1.Introduction Irreversible electroporation(IRE)has emerged as a promising non-thermal ablation technique for the treatment of malignant tumors.^([1-3])By applying high-voltage electrical pulses to tumor tissue,IRE cr...1.Introduction Irreversible electroporation(IRE)has emerged as a promising non-thermal ablation technique for the treatment of malignant tumors.^([1-3])By applying high-voltage electrical pulses to tumor tissue,IRE creates irrecoverable pores in the cell membrane,thus disrupting the balance between the intracellular and extracellular environments,and ultimately causing cell death.^([1])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 Irreversible electroporation(IRE)is a novel local tumor ablation approach with the potential to activate the host’s immune system.However,this approach is insufficient to prevent cancer progression,and com...BACKGROUND Irreversible electroporation(IRE)is a novel local tumor ablation approach with the potential to activate the host’s immune system.However,this approach is insufficient to prevent cancer progression,and complementary approaches are required for effective immunotherapy.AIM To assess the immunomodulatory effects and mechanism of IRE combined antiprogrammed cell death protein 1(PD-1)treatment in subcutaneous pancreatic cancer models.METHODS C57BL-6 tumor-bearing mice were randomly divided into four groups:Control group;IRE group;anti-PD-1 group;and IRE+anti-PD-1 group.Tumor-infiltrating T,B,and natural killer cell levels and plasma concentrations of T helper type 1 cytokines(interleukin-2,interferon-γ,and tumor necrosis factor-α)were evaluated.Real-time PCR was used to determine the expression of CD8(marker of CD8+T cells)in tumor tissues of the mice of all groups at different points of time.The growth curves of tumors were drawn.RESULTS The results demonstrated that the IRE+anti-PD-1 group exhibited significantly higher percentages of T lymphocyte infiltration,including CD4+and CD8+T cells compared with the control group.Additionally,the IRE+anti-PD-1 group showed increased infiltration of natural killer and B cells,elevated cytokine levels,and higher CD8 mRNA expression.Tumor volume was significantly reduced in the IRE+anti-PD-1 group,indicating a more pronounced therapeutic effect.CONCLUSION The combination of IRE and anti-PD-1 therapy promotes CD8+T cell immunity responses,leading to a more effective reduction in tumor volume and improved therapeutic outcomes,which provides a new direction for ablation and immunotherapy of pancreatic cancer.展开更多
Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some studies.However,higher quality studies with proper...Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some studies.However,higher quality studies with proper controls and randomization are required to establish its superiority when added with neoadjuvant chemotherapy over the current management of choice,which is chemotherapy alone.Further studies are required before establishment of any survival benefit in metastatic pancreatic carcinoma,and such evidence is lacking at present.展开更多
BACKGROUND Irreversible electroporation(IRE)is a novel non-thermal ablation technology for unresectable tumors.Hypertension and tachycardia usually occur during the IRE.To date,there has been little explanation about ...BACKGROUND Irreversible electroporation(IRE)is a novel non-thermal ablation technology for unresectable tumors.Hypertension and tachycardia usually occur during the IRE.To date,there has been little explanation about this phenomenon.AIM To investigate the reasons of hypertension and tachycardia and appropriate preventive measures.METHODS IRE was performed under general anesthesia and neuromuscular blockade.Systolic blood pressures,diastolic blood pressures,heart rate,and the distance of the electrode from abdominal aorta and adrenal gland during IRE were recorded.RESULTS All of 78 patients underwent 96 IRE sessions,44(56.4%)patients occurred hypertension when the electrode was close to the abdominal aorta(<2.0 cm).The median systolic blood pressures and diastolic blood pressures was 194 and 108 mmHg.Furthermore,11(14.1%)patients occurred tachycardia when the electrode was close to the adrenal gland(<1.3 cm).The median heart rate of patients with tachycardia was 114 beats per minute.Furthermore,hypertension and tachycardia can be prevented with nicardipine and esmolol before treatment.CONCLUSION Intraoperative hypertension and tachycardia occur because electrodes close to the abdominal aorta(<2.0 cm)and adrenal glands(<1.3 cm),which can be prevented by preoperative treatment of vasoactive drugs.展开更多
One of the main causes of liver fibrosis and cancer,non-alcoholic fatty liver disease(NAFLD)is becoming more common every year.The novel work by Yu et al,which evaluates the viability and efficacy of duodenal mucosal ...One of the main causes of liver fibrosis and cancer,non-alcoholic fatty liver disease(NAFLD)is becoming more common every year.The novel work by Yu et al,which evaluates the viability and efficacy of duodenal mucosal ablation(DMA)with irreversible electroporation(IRE)in NAFLD rat models,is examined in this article.When DMA was used with IRE to small rodents,the study found that the duodenum healed successfully two weeks later and had thicker myenterons,narrower and shallower crypts,and slimmer villi than in the sham-control group.When DMA with IRE were used,liver lipid deposition and serum lipid index values decreased;these improvements occurred regardless of food consumption or weight loss.Furthermore,the DMA group's enteroendocrine parameters varied among the various duodenal areas,including claudin and zonula ocludens-1 Levels in the duodenal mucosa.As a result,DMA with IRE in rodents demonstrated no duodenal bleeding or perforation following ablation,providing a promising path for more advanced NAFLD treatment approaches.In order to improve approach outcomes,this paper addresses the implications of extending the study length and animal size,analyzing inflammatory marker studies,and measuring intestinal lipid indexes and endocrine parameters on a weekly basis.展开更多
We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study of...We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study offers valuable mechanistic insights into local ablation,enhancing the efficacy of immune checkpoint blockade.However,critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation.We recommend clarifying experimental details,optimizing murine models,applying more robust statistical analyses,and tempering conclusions to reflect the correlative nature of the findings.Further work should investigate immune mechanisms,durability of response,and safety in clinically relevant models to maximize translational potential.These refinements will strengthen the study’s impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.展开更多
