Effect of magnetic resonance imaging in liver metastases

This letter to the editor is a commentary on a study titled"Liver metastases:The role of magnetic resonance imaging."Exploring a noninvasive imaging evaluation system for the biological behavior of hepatocellular carcinoma(HCC)is the key to achieving precise diagnosis and treatment and improving prognosis.This review summarizes the role of magnetic resonance imaging in the detection and evaluation of liver metastases,describes its main imaging features,and focuses on the added value of the latest imaging tools(such as T1 weighted in phase imaging,T1 weighted out of phase imaging;diffusion-weighted imaging,T2 weighted imaging).In this study,I investigated the necessity and benefits of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid for HCC diagnostic testing and prognostic evaluation.

平台纵摇对漂浮式风电机组叶片气弹特性的影响研究

海上风电向深远海发展,漂浮式风电机组成为发展方向。漂浮式风电机组存在多自由度平台运动,同时伴随海上多变的风况,叶片的气动特性和结构响应非常复杂。本文基于自由涡尾迹法与模态法建立了漂浮式风电机组叶片气弹模型,对NREL 5MW风电机组叶片的气弹特性进行了模拟,与采用BEM和GDW方法的计算结果进行对比。在对比验证的基础上,采用耦合模型研究了平台纵摇运动下NREL 5MW风电机组叶片气弹特性,结果表明,本文建立的耦合模拟方法可以准确地模拟平台运动下的气动性能与结构动态响应;平台运动会显著增加叶片气动性能的波动,平均功率明显增大,平均推力略有降低;平台运动使叶片表面等效应力发生波动,叶尖变形增大,中内叶展较外叶展更容易受到平台运动的影响。

基于等效建模的风电机组增功技改快速评估方法研究

针对当前风电机组增功技改中存在获取建模参数困难,所建模型精确度不高的问题,提出一种基于等效建模的风电机组增功技改的快速评估方法。采用基于SCADA数据概率统计方法,建立了风电机组控制参数模型;基于翼型数据库与叶素动量理论,建立了叶片基本几何模型,采用优化算法,以风电机组特性曲线为目标进行模型优化。利用NREL5MW风电机组对等效建模方法进行验证,得出功率与推力曲线吻合很好。对某2MW风电机组进行等效建模,在等效模型的基础上研究了叶尖加长方法,并对加长的效果进行了气动评估,结果表明通过SCADA数据获取的参数能更好地符合实际机组的运行情况,等效模型能准确模拟出原模型的气动特性,叶尖加长后能显著提高风电机组的年发电量,具有较好的经济效益,是解决风电机组发电效率低、经济效益差的有效方法。

Electrophoretic deposition of hybrid organic-inorganic PTFE/Al/CuO energetic film

Thermite films are typical energetic materials(EMs)and have great value in initiating explosive devices.However,research in thermite film preparation is far behind that of research in thermite powders.Electrophoretic deposition(EPD)is an emerging,rapid coating method for film fabrication,including of energetic composite films.In this work,a polytetrafluoroethylene(PTFE)/Al/CuO organic-inorganic hybrid energetic film was successfully obtained using the above method for the first time.The addition of lithocholic acid as a surfactant into the electroplating suspension enabled PTFE to be charged.The combustion and energy release were analyzed by means of a high-speed camera and differential scanning calorimetery(DSC).It was found that the combustion process and energy release of PTFE/Al/CuO were much better than that of Al/CuO.The main reason for the excellent combustion performance of the hybrid PTFE/Al/CuO system was that the oxidability of PTFE accelerated the redox reaction between Al and CuO.The prepared PTFE/Al/CuO film was also employed as ignition material to fire a B-KNO_3 explosive successfully,indicating considerable potential for use as an ignition material in micro-ignitors.This study sheds light on the preparation of fluoropolymer-containing organic-inorganic hybrid energetic films by one-step electrophoretic deposition.

