经导管动脉栓塞术治疗肝癌:最新临床证据

对不能接受根治性治疗如肝移植、肿瘤切除术或经皮射频消融术(radiofrequency ablation,RFA)的肝细胞肝癌(hepatocellular carcinoma,HCC)患者,经导管动脉化疗栓塞术(transarterial chemoembolization,TACE)或放疗栓塞术(transarterial radioembolization,TARE)是治疗的核心手段。近期研究证据显示:对于无血管侵犯、3 cm及以下单结节型HCC患者,TACE与肿瘤切除术及RFA后的5年总生存率相似。尽管已应用数十年,碘油(超液化碘油®,Lipiodol®Ultra Fluid,Guerbet,France)作为一种亲肿瘤性且不透射线的药物运输载体在肿瘤介入治疗中的地位依然重要。药物缓释微球(drug-eluting bead,DEB)是栓塞术中一种较新型的药物输送方式,既可维持药物浓度,也可持续释放抗癌药。现有三种DEB可供临床选择使用,即Tandem®(Celo Nova Biosciences Inc.),DC-Beads®(BTG,UK)和Hepa Sphere®(Bio Sphere Medical,Inc.,USA)。经动脉TARE已被证实可安全有效地运用于晚期肝癌及有肝血管侵犯的患者。两种放射性栓塞微粒可供临床选择使用,即SIR-Spheres®(Sirtex Medical Limited,Australia)和Thera Sphere®(BTG,UK)。本文总结肝癌经导管动脉治疗的关键临床试验。

Transcatheter embolization therapy in liver cancer:an update of clinical evidences

Transarterial chemoembolization （TACE） is a form of intra-arterial catheter-based chemotherapy that selectively delivers high doses of cytotoxic drug to the tumor bed combining with the effect of ischemic necrosis induced by arterial embolization. Chemoembolization and radioembolization are at the core of the treatment of liver hepatocellular carcinoma （HCC） patients who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. TACE for liver cancer has been proven to be useful in local tumor control, to prevent tumor progression, prolong patients＇ life and control patient symptoms. Recent evidence showed in patients with single-nodule HCC of 3 cm or smaller without vascular invasion, the 5-year overall survival （OS） with TACE was similar to that with hepatic resection and radiofrequency ablation. Mthough being used for decades, Lipiodol~ （Lipiodol~ Ultra Fluid~, Guerbet, France） remains important as a tumor-seeking and radio-opaque clrug delivery vector in intervendonal oncology. There have been efforts to improve the delivery of chemotherapeutic agents to tumors. Drug-eluting bead （DEB） is a relatively novel drug delivery embolization system which allows for fixed dosing and the ability to release the anticancer agents in a sustained manner. Three DEBs are available, i.e., Tandem~ （CeloNova Biosciences Inc., USA）, DC-Beads~ （BTG, UK） and HepaSphere~ （BioSphere Medical, Inc., USA）. Transarterial radioembolization （TARE） technique has been developed, and proven to be efficient and safe in advanced liver cancers and those with vascular complications. Two types of radioembolization microspheres are available i.e., SIR-Spheres~ （Sirtex Medical Limited, Australia） and TheraSphere~ （BTG, UK）. This review describes the basic procedure of TACE, properties and efficacy of some chemoembolization systems and radioembolization agents which are commercially available and/or currently under clinical evaluation. The key clinical trials of transcatheter arterial therapy for liver cancer are summarized.

