Simultaneous transcatheter arterial chemoembolization and portal vein embolization for patients with large hepatocellular carcinoma before major hepatectomy

BACKGROUND Sequential transarterial chemoembolization(TACE)and portal vein embolization(PVE)are associated with long time interval that can allow tumor growth and nullify treatments'benefits.AIM To evaluate the effect of simultaneous TACE and PVE for patients with large hepatocellular carcinoma(HCC)prior to elective major hepatectomy.METHODS Fifty-one patients with large HCC who underwent PVE combined with or without TACE prior to hepatectomy were included in this study,with 13 patients in the simultaneous TACE+PVE group,17 patients in the sequential TACE+PVE group,and 21 patients in the PVE-only group.The outcomes of the procedures were compared and analyzed.RESULTS All patients underwent embolization.The mean interval from embolization to surgery,the kinetic growth rate of the future liver remnant(FLR),the degree of tumor size reduction,and complete tumor necrosis were significantly better in the simultaneous TACE+PVE group than in the other groups.Although the patients in the simultaneous TACE+PVE group had a higher transaminase levels after PVE and TACE,they recovered to comparable levels with the other two groups before surgery.The intraoperative course and the complication and mortality rates were similar among the three groups.The overall survival and disease-free survival were higher in the simultaneous TACE+PVE group than in the other two groups.CONCLUSION Simultaneous TACE and PVE is a safe and effective approach to increase FLR volume for patients with large HCC before major hepatectomy.

Effect of mixing rate and temperature on primary Si phase of hypereutectic Al-20Si alloy during control ed diffusion solidification(CDS) process

Controlled Diffusion Solidification(CDS) is a promising process relied on mixing two liquid alloys of precisely controlled chemistry and temperature in order to produce a predetermined alloy composition. In this study, the CDS was employed to prepare hypereutectic Al-20%Si(mass fraction) alloy using Al-30%Si and pure Al of different temperatures. The mixing rate was controlled using three small crucibles with a hole of different diameters in their bottom. The effect of mixing rate and temperature on the microstructure of the primary Si-phase during the mixing of molten Al and Al-30%Si was studied. The results showed that when the diameter of the small crucible bottom hole is 16 mm, a higher mass mixing rate 0.217 kg·s-1 would results in a lower stream velocity 0.414 m·s-1. Conversely a lower mass mixing rate 0.114 kg·s-1(the diameter of the small crucible bottom hole is 8 mm) would result in a higher fluid stream velocity 0.879 m·s-1. A lower mass mixing rate would be better to refine the primary Si than a higher mass mixing rate. Meanwhile, the morphology and distribution of primary Si could also be improved. Especially, when Al-30%Si alloy at 820 °C was mixed with pure Al at 670 °C in the case of a mass mixing rate of 0.114 kg·s-1 and a pouring temperature of 680 °C, the average size of the primary Si phase would be only 18.2 μm. Its morphology would mostly be octahedral and the primary Si would distribute uniformly in the matrix microstructure. The lower mass mixing rate(0.114 kg·s-1) will enhance the broken tendency of Al-30%Si steam and the mixing agitation of resultant melt, so the primary Si phase can be better refined.