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1.
Am J Sports Med ; : 363546520981743, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33464924

RESUMO

BACKGROUND: Double-bundle anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-known treatment that restores the stability of ACL-deficient knees. However, some isolated ACL-reconstructed knees ultimately show rotatory laxity and develop osteoarthritis. Whether combined ACLR with anterolateral structure (ALS) augmentation (ALSA) can provide better improvement in the in vivo knee rotational kinematics remains unknown. HYPOTHESIS: When compared with isolated double-bundle ACLR, combined double-bundle ACLR with ALSA can improve knee in vivo rotational kinematics and provide better restoration of knee kinematics. STUDY DESIGN: Controlled laboratory study. METHODS: Sixteen patients with unilateral ACL injury were randomly divided into 2 groups to receive either combined double-bundle ACLR and ALSA (ALSA group) or isolated double-bundle ACLR (ACLR group). All patients performed a single-leg lunge using the operative and nonoperative/contralateral legs under dual-fluoroscopic imaging system surveillance during a hospital visit at a minimum 1 year (12-13 months) of follow-up to assess the 6 degrees of freedom knee kinematics. Functional evaluation using the Lysholm and Marx rating scales and clinical examinations were also performed. RESULTS: From full extension to approximately 90° of knee flexion at 5° intervals, the mean ± SD internal rotation of the reconstructed knees in the ALSA group (1.5°± 0.9°) was significantly smaller than that of the contralateral knees (8.2°± 1.9°; P = .008). The ALSA group knees also showed significantly (P = .045) more medial translation than the contralateral knees. In the ACLR group, the mean internal rotation of the reconstructed knee (6.0°± 2.1°) was significantly smaller than that of the contralateral knees (8.9°± 0.6°; P < .001). At full extension, the tibia was significantly more externally rotated than that of the contralateral legs (0.5°± 7.4° vs 7.6°± 3.4°, P = .049). CONCLUSION: When compared with isolated double-bundle ACLR, double-bundle ACLR augmented with ALS reconstruction resulted in anterolateral rotatory overconstraint during the lunge motion. CLINICAL RELEVANCE: Additional ALSA of double-bundle ACL-reconstructed knees overconstrained rotatory stability. Therefore, the use of ALSA for ACL-reconstructed knees should be considered with caution for patients with ACL deficiency and anterolateral rotatory instability. Longer-term follow-up to evaluate long-term outcomes and altered kinematics over time is recommended.

2.
Sci Total Environ ; 762: 144586, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33373748

RESUMO

Carbonaceous aerosols and gaseous pollutants emitted from wildfires play a crucial role in both the global climate system and regional air quality. Here, using multisource satellite and ground-based observations combined with reanalysis data, we investigate the three-dimensional evolution of biomass-burning emissions from a forest wildfire event in Liangshan, Southwest China, which occurred from 29 March to 1 April 2020. The meteorological field analysis showed that the negative anomaly of relative humidity and precipitation, as well as the positive anomaly of near-surface wind speed, created favourable conditions for the occurrence and spread of this wildfire event. During the fire, satellite observations suggested a maximum fire radiation power of over 100 MW. In addition, there were significant short-term effects of fire activity on regional air quality, with downwind surface PM2.5 concentrations at the Xichang site reaching a maximum of approximately 470 µg·m -3 on March 31. Driven by a southwesterly airflow, large amounts of smoke aerosols were transported rapidly to downstream areas, significantly deteriorating air quality, with the maximum value of the aerosol optical depth (AOD) exceeding 2. Moreover, the quantitative evaluation based on Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) reanalysis showed that the instantaneous maximum values of the column mass concentration of black carbon (BC) and organic carbon (OC) reached 9.8 g·m-2 and 1.8 g·m-2 during the fire respectively. Further analysis suggested that the interaction between the lower and upper atmosphere constrained the smoke aerosols to altitudes below approximately 5 km, which was also supported by the vertical distribution of elevated smoke aerosols observed by the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP).

