demands for a self-developed intelligent medication administration system and proposed optimization schemes,thus providing reference to developing geriatric-friendly technologies and products.Methods A cross-sectional survey was conducted to explore older adults’technological demands for the self-developed intelligent medication administration system,and data were analyzed based on the Kano model.A self-made questionnaire was administered from July 2020 to October 2020 after participants used this system for two weeks.The study was registered with the Chinese Clinical Trial Registry(ChiCTR2000040644).Results A total of 354 older adults participated in the survey.Four items,namely larger font size,simpler operation process,scheduled medication reminders and reliable hardware,were classified as must-be attributes;three items,namely searching drug instructions through WeChat,more sensitive system and longer battery life,as attractive attributes;one item,viewing disease-related information through WeChat,as the one-dimensional attribute;and the rest were indifferent attributes,including simple and beautiful displays,blocking advertisements automatically,providing user privacy protection protocol,viewing personal medical information only by logged-in users,recording all the medications,ordering medications through WeChat.The satisfaction values were between 0.24 and 0.69,and dissatisfaction values were between 0.06 and 0.94.Conclusion This study suggested that older adults had personalized technology demands.Including their technological demands and desire may assist in decreasing the digital divide and promoting the satisfaction of e-health and/or m-health.Based on older adults’demands,our study proposed optimization schemes of the intelligent medication administration system,which may help developers design geriatric-friendly intelligent products and nurses to perform older adults-centered and efficient medication management.

Is transesophageal echocardiography needed for evaluating tissue-based transient ischemic attack？

Transient ischemic attack（TIA） is a warning signal for stroke.A comprehensive evaluation of TIA may reduce the risk for subsequent stroke.Data on the findings of cardiac evaluation with transesophageal echocardiography（TEE） in patients with TIA are sparse.Our aims were to determine the frequency of TEE performance and to investigate the findings of TEE in patients with TIA based on the new definition of TIA（i.e.,transient neurological symptoms without evidence of infarction）.During a 4-year period（2011–2014）,1071 patients（mean age,70 ± 13 years;female,49.7%） with TIA were included in a prospective study and evaluated.Of 1071 consecutive patients suffering from TIA,288 patients（27%） underwent TEE.The median time between admission and TEE was 6 days.Patients with TIA who were evaluated by TEE were younger（67 vs.71 years,P 〈 0.001） than those who were not evaluated by TEE.They had a higher rate of sensibility disturbance as a TIA symptom（39% vs.31%,P = 0.012） but a lower rate of previous stroke（15% vs.25%,P = 0.001） and atrial fibrillation（2% vs.21%,P 〈 0.001） than those who did not.Foramen ovale was detected in 71 patients（25.7%）,atrial septal aneurysm in 13 patients（4.6%）,and severe atherosclerotic plaques（grade 4 and 5） in the aortic arch in 25 patients（8.7%）.One patient（0.3%） had a fibroma detected by TEE.In 17 of the 288 patients（6%） who underwent TEE,the indication for anticoagulation therapy was based on the TEE results,and 1 patient with fibroma underwent heart surgery.During hospitalization,7 patients experienced a subsequent stroke,and 27 patients had a recurrent TIA.At 3 months following discharge,the rates of readmission,stroke,recurrent TIA,and death were 19%,2.7%,4.2%,and 1.6%,respectively.The rates of mortality（0.9% vs.1.8%,P = 0.7）,stroke risk（1.9% vs.3.0%,P = 0.8）,and recurrent TIA（5.0% vs.3.9%,P = 0.8） were similar in patients who underwent TEE and in those who did not.Performing TEE in patients with tissue-based TIA is helpful in detecting cardiac sources for embolism and may indicate for anticoagulation.

A Review of Non-operative Treatments for Hepatocellular Carcinoma with Advanced Portal Vein Tumor Thrombus

Portal vein tumor thrombus (PVTT) frequently occurs with the progression of hepatocellular carcinoma (HCC) and is an important factor in determining the prognosis of HCC.In many cases of HCC with advanced PVTT,treatment is difficult because the tumor has considerable extension into the liver,and portal hypertension is a frequent complication.The standard therapy for unresectable HCC with advanced PVTT is sorafenib therapy in patients with good hepatic function.However,the outcomes of sorafenib therapy are not completely satisfactory,making the development of another therapy an urgent task.Therefore,this review aims to summarize non-operative treatments for HCC with advanced PVTT and discuss future perspectives based on those therapies,including therapies still being developed.

Anti-anger Effects of Herbal Medicine:A Mini-Review of Rat Studies

Objective:To analyze the available data on the anti-anger effects of herbal medicines(HMs)as well as their underlying mechanisms in rat models.Methods:From 6 electronic databases[PubMed,EMBASE,China National Knowledge Infrastructure(CNKI),Wanfang,Oriental Medicine Advanced Searching Integrated System(OASIS),and Research Information Sharing Service(RISS)],relevant animal experiments were searched by using"anger,""rats,"and"animal"as search keywords.The last search was conducted on November 22,2019,and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.Results:A total of 24 studies with 16 kinds of HMs were included.Most studies have used the tail irritating method and"social isolation and resident intruder"method to establish anger models.According to the included studies,the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology(Bupleuri Radix,Paeoniae Radix Alba,and Glycyrrhizae Radix),regulation of sex hormones(Bupleuri Radix,Cyperi Rhizoma,and Paeoniae Radix Alba),regulation of neurotransmitters(Cyperi Rhizoma),regulation of anger-related genes(Bupleuri Radix,Glycyrrhizae Radix,and Paeoniae Radix Alba),and other effects.Overall,Liver(Gan)qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.Conclusions:This review found the frequent methods to establish an anger model,and major mechanisms of anti-anger effects of HMs.Interestingly,some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM.These findings provide insight into the role and relevance of HMs in the field of anger management.