The numerical simulation of flow field around Hayabusa capsule loaded with light-weight ablator thermal response coupled with pyrolysis gas flow inside the ablator was carried out. In addition, the radiation from high...The numerical simulation of flow field around Hayabusa capsule loaded with light-weight ablator thermal response coupled with pyrolysis gas flow inside the ablator was carried out. In addition, the radiation from high temperature gas around the capsule was coupled with flow field. Hayabusa capsule reentered the atmosphere about 12 km/sec in velocity and Mach number about 30. During such an atmospheric entry, space vehicle is exposed to very savior aerodynamic heating due to convection and radiation. In this study, Hayabusa capsule was treated as a typical model of the atmospheric entry spacecraft. The light-weight ablator had porous structure, and permeability was an important parameter to analyze flow inside ablator. In this study, permeability was a variable parameter dependent on density of ablator. It is found that the effect of permeability of light-weight ablator was important with this analysis.展开更多
Hydrodynamic instability growth at the deuterium-tritium(DT)fuel-ablator interface plays a critical role in determining the performance of inertial confinement fusion implosions.During the late stages of implosion,ins...Hydrodynamic instability growth at the deuterium-tritium(DT)fuel-ablator interface plays a critical role in determining the performance of inertial confinement fusion implosions.During the late stages of implosion,insufficient doping of the ablator material can result in highenergy X-ray preheat,which may trigger the development of a classical-like Rayleigh-Taylor instability(RTI)at the fuel-ablator interface.In implosion experiments at the Shenguang 100 kJ-level laser facility,the primary source of perturbation is the roughness of the inner DT ice interface.In this study,we propose an analytical model to describe the feed-out process of the initial roughness of the inner DT ice interface.The perturbation amplitude derived from this model serves as the initial seed for the late-time RTI during the acceleration phase.Our findings confirm the presence of classical-like RTI at the fuel-ablator interface.Numerical simulations conducted using a radiation hydrodynamic code validate the proposed analytical model and demonstrate the existence of a peak mode number in both the feed-out process and the classical-like RTI.It provides an alternative bridge between the current target fabrication limitations and the unexpected implosion performance.展开更多
Lightweight and high-toughness carbon fiber/phenolic ablator(CFPA)is required as the Thermal Protection System(TPS)material of aerospace vehicles for next-generation space missions.To improve the ablative properties,s...Lightweight and high-toughness carbon fiber/phenolic ablator(CFPA)is required as the Thermal Protection System(TPS)material of aerospace vehicles for next-generation space missions.To improve the ablative properties,silica sol with good particle size distribution prepared using tetramethoxysilane(TMOS)was blended with natural rubber latex and deposited onto carbon fiber felt,which was then integrated with phenolic aerogel matrix,introducing nano-silica into the framework of CFPA.The modified CFPA with a low density of 0.28—0.31 g/cm3exhibits strain-in-fracture as high as 31.2%and thermal conductivity as low as 0.054 W/(m·K).Furthermore,a trace amount of nano-silica could effectively protect CFPA from erosion of oxidizing atmosphere in different high-temperature environments.The oxyacetylene ablation test of 3000°C for 20 s shows a mass ablation rate of 0.0225 g/s,a linear ablation rate of 0.209 mm/s for the modified CFPA,which are 9.64%and 24.82%lower than the unmodified one.Besides,the long-time butane ablation test of 1200°C for 200 s shows an insignificant recession with mass and linear ablation rate of 0.079 g/s and 0.039 mm/s,16.84%and 13.33%lower than the unmodified one.Meanwhile,the fixed thermocouple in the test also demonstrates a good thermal insulation performance with a low peak back-face temperature of 207.7°C,12.25%lower than the unmodified one.Therefore,the nano-silica modified CFPA with excellent overall performance presents promising prospects in high-temperature aerospace 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
Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,...Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,and investigated their ablation behaviors under an oxyacetylene torch with a heat flux of 2.4 MW m^(-2).It was observed that the x=0.1 oxide scale bulged but was denser,and the x=0.2 oxide scale was blown away due to the formation of excessive liquid.Based on these findings,we further de-veloped a duplex(Hf-Zr-Ta)B_(2)coating that showed a linear recession rate close to zero(0.11μm s^(-1))after two 120-s ablation cycles.It is identified that the resulting oxide scale is mainly composed of(Hf,Zr)_(6)Ta_(2)O_(17)and(Hf,Zr,Ta)O_(2)by performing aberration-corrected(scanning)transmission electron microscopy.The protective mechanism is related to the peritectic transformation of orthorhombic-(Hf,Zr)_(6)Ta_(2)O_(17)to tetragonal-(Hf,Zr,Ta)O_(2)plus Ta-dominated liquid.This study contributes to the develop-ment of Ta-containing multicomponent UHTC bulk and coatings for ultra-high temperature applications.展开更多
