AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clin...AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.展开更多
Introduction:Transcatheter arterial chemoembolization(TACE)plus thermal ablation has been widely used recently in the treatment of hepatocellular carcinoma(HCC).In this study,we aimed to compare results of the combina...Introduction:Transcatheter arterial chemoembolization(TACE)plus thermal ablation has been widely used recently in the treatment of hepatocellular carcinoma(HCC).In this study,we aimed to compare results of the combination of TACE and percutaneous thermal ablation with those of hepatectomy in patients with HCC.Methods:The clinical data of 137 HCC patients who sequentially received TACE and computed tomography(CT)-guided percutaneous thermal ablation as an initial curative treatment(combination group)and 148 matched HCC patients who received hepatectomy(surgery group)between 2004 and 2011 were collected and analyzed.After TACE,multiphase contrast-enhanced CT was performed to identify the total number of tumors as well as lipiodol deposition in the liver.Survival was calculated by using the Kaplan-Meier method and compared by using the log-rank test.The prognostic factors were assessed with multivariate Cox proportional hazards regression analysis.Results:Of all 285 patients,225(79.0%)had cancerous lesions≤5 cm in diameter.In preoperative contrast-enhanced CT or magnetic resonance imaging,the number of tumors was 1–4 for each patient.The 1-,3-,and 5-year overall survival rates were 95,74%,and 67%in the combination group and 88,66,and 47%in the surgery group,respectively(P=0.004);the corresponding recurrence-free survival rates for the two groups were 92,69,and 61%and 75,58,and44%,respectively(P=0.001).In the multivariate analysis,treatment allocation was an independent prognostic factor for survival.Only 60 patients in the combination group had sufficient imaging data,and 135 new lesions with lipiodol deposition were diagnosed as malignancies in 22 of 60 patients,whereas 20 new lesions were found in 11 of 148patients in the surgery group.Conclusion:The combination of TACE and CT-guided percutaneous thermal ablation for HCC improves survival of HCC patients compared with hepatectomy.展开更多
Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided ...Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided into groups according to their assigned surgical plans.The control group was treated with TACE alone,and the observation group was treated with TACE+CT-guided MWA.The efficacy of the treatment and the liver function indicators and follow-up results of the patients of the two groups were compared.Results:The efficacy of the treatment received by the observation group was higher than that of the control group.Besides,the patients in the observation group exhibited better improvement in liver function indicators after 3 months of treatment.Furthermore,the survival rates of 1 and 2 years after surgery of the observation group were all higher than those of the control group(P<0.05).Conclusion:TACE combined with CT-guided MWA is more effective in treating primary liver cancer compared to TACE alone.Besides,it resulted in better improvement of liver function and long-term survival rate.Therefore,this treatment regime should be popularized.展开更多
The survival of most patients with both unresectable hepatic and pulmonary metastases of colorectal cancer is poor. In this retrospective study, we investigated the efficacy of computed tomography(CT)-guided radiofreq...The survival of most patients with both unresectable hepatic and pulmonary metastases of colorectal cancer is poor. In this retrospective study, we investigated the efficacy of computed tomography(CT)-guided radiofrequency ablation(RFA) and systemic chemotherapy plus hepatic artery infusion of floxuridine(HAIFUDR). Sixty-one patients were selected from 1,136 patients with pulmonary and hepatic metastases from colorectal cancer. Patients were treated with RFA and systemic chemotherapy plus HAI-FUDR(ablation group, n = 39) or systemic chemotherapy plus HAI-FUDR(FUDR group, n = 22). Patients in the two groups were matched by sex, age, number of metastases, and calendar year of RFA or FUDR. Survival data were evaluated by using univariate and multivariate analyses. Clinical characteristics were comparable between the two groups. All patients in the ablation group underwent RFA and chemotherapy. Median follow-up was 56.8 months. The 1-, 3-, and 5-year overall survival(OS) rates were 97%, 64%, and 37%, respectively, for the ablation group, and 82%, 32%, and 19%, respectively, for the FUDR group. The 1-, 3-, and 5-year survival rates after metastasis were 97%, 49%, and 26% for the ablation group, and 72%, 24%, and 24% for the FUDR group, respectively. The median OS times were 45 and 25 months for the ablation and FUDR groups, respectively. In the multivariate analysis, treatment allocation was a favorable independent prognostic factor for OS(P = 0.001) and survival after metastasis(P = 0.009). These data suggest that the addition of RFA to systemic chemotherapy plus HAI-FUDR improves the survival of patients with both unresectable hepatic and pulmonary metastases from colorectal cancer.展开更多