3.
Signal Transduct Target Ther ; 5(1): 298, 2020 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-33361760

RESUMO

Sorafenib is the first-line chemotherapeutic therapy for advanced hepatocellular carcinoma (HCC). However, sorafenib resistance significantly limits its therapeutic efficacy, and the mechanisms underlying resistance have not been fully clarified. Here we report that a circular RNA, circRNA-SORE (a circular RNA upregulated in sorafenib-resistant HCC cells), plays a significant role in sorafenib resistance in HCC. We found that circRNA-SORE is upregulated in sorafenib-resistant HCC cells and depletion of circRNA-SORE substantially increases the cell-killing ability of sorafenib. Further studies revealed that circRNA-SORE binds the master oncogenic protein YBX1 in the cytoplasm, which prevents YBX1 nuclear interaction with the E3 ubiquitin ligase PRP19 and thus blocks PRP19-mediated YBX1 degradation. Moreover, our in vitro and in vivo results suggest that circRNA-SORE is transported by exosomes to spread sorafenib resistance among HCC cells. Using different HCC mouse models, we demonstrated that silencing circRNA-SORE by injection of siRNA could substantially overcome sorafenib resistance. Our study provides a proof-of-concept demonstration for a potential strategy to overcome sorafenib resistance in HCC patients by targeting circRNA-SORE or YBX1.

5.
Chin Med J (Engl) ; 133(23): 2778-2786, 2020 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-33273325

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) prevalence among student men who have sex with men (MSM) in college is more than 5.0% and keeps on increasing in China. This study aims to clarify the proportion of HIV recent infection, its propeller and the source among college student MSM. METHODS: We conducted a multicenter cross-sectional study in seven major Chinese cities during 2012-2013. HIV recent infections (≤ 168 days) and incidence was measured and estimated by BED HIV-1 capture enzyme immunoassay (BED-CEIA) testing strategy. HIV-related behaviors and transmitted drug resistance (TDR) were investigated and compared between the college student MSM, <25-year-old non-student youth MSM (NSYM), and ≥25-year-old non-student non-youth MSM (NSNYM), using structured survey, and analyses of drug resistance. RESULTS: Overall, 4,496 (4496/4526, 99.3%) were eligible for enrollment, comprising 565 college student MSM, 1,094 NSYM, and 2,837 NSNYM. The proportion of HIV recent infection were 70.3% (26/37), 50.8% (65/128) and 35.1% (95/271), the HIV incidence rate were 10.0 (95% CI: 6.2-13.9)/100PY, 12.9 (95% CI: 9.8-16.1)/100PY, 6.8 (95% CI: 5.4-8.2)/100PY, and TDR prevalence were 7.4% (2/27), 2.0%, (2/98) and 4.9% (11/226), among student MSM, NSYM, and NSNYM, respectively. Among HIV positive student MSM with age< 21-year-old, the proportion of HIV recent infection is 90.9% (10/11). Factors independently associated with HIV recent infection in student MSM was usage of recreational drug in the past 6 months (AOR: 2.5; 95% CI: 1.0-5.8). CONCLUSIONS: College student MSM had higher proportion of HIV recent infection and TDR than the youth and older MSM in China during 2012-2013. The HIV infections were more likely to happen during the early year of college life among student MSM.

