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A network Meta-analysis of the impact of various teaching methods on medical students' doctor-patient communication Yang Min, Zhou Yongjia, Xu Caihua, Liu Jingyi, Zhou Haiyan, Li Jiang, Cong Minghua Electronic Journal of Liver Tumor    2025, 12 (2): 44-53.   Abstract （51）      PDF （4063KB）（0）       Knowledge map    Save Objective: To compare the effectiveness of different teaching methods in enhancing the communication skills of medical students in China, providing evidence-based recommendations for optimal teaching strategies. Methods: From the establishment of the library until October 15, 2024, a systematic search was conducted in seven databases, including China National Knowledge Infrastructure, China Biomedical Literature Database, PubMed, and Web of Science, to evaluate teaching methods on doctor-patient communication among Chinese medical students. Two independent reviewers screened the studies, extracted relevant data, assessed the risk of bias, and performed statistical analyses. Results: A total of 26 studies involving 2 045 participants and 14 different teaching methods were included. Network Meta-analysis and cumulative ranking probability plots indicated that case-based learning combined with standardized patient teaching (weighted mean difference [WMD]=7.68, 95% confidence interval [95%CI]: 4.76-10.59) and small private online course combined with case-based learning (WMD=7.67, 95%CI: 1.04-14.30) were the most effective in improving medical students' doctor-patient communication skills. Subgroup analysis showed that case-based learning alone was more effective in improving communication skills among medical students and interns, while case-based learning combined with standardized patient teaching was more effective for residents and attending physicians. Conclusion: Case-based learning combined with standardized patient learning or small private online course appear to be superior to other teaching methods for enhancing doctor-patient communication skills. However, the selection of teaching strategies should be tailored to the specific characteristics of the learners to maximize effectiveness in practical applications. Reference | Related Articles | Metrics

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Efficacy and safety of lenvatinib in patients with hepatocellular carcinoma Zhou Jianguo, Wang Bingchen, Li Haocheng, Zhang Yuewei, Peng Tao, Liu Hongli, Xiang Xiaojun, Sun Chuandong, Liu Jun, Li Guangming, Li Dewei, Wang Yu, Cai Jianqiang Electronic Journal of Liver Tumor    2025, 12 (3): 1-6.   Abstract （36）      PDF （2070KB）（3）       Knowledge map    Save Objective: To evaluate the efficacy and safety of the comprehensive treatment regimen based on lenvatinib in patients with HCC. Methods: This study was a retrospective real-world study. A total of 1,000 HCC patients who received comprehensive treatment based on lenvatinib and were admitted to 13 research centers across the country from January 2022 to December 2024 were included. The basic clinical information of patients, treatment plans, laboratory indicators and survival outcomes were all collected and managed through standardized databases. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints included the 1-year PFS rate, 1-year overall survival rate (OS), and safety analysis. Statistical analysis was conducted using Kaplan-Meier survival analysis and log-rank test to evaluate the differences in efficacy among different treatment strategies. Results: Among 1 000 patients, 83.70% were male, and the median age was 59.0 years (IQR: 52.0, 67.0). In the analysis of the combined disease history of the patients, the disease distribution showed significant differences: The proportion of history of hypertension was the highest (15.60%), followed by history of diabetes (5.80%), and liver cirrhosis (5.00%). The proportion of patients who had received surgical treatment in the past was 30.50%, the proportion of liver resection was 19.50%, and only 1.80% of the patients had received radiotherapy. The application rate of interventional therapy in the population of this study was 34.60%. The positive rate of hepatitis B virus surface antigen was 55.10% and the positive rate of anti-hepatitis C virus antibody was 3.80%. According to the Barcelona Clinic Liver Cancer(BCLC) staging, the proportion of patients in the advanced stage (BCLC-C, D stage) was 28.00%. In terms of treatment regimens, 79.80% of the patients received 8mg lenvatinib treatment, 60.7% of the patients received lenvatinib monotherapy, and 20.8% of the patients received combined immunotherapy. The therapeutic effect analysis showed that the median PFS of the overall patients was 7.0 months (95%CI: 7.0-8.0), and the 1-year OS rate was 97.00%(95%CI: 96.00%-98.00%). The 1-year PFS rate was 16.00%(95%CI: 14.00%-19.00%). The adverse events occurred rate was 23.60% during the follow-up period, and no serious adverse events were observed. Conclusion: The lenvatinib combination strategy has a positive impact on survival prognosis for HCC patients, but it still needs to be optimized for long-term disease control. Reference | Related Articles | Metrics