Radiofrequency ablation(RFA),particularly endoscopic ultrasound-guided RFA(EUS-RFA),has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer,especially in patients with locally adv...Radiofrequency ablation(RFA),particularly endoscopic ultrasound-guided RFA(EUS-RFA),has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer,especially in patients with locally advanced or unresectable disease.This review outlines recent technological developments in EUS-RFA,including innovations in energy delivery systems,probe design,and real-time thermal monitoring,which have improved the precision and safety of the procedure.Clinical studies combining EUS-RFA with chemotherapy have demonstrated encouraging outcomes,with improvements in overall survival,progression-free survival,tumor necrosis,and symptom control compared to chemotherapy alone.Additionally,RFA-induced tumor antigen release and modulation of the tumor microenvironment suggest a potential synergistic role with immunotherapy.Despite its promise,the widespread adoption of EUS-RFA is limited by a lack of large-scale randomized controlled trials and standardized treatment protocols.展开更多
BACKGROUND Data comparing the outcomes of hepatocellular carcinoma(HCC)ablation by multibipolar radiofrequency ablation(mbp-RFA)and microwave ablation(MWA)are lacking.This study compares safety and efficacy of the two...BACKGROUND Data comparing the outcomes of hepatocellular carcinoma(HCC)ablation by multibipolar radiofrequency ablation(mbp-RFA)and microwave ablation(MWA)are lacking.This study compares safety and efficacy of the two techniques in treatment-naive HCC.AIM To compare the risk of local tumor progression(LTP)according to the technique;secondary endpoints included technique efficacy rate at one-month,overall survival and major complication rate.METHODS A bi-institutional retrospective analysis of patients undergoing treatment-naive HCC ablation by either technique was performed.Inverse probability of treatment weighting was used to compare the two groups.Mixed effects multivariate Cox regression was applied to identify risk factors for LTP.RESULTS A total of 362 patients(mean age,66.1±6.2 years,308 men)were included,of which 242(323 tumors)treated by mbp-RFA and 120(168 tumors)by MWA.After a median follow-up of 27 months,cumulative LTP was 11.4%after mbp-RFA and 25.2%after MWA.Independent risk factors for LTP at multivariate analysis were MWA(hazard ratio=2.85,P<0.001)and tumor size(hazard ratio=1.08,P<0.001).Two-year LTP-free survival was higher after mbp-RFA than MWA regardless of size(<3 cm:96%vs 87.1%,P<0.01;≥3 cm:87.5%vs 74%,P=0.04).Technique efficacy rate was higher after mbp-RFA(94.1%vs 87.5%,P=0.01).No difference was observed in major complication rate(9.5%vs 7.5%,P=0.59),nor 5-year overall survival(63.6%vs 58.3%,P=0.33).CONCLUSION Mbp-RFA leads to better local tumor control of treatment-naïve HCC than MWA regardless of tumor size and has better primary efficacy,while maintaining a comparable safety profile.展开更多
Alkali metal thermochemical ablation is a promising anti-tumor therapy in which tumor tissue can be efficiently destroyed via both heat and hydroxyl ions released from the chemical reaction in tissue between an alkali...Alkali metal thermochemical ablation is a promising anti-tumor therapy in which tumor tissue can be efficiently destroyed via both heat and hydroxyl ions released from the chemical reaction in tissue between an alkali metal and water. Encouraging results have been reported from in vitro and in vivo trials in a previous study. However, the precise process of heat and mass transfer triggered by the above thermochemical reaction in tumor tissue has still remained confusing. Here, to better understand the temperature and p H responses of tumor tissue subject to alkali metal therapy, a theoretical model coupling temperature and concentration field is developed for characterizing the physicochemical reaction and the transport process occurring around the inserted sodium capsule during treatment. Preliminary experiments in tumor tissue are performed to validate the theoretical predictions of temperature, and the results indicate that the bioheat transfer model can predict the temperature responses in the tissues heated by the sodium capsule very well. Furthermore, comprehensive parametric studies are performed to evaluate the effects of either physiological or physicochemical parameters, including ablation time, time lags, and blood perfusion rate. Based on the numerical results, useful instructions are suggested for planning alkali metal tumor ablation treatment.展开更多
Microwave ablation(MWA)is a minimally invasive technique for treating hepatic tumors,necessitating precise monitoring to ensure treatment efficacy and minimize damage to surrounding tissues.This study explores the pot...Microwave ablation(MWA)is a minimally invasive technique for treating hepatic tumors,necessitating precise monitoring to ensure treatment efficacy and minimize damage to surrounding tissues.This study explores the potential of photoacoustic imaging(PAI)in monitoring MWA by examining ex vivo porcine liver tissues.In this study,a comprehensive analysis of photoacoustic signals was performed to compare the main lobe width(MLW)between ablated and normal regions in porcine liver tissue.Histological staining with succinate dehydrogenase(SDH)and shear wave elastography(SWE)were employed to validate the changes in tissue elasticity after ablation.The analysis demonstrated a notable reduction in the MLW of the average A-lines in ablated tissues compared to nonablated regions(p<0.01).This reduction,attributed to increased tissue density and enhanced elasticity,indicates accelerated sound propagation in thermally ablated areas,which then serves as a critical parameter for mapping tissue characteristics.The reconstruction of the MLW distribution successfully delineated the ablated regions,and was consistent with the results of SDH staining and SWE.In addition,MLW-based imaging exhibited higher spatial resolution compared to SWE.Incorporating MLW analysis into PAI may be a promising strategy to improve the accuracy and effectiveness of MWA monitoring in clinical settings.展开更多
Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by ...Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by Hu et al,which evaluated the survival outcomes of patients with metastatic CRC who received image-guided thermal ablation(IGTA).These findings provide valuable clinical evidence supporting IGTA as a feasible,minimally invasive approach and underscore the prognostic significance of metastatic distribution.However,the study by Hu et al has several limitations,including that not all pulmonary lesions were pathologically confirmed,postoperative follow-up mainly relied on dynamic contrast-enhanced computed tomography,no comparative analysis was performed with other local treatments,and the impact of other imaging features on efficacy and prognosis was not evaluated.Future studies should include complete pathological confirmation,integrate functional imaging and radiomics,and use prospective multicenter collaboration to optimize patient selection standards for IGTA treatment,strengthen its clinical evidence base,and ultimately promote individualized decision-making for patients with metastatic CRC.展开更多
This paper focused on a simplified method for solving the hybrid robot kinematics in CT-guided （computerized tomography, CT） surgery. By position constraint introduced, the hybrid robot can be transformed as a redun...This paper focused on a simplified method for solving the hybrid robot kinematics in CT-guided （computerized tomography, CT） surgery. By position constraint introduced, the hybrid robot can be transformed as a redundant serial 7-DOF robot. The forward displacement calculation was developed based on the product-of-exponential formula （POE）. Because of the kinematics complexity of the hybrid and redundant robot, the combination technique of Ulrich two-step iteration method and paul variables detachment method （UTI-PVD） was introduced to fulfill the inverse kinematics of redundant robot, the novelty of which lay in the flexibility of various robots structures and in high calculation efficiency for realtime control. The process of solving the inverse displacement was analyzed. The UTI-PVD method can be applicable to kinematics of many robots, especially for redundant robots with more than 6DOF. The kinematics simulation was provided, and robot dexterity analysis was presented. The results indicated that the hybrid robot could implement the minimally invasive CT-guided surgery.展开更多
Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was...Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was performed in 26 patients. Histopathological diagnosis was obtained and accuracy was calculated. Two blinded radiologists determined feasibility of biopsy procedures on routine CT-guidance, and compared accessibility of target lesions using contrast-enhanced and non-contrast-enhanced CT. Results: Satisfactory samples were obtained in all 26 patients and pathological diagnosis was made in 24. Accuracy was 95.5%. Routine CT-guided biopsy punctures were not satisfaction in 4/26 patients, and contrast-enhanced CT scans rendered the target lesions more accessible in 16 patients. Conclusion: Contrast-enhanced CT-guided biopsy increases the feasibility of biopsy of retroperitoneal masses.展开更多
Objectives: The aim of this study was to assess the safety and efficacy of percutaneous CT-guided drainage of gastric leaks post sleeve gastrectomy. Methods: For this single-center retrospective study, we reviewed the...Objectives: The aim of this study was to assess the safety and efficacy of percutaneous CT-guided drainage of gastric leaks post sleeve gastrectomy. Methods: For this single-center retrospective study, we reviewed the clinical data of 78 patients (44 men and 34 women with an average age of 34.6 ±10.5 years and a body mass index (BMI) of 45 kg/m2 ±3.2) that underwent percutaneous CT-guided drainage of gastric leaks due to sleeve gastrectomy from September 2011 to September 2018. The outcome measurements were technical and clinical success, complications, and the need for revisional surgery. Results: The technical success rate of drain insertion was 97.5% (76/78 patients). All of the patients (76/76 patients) exhibited early clinical and laboratory improvement, and no emergency surgery was required. However, six patients underwent revisional surgery after 3 - 5 months for non-healing gastric leaks/fistulas. One patient had a major complication of active bleeding due to arterial injury;this was managed by transcatheter coil embolization. All patients underwent endoluminal stent placement and received antimicrobial therapy and nutritional support. Conclusion: Percutaneous CT-guided drainage of gastric leaks after sleeve gastrectomy is a safe, effective, and minimally invasive alternative to surgery. This technique is in line with other conservative measures (endoluminal stent placement, antimicrobial therapy, and nutritional support), which heal most gastric leaks due to sleeve gastrectomy and prevent the need for revisional surgery.展开更多
Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patie...Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.展开更多
Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried ou...Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried out between 2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patient demographics, lung lesions, and biopsy procedures. ResultsA total of 281 biopsy procedures were enrolled. The total complication rate was 55.9% with pneumothorax 32.4% (91/281) and bleeding 34.5% (97/281). The risk factors affecting pneumothorax rate were lesion location, lesion depth, and time of pleural pierce; and the risk factors affecting bleeding complications were lesion depth, lesion size, and age. Predictive models for pneumothorax and bleeding were established by logistic regression. The pneumothorax model had a sensitivity of 80.0% with a specificity of 62.4%,and the bleeding model had a sensitivity of 67.4% with a specificity of 88.8%. ConclusionLesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factor for bleeding. The predictive models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.展开更多
