Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recent...Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recently,this technique has also been used in the treatment of intrahepatic cholangiocarcinoma for patients who are not eligible for surgical resection.There are several types of thermal ablation techniques.Radiofrequency ablation and microwave ablation are two common methods that induce necrosis of the lesions.Irreversible electroporation is a relatively new non-thermal technique and is suitable in cases where thermal ablation would be ineffective or dangerous(e.g.,malignant tumors close to vascular or biliary structures).Irreversible electroporation can induce tumoral necrosis without damage to vascular and biliary structures.The aim of this minireview was to describe the safety,efficacy,and clinical indications of these techniques in the treatment of patients with intrahepatic cholangiocarcinoma who are ineligible for surgery.展开更多
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for...Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology. To date, many reports and case series have confirmed the safety and feasibility of that kind of ablation technique in the pancreatic setting. Moreover, EUS-guided fine-needle injection is emerging as a method to deliver ablative and anti-tumoral agents inside the tumuor. Ethanol injection has been proposed mostly for the treatment of PCLs and for symptomatic functioning PNETs, and the use of gemcitabine and paclitaxel is also interesting in this setting. EUS-guided injection of chemical or biological agents including mixed lymphocyte culture, oncolytic viruses, and immature dendritic cells has been investigated for the treatment of LAPC. Data on the long-term efficacy of these approaches, and large prospective randomized studies are needed to confirm the real clinical benefits of these techniques for the management of pancreatic lesions.展开更多
Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablatio...Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablation and cryoablation and highlights its clinical efficacy,safety,and technical considerations.MWA offers significant benefits,including higher intratumoral temperatures,larger ablation zones,and reduced susceptibility to the heat-sink effect,which make it particularly suitable for tumors near large blood vessels.This review details the patient selection criteria,procedural approaches,and the use of advanced imaging techniques to improve the precision and effectiveness of MWA.Clinical outcomes indicate that MWA achieves high rates of complete tumor ablation and long-term survival with a favorable safety profile.This review is significant because it provides updated insights into the expanding role of MWA in treating unresectable CRLM and its potential as an alternative to surgical resection for resectable tumors.By summarizing recent studies and clinical trials,this review highlights the comparative effectiveness,safety,and integration with systemic therapies of MWA.In conclusion,MWA is a promising treatment option for CRLM and offers outcomes comparable to or better than those of other ablative techniques.Future research should focus on optimizing technical parameters,integrating MWA with systemic therapies,and conducting large-scale randomized controlled trials to establish standardized treatment protocols.Advancing our understanding of MWA will enhance its application and improve long-term survival and quality of life for patients with CRLM.展开更多
BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chem...BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chemotherapy failure remains underexplored.AIM To assess long-term survival and factors affecting outcomes of RFA in patients with multiple refractory CRLM.METHODS A retrospective study was conducted on patients who underwent ablation of CRLM at our institution between January 2015 and June 2024.A total of 80 patients were included,with 42 individuals receiving single-session ablation and 38 underwent repeat ablation.Enhanced computed tomography imaging was utilized to evaluate procedural efficacy 24 hours post-RFA,followed by follow-up scans every 3-4 months.Progression-free survival(PFS)and overall survival(OS)rates were compared at endpoint using Kaplan-Meier curves.Cox regression was used to identify the factors associated with OS and PFS.RESULTS The technical success rate was recorded at 98.7%.At endpoint,42(52.5%)patients achieved tumor-free survival,while 28(35%)remained alive with residual tumors present.No significant OS/PFS differences existed between single-session(median follow-up 29.5 months,median PFS 24.5 months)and repeat ablation(30 months,14 months)cohorts(P>0.05).Multivariate analysis showed that larger tumor size(P<0.001)and older age(P=0.01)were associated with worse OS.The median PFS was 13.5 months,with tumor size emerging as the only independent predictor(P=0.04).CONCLUSION For patients with multiple refractory CRLM,both single-session ablation and repeat ablation can increase the proportion of patients achieving tumor-free status.However,careful consideration is necessary for ablation of metastases larger than 2.7 cm.展开更多
Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with s...Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.展开更多
