Efficacy of radiofrequency ablation combined with sorafenib for treating liver cancer complicated with portal hypertension and prognostic factors

BACKGROUND Patients with liver cancer complicated by portal hypertension present complex challenges in treatment.AIM To evaluate the efficacy of radiofrequency ablation in combination with sorafenib for improving liver function and its impact on the prognosis of patients with this condition.METHODS Data from 100 patients with liver cancer complicated with portal hypertension from May 2014 to March 2019 were analyzed and divided into a study group(n=50)and a control group(n=50)according to the treatment regimen.The research group received radiofrequency ablation(RFA)in combination with sorafenib,and the control group only received RFA.The short-term efficacy of both the research and control groups was observed.Liver function and portal hypertension were compared before and after treatment.Alpha-fetoprotein(AFP),glypican-3(GPC-3),and AFP-L3 levels were compared between the two groups prior to and after treatment.The occurrence of adverse reactions in both groups was observed.The 3-year survival rate was compared between the two groups.Basic data were compared between the survival and non-surviving groups.To identify the independent risk factors for poor prognosis in patients with liver cancer complicated by portal hypertension,multivariate logistic regression analysis was employed.RESULTS When comparing the two groups,the research group's total effective rate(82.00%)was significantly greater than that of the control group(56.00%;P<0.05).Following treatment,alanine aminotransferase and aspartate aminotransferase levels increased,and portal vein pressure decreased in both groups.The degree of improvement for every index was substantially greater in the research group than in the control group(P<0.05).Following treatment,the AFP,GPC-3,and AFP-L3 levels in both groups decreased,with the research group having significantly lower levels than the control group(P<0.05).The incidence of diarrhea,rash,nausea and vomiting,and fatigue in the research group was significantly greater than that in the control group(P<0.05).The 1-,2-,and 3-year survival rates of the research group(94.00%,84.00%,and 72.00%,respectively)were significantly greater than those of the control group(80.00%,64.00%,and 40.00%,respectively;P<0.05).Significant differences were observed between the survival group and the non-surviving group in terms of Child-Pugh grade,history of hepatitis,number of tumors,tumor size,use of sorafenib,stage of liver cancer,histological differentiation,history of splenectomy and other basic data(P<0.05).Logistic regression analysis demonstrated that high Child-Pugh grade,tumor size(6–10 cm),history of hepatitis,no use of sorafenib,liver cancer stage IIIC,and previous splenectomy were independent risk factors for poor prognosis in patients with liver cancer complicated with portal hypertension(P<0.05).CONCLUSION Patients suffering from liver cancer complicated by portal hypertension benefit from the combination of RFA and sorafenib therapy because it effectively restores liver function and increases survival rates.The prognosis of patients suffering from liver cancer complicated by portal hypertension is strongly associated with factors such as high Child-Pugh grade,tumor size(6-10 cm),history of hepatitis,lack of sorafenib use,liver cancer at stage IIIC,and prior splenectomy.

食管黏膜病变内镜黏膜下剥离术前和术后的临床病理分析

目的回顾性分析早期食管癌和癌前病变的内镜下特征及临床病理特征,探讨内镜黏膜下剥离术(ESD)治疗的必要性、安全性和有效性。方法纳入2013年5月-2016年4月经白光内镜及病理活检诊断为早期食管癌及上皮内瘤变的患者51例,分析毛细血管袢(IPCL)、碘染色、术前术后病理结果及相关并发症的发生情况。结果 51例患者共58处病变,IPCL分类58处病变中A型8处(13.79%),B1型44处(75.86%),B2型6处(10.34%);术前活检结果 11处(18.97%)为低级别上皮内瘤变(LGIN),42处(72.41%)为高级别上皮内瘤变(HGIN),5处(8.62%)为鳞状细胞癌,术后病理结果 10处(17.54%)病变为LGIN,27处(46.55%)为HGIN,21处(36.21%)病变为鳞状细胞癌,术前术后病理结果符合率为60.34%。微穿孔、狭窄和术后迟发性出血的概率分别为0.00%(0/58)、8.62%(5/58)和3.45%(2/58)。结论 ESD术后食管早癌的检出率显著增加,术前活检对诊断和治疗有指导意义,ESD治疗能减少食管早癌的漏诊。