This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy...This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.展开更多
Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan ...Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.展开更多
Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recent...Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recently,this technique has also been used in the treatment of intrahepatic cholangiocarcinoma for patients who are not eligible for surgical resection.There are several types of thermal ablation techniques.Radiofrequency ablation and microwave ablation are two common methods that induce necrosis of the lesions.Irreversible electroporation is a relatively new non-thermal technique and is suitable in cases where thermal ablation would be ineffective or dangerous(e.g.,malignant tumors close to vascular or biliary structures).Irreversible electroporation can induce tumoral necrosis without damage to vascular and biliary structures.The aim of this minireview was to describe the safety,efficacy,and clinical indications of these techniques in the treatment of patients with intrahepatic cholangiocarcinoma who are ineligible for surgery.展开更多
To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composite...To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composites using Zr_(2)Cu as the filler.The microstructure,mechanical properties,and ablation properties of the Zr_(2)Cu packed composites were analyzed.Results show that during Zr_(2)Cu impregnation,the melt efficiently fills the large pores of the composites and is converted to ZrCu due to a partial reaction of zirconium with carbon.This results in an increase in composite density from 1.91 g/cm^(3)to 2.24 g/cm^(3)and a reduction in open porosity by 27.35%.Additionally,the flexural strength of Zr_(2)Cu packed C/C-SiC-ZrC composites is improved from 122.78±8.09 MPa to 135.53±5.40 MPa.After plasma ablation for 20 s,the modified composites demonstrate superior ablative resistance compared to PIP C/C-SiC-ZrC,with mass ablation and linear ablation rates of 2.77×10^(−3)g/s and 2.60×10^(−3)mm/s,respectively.The“selftranspiration”effect of the low-melting point copper-containing phase absorbs the heat of the plasma flame,further reducing the ablation temperature and promoting the formation of refined ZrO_(2)particles within the SiO_(2)melting layer.This provides more stable erosion protection for Zr_(2)Cu packed C/C-SiC-ZrC composites.展开更多
Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablatio...Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablation and cryoablation and highlights its clinical efficacy,safety,and technical considerations.MWA offers significant benefits,including higher intratumoral temperatures,larger ablation zones,and reduced susceptibility to the heat-sink effect,which make it particularly suitable for tumors near large blood vessels.This review details the patient selection criteria,procedural approaches,and the use of advanced imaging techniques to improve the precision and effectiveness of MWA.Clinical outcomes indicate that MWA achieves high rates of complete tumor ablation and long-term survival with a favorable safety profile.This review is significant because it provides updated insights into the expanding role of MWA in treating unresectable CRLM and its potential as an alternative to surgical resection for resectable tumors.By summarizing recent studies and clinical trials,this review highlights the comparative effectiveness,safety,and integration with systemic therapies of MWA.In conclusion,MWA is a promising treatment option for CRLM and offers outcomes comparable to or better than those of other ablative techniques.Future research should focus on optimizing technical parameters,integrating MWA with systemic therapies,and conducting large-scale randomized controlled trials to establish standardized treatment protocols.Advancing our understanding of MWA will enhance its application and improve long-term survival and quality of life for patients with CRLM.展开更多
Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with s...Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.展开更多