BACKGROUND Irreversible transmural intestinal necrosis(ITIN)is associated with high mortality rates in patients with acute occlusive mesenteric ischemia(AOMI).Currently,there are not many studies on the use of dual en...BACKGROUND Irreversible transmural intestinal necrosis(ITIN)is associated with high mortality rates in patients with acute occlusive mesenteric ischemia(AOMI).Currently,there are not many studies on the use of dual energy computed tomography(DECT)for evaluating ITIN.AIM To evaluate the diagnostic value of DECT for ITIN in AOMI.METHODS The cases and computed tomography(CT)images of 102 patients with clinically diagnosed AOMI(including 48 ITIN)from January 2012 to January 2022 were retrospectively collected.The CT scans included both multidetector CT and DECT.The raw data from DECT portal-venous phase were reconstructed into 120 kVp mixed energy image,50 keV virtual monoenergetic imaging,and iodine map.Two radiologists independently completed the subjective visual assessment of CT signs related to AOMI.Objective parameters,including the attenuation of the normal and_(lesion)intestinal wall segment(CT50 keV_(lesion),CT_(50 keV normal/lesion))and iodine concentrations(IC_(lesion)and I_(Cnormal/lesion)),were quantified.Furthermore,multivariate logistic regression,receiver operating characteristic curves,and area under the curve(AUC)values were used to evaluate the subjective and objective indicators in predicting ITIN.RESULTS Regarding subjective signs,logistic regression analysis revealed reduced or absent bowel wall enhancement[odds ratio(OR)=5.576,95%confidence interval(CI):1.547-20.093],bowel dilation(OR=11.613,95%CI:3.790-35.586),and parenchymatous organ infarction(OR=4.727,95%CI:1.536-14.551)were independent risk factors for the ITIN.CT subjective signs had a high diagnostic efficacy for ITIN(AUC=0.853).The two DECT objective parameters also exhibited excellent diagnostic value for ITIN,with an AUC of 0.79,a cut-off value of CT50 keV normal/_(lesion)=2.81,and an AUC of 0.777 with a cut-off value of I_(Cnormal/lesion)=2.39.The Delong test showed that there was no significant difference in the efficacy of subjective CT signs and objective DECT parameters(P>0.05).Importantly,we observed that I_(Cnormal/lesion)combined with subjective signs(bowel dilation and parenchymatous organ infarction)had the highest predictive performance(AUC=0.894),sensitivity(100%),and specificity(70.83%),which was statistically different from the AUC of CT subjective signs(P=0.017).CONCLUSION I_(Cnormal/lesion)(DECT-based features)combined with CT subjective signs(bowel dilatation and parenchymatous organ infarction)showed favorable predictive performance for ITIN in AOMI,which may help clinicians develop timely treatment strategies.展开更多
BACKGROUND Irreversible electroporation(IRE)represents an innovative localized technique for tumor ablation,possessing the capacity to activate the immune response of the host.However,this method alone is inadequate t...BACKGROUND Irreversible electroporation(IRE)represents an innovative localized technique for tumor ablation,possessing the capacity to activate the immune response of the host.However,this method alone is inadequate to halt cancer progression,necessitating the integration of additional strategies to achieve effective immuno-therapy.AIM To investigate the effects and underlying mechanisms of antitumor immunity derived from the synergistic application of IRE and anti-programmed cell death protein 1(PD-1)therapy within a murine model of hepatocellular carcinoma.METHODS C57BL-6 mice with tumor growth were divided into four separate cohorts:Control group;IRE group;Anti-PD-1 group;And IRE+anti-PD-1 group.The infiltration levels of T,B,and natural killer cells within the tumors,as well as the plasma concentrations of T helper type 1 cytokines(interleukin-2,interferon-γ,and tumor necrosis factor-β),were evaluated.Real-time polymerase chain reaction was utilized to quantify the expression of cluster of differentiation(CD)8(a marker indicative of CD8+T cells)in the tumor specimens of the mice at various temporal intervals.Tumor growth trajectories were charted.RESULTS The results indicated that the IRE+anti-PD-1 group exhibited significantly heightened percentages of T lymphocyte infiltration,particularly CD4+and CD8+T cells,when compared to the control cohort.Additionally,this group displayed increased infiltration of natural killer and B cells,augmented cytokine levels,and elevated CD8 messenger RNA expression.A marked decrease in tumor volume was noted in the IRE+anti-PD-1 group,indicating enhanced therapeutic efficacy.CONCLUSION The combined application of IRE and checkpoint blockade elicits an antitumor immune response,leading to a more substantial reduction in tumor volume and improved therapeutic outcomes,thereby establishing a novel avenue for the ablation and immunotherapy of hepatocellular carcinoma.展开更多
To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we re...To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we report the thermal behaviors of NCA/Si–C pouch cell during the charge/discharge processes at different current densities.The total heat generations are derived from the surface temperature change during electrochemical Li+insertion/extraction in adiabatic surrounding.The reversible heat is determined by the entropic coefficients,which are related with open-circuit voltage at different temperatures; while the irreversible heat is determined by the internal resistance,which can be obtained via V–I characteristic,electrochemical impedance spectroscopy and hybrid pulse power characterization(HPPC).During the electrochemical process,the reversible heat contributes less than 10% to total heat generation; and the heat generated in charge process is less than that in discharge process.The results of thermal behaviors analyses are conducive to understanding the safety management and paving the way for building a reliable thermal model of high energy density lithium ion battery.展开更多