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Research on the application of clinical nursing based on the target theory in the transcatheter arterial chemoembolization treatment of patients with intermediate and advanced liver cancer Kou Yinhu Electronic Journal of Liver Tumor    2025, 12 (2): 37-41.   Abstract （35）      PDF （1747KB）（0）       Knowledge map    Save Objective: To explore the impact of clinical nursing based on the target theory on the recovery and prognosis of patients with intermediate and advanced liver cancer treated with transcatheter arterial chemoembolization (TACE). Methods: 92 patients with intermediate and advanced liver cancer who were treated with transdermal puncture TACE in Beijing Friendship Hospital, Capital Medical University from February 2022 to March 2024 were selected as the research subjects. They were divided into a control group and a research group according to the random number table method. The number of patients was 46 in each case. The control group received routine nursing care, while the research group adopted clinical care based on the standard theory in addition to routine care. Hospitalization (length of stay, cost of stay), pain (visual analogue scale [VAS] score), psychological state (Hamilton anxiety scale [HAMA] score, Hamilton depression scale [HAMD] score), quality of life (quality of life questionnaire-core 30 [QLQ-C30] score) and occurrence of complications were compared between the two groups. Results: There was no significant difference in hospitalization time and hospitalization expenses between the two groups (both P>0.05). Before nursing, there was no significant difference in the VAS score, HAMA score, HAMD score and QLQ-C30 score between the two groups of patients (all P>0.05). After nursing, the VAS score, HAMA score, and HAMD score of the two groups of patients were significantly decreased, and the decrease was more significant in the study group (all P<0.05); After care, the QLQ-C30 scores of both groups of patients increased significantly, and the increase was more significant in the study group (P<0.05); the incidence of complications in the study group was significantly lower than that of the control group (P<0.05). Conclusion: Clinical nursing based on target-reaching theory can relieve pain, improve negative emotions, and improve quality of life for patients with advanced liver cancer treated with percutaneous TACE. Reference | Related Articles | Metrics

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ERCC6L mediates DNA repair and replication signaling to promote hepatocellular carcinoma proliferation and metastasis Li Dongliang, Zhou Baofu, Du Chaogang, Wu Jing, Huang Cheng Electronic Journal of Liver Tumor    2025, 12 (3): 19-29.   Abstract （34）      PDF （10189KB）（20）       Knowledge map    Save Objective: To explore the mechanism of ERCC6L gene in hepatocellular carcinoma(HCC). Methods: The expression and prognostic differences of ERCC6L and DNA methylation levels in HCC cells were analyzed by public databases and immunohistochemistry; the effects of ERCC6L expression on HCC cells proliferation, transfer and invasion were analyzed by in vivo and in vitro experiments, and the cell cycle effects of ERCC6L on HCC cells were analyzed by flow cytometry. The effects of ERCC6L on DNA repair and replication signals (RRM1,RRM2,POLE2 and LIG1) in HCC cells were analyzed by functional enrichment and protein immunoblotting experiments. Results: ERCC6L mRNA and protein levels were up-regulated in HCC tissues (all P<0.05).The overall survival rate of HCC patients with high expression of ERCC6L was lower than that of patients with low expression (P<0.05). ERCC6L showed hypomethylation status in HCC patients,including cg01004805, cg12747864, cg09743261, cg05279113. Knockdown of ERCC6L inhibited HCC cell viability, proliferation, migration and invasive ability, and reduced HCC tumor growth (all P<0.05). The KEGG signaling pathway of ERCC6L was mainly enriched in cell cycle,DNA replication and Fanconi anemia pathways. Knockdown of ERCC6L expression induced G0/G1 phase arrest in HCC cells and decreased the levels of RRM1,RRM2,POLE2 and LIG1 protein expression (all P<0.05). Conclusion: ERCC6L is highly expressed in HCC patients and mediates worse prognosis by a potential mechanism through mediating DNA repair and replication signaling. Reference | Related Articles | Metrics

