Background
This study aimed to compare sequential treatment by transcatheter arterial chemoembolization (TACE) and percutaneous radiofrequency ablation (RFA) with partial hepatectomy for ...hepatocellular carcinoma (HCC) within the Milan criteria.
Methods
In a randomized clinical trial, patients with HCC within the Milan criteria were included and randomized 1 : 1 to the partial hepatectomy group or the TACE + RFA group. The primary outcome was overall survival and the secondary outcome was recurrence‐free survival.
Results
Two hundred patients were enrolled. The 1‐, 3‐ and 5‐year overall survival rates were 97·0, 83·7 and 61·9 per cent for the partial hepatectomy group, and 96·0, 67·2 and 45·7 per cent for the TACE + RFA group (P = 0·007). The 1‐, 3‐ and 5‐year recurrence‐free survival rates were 94·0, 68·2 and 48·4 per cent, and 83·0, 44·9 and 35·5 per cent respectively (P = 0·026). On Cox proportional hazard regression analysis, HBV‐DNA (hazard ratio (HR) 1·76; P = 0·006), platelet count (HR 1·00; P = 0·017) and tumour size (HR 1·90; P < 0·001) were independent prognostic factors for recurrence‐free survival, and HBV‐DNA (HR 1·61; P = 0·036) was a risk factor for overall survival. The incidence of complications in the partial hepatectomy group was higher than in the TACE + RFA group (23·0 versus 11·0 per cent respectively; P = 0·024).
Conclusion
For patients with HCC within the Milan criteria, partial hepatectomy was associated with better overall and recurrence‐free survival than sequential treatment with TACE and RFA. Registration number: ACTRN12611000770965 (http://www.anzctr.org.au/).
Partial hepatectomy better
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Ti–22Al–25Nb (at.%) intermetallic is a light weight, high performance, high temperature material with density of merely ˜60% of Ni-based superalloys. The advent and rapid development ...of selective laser melting (SLM) enable direct fabrication of the Ti–22Al–25Nb intermetallic into complex geometry parts, promising for various critical applications. This paper is dedicated to better understanding the effects of hatch distance, an important but often underestimated processing factor, on microstructure and mechanical properties of the SLM-prepared Ti–22Al–25Nb. Along with analytical means such as transmission electron microscopy (TEM) and electron backscatter diffraction (EBSD), finite element simulation has also been employed to explore the underlying mechanisms. It is determined that the highest mechanical properties are achieved at a hatch distance of 0.16 mm due to the following factors: (a) High density dislocation, (2) favorable phase features, and (3) high relative density. As-fabricated parts of micro-turbine engine using the optimized parameters are provided in the end of the study to demonstrate the capability of SLM to manufacture high quality and delicate structural parts of the Ti–22Al–25Nb intermetallic.
It has long been known that males are more susceptible than females to hepatocellular carcinoma (HCC), but the reason remains elusive. In this study, we investigated the expression and function of ...the long noncoding RNA FTX (lnc-FTX), an X-inactive-specific transcript (XIST) regulator transcribed from the X chromosome inactivation center, in both HCC and HCC gender disparity. lnc-FTX is expressed at higher levels in female livers than in male livers and is significantly downregulated in HCC tissues compared with normal liver tissues. Patients with higher lnc-FTX expression exhibited longer survival, suggesting that lnc-FTX is a useful prognostic factor for HCC patients. lnc-FTX inhibits HCC cell growth and metastasis both in vitro and in vivo. Mechanistically, lnc-FTX represses Wnt/β-catenin signaling activity by competitively sponging miR-374a and inhibits HCC cell epithelial-mesenchymal transition and invasion. In addition, lnc-FTX binds to the DNA replication licensing factor MCM2, thereby impeding DNA replication and inhibiting proliferation in HCC cells. In conclusion, these findings suggest that lnc-FTX may act as a tumor suppressor in HCC through physically binding miR-374a and MCM2. It may also be one of the reasons for HCC gender disparity and may potentially contribute to HCC treatment.
Background
Health‐related quality of life (HRQL) is an important outcome measure in studies of cancer therapy. This study aimed to investigate HRQL and survival in patients with small hepatocellular ...carcinoma (HCC) treated with either surgical resection or percutaneous radiofrequency ablation (RFA).
Methods
Between January 2006 and June 2009, patients with newly diagnosed solitary, small (3 cm or less) HCC were invited to participate in this non‐randomized prospective parallel cohort study. The Functional Assessment of Cancer Therapy – Hepatobiliary (FACT‐Hep) instrument was used for assessing HRQL. HRQL and survival were compared between the two treatment groups.
Results
A total of 389 patients were enrolled. Questionnaires were completed fully by 99·7 per cent of invited participants (388 of 389) at baseline, 98·7 per cent (383 of 388) at 3 months, 99·0 per cent (379 of 383) at 6 months, 98·4 per cent (365 of 371) at 1 year, 96·6 per cent (336 of 348) at 2 years and 95·1 per cent (289 of 304) at 3 years. There were no significant differences in disease‐free and overall survival between the two groups. Patients treated with percutaneous RFA had significantly better HRQL total scores after 3, 6, 12, 24 and 36 months than those who had surgical resection (P < 0·001, P < 0·001, P = 0·001, P = 0·003 and P = 0·025 respectively). On multivariable analysis, the presence of concomitant disease, cirrhosis and surgical resection were significant risk factors associated with a worse HRQL score after treatment.