In this paper, we try to use the entransy theory to analyze the heat–work conversion systems with inner irreversible thermodynamic cycles. First, the inner irreversible thermodynamic cycles are analyzed. The influenc...In this paper, we try to use the entransy theory to analyze the heat–work conversion systems with inner irreversible thermodynamic cycles. First, the inner irreversible thermodynamic cycles are analyzed. The influences of different inner irreversible factors on entransy loss are discussed. We find that the concept of entransy loss can be used to analyze the inner irreversible thermodynamic cycles. Then, we analyze the common heat–work conversion systems with inner irreversible thermodynamic cycles. As an example, the heat–work conversion system in which the working fluid of the thermodynamic cycles is heated and cooled by streams is analyzed. Our analyses show that larger entransy loss leads to larger output work when the total heat flow from the high temperature heat source and the corresponding equivalent temperature are fixed.Some numerical cases are presented, and the results verify the theoretical analyses. On the other hand, it is also found that larger entransy loss does not always lead to larger output work when the preconditions are not satisfied.展开更多
Background: Irreversible electroporation(IRE) is a novel ablative technique for hepatobiliary and pancreatic cancers. This review summarizes the data regarding the safety and efficacy of IRE in the treatment of hepato...Background: Irreversible electroporation(IRE) is a novel ablative technique for hepatobiliary and pancreatic cancers. This review summarizes the data regarding the safety and efficacy of IRE in the treatment of hepatobiliary and pancreatic cancers. Data sources: Studies were identified by searching Pub Med and Embase for articles published in English from database inception through July 31, 2017. For inclusion, each clinical study had to report morbidity and survival data on hepatobiliary and pancreatic cancers treated with IRE and contain at least 10 patients. Studies that met these criteria were included for analysis. Two authors assessed each clinical study for data extraction. The controversial parts were resolved through discussion with seniors. Results: A total of 24 clinical studies were included. Fourteen focused on hepatic ablation with IRE comprising 437 patients with 666 lesions of different tumor types. Two patients(0.5%) died after the IRE procedure. Morbidity of hepatic ablation with IRE ranged from 7% to 35%. Most complications were mild. Complete response for hepatic tumors was reported as 57%–97%. Ten studies with 455 patients focused on pancreatic IRE. The overall mortality of IRE in pancreatic cancer was 2%. Overall severe morbidity of IRE in pancreatic cancer ranged from 0 to 20%. The median overall survival after IRE ranged from 7 to 23 months. Patients treated with IRE combined with surgical resection showed a longer overall survival. Conclusions: IRE significantly improves the prognosis of advanced hepatobiliary and pancreatic malignances, and companied with less complications. Hence, IRE is a relatively safe and effective non-thermal ablation strategy and potentially recommended as an option for therapy of patients with hepatobiliary and pancreatic malignances.展开更多
Pancreatic cancer is currently the seventh leading cause of cancer death(4.5%of all cancer deaths)while 80%-90%of the patients suffer from unresectable disease at the time of diagnosis.Prognosis remains poor,with a me...Pancreatic cancer is currently the seventh leading cause of cancer death(4.5%of all cancer deaths)while 80%-90%of the patients suffer from unresectable disease at the time of diagnosis.Prognosis remains poor,with a mean survival up to 15 mo following systemic chemotherapy.Loco-regional thermal ablative techniques are rarely implemented due to the increased risk of thermal injury to the adjacent structures,which can lead to severe adverse events.Irreversible electroporation,a promising novel non-thermal ablative modality,has been recently introduced in clinical practice for the management of inoperable pancreatic cancer as a safer and more effective loco-regional treatment option.Experimental and initial clinical data are optimistic.This review will focus on the basic principles of IRE technology,currently available data,and future directions.展开更多
BACKGROUND Locally advanced pancreatic cancer(LAPC)is a common malignant digestive system tumor that ranks as the fourth leading cause of cancer-related death in the world.The prognosis of LAPC is poor even after stan...BACKGROUND Locally advanced pancreatic cancer(LAPC)is a common malignant digestive system tumor that ranks as the fourth leading cause of cancer-related death in the world.The prognosis of LAPC is poor even after standard treatment.Irreversible electroporation(IRE)is a novel ablative strategy for LAPC.Several studies have confirmed the safety of IRE.To date,no prospective studies have been performed to investigate the therapeutic efficacy of conventional gemcitabine(GEM)plus concurrent IRE.AIM To compare the therapeutic efficacy between conventional GEM plus concurrent IRE and GEM alone for LAPC.METHODS From February 2016 to September 2017,a total of 68 LAPC patients were treated with GEM plus concurrent IRE(n=33)or GEM alone(n=35).Overall survival(OS),progression free survival(PFS),and procedure-related complications were compared between the two groups.Multivariate analyses were performed to identify any prognostic factors.RESULTS There were no treatment-related deaths.The technical success rate of IRE ablation was 100%.The GEM+IRE group had a significantly longer OS from the time of diagnosis of LAPC(19.8 mo vs 9.3 mo,P<0.0001)than the GEM alone group.The GEM+IRE group had a significantly longer PFS(8.3 mo vs 4.7 mo,P<0.0001)than the GEM alone group.Tumor volume less than 37 cm3 and GEM plus concurrent IRE were identified as significant favorable factors for both the OS and PFS.CONCLUSION Gemcitabine plus concurrent IRE is an effective treatment for patients with LAPC.展开更多
BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs a...BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs and the mechanism is still unclear.AIM To evaluate the clinical outcomes of and to identify predictive factors for irreversible intestinal ischemia requiring surgical resection in AMVT patients treated by TT.METHODS The records of consecutive patients with AMVT treated by TT from January 2010 to October 2017 were retrospectively analyzed.We compared patients who required resection of irreversible intestinal ischemia to patients who did not require.RESULTS Among 58 patients,prompt TT was carried out 28.5 h after admission.A total of 42(72.4%)patients underwent arteriovenous combined thrombolysis,and 16(27.6%)underwent arterial thrombolysis alone.The overall 30-d mortality rate was 8.6%.Irreversible intestinal ischemia was indicated in 32(55.2%)patients,who had a higher 30-d mortality and a longer in-hospital stay than patients without resection.The significant independent predictors of irreversible intestinal ischemia were Acute Physiology and Chronic Health Evaluation(APACHE)II score(odds ratio=2.368,95% confidence interval:1.047-5.357,P=0.038)and leukocytosis(odds ratio=2.058,95% confidence interval:1.085-3.903,P=0.027).Using the receiver operating characteristic curve,the cutoff values of the APACHE II score and leukocytosis for predicting the onset of irreversible intestinal ischemia were calculated to be 8.5 and 12×10^9/L,respectively.CONCLUSION Prompt TT could achieve a favorable outcome in AMVT patients.High APACHE II score and leukocytosis can significantly predict the occurrence of irreversible intestinal ischemia.Therefore,close monitoring of these factors may help with the early identification of patients with irreversible intestinal ischemia,in whom ultimately surgical resection is required,before the initiation of TT.展开更多
Irreversible electroporation(IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable.We present the first case of acute superior m...Irreversible electroporation(IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable.We present the first case of acute superior mesenteric artery(SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature.A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma.IRE procedure was applied to the patient during laparotomy under general anesthesia.After finishing the procedure,an acute intestinal ischemia was detected.A conventional vascular angiography was performed and a metallic stent was successfully placed to the SMA and blood flow was maintained.It is important to be careful in such cases of tumor involvement of SMA when evaluating for IRE procedure of pancreatic tumor.展开更多
A novel flow-injection irreversible biamperometric method is described for the direct determination of iodide. The method is based on electrochemical oxidation of iodide at the gold electrode and the reduction of perm...A novel flow-injection irreversible biamperometric method is described for the direct determination of iodide. The method is based on electrochemical oxidation of iodide at the gold electrode and the reduction of permanganate at the platinum electrode to form an irreversible biamperometric detection system. Under the applied potential difference of 0 V, in the 0.05 mol/L sulfuric acid, iodidecan be determined over the range 4.00×10^-7-1.00×10^-5 mol/L with a sampling frequency of 120 samples per hour. The detection limit for I- is 3.0×10^-7 mol/L and the RSD for 40 replicate determinations of 4.0×10^-5 mol/L potassium iodide is 1.68%. The new method was applied to the analysis of iodide in table salt with satisfactory results.展开更多
A flow injection irreversible biamperometric method for the determination of chlorogenic acid is described. The proposed method is based on the electrochemical oxidation of chlorogenic acid at pretreated platinum elec...A flow injection irreversible biamperometric method for the determination of chlorogenic acid is described. The proposed method is based on the electrochemical oxidation of chlorogenic acid at pretreated platinum electrode and the reduction of permanganate at another electrode to form an irreversible biamperometric detection system. Under the external potential difference （z^v） of 0 V, in the 0.05 mol/L sulfuric acid, chlorogenic acid can be determined over the range 0.8-120 mg/L with a sample measurement frequency of 80 samples/h. The detection limit is 0.18 mg/L. The proposed method exhibits the satisfactory reproducibility with a relative standard derivation （R.S.D.） of 2.21% for 19 successive determinations of 40 mg/L.展开更多
Portal vein thrombosis(PVT) is a rare but serious postoperative complication associated with irreversible electroporation(IRE). We report a case of postoperative PVT in a 54-year-old woman who underwent IRE for locall...Portal vein thrombosis(PVT) is a rare but serious postoperative complication associated with irreversible electroporation(IRE). We report a case of postoperative PVT in a 54-year-old woman who underwent IRE for locally advanced pancreatic cancer. Drain removal and discharge of the patient from the hospital were scheduled on postoperative day(POD) 7; however, a magnetic resonance imaging scan revealed the presence of PVT. We suspected postoperative inflammation in the pancreas as the main cause of PVT. However, the patient did not undergo any medical treatment because she did not have any clinical symptoms, and she was discharged on POD 8.展开更多
Ischemic stroke and irreversible consequences:Ischemic stroke in humans is the second most common cause of death in the world(Mozaffarian et al.,2016).The outcomes after a stroke are often dependent on complications,i...Ischemic stroke and irreversible consequences:Ischemic stroke in humans is the second most common cause of death in the world(Mozaffarian et al.,2016).The outcomes after a stroke are often dependent on complications,including motor disorders,depression and dementia(Pluta et al.,2018a),which causes a high risk of re-hospitalization and/or palliative care.This is also the main reason for long-term disability in people after stroke,with up to half of those who survived the stroke will not regain their independence until the end of their lives(Mozaffarian et al.,2016).According to epidemiological forecasts,human ischemic stroke will soon become the dominant cause of death worldwide(Bejot et al.,2016)as well as dementia with the phenotype of Alzheimer’s disease(AD;Kim and Lee 2018).It is suggested that human ischemic stroke and experimental brain ischemia in animals are associated with the possible development of AD neuropathology(Pluta et al.,2018a).展开更多
文摘1.Introduction Irreversible electroporation(IRE)has emerged as a promising non-thermal ablation technique for the treatment of malignant tumors.^([1-3])By applying high-voltage electrical pulses to tumor tissue,IRE creates irrecoverable pores in the cell membrane,thus disrupting the balance between the intracellular and extracellular environments,and ultimately causing cell death.^([1])
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Science and Technology Program of Guangzhou,No.202102010077International Science Foundation of Guangzhou Fuda Cancer Hospital,No.Y2020-ZD-03.