6.
BMC Plant Biol ; 20(1): 538, 2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33256588

RESUMO

BACKGROUND: Pistil development is a complicated process in plants, and female sterile mutants are ideal material for screening and cloning pistil development-related genes. Using the female sterile mutant (fsm1), BraA04g009730.3C was previously predicted as a candidate mutant gene encoding the STERILE APETALA (SAP) transcriptional regulator. In the current study, a parallel female sterile mutant (fsm2) was derived from EMS mutagenesis of a Chinese cabbage DH line 'FT' seeds. RESULTS: Both fsm2 and fsm1 mutant phenotypes exhibited pistil abortion and smaller floral organs. Genetic analysis indicated that the phenotype of mutant fsm2 was also controlled by a single recessive nuclear gene. Allelism testing showed that the mutated fsm1 and fsm2 genes were allelic. A single-nucleotide mutation (G-to-A) in the first exon of BraA04g009730.3C caused a missense mutation from GAA (glutamic acid) to GGA (glycine) in mutant fsm2 plants. Both allelic mutations of BraA04g009730.3C in fsm1 and fsm2 conferred the similar pistil abortion phenotype, which verified the SAP function in pistil development. To probe the mechanism of SAP-induced pistil abortion, we compared the mutant fsm1 and wild-type 'FT' pistil transcriptomes. Among the 3855 differentially expressed genes obtained, 29 were related to ovule development and 16 were related to organ size. CONCLUSION: Our study clarified the function of BraA04g009730.3C and revealed that it was responsible for ovule development and organ size. These results lay a foundation to elucidate the molecular mechanism of pistil development in Chinese cabbage.

9.
Polymers (Basel) ; 12(11)2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33147735

RESUMO

The influence of nano-silica (nSiO2) and micro-silica (mSiO2) in the shell and wood fiber filler in the core on the thermal expansion behavior of co-extruded wood/polyethylene composites (Co-WPCs) was investigated to optimize the thermal expansion resistance. The cut Co-WPCs samples showed anisotropic thermal expansion, and the thermal expansion strain and linear coefficient of thermal expansion (LCTE) decreased by filling the shell layer with rigid silica, especially nSiO2. Finite element analysis indicated that the polymer-filled shell was mainly responsible for the thermal expansion. The entire Co-WPCs samples exhibited a lower thermal expansion strain than the cut Co-WPCs samples due to protection by the shell. Increasing the wood fiber content in the core significantly decreased the thermal expansion strain and LCTE of the Co-WPCs. The Co-WPCs whose core layer was filled with 70% wood fiber exhibited the greatest anisotropic thermal expansion.

10.
J Dent Educ ; 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33197040

RESUMO

OBJECTIVE: The aims of this study were to 1) evaluate patient demographic data for new patient exams (NPE) and 2) analyze lead response time for checked-in and no-show appointments in predoctoral clinics in a dental school. METHODS: The data for the study were collected from the predoctoral clinics at Tufts University School of Dental Medicine (TUSDM) for patients with NPE appointments with American Dental Association's (ADA) diagnostic code of D100. A total of 26,826 appointments and 24,419 unique patients were reviewed from January 1, 2015 to December 31, 2019. Patient demographic variables such as age, gender, zip codes, and lead response time were analyzed. RESULTS: From 26,826 total number of appointments, 10,454 appointments were categorized as no-show appointments (38.97%). In the no-show appointments, the sex distribution was 59.93% female and 40.07% male, and in checked-in category, the sex distribution was 53.75% female and 46.25% male. As the lead response time increased over 5 days, the no-show rate increased to 49.79%. Approximately 55% of the entire NPE was from Greater Boston area. CONCLUSION: The association between lead time and no-show rate was shown that when lead time was reduced, no-show rate decreased. By identifying the no-show appointments and lead time, schools and clinics can improve operational efficiency, reduce financial loss, and maintain continuation of care by supporting patients who need access to care and creating secondary automated recall system to maximize communication and chair use.

