Real-world 10-year retrospective study of the guidelines for diagnosis and treatment of primary liver cancer in China.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common malignant tumor worldwide. Many regions across the world have issued various HCC diagnosis and treatment protocols to improve the diagnosis and targeted treatment of patients with HCC. However, real-world studies analysing the practice, application value, and existing problems of the China Liver Cancer (CNLC) staging system are scarce. AIM: To analyze the current situation and problems associated with the Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China. METHODS: We collected the medical records of all patients with HCC admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2011 to December 31, 2019, and recorded the hospitalization information of those patients until December 31, 2020. All information on the diagnosis and treatment of the target patients was recorded, and their demographic and sociological characteristics, CNLC stages, screening situations, and treatment methods and effects were analyzed. The survival status of the patients was obtained from follow-up data. RESULTS: This study included the medical records of 3022 patients with HCC. Among these cases, 304 patients were screened before HCC diagnosis; their early-stage diagnosis rate was 69.08%, which was significantly higher than that of patients with HCC who were diagnosed without screening and early detection (33.74%). Herein, patients with no clinical outcome at discharge were followed up, and the survival information of 1128 patients was obtained. A Cox model was used to analyse independent risk factors affecting overall survival, which were revealed as age > 50 years, no screening, alpha-fetoprotein > 400 ng/mL, Child-Pugh grade B, and middle and late CNLC stages. Based on the Cox model survival analysis, in our study, patients with HCC identified via screening had significant advantages in overall and tumor-free survival after hepatectomy. CONCLUSION: Early diagnosis and treatment can be achieved by screening groups at high risk for HCC based on the guidelines; however, real-world compliance is poor.

A fullerene based hybrid nanoparticle facilitates enhanced photodynamic therapy via changing light source and oxygen consumption.

Recently, fullerene (C60) has been widely used as a nano photosensitizer (PS) for tumor related photodynamic therapy (PDT). However, current PDT based on C60 is severely restricted by the visible light source (shallow tissue penetrating depth) and oxygen dependent (tumor hypoxia). Therefore, taking advantages of the surface plasmon resonance (SPR) effect of gold nanoparticles (GNPs) and "electronic sponge" property of C60, a C60 based hybrid nanostructured photosensitizer (C60@GNPs) with high light stability, near infrared light (NIR) excitation, and oxygen non-dependent properties was rational designed according to the mechanism of PDT. Compared with C60, after GNPs in-situ synthesis, the PDT mechanism of C60@GNPs changed from type II to type I, and the main product of PDT changed from singlet oxygen to hydroxyl radicals. Furthermore, C60@GNPs hybrid could efficiently generate hydroxyl radicals under NIR light excitation even in the hypoxia condition. These results suggest that C60@GNPs hybrid has a great potential for in vivo PDT applications.

A systematic review of anxiety across smoking stages in adolescents and young adults.

BACKGROUND: In adolescence and young adults, inconsistence of the association between anxiety and smoking remains to be investigated and clarified. The aim of this study is investigated and clarified the association between anxiety and smoking stages in adolescence and young adults. METHODS: The data on the causal influence of anxiety on smoking in adolescents and young adults aged 14 to 25 years old was retrieved from electronic databases. RESULTS: Nineteen of 668 articles were subjected to a systematic review. Definitional differences with respect to smoking stages constrained homogeneity across the nineteen analyzed reports. Anxiety appears to play a more consistent risk role for nicotine dependent (ND) smokers than for non-nicotine dependent (non-ND) regular or daily smokers. Anxious non-ND smokers are at higher risk to become nicotine dependent. CONCLUSIONS: A ununified definition of smoking stages is responsible for the production of inconsistent results. The analysis reinforced anxiety as a significant risk factor for smoking in one's lifetime. Anxious non-ND smokers are the key target for interventions aimed at preventing nicotine dependence and smoking-related health problems.