文摘BACKGROUND Irreversible electroporation(IRE)is a novel local tumor ablation approach with the potential to activate the host’s immune system.However,this approach is insufficient to prevent cancer progression,and complementary approaches are required for effective immunotherapy.AIM To assess the immunomodulatory effects and mechanism of IRE combined antiprogrammed cell death protein 1(PD-1)treatment in subcutaneous pancreatic cancer models.METHODS C57BL-6 tumor-bearing mice were randomly divided into four groups:Control group;IRE group;anti-PD-1 group;and IRE+anti-PD-1 group.Tumor-infiltrating T,B,and natural killer cell levels and plasma concentrations of T helper type 1 cytokines(interleukin-2,interferon-γ,and tumor necrosis factor-α)were evaluated.Real-time PCR was used to determine the expression of CD8(marker of CD8+T cells)in tumor tissues of the mice of all groups at different points of time.The growth curves of tumors were drawn.RESULTS The results demonstrated that the IRE+anti-PD-1 group exhibited significantly higher percentages of T lymphocyte infiltration,including CD4+and CD8+T cells compared with the control group.Additionally,the IRE+anti-PD-1 group showed increased infiltration of natural killer and B cells,elevated cytokine levels,and higher CD8 mRNA expression.Tumor volume was significantly reduced in the IRE+anti-PD-1 group,indicating a more pronounced therapeutic effect.CONCLUSION The combination of IRE and anti-PD-1 therapy promotes CD8+T cell immunity responses,leading to a more effective reduction in tumor volume and improved therapeutic outcomes,which provides a new direction for ablation and immunotherapy of pancreatic cancer.
基金Supported by Department of Biotechnology,Government of India,No.RLS/BT/Re-entry/05/2012.
文摘Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some studies.However,higher quality studies with proper controls and randomization are required to establish its superiority when added with neoadjuvant chemotherapy over the current management of choice,which is chemotherapy alone.Further studies are required before establishment of any survival benefit in metastatic pancreatic carcinoma,and such evidence is lacking at present.
基金Supported by International Science Foundation of Guangzhou Fuda Cancer Hospital,No.Y2022-MS-02.
文摘BACKGROUND Irreversible electroporation(IRE)is a novel non-thermal ablation technology for unresectable tumors.Hypertension and tachycardia usually occur during the IRE.To date,there has been little explanation about this phenomenon.AIM To investigate the reasons of hypertension and tachycardia and appropriate preventive measures.METHODS IRE was performed under general anesthesia and neuromuscular blockade.Systolic blood pressures,diastolic blood pressures,heart rate,and the distance of the electrode from abdominal aorta and adrenal gland during IRE were recorded.RESULTS All of 78 patients underwent 96 IRE sessions,44(56.4%)patients occurred hypertension when the electrode was close to the abdominal aorta(<2.0 cm).The median systolic blood pressures and diastolic blood pressures was 194 and 108 mmHg.Furthermore,11(14.1%)patients occurred tachycardia when the electrode was close to the adrenal gland(<1.3 cm).The median heart rate of patients with tachycardia was 114 beats per minute.Furthermore,hypertension and tachycardia can be prevented with nicardipine and esmolol before treatment.CONCLUSION Intraoperative hypertension and tachycardia occur because electrodes close to the abdominal aorta(<2.0 cm)and adrenal glands(<1.3 cm),which can be prevented by preoperative treatment of vasoactive drugs.
文摘One of the main causes of liver fibrosis and cancer,non-alcoholic fatty liver disease(NAFLD)is becoming more common every year.The novel work by Yu et al,which evaluates the viability and efficacy of duodenal mucosal ablation(DMA)with irreversible electroporation(IRE)in NAFLD rat models,is examined in this article.When DMA was used with IRE to small rodents,the study found that the duodenum healed successfully two weeks later and had thicker myenterons,narrower and shallower crypts,and slimmer villi than in the sham-control group.When DMA with IRE were used,liver lipid deposition and serum lipid index values decreased;these improvements occurred regardless of food consumption or weight loss.Furthermore,the DMA group's enteroendocrine parameters varied among the various duodenal areas,including claudin and zonula ocludens-1 Levels in the duodenal mucosa.As a result,DMA with IRE in rodents demonstrated no duodenal bleeding or perforation following ablation,providing a promising path for more advanced NAFLD treatment approaches.In order to improve approach outcomes,this paper addresses the implications of extending the study length and animal size,analyzing inflammatory marker studies,and measuring intestinal lipid indexes and endocrine parameters on a weekly basis.