Purpose: To evaluate a new miniature optical navigation system for CT-guided liver interventions. Material and Methods: A two-center, prospective study was performed with four interventional radiologists. A total of 2...Purpose: To evaluate a new miniature optical navigation system for CT-guided liver interventions. Material and Methods: A two-center, prospective study was performed with four interventional radiologists. A total of 20 patients had CT-guided liver biopsy or ablation interventions utilizing the CT-Guide? navigation system (ActiViews Inc., Wakefield, MA) between July 2011 and December 2011. The navigation system consists of a self-adhesive patientsticker printed with coincident colored and radio-opaque reference markers, a miniature disposable video camera that clips on and off an interventional instrument, and software loaded on a computer to display the navigation information. The primary end point was the frequency of a satisfactory instrument position for the intended intervention. Results: The cohort consisted of 13 males and 7 females with an average age of 63.1 years (range of 38 to 80). Most of the patients, 70%, underwent CT-guided liver biopsy while the remainder had CT-guided ablation therapy. The average lesion size was 3.1 cm (range of 1.1 - 6.9 cm). All of the interventions, regardless of lesion size, met the primary end point of satisfactory instrument positioning. There were no device-related or unexpected adverse events recorded. Only one patient had a mild adverse event and it resolved without intervention. Conclusions: This study demonstrated the safety and effectiveness of the CT-Guide? navigation system for CT-guided liver interventions, for both biopsies and ablations. The targeting success rate for a satisfactory intervention was 100% with the system.展开更多
AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. A...AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9(ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's gender.RESULTS The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease(OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men(OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection(OR = 1.31, P < 0.001) or an ablation(OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization(TACE).CONCLUSION Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.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
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
BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invas...BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques,such as transcatheter arterial chemoembolization(TACE)and microwave ablation(MWA).AIM To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.METHODS This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024.Eighty-two patients with hepatic hemangiomas>5 cm were divided into two groups:Observation(TACE+MWA,n=50)and control(TACE,n=32).Tumor diameter and treatment outcomes were evaluated at baseline,12 months,and>3 years.Appropriate statistical tests were chosen based on the type and distribution of the data.RESULTS At baseline,the median tumor diameter was 8.3(range:5.0-19.2)cm in the observation group and 8.5(range:5.0-20.0)cm in the control group.The median follow up duration was 44.6(95%confidence interval:36.7-52.5)months.At 12 months post-treatment,the observation group demonstrated a higher tumor reduction ratio compared to the control group(50.98%vs 23.28%,respectively;P<0.001).The objective response rate was 93.94%in the observation group,which was significantly higher than that in the control group(33.33%)(P<0.001).No recurrence occurred in the observation group,while one case occurred in the control group.Notably,no cases of hemoglobinuria or acute kidney injury were reported in the observation group.CONCLUSION Combination treatment enhances tumor shrinkage,promotes long-term tumor control,and reduces the complications associated with MWA,thereby presenting a promising alternative to surgical resection.展开更多
Carbon Carbon(C/C)composites in thermal-protection system are exposed to severe thermochemical ablation and mechanical erosion,and their thermal-protection performance is of vital importance to the structural safety a...Carbon Carbon(C/C)composites in thermal-protection system are exposed to severe thermochemical ablation and mechanical erosion,and their thermal-protection performance is of vital importance to the structural safety and flight status of hypersonic vehicles.We numerically analyzes the mesoscopic ablation-erosion of C/C Composites with Inclined Fibers(CCIF).First,a thermochemical ablation model describing the reaction-diffusion coupled problem of C/C composites on mesoscale is employed to analyze ablative process,and the corresponding surface ablation morphology is obtained.Then,the ablation morphology of CCIF is taken as the geometrical model for mechanical erosion analysis,and their damage and failure behavior under high-speed airflow shear is analyzed by using progressive damage method.Moreover,the effects of fiber inclined angle and airflow direction on the mechanical erosion of CCIF are investigated,and the ablationerosion behavior is analyzed and discussed.The results show that the failure modes of mechanical erosion in inner and edge regions are obviously different,showing granular and block erosion phenomena respectively.The mechanical erosion of CCIF in the direction of reverse flow is easier than that in the direction of forward flow.These results can provide a theoretical basis for the design and optimization of thermal protection system materials.展开更多
文摘AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.
