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
The stellar initial mass function (IMF) is commonly assumed to be an invariant probability density distribution function of initial stellar masses. These initial stellar masses are generally ...represented by the canonical IMF, which is defined as the result of one star formation event in an embedded cluster. As a consequence, the galaxy-wide IMF (gwIMF) should also be invariant and of the same form as the canonical IMF; gwIMF is defined as the sum of the IMFs of all star-forming regions in which embedded clusters form and spawn the galactic field population of the galaxy. Recent observational and theoretical results challenge the hypothesis that the gwIMF is invariant. In order to study the possible reasons for this variation, it is useful to relate the observed IMF to the gwIMF. Starting with the IMF determined in resolved star clusters, we apply the IGIMF-theory to calculate a comprehensive grid of gwIMF models for metallicities, Fe/H ∈ (−3, 1), and galaxy-wide star formation rates (SFRs), SFR ∈ (10−5, 105) M⊙ yr−1. For a galaxy with metallicity Fe/H < 0 and SFR > 1 M⊙ yr−1, which is a common condition in the early Universe, we find that the gwIMF is both bottom light (relatively fewer low-mass stars) and top heavy (more massive stars), when compared to the canonical IMF. For a SFR < 1 M⊙ yr−1 the gwIMF becomes top light regardless of the metallicity. For metallicities Fe/H > 0 the gwIMF can become bottom heavy regardless of the SFR. The IGIMF models predict that massive elliptical galaxies should have formed with a gwIMF that is top heavy within the first few hundred Myr of the life of the galaxy and that it evolves into a bottom heavy gwIMF in the metal-enriched galactic centre. Using the gwIMF grids, we study the SFR−Hα relation and its dependency on metallicity and the SFR. We also study the correction factors to the Kennicutt SFRK − Hα relation and provide new fitting functions. Late-type dwarf galaxies show significantly higher SFRs with respect to Kennicutt SFRs, while star-forming massive galaxies have significantly lower SFRs than hitherto thought. This has implications for gas-consumption timescales and for the main sequence of galaxies. We explicitly discuss Leo P and ultra-faint dwarf galaxies.
To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors.
H. pylori strains were collected from ...patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method.
H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China.
The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.
Background
The Child–Pugh (CP) score is used widely to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the albumin–bilirubin (ALBI) ...score has been validated as a predictor of overall survival in these patients. This study aimed to compare the ability of the ALBI and CP scores to predict outcomes in patients with HCC after liver resection with curative intent.
Methods
Consecutive patients who underwent liver resection with curative intent for HCC between January 2007 and July 2013 were included in this retrospective study. The performance of the ALBI score in predicting postoperative liver failure (PHLF) and long‐term survival was compared with that of the CP score.
Results
A total of 1242 patients were enrolled. Of these, 166 (13·4 per cent) experienced PHLF. The area under the receiver operating characteristic (ROC) curve of the ALBI score for predicting PHLF was greater than that of the CP score (0·723 versus 0·607; P < 0·001). Similar to findings for CP grade, the incidence and severity of PHLF increased with increasing ALBI grade. The ALBI grade stratified patients into at least two distinct overall survival cohorts (P < 0·001), whereas the CP grade did not. The ALBI grade also classified patients with CP grade A disease into two distinct overall survival cohorts (P < 0·001), and overall survival rates in the group with poorer survival were similar to those in the majority of patients with CP grade B disease. Both CP and ALBI scores had low power in predicting disease‐free survival.
Conclusion
The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade.
ALBI score may be better
A general feature of unconventional superconductors is the existence of a superconducting dome in the phase diagram. Here we report a series of discrete superconducting phases in the simplest ...iron-based superconductor, FeSe thin flakes, by continuously tuning the carrier concentration through the intercalation of Li and Na ions with a solid ionic gating technique. Such discrete superconducting phases are robust against the substitution of 20% S for Se, but they are vulnerable to the substitution of 2% Cu for Fe, highlighting the importance of the iron site being intact. The superconducting phase diagram for FeSe derivatives is given, which is distinct from that of other unconventional superconductors.
The dependencies of global positioning system (GPS) scintillation indices on ionospheric plasma flow and the rate of change of total electron content (TEC) around the dawn sector for the first time ...of the polar ionosphere are investigated. The phase scintillation index (σφ) derived from GPS measurements of the Canadian High Arctic Ionospheric Network (CHAIN) shows linear dependencies on both the plasma drift speed measured by the SuperDARN radar and on the rate of change of TEC estimated from the GPS receivers of CHAIN. However, the amplitude scintillation index (S4) does not show any dependence on the plasma flow or the rate of change of TEC. These results further support Wang et al. (2018), https://doi.org/10.1002/2017JA024805 at the noon sector. The dependence of the phase scintillation index on the plasma flow further evidences that the standard phase scintillation index is dominated by refractive variations due to the use of a fixed cut‐off frequency of 0.1 Hz while detrending the phase observable. The dependence of the phase scintillation index on the rate of change of TEC consolidates the dominance of refractive variations inside.