Multiple inflammatory pseudotumor formation after craniopharyngioma resection via an extended nasal endoscopic approach:A case report

BACKGROUND This report describes a case of intracranial multiple inflammatory pseudotumors(IP)after endoscopic resection of a craniopharyngioma,which is relatively rarely reported in the literature,and neurosurgeons should be aware of its existence.CASE SUMMARY Herein,we report the case of a 56-year-old man who developed decreased visual acuity and blurred vision without obvious cause or inducement on April 27,2020.To seek further treatment,he went to the Department of Neurosurgery,Clinical Medical College,Yangzhou University.After falling ill,there was no nausea,vomiting,limb convulsions,obvious disturbance of consciousness,speech disorders,cough,or persistent fever.The neurological examination findings were normal,and pituitary magnetic resonance imaging(MRI)revealed multiple nodules with abnormal signals in the sellar region.The diagnosis was craniopharyngioma.We performed total resection of the tumor via transnasal endoscopy,and the postoperative pathology suggested that the type of tumor was craniopharyngioma.Six months after the operation,the patient experienced sudden hearing loss in the right ear,tinnitus in both ears,and numbness on the right side of the face and head.Meanwhile,cranial MRI showed multiple IP.After steroid hormone and anti-inflammatory therapy,the above symptoms did not significantly improve.Finally,the patient's symptoms were well improved by surgery,and the postoperative pathological diagnosis was multiple IP.CONCLUSION Intracranial inflammatory pseudotumor is a benign disease with slow progression,but the clinical symptoms and imaging findings are not typical,there are no pathological findings,and the diagnosis is relatively difficult.Most of the cases are treated by surgical resection,and the prognosis is good after surgery.

重新开放房角在重症急性闭角型青光眼治疗中的临床意义

目的:探讨360°"最大程度"房角关闭的重症急性闭角型青光眼,通过"双穿刺"、联合超声乳化加房角分离手术,能否重新开放房角,开放的范围和眼压变化。方法:回顾性系列病例研究。2008-11/2015-11收住我院病例完整的重症急性闭角型青光眼患者33眼,均为最大量药物治疗无效的患者。入院后行"双穿刺"手术短时间降低眼内压(术前和术后7d查房角),7～14d后行超声乳化联合房角分离手术治疗(术中检查房角),比较两次手术前后患者眼压、房角变化,观察手术并发症。随访时间为6～24mo。结果:"双穿刺"术前眼压为53.4±10.7mm Hg(1mm Hg=0.133k Pa),"双穿刺"手术后32眼眼压正常(其中2眼激光打孔后眼压正常),平均眼压为16.9±13.2mm Hg。1眼眼压仍高。双穿刺术前、术后眼压比较差异有统计学意义(t=9.21,P<0.001)。超声乳化术后1wk眼压为16.7±4.8mm Hg。双穿刺术后与超声乳化术后眼压比较差异无统计学意义(t=0.38,P>0.05)。1眼术后眼压异常,术后30d后正常。双穿刺术后房角的检查结果为:房角开放均值(131.8±111.3)°。术后7～14d 32眼行超声乳化联合房角分离术,1眼行超乳联合小梁切除手术,房角开放手术治疗有效率为32/33(97%)。术中房角开放均值(228.6±108.3)°,术后3mo房角开放均值(234.6±107.2)°。双穿刺术后与超声乳化术中房角开放度数比较差异有统计学意义(t=4.52,P<0.001),超声乳化术后3mo房角均值大于术中房角,差异无统计学意义(t=0.46,P>0.05)。没有严重并发症发生。结论:"最大程度"房角关闭的重症急性闭角型青光眼,可以通过"双穿刺"联合晶状体摘除手术逐步开放房角、降低眼压。开放房角可以作为重症急性闭角型青光眼的选择。

