Small particle drug-eluting beads-transarterial chemoembolization combined with targeted therapy in the clinical treatment of unresectable liver cancer

BACKGROUND Liver cancer is a highly malignant tumor with significant clinical impact.Chemotherapy alone often yields suboptimal outcomes in both the short and long term,characterized by high rates of local recurrence and distant metastasis,leading to a poor long-term prognosis.AIM To evaluate the clinical efficacy of small particle drug-eluting beads-transarterial chemoembolization(DEB-TACE)combined with targeted therapy for the treatment of unresectable liver cancer.METHODS We analyzed clinical data from 74 patients with unresectable liver cancer admitted between January 2019 and December 2020.Based on the different treatment regimens administered,patients were divided into the control(36 patients receiving sorafenib alone)and joint(38 patients receiving small particle DEB-TACE combined with sorafenib)groups.We compared liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB)]and serum tumor markers[alpha fetoprotein(AFP)]before and after treatment in both groups.Short-term efficacy measures[complete response(CR),partial response,progression disease,stable disease,objective response rate(ORR),and disease control rate(DCR)]were assessed post-treatment.Long-term follow-up evaluated median overall survival(OS),progression-free survival(PFS),and adverse reaction rates between the two groups.RESULTS One month post-treatment,the joint group demonstrated significantly higher rates of CR,ORR,and DCR compared to the control group(P<0.05).Three days after treatment,the joint group showed elevated levels of ALT,AST,and TBIL but reduced levels of ALB and AFP compared to the control group(P<0.05).The median OS was 18 months for the control group and 25 months for the joint group,while the median PFS was 15 months for the control group and 22 months for the joint group,with significant differences observed(log-rank:χ2=7.824,6.861,respectively;P=0.005,0.009,respectively).The incidence of adverse reactions was not significantly different between the groups(P>0.05).CONCLUSION The combination of small particle DEB-TACE and sorafenib significantly improves both short-and long-term outcomes in the treatment of unresectable liver cancer while preserving liver function.

Multifractal estimation of NMR T_(2) cut-off value in low-permeability rocks considering spectrum kurtosis: SMOTE-based oversampling integrated with machine learning

The transverse relaxation time (T_(2)) cut-off value plays a crucial role in nuclear magnetic resonance for identifying movable and immovable boundaries, evaluating permeability, and determining fluid saturation in petrophysical characterization of petroleum reservoirs. This study focuses on the systematic analysis of T_(2) spectra and T_(2) cut-off values in low-permeability reservoir rocks. Analysis of 36 low-permeability cores revealed a wide distribution of T_(2) cut-off values, ranging from 7 to 50 ms. Additionally, the T_(2) spectra exhibited multimodal characteristics, predominantly displaying unimodal and bimodal morphologies, with a few trimodal morphologies, which are inherently influenced by different pore types. Fractal characteristics of pore structure in fully water-saturated cores were captured through the T_(2) spectra, which were calculated using generalized fractal and multifractal theories. To augment the limited dataset of 36 cores, the synthetic minority oversampling technique was employed. Models for evaluating the T_(2) cut-off value were separately developed based on the classified T_(2) spectra, considering the number of peaks, and utilizing generalized fractal dimensions at the weight <0 and the singular intensity range. The underlying mechanism is that the singular intensity and generalized fractal dimensions at the weight <0 can detect the T_(2) spectral shift. However, the T_(2) spectral shift has negligible effects on multifractal spectrum function difference and generalized fractal dimensions at the weight >0. The primary objective of this work is to gain insights into the relationship between the kurtosis of the T_(2) spectrum and pore types, as well as to predict the T_(2) cut-off value of low-permeability rocks using machine learning and data augmentation techniques.

Early Intratracheal Administration of Corticosteroid and Pulmonary Surfactant for Preventing Bronchopulmonary Dysplasia in Preterm Infants with Neonatal Respiratory Distress Syndrome: A Meta-analysis

There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. Moreover, the percentage of infants using PS more than one time was lower in ICS group than in the placebo control group, with the RR and 95% CI being 0.55 (95% CI: 0.45-0.67), and that in ICS intratracheal instillation subgroup lower than in ICS inhalation subgroup (RR: 0.56;95% CI: 0.45-0.69, and RR: 0.35;95% CI:0.08-1.52 respectively). There was no significant difference in the incidence of infection or retinopathy of prematurity and neuro-motor system impairment between ICS group and placebo control group, with the corresponding RR being 0.95 (95% CI:0.59-1.52), 0.92 (95% CI: 0.62-1.38) and 1.13 (95% CI: 0.92-1.39), respectively. It was concluded that early administration of ICS and PS is an effective and safe option for preterm infants with NRDS in preventing BPD and reducing mortality, decreasing the additional PS usage, especially for the ICS intratracheal instillation subgroup. Furthermore, the appropriate dose and duration of ICS, combined use of inhalation or instillation of ICS with PS and the long-term safety of airway administration of corticosteroids need to be assessed in large trials.

Correlation of BI-RADS grading with cancer cell proliferation and invasion

Objective:To investigate the correlation of BI-RADS grading with cancer cell proliferation and invasion.Methods: A total of 138 patients who were diagnosed with breast cancer in our hospital between August 2015 and October 2017 were divided into 2 cases at stage Ⅲ, 51 cases at stage Ⅳ and 85 cases at stage Ⅴ after the BI-RADS grading was reviewed. Differences in the expression of proliferation-related genes and invasion-related genes were compared among the three groups of patients.Results: Expressions of pro-proliferation genes MTA2, mTOR, PKM2, Notch1 and FSCN1 mRNA in lesion tissue of patients at stage Ⅴ and Ⅳ were higher than those of patients at stage Ⅲ whereas expressions of anti-proliferation genes BRCA1 and PTEN mRNA were lower than those of patients at stage Ⅲ;expressions of pro-invasion genes Gab2 and NUAK1 mRNA were higher than those of patients at stage Ⅲ whereas expressions of anti-invasion genes EBP50, EDN3, FBXW7 and NDRG1 mRNA were lower than those of patients at stage Ⅲ. With the increase of BI-RADS grades, the expression levels of pro-proliferation genes and pro-invasion genes further increased while the expression levels of anti-proliferation and anti-invasion genes further decreased in the lesion tissue.Conclusions: BI-RADS grading of patients with breast cancer is positively correlated with the proliferation and invasion activity of cancer cells.

抗AD活性天然化合物的结构与功能

阿尔茨海默症(Alzheimer's disease, AD)已成为影响人类健康的第四大杀手,给全球公共健康带来重大影响与挑战.近年来,新型治疗AD药物的研制成为生命与健康领域的重要课题,如何发现具有抗AD活性的苗头分子和先导结构是其中的关键科学问题与技术难点.植物来源的天然化合物具有多骨架、多活性、多靶点的成药性特征.本文综述了AD的发病机制和具有抗AD活性的天然化合物的化学结构与功能,为新型抗AD药物的研制提供参考.

A Note on“Prospect Theory and the Newsvendor Problem”

Based on the newsvendor setting,many behavioral models are proposed to predict the biases of decision makers in inventory management.Recently,Nagarajan and Shechter(Manag Sci 60:1057–1062,2014)claimed that prospect theory cannot explain the consistent empirical findings.However,it is noticed that their model is a special case of the general prospect theorymodel.In this note,we showthat the general prospect theory model may be powerful in predicting the preferences of decision makers in inventory management.