Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma

Background: Percutaneous radiofrequency ablation(RFA) is a first?line treatment for very?early?stage hepatocellular carcinoma(HCC), whereas the efficacy of percutaneous microwave ablation(MWA) for very?early?stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very?early?stage HCC.Methods: Clinical data of 460 patients who were diagnosed with very?early?stage HCC and treated with percutane?ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili?tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival(OS), recurrence?free survival(RFS), local tumor progression(LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed.Results: No significant differences were observed between the two groups in terms of the 1?, 3?, or 5?year OS rates(99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively; P = 0.331). Furthermore, no signif?icant differences were observed between the two groups in terms of the corresponding RFS rates(94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively; P ete ablation rates(98.3% vs. 98.1%, P = 0.309), the LTP rates(9.6% vs. 10.1%, P = 0.883), the compl multivariate analysis, LTP, an= 0.860), or the occurrence rates of major complications(0.7% vs. 0.6%, P = 0.691). Bytiviral therapy, and treatment of recurrence were independent risk fac?tors for OS(P < 0.001), and the alpha?fetoprotein level was an independent prognostic factor for RFS(P = 0.002).Conclusions: MWA is as safe and effective as RFA in treating very?early?stage HCC, supporting MWA as a first?line treatment option for this disease.

Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation

AIM:To evaluate the outcomes of patients withmedium-sized hepatocellular carcinoma(HCC)who underwent percutaneous microwave ablation(MWA).METHODS:We retrospectively reviewed all patients with a single medium-sized HCC who underwent percutaneous MWA from January 2010 to January2013.Technical success,technical effectiveness and complications were subsequently observed.Survival curves were constructed using the Kaplan-Meier method.The Cox proportional hazards model was fitted to each variable.The relative prognostic significance o f t h e va r i a b l e s fo r p re d i c t i n g ove ra l l s u r v i va l rate,recurrence-free survival rate and local tumor recurrence(s)was assessed using univariate analysis.All variables with a P value<0.20 were subjected to multivariate analysis.RESULTS:The study included 182 patients(mean age,58 years;age range:22-86 years)with a single HCC(mean size,3.72±0.54 cm;range:3.02-5.00cm).The estimated technical effectiveness rate was93%in 182 patients.The major complication rate was2.7%(5/182),including liver abscess in 4 cases,and abdominal bleeding at the puncture site in 1 case.Thirty-day mortality rate was 0.5%(1/182).One patient died due to liver abscess-related septicemia.Cumulative recurrence-free survival and overall survival(OS)rates were 51%,36%,27%and 89%,74%,60%at 1,2,and 3 years,respectively.Age(P=0.017)and tumor diameter(P=0.029)were independent factors associated with local tumor recurrence.None of the factors had a statistically significant impact on recurrence-free survival.Serum albumin level(P=0.009)and new lesion(s)(P=0.029)were independently associated with OS.CONCLUSION:Percutaneous MWA is a relatively safe and effective treatment for patients with medium-sized HCC.

Exhaled nitric oxide in neonates with or without hypoxemic respiratory failure

BACKGROUND： Exhaled nitric oxide （eNO） is one of the airway condensate derived markers, reflecting mainly airway inflammation in asthma and other lung diseases. The changes of eNO levels as pathophysiology of neonatal hypoxemic respiratory failure （HRF） in early postnatal life have not been thoroughly studied. The present study was to establish a method for measuring eNO concentrations in neonates with or without HRF. METHODS： Twenty-two newborn infants with HRF and 26 non-NRF controls were included within the first 24 hours of postnatal life. Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation （SpO2）, inspired fraction of oxygen （FiO2） and other parameters. RESULTS：During the first two days of postnatal life, eNO values of HRF neonates were significantly higher than those of the control neonates （day 1,7.9±3.2 vs. 5.8±1.8 parts per billion [ppb], P〈0.05; day 2, 8.8±3.2 vs. 6.0±2.4 ppb, P〈0.05）, but there were no significant differences in the following days. With SpOJFiO2 increasing, difference of eNO values between the HRF and non-HRF neonates became narrowed, but there was still a two-fold difference of eNO/[SpO2/（FiO2×100）] on days 5-7. CONCLUSION： We established a method for measuring eNO and found difference in neonates with or without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF.

Application of a UPLC–MS/MS method to the protein binding study of TM-2 in rat, human and beagle dog plasma

TM-2 known as a potential antitumor drug is a novel semi-synthetic taxane derivative. As drug-protein interactions contribute to insights into pharmacokinetic and pharmacodynamic properties, we eluci- dated the binding of TM-2 to plasma protein. In this study, a simple, rapid and reliable method was developed and validated employing equilibrium dialysis for the separation of bound and unbound drugs and ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） for the quantitation. Protein binding reached equilibrium within 24 h of incubation at 37 ℃. After liquid-liquid extraction with methyl tert-butyl ether, the samples were separated on Thermo Syncronis UPLC C18 （2.1 mm× 50 mm, 1.7 μm）, and acquisition of mass spectrometric data was performed in multiple re- action monitoring （MRM） mode via positive electrospray ionization. The assay was linear over the concentration rang of 5-2000 nglmL The intra- and inter-day precisions were 0.1%-14.8%, and the accuracy was from -6.4% to Z0%. This assay has been successfully applied to a protein binding study of TM-2 in rat, human and beagle dog plasma. TM-2 showed high protein binding of 81.4% ± 6.5% （rat）, 87.9% ± 3.6% （human） and 79.4% ± 4.0% （beagle dog）. The results revealed that there was an insignificant difference among the three species.