随机风况下风力机翼型结冰对气动特性的影响研究

风力机叶片表面结冰会影响风力机风能吸收效率及安全性。采用计算流体力学(CFD)可以模拟叶片表面结冰过程及其对风力机气动性能的影响。但传统的CFD模拟不能考虑来流风况的随机性。本文采用FENSAP软件模拟了NREL S825翼型表面的结冰过程,采用雷诺平均NS (RANS)模拟研究了结冰对该翼型气动特性的影响。为了研究来流风况的随机性对结冰过程及翼型气动特效的影响,基于概率配置点的非嵌入式多项式混沌方法与RANS模拟进行耦合,研究来流风速和攻角为高斯分布的随机参数时翼型表面冰型的变化,获得了冰型变化的统计特性,以及结冰后翼型气动性能的响应特性。研究结果表明,较洁净翼型相比,结冰后的翼型气动性能下降严重。与攻角的波动相比,来流风速的不确定波动对结冰后翼型的气动性能影响更大。大攻角下,确定性计算会低估攻角对结冰的影响,进而低估对升力系数的影响。风速和攻角的耦合作用削弱了不确定性对气动特性的影响。

低聚离子液体的体相与界面及其电化学储能应用

近年来,随着单阳离子液体的发展,新型低聚物离子液体被合成并应用。这类离子液体可看作是由几个重复的单阳离子组合而成,可以通过改变阳离子带电基团、间隔连接的长度或种类、末端链的长度以及阴离子种类来获得更多不同的结构。因此,低聚离子液体有更复杂的微观结构和内部相互作用,决定了其多特征的物化性质和电化学特性,有望满足更多对溶剂性能有特定要求的应用。例如,与单阳离子液体相比,低聚离子液体具有更大的可调节性、更宽的液态温度范围、更高的热稳定性等优点,使其在电化学储能设备中得到越来越多的应用,如用作超级电容器和锂离子电池的电解液。在本综述中,我们系统地总结并详细解释了低聚离子液体的性质和结构(包括单个离子的结构和本体液内部的纳米组织)之间的关联,主要是双阳离子液体和三阳离子液体;概括了低聚离子液体作为超级电容器和锂离子电池的电解液的相关研究,重点阐述了由低聚离子液体和不同类型电极组成的双电层的结构和性能,以及与相应单阳离子液体电解液的比较结果;提供了降低低聚离子液体粘度和加速离子扩散的优化措施,提出了低聚离子液体电解液未来可能面临的主要问题和发展前景。

平台运动对漂浮式风电机组气动功率和推力的影响研究

漂浮式风电机组存在平台六自由度运动,使得风电机组气动特性的非定常性显著。本文采用自由涡尾迹法对NREL 5MW风电机组的气动特性进行了模拟。为了能清晰比较单个平台运动对气动性能的影响,将浮式平台的纵摇、纵荡以及横摇运动简化为给定的正弦函数,研究了不同振幅的平台纵荡、纵摇、横摇运动以及两者和三者之间耦合运动下风电机组的气动功率和推力变化。结果表明:浮式平台的运动会导致风电机组功率和推力的波动,平台纵摇运动影响最大,横摇运动的影响最小;较剧烈的耦合运动会显著增加平均发电量;平台三自由度耦合运动中,增大纵荡振幅可以增大平均功率输出,并减少平均推力。

基于代理模型与遗传算法的翼型优化设计方法研究

计算流体力学(CFD)广泛用于翼型的气动优化设计。由于CFD计算量大、计算时间长,常用响应面或人工神经网络等代理模型来代替CFD模拟进行气动性能评估。代理模型的预测精度关系着优化结果的可信度。本文研究基于代理模型与优化算法的翼型气动优化设计方法。采用CST函数建立了翼型的参数化方法。采用拉丁超立方实验设计方法,在设计空间内选择训练样本。基于开源CFD求解器OpenFOAM计算样本翼型的气动参数,建立基于径向基神经网络的代理模型,以减少计算量。以S809翼型为对象,升力最大为目标函数,最大厚度为约束条件,利用代理模型与遗传算法结合优化得到最优翼型,并采用了代理模型的由粗到精的外层迭代,以提高代理模型的精度和效率。结果显示:优化后的翼型较原S809翼型气动性能有了明显提升,升力系数提高,阻力系数降低;采用外层迭代后,代理模型的预测精度提高,保证了全局最优性,同时总计算量减少。