文摘Introduction:Transcatheter arterial chemoembolization(TACE)plus thermal ablation has been widely used recently in the treatment of hepatocellular carcinoma(HCC).In this study,we aimed to compare results of the combination of TACE and percutaneous thermal ablation with those of hepatectomy in patients with HCC.Methods:The clinical data of 137 HCC patients who sequentially received TACE and computed tomography(CT)-guided percutaneous thermal ablation as an initial curative treatment(combination group)and 148 matched HCC patients who received hepatectomy(surgery group)between 2004 and 2011 were collected and analyzed.After TACE,multiphase contrast-enhanced CT was performed to identify the total number of tumors as well as lipiodol deposition in the liver.Survival was calculated by using the Kaplan-Meier method and compared by using the log-rank test.The prognostic factors were assessed with multivariate Cox proportional hazards regression analysis.Results:Of all 285 patients,225(79.0%)had cancerous lesions≤5 cm in diameter.In preoperative contrast-enhanced CT or magnetic resonance imaging,the number of tumors was 1–4 for each patient.The 1-,3-,and 5-year overall survival rates were 95,74%,and 67%in the combination group and 88,66,and 47%in the surgery group,respectively(P=0.004);the corresponding recurrence-free survival rates for the two groups were 92,69,and 61%and 75,58,and44%,respectively(P=0.001).In the multivariate analysis,treatment allocation was an independent prognostic factor for survival.Only 60 patients in the combination group had sufficient imaging data,and 135 new lesions with lipiodol deposition were diagnosed as malignancies in 22 of 60 patients,whereas 20 new lesions were found in 11 of 148patients in the surgery group.Conclusion:The combination of TACE and CT-guided percutaneous thermal ablation for HCC improves survival of HCC patients compared with hepatectomy.
文摘Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided into groups according to their assigned surgical plans.The control group was treated with TACE alone,and the observation group was treated with TACE+CT-guided MWA.The efficacy of the treatment and the liver function indicators and follow-up results of the patients of the two groups were compared.Results:The efficacy of the treatment received by the observation group was higher than that of the control group.Besides,the patients in the observation group exhibited better improvement in liver function indicators after 3 months of treatment.Furthermore,the survival rates of 1 and 2 years after surgery of the observation group were all higher than those of the control group(P<0.05).Conclusion:TACE combined with CT-guided MWA is more effective in treating primary liver cancer compared to TACE alone.Besides,it resulted in better improvement of liver function and long-term survival rate.Therefore,this treatment regime should be popularized.
基金supported by a grant from the National High Technology Research and Development Program (863 Program), P. R. China (No. 2012AA022701)
文摘The survival of most patients with both unresectable hepatic and pulmonary metastases of colorectal cancer is poor. In this retrospective study, we investigated the efficacy of computed tomography(CT)-guided radiofrequency ablation(RFA) and systemic chemotherapy plus hepatic artery infusion of floxuridine(HAIFUDR). Sixty-one patients were selected from 1,136 patients with pulmonary and hepatic metastases from colorectal cancer. Patients were treated with RFA and systemic chemotherapy plus HAI-FUDR(ablation group, n = 39) or systemic chemotherapy plus HAI-FUDR(FUDR group, n = 22). Patients in the two groups were matched by sex, age, number of metastases, and calendar year of RFA or FUDR. Survival data were evaluated by using univariate and multivariate analyses. Clinical characteristics were comparable between the two groups. All patients in the ablation group underwent RFA and chemotherapy. Median follow-up was 56.8 months. The 1-, 3-, and 5-year overall survival(OS) rates were 97%, 64%, and 37%, respectively, for the ablation group, and 82%, 32%, and 19%, respectively, for the FUDR group. The 1-, 3-, and 5-year survival rates after metastasis were 97%, 49%, and 26% for the ablation group, and 72%, 24%, and 24% for the FUDR group, respectively. The median OS times were 45 and 25 months for the ablation and FUDR groups, respectively. In the multivariate analysis, treatment allocation was a favorable independent prognostic factor for OS(P = 0.001) and survival after metastasis(P = 0.009). These data suggest that the addition of RFA to systemic chemotherapy plus HAI-FUDR improves the survival of patients with both unresectable hepatic and pulmonary metastases from colorectal cancer.