目标导向式健康威胁行为扭转延续护理干预对消化性溃疡患者生活质量的影响

目的 分析目标导向式健康威胁行为扭转延续护理干预对消化性溃疡患者生活质量的影响。方法 选取郑州大学第一附属医院2020年1月至2022年10月收治的86例消化性溃疡患者作为研究对象,以抽签法分为对照组与观察组,每组43例。对照组行常规护理干预,观察组行目标导向式健康威胁行为扭转延续护理干预,比较两组的负性情绪、胃肠激素、希望水平、生活质量、护理依从性。结果 护理后观察组负性情绪评分低于对照组(P <0.001);观察组血清胃动素(MTL)、胃泌素(GAS)低于对照组,生长抑素(SS)与表皮生长因子(EGF)高于对照组(P <0.001);观察组希望水平评分、生活质量评分高于对照组(P <0.05);观察组护理总依从率高于对照组(95.35%vs.79.07%,P=0.024)。结论 目标导向式健康威胁行为扭转延续护理能够改善消化性溃疡患者的负性情绪,提高其护理依从性与希望水平,对胃肠激素分泌有一定影响,有利于提高患者生活质量,促进疾病转归。

Elevated serum interleukin-38 level at baseline predicts virological response in telbivudine-treated patients with chronic hepatitis B

AIM: To investigate serum interleukin(IL)-38 level and its clinical role in predicting virological response(VR) to telbivudine(Ld T) in patients with chronic hepatitis B(CHB).METHODS: The study participants were divided into two groups; one group consisted of 43 healthy controls(HCs) and the other group consisted of 46 patients with hepatitis B e antigen-positive CHB. All patients were administered 600 mg of oral Ld T daily for 52 wk, and they visited physicians every 12 wk for physical examination and laboratory tests. Serum IL-38 levels were determined using ELISA. The concentrations of serum Th1- and Th2-type cytokines were measured using the cytometric bead array(CBA) method. RESULTS: Serum levels of IL-38 at baseline in all patients were higher than those in HCs [306.97(123.26-492.79) pg/m L vs 184.50(135.56-292.16) pg/m L, P = 0.019]; the levels returned to normal after the first 12 wk of treatment with Ld T [175.51(103.90-331.91) pg/m L vs 184.50(135.56-292.16) pg/m L, P > 0.05]. Serum IL-38 levels at baseline were positively associated with serum aspartate aminotransferase levels in patients with CHB(r = 0.311, P = 0.036). Higher levels of serum IL-38 at baseline were associated with a greater probability of VR to Ld T treatment at 24 wk(48.15% vs 15.79%, P = 0.023) and 52 wk(66.67% vs 36.84%, P = 0.044). The levels of serum IL-38 in patients with primary nonresponse at week 12 after treatment initiation were lower than those in patients with primary response [64.44(49.85-172.08) pg/m L vs 190.54(121.35-355.28) pg/m L, P = 0.036]. Serum IL-38 levels were correlated with serum IL-6 and IL-12 levels in patients with CHB during treatment with Ld T. CONCLUSION: Elevated serum IL-38 levels in untreated CHB patients reflect ongoing liver injury. Higher serum IL-38 levels before treatment indicate a greater probability of VR to Ld T treatment.

Different phenotypes of monocytes in patients with newonset mild acute pancreatitis

AIM To evaluate the numbers of different subsets of monocytes and their associations with the values of clinical measures in mild acute pancreatitis(MAP) patients.METHODS The study included one group of 13 healthy controls and another group of 24 patients with new-onset MAP. The numbers of different subsets of monocytes were examined in these two groups of subjects by flow cytometry. The concentrations of plasma interleukin(IL)-10 and IL-12 were determined by cytometric bead array. The acute physiology and chronic health evaluation(APACHE) II scores of individual patients were evaluated, and the levels of plasma C-reactive protein(CRP) as well as the activities of amylase and lipase were measured. RESULTS In comparison with that in the controls, significantly increased numbers of CD14+CD163-, CD14+CD163-MAC387+ M1 monocytes, but significantly reduced numbers of CD14+CD163+IL-10+ M2 monocytes were detected in the MAP patients(P < 0.01 or P < 0.05). Furthermore, significantly higher levels of plasma IL-10 and IL-12 were observed in the MAP patients(P < 0.01 for all). More importantly, the levels of plasma CRP were positively correlated with the numbers of CD14+CD163-(R = 0.5009, P = 0.0127) and CD14+CD163-MAC387+(R = 0.5079, P = 0.0113) M1 monocytes and CD14+CD163+CD115+ M2 monocytes(R = 0.4565, P = 0.0249) in the patients. The APACHE II scores correlated with the numbers of CD14+CD163+CD115+(R = 0.4581, P = 0.0244) monocytes and the levels of plasma IL-10(R = 0.4178, P = 0.0422) in the MAP patients. However, there was no significant association among other measures tested in this population. CONCLUSION Increased numbers of CD14+CD163- and CD14+ CD163-MAC387+ monocytes may contribute to the pathogenesis of MAP, and increased numbers of CD14+CD163+CD115+ monocytes may be a biomarker for evaluating the severity of MAP.