风剪切与平台纵摇对漂浮式风电机组气动失谐的影响

漂浮式风电机组浮式平台在风浪流耦合作用下存在六自由度运动,使风轮旋转平面内的气动力不均匀,导致风轮产生气动失谐。而风剪切使风电机组的失谐特性更加明显。文中使用计算流体力学方法(CFD)研究风剪切来流与平台纵摇运动分别对风电机组总体性能与叶片不同展向截面气动载荷的影响。结果表明纵摇运动使风电机组的总体性能发生波动,且随着幅值的增加而增加。风剪切0.2与0.3使风电机组总体气动性能增加,且随着风剪切系数的增加而增加。平台纵摇使截面气动载荷的波动从外叶展到内叶展逐渐增大,风剪切造成的截面气动载荷的波动从外叶展到内叶展逐渐减小。风剪切与幅值较低的纵摇运动对截面气动载荷的影响相当。

Hepatic artery infusion with raltitrexed or 5-fluorouracil for colorectal cancer liver metastasis

AIM To evaluate the efficiency and safety of hepatic artery infusion chemotherapy(HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer(CRC) liver metastasis(CRCLM).METHODS A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed. RESULTS The median survival time(MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed(TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil(FOLFOX) arm(P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm(P = 0.734). Median progression-free survival(PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm(P= 0.215). Leukopenia(P = 0.026) was more common in the FOLFOX arm, and hepatic disorder(P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.CONCLUSION No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.

Modified laparoscopic splenectomy and azygoportal disconnection combined with cell salvage is feasible and might reduce the need for blood transfusion

AIM:To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy and azygoportal disconnection(MLSD)with intraoperative autologous cell salvage.METHODS:We retrospectively evaluated outcomes in79 patients admitted to the Clinical Medical College of Yangzhou University with cirrhosis,portal hypertensive bleeding and secondary hypersplenism who underwent MLSD without(n=46)or with intraoperative cell salvage and autologous blood transfusion,including splenic blood and operative hemorrhage(n=33),between February 2012 and January 2014.Their intraoperative and postoperative variables were compared.These variables mainly included:operation time;estimated intraoperative blood loss;volume of allogeneic blood transfused;visual analog scale forpain on the first postoperative day;time to first oral intake;initial passage of flatus and off-bed activity;perioperative hemoglobin(Hb)concentration;and red blood cell concentration.RESULTS:There were no significant differences between the groups in terms of duration of surgery,estimated intraoperative blood loss and overall perioperative complication rate.In those receiving salvaged autologous blood,Hb concentration increased by an average of 11.2±4.8 g/L(P<0.05)from preoperative levels by the first postoperative day,but it had fallen by 9.8±6.45 g/L(P<0.05)in the group in which cell salvage was not used.Preoperative Hb was similar in the two groups(P>0.05),but Hb on the first postoperative day was significantly higher in the autologous blood transfusion group(118.5±15.8g/L vs 102.7±15.6 g/L,P<0.05).The autologous blood transfusion group experienced significantly fewer postoperative days of temperature>38.0℃(P<0.05).CONCLUSION:Intraoperative cell salvage during MLSD is feasible and safe and may become the gold standard for liver cirrhosis with portal hypertensive bleeding and hypersplenism.

On-treatment monitoring of liver fibrosis with serum hepatitis B core-related antigen in chronic hepatitis B

