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 hepatocel...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.展开更多
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 ...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.展开更多
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 s...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.展开更多
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 patien...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.展开更多
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 exp...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.展开更多
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 h...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.展开更多
AIM: To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy and azygoportal disconnection (MLSD) with intraoperative autologous cell salvage.
AIM: To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy or open splenectomy and azygoportal disconnection for portal hypertension.
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 ...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.展开更多
BACKGROUND Neoadjuvant chemotherapy is currently recommended as preoperative treatment for locally advanced rectal cancer(LARC);however,evaluation of treatment response to neoadjuvant chemotherapy is still challenging...BACKGROUND Neoadjuvant chemotherapy is currently recommended as preoperative treatment for locally advanced rectal cancer(LARC);however,evaluation of treatment response to neoadjuvant chemotherapy is still challenging.AIM To create a multi-modal radiomics model to assess therapeutic response after neoadjuvant chemotherapy for LARC.METHODS This retrospective study consecutively included 118 patients with LARC who underwent both computed tomography(CT)and magnetic resonance imaging(MRI)before neoadjuvant chemotherapy between October 2016 and June 2019.Histopathological findings were used as the reference standard for pathological response.Patients were randomly divided into a training set(n=70)and a validation set(n=48).The performance of different models based on CT and MRI,including apparent diffusion coefficient(ADC),dynamic contrast enhanced T1 images(DCE-T1),high resolution T2-weighted imaging(HR-T2WI),and imaging features,was assessed by using the receiver operating characteristic curve analysis.This was demonstrated as area under the curve(AUC)and accuracy(ACC).Calibration plots with Hosmer-Lemeshow tests were used to investigate the agreement and performance characteristics of the nomogram.RESULTS Eighty out of 118 patients(68%)achieved a pathological response.For an individual radiomics model,HR-T2WI performed better(AUC=0.859,ACC=0.896)than CT(AUC=0.766,ACC=0.792),DCE-T1(AUC=0.812,ACC=0.854),and ADC(AUC=0.828,ACC=0.833)in the validation set.The imaging performance for extramural venous invasion detection was relatively low in both the training(AUC=0.73,ACC=0.714)and validation(AUC=0.578,ACC=0.583)sets.The multi-modal radiomics model reached an AUC of 0.925 and ACC of 0.886 in the training set,and an AUC of 0.93 and ACC of 0.875 in the validation set.For the clinical radiomics nomogram,good agreement was found between the nomogram prediction and actual observation.CONCLUSION A multi-modal nomogram using traditional imaging features and radiomics of preoperative CT and MRI adds accuracy to the prediction of treatment outcome,and thus contributes to the personalized selection of neoadjuvant chemotherapy for LARC.展开更多
基金Chongqing Natural Science Foundation General Project,No.2023NSCQ-MSX1632 and No.2023NSCQ-MSX1633Key Scientific and Technological Research Project of Chongqing Municipal Education Commission,No.KJ202302884457913 and No.KJZDK202302801+1 种基金2022 Scientific Research Project of Chongqing Medical and Pharmaceutical College,No.ygz2022104Scientific Research and Seedling Breeding Project of Chongqing Medical Biotechnology Association,No.cmba2022kyym-zkxmQ0003.
文摘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.
基金supported by National Natural Science Foundation of China(No.21905032)Natural Science Foundation of the Higher Education Institutions of Anhui Province(No.KJ2019A0687,No.KJ2016A503)+2 种基金High-level Humanities and Social Science Award Cultivation Project of Chaohu University and Innovation(No.kj20zkjp01,No.kj20xqyx02)Entrepreneurship Training Program for Students of National and school level(No.202010380014,X202010380013)Chaohu University for the Start-Up grant(No.KYQD-201907)。
文摘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.
文摘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.
基金supported by the State Key Program of National Natural Science of China(No.51936004)the Science Fund for Creative Research Groups of the National Natural Science Foundation of China(No.51821004)+2 种基金the Fundamental Research Funds for the Central Universities(No.2020MS063)support from the China Postdoctoral Science Foundation Funded Project(No.2022T150228)support from the Program for HUST Academic Frontier Youth Team。
基金Supported by Capital Medical Development and Scientific Research Fund,China,No.2014-2-2154
文摘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.
基金Supported by the National Natural Science Foundation of China,No.81570375
文摘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.
基金Supported by Chinese Ministry of Science and Technology Grants the Major Science and Technology Special Project Fund Scheme,No.2013ZX10005002Beijing the Special Clinical Application Research and Translational Grants,No.Z151100004015221
文摘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.
基金Supported by Science and Education Foundation of Yangzhou,China
文摘AIM: To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy and azygoportal disconnection (MLSD) with intraoperative autologous cell salvage.
文摘AIM: To investigate perioperative outcomes in patients undergoing modified laparoscopic splenectomy or open splenectomy and azygoportal disconnection for portal hypertension.
基金Supported by Beijing Municipal Science and Technology Commission(Z181100010118001)Foundation of Chinese Geriatric Oncology Society(CGOS-01-2012-1-00800)+1 种基金National Key R and D Program of China(2017YFC0114004)National Natural Science Foundation of China(81971717).
文摘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.
基金Supported by Research Grant of National Nature Science Foundation of China,No.81971571Multimodal MR Imaging and Radiomics of Rectal Cancer,Science and Technology Department of Sichuan Province,No.2019YFS0431Sichuan University Training Program of Innovation and Entrepreneurship for Undergraduates,No.C2019104739.
文摘BACKGROUND Neoadjuvant chemotherapy is currently recommended as preoperative treatment for locally advanced rectal cancer(LARC);however,evaluation of treatment response to neoadjuvant chemotherapy is still challenging.AIM To create a multi-modal radiomics model to assess therapeutic response after neoadjuvant chemotherapy for LARC.METHODS This retrospective study consecutively included 118 patients with LARC who underwent both computed tomography(CT)and magnetic resonance imaging(MRI)before neoadjuvant chemotherapy between October 2016 and June 2019.Histopathological findings were used as the reference standard for pathological response.Patients were randomly divided into a training set(n=70)and a validation set(n=48).The performance of different models based on CT and MRI,including apparent diffusion coefficient(ADC),dynamic contrast enhanced T1 images(DCE-T1),high resolution T2-weighted imaging(HR-T2WI),and imaging features,was assessed by using the receiver operating characteristic curve analysis.This was demonstrated as area under the curve(AUC)and accuracy(ACC).Calibration plots with Hosmer-Lemeshow tests were used to investigate the agreement and performance characteristics of the nomogram.RESULTS Eighty out of 118 patients(68%)achieved a pathological response.For an individual radiomics model,HR-T2WI performed better(AUC=0.859,ACC=0.896)than CT(AUC=0.766,ACC=0.792),DCE-T1(AUC=0.812,ACC=0.854),and ADC(AUC=0.828,ACC=0.833)in the validation set.The imaging performance for extramural venous invasion detection was relatively low in both the training(AUC=0.73,ACC=0.714)and validation(AUC=0.578,ACC=0.583)sets.The multi-modal radiomics model reached an AUC of 0.925 and ACC of 0.886 in the training set,and an AUC of 0.93 and ACC of 0.875 in the validation set.For the clinical radiomics nomogram,good agreement was found between the nomogram prediction and actual observation.CONCLUSION A multi-modal nomogram using traditional imaging features and radiomics of preoperative CT and MRI adds accuracy to the prediction of treatment outcome,and thus contributes to the personalized selection of neoadjuvant chemotherapy for LARC.