11.
Mol Cancer ; 19(1): 163, 2020 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-33222692

RESUMO

BACKGROUND AND AIMS: Accumulating evidence suggests that the primary and acquired resistance of hepatocellular carcinoma (HCC) to sorafenib is mediated by multiple molecular, cellular, and microenvironmental mechanisms. Understanding these mechanisms will enhance the likelihood of effective sorafenib therapy. METHODS: In vitro and in vivo experiments were performed and clinical samples and online databases were acquired for clinical investigation. RESULTS: In this study, we found that a circular RNA, circRNA-SORE, which is up-regulated in sorafenib-resistant HCC cells, was necessary for the maintenance of sorafenib resistance, and that silencing circRNA-SORE substantially increased the efficacy of sorafenib-induced apoptosis. Mechanistic studies determined that circRNA-SORE sequestered miR-103a-2-5p and miR-660-3p by acting as a microRNA sponge, thereby competitively activating the Wnt/ß-catenin pathway and inducing sorafenib resistance. The increased level of circRNA-SORE in sorafenib-resistant cells resulted from increased RNA stability. This was caused by an increased level of N6-methyladenosine (m6A) at a specific adenosine in circRNA-SORE. In vivo delivery of circRNA-SORE interfering RNA by local short hairpin RNA lentivirus injection substantially enhanced sorafenib efficacy in animal models. CONCLUSIONS: This work indicates a novel mechanism for maintaining sorafenib resistance and is a proof-of-concept study for targeting circRNA-SORE in sorafenib-treated HCC patients as a novel pharmaceutical intervention for advanced HCC.

12.
Arthroscopy ; 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33227322

RESUMO

PURPOSE: To analyze the contribution of a secondary anterolateral structure (ALS) deficiency to knee instability based on anterior cruciate ligament (ACL) deficiency, in the condition of a functional iliotibial band (ITB). METHODS: Nine freshly-frozen cadaveric knees were sectioned sequentially to create ACL-deficiency and ACL-ALS deficiency, using intact knees before sectioning as controls. When ITB was tensioned with 30N, four separate aspects of knee instability were tested as follows: anterior translation in 90N anterior load, isolated internal rotation in 5N·m internal rotational torque from 0° to 90° in 15° increments, and anterolateral translation and internal rotation during a simulated pivot-shift test at 0°, 15°, 30° and 45°. The contribution of ACL deficiency alone and an additional ALS deficiency to knee instability were evaluated. RESULTS: The addition of an ALS lesion produced no significant exacerbation of either anterior translational or pivot shift instability in ACL-deficient knees. Additional ALS deficiency in an ACL deficient knee resulted in a significant increase in isolated internal rotation from 45° to 90°(P=.001 at 45° and P<.001 in other cases). After sequentially sectioning, the contribution to instability of additional ALS deficiency to the entire instability in ACL-ALS deficient knees were significantly smaller than that of ACL deficiency alone during anterior load and pivot-shift test (P<.001 in all cases), but significantly contributed more to isolated internal rotational instability at 60° (P=.011) and 90° (P=.015) CONCLUSIONS: When ITB was tensioned, ALS played a minor role in controlling both anterior or pivot shift stability in ACL-deficient knees while did the major role in restraining isolated internal rotation from 45° to 90°.

13.
J Med Internet Res ; 22(10): e22388, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33052132

RESUMO

BACKGROUND: Over half of men who have sex with men (MSM) use geosocial networking (GSN) apps to encounter sex partners. GSN apps' users have become a unique large subpopulation among MSM for interventions concerning HIV prevention and control. Pre-exposure prophylaxis (PrEP) is a promising measure for HIV prevention, especially for MSM, but its effectiveness largely depends on medication adherence. However, little is known about PrEP adherence among GSN apps' users, which is critical to addressing the overall optimization of PrEP compliance outside of clinical trials in the context of large-scale implementation. OBJECTIVE: The objective of this study is to understand the correlation between GSN apps' use and medication adherence among MSM receiving PrEP, with the aim to increase their awareness about PrEP use in order to increase adherence. METHODS: This study based on the China Real-world Oral intake of PrEP (CROPrEP) project, a multicenter, real-world study of Chinese MSM on daily and event-driven PrEP. Eligible participants completed a detailed computer-assisted self-interview on sociodemographic, GSN apps' use, and sexual behavior. Then participants were followed up for 12 months and assessed for various characteristics (eg, PrEP delivery, adherence assessment, PrEP coverage of sexual activities, and regimens switch). A generalized estimation equation was used to analyze the predictors of medication adherence and regimen conversion among GSN apps' users and nonusers. RESULTS: At baseline, 756 of the 1023 eligible participants (73.90%) reported primarily using GSN apps to seek sexual partners, and GSN apps' users are more likely to have high-risk behaviors such as multiple sex partners and condomless anal intercourse than other nonusers (all P<.05). During follow-up, GSN apps' users had a significantly low level of pill-counting adherence than nonusers (adjusted odds ratio [aOR] 0.8, 95% CI 0.6-1.0, P=.038). In the event-driven group, GSN apps' users had marginally lower levels of self-reported adherence (aOR 0.7, 95% CI 0.4-1.0, P=.060) and lower PrEP coverage of sexual practices (aOR 0.6, 95% CI 0.4-1.0, P=.038). Additionally, GSN apps' users seemed more likely to switch from event-driven to daily regimen (aOR 1.8, 95% CI 0.9-3.3, P=.084). CONCLUSIONS: GSN apps' users are highly prevalent among MSM, despite their higher sexual risk and lower adherence levels, suggesting that eHealth needs to be introduced to the GSN platform to promote PrEP adherence. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-IIN-17013762; https://tinyurl.com/yy2mhrv4. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12879-019-4355-y.