The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which ha...The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which hampers their conversion into boride-based ultrahigh temperature ceramics.To tackle these challenges,a serious of pioneering liquid multi-component hafnium-containing ceramic SiHfCB precursors(with different Hf/Si ratios)have been developed.These novel precursors are featured with stable molec-ular structure and high ceramic yield which were successfully created through a novel one-pot polymer-ization process.They present in liquid form and their structure is characterized by C-C bonds forming its main chain with branched chains of O-Si-O,Si-O-Hf,Si-O-B,and B-O-Hf which have untapped advantages including uniform component dispersion,and excellent fluidity.The ceramic yield of SiHfCB precursor with Hf/Si of 0.2 is remarkably up to 68.6 wt.%at 1500℃,and their Hf content exceeded 50 wt.%.Of particular interest,the pyrolyzed product HfB_(2)-SiC nanopowders derived from the SiHfCB precursor with Hf/Si of 0.2,consist of nanopowders in the 40-60 nm range with a density of 5.23 g cm^(−3).Remarkably,this material demonstrates exceptional performance in ultrahigh temperature oxygen-containing environ-ments at 2500℃,showing near-zero ablation with a linear ablation rate of just 2.5×10^(−4) mm s^(−1).Post-ablation analysis of the microstructure reveals that the formation of a lava-like HfO_(2) and HfO_(2)-SiO_(2) oxide layer effectively blocks oxygen penetration and provides excellent oxidation resistance.The inno-vative SiHfCB hafnium-containing ceramic precursor offers a groundbreaking solution for the preparation of lightweight ultrahigh-temperature ceramics.This development is poised to provide robust technical support for the use of ultrahigh temperature ceramics in non-ablative thermal protective systems,partic-ularly in the construction of hypersonic vehicles,where ultrahigh temperature resilience is crucial.展开更多
Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which i...Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which is prone to either inadequate or excessive ablation.This paper aims to establish an ablation prediction model that guides MWA tumor surgical planning.Methods:An MWA process was first simulated by incorporating electromagnetic radiation equations,thermal equations,and optimized biological tissue parameters(dynamic dielectric and thermophysical parameters).The temperature distributions(the short/long diameters,and the total volume of the ablation zone)were then generated and verified by 60 cases ex vivo porcine liver experiments.Subsequently,a series of data were obtained from the simulated temperature distributions and to further fit the novel ablation coagulated area prediction model(ACAPM),thus rendering the ablation-dose table for the guiding surgical plan.The MWA clinical patient data and clinical devices suggested data were used to validate the accuracy and practicability of the established predicted model.Results:The 60 cases ex vivo porcine liver experiments demonstrated the accuracy of the simulated temperature distributions.Compared to traditional simulation methods,our approach reduces the long-diameter error of the ablation zone from 1.1 cm to 0.29 cm,achieving a 74%reduction in error.Further,the clinical data including the patients'operation results and devices provided values were consistent well with our predicated data,indicating the great potential of ACAPM to assist preoperative planning.展开更多
Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how...Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how quickly the diagnosis is made. Chemotherapy and radiotherapy can be both used in cases of nonresectable pancreatic cancer. In cases of pancreatic neoplasm that is locally advanced, non-resectable, but non-metastatic, it is possible to apply percutaneous treatments that are able to induce tumor cytoreduction. The aim of this article will be to describe the multiple currently available treatment techniques(radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation), their results, and their possible complications, with the aid of a literature review.展开更多
Many studies suggest that combined multimodality treatments including ablative therapies may achieve better outcomes than systemic chemotherapy alone in patients with colorectal liver metastases. Nevertheless, ablativ...Many studies suggest that combined multimodality treatments including ablative therapies may achieve better outcomes than systemic chemotherapy alone in patients with colorectal liver metastases. Nevertheless, ablative therapies are not yet considered as effective options because their efficacy has never been proved by randomized controlled trials (RCT). However, there are in literature no trials that failed in demonstrating the effectiveness of ablative treatments: what are lacking, are the trials. All the attempts to organize phase III studies on this topic failed as a result of non accrual. Just one prospective RCT comparing radiofrequency ablation combined with systemic chemotherapy vs chemotherapy alone has been published. It was designed as a phase III study, but it was closed early because of slow accrual, and was downscaled to phase II study, with the consequent limits in drawing definite conclusions on the benefit of combined treatment. However, the combination treatment met the primary end point of the study and obtained a significantly higher 3-year progression-free survival than systemic chemotherapy alone. It is very unlikely that ultimate efficacy of ablation treatments will ever be tested again, and the best available evidence points toward a benefit for the combination strategy using ablative treatments and chemotherapy.展开更多
BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver d...BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver disease(NAFLD).However,the specific metabolic contributions of DMA using IRE in NAFLD remain unclear.AIM To assess the feasibility and effectiveness of DMA using IRE in NAFLD rat models.METHODS Seven-week-old male Sprague-Dawley rats underwent DMA using IRE after 8 weeks on a high-fat diet.Two weeks post-treatment,duodenal and liver tissues and blood samples were collected.We evaluated differences in the duodenal wall structure,liver lipid deposition,enteroendocrine,claudin,and zonula ocludens-1 in the duodenal mucosa.RESULTS DMA using IRE could be safely performed in rats with NAFLD without duodenal bleeding,perforation,or stenosis.The duodenum healed well 2 weeks after DMA and was characterized by slimmer villi,narrower and shallower crypts,and thicker myenterons compared with the sham-control setting.Liver lipid deposition was reduced and serum lipid index parameters were considerably improved in the DMA setting.However,these improvements were independent of food intake and weight loss.In addition,enteroendocrine parameters,such as claudin,and zonula ocludens-1 levels in the duodenal mucosa,differed between the different settings in the DMA group.CONCLUSION By altering enteroendocrine and duodenal permeability,simple DMA using IRE ameliorated liver lipid deposition and improved serum lipid parameters in NAFLD rats.展开更多
Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,...Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,and investigated their ablation behaviors under an oxyacetylene torch with a heat flux of 2.4 MW m^(-2).It was observed that the x=0.1 oxide scale bulged but was denser,and the x=0.2 oxide scale was blown away due to the formation of excessive liquid.Based on these findings,we further de-veloped a duplex(Hf-Zr-Ta)B_(2)coating that showed a linear recession rate close to zero(0.11μm s^(-1))after two 120-s ablation cycles.It is identified that the resulting oxide scale is mainly composed of(Hf,Zr)_(6)Ta_(2)O_(17)and(Hf,Zr,Ta)O_(2)by performing aberration-corrected(scanning)transmission electron microscopy.The protective mechanism is related to the peritectic transformation of orthorhombic-(Hf,Zr)_(6)Ta_(2)O_(17)to tetragonal-(Hf,Zr,Ta)O_(2)plus Ta-dominated liquid.This study contributes to the develop-ment of Ta-containing multicomponent UHTC bulk and coatings for ultra-high temperature applications.展开更多
This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy...This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.展开更多
To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composite...To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composites using Zr_(2)Cu as the filler.The microstructure,mechanical properties,and ablation properties of the Zr_(2)Cu packed composites were analyzed.Results show that during Zr_(2)Cu impregnation,the melt efficiently fills the large pores of the composites and is converted to ZrCu due to a partial reaction of zirconium with carbon.This results in an increase in composite density from 1.91 g/cm^(3)to 2.24 g/cm^(3)and a reduction in open porosity by 27.35%.Additionally,the flexural strength of Zr_(2)Cu packed C/C-SiC-ZrC composites is improved from 122.78±8.09 MPa to 135.53±5.40 MPa.After plasma ablation for 20 s,the modified composites demonstrate superior ablative resistance compared to PIP C/C-SiC-ZrC,with mass ablation and linear ablation rates of 2.77×10^(−3)g/s and 2.60×10^(−3)mm/s,respectively.The“selftranspiration”effect of the low-melting point copper-containing phase absorbs the heat of the plasma flame,further reducing the ablation temperature and promoting the formation of refined ZrO_(2)particles within the SiO_(2)melting layer.This provides more stable erosion protection for Zr_(2)Cu packed C/C-SiC-ZrC composites.展开更多
Ultraviolet nanoimprint lithography(UV-NIL)is a versatile and cost-effective technique for the fabrication of micro-and nanostructures by copying master patterns in a planar or a roll-to-roll process through curing of...Ultraviolet nanoimprint lithography(UV-NIL)is a versatile and cost-effective technique for the fabrication of micro-and nanostructures by copying master patterns in a planar or a roll-to-roll process through curing of a liquid UV-sensitive precursor.For applications with a high pattern complexity,new UV-NIL process chains must be specified.Master fabrication is a challenging part of the development and often cannot be accomplished using a single master fabrication technique.Therefore,an approach combining different patterning fabrication techniques is developed here for polymer masters using laser direct writing and photolithography.The polymer masters produced in this way are molded into inverse silicone stamps that are used for roll-to-roll replication into an acrylate formulation.To fit the required roller size for large-area UV-NIL,several submasters with micrometer-sized dot and line gratings and prism arrays,which have been patterned by these different techniques,are assembled to final size of ~200×600 mm^(2) with an absolute precision of better than 50μm.The size of the submasters allows the use of standard laboratory equipment for patterning and direct writing,thus enabling the fabrication of micro-and even nanostructures when electron-beam writing is utilized.In this way,the effort,time,and costs for the fabrication of masters for UV-NIL processes are reduced,enabling further development for particular structures and applications.Using this approach,patterns fabricated with different laboratory tools are finally replicated by UV-NIL in an acrylate formulation,demonstrating the high quality of the whole process chain.展开更多
Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising ...Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.展开更多
BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic ...BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic options.AIM To evaluate the role of laparoscopic ultrasound in resection and ablation of colorectal liver metastases(CRLM).METHODS Between June 2018 and June 2020,300 patients with CRC and liver metastases were admitted to our hospital.They were divided into two groups(150 cases each)based on treatment method:The control group(ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging)and the observation group[contrast-enhanced ultrasound with Sonazoid(S-CEUS)].RESULTS The study group demonstrated better efficacy(P<0.05),fewer adverse events(P<0.05),and better survival outcomes compared to the control group(1-year:80%vs 62%;3-year:54%vs 33%;5-year:32%vs 18%;median survival:48 months vs 30 months;hazard ratio=0.63,95%CI:0.48-0.83,P<0.001).Although Karnofsky Performance Status scores improved in both groups,the scores were significantly higher in the observation group(P<0.05).Multivariate analysis confirmed intraoperative S-CEUS and tumor differentiation as independent prognostic factors(P<0.05).CONCLUSION Laparoscopic ultrasound-guided resection/ablation improved outcomes in CRLM,reducing complications and enhancing survival.Intraoperative S-CEUS was an independent prognostic factor,supporting its clinical value.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surg...BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.展开更多
Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United State...Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United States,over 73%were solid organ tumors.Ablative therapies offer minimally invasive solutions for malignant tissue destruction in situ,often with reduced cost and morbidity compared to surgical resection.This review examines the current Food and Drug Administration-approved locoregional ablative therapies(radiofrequency,microwave,cryogenic,high-intensity focused ultrasound,histotripsy)and their evolving role in cancer care.Data were collected through a comprehensive survey of the PubMed-inde-xed literature on tumor ablation techniques,their clinical indications,and outco-mes.Over time,emerging clinical data will help establish these therapies as the standard of care in solid organ tumor treatment,supported by improved long-term outcomes and progression-free survival.展开更多
In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure thes...In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure these statistical correlations,impeding machine learning models from effectively capturing the underlying patterns,thereby hampering efficient optimization of material properties.This work presents a novel active learning framework that integrates generative adversarial networks(GAN)with a directionally constrained expected absolute improvement(EAI)acquisition function to accelerate the discovery of ultra-high temperature ceramics(UHTCs)using small data.The framework employs GAN for data augmentation,symbolic regression for feature weight derivation,and a self-developed EAI function that incorporates input feature importance weighting to quantify bidirectional deviations from zero ablation rate.Through only two iterations,this framework successfully identified the optimal composition of HfB_(2)-3.52SiC-5.23TaSi_(2),which exhibits robust near-zero ablation rates under plasma ablation at 2500℃ for 200 s,demonstrating superior sampling efficiency compared to conventional active learning approaches.Microstructural analysis reveals that the exceptional performance stems from the formation of a highly viscous HfO_(2)-SiO_(2)-Ta_(2)O_(5)-HfSiO_(4)-Hf_(3)(BO_(3))_(4) oxide layer,which provides effective oxygen barrier protection.This work demonstrates an efficient and universal approach for rapid materials discovery using small data.展开更多
BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs interve...BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.展开更多
文摘Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recently,this technique has also been used in the treatment of intrahepatic cholangiocarcinoma for patients who are not eligible for surgical resection.There are several types of thermal ablation techniques.Radiofrequency ablation and microwave ablation are two common methods that induce necrosis of the lesions.Irreversible electroporation is a relatively new non-thermal technique and is suitable in cases where thermal ablation would be ineffective or dangerous(e.g.,malignant tumors close to vascular or biliary structures).Irreversible electroporation can induce tumoral necrosis without damage to vascular and biliary structures.The aim of this minireview was to describe the safety,efficacy,and clinical indications of these techniques in the treatment of patients with intrahepatic cholangiocarcinoma who are ineligible for surgery.
