Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients

AIM: To investigate the efficacy and safety of adjuvant sorafenib after curative resection for patients with Barcelona Clinic Liver Cancer(BCLC)-stage C hepatocellular carcinoma(HCC).METHODS: Thirty-four HCC patients, classified as BCLC-stage C, received adjuvant sorafenib for highrisk of tumor recurrence after curative hepatectomy at a tertiary care university hospital. The study group was compared with a case-matched control group of 68 patients who received curative hepatectomy for HCC during the study period in a 1:2 ratio.RESULTS: The tumor recurrence rate was markedly lower in the sorafenib group(15/34, 44.1%) than in the control group(51/68, 75%, P = 0.002). The median disease-free survival was 12 mo in the study group and 10 mo in the control group. Tumor number more than 3, macrovascular invasion, hilar lymph nodes metastasis, and treatment with sorafenib were significant factors of disease-free survival by univariate analysis. Tumor number more than 3 and treatment with sorafenib were significant risk factors of diseasefree survival by multivariate analysis in the Cox proportional hazards model. The disease-free survival and cumulative overall survival in the study group were significantly better than in the control group(P = 0.034 and 0.016, respectively). CONCLUSION: Our study verifies the potential benefit and safety of adjuvant sorafenib for both decreasing HCC recurrence and extending disease-free and overall survival rates for patients with BCLC-stage C HCC after curative resection.

Thickness-related synchronous increase in strength and ductility of ultrafine-grained pure aluminum sheets

To explore the specimen size effect of mechanical behavior of ultrafine-grained(UFG)materials with different structures,UFG Al sheets processed by equal channel angular pressing(ECAP)were selected as target materials and the dependency of tensile behavior on sheet thickness(t)was systematically investigated.The strength and ductility of ECAPed UFG Al sheets were improved synchronously as t increased from 0.2 to 0.7 mm,and then no apparent change occurred when t reached to 0.7 and 1.0 mm.The corresponding microstructure evolved from dislocation networks in equiaxed grains into the walls and subgrains and finally into the dominated cells in elongated grains or subgrains.Meanwhile,dense shear lines(SLs)and shear bands(SBs)were clearly observed and microvoids and cracks were initiated along SBs with the increase of t.These observations indicated that the plastic deformation of UFG Al sheets was jointly controlled by shear banding,dislocation sliding,and grain-boundary sliding.Furthermore,the propagation of SBs became difficult as t increased.Finally,the obtained results were discussed and compared with those of annealed UFG Al and UFG Cu.

Variation of the uniaxial tensile behavior of ultrafine-grained pure aluminum after cyclic pre-deformation

To explore the influence of cyclic pre-deformation on the mechanical behavior of ultrafine-grained（UFG）materials with a high stacking fault energy（SFE）,UFG Al processed by equal-channel angular pressing（ECAP）was selected as a target material and its tensile behavior at different pre-cyclic levels D（D=N_i/N_f,where N_i and N_f are the applied cycles and fatigue life at a constant stress amplitude of 50 MPa,respectively）along with the corresponding microstructures and deformation features were systematically studied.The cyclic pre-deformation treatment on the ECAPed UFG Al led to a decrease in flow stress,and a stress quasi-plateau stage was observed after yielding for all of the different-state UFG Al samples.The yield strengths_（YS）,ultimate tensile strengths_（UTS）,and uniform straineexhibited a strong dependence on D when D≤20%;however,when D was in the range from 20%to 50%,no obvious change in mechanical properties was observed.The micro-mechanism for the effect of cyclic pre-deformation on the tensile properties of the ECAPed UFG Al was revealed and compared with that of ECAPed UFG Cu through the observations of deformation features and microstructures.