14.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(5): 403-408, 2020 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-33047562

RESUMO

In this paper, a nucleic acid protein analyzer based on Lambert-Beer law and ultraviolet spectrophotometry is introduced, which is composed of ultraviolet monochromatic light generator, photoelectric signal detection module, vortex mixer, touch screen and embedded central controller. For ultra-micro measurement, a continuous-wavelength full-spectrum spectrophotometric detection circuit is designed in the hardware part. The transmitted light signal is collected by silicon photodiode, amplified and processed by subsequent circuit, and then transmitted to a single chip computer STM32F407VGT6 with CortexTM-M4 core after A/D conversion. The concentration and purity of nucleic acid protein are evaluated by assistant software detection algorithm. The instrument has the characteristics of compact size, flexible use, simple operation, high sensitivity and high detection efficiency. The experimental results show that the instrument has good sensitivity, repeatability and accuracy, and is suitable for the ultra-micro measurement of nucleic acid sample concentration, purity and protein concentration.

16.
Arthrosc Tech ; 9(8): e1141-e1146, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32874894

RESUMO

The outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction leave room for improvement. We hope to augment double-bundle ACL reconstruction with the reconstruction of an ACL-mimicking anterolateral structure (ALS). Thus, we would like to introduce a combined double-bundle ACL reconstruction and ACL-mimicking ALS reconstruction technique. The main indication for this technique is ACL injury with a high degree of pivot shift test, general laxity, or near critical value of the posterior tibial slope. The main steps in this technique include preparation of an isolated graft for the anteromedial bundle of the ACL and a combined graft for the posterolateral bundle of the ACL and ALS, creation of three tibial tunnels and two femoral tunnels, graft placement, and final graft fixation at an adjustable loop. We have obtained promising clinical outcomes with this technique and consider that this report will provide new options in ACL reconstruction.

17.
Artigo em Inglês | MEDLINE | ID: mdl-32923885

RESUMO

PURPOSE: Intrahepatic cholangiocarcinoma (IHCCA), a global health problem, is increasing in incidence and has differing etiologies worldwide. Next-generation sequencing (NGS) is rapidly being incorporated into the clinical management of biliary cancers. IHCCA is enriched with actionable mutations, and there are several promising targeted therapies under development. NGS data from Asia, where IHCCA is most prevalent, are limited. METHODS: Comprehensive genomic profiling of formalin-fixed paraffin-embedded tumor tissue from 164 Asian and 283 Western patients with IHCCA was performed using NGS. We measured the distribution of DNA repair genetic aberrations (GAs) in IHCCA, along with actionable mutations. Also, we evaluated the association between DNA repair GAs and tumor mutation burden (TMB). Based on the TMB status, patients were distinguished into 3 levels: low (< 6 mut/Mb), intermediate (6-10 mut/Mb), and high (TMB-H; ≥ 10 mut/Mb). RESULTS: Seventy-two percent of Asian patients had ≥ 1 actionable GA, with a significantly higher frequency in KMT2C , BRCA1/2, and DDR2 compared with Western patients (P = .02, .003, and .003, respectively); 60.9% of Western patients had ≥ 1 actionable GA and higher frequency of CDKN2A/B and IDH1/2 GAs (P = .0004 and < .001, respectively). GAs in nuclear factor kappa B pathway regulators and DNA repair genes occurred more frequently in Asian patients (P = .006 and .001, respectively). There was a higher frequency of TMB-H in Asian compared with the Western cohort (12.2% v 5.9%; P = .07). CONCLUSION: A higher burden of DNA repair mutations and frequency of patients with TMB-H in the Asian IHCCA cohort compared with the Western patients suggests a potential role for DNA repair and immune checkpoint inhibitors in the Asian population. Future clinical trials should account for this genetic heterogeneity.