文摘We read with great interest the recent article by Xing et al,which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model.The study offers valuable mechanistic insights into local ablation,enhancing the efficacy of immune checkpoint blockade.However,critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation.We recommend clarifying experimental details,optimizing murine models,applying more robust statistical analyses,and tempering conclusions to reflect the correlative nature of the findings.Further work should investigate immune mechanisms,durability of response,and safety in clinically relevant models to maximize translational potential.These refinements will strengthen the study’s impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.
基金Supported by The Project of Nantong City Health Committee,No.MS2023027 and WKZL2018017The“333”Talent Funding Project of Jiangsu Province,No.BRA2020198+1 种基金The Project of Jiangsu Provincial Health Commission,No.ZD2021059The Youth Research Fund of Nantong Municipal Health Commission,No.QNZ2023027.
文摘BACKGROUND Irreversible transmural intestinal necrosis(ITIN)is associated with high mortality rates in patients with acute occlusive mesenteric ischemia(AOMI).Currently,there are not many studies on the use of dual energy computed tomography(DECT)for evaluating ITIN.AIM To evaluate the diagnostic value of DECT for ITIN in AOMI.METHODS The cases and computed tomography(CT)images of 102 patients with clinically diagnosed AOMI(including 48 ITIN)from January 2012 to January 2022 were retrospectively collected.The CT scans included both multidetector CT and DECT.The raw data from DECT portal-venous phase were reconstructed into 120 kVp mixed energy image,50 keV virtual monoenergetic imaging,and iodine map.Two radiologists independently completed the subjective visual assessment of CT signs related to AOMI.Objective parameters,including the attenuation of the normal and_(lesion)intestinal wall segment(CT50 keV_(lesion),CT_(50 keV normal/lesion))and iodine concentrations(IC_(lesion)and I_(Cnormal/lesion)),were quantified.Furthermore,multivariate logistic regression,receiver operating characteristic curves,and area under the curve(AUC)values were used to evaluate the subjective and objective indicators in predicting ITIN.RESULTS Regarding subjective signs,logistic regression analysis revealed reduced or absent bowel wall enhancement[odds ratio(OR)=5.576,95%confidence interval(CI):1.547-20.093],bowel dilation(OR=11.613,95%CI:3.790-35.586),and parenchymatous organ infarction(OR=4.727,95%CI:1.536-14.551)were independent risk factors for the ITIN.CT subjective signs had a high diagnostic efficacy for ITIN(AUC=0.853).The two DECT objective parameters also exhibited excellent diagnostic value for ITIN,with an AUC of 0.79,a cut-off value of CT50 keV normal/_(lesion)=2.81,and an AUC of 0.777 with a cut-off value of I_(Cnormal/lesion)=2.39.The Delong test showed that there was no significant difference in the efficacy of subjective CT signs and objective DECT parameters(P>0.05).Importantly,we observed that I_(Cnormal/lesion)combined with subjective signs(bowel dilation and parenchymatous organ infarction)had the highest predictive performance(AUC=0.894),sensitivity(100%),and specificity(70.83%),which was statistically different from the AUC of CT subjective signs(P=0.017).CONCLUSION I_(Cnormal/lesion)(DECT-based features)combined with CT subjective signs(bowel dilatation and parenchymatous organ infarction)showed favorable predictive performance for ITIN in AOMI,which may help clinicians develop timely treatment strategies.
基金Supported by the Science and Technology Program of Guangzhou,No.202201020024.
文摘BACKGROUND Irreversible electroporation(IRE)represents an innovative localized technique for tumor ablation,possessing the capacity to activate the immune response of the host.However,this method alone is inadequate to halt cancer progression,necessitating the integration of additional strategies to achieve effective immuno-therapy.AIM To investigate the effects and underlying mechanisms of antitumor immunity derived from the synergistic application of IRE and anti-programmed cell death protein 1(PD-1)therapy within a murine model of hepatocellular carcinoma.METHODS C57BL-6 mice with tumor growth were divided into four separate cohorts:Control group;IRE group;Anti-PD-1 group;And IRE+anti-PD-1 group.The infiltration levels of T,B,and natural killer cells within the tumors,as well as the plasma concentrations of T helper type 1 cytokines(interleukin-2,interferon-γ,and tumor necrosis factor-β),were evaluated.Real-time polymerase chain reaction was utilized to quantify the expression of cluster of differentiation(CD)8(a marker indicative of CD8+T cells)in the tumor specimens of the mice at various temporal intervals.Tumor growth trajectories were charted.RESULTS The results indicated that the IRE+anti-PD-1 group exhibited significantly heightened percentages of T lymphocyte infiltration,particularly CD4+and CD8+T cells,when compared to the control cohort.Additionally,this group displayed increased infiltration of natural killer and B cells,augmented cytokine levels,and elevated CD8 messenger RNA expression.A marked decrease in tumor volume was noted in the IRE+anti-PD-1 group,indicating enhanced therapeutic efficacy.CONCLUSION The combined application of IRE and checkpoint blockade elicits an antitumor immune response,leading to a more substantial reduction in tumor volume and improved therapeutic outcomes,thereby establishing a novel avenue for the ablation and immunotherapy of hepatocellular carcinoma.
基金supported by the National Key R&D Program of China:Trackling Key Technology for Development and Industrialization of Power Lithium Ion Battery with High Specific Energy (Grant No.2016YFB0100508)
文摘To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we report the thermal behaviors of NCA/Si–C pouch cell during the charge/discharge processes at different current densities.The total heat generations are derived from the surface temperature change during electrochemical Li+insertion/extraction in adiabatic surrounding.The reversible heat is determined by the entropic coefficients,which are related with open-circuit voltage at different temperatures; while the irreversible heat is determined by the internal resistance,which can be obtained via V–I characteristic,electrochemical impedance spectroscopy and hybrid pulse power characterization(HPPC).During the electrochemical process,the reversible heat contributes less than 10% to total heat generation; and the heat generated in charge process is less than that in discharge process.The results of thermal behaviors analyses are conducive to understanding the safety management and paving the way for building a reliable thermal model of high energy density lithium ion battery.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.51376101 and 51356001)
文摘In this paper, we try to use the entransy theory to analyze the heat–work conversion systems with inner irreversible thermodynamic cycles. First, the inner irreversible thermodynamic cycles are analyzed. The influences of different inner irreversible factors on entransy loss are discussed. We find that the concept of entransy loss can be used to analyze the inner irreversible thermodynamic cycles. Then, we analyze the common heat–work conversion systems with inner irreversible thermodynamic cycles. As an example, the heat–work conversion system in which the working fluid of the thermodynamic cycles is heated and cooled by streams is analyzed. Our analyses show that larger entransy loss leads to larger output work when the total heat flow from the high temperature heat source and the corresponding equivalent temperature are fixed.Some numerical cases are presented, and the results verify the theoretical analyses. On the other hand, it is also found that larger entransy loss does not always lead to larger output work when the preconditions are not satisfied.
基金supported by grants from the Traditional Chinese Medicine Scientific Research Fund Project of Zhejiang province(No.2017ZA079)the Key Research Development Program of Zhejiang province(No.2018C03018)+1 种基金the Key Science and Tech-nology Program of Zhejiang Provience(No.WKJ-ZJ-1923)the National S&T Major Project of China(No.2018ZX10301201)
文摘Background: Irreversible electroporation(IRE) is a novel ablative technique for hepatobiliary and pancreatic cancers. This review summarizes the data regarding the safety and efficacy of IRE in the treatment of hepatobiliary and pancreatic cancers. Data sources: Studies were identified by searching Pub Med and Embase for articles published in English from database inception through July 31, 2017. For inclusion, each clinical study had to report morbidity and survival data on hepatobiliary and pancreatic cancers treated with IRE and contain at least 10 patients. Studies that met these criteria were included for analysis. Two authors assessed each clinical study for data extraction. The controversial parts were resolved through discussion with seniors. Results: A total of 24 clinical studies were included. Fourteen focused on hepatic ablation with IRE comprising 437 patients with 666 lesions of different tumor types. Two patients(0.5%) died after the IRE procedure. Morbidity of hepatic ablation with IRE ranged from 7% to 35%. Most complications were mild. Complete response for hepatic tumors was reported as 57%–97%. Ten studies with 455 patients focused on pancreatic IRE. The overall mortality of IRE in pancreatic cancer was 2%. Overall severe morbidity of IRE in pancreatic cancer ranged from 0 to 20%. The median overall survival after IRE ranged from 7 to 23 months. Patients treated with IRE combined with surgical resection showed a longer overall survival. Conclusions: IRE significantly improves the prognosis of advanced hepatobiliary and pancreatic malignances, and companied with less complications. Hence, IRE is a relatively safe and effective non-thermal ablation strategy and potentially recommended as an option for therapy of patients with hepatobiliary and pancreatic malignances.
文摘Pancreatic cancer is currently the seventh leading cause of cancer death(4.5%of all cancer deaths)while 80%-90%of the patients suffer from unresectable disease at the time of diagnosis.Prognosis remains poor,with a mean survival up to 15 mo following systemic chemotherapy.Loco-regional thermal ablative techniques are rarely implemented due to the increased risk of thermal injury to the adjacent structures,which can lead to severe adverse events.Irreversible electroporation,a promising novel non-thermal ablative modality,has been recently introduced in clinical practice for the management of inoperable pancreatic cancer as a safer and more effective loco-regional treatment option.Experimental and initial clinical data are optimistic.This review will focus on the basic principles of IRE technology,currently available data,and future directions.
基金Supported by International Science Foundation of Affiliated Fuda Cancer Hospital,Jinan University,No.Y2018-ZD-01.
文摘BACKGROUND Locally advanced pancreatic cancer(LAPC)is a common malignant digestive system tumor that ranks as the fourth leading cause of cancer-related death in the world.The prognosis of LAPC is poor even after standard treatment.Irreversible electroporation(IRE)is a novel ablative strategy for LAPC.Several studies have confirmed the safety of IRE.To date,no prospective studies have been performed to investigate the therapeutic efficacy of conventional gemcitabine(GEM)plus concurrent IRE.AIM To compare the therapeutic efficacy between conventional GEM plus concurrent IRE and GEM alone for LAPC.METHODS From February 2016 to September 2017,a total of 68 LAPC patients were treated with GEM plus concurrent IRE(n=33)or GEM alone(n=35).Overall survival(OS),progression free survival(PFS),and procedure-related complications were compared between the two groups.Multivariate analyses were performed to identify any prognostic factors.RESULTS There were no treatment-related deaths.The technical success rate of IRE ablation was 100%.The GEM+IRE group had a significantly longer OS from the time of diagnosis of LAPC(19.8 mo vs 9.3 mo,P<0.0001)than the GEM alone group.The GEM+IRE group had a significantly longer PFS(8.3 mo vs 4.7 mo,P<0.0001)than the GEM alone group.Tumor volume less than 37 cm3 and GEM plus concurrent IRE were identified as significant favorable factors for both the OS and PFS.CONCLUSION Gemcitabine plus concurrent IRE is an effective treatment for patients with LAPC.