Clinical outcomes of elderly South-East Asian patients in primary percutaneous coronary intervention for ST- elevation myocardial infarction

评估临床的特征和经历主要经皮的冠的干预(PPCI ) 的老东南亚洲病人的在里面医院结果 .MethodsFrom 2009 年 1 月到 2012 年 12 月， 1268 个病人(86.4% 男性， 58.4 楴 的吝啬的年龄？

Mode-Locked Erbium-Doped Fiber Laser Using Vanadium Oxide as Saturable Absorber

A mode-locked erbium doped fiber laser（EDFL） is demonstrated using the vanadium oxide（V2O5） material as a saturable absorber（SA）. The V2O5 based SA is hosted into poly ethylene oxide film and attached on fiber ferule in the laser cavity. It shows 7% modulation depth with 71 MW/cm2 saturation intensity. By incorporating the SA inside the EDFL cavity with managed intra-cavity dispersion, ultrashort soliton pulses are successfully generated with a full width at half maximum of 3.14 ps. The laser operated at central wavelength of 1559.25 nm and repetition frequency of 1 MHz.

Announcers and confessors: How people self-disclose depression in health panels

Focus groups can be used to explore sensitive topics and have been found to increase the likelihood and depth of disclosure of personal and sensitive information in comparison to individual interviews. This article focuses on how people make self-disclosures in group research settings, specifically self-disclosure of depression. Data was collected from twelve health panel groups, held in Somerset, England. Health panels are a focus group-based method where members of the public are brought together to discuss a variety of topics including sensitive ones. The topic discussed by the health panel was attitudes to help-seeking for stress and depression. In this paper I conceptualize two new types of discloser—which I term “announcers” and “confessors” and illustrate how normalizing language can facilitate disclosures. This study has important implications for focus group-based research and for health professionals who deal with stigmatized conditions such as depression.

Angle-Resolved Plasmonic Properties of Single Gold Nanorod Dimers

Through wet-chemical assembly methods, gold nanorods were placed close to each other and formed a dimer with a gap distance *1 nm, and hence degenerated plasmonic dipole modes of individual nanorods coupled together to produce hybridized bonding and antibonding resonance modes. Previous studies using a condenser for illumination result in averaged signals over all excitation angles. By exciting an individual dimer obliquely at different angles, we demonstrate that these two new resonance modes are highly tunable and sensitive to the angle between the excitation polarization and the dimer orientation, which follows cos2 u dependence. Moreover, for dimer structures with various structure angles, the resonance wavelengths as well as the refractive index sensitivities were found independent of the structure angle. Calculated angle-resolved plasmonic properties are in good agreement with the measurements. The assembled nanostructures investigated here are important for fundamental researches as well as potential applications when they are used as building blocks in plasmon-based optical and optoelectronic devices.

Insight on the Ultrastructure, Physicochemical, Thermal Characteristics and Applications of Palm Kernel Shells

The ultrastructure and physicochemical and thermal properties of Palm Kernel Shells (PKS) in comparison with Coconut Kernel Shells (CKS) were investigated herein. Powder samples were prepared and characterized using Surface Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). Chemical and elemental constituents, as well as thermal performance were assessed by Van Soest Method, TEM/EDXA and SEM/EDS techniques. Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TGA) were also performed for thermal characterization. SEM/EDS and TEM/EDXA revealed that most of the PKS and CKS materials are composed of particles with irregular morphology;these are mainly amorphous phases of carbon/oxygen with small amounts of K, Ca and Mg. The DSC data permitted to derive the materials’ thermal transition phases and the relevant characteristic temperatures and physical properties. Thermal Transition phases of PKS observed herein are consistent with the chemical composition obtained and are similar to those of CKS. Nonetheless, TGA/DTG showed that the combustion characteristics of PKS are higher than those of CKS. Taken together, our results reveal that PKS have nanopores and can be efficiently used for 3D printing and membrane filtration applications. Moreover, the chemical constituents found in PKS samples are in agreement with those reported in the literature for material structural applications and thus, present potential use of PKS in these applications.