文摘Radiofrequency ablation(RFA),particularly endoscopic ultrasound-guided RFA(EUS-RFA),has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer,especially in patients with locally advanced or unresectable disease.This review outlines recent technological developments in EUS-RFA,including innovations in energy delivery systems,probe design,and real-time thermal monitoring,which have improved the precision and safety of the procedure.Clinical studies combining EUS-RFA with chemotherapy have demonstrated encouraging outcomes,with improvements in overall survival,progression-free survival,tumor necrosis,and symptom control compared to chemotherapy alone.Additionally,RFA-induced tumor antigen release and modulation of the tumor microenvironment suggest a potential synergistic role with immunotherapy.Despite its promise,the widespread adoption of EUS-RFA is limited by a lack of large-scale randomized controlled trials and standardized treatment protocols.
文摘BACKGROUND Data comparing the outcomes of hepatocellular carcinoma(HCC)ablation by multibipolar radiofrequency ablation(mbp-RFA)and microwave ablation(MWA)are lacking.This study compares safety and efficacy of the two techniques in treatment-naive HCC.AIM To compare the risk of local tumor progression(LTP)according to the technique;secondary endpoints included technique efficacy rate at one-month,overall survival and major complication rate.METHODS A bi-institutional retrospective analysis of patients undergoing treatment-naive HCC ablation by either technique was performed.Inverse probability of treatment weighting was used to compare the two groups.Mixed effects multivariate Cox regression was applied to identify risk factors for LTP.RESULTS A total of 362 patients(mean age,66.1±6.2 years,308 men)were included,of which 242(323 tumors)treated by mbp-RFA and 120(168 tumors)by MWA.After a median follow-up of 27 months,cumulative LTP was 11.4%after mbp-RFA and 25.2%after MWA.Independent risk factors for LTP at multivariate analysis were MWA(hazard ratio=2.85,P<0.001)and tumor size(hazard ratio=1.08,P<0.001).Two-year LTP-free survival was higher after mbp-RFA than MWA regardless of size(<3 cm:96%vs 87.1%,P<0.01;≥3 cm:87.5%vs 74%,P=0.04).Technique efficacy rate was higher after mbp-RFA(94.1%vs 87.5%,P=0.01).No difference was observed in major complication rate(9.5%vs 7.5%,P=0.59),nor 5-year overall survival(63.6%vs 58.3%,P=0.33).CONCLUSION Mbp-RFA leads to better local tumor control of treatment-naïve HCC than MWA regardless of tumor size and has better primary efficacy,while maintaining a comparable safety profile.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant No.XDB1030000)the Beijing United Fund (Grant No.L252063)。
文摘Alkali metal thermochemical ablation is a promising anti-tumor therapy in which tumor tissue can be efficiently destroyed via both heat and hydroxyl ions released from the chemical reaction in tissue between an alkali metal and water. Encouraging results have been reported from in vitro and in vivo trials in a previous study. However, the precise process of heat and mass transfer triggered by the above thermochemical reaction in tumor tissue has still remained confusing. Here, to better understand the temperature and p H responses of tumor tissue subject to alkali metal therapy, a theoretical model coupling temperature and concentration field is developed for characterizing the physicochemical reaction and the transport process occurring around the inserted sodium capsule during treatment. Preliminary experiments in tumor tissue are performed to validate the theoretical predictions of temperature, and the results indicate that the bioheat transfer model can predict the temperature responses in the tissues heated by the sodium capsule very well. Furthermore, comprehensive parametric studies are performed to evaluate the effects of either physiological or physicochemical parameters, including ablation time, time lags, and blood perfusion rate. Based on the numerical results, useful instructions are suggested for planning alkali metal tumor ablation treatment.
基金supported by the National Natural Science Foundation of China(82427808,61875085)the Jiangsu Provincial University Natural Science Foundation(25KJB413004)+1 种基金the Nanjing Health Science and Technology Development Foundation(ZKX24043)the Fundamental Research Funds for the Central Universities(NJ2024029).
文摘Microwave ablation(MWA)is a minimally invasive technique for treating hepatic tumors,necessitating precise monitoring to ensure treatment efficacy and minimize damage to surrounding tissues.This study explores the potential of photoacoustic imaging(PAI)in monitoring MWA by examining ex vivo porcine liver tissues.In this study,a comprehensive analysis of photoacoustic signals was performed to compare the main lobe width(MLW)between ablated and normal regions in porcine liver tissue.Histological staining with succinate dehydrogenase(SDH)and shear wave elastography(SWE)were employed to validate the changes in tissue elasticity after ablation.The analysis demonstrated a notable reduction in the MLW of the average A-lines in ablated tissues compared to nonablated regions(p<0.01).This reduction,attributed to increased tissue density and enhanced elasticity,indicates accelerated sound propagation in thermally ablated areas,which then serves as a critical parameter for mapping tissue characteristics.The reconstruction of the MLW distribution successfully delineated the ablated regions,and was consistent with the results of SDH staining and SWE.In addition,MLW-based imaging exhibited higher spatial resolution compared to SWE.Incorporating MLW analysis into PAI may be a promising strategy to improve the accuracy and effectiveness of MWA monitoring in clinical settings.