文摘Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology. To date, many reports and case series have confirmed the safety and feasibility of that kind of ablation technique in the pancreatic setting. Moreover, EUS-guided fine-needle injection is emerging as a method to deliver ablative and anti-tumoral agents inside the tumuor. Ethanol injection has been proposed mostly for the treatment of PCLs and for symptomatic functioning PNETs, and the use of gemcitabine and paclitaxel is also interesting in this setting. EUS-guided injection of chemical or biological agents including mixed lymphocyte culture, oncolytic viruses, and immature dendritic cells has been investigated for the treatment of LAPC. Data on the long-term efficacy of these approaches, and large prospective randomized studies are needed to confirm the real clinical benefits of these techniques for the management of pancreatic lesions.
基金Supported by the Joint Medical Scientific Research Project of Chongqing Science and Technology Committee and Chongqing Health Committee,No.2021MSXM308.
文摘Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablation and cryoablation and highlights its clinical efficacy,safety,and technical considerations.MWA offers significant benefits,including higher intratumoral temperatures,larger ablation zones,and reduced susceptibility to the heat-sink effect,which make it particularly suitable for tumors near large blood vessels.This review details the patient selection criteria,procedural approaches,and the use of advanced imaging techniques to improve the precision and effectiveness of MWA.Clinical outcomes indicate that MWA achieves high rates of complete tumor ablation and long-term survival with a favorable safety profile.This review is significant because it provides updated insights into the expanding role of MWA in treating unresectable CRLM and its potential as an alternative to surgical resection for resectable tumors.By summarizing recent studies and clinical trials,this review highlights the comparative effectiveness,safety,and integration with systemic therapies of MWA.In conclusion,MWA is a promising treatment option for CRLM and offers outcomes comparable to or better than those of other ablative techniques.Future research should focus on optimizing technical parameters,integrating MWA with systemic therapies,and conducting large-scale randomized controlled trials to establish standardized treatment protocols.Advancing our understanding of MWA will enhance its application and improve long-term survival and quality of life for patients with CRLM.
基金Supported by National Natural Science Foundation of China,No.82027803 and No.81971623Key Research and Development Project of Zhejiang Province,No.2024C03092.
文摘BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chemotherapy failure remains underexplored.AIM To assess long-term survival and factors affecting outcomes of RFA in patients with multiple refractory CRLM.METHODS A retrospective study was conducted on patients who underwent ablation of CRLM at our institution between January 2015 and June 2024.A total of 80 patients were included,with 42 individuals receiving single-session ablation and 38 underwent repeat ablation.Enhanced computed tomography imaging was utilized to evaluate procedural efficacy 24 hours post-RFA,followed by follow-up scans every 3-4 months.Progression-free survival(PFS)and overall survival(OS)rates were compared at endpoint using Kaplan-Meier curves.Cox regression was used to identify the factors associated with OS and PFS.RESULTS The technical success rate was recorded at 98.7%.At endpoint,42(52.5%)patients achieved tumor-free survival,while 28(35%)remained alive with residual tumors present.No significant OS/PFS differences existed between single-session(median follow-up 29.5 months,median PFS 24.5 months)and repeat ablation(30 months,14 months)cohorts(P>0.05).Multivariate analysis showed that larger tumor size(P<0.001)and older age(P=0.01)were associated with worse OS.The median PFS was 13.5 months,with tumor size emerging as the only independent predictor(P=0.04).CONCLUSION For patients with multiple refractory CRLM,both single-session ablation and repeat ablation can increase the proportion of patients achieving tumor-free status.However,careful consideration is necessary for ablation of metastases larger than 2.7 cm.
基金supported by the 2024 University Scientific Research Project of Guangzhou Education Bureau(Project No.24312286Certificate No.gd20249983112).
文摘Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.
基金supported by the Key Program of the National Natural Science Foundation of China(No.52032003)the Major Program of the National Natural Science Foundation of China(No.52293372)+2 种基金the National Natural Science Foundation of China(No.51972082)the National Natural Science Foundation of China(No.52102093)the National Natural Science Foundation of China(No.52172041)and the science foundation of national key laboratory of science and technology on advanced composites in special environments.