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Evidence summary for perioperative pain management in patients with open hepatectomy Niu Yushuo, Li Cuicui, Wang Lin, Li Yajun, Zhao Runan, Hou Xiaohong Electronic Journal of Liver Tumor    2025, 12 (2): 30-36.   Abstract （30）      PDF （1648KB）（0）       Knowledge map    Save Objective: To retrieve, evaluate, and integrate evidence of perioperative pain management in patients with open hepatectomy, and to provide references for clinical nursing practice. Methods: Clinical decisions, guidelines, evidence summaries, best practices, recommended practices, expert consensus, systematic reviews, and meta-analyses related to perioperative pain management in patients with open hepatectomy were systematically searched from domestic and foreign databases. The search period is from the inception of the databases until August 2023. Three researchers assessed the quality of the literature and extracted and summarized evidence based on this topic. Results: A total of 18 articles were included, including 1 clinical decision, 4 guidelines, 3 expert consensus, 2 evidence summaries, and 8 systematic reviews. A total of 31 pieces from 8 aspects of evidence were summarized, including team building, pain assessment, pain planning, pain education, preventive analgesia, multimodal analgesia, and dynamic evaluation. Conclusion: This study summarizes the evidence for perioperative pain management in patients with open hepatectomy and provides a reference basis for clinical practice. Medical staff should take good nursing measures for pain management according to the clinical situation to reduce patients' postoperative pain. Reference | Related Articles | Metrics

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Clinicopathologic characteristics of hepatic EBV(+) inflammatory follicular dendritic cell sarcoma and literature review Zhang Huijuan, Feng Xiaolong, Guan Jian, Huang Wenting Electronic Journal of Liver Tumor    2025, 12 (1): 5-9.   Abstract （29）      PDF （3786KB）（2）       Knowledge map    Save Reference | Related Articles | Metrics

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Risk network calculators and prognosticators for Embolic syndrome after TACE in hepatocellular carcinoma Chen Yan, Tian Qifeng, Chen Cheng, Tian Shuilin Electronic Journal of Liver Tumor    2025, 12 (1): 33-38.   Abstract （29）      PDF （2290KB）（1）       Knowledge map    Save Objective: To analyse the prognostic impact of post-embolisation syndrome (PES) after first transarterial chemoembolisation (TACE) for advanced hepatocellular carcinoma (HCC), and to analyse the risk factors for PES and construct a risk assessment network calculator. Methods: Patients with advanced HCC treated with first TACE between January 2020 and September 2022 in our hospital were selected. Kaplan-Meier method were used to survival analysis, and unifactorial and multifactorial Cox risk regression were used to analyse patients' risk factors for death. Multifactorial logistic regression model was used to analyse PES risk factors, column line graphs of advanced PES risk were constructed based on PES risk factors, internal dataset was used for calibration curves, decision curves, and clinical impact curves analysis, and column line graphs were published into Netwatch to construct the Risk Assessment Network Calculator. Results: The incidence of PES after the first TACE was 62.6% in 147 patients with advanced HCC.The mean follow-up time after TACE was (12.42 ± 3.58) months, of which 99 (67.3%) patients died.The overall survival rate of patients with PES was lower than that of patients with non-PES (P<0.05). Multifactorial Cox proportional risk regression showed that PES, number of TACE and combination therapy were independent risk factors for prognosis in patients with advanced HCC (all P<0.05). Multifactorial logistic regression analysis showed that age, maximum tumour diameter, drug delivery route, total bilirubin (TB) and albumin (ALB) were independent risk factors for PES (all P<0.05). The area under the curve of the receiver operating characteristic curve - curve of the predicted PES risk nomogram was 0.863 (0.796-0.914), and the calibration curve showed a C-index of 0.879, which indicated that the nomogram had a high predictive accuracy. Conclusions: PES is associated with reduced survival in patients with advanced HCC after TACE. A PES risk network calculator based on age, maximum tumour diameter, drug delivery method, TB and ALB can provide a reference basis for more active measures to manage PES. Reference | Related Articles | Metrics