Characterization of Tannin-Based Resins from the Barks of <i>Ficus platyphylla</i>and of <i>Vitellaria paradoxa</i>: Composites’ Performances and Applications

This work investigates the physico-chemical and mechanical properties of tannins extracted from wood for composite materials manufacturing. Sustainable knowledge (in terms of physico-chemical properties and behaviours) of the material is needed to further enhance its applications. The condensed tannins extracted from the Bark of Ficus platyphylla (BFP) and the Bark of Vitellaria paradoxa (BVP) were analyzed using Matrix Assisted Laser Desorption/Ionization Time-Of-Flight (MALDI-TOF), Mass Spectroscopy and Attenuated Total Reflectance Fourier Transform Mid-InfraRed (ATR-FT MIR) spectra in the ranges 1800 cm-1 and 600 cm-1, as well as using CP MAS 13C-NMR. It was found that, these two tannins are procyanidin/prodelphinidin and made up of catechin/epicatechin, gallocatechin/epigallocatechin units, fisetinidin, galloyl and carbohydrates residues. Furthermore, BFP and BVP tannin bonded particleboard densities lie in the range recommended by NF EN 326-1994 standard. The resins also yielded good internal bond strength results of the panels, above relevant international standard specifications minimum requirements for interior-grade panels. The Transmission Electron Microscopy with Energy Dispersive X-ray Spectroscopy Analysis (TEM/ EDXA) are showing the ultrastructure and reveal that most of the resin material appears to be in an amorphous phase mainly composed of carbon/oxygen with small amounts of K, Ca and Mg. These particles have a very irregular morphology.

Candidate organic electrolytes for electric double-layer capacitor application

Electrolytic conductivity, viscosity and electrochemical behavior were investigated for organic electrolytes based on PC（Propylene carbonate）, MAN（Methoxy acetonitrile） and GBL（γ-Butyrolactone） solvents. It was found that 1 mol/L Et4NBF4-MAN had the highest conductivity, lowest viscosity and acceptable potential window. The specific capacitance and energy density obtained from the capacitor using 1 mol/L Et4NBF4-MAN as electrolyte were the highest among all the tested electrolytes.（1 mol/L） Et4NBF4-GBL also seemed promising to be used in electric double-layer capacitor （EDLCs）.

Improved Bearing Fault Diagnosis by Feature Extraction Based on GLCM, Fusion of Selection Methods, and Multiclass-Naïve Bayes Classification

The presence of bearing faults reduces the efficiency of rotating machines and thus increases energy consumption or even the total stoppage of the machine. It becomes essential to correctly diagnose the fault caused by the bearing. Hence the importance of determining an effective features extraction method that best describes the fault. The vision of this paper is to merge the features selection methods in order to define the most relevant featuresin the texture of the vibration signal images. In this study, the Gray Level Co-occurrence Matrix (GLCM) in texture analysis is applied on the vibration signal represented in images. Features selection based on the merge of PCA (Principal component Analysis) method and SFE (Sequential Features Extraction) method is done to obtain the most relevant features. The multiclass-Na?ve Bayesclassifier is used to test the proposed approach. The success rate of this classification is 98.27%. The relevant features obtained give promising results and are more efficient than the methods observed in the literature.

Validating “announcer” and “confessor” styles of mental health self-disclosure through use of archived qualitative data

Two new conceptual styles of self-disclosure were identified in a previous study—“announcers” and “confessors”. The styles and characteristics of each had been derived from disclosures made during Somerset Health Panel discussions in 2001 on attitudes to stress and depression. The aim of this article is to validate and refine the concepts of “announcer” and “confessor” styles of self-disclosure. Data from archived qualitative data of seven focus groups collected in 2006 for the Cultural Context of Youth Suicide study was analysed. The results validated the concept of two styles of self-disclosure (announcers and confessors) and highlight additional factors that impact on disclosure. This study adds new insights in how people disclose personal or sensitive information and the impact of specific factors (contextual, individual and methodological) on the disclosure style used. Importantly, this article also demonstrates that qualitative data can be reused successfully in the development of models in communication and social interaction theory.