CYP4F2 polymorphism as a genetic risk factor for major hemorrhagic complications in Chinese patients on warfarin therapy

Warfarin is a commonly used anticoagulant with a narrow therapeutic range and risk of hemorrhagic complications. After CYP2C9 and VKORC1, CYP4F2 was confirmed as the third principle genetic determinant of warfarin dose variability.

Ligand-free CsPbBr_(3) with calliandra-like nanostructure for efficient artificial photosynthesis

The low-efficiency CO_(2) uptake capacity and insufficient photogenerated exciton dissociation of current metal halide perovskite(MHP)nanocrystals with end-capping ligands extremely restrict their application in the field of artificial photosynthesis.Herein,we demonstrate that ligand-free CsPbBr_(3) with calliandralike nanostructure(LF-CPB CL)can be synthesized easily through a ligand-free seed-assisted dissolutionrecrystallization growth process,exhibiting significantly enhanced CO_(2) uptake capacity.More specifically,the abundant surface bromine(Br)vacancies in ligand-free MHP materials are demonstrated to be beneficial to photogenerated carrier separation.The electron consumption rate of LF-CPB CL for photocatalytic CO_(2) reduction increases 7 and 20 times over those of traditional ligand-capping CsPbBr_(3)nanocrystal(L-CPB NC)and bulk CsPbBr_(3),respectively.Moreover,the absence of ligand hindrance can facilitate the interfacial electronic coupling between LF-CPB CL and tetra(4-carboxyphenyl)porphyrin iron(Ⅲ)chloride(Fe-TCPP)cocatalyst,bringing forth significantly accelerated interfacial charge separation.The LF-CPB CL/Fe-TCPP exhibits a total electron consumption rate of 145.6μmol g^(-1) h^(-1) for CO_(2)photoreduction coupled with water oxidation which is over 14 times higher than that of L-CPB NC/FeTCPP.

Age-related increase of early afterdepolarization in calsequestrin-2 knock-in mouse cardiomycyte

Objective To characterize early afterdepolarizations （EADs） caused triggered activity （TA） among calsequestrin-2 （CASQ2） knock-in （CASQ2 KI） mice and its relationship with aging. Methods Electrophysiological properties of ventricular myocytes from 3- month （mo, young）, 9-mo （adult-l） and 12-too （adult-2） in wild-type （WT） and CASQ2 KI mice were investigated with patch-clamp technique. Results The incidences of EADs and TA in CASQ2 KI cardiomyocytes increased with increasing age. In contrast, WT mice cardiomyocytes showed no significant change in matched-age groups. Compared with that in 3-mo CASQ2 KI mice, the 50% repolarization of action potential （APD50） showed prolongation in both 9-mo and 12-mo ones （9.2±0.9 ms of 9-mo and 10.3 ± 1.2 ms of 12- mo vs. 5.6± 0.3 ms of 3-mo）, while the 90 % repolarization of action potential （APD90） was similar among 3 age groups. Compared with 3-mo mice, the 9-mo and 12-mo CASQ2 KI mice showed markedly reduced transient outward potassium current （Ito） densities but increased L-type calcium current （ICa-L） densities. Conlcusion This study suggested that events of EADs and TA in CASQ2 KI mice increased with increasing age, It might be associated partly with the augment of cellular calcium concentration and the prolongation of APD50 induced by decrease of Ito and increase of ICa-L in adult CASQ2 KI mice

Hyperpolarization activated cation current (If) in cardiac myocytes from pulmonary vein sleeves in the canine with atrial fibrillation

Objective To investigate the characteristics of ectopic automaticity and cation current (If) of cardiac myocytes from pulmonary vein sleeves (PVs) in canines with atrial fibrillation. Methods The canines (8–10 years old) were subjected to long-term, rapid atrial pacing (RAP) for 10 weeks, which induced the atrial fibrillation model. Disassociation of PVs of canines yielded single cardiac myocytes from a Landengorff column. Action potential, If and hyperpolarisation activated cyclic nucleotide-gated (HCN) currents were measured with the patch-clamp technique. Results Compared with the control group, cardiac myocytes from the RAP canine PVs had spontaneous diastolic depolarization, shorter action potential duration, and larger If densities. In the group of RAP cells, the half maximal activation potential (V1/2) was found to be less negative (��105.5 ±5.2 mV) compared to control cells (��87.3 ±4.9 mV). Current densities of If were increased significantly by β-adrenergic receptor stimulation with isoproterenol and caused an acceleration of current activation. In contrast, If currents in the RAP were reduced by carvedilol, a selective beta-adrenergic receptor. Another important finding is that HCN4-based channels may make a significant contribution to If in PVs cells, but not HCN2. Meanwhile, HCN4 current significantly increases in canine PVs cardiac myocytes with RAP. Conclusions The spontaneous action potential and larger If currentwere observed in the PVs cardiac myocytes using RAP, whichmay contribute tomore ectopic activity events to trigger and maintain atrial fibrillation.