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Heat shock protein family A member 1A expression is increased in hepatocellular carcinoma and mediates sorafenib resistance Yang Li, Lu Xue Electronic Journal of Liver Tumor    2025, 12 (2): 14-21.   Abstract （29）      PDF （5456KB）（1）       Knowledge map    Save Objective: To explore the expression of heat shock protein family A member 1A (HSPA1A) in hepatocellular carcinoma (HCC) patients and whether it is involved in sorafenib resistance mechanism. Methods: The 152 patients with HCC admitted to our hospital from March 2022 to March 2024 were selected. Hub genes mediating sorafenib resistance were screened by three microarray data from the Gene Expression Omnibus database. Resistance genes were further explored by The Cancer Genomic Atlas-HCC cohort, immunohistochemistry (IHC), quantitative real-time polymerase chain reaction (RT-qPCR), western blot (WB) analyses, and cellular function. The correlation between HSPA1A expression and sorafenib 50% inhibitory concentration(IC50) was analysed by drug sensitivity. The relationship between HSPA1A expression and autophagy signalling was analysed by single-sample single sample gene set enrichment analysis (ssGSEA) algorithm. Results: HSPA1A expression was significantly higher in both sorafenib-treated and resistance tissues (P<0.05). IHC, RT-qPCR and WB confirmed that HSPA1A expression levels were higher in sorafenib-resistant patients than in responding patients (all P<0.05). Gene Expression Profiling Interactive Analysis database and IHC showed significantly higher HSPA1A protein expression in HCC tissues. Clinical cohorts and the Kaplan-Meier plotter database confirmed lower overall survival rate and relapse-free survival rate in patients with high HSPA1A expression (all P<0.05). CCK-8, clone formation, scratch and invasion assays confirmed that knockdown of HSPA1A significantly inhibited Huh-7 and MHCC97-L cell viability, proliferation, migration and invasion ability (all P<0.05).CCK-8 assay showed that the IC50 of sorafenib in Huh-7 and MHCC97-L cells knocked down by HSPA1A decreased by 17.4% and 19.3% (all P<0.05), increasing the therapeutic sensitivity of sorafenib. ssGSEA analysis showed that high HSPA1A mRNA expression inhibited autophagy activity (P<0.05). Conclusion: HSPA1A expression is increased in HCC and may be involved in the mechanism of sorafenib resistance, and the underlying mechanism may be related to autophagy signalling. Further experiments are needed to explore the potential mechanism of HSPA1A in HCC and provide new strategies to overcome sorafenib resistance. Reference | Related Articles | Metrics

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Primary invasive B-cell lymphoma involving anastomotic hemangioma in the liver: a case report Wang Ziyue, Zhu Yinan, Lu Wanchen, Xi Haiyan, Lin Xuyong, Song Yan Electronic Journal of Liver Tumor    2025, 12 (1): 30-32.   Abstract （28）      PDF （3536KB）（0）       Knowledge map    Save Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2025, 12 (2): 42-43.   Abstract （28）      PDF （2549KB）（1）       Knowledge map    Save Reference | Related Articles | Metrics