BACKGROUND Non-invasive evaluation for liver fibrosis is clinically important,especially in patients with undetectable hepatitis B virus(HBV)DNA treated with nucleoside analogs.AIM To clarify the monitoring power of hepatitis B core-related antigen(HBcrAg)for hepatic histologic changes in patients with chronic hepatitis B(CHB)treated with entecavir.METHODS This prospective multicenter study used multiple ordinal and multivariate logistics regression analysis to assess variables associated with Ishak fibrosis score and regression for fibrosis regression,respectively,in 403 CHB patients,including 374 with entecavir for 72 weeks(291 underwent paired liver biopsy)and 29 as controls.RESULTS Level of HBcrAg correlated negatively with liver fibrosis staging(γ=-0.357,P<0.001)in hepatitis B e antigen(HBeAg)-positive patients,and positively with liver fibrosis staging in HBeAg-negative patients.Higher HBcrAg concentration was associated with younger age,HBeAg positive status,high HBV DNA loads,high level of hepatitis B surface antigen(HBsAg)and higher necroinflammation,but not with HBV genotype.Serum concentration of HBcrAg,basal core promoter/precore(BCP/PC)mutant,quantitation of HBsAg(qHBsAg)and platelet counts were independently associated with Ishak fibrosis score on multiple ordinal regression.HBV DNA was undetectable in 88.37%of patients treated with entecavir at week 72,while their level of HBcrAg was still detectable.A greater reduction in post-treatment HBcrAg concentration was associated with the regression of hepatic fibrosis and histological improvement.HBcrAg concentration>6.33 log IU/mL at baseline and logarithmic reduction>1.03 log IU/mL at week 72 were associated with a higher chance of regression of liver fibrosis and histological improvement,respectively.CONCLUSION HBcrAg level is associated with liver fibrosis progression.HBcrAg is an excellent monitor of hepatic histological changes,especially in CHB patients treated with nucleoside analogs.

Functional role of long non-coding RNA CASC19/miR-140-5p/CEMIP axis in colorectal cancer progression in vitro

BACKGROUND Long non-coding RNAs(lncRNAs) are widely involved in tumor regulation.Nevertheless, the role of the lncRNA cancer susceptibility 19(CASC19) in colorectal cancer(CRC) has yet to be fully clarified.AIM To explore the effect of CASC19 on proliferation and metastasizing ability of CRC cells.METHODS CASC19 expression in human CRC tissues, pair-matched adjacent normal colon tissues, and CRC cells was detected using quantitative real-time PCR(qRT-PCR).CASC19 expression, as well as its relation to overall survival, was extrapolated by Kaplan-Meier survival analysis together with multivariable Cox regression assay.In vitro experiments were performed to confirm whether CASC19 regulates CRC cell invasion, migration, proliferation, and apoptosis.RESULTS CASC19 expression was markedly upregulated in CRC tissues and CRC cell lines(P < 0.05). qRT-PCR revealed that CASC19 expression was higher in 25 tissue samples from patients with aggressive CRC compared with the 27 tissue samples from patients with nonaggressive CRC(P < 0.05). Higher CASC19 expression was associated with poorer patient prognoses. Furthermore, in vitro experiments demonstrated that CASC19 overexpression enhanced CRC cell invasion,migration, and proliferation. CASC19 overexpression enhanced the expression of cell migration inducing hyaluronidase 1(CEMIP) and epithelial-mesenchymal transition markers. MiR-140-5 p was found to be able to bind directly to CASC19 and CEMIP. Overexpression of miR-140-5 p reversed the effect of CASC19 on cellproliferation and tumor migration, as well as suppressed CASC19-induced CEMIP expression.CONCLUSION CASC19 positively regulates CEMIP expression through targeting miR-140-5 p.CASC19 may possess an oncogenic function in CRC progression, highlighting its potential as an essential biomarker in CRC diagnosis and therapy.

Perioperative advantages of modified laparoscopic vs open splenectomy and azygoportal disconnection

AIM: To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy or open splenectomy and azygoportal disconnection for portal hypertension.METHODS: This study included 44 patients who underwent modified laparoscopic splenectomy and azygoportal disconnection(MLSD) and 71 who underwent open procedures for portal hypertension. Blood samples were collected before surgery and on days 1, 3, and 7 after surgery. Markers of liver and renal function, C-reactive protein(CRP), interleukin-6(IL-6), and procalcitonin(PCT) were measured, and perioperative variables were compared between the two groups.RESULTS: The modified laparoscopic group showed significantly better and faster recovery, better liver and renal function, and fewer complications than the open group. CRP, IL-6, and PCT concentrations on postoperative days 1, 3, and 7 were significantly lower in the modified laparoscopic group than in the open group.CONCLUSION: MLSD was associated with lower inflammatory immune responses, less impairment of liver and renal function, and faster and better recovery.