Rare imaging findings of hypersensitivity pneumonitis:A case report

BACKGROUND Hypersensitivity pneumonitis(HP)is an immune-mediated syndrome caused by allergen inhalation.High-resolution computed tomography(HRCT)of HP may show diffuse ground-glass opacity,centrilobular ground-glass nodules,areas of air-trapping,thin-walled cysts,or fibrotic changes.CASE SUMMARY A 47-year-old male patient went to the hospital complaining of cough and gradual aggravation of shortness of breath.HRCT of the lung showed that multiple nodules and ground-glass high-density shadows were present in both lungs.In addition,circular high-density shadows of various sizes were widely distributed in both lungs with relatively normal lung markings inside them.But other tests did not have a positive finding that can clarify the cause.Therefore,the patient underwent a lung biopsy.The pathological results showed that the lesions tended to be HP.After 4 mo of follow-up,the lesions in the patient's lungs were absorbed spontaneously,and the symptoms of cough and shortness of breath have disappeared.The review results suggested that the patient's disease was self-healing,which was consistent with the characteristics of HP.CONCLUSION For some patients with HP,abnormal HRCT findings,such as the lesions in the lungs,can be absorbed on their own,which is an important clue in the diagnosis of the disease.Early diagnosis by lung biopsy is necessary when antigen exposure is unknown.

Numerical experiments on the evolution in coronal magnetic configurations including a filament in response to the change in the photosphere

We investigate equilibrium height of a flux rope, and its internal equilib- rium in a realistic plasma environment by carrying out numerical simulations of the evolution of systems including a current-carrying flux rope. We find that the equilib- rium height of a flux rope is approximately described by a power-law function of the relative strength of the background field. Our simulations indicate that the flux rope can escape more easily from a weaker background field. This further confirms that a catastrophe in the magnetic configuration of interest can be triggered by a decrease in strength of the background field. Our results show that it takes some time to reach internal equilibrium depending on the initial state of the flux rope. The plasma flow inside the flux rope due to the adjustment for the internal equilibrium of the flux rope remains small and does not last very long when the initial state of the flux rope com- mences from the stable branch of the theoretical equilibrium curve. This work also confirms the influence of the initial radius of the flux rope in its evolution; the results indicate that a flux rope with a larger initial radius erupts more easily. In addition, by using a realistic plasma environment and a much higher resolution in our simulations, we notice some different characteristics compared to previous studies in Forbes.

Effects of acupuncture on iron metabolism in the hippocampus of the rats with cerebral ischemia-reperfusion injury based on the imbalance of iron homeostasis