18.
Opt Express ; 28(17): 24471-24488, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32906988

RESUMO

Compared with ground-based lidar, airborne lidar has a wider observation area, which is useful for studying aerosol distribution and transportation. A dual-wavelength high spectral resolution Lidar (HSRL) was developed for the validation and calibration of an upcoming satellite payload. The HSRL was installed on an airplane, and field campaigns were conducted in Qinhuangdao, China. Meanwhile, four observation sites were established at different locations on the ground to verify the results of the airborne lidar. This article compares the HSRL measurements with those from ground-based micro-pulse lidar (MPL), Mie-scattering lidar, sun photometer, and spaceborne cloud-aerosol Lidar and infrared pathfinder satellite observations (CALIPSO), and Moderate Resolution Imaging Spectroradiometer (MODIS). The stability and reliability of the HSRL system were fully verified. The flight area covered several surface types, including ocean, town, mountain, and forest, which strongly affect the AOD above them. The boundary layer AOD was analyzed in different regions, based on the impact of human activities. The results demonstrated that the AOD in urban area was the largest, and smallest in marine areas, a result ascribed to the influence of industrial activities.

19.
Virology ; 550: 89-98, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32920454

RESUMO

The relationship between NK cell counts during primary infection and disease progression or immune restoration after antiretroviral treatment (ART) was explored. We followed 462 individuals with HIV infection and measured their NK, CD4+ T, CD8+ T cell counts and viral loads. Our data showed that individuals with high NK cell counts had much lower viral loads and higher CD4+ T cell counts. NK cell counts during primary infection were negatively correlated with viral set-point and viral loads at one-year-infection point, and positively correlated with CD4+ T cell counts at one-year-infection and one-year-ART point. Moreover, the NK cell counts during primary infection can predict HIV disease progression and immune restoration after ART. In conclusion, NK cell counts during primary infection represents a potential predictive biomarker to predict HIV disease prognosis in the clinic.

20.
Int J Surg ; 83: 196-204, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32980518

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) has a high rate of recurrence. This network meta-analysis aimed to compare the oncological prognosis of the conventional treatments for intrahepatic recurrent hepatocellular carcinoma (rHCC) and identify the optimal strategy. METHODS: We conducted a literature search of online database, published between January 2009 and October 2019. Relevant studies analyzing the outcomes of the different interventions for rHCC were included. We synthesized the results using R software and the "gemtc" package. RESULTS: A total of 21 studies involving 2818 patients were ultimately enrolled to be analyzed. We assessed five related therapeutic interventions and two oncological outcomes. The benefits orders of overall survival (OS) from largest to least were salvage liver transplantation (SLT), repeat hepatectomy (RH), radiofrequency ablation (RFA), stereotactic body radiation therapy (SBRT), and transarterial chemoembolization (TACE). For the benefits of recurrence-free survival (RFS), SLT and RH remained the top two treatments. Subgroup analysis of smaller (≤3 cm) and larger (>3 cm) tumour reached similar results. Consistency and heterogeneity analysis did not show significant inconsistency and heterogeneity. DISCUSSION: Our findings demonstrated that SLT and RH were the best two treatments for rHCC. Nevertheless, the selection of strategies should also depend on tumour characteristics and basic health situation.

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