Short-term effects of air pollution on acute myocardial infarctions in Shanghai, China, 2013-2014

BackgroundAlthough 微粒物质，与直径 <；2.5 µ； m (下午 2.5) 和 <； 10 µ ； m (下午10),和另外的污染物质与心血管的病态和死亡被联系了，尖锐心肌的梗塞( AMI )上的污染物质的效果很少在亚洲被调查了特别在上海， China.MethodsBetween 1 2013年11月和2014年4月27日，从 Pudong 区域的 972 个病人，上海城市，被紧急情况医疗服务估计。一个盒子转线路图案被用来分析暴露让污染和 AMI 风险通风。暴露到下午 2.5, 下午 10, 氮二氧化物(没有 2), sulphurdioxide (2), 和碳一氧化物(公司) 因此基于吝啬的城市的背景层次。在 AMI 录取，包括的污染物质，温度，和相对湿度之中的协会用城市的背景下午 2.5, 下午 10 铺平的关联和逻辑 regression.ResultsThe 被分析，公司与 AMI 的增加的风险被联系，不同于没有 2 并且那么 2 层次。为 AMI 的 OR (95% CI ) 是 1.16 (1.03-1.29 ) ， 1.05 (1.01-1.16 ) ， 0.82 (0.75-1.02 ) ， 0.87 (0.63-1.95 ) ，并且 1.08 (1.02-1.21 ) 为下午 2.5, 下午 10, 没有 2, 那么 2, 和公司分别地。空气质量索引(AQI ) 的增加与更多的 AMI 出现被联系。与到中等严肃的污染层次的 AMI 医院 admissions.ConclusionsShort 术语暴露在在温度和相对湿度的变化之间没有关联与 AMI 的增加的风险被联系。增加的下午 2.5, 下午 10 和公司层次与增加的 AMI 录取有关。

Sorafenib combined with embolization plus hepatic arterial infusion chemotherapy for inoperable hepatocellular carcinoma

BACKGROUND There is little evidence of combining sorafenib with hepatic arterial infusion chemotherapy(HAIC)after transarterial chemoembolization(TACE)for intermediate and advanced hepatocellular carcinoma(HCC).It is important to identify that patients with intermediate and advanced HCC are most likely to benefit from this combination therapy.AIM To investigate the safety and clinical outcomes of sorafenib combined with HAIC with folinic acid,5-fluorouracil(5-FU),and oxaliplatin(FOLFOX)after TACE for intermediate and advanced HCC.METHODS This prospective phase II study enrolled patients with intermediate and advanced HCC who underwent treatment with sorafenib combined with TACEHAIC.All patients initially received the standard 400 mg dose of sorafenib twice daily before TACE-HAIC.Participants at our institute with intermediate and advanced HCC underwent routine TACE.Then,the catheter used for embolization was kept in place in the hepatic artery,and oxaliplatin was intraarterially administered for 6 h,followed by 5-FU for 18 h,and folinic acid was intravenously administered for 2 h.The primary endpoints were safety,as evaluated by the Common Terminology and Criteria for Adverse Events version 4.0,and 12-mo progression-free survival(PFS),as analyzed by the Kaplan-Meier method.As secondary endpoints,the objective response rate(ORR)was evaluated by the modified Response Evaluation Criteria for Solid Tumors,and survival time[overall survival(OS)]was analyzed by the Kaplan-Meier method.RESULTS Sixty-six participants at our institute with intermediate and advanced HCC were enrolled in this prospective study(mean age,53.3±11.7 years).Approximately 56.1%of participants had Barcelona Clinic Liver Cancer(BCLC)stage C disease,and 43.9%had BCLC stage B disease.The ORR was 42.4%.The disease control rate was 87.9%.The grade 3-4 toxicities consisted of thrombocytopenia(4.5%),neutropenia(3.0%),and elevated aspartate aminotransferase(12.2%).Hand-foot skin reaction was also observed(40.9%).The median PFS was 13.1 mo(13.5 mo in the BCLC stage B participants and 9.4 mo in the BCLC stage C participants).The 6-mo,12-mo,and 24-mo PFS rates were 75.0%,54.7%,and 30.0%,respectively.The median OS was 21.8 mo.CONCLUSION Sorafenib combined with HAIC(FOLFOX)after TACE may be a feasible treatment choice for intermediate and advanced HCC because this treatment met the prespecified endpoint of a 6-mo PFS rate exceeding 50%and had good patient tolerance.Prospective randomized controlled trials are needed to confirm the effect of this combination therapy.