The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which ha...The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which hampers their conversion into boride-based ultrahigh temperature ceramics.To tackle these challenges,a serious of pioneering liquid multi-component hafnium-containing ceramic SiHfCB precursors(with different Hf/Si ratios)have been developed.These novel precursors are featured with stable molec-ular structure and high ceramic yield which were successfully created through a novel one-pot polymer-ization process.They present in liquid form and their structure is characterized by C-C bonds forming its main chain with branched chains of O-Si-O,Si-O-Hf,Si-O-B,and B-O-Hf which have untapped advantages including uniform component dispersion,and excellent fluidity.The ceramic yield of SiHfCB precursor with Hf/Si of 0.2 is remarkably up to 68.6 wt.%at 1500℃,and their Hf content exceeded 50 wt.%.Of particular interest,the pyrolyzed product HfB_(2)-SiC nanopowders derived from the SiHfCB precursor with Hf/Si of 0.2,consist of nanopowders in the 40-60 nm range with a density of 5.23 g cm^(−3).Remarkably,this material demonstrates exceptional performance in ultrahigh temperature oxygen-containing environ-ments at 2500℃,showing near-zero ablation with a linear ablation rate of just 2.5×10^(−4) mm s^(−1).Post-ablation analysis of the microstructure reveals that the formation of a lava-like HfO_(2) and HfO_(2)-SiO_(2) oxide layer effectively blocks oxygen penetration and provides excellent oxidation resistance.The inno-vative SiHfCB hafnium-containing ceramic precursor offers a groundbreaking solution for the preparation of lightweight ultrahigh-temperature ceramics.This development is poised to provide robust technical support for the use of ultrahigh temperature ceramics in non-ablative thermal protective systems,partic-ularly in the construction of hypersonic vehicles,where ultrahigh temperature resilience is crucial.展开更多
Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which i...Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which is prone to either inadequate or excessive ablation.This paper aims to establish an ablation prediction model that guides MWA tumor surgical planning.Methods:An MWA process was first simulated by incorporating electromagnetic radiation equations,thermal equations,and optimized biological tissue parameters(dynamic dielectric and thermophysical parameters).The temperature distributions(the short/long diameters,and the total volume of the ablation zone)were then generated and verified by 60 cases ex vivo porcine liver experiments.Subsequently,a series of data were obtained from the simulated temperature distributions and to further fit the novel ablation coagulated area prediction model(ACAPM),thus rendering the ablation-dose table for the guiding surgical plan.The MWA clinical patient data and clinical devices suggested data were used to validate the accuracy and practicability of the established predicted model.Results:The 60 cases ex vivo porcine liver experiments demonstrated the accuracy of the simulated temperature distributions.Compared to traditional simulation methods,our approach reduces the long-diameter error of the ablation zone from 1.1 cm to 0.29 cm,achieving a 74%reduction in error.Further,the clinical data including the patients'operation results and devices provided values were consistent well with our predicated data,indicating the great potential of ACAPM to assist preoperative planning.展开更多
BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chem...BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chemotherapy failure remains underexplored.AIM To assess long-term survival and factors affecting outcomes of RFA in patients with multiple refractory CRLM.METHODS A retrospective study was conducted on patients who underwent ablation of CRLM at our institution between January 2015 and June 2024.A total of 80 patients were included,with 42 individuals receiving single-session ablation and 38 underwent repeat ablation.Enhanced computed tomography imaging was utilized to evaluate procedural efficacy 24 hours post-RFA,followed by follow-up scans every 3-4 months.Progression-free survival(PFS)and overall survival(OS)rates were compared at endpoint using Kaplan-Meier curves.Cox regression was used to identify the factors associated with OS and PFS.RESULTS The technical success rate was recorded at 98.7%.At endpoint,42(52.5%)patients achieved tumor-free survival,while 28(35%)remained alive with residual tumors present.No significant OS/PFS differences existed between single-session(median follow-up 29.5 months,median PFS 24.5 months)and repeat ablation(30 months,14 months)cohorts(P>0.05).Multivariate analysis showed that larger tumor size(P<0.001)and older age(P=0.01)were associated with worse OS.The median PFS was 13.5 months,with tumor size emerging as the only independent predictor(P=0.04).CONCLUSION For patients with multiple refractory CRLM,both single-session ablation and repeat ablation can increase the proportion of patients achieving tumor-free status.However,careful consideration is necessary for ablation of metastases larger than 2.7 cm.展开更多