Plain Language Summary
In decades, the standard scintillation indices are widely used to represent the strength of scintillations in the ionosphere, which were usually calculated from the sixth order Butterworth filter with a fixed cut‐off frequency of 0.1 Hz by the ground‐based Global Navigation Satellite System (GNSS) receiver automatically. At middle‐to‐low latitudes, the applications of these indices are working very well. However, over the polar ionosphere, the completely different scintillation phenomenon “Phase without Amplitude” occurred when confronting the hazard conditions. Then, in order to explaining this weird, many researchers have carried out a lot of valuable approaches, fundamentally challenging the direct adopt of standard phase scintillation index. Here, for the first time, we present an experimental evidence on the dawn sector to prove the clear positive dependence of phase scintillation index on the convection flow speed and also the TEC variations. It reminds us to be careful when using the standard phase scintillation index over the polar region, in particular with high‐speed flows.
Key Points
The dependencies of global positioning system scintillation indices on plasma flow and total electron content (TEC) variation were evaluated around the dawn sector of polar ionosphere
The phase scintillation index depends linearly only on the plasma flow speed and the rate of change of TEC
However, the amplitude scintillation index does not rely on the plasma flow and also the rate of change of TEC
This paper is a statistical survey of polar cap patches in relation to solar and geomagnetic activity. Ten thousand six hundred eighty‐eight patches have been identified from in situ plasma ...observations of the Defense Meteorological Satellite Program F16 satellite for 14 years (2005–2018). These patches are divided into two groups: (a) cold patches, which consist of dense but cold plasma; and (b) hot patches, which consist of dense but hot plasma. The statistical results indicate that (a) the occurrence of cold patches is clearly dependent on solar and geomagnetic activity, but hot patches don not show such dependence; (b) both cold and hot patches preferably appear in the winter season; (c) the spatial size of both cold and hot patches decreases (increases) with solar (geomagnetic) activity; (d) the spatial size of cold patches appears larger than that of hot patches under similar solar and geomagnetic activity.
Plain Language Summary
Polar cap patches are localized regions of enhanced plasma density in the polar ionosphere. They are associated with strong electron density gradients resulting in non‐negligible ionospheric scintillations for satellite communication and navigation systems. To characterize polar cap patches and investigate their statistical dependence on solar and geomagnetic activity, 10,688 patches have been identified from 14 years of in situ Defense Meteorological Satellite Program satellite plasma observations. These patches have been divided into cold and hot patches. We find that cold patches occur more frequently during solar maximum years. The spatial size of cold and hot patches decreases with solar activity (increases with geomagnetic activity). Furthermore, the spatial size of cold patches is larger than that of hot patches under similar solar and geomagnetic activity.
Key Points
The occurrence of cold patches is clearly dependent on solar and geomagnetic activity, while hot patches do not show such dependence
In NH winter, the spatial size of both cold and hot patches decreases (increases) with solar (geomagnetic) activity
In NH winter, the spatial size of cold patches appears larger than that of hot patches under similar solar and geomagnetic activity
•MSTN−/− pigs subcutaneous adipose tissue clearly showed characteristic multilocular lipid droplets like beige adipose in contrast to the tissues from WT pigs.•MSTN gene deletion in adipose tissue ...activates the browning of white fat via the AMPK signaling pathway.•MSTN−/− skeletal muscle secretes IL-6 and modulates the AMPK pathway in adipocytes, and induces white adipose conversion into beige adipose in pigs.
Myostatin (MSTN) is primarily expressed in skeletal muscle and plays an important role in the regulation of muscle growth and development as well as fat deposition; however, little is known about the molecular mechanism through which MSTN regulates body fat deposition. Therefore, in this study, we sought to identify the signaling pathways through which MSTN regulates fat accumulation in pigs. MSTN knockout (MSTN−/−) pigs showed increased muscle mass, decreased fat mass, and a leaner body composition. In this study, we found that the adipose tissue of MSTN−/− pigs exhibits the characteristics of beige adipose tissue, and the mRNA expression levels of beige adipose marker genes, including UCP3, Cidea, and CD137, were significantly increased. Remarkably, the observed beige phenotype was not adipocyte autonomous but rather caused by muscle-secreted myokine interleukin (IL)-6. This occurrence results in increased AMP-activated protein kinase (AMPK) phosphorylation in adipose tissue, which subsequently activates peroxisome proliferator-activated receptor gamma coactivator 1α and the conversion of white adipocytes to beige in pigs. Therefore, we concluded that MSTN deficiency leads to increased IL-6 secretion in skeletal muscle and activates AMPK in adipocytes, thereby increasing the beige adipose tissue in MSTN−/− pigs.
PDF