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Advances in study on farnesoid X receptor in hepatocellular carcinoma Zhao Weihua, Li Changying Electronic Journal of Liver Tumor    2025, 12 (2): 22-25.   Abstract （26）      PDF （1625KB）（0）       Knowledge map    Save Farnesoid X receptor (FXR) is a ligand-activated transcription factor involved in the control of bile acid synthesis and enterohepatic circulation. In recent years, more and more studies have shown that the expression of hepatic FXR is inversely correlated with multiple malignant clinicopathological characteristics of hepatocellular carcinoma. This article reviewed the advances in study on FXR in hepatocellular carcinoma to provide necessary reference for the prevention and treatment of hepatocellular carcinoma. Reference | Related Articles | Metrics

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Multifocal perivascular epithelioid cell tumor of pancreas and liver: a case report and literature review Guan Jian, Shen Guihua, Huang Wenting Electronic Journal of Liver Tumor    2025, 12 (1): 24-29.   Abstract （26）      PDF （7101KB）（0）       Knowledge map    Save Reference | Related Articles | Metrics

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Clinicopathological characteristics of three cases of liver primary pleomorphic undifferentiated sarcoma and literature review Li Zhuo, Gong Lihua, Ma Peiqing, Wang Bingning, Li Jin, Lu Haizhen Electronic Journal of Liver Tumor    2025, 12 (1): 10-14.   Abstract （26）      PDF （4549KB）（10）       Knowledge map    Save Reference | Related Articles | Metrics

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Clinicopathological features and literature review of undifferentiated embryonal sarcoma of the liver Zhang Yinping, Wang Yuan, Wang Yuanyuan, Zhang Bing, Gao Ge, Xia Qingxin Electronic Journal of Liver Tumor    2025, 12 (1): 15-18.   Abstract （26）      PDF （3278KB）（0）       Knowledge map    Save Reference | Related Articles | Metrics

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Research progress on resection margin of liver metastasis in colorectal cancer Han Jixiang, Zhao Jianjun, Wang Jingtao Electronic Journal of Liver Tumor    2025, 12 (2): 26-29.   Abstract （24）      PDF （1580KB）（0）       Knowledge map    Save The resection margin of liver metastases refers to the distance from the tumor edge to the liver section. The liver is the main target organ for distant metastasis of colorectal cancer. The issue of resection margin should not only follow the basic principles of liver surgery, but also consider the unique biological characteristics of colorectal liver metastases. Surgical resection margin is the focus and difficulty in surgical treatment. The definition of R0 resection has undergone a shift from a margin greater than 1 cm to greater than 1 mm. With further research, tumor R1 resection has gradually been proposed and accepted under specific conditions. High tumor burden, RAS gene mutations, tumor pathology, and vascular relationships are associated with higher R1 resection rates. This article intends to review and analyze the study of surgical margins for liver metastases in colorectal cancer. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2025, 12 (2): 54-56.   Abstract （24）      PDF （1533KB）（6）       Knowledge map    Save Related Articles | Metrics

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Expert guidance on three-level prevention of radiation-induced liver diseases Wu Zhifeng, Zeng Zhaochong Electronic Journal of Liver Tumor    2025, 12 (2): 1-7.   Abstract （23）      PDF （1891KB）（9）       Knowledge map    Save With the improvement of the efficacy of radiotherapy (RT) for abdominal tumors such as liver cancer, the clinical contradiction between the efficacy of RT and the occurrence of radiation-induced liver diseases (RILD) has become increasingly prominent. As one of the dose-limiting complications of abdominal tumor RT, RILD currently lacks a consensus on the clinical three-level prevention. On the basis of elucidating the pathogenesis of RILD, this article summarizes the influencing factors and corresponding prevention and treatment measures of RILD prevention and treatment in three levels, and provides expert guidance, summarizes the influencing factors and corresponding measures for RILD prevention and control at three levels, with the aim of enabling clinicians to be familiar with and master the potential fatal RILD during the RT process for abdominal tumors. Reference | Related Articles | Metrics

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A longitudinal study of the trajectory of change in cancer-related fatigue in patients treated with chemotherapy for advanced hepatocellular carcinoma Jia Yide, Cao Zhiguo, Wu Deping, Chang Yuanhua, Xiang Zhu Electronic Journal of Liver Tumor    2025, 12 (2): 8-13.   Abstract （22）      PDF （1992KB）（2）       Knowledge map    Save Objective: To investigate the trajectory of cancer-related fatigue (CRF) and its influencing factors in chemotherapy patients with advanced hepatocellular carcinoma (HCC). Methods: Ninety-five patients with advanced HCC treated between October 2021 and October 2023 in Affiliated Hospital of West Anhui Health Vocational College were selected. Patients' CRF was assessed by Piper fatigue scale-revised (PFS-R) before, after and 1 week after 6 chemotherapy sessions. A mixed growth model was used to identify CRF trajectory subtypes. The Kaplan-Meier method was used to analyze the overall survival of different CRF trajectory subtypes. Multifactorial logistic regression was used to analyze the influencing factors of different CRF trajectory subtypes. Results: A total of four CRF trajectory subtypes were identified in this study: high fatigue fast-growth type in 15 cases (15.8%), high fatigue moderate-growth type in 10 cases (10.5%), moderate fatigue slow-growth type in 29 cases (30.5%) and low fatigue slow-growth type in 41 cases (43.2%). The overall survival rates of high-fatigue rapid-growth, high-fatigue moderate-growth, moderate-fatigue stable, and low-fatigue slow-growth types increased gradually (all P<0.05). Multifactorial logistic regression analysis showed that age, body mass index and C-reactive protein were the common influencing factors for the three CRF growth types (P<0.05); albumin was a independent influencing factors for the moderate-fatigue slow-growth type (P<0.05); and literacy level and mode of residence were the independent influencing factors for the high-fatigue fast-growth type (all P<0.05). Conclusion: CRF in advanced HCC chemotherapy patients presented four CRF trajectory subtypes, and the unique influencing factors of different CRF trajectory subtypes were identified, which provided clinical basis and new ideas for the personalized and holistic management of CRF in advanced HCC chemotherapy patients. Reference | Related Articles | Metrics

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Development of a checklist management pathway based on goal achievement theory and its application in discharge preparation for percutaneous transhepatic biliary drainage patients Ding Zhiying, Zhao Xiaoyun, Dai Qiqi, Cai Chaohong Electronic Journal of Liver Tumor    2025, 12 (1): 46-52.   Abstract （22）      PDF （2512KB）（2）       Knowledge map    Save Objective: To evaluate the impact of a goal achievement theory (GAT)-based checklist management model on discharge preparedness in patients undergoing percutaneous transhepatic biliary drainage (PTBD). Method: Sixty patients from the interventional department of a tertiary hospital in Suzhou, undergoing PTBD for the first time and requiring long-term catheter maintenance, were enrolled using convenience sampling. Patients were divided into a control group (n=34), receiving conventional perioperative PTBD care, and an experimental group (n=26), receiving care based on the GAT-based checklist management model. Key outcomes included discharge preparedness scores, patient satisfaction, catheter-related complication rates within 30 days post-discharge, and unplanned readmission rates. Result: The experimental group had significantly higher discharge readiness scores and satisfaction compared to the control group (P<0.05). Within 30 days post-discharge, the experimental group had a lower incidence of complications such as catheter slippage, blockage, infection, and related skin damage compared to the control group (P<0.05). No significant difference in the unplanned readmission rate was found between the two groups (P>0.05). Conclusion: The GAT-based checklist management model can enhance patients' catheter management and self-care abilities, as well as improve their compliance and engagement in disease management. Additionally, this model deepens the communication between patients and healthcare providers, fostering interaction and improving discharge readiness and patient satisfaction. It also reduces the incidence of related complications and the rate of unplanned readmissions. Reference | Related Articles | Metrics

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A case of clear cell type hepatocellular carcinoma and review of literature Wang Jing, Xu Enwei Electronic Journal of Liver Tumor    2025, 12 (1): 19-23.   Abstract （22）      PDF （5925KB）（0）       Knowledge map    Save Reference | Related Articles | Metrics