What Prevents Eligible Patients from Receiving Progesterone Therapy to Prevent Recurrent Preterm Birth

Objective: The use of intramuscular 17-alpha-hydroxyprogesterone caproate (17-OHPC) has been shown to be beneficial for the prevention of preterm birth (PTB) in women with a prior history. Not all patients with a prior preterm birth receive 17-OHPC. The purpose of this study was to investigate potential barriers to receiving this therapy. Methods: A retrospective chart review of those patients at our institution who received the diagnosis of “previous preterm delivery” in 2010 and 2011 was performed to see whether they were offered and received 17-OHPC. Patients were considered eligible if they had a prior delivery at less than 36 weeks of gestation secondary to idiopathic preterm labor. For those patients that were deemed eligible but did not receive therapy, an explanation was sought. Results: Sixty-six charts were reviewed in detail. Forty-three patients were considered eligible to receive 17-OHPC. The remaining had medical indications for delivery including premature rupture of membranes (PROM) (15), intrauterine growth restriction (IUGR) (1), and hypertension (2). Of the 43 patients deemed eligible, 17 did not receive 17-OHPC. Of these, eight patients were not offered therapy, 2 patients declined therapy, 3 patients presented with therapy after 28 weeks (too late), and 4 received a prophylactic cerclage as their only therapy. There were no significant differences between the two groups. Conclusion: In an effort to increase 17-OHPC use among eligible patients, we must continually identify physician biases and patient barriers that prevent utilization of this intervention. In addition, patients who deliver preterm should be told the importance of presenting early in subsequent pregnancies in order to receive the full benefits of this therapy.

Strategies to prevent preterm birth and cerebral palsy: Compliance with current recommendations

Objective: Magnesium sulfate (MgSO4) administration to patients with preterm delivery has been associated with a decrease in cerebral palsy. At our institution, a protocol was established regarding the administration of magnesium sulfate for patients in preterm labor at less than 32 weeks of gestation. Despite this protocol, not all eligible patients received this therapy. The purpose of this study was to investigate potential barriers to MgSO4 administration. Methods: A retrospective chart review was performed of those patients who received the diagnosis of “Early Onset Delivery” or “preterm labor” from January through December of 2010, to see what therapies were offered and received. Results: 119 patients met initial criteria. Of those, 68 patients had preterm labor less than 32 weeks. 15 of the 68 patients (22%) received MgSO4. Of those patients that did not receive MgSO4, only 6 delivered <32 weeks. Five were considered eligible. One patient had a relative contraindication to therapy. There were no demographic differences between those patients that received MgSO4, and those that were eligible and did not. Potential barriers included short time frame from presentation to delivery, treatment not considered by healthcare provider, and unanticipated delivery. No patient declined therapy. Conclusions: At our institution, the rate of MgSO4 administration for neuroprotection to eligible candidates was 75%. The subgroup of patients where MgSO4 was not administered in eligible candidates was unanticipated delivery (4), and premature rupture of membranes (1). A 4 gram load of MgSO4 should be attempted prior to delivery of eligible patients, as this strategy has also been shown to be of benefit.

Demographic and Assisted Reproduction Related Factors Associated with Dichorionic Triplet Gestations

Our objective was to evaluate which demographic factors or assisted reproductive technologies were associated with IVF triplet gestations where one of the embryos split, resulting in a dichorionic triplet gestation. This was a case-control study of dichorionic versus trichorionic triplet gestations that underwent assisted reproductive technology over the last 5 years at our fertility center. There were 53 cases of dichorionic triamniotic triplet gestations compared to 119 trichorionic triplet controls. There were no significant demographic differences between the cases and controls. 51/53 dichorionic triplets and 86/119 trichorionic triplets were conceived through IVF, the remaining utilized intrauterine insemination. ICSI was performed in virtually all patients that underwent IVF. Of the potential risk factors studied, hatching was used in 70.6% of dichorionic compared to 89.5% of trichorionic IVF triplets (p = 0.005);embryo transfer was performed on Day 5 or 6 compared to Day 3 in 88.0% dichorionic vs 71.8% trichorionic (p = 0.028). Frozen sperm was utilized more frequently with dichorionic than with trichorionic triplets, 26.0% vs 10.9% (p < 0.011). Only 4 (7.5%) of the IVF cases underwent pre-implantation genetics. Certain assisted reproductive technologies appear to be associated with embryo splitting and a dichorionic triplet gestation. More research is needed in this area to further elucidate these findings.