文摘Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by Hu et al,which evaluated the survival outcomes of patients with metastatic CRC who received image-guided thermal ablation(IGTA).These findings provide valuable clinical evidence supporting IGTA as a feasible,minimally invasive approach and underscore the prognostic significance of metastatic distribution.However,the study by Hu et al has several limitations,including that not all pulmonary lesions were pathologically confirmed,postoperative follow-up mainly relied on dynamic contrast-enhanced computed tomography,no comparative analysis was performed with other local treatments,and the impact of other imaging features on efficacy and prognosis was not evaluated.Future studies should include complete pathological confirmation,integrate functional imaging and radiomics,and use prospective multicenter collaboration to optimize patient selection standards for IGTA treatment,strengthen its clinical evidence base,and ultimately promote individualized decision-making for patients with metastatic CRC.
基金Sponsored by the International Cooperation Project from the Ministry of Science and Technology of China ( No. 2006DFA12290)Project of Natural Science Fund of China (No. 60705033)Studying abroad and Homecoming Fund from the Ministry of Education
文摘This paper focused on a simplified method for solving the hybrid robot kinematics in CT-guided （computerized tomography, CT） surgery. By position constraint introduced, the hybrid robot can be transformed as a redundant serial 7-DOF robot. The forward displacement calculation was developed based on the product-of-exponential formula （POE）. Because of the kinematics complexity of the hybrid and redundant robot, the combination technique of Ulrich two-step iteration method and paul variables detachment method （UTI-PVD） was introduced to fulfill the inverse kinematics of redundant robot, the novelty of which lay in the flexibility of various robots structures and in high calculation efficiency for realtime control. The process of solving the inverse displacement was analyzed. The UTI-PVD method can be applicable to kinematics of many robots, especially for redundant robots with more than 6DOF. The kinematics simulation was provided, and robot dexterity analysis was presented. The results indicated that the hybrid robot could implement the minimally invasive CT-guided surgery.
文摘Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was performed in 26 patients. Histopathological diagnosis was obtained and accuracy was calculated. Two blinded radiologists determined feasibility of biopsy procedures on routine CT-guidance, and compared accessibility of target lesions using contrast-enhanced and non-contrast-enhanced CT. Results: Satisfactory samples were obtained in all 26 patients and pathological diagnosis was made in 24. Accuracy was 95.5%. Routine CT-guided biopsy punctures were not satisfaction in 4/26 patients, and contrast-enhanced CT scans rendered the target lesions more accessible in 16 patients. Conclusion: Contrast-enhanced CT-guided biopsy increases the feasibility of biopsy of retroperitoneal masses.
文摘Objectives: The aim of this study was to assess the safety and efficacy of percutaneous CT-guided drainage of gastric leaks post sleeve gastrectomy. Methods: For this single-center retrospective study, we reviewed the clinical data of 78 patients (44 men and 34 women with an average age of 34.6 ±10.5 years and a body mass index (BMI) of 45 kg/m2 ±3.2) that underwent percutaneous CT-guided drainage of gastric leaks due to sleeve gastrectomy from September 2011 to September 2018. The outcome measurements were technical and clinical success, complications, and the need for revisional surgery. Results: The technical success rate of drain insertion was 97.5% (76/78 patients). All of the patients (76/76 patients) exhibited early clinical and laboratory improvement, and no emergency surgery was required. However, six patients underwent revisional surgery after 3 - 5 months for non-healing gastric leaks/fistulas. One patient had a major complication of active bleeding due to arterial injury;this was managed by transcatheter coil embolization. All patients underwent endoluminal stent placement and received antimicrobial therapy and nutritional support. Conclusion: Percutaneous CT-guided drainage of gastric leaks after sleeve gastrectomy is a safe, effective, and minimally invasive alternative to surgery. This technique is in line with other conservative measures (endoluminal stent placement, antimicrobial therapy, and nutritional support), which heal most gastric leaks due to sleeve gastrectomy and prevent the need for revisional surgery.
文摘Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.
文摘Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried out between 2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patient demographics, lung lesions, and biopsy procedures. ResultsA total of 281 biopsy procedures were enrolled. The total complication rate was 55.9% with pneumothorax 32.4% (91/281) and bleeding 34.5% (97/281). The risk factors affecting pneumothorax rate were lesion location, lesion depth, and time of pleural pierce; and the risk factors affecting bleeding complications were lesion depth, lesion size, and age. Predictive models for pneumothorax and bleeding were established by logistic regression. The pneumothorax model had a sensitivity of 80.0% with a specificity of 62.4%,and the bleeding model had a sensitivity of 67.4% with a specificity of 88.8%. ConclusionLesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factor for bleeding. The predictive models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.