Conclusion
Percutaneous RFA produced better post‐treatment HRQL than surgical resection for patients with solitary small (no more than 3 cm) HCC.
Radiofrequency ablation is a good alternative for surgery
Our recent efforts in developing electrocatalysts for ethanol oxidation reaction are focused on the ternary Pt–Rh–SnO2 catalysts due to their superior performance in splitting CC bond and the ability ...to fully oxidize ethanol to CO2. This work reports on the role of Rh from studies of the well-defined Rh(111) single-crystal and a series of carbon-supported nanoparticle catalysts for the electrooxidation of ethanol. A comparative study of supported nanocatalysts was carried out and their activity for ethanol oxidation decreased in the order of PtRhSnO2>PtSnO2>Pt>PtRh>Rh>RhSnO2. In situ infrared reflection–absorption spectroscopy studies showed that the catalysts’ selectivity toward ethanol total oxidation to CO2 decreased in the order of: PtRhSnO2∼RhSnO2>PtRh>Pt>PtSnO2∼Rh, verifying the role of Rh in breaking the CC bond, and the roles of the two other constituents, SnO2 and Pt, that facilitate the oxidation of the reaction intermediates and lessen their bonding to Rh. These results help understanding the role of Rh and SnO2 in the catalytic oxidation of ethanol and provide insights for designing catalysts with improved propeties.
HIAF (High Intensity heavy ion Accelerator Facility), a new facility planned in China for heavy ion related researches, consists of two ion sources, a high intensity Heavy Ion Superconducting Linac ...(HISCL), a 45 Tm Accumulation and Booster Ring (ABR-45) and a multifunction storage ring system. The key features of HIAF are unprecedented high pulse beam intensity and versatile operation mode. The HIAF project aims to expand nuclear and related researches into presently unreachable region and give scientists possibilities to conduct cutting-edge researches in these fields. The general description of the facility is given in this article with a focus on the accelerator design.
Strong interplanetary shock interactions with the Earth's magnetosphere have great impacts on energetic particle dynamics in the magnetosphere. An interplanetary shock on 7 November 2004 (with the ...maximum solar wind dynamic pressure of ∼70 nPa) was observed by the Cluster constellation to induce significant ULF waves in the plasmasphere boundary, and energetic electrons (up to 2 MeV) were almost simultaneously accelerated when the interplanetary shock impinged upon the magnetosphere. In this paper, the relationship between the energetic electron bursts and the large shock‐induced ULF waves is studied. It is shown that the energetic electrons could be accelerated and decelerated by the observed ULF wave electric fields, and the distinct wave number of the poloidal and toroidal waves at different locations also indicates the different energy ranges of electrons resonating with these waves. For comparison, a rather weak interplanetary shock on 30 August 2001 (dynamic pressure ∼2.7 nPa) is also investigated. It is found that interplanetary shocks or solar wind pressure pulses with even small dynamic pressure change can have a nonnegligible role in the radiation belt dynamics.
X-ray crystallography often requires non-native constructs involving mutations or truncations, and is challenged by membrane proteins and large multicomponent complexes. We present here a bottom-up ...endogenous structural proteomics approach whereby near-atomic-resolution cryo electron microscopy (cryoEM) maps are reconstructed ab initio from unidentified protein complexes enriched directly from the endogenous cellular milieu, followed by identification and atomic modeling of the proteins. The proteins in each complex are identified using cryoID, a program we developed to identify proteins in ab initio cryoEM maps. As a proof of principle, we applied this approach to the malaria-causing parasite Plasmodium falciparum, an organism that has resisted conventional structural-biology approaches, to obtain atomic models of multiple protein complexes implicated in intraerythrocytic survival of the parasite. Our approach is broadly applicable for determining structures of undiscovered protein complexes enriched directly from endogenous sources.
Epileptic encephalopathies are severe epilepsy disorders with strong genetic bases. We performed targeted next‐generation sequencing (NGS) in 70 patients with epileptic encephalopathies. The likely ...pathogenicity of variants in candidate genes was evaluated by American College of Medical Genetics and Genomics (ACMG) scoring taken together with the accepted clinical presentation. Thirty‐three candidate variants were detected after population filtration and computational prediction. According to ACMG, 21 candidate variants, including 18 de novo variants, were assessed to be pathogenic/likely pathogenic with clinical concordance. Twelve variants were initially assessed as uncertain significance by ACMG, among which 3 were considered causative and 3 others were considered possibly causative after analysis of clinical concordance. In total, 24 variants were identified as putatively causative, among which 19 were novel findings. SCN1A mutations were identified in 50% of patients with Dravet syndrome. TSC1/TSC2 mutations were detected in 66.7% of patients with tuberous sclerosis. STXBP1 mutations were the main findings in patients with West syndrome. Mutations in SCN2A, KCNT1, KCNQ2 and CLCN4 were identified in patients with epileptic infantile with migrating focal seizures; among them, KCNQ2 and CLCN4 were first identified as potential causative genes. Only one CHD2 mutation was detected in patients with Lennox‐Gastaut syndrome. This study highlighted the utility of targeted NGS in genetic diagnoses of epileptic encephalopathies and a comprehensive evaluation of the pathogenicity of variants based on ACMG scoring and assessment of clinical concordance. Epileptic encephalopathies differ in genetic causes, and the genotype‐phenotype correlations would provide insights into the underlying pathogenic mechanisms.
We identified 24 causative mutations (19 novel) in a cohort of 70 EE patients and delineated new phenotype associated with CLCN4 and KCNQ2.
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