Coexpression of MYC and BCL-2 predicts prognosis in primary gastrointestinal diffuse large B-cell lymphoma

AIM:To investigate whether MYC and BCL-2 coexpression has prognostic significance in primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL)patients,and explore its associations with patients’clinical parameters.METHODS:Fresh and paraffin-embedded tumor tissue samples from 60 PGI-DLBCL patients who had undergone surgery at the Tianjin Medical University Cancer Institute and Hospital from January 2005 to May 2010 were obtained,and 30 lymphoid tissue samples from reactive lymph nodes of age-and sexmatched patients represented control samples.Staging and diagnostic procedures were conducted according to the Lugano staging system.All patients had been treated with three therapeutic modalities:surgery,chemotherapy,or radiotherapy.Expression of MYC and BCL-2 were detected at both protein and m RNA levels by immunohistochemistry and real-time RT-PCR.RESULTS:Positive expression levels of MYC and BCL-2proteins were detected in 35%and 45%of patients,respectively.MYC+/BCL-2+protein was present in30%of patients.MYC and BCL-2 protein levels were correlated with high MYC and BCL-2 m RNA expression,respectively(both P<0.05).We found that advancedstage disease(atⅡE-Ⅳ)was associated with MYC and BCL-2 coexpression levels(P<0.05).In addition,MYC+/BCL-2+patients had more difficulty in achieving complete remission than others(P<0.05).Presenceof MYC protein expression only affected overall survivaland progression-free survival(PFS)when BCL-2 proteinwas coexpressed.The adverse prognostic impact ofMYC+/BCL-2+protein on PFS remained significant(P<0.05)even after adjusting for age,Lugano stage,international prognostic index,and BCL-2 proteinexpression in a multivariable model.CONCLUSION:MYC+/BCL-2+patients have worsechemotherapy response and poorer prognosis thanpatients who only express one of the two proteins,suggesting that assessment of MYC and BCL-2 expressionby immunohistochemistry has clinical significance inpredicting clinical outcomes of PGI-DLBCL patients.

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis:A single-center retrospective cohort study

AIM: To assess the efficiency and safety of radiofrequencyassisted hepatectomy in patients with hepatocellular carcinoma(HCC) and cirrhosis.METHODS: From January 2010 to December 2013, 179 patients with HCC and cirrhosis were recruited for this retrospective study. Of these, 100 patients who received radiofrequency-assisted hepatectomy(RF+ group) were compared to 79 patients who had hepatectomy without ablation(RF- group). The primary endpoint was intraoperative blood loss. The secondary endpoints included liver function, postoperative complications, mortality, and duration of hospital stay.RESULTS: The characteristics of the two groups were closely matched. The Pringle maneuver was not used in the RF+ group. There was significantly less median intraoperative blood loss in the RF+ group(300 vs 400 m L, P = 0.01). On postoperative days(POD) 1 and 5, median alanine aminotransferase was significantly higher in the RF+ group than in the RF- group(POD 1: 348.5 vs 245.5, P = 0.01; POD 5: 112 vs 82.5, P = 0.00), but there was no significant difference between the two groups on POD 3(260 vs 220, P = 0.24). The median AST was significantly higher in the RF+ group on POD 1(446 vs 268, P = 0.00), but there was no significant difference between the two groups on POD 3 and 5(POD 3: 129.5 vs 125, P = 0.65; POD 5: 52.5vs 50, P = 0.10). Overall, the rate of postoperative complications was roughly the same in these two groups(28.0% vs 17.7%, P = 0.11) except that post hepatectomy liver failure was far more common in the RF+ group than in the RF- group(6% vs 0%, P = 0.04).CONCLUSION: Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and liver failure.

Investigations of In Vitro Bioactivity of Sea Shells with Different Microstructures

Biological minerals(e.g.,shells,coral,etc.)not only exhibit outstanding mechanical properties with good toughness and strength,but also have a good biological activity due to the existence of organic matter of few percent.In the present work,three kinds of shells with different microstructures were selected as the target materials,i.e.,Saxidomus purpuratus shell exhibiting a hierarchical structure with complex crossed-lamellar structure and porous fi-

Application of Grain Boundary Engineering to Improve Intergranular Corrosion Resistance in a Fe–Cr–Mn–Mo–N High-Nitrogen and Nickel-Free Austenitic Stainless Steel