了解微观和亚微观结构特征对HVO/AF喷涂WC-CoCr金属陶瓷机械性能的影响

HVOF工艺代表着耐磨和耐蚀涂层的制备水平。该工艺气体速度达到超音速,火焰温度适合,可以制备高结合强度、高表面光洁度和低氧化物水平的涂层。然而,新一代涂层材料（细粉）、严格的质量要求和行业所需的高生产率将HVOF技术推向极限。

UVA在日光诱导皮肤生物学变化中的重要作用

日光中可到达地球表面的紫外线（UV）包括UVB（中波紫外线，波长290～320nm）和UVA（长波紫外线，波长320～400nm）。由于UVA的能量低于UVB，因此长期以来认为UVB是日光中导致皮肤损伤的主要原因。但是近年的研究证明，UVA在导致皮肤光损伤方面起到至关重要的作用。UVA不仅是日光中UV的主要成分。而且具有比UVB更强的穿透能力，可对皮肤真皮结缔组织产生持久性影响。

Potential Mineralization of Various Organic Pollutants During Composting

The objectives of this work were to determine the potential mineralization of various organic pollutants that are likely found in compostable materials during composting, and to evaluate the participation of the microflora of the thermophilic and maturation composting phases in pollutant mineralization. Four composts were used: a biowaste compost (BioW), a municipal solid waste compost (MSW), a green waste compost (GW) and a co-compost of green waste and sludge (GW+S). In each composting plant, two samples were withdrawn: one in the thermophilic phase (fresh compost) and one in the maturation phase (mature compost) to have the microflora of thermophilic and maturation phases active, respectively. The mineralization of 5 organic pollutants, 3 polycyclic aromatic hydrocarbons (PAHs) (i.e., phenanthrene, fluoranthene and benzo(a)pyrene), 1 herbicide (dicamba) and 1 polychlorinated biphenyl (PCB, congener 52), was measured in a laboratory setting during incubations at 60 ℃ in fresh composts and at 28 ℃ in mature composts. All molecules were 14 C-labeled, which allowed the mineralization of the molecules to be measured by trapping of produced 14CO2 in NaOH. Their volatilization was also measured by trapping molecules on glass wool impregnated with paraffin oil. Mineralization of the organic molecules was only observed when the maturation microflora was present in the mature composts or when it was inoculated into the fresh compost. Phenanthrene mineralization of up to 60% in the fresh GW+S compost was the only exception. Mineralization of PAH decreased when the complexity of the PAH molecules increased. Mineralization of phenanthrene and fluoranthene reached 50%-70% in all mature composts. Benzo(a)pyrene was mineralized (30%) only in the MSW mature compost. Dicamba was moderately mineralized (30%-40%). Finally, no PCB mineralization was detected, but 20% of the PCB had volatilized after 12 d at 60 ℃. No clear difference was observed in the degrading capacity of the different composts, and the major difference was the larger mineralizing capacity of the maturation microflora compared with the thermophilic microflora.

SPF／UVA—PF（PPD）≤3的均衡防晒剂能有效保护皮肤免受UVA和UVB的损伤

日光中能够到达地表的uv主要有UVB（波长290～320nm）和UVA（波长320～400nm），UVA占其中的绝大部分（至少为95％）。急性或长期慢性日光照射可导致日晒伤、免疫抑制、光致癌和皮肤光老化等生物学和临床损伤。

Transparent Interconnection of Metro Access and Metro Core Networks Including Protection

We proposed and demonstrated a solution for the transparent interconnection of metro access and metro core networks enabling end-to-end wavelength provisioning including the protection.