To the Editor:Irreversible electroporation(IRE)is a promising ablative technique for hepatobiliary cancers.IRE has unique advantages,including no detrimental heat sink effect[1]and no injury of the surrounding tissues...To the Editor:Irreversible electroporation(IRE)is a promising ablative technique for hepatobiliary cancers.IRE has unique advantages,including no detrimental heat sink effect[1]and no injury of the surrounding tissues[2].For lesions in complex areas,bile duct[3],and large blood vessels[4],IRE has been developed as an alternative to thermal ablation such as radiofrequency and microwave.The IRE tumor ablative technique combines cell biology and pulsed high-voltage engineering.Repeated high-voltage,high-frequency and transient pulses can create irreversible electroporation in the phospholipid bilayer of the cell membrane and nuclear envelope,resulting in cell apoptosis.Compared with radiofrequency ablation and microwave ablation[5],IRE does not cause damage to important vessels and ducts.IRE has some unique shortcomings in delivering high currents,which has limited its clinical applications in the past.In animal and clinical studies,side effects including muscle contraction,procedural hypertension,and arrhythmia are frequently reported[6].However,during the ablation process,if the pulse is synchronized with the heart rhythm,the risk of arrhythmia is reduced.Sufficient muscle relaxant eliminates muscle contraction.Still,arrhythmia[7],hypertension[8],and myocardial infarction[9]are potential risks requiring proper precautions.These adverse events are mostly moderate and self-limiting,but they may have serious consequences for patients with coronary artery disease.Due to the potential risks,patients with a history of cardiovascular disease are not recommended for IRE treatment.展开更多
Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United State...Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United States,over 73%were solid organ tumors.Ablative therapies offer minimally invasive solutions for malignant tissue destruction in situ,often with reduced cost and morbidity compared to surgical resection.This review examines the current Food and Drug Administration-approved locoregional ablative therapies(radiofrequency,microwave,cryogenic,high-intensity focused ultrasound,histotripsy)and their evolving role in cancer care.Data were collected through a comprehensive survey of the PubMed-inde-xed literature on tumor ablation techniques,their clinical indications,and outco-mes.Over time,emerging clinical data will help establish these therapies as the standard of care in solid organ tumor treatment,supported by improved long-term outcomes and progression-free survival.展开更多
Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising ...Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.展开更多
In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure thes...In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure these statistical correlations,impeding machine learning models from effectively capturing the underlying patterns,thereby hampering efficient optimization of material properties.This work presents a novel active learning framework that integrates generative adversarial networks(GAN)with a directionally constrained expected absolute improvement(EAI)acquisition function to accelerate the discovery of ultra-high temperature ceramics(UHTCs)using small data.The framework employs GAN for data augmentation,symbolic regression for feature weight derivation,and a self-developed EAI function that incorporates input feature importance weighting to quantify bidirectional deviations from zero ablation rate.Through only two iterations,this framework successfully identified the optimal composition of HfB_(2)-3.52SiC-5.23TaSi_(2),which exhibits robust near-zero ablation rates under plasma ablation at 2500℃ for 200 s,demonstrating superior sampling efficiency compared to conventional active learning approaches.Microstructural analysis reveals that the exceptional performance stems from the formation of a highly viscous HfO_(2)-SiO_(2)-Ta_(2)O_(5)-HfSiO_(4)-Hf_(3)(BO_(3))_(4) oxide layer,which provides effective oxygen barrier protection.This work demonstrates an efficient and universal approach for rapid materials discovery using small data.展开更多
BACKGROUND According to the GLOBCAN2022 database,pancreatic cancer has become the 6th leading cause of cancer-related death worldwide.The latest statistics suggest that the incidence of pancreatic cancer is increasing...BACKGROUND According to the GLOBCAN2022 database,pancreatic cancer has become the 6th leading cause of cancer-related death worldwide.The latest statistics suggest that the incidence of pancreatic cancer is increasing at a rate of 0.5%to 1.0%per year,and it is expected to become the 2nd leading cause of tumor-related deaths in the United States by 2030.More than 50%of pancreatic cancer patients have already developed distant metastases at the time of diagnosis,with the liver being the most common site.Patients with pancreatic cancer with liver metastasis(PCLM)have a worse prognosis than those with locally progressed pancreatic cancer,with a median survival of less than six months.Therefore,the outcome of liver metastases is often a vital determinant of the prognosis of patients with PCLM.There are few successful cases of localized treatment for PCLM patients.Our department recently performed local radiofrequency ablation(RFA)treatment for a PCLM patient through an evidence-based medicine approach,with remarkable therapeutic effects.CASE SUMMARY The patient was admitted to the hospital on May 03,2018