基金Supported by National Natural Science Foundation of China,No.81770532Jiangsu Province Medical Foundation for Youth Talents,China,No.QNRC2016901.
文摘BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs and the mechanism is still unclear.AIM To evaluate the clinical outcomes of and to identify predictive factors for irreversible intestinal ischemia requiring surgical resection in AMVT patients treated by TT.METHODS The records of consecutive patients with AMVT treated by TT from January 2010 to October 2017 were retrospectively analyzed.We compared patients who required resection of irreversible intestinal ischemia to patients who did not require.RESULTS Among 58 patients,prompt TT was carried out 28.5 h after admission.A total of 42(72.4%)patients underwent arteriovenous combined thrombolysis,and 16(27.6%)underwent arterial thrombolysis alone.The overall 30-d mortality rate was 8.6%.Irreversible intestinal ischemia was indicated in 32(55.2%)patients,who had a higher 30-d mortality and a longer in-hospital stay than patients without resection.The significant independent predictors of irreversible intestinal ischemia were Acute Physiology and Chronic Health Evaluation(APACHE)II score(odds ratio=2.368,95% confidence interval:1.047-5.357,P=0.038)and leukocytosis(odds ratio=2.058,95% confidence interval:1.085-3.903,P=0.027).Using the receiver operating characteristic curve,the cutoff values of the APACHE II score and leukocytosis for predicting the onset of irreversible intestinal ischemia were calculated to be 8.5 and 12×10^9/L,respectively.CONCLUSION Prompt TT could achieve a favorable outcome in AMVT patients.High APACHE II score and leukocytosis can significantly predict the occurrence of irreversible intestinal ischemia.Therefore,close monitoring of these factors may help with the early identification of patients with irreversible intestinal ischemia,in whom ultimately surgical resection is required,before the initiation of TT.
文摘Irreversible electroporation(IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable.We present the first case of acute superior mesenteric artery(SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature.A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma.IRE procedure was applied to the patient during laparotomy under general anesthesia.After finishing the procedure,an acute intestinal ischemia was detected.A conventional vascular angiography was performed and a metallic stent was successfully placed to the SMA and blood flow was maintained.It is important to be careful in such cases of tumor involvement of SMA when evaluating for IRE procedure of pancreatic tumor.
基金support of the Guangxi Science Fund For Youth(No.0135003)Guangxi Universities One Hundred Young-middle Scholar Fund for the present work.
文摘A novel flow-injection irreversible biamperometric method is described for the direct determination of iodide. The method is based on electrochemical oxidation of iodide at the gold electrode and the reduction of permanganate at the platinum electrode to form an irreversible biamperometric detection system. Under the applied potential difference of 0 V, in the 0.05 mol/L sulfuric acid, iodidecan be determined over the range 4.00×10^-7-1.00×10^-5 mol/L with a sampling frequency of 120 samples per hour. The detection limit for I- is 3.0×10^-7 mol/L and the RSD for 40 replicate determinations of 4.0×10^-5 mol/L potassium iodide is 1.68%. The new method was applied to the analysis of iodide in table salt with satisfactory results.
基金the National Natural Science Foundation of China （No. 20665001） Guangxi Science Fund （No. 0640029） Innovation Project of Guangxi Graduate Education （No. 2006105930502m33）.
文摘A flow injection irreversible biamperometric method for the determination of chlorogenic acid is described. The proposed method is based on the electrochemical oxidation of chlorogenic acid at pretreated platinum electrode and the reduction of permanganate at another electrode to form an irreversible biamperometric detection system. Under the external potential difference （z^v） of 0 V, in the 0.05 mol/L sulfuric acid, chlorogenic acid can be determined over the range 0.8-120 mg/L with a sample measurement frequency of 80 samples/h. The detection limit is 0.18 mg/L. The proposed method exhibits the satisfactory reproducibility with a relative standard derivation （R.S.D.） of 2.21% for 19 successive determinations of 40 mg/L.
文摘Portal vein thrombosis(PVT) is a rare but serious postoperative complication associated with irreversible electroporation(IRE). We report a case of postoperative PVT in a 54-year-old woman who underwent IRE for locally advanced pancreatic cancer. Drain removal and discharge of the patient from the hospital were scheduled on postoperative day(POD) 7; however, a magnetic resonance imaging scan revealed the presence of PVT. We suspected postoperative inflammation in the pancreas as the main cause of PVT. However, the patient did not undergo any medical treatment because she did not have any clinical symptoms, and she was discharged on POD 8.
文摘Ischemic stroke and irreversible consequences:Ischemic stroke in humans is the second most common cause of death in the world(Mozaffarian et al.,2016).The outcomes after a stroke are often dependent on complications,including motor disorders,depression and dementia(Pluta et al.,2018a),which causes a high risk of re-hospitalization and/or palliative care.This is also the main reason for long-term disability in people after stroke,with up to half of those who survived the stroke will not regain their independence until the end of their lives(Mozaffarian et al.,2016).According to epidemiological forecasts,human ischemic stroke will soon become the dominant cause of death worldwide(Bejot et al.,2016)as well as dementia with the phenotype of Alzheimer’s disease(AD;Kim and Lee 2018).It is suggested that human ischemic stroke and experimental brain ischemia in animals are associated with the possible development of AD neuropathology(Pluta et al.,2018a).
