Immunotherapies for hepatocellular carcinoma

Cases of hepatocellular carcinoma (HCC) are rapidly rising. This is particularly the case in the Western world, as a result of increasing rates of chronic liver disease, secondary to lifestyle-associated risk factors and the lack of an established screening programme for the general population. Traditionally, radical/curative treatment options for HCC, including liver transplantation and surgical resection are reserved for the minority of patients, presenting with an early stage cancer. For patients with advanced disease, Sorafenib and Lenvatinib were, until recently, the only licensed systemic treatments, and provided only limited survival benefits at the cost of a multitude of potential side effects. Recent scientific advances in the field of cancer immunotherapy have renewed significant interest in advanced HCC, in order to fulfil this apparent area of unmet clinical need. This has led to the success and recent regulatory approval of an Atezolizumab/Bevacizumab combination for the first-line treatment of advanced HCC following results from the IMbrave150 clinical trial in 2019, with further immune checkpoint inhibitors currently undergoing testing in advanced clinical trials. Furthermore, other cancer immunotherapies, including chimeric antigen receptor T-cells, dendritic cell vaccines and oncolytic viruses are also in early stage clinical trials, for the treatment of advanced HCC. This review will summarise the major approaches that have been and are currently in development for the systemic treatment of advanced HCC, their advantages, drawbacks, and predictions of where this revolutionary treatment field will continue to travel for the foreseeable future

Frequencies of board meetings on various topics and corporate governance: evidence from China

This paper examines the relationship between number of topic-specific board meetings and quality of corporate governance. The quality of corporate governance is estimated by CEO turnover-performance and compensation-performance sensitivities. Information about topic-specific meetings is collected from the reports of independent directors of Chinese listed firms. We find that more frequent discussions of growth strategies related to the use of IPO proceeds, investment and acquisitions increase CEO compensation-performance sensitivity. By contrast, more discussions about the nomination of directors and top management are likely to reduce the sensitivities of both CEO turnover and compensation to performance. Our findings shed light on what makes boards efficient, and how board monitoring of assorted decisions modifies the relationship between CEO interests and firm performance

Comparison of three coating methods for resin zirconia bonding

Poster Session - 24 Dental Materials - Zirconia and Porcelain: no. 317OBJECTIVE: To contrast and compare the effects of three surface coatings on the bond strength between zirconia and resin-cement. METHOD: 32 pre-sintered zirconia discs (25 mm diameter, 1.5 mm thickness) were sectioned from zirconia blocks and polished under running water. All the samples were randomly divided into four experimental groups and treated as follows: control group (fully sintered, no treatment), group S (fully sintered and sandblasted with silica-coated alumina powders), group G (fully sintered + glazing porcelain veneering + HF etching), group Si (coated with silica and fully sintered). After being ultrasonically cleans...link_to_OA_fulltex

End-of-life care In Hong Kong

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Emodin abrogates peritoneal dialysis fluid induction of matrix protein synthesis and morphologic changes in human peritoneal mesothelial cells

Poster SessionPeritoneal dialysis (PD) is recognised as a therapy for patients with end stage renal failure. Continuous prolonged exposure of the peritoneal membrane to unphysiologic PD solutions results in the activation of the mesothelium, with increased synthesis and secretion of pro-inflammatory/fibrotic mediators, and increased deposition of matrix proteins. We have recently shown that emodin, a natural anthraquinone can abrogate elevated glucose-induced matrix synthesis in human peritoneal mesothelial cells (HPMC). This study aims to investigate the modulatory role of emodin on HPMC morphology, matrix synthesis (fibronectin and collagen type I), and TGF-β1 and IL-1β secretion after stimulation with either spent non-infected or infected conventional PD fluids. HPMC were characterized by their cobblestone, polygonal morphology, and positive staining for vimentin and cytokeratin. HPMC cultured with either spent non-infected or infected PD fluids for 48h resulted in an elongated fibroblastic appearance. These transdifferentiated mesothelial cells were activated as demonstrated by their positive staining for smooth muscle actin. Activation of HPMC was accompanied by an increase in fibronectin, collagen type I, TGF-β1 and IL-1β secretion (210.5±12.5ng/μg cellular protein, 64.5±5.4ng/μg cellular protein, 3.9±0.5 pg/μg cellular protein, and 4.2pg/μg cellular protein respectively for non-infected PD fluid; 390.5±24.5ng/μg cellular protein, 108±12.9ng/μg cellular protein, 5.2±1.6 pg/μg cellular protein, and 7.9±2.7pg/μg cellular protein respectively for infected PD fluid (P<0.05 for all, infected vs non-infected, n=5). Co-incubation of HPMC with spent non-infected or infected PD fluids and emodin (20μg/ml) resulted in a reduction in activated mesothelial cells, with a significant number of cells reverting back to their polygonal, epithelial morphology. Furthermore, emodin significantly reduced matrix protein and cytokine/growth factor secretion to levels similar to basal conditions. Our preliminary results show that emodin may have therapeutic potential in preserving the structural integrity of the peritoneal membrane during long-term PD

End-of-life care: Towards a more dignified dying process in residential care homes for the elderly

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Financial abuse in a mentally incapacitated old man

A mentally incapacitated 82-year-old man with no relatives was managed by a geriatrician-led multidisciplinary team when medical staff realised he was at risk of being exploited. They initiated a series of protective measures including an emergency guardianship application. The Guardianship Board appointed the Director of Social Welfare as his public guardian. This case illustrates that hospital staff should be alert to potential elder abuse to ensure timely protection of potential victims.link_to_subscribed_fulltex