文摘Purpose: To evaluate a new miniature optical navigation system for CT-guided liver interventions. Material and Methods: A two-center, prospective study was performed with four interventional radiologists. A total of 20 patients had CT-guided liver biopsy or ablation interventions utilizing the CT-Guide? navigation system (ActiViews Inc., Wakefield, MA) between July 2011 and December 2011. The navigation system consists of a self-adhesive patientsticker printed with coincident colored and radio-opaque reference markers, a miniature disposable video camera that clips on and off an interventional instrument, and software loaded on a computer to display the navigation information. The primary end point was the frequency of a satisfactory instrument position for the intended intervention. Results: The cohort consisted of 13 males and 7 females with an average age of 63.1 years (range of 38 to 80). Most of the patients, 70%, underwent CT-guided liver biopsy while the remainder had CT-guided ablation therapy. The average lesion size was 3.1 cm (range of 1.1 - 6.9 cm). All of the interventions, regardless of lesion size, met the primary end point of satisfactory instrument positioning. There were no device-related or unexpected adverse events recorded. Only one patient had a mild adverse event and it resolved without intervention. Conclusions: This study demonstrated the safety and effectiveness of the CT-Guide? navigation system for CT-guided liver interventions, for both biopsies and ablations. The targeting success rate for a satisfactory intervention was 100% with the system.
文摘AIM To evaluate disparities in the treatment of hepatocellular carcinoma(HCC) based on gender.METHODS A retrospective database analysis using the Nationwide Inpatient Sample(NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9(ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's gender.RESULTS The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease(OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men(OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection(OR = 1.31, P < 0.001) or an ablation(OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization(TACE).CONCLUSION Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.
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.
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 Peking Union Medical College Hospital Central High-Level Hospital Clinical Research Project,No.2022-PUMCH-B-069。
文摘BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques,such as transcatheter arterial chemoembolization(TACE)and microwave ablation(MWA).AIM To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.METHODS This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024.Eighty-two patients with hepatic hemangiomas>5 cm were divided into two groups:Observation(TACE+MWA,n=50)and control(TACE,n=32).Tumor diameter and treatment outcomes were evaluated at baseline,12 months,and>3 years.Appropriate statistical tests were chosen based on the type and distribution of the data.RESULTS At baseline,the median tumor diameter was 8.3(range:5.0-19.2)cm in the observation group and 8.5(range:5.0-20.0)cm in the control group.The median follow up duration was 44.6(95%confidence interval:36.7-52.5)months.At 12 months post-treatment,the observation group demonstrated a higher tumor reduction ratio compared to the control group(50.98%vs 23.28%,respectively;P<0.001).The objective response rate was 93.94%in the observation group,which was significantly higher than that in the control group(33.33%)(P<0.001).No recurrence occurred in the observation group,while one case occurred in the control group.Notably,no cases of hemoglobinuria or acute kidney injury were reported in the observation group.CONCLUSION Combination treatment enhances tumor shrinkage,promotes long-term tumor control,and reduces the complications associated with MWA,thereby presenting a promising alternative to surgical resection.
基金supported by the National Natural Science Foundation of China(Nos.U2241240,12172045 and 12221002)the Opening Fund of State Key Laboratory of Explosion Science and Technology of Beijing Institute of Technology,China(No.ZDKT23-02)。
文摘Carbon Carbon(C/C)composites in thermal-protection system are exposed to severe thermochemical ablation and mechanical erosion,and their thermal-protection performance is of vital importance to the structural safety and flight status of hypersonic vehicles.We numerically analyzes the mesoscopic ablation-erosion of C/C Composites with Inclined Fibers(CCIF).First,a thermochemical ablation model describing the reaction-diffusion coupled problem of C/C composites on mesoscale is employed to analyze ablative process,and the corresponding surface ablation morphology is obtained.Then,the ablation morphology of CCIF is taken as the geometrical model for mechanical erosion analysis,and their damage and failure behavior under high-speed airflow shear is analyzed by using progressive damage method.Moreover,the effects of fiber inclined angle and airflow direction on the mechanical erosion of CCIF are investigated,and the ablationerosion behavior is analyzed and discussed.The results show that the failure modes of mechanical erosion in inner and edge regions are obviously different,showing granular and block erosion phenomena respectively.The mechanical erosion of CCIF in the direction of reverse flow is easier than that in the direction of forward flow.These results can provide a theoretical basis for the design and optimization of thermal protection system materials.