Optimization of grain boundary engineering(GBE) process is explored in a Fe–20Cr–19Mn–2Mo–0.82N high-nitrogen and nickel-free austenitic stainless steel, and its intergranular corrosion(IGC) property after GBE treatment is experimentally evaluated. The proportion of low Σ coincidence site lattice(CSL) boundaries reaches 79.4% in the sample processed with 5% cold rolling and annealing at 1423 K for 72 h;there is an increase of 32.1% compared with the solution-treated sample. After grain boundary character distribution optimization, IGC performance is noticeably improved. Only Σ3 boundaries in the special boundaries are resistant to IGC under the experimental condition. The size of grain cluster enlarges with increasing fraction of low ΣCSL boundaries, and the amount of Σ3 boundaries interrupting the random boundary network increases during growth of the clusters, which is the essential reason for the improvement of IGC resistance.

Effect of Short-Range Ordering on the Strength-Ductility Synergy of Fine-Grained Cu–Mn Alloys at Different Temperatures

Uniaxial tensile tests were carried out at room temperature(RT)and 250℃,respectively,to investigate the effect of shortrange ordering(SRO)on the mechanical properties and deformation micromechanism of fine-grained(FG)Cu–Mn alloys with high stacking fault energy.The results show that at RT,with the increase in SRO degree,the strength of FG Cu–Mn alloys is improved without a loss of ductility,and corresponding deformation micromechanism is mainly manifested by a decrease in the size of dislocation cells.In contrast,at a high temperature of 250℃,the SRO degree becomes violently enhanced with increasing Mn content,and the deformation microstructures thus transform from dislocation cells to planar slip bands and even to deformation twins,significantly enhancing the work hardening capacity of the alloys and thus achieving a better strength-ductility synergy of FG Cu–Mn alloys.

Coupled Influence of Temperature and Strain Rate on Tensile Deformation Characteristics of Hot-Extruded AZ31 Magnesium Alloy

To explore the coupled effect of temperature T and strain rate ε on the deformation features of AZ31 Mg alloy, mechanical behaviors and microstructural evolutions as well as surface deformation and damage features were system- atically examined under uniaxial tension at T spanning from 298 to 523 K and ε from 10^-4 to 10^-2 s-1. The increase in T or the decrease in ε leads to the marked decrease in flow stress, the appearance of a stress quasi-plateau after an initially rapid strain hardening, and even to the occurrence of successive strain softening. Correspondingly, the plastic deformation modes of AZ31 Mg alloy transform from the predominant twinning and a limited amount of dislocation slip into the enhanced non-basal slip and the dynamic recrystallization （DRX） together with the weakened twinning. Meanwhile, the cracking modes also change from along grain boundaries （GBs） and at twin boundaries （TBs） or the end of twins into nearby GBs where the DRX has occurred. The appearance of a stress quasi-plateau, the formation of large-sized cracks nearby GBs, and the occurrence of continuous strain softening, are intimately related to the enhancement of the non-basal slip and the DRX.

Temperature-Dependent Compressive Deformation Behavior of Commercially Pure Iron Processed by ECAP

To explore the temperature dependence of deformation behavior of BCC structural materials and the relevant effect of pre-annealing, commercially pure iron （CP Fe） produced by equal-channel angular pressing （ECAP） is selected as the experimental material. The influences of deformation temperature T and pre-annealing on deformation behavior, surface deformation characteristics and substructures of ECAP Fe were systematically studied. The results show that ECAP Fe undergoes a remarkable strain softening stage after a rapid strain hardening during uniaxial compression, and the softening degree and the yield strength avs first decrease and then increase with raising temperature. Pre-annealing at 400 ℃ effectively weakens the strain softening degree and increases trys. To understand the influence of deformation temperature on deformation behavior, as well as the relevant pre-annealing effect, deformation and damage characteristics and dislocation structures are studied in detail. In a word, the strain softening of ECAP Fe is associated not only with internal structural instability, but also with temperature, and pre-annealing at 400 ℃ improves high-temperature me- chanical properties of ECAP Fe.