文摘The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which hampers their conversion into boride-based ultrahigh temperature ceramics.To tackle these challenges,a serious of pioneering liquid multi-component hafnium-containing ceramic SiHfCB precursors(with different Hf/Si ratios)have been developed.These novel precursors are featured with stable molec-ular structure and high ceramic yield which were successfully created through a novel one-pot polymer-ization process.They present in liquid form and their structure is characterized by C-C bonds forming its main chain with branched chains of O-Si-O,Si-O-Hf,Si-O-B,and B-O-Hf which have untapped advantages including uniform component dispersion,and excellent fluidity.The ceramic yield of SiHfCB precursor with Hf/Si of 0.2 is remarkably up to 68.6 wt.%at 1500℃,and their Hf content exceeded 50 wt.%.Of particular interest,the pyrolyzed product HfB_(2)-SiC nanopowders derived from the SiHfCB precursor with Hf/Si of 0.2,consist of nanopowders in the 40-60 nm range with a density of 5.23 g cm^(−3).Remarkably,this material demonstrates exceptional performance in ultrahigh temperature oxygen-containing environ-ments at 2500℃,showing near-zero ablation with a linear ablation rate of just 2.5×10^(−4) mm s^(−1).Post-ablation analysis of the microstructure reveals that the formation of a lava-like HfO_(2) and HfO_(2)-SiO_(2) oxide layer effectively blocks oxygen penetration and provides excellent oxidation resistance.The inno-vative SiHfCB hafnium-containing ceramic precursor offers a groundbreaking solution for the preparation of lightweight ultrahigh-temperature ceramics.This development is poised to provide robust technical support for the use of ultrahigh temperature ceramics in non-ablative thermal protective systems,partic-ularly in the construction of hypersonic vehicles,where ultrahigh temperature resilience is crucial.
基金supported by the National Major Scientific Instruments and Equipment Development Project Funded by the National Natural Science Foundation of China(81827803)the Jiangsu Province Key Research and Development Program(Social Development)Project(BE2020705).
文摘Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which is prone to either inadequate or excessive ablation.This paper aims to establish an ablation prediction model that guides MWA tumor surgical planning.Methods:An MWA process was first simulated by incorporating electromagnetic radiation equations,thermal equations,and optimized biological tissue parameters(dynamic dielectric and thermophysical parameters).The temperature distributions(the short/long diameters,and the total volume of the ablation zone)were then generated and verified by 60 cases ex vivo porcine liver experiments.Subsequently,a series of data were obtained from the simulated temperature distributions and to further fit the novel ablation coagulated area prediction model(ACAPM),thus rendering the ablation-dose table for the guiding surgical plan.The MWA clinical patient data and clinical devices suggested data were used to validate the accuracy and practicability of the established predicted model.Results:The 60 cases ex vivo porcine liver experiments demonstrated the accuracy of the simulated temperature distributions.Compared to traditional simulation methods,our approach reduces the long-diameter error of the ablation zone from 1.1 cm to 0.29 cm,achieving a 74%reduction in error.Further,the clinical data including the patients'operation results and devices provided values were consistent well with our predicated data,indicating the great potential of ACAPM to assist preoperative planning.
文摘Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how quickly the diagnosis is made. Chemotherapy and radiotherapy can be both used in cases of nonresectable pancreatic cancer. In cases of pancreatic neoplasm that is locally advanced, non-resectable, but non-metastatic, it is possible to apply percutaneous treatments that are able to induce tumor cytoreduction. The aim of this article will be to describe the multiple currently available treatment techniques(radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation), their results, and their possible complications, with the aid of a literature review.
文摘Many studies suggest that combined multimodality treatments including ablative therapies may achieve better outcomes than systemic chemotherapy alone in patients with colorectal liver metastases. Nevertheless, ablative therapies are not yet considered as effective options because their efficacy has never been proved by randomized controlled trials (RCT). However, there are in literature no trials that failed in demonstrating the effectiveness of ablative treatments: what are lacking, are the trials. All the attempts to organize phase III studies on this topic failed as a result of non accrual. Just one prospective RCT comparing radiofrequency ablation combined with systemic chemotherapy vs chemotherapy alone has been published. It was designed as a phase III study, but it was closed early because of slow accrual, and was downscaled to phase II study, with the consequent limits in drawing definite conclusions on the benefit of combined treatment. However, the combination treatment met the primary end point of the study and obtained a significantly higher 3-year progression-free survival than systemic chemotherapy alone. It is very unlikely that ultimate efficacy of ablation treatments will ever be tested again, and the best available evidence points toward a benefit for the combination strategy using ablative treatments and chemotherapy.
基金Supported by the National Key Research and Development Program,No.2023YFF0713700 and No.2023YFF0713705Common Technology R&D Platform of Shaanxi Province,No.2023GXJS-01-1-2the Cyrus Tang Foundation Chung Ying Young Scholars Program.
文摘BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver disease(NAFLD).However,the specific metabolic contributions of DMA using IRE in NAFLD remain unclear.AIM To assess the feasibility and effectiveness of DMA using IRE in NAFLD rat models.METHODS Seven-week-old male Sprague-Dawley rats underwent DMA using IRE after 8 weeks on a high-fat diet.Two weeks post-treatment,duodenal and liver tissues and blood samples were collected.We evaluated differences in the duodenal wall structure,liver lipid deposition,enteroendocrine,claudin,and zonula ocludens-1 in the duodenal mucosa.RESULTS DMA using IRE could be safely performed in rats with NAFLD without duodenal bleeding,perforation,or stenosis.The duodenum healed well 2 weeks after DMA and was characterized by slimmer villi,narrower and shallower crypts,and thicker myenterons compared with the sham-control setting.Liver lipid deposition was reduced and serum lipid index parameters were considerably improved in the DMA setting.However,these improvements were independent of food intake and weight loss.In addition,enteroendocrine parameters,such as claudin,and zonula ocludens-1 levels in the duodenal mucosa,differed between the different settings in the DMA group.CONCLUSION By altering enteroendocrine and duodenal permeability,simple DMA using IRE ameliorated liver lipid deposition and improved serum lipid parameters in NAFLD rats.
基金supported by the National Key R&D Pro-gram of China(Grant No.2021YFA0715803)the National Natural Science Foundation of China(Grant Nos.52293373,52130205,and 52302091)+1 种基金the Joint Fund of Henan Province Science and Technol-ogy R&D Program(No.225200810002)the ND Basic Research Funds of Northwestern Polytechnical University(No.G2022WD).
文摘Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,and investigated their ablation behaviors under an oxyacetylene torch with a heat flux of 2.4 MW m^(-2).It was observed that the x=0.1 oxide scale bulged but was denser,and the x=0.2 oxide scale was blown away due to the formation of excessive liquid.Based on these findings,we further de-veloped a duplex(Hf-Zr-Ta)B_(2)coating that showed a linear recession rate close to zero(0.11μm s^(-1))after two 120-s ablation cycles.It is identified that the resulting oxide scale is mainly composed of(Hf,Zr)_(6)Ta_(2)O_(17)and(Hf,Zr,Ta)O_(2)by performing aberration-corrected(scanning)transmission electron microscopy.The protective mechanism is related to the peritectic transformation of orthorhombic-(Hf,Zr)_(6)Ta_(2)O_(17)to tetragonal-(Hf,Zr,Ta)O_(2)plus Ta-dominated liquid.This study contributes to the develop-ment of Ta-containing multicomponent UHTC bulk and coatings for ultra-high temperature applications.
文摘This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.
基金Open Fund of Zhijian Laboratory,Rocket Force University of Engineering(2024-ZJSYS-KF02-09)National Natural Science Foundation of China(51902028,52272034)+1 种基金Key Research and Development Program of Shaanxi(2023JBGS-15)Fundamental Research Funds for the Central Universities(Changan University,300102313202,300102312406)。
文摘To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composites using Zr_(2)Cu as the filler.The microstructure,mechanical properties,and ablation properties of the Zr_(2)Cu packed composites were analyzed.Results show that during Zr_(2)Cu impregnation,the melt efficiently fills the large pores of the composites and is converted to ZrCu due to a partial reaction of zirconium with carbon.This results in an increase in composite density from 1.91 g/cm^(3)to 2.24 g/cm^(3)and a reduction in open porosity by 27.35%.Additionally,the flexural strength of Zr_(2)Cu packed C/C-SiC-ZrC composites is improved from 122.78±8.09 MPa to 135.53±5.40 MPa.After plasma ablation for 20 s,the modified composites demonstrate superior ablative resistance compared to PIP C/C-SiC-ZrC,with mass ablation and linear ablation rates of 2.77×10^(−3)g/s and 2.60×10^(−3)mm/s,respectively.The“selftranspiration”effect of the low-melting point copper-containing phase absorbs the heat of the plasma flame,further reducing the ablation temperature and promoting the formation of refined ZrO_(2)particles within the SiO_(2)melting layer.This provides more stable erosion protection for Zr_(2)Cu packed C/C-SiC-ZrC composites.
文摘Ultraviolet nanoimprint lithography(UV-NIL)is a versatile and cost-effective technique for the fabrication of micro-and nanostructures by copying master patterns in a planar or a roll-to-roll process through curing of a liquid UV-sensitive precursor.For applications with a high pattern complexity,new UV-NIL process chains must be specified.Master fabrication is a challenging part of the development and often cannot be accomplished using a single master fabrication technique.Therefore,an approach combining different patterning fabrication techniques is developed here for polymer masters using laser direct writing and photolithography.The polymer masters produced in this way are molded into inverse silicone stamps that are used for roll-to-roll replication into an acrylate formulation.To fit the required roller size for large-area UV-NIL,several submasters with micrometer-sized dot and line gratings and prism arrays,which have been patterned by these different techniques,are assembled to final size of ~200×600 mm^(2) with an absolute precision of better than 50μm.The size of the submasters allows the use of standard laboratory equipment for patterning and direct writing,thus enabling the fabrication of micro-and even nanostructures when electron-beam writing is utilized.In this way,the effort,time,and costs for the fabrication of masters for UV-NIL processes are reduced,enabling further development for particular structures and applications.Using this approach,patterns fabricated with different laboratory tools are finally replicated by UV-NIL in an acrylate formulation,demonstrating the high quality of the whole process chain.
文摘Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.
基金Supported by National Clinical Key Specialty Major Research Project of Hunan Provincial Health Commission in 2023,No.Z2023165.
文摘BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic options.AIM To evaluate the role of laparoscopic ultrasound in resection and ablation of colorectal liver metastases(CRLM).METHODS Between June 2018 and June 2020,300 patients with CRC and liver metastases were admitted to our hospital.They were divided into two groups(150 cases each)based on treatment method:The control group(ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging)and the observation group[contrast-enhanced ultrasound with Sonazoid(S-CEUS)].RESULTS The study group demonstrated better efficacy(P<0.05),fewer adverse events(P<0.05),and better survival outcomes compared to the control group(1-year:80%vs 62%;3-year:54%vs 33%;5-year:32%vs 18%;median survival:48 months vs 30 months;hazard ratio=0.63,95%CI:0.48-0.83,P<0.001).Although Karnofsky Performance Status scores improved in both groups,the scores were significantly higher in the observation group(P<0.05).Multivariate analysis confirmed intraoperative S-CEUS and tumor differentiation as independent prognostic factors(P<0.05).CONCLUSION Laparoscopic ultrasound-guided resection/ablation improved outcomes in CRLM,reducing complications and enhancing survival.Intraoperative S-CEUS was an independent prognostic factor,supporting its clinical value.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.
文摘Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United States,over 73%were solid organ tumors.Ablative therapies offer minimally invasive solutions for malignant tissue destruction in situ,often with reduced cost and morbidity compared to surgical resection.This review examines the current Food and Drug Administration-approved locoregional ablative therapies(radiofrequency,microwave,cryogenic,high-intensity focused ultrasound,histotripsy)and their evolving role in cancer care.Data were collected through a comprehensive survey of the PubMed-inde-xed literature on tumor ablation techniques,their clinical indications,and outco-mes.Over time,emerging clinical data will help establish these therapies as the standard of care in solid organ tumor treatment,supported by improved long-term outcomes and progression-free survival.
基金supported by the Natural Science Foundation of China[grant numbers 52302093]Natural Science Foundation of Jiangxi Province[grant numbers 20224BAB204021].
文摘In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure these statistical correlations,impeding machine learning models from effectively capturing the underlying patterns,thereby hampering efficient optimization of material properties.This work presents a novel active learning framework that integrates generative adversarial networks(GAN)with a directionally constrained expected absolute improvement(EAI)acquisition function to accelerate the discovery of ultra-high temperature ceramics(UHTCs)using small data.The framework employs GAN for data augmentation,symbolic regression for feature weight derivation,and a self-developed EAI function that incorporates input feature importance weighting to quantify bidirectional deviations from zero ablation rate.Through only two iterations,this framework successfully identified the optimal composition of HfB_(2)-3.52SiC-5.23TaSi_(2),which exhibits robust near-zero ablation rates under plasma ablation at 2500℃ for 200 s,demonstrating superior sampling efficiency compared to conventional active learning approaches.Microstructural analysis reveals that the exceptional performance stems from the formation of a highly viscous HfO_(2)-SiO_(2)-Ta_(2)O_(5)-HfSiO_(4)-Hf_(3)(BO_(3))_(4) oxide layer,which provides effective oxygen barrier protection.This work demonstrates an efficient and universal approach for rapid materials discovery using small data.
文摘BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.