High Serum CEA and CYFRA21-1 Levels after a Two-Cycle Adjuvant Chemotherapy for NSCLC:Possible Poor Prognostic Factors

Objective The aim of this study was to test whether carcinoembryonic antigen(CEA) and cytokeratin 19 fragments(CYFRA21-1) can be used as a prognostic factor for non-small-cell lung cancer(NSCLC) after two cycles of adjuvant chemotherapy in NSCLC patients. Methods A total of 169 patients underwent at least two cycles of adjuvant chemotherapy.The serum levels of CEA and CYFRA21-1 were recorded after the second cycle of chemotherapy,and the patient follow-up was conducted.Overall survival(OS) and diseasefree survival(DFS) were used as the primary endpoint and the secondary endpoint,respectively. Results The high levels of CEA and CYFRA21-1 after two cycles of adjuvant chemotherapy were poor prognostic factors for OS,with risk ratios(RR) of 2.003 and 1.702,respectively.A high CEA level was a poor prognostic factor(RR 1.152) for DFS.The median survival time(MST) of the high CEA level group was 26 months,whereas that of the normal group was 61 months(P<0.0001).The median DFS time of the high CEA group and the normal group was 34 and 53 months,respectively(P<0.0001).The MST of the high CYFRA21-1 group and the normal group was 43 and 56 months,respectively(PO.0001). Conclusions The high serum levels of CEA or CYFRA21-1 after two cycles of adjuvant chemotherapy are poor prognostic factors for NSCLC patients.

宫腔镜窄带成像技术诊断不同类型子宫内膜增生性病变的价值

目的探讨宫腔镜窄带成像技术(NBI)诊断不同类型子宫内膜增生性病变的价值。方法选取148例异常子宫出血患者行宫腔镜检查,分别于白光和NBI模式下观察子宫内膜,对可疑病灶行靶向活检,送病理组织学检查。以病理诊断为金标准,比较白光与NBI模式对不同分类子宫内膜增生性病变的诊断价值。结果低危型子宫内膜增生性病变表现以Ⅱ型微血管为主,高危型子宫内膜增生性病变以Ⅲ~Ⅳ型微血管为主。宫腔镜白光及NBI模式诊断低危型子宫内膜增生性病变的敏感性分别为65.52%及86.21%,差异有统计学意义(χ~2=6.78,P=0.009);NBI模式诊断低危型子宫内膜增生性病变与病理学诊断一致性中等(Kappa值为0.617)。宫腔镜白光、NBI模式诊断高危型子宫内膜增生性病变的准确率分别为81.08%及89.86%(χ~2=4.60,P=0.032),敏感性分别为57.14%及92.86%(χ~2=14.29,P=0.000),阴性预测值分别为84.21%及96.91%(χ~2=9.43,P=0.002),差异均有统计学意义;特异性分别为90.57%及88.68%(χ~2=0.20,P=0.652),阳性预测值分别为70.59%及76.47%(χ~2=0.37,P=0.544),差异均无统计学意义;NBI模式诊断高危型子宫内膜增生性病变与病理学诊断有较好的一致性(Kappa值为0.766)。结论宫腔镜NBI可清晰地观察子宫内膜表面及深层的微血管形态变化,有助于减少低危型子宫内膜增生性病变的漏诊,提高诊断高危型子宫内膜增生性病变的准确率。NBI在诊断不同分类子宫内膜病变中具有一定临床应用价值。