Objective:This study aimed to observe the effects of acupuncture on iron metabolism in the hippocampus of rats with cerebral ischemia-reperfusion injury(CIRI)and to explore the mechanism of acupuncture on neural repairinCIRIrats.Methods:After general feeding for 3 days,16 of 48 healthy Sprague-Dawley rats were selected according to a random number table to form a sham-occlusion group,and the models were prepared in the remaining rats.After successful modeling,the rats were randomized into model and acupuncture groups,with 16 rats in each group.The CIRI models were prepared using the modified Zea Longa suture-occlusion method.In the acupuncture group,the rats were fixed and acupuncture was delivered at“Shuigou"(GV26),“Dazhui"(GV14),and“Baihui"(GV20),and the needles were manipulated once every 15 min.In the sham-occlusion and model groups,rats were fixed without acupuncture.The intervention was performed for 30 min in each group,once every 12 h,seven times.The degree of neurological impairment was assessed by using the modified Garcia score.Cerebral blood flow(CBF)was monitored using a laser speckle blood flow imaging system.The cerebral infarction area ratio was measured using triphenyltetrazolium chloride staining.Ferric ion aggregation in brain tissue was noted using Prussian blue staining.The ferric ion and glutathione(GSH)contents of the hippocampal tissue on the ischemic side were detected using ferric ion and GSH kits.The protein expression of transferrin receptor 1(TFR1),iron regulatory protein 2(IRP2),and ferroportin(FPN)was detected via western blotting.Results:(1)Before intervention,compared with the sham-occlusion group,the Garcia neurological score was significantly reduced in the model and acupuncture groups(both P<0.01).After the intervention,compared with the sham-occlusion group,the Garcia neurological score in the model group decreased significantly(P<0.01),and the score in the acupuncture group was elevated compared with the model group(P<0.o5).Compared to before the intervention,the Garcia neurological score increased after the intervention in the acupuncture group(P<0.05).(2)Compared with the sham-occlusion group,in the model group,CBF was reduced,the infarct area was significantly enlarged,ferric ion aggregation increased in the hippocampus,the content of ferric ion increased,and that of GSH decreased significantly(both P<0.01),while the protein expression of TFR1 and IRP2 was upregulated and that of FPN was downregulated(both P<0.05).When compared with the model group,in the acupuncture group,CBF was increased,the infarct area was reduced(P<0.01),the ferric ion aggregation was reduced in the hippocampus,the content of ferric ion decreased,and that of GSH increased significantly(P<0.05,P<0.01);the protein expression of TFR1 and IRP2 was downregulated and that of FPN was upregulated(both P<0.05).Conclusion:Acupuncture can alleviate CiRI,which may be related to the regulation of iron homeostasisassociated transferrin in the hippocampus,attenuation of ferric ion aggregation in hippocampal tissue,reduction of lipid peroxidation,and inhibition of ferroptosis.

Enhancing the photoelectrocatalytic performance of metal-free graphdiyne-based catalyst

As a new member of the carbon family,graphdiyne is an intrinsic semiconductor featuring a natural bandgap,which endues it potential for direct application in photoelectric devices.However,without cooperating with other active materials,conventional hexacetylene-benzene graphdiyne(HEB-GDY)shows poor performances in photocatalysis and photoelectric devices due to its non-ideal visible light absorption,low separation efficiency of the photogenerated carriers and insufficient sites for hydrogen production.Herein,we report a molecular engineering strategy for the regulation of GDY-based carbon materials,by incorporating a strong pyrene absorption group into the matrix of graphdiyne,to obtain pyrenyl graphdiyne(Pyr-GDY)nanofibers through a modified Glaser-Hay coupling reaction of 1,3,6,8-tetraethynylpyrene(TEP)monomers.For comparison,phenyl graphdiyne(Phe-GDY)nanosheets were also constructed using 1,3,4,6-tetraethynylbenzene(TEB)as a monomer.Compared with Phe-GDY,Pyr-GDY exhibits a wider visible light absorption band,promoted efficiency of the charge separation/transport and more sufficient active sites for water reduction.As a result,Pyr-GDY alone displays superior photoelectrocatalytic performance for water splitting,giving a cathode photocurrent density of^138μA cm-2 at a potential of-0.1 Vversus normal hydrogen electrode(NHE)in neutral aqueous solution,which is almost ten and twelve times as high as those of Phe-GDY(14μA cm-2)and HEB-GDY(12μA cm-2),respectively.Such a performance is also superior to those of most reported carbonbased metal-free photocathode.The results of theoretical calculations reveal that the carbon atoms in the acetylene bonds are the active sites for proton reduction.This work offers a new strategy for the construction of graphdiyne-based metal-free photoelectrocatalysts with enhanced photoelectrocatalytic performance.

Preparation,Characterization and Application of Polyaniline/Epoxide Polysiloxane Composite Films

Composites of polyaniline（PAn） and epoxide polysiloxane（EPSi） are reported for the first time. EPSi is designed, synthesized and N-grafted onto the PAn backbone through covalent bonds. As-prepared EPSi-g-PAn composites are soluble in organic solvents and the corresponding films can be easily produced via a simple solution-casting procedure. The composite films combine the mechanical characteristics of EPSi and the chemical properties of PAn, enabling the facile introduction of the noble metal particles. The successful fabrication of the composites is confirmed by the investigation of the molecular structure, crystalline structure and microstructure of the materials. The resulting composite films containing noble metal particles are employed as the catalysts for the hydrogenation of phenol to produce cyclohexanone, which exhibit the convenience and recyclability for usage as well as the high catalytic activities, including the conversion ratio of 97%-100% and the selectivity as high as 84%-98%. The present work not only provides a new method to improve the processability of the conducting polymers but also describes a kind of composite materials that may display outstanding preformances in industrial catalysis.