Objectives(1) Understanding the characteristics of online learning experiences of Chinese undergraduate medical students; (2) Investigating students’ perceptions of ongoing online education developed in response to COVID-19 and (3) Exploring how prior online learning experiences are associated with students’ perceptions.DesignStudents’ familiarity with online learning modes and corresponding perceived usefulness (PU) according to their previous experiences were investigated using an online survey. The survey also collected data on students’ perceptions through their evaluation of and satisfaction with current online learning.SettingIn response to the educational challenges created by COVID-19, medical schools in China have adopted formal online courses for students.ParticipantsThe questionnaire was sent to 225 329 students, of whom 52.38% (118 080/225 329) replied, with valid data available for 44.18% (99 559/225 329).MethodsPearson correlations and t-tests were used to examine the relationship between familiarity and PU. Multiple linear regression and logistic regression analyses were used to determine the impact of prior learning experiences and its interactions with gender, area, learning phase and academic performance on students’ perceptions.ResultsStudents’ PU had a significant positive correlation with their familiarity with online learning modes (p<0.01). Students’ evaluation of and satisfaction with their current online education were positively associated with their familiarity (β=0.46, 95% CI 0.45 to 0.48, p<0.01; OR 1.14, 95% CI 1.13 to 1.14, p<0.01) with and PU (β=3.11, 95% CI 2.92 to 3.30, p<0.01; OR 2.55, 95% CI 2.37 to 2.75, p<0.01) of online learning. Moreover, the higher the students’ learning phases, the lower the associations between PU and students’ evaluation of and satisfaction with ongoing online education.ConclusionsMedical students in China have experiences with various online learning modes. Prior learning experiences are positively associated with students’ evaluation of and satisfaction with current online education. Higher learning phases, in which clinical practices are crucial, and high academic performance led to lower evaluation and satisfaction scores.

No abstract

The incidence is rising faster than that for any other cancer in both men and women, and the 5-year survival rate is less than 18%. 1 Hepatocellular carcinoma (HCC) is a type of primary liver cancer, which is accounting for approximately 90% of liver cancer. Most HCC patients were diagnosed at the advanced stages, missing the best treatment time, which seriously affected the survival time of patients. 2 Thus, finding the method or marker for early diagnosis is important for prognosis of HCC. Circular RNAs (circRNAs) have been reported as a regulator in many cellular processes, such as proliferation and differentiation. 3 circRNAs is a class of noncoding RNAs with a characteristic of circle structure to prevent circRNAs from being degraded by endogenous RNase, therefore stably exist in cells. circRNAs regulated gene expression by sponging mircoRNAs (miRNA), RNA-binding protein (RBP) sequestering agents and transcription regulators. 4 Increasing studies showed that circRNAs play important roles in tumour procession, such as osteosarcoma cell 5 , leukaemia 6 , lung cancer 7 and cervical cancer. 8 Thus, circRNAs might be suitable as potential biomarkers and targets for novel therapeutic approaches for human

CAR-T cell therapy has demonstrated encouraging therapeutic effects when treating haematological malignancies. 1,2 Two CAR-T treatments targeting CD19 have been launched successfully. 3,4 CAR-T targeting the B-cell maturation antigen (BCMA) has also shown positive therapeutic effects in clinical trials. [5][6][7] However, CAR-T cell therapy has not yet had similar results in solid tumours. [8][9][10] Solid tumours have a more complex immunosuppressive microenvironment and there are many immunosuppressive cells and cytokines which inhibit the activation and survival of CAR-T cells within the tumour. 11,12 The dense extracellular matrix (ECM) also prevents CAR-T cells from infiltrating into solid tumours and can affect CAR-T cell activity. 13,14 During cultivation, additional cytokines, such as IL7 and IL15, can promote the effective proliferation and maintenance of the memory phenotype of CAR-T cells. 15,16 However, adding extra IL-7 during cultivation has no effect in vivo. It is difficult for T cells, including CAR-T cells, to penetrate the extracellular matrix and thus infiltrate the tumour. 13,14 Reports suggest that recombinant hyaluronidase rHPH20

In the increasing pervasiveness of today's digital society, mobile devices are changing the face of education. Students can interact with mobile devices in context-aware environment. This paper presents a mobile application based on expert system (Plant-E) for students to acquire knowledge about plant classification by answering decision-making questions. In order to study effectiveness of Plant-E and cognitive load of students who experience different kinds of interaction in learning process, another mobile application (Plant-G) only providing information pages of plants was developed. A quasi-experiment was conducted with three classes of 137 seventh graders. The three classes, Class A with 46 students using Plant-E in campus, Class B with 44 students using Plant-G in campus, and Class C with 47 students using Plant-G in a traditional classroom, constitute three groups with different interaction complexity. The research conducted pretest, posttest, and delayed test to evaluate learning performance of students in three classes and used a questionnaire to investigate their perceptions and attitudes towards proposed system. Results show that interaction complexity has an impact on students' learning performance and mental effort in mobile learning; the higher the interaction complexity is, the higher mental effort and the better learning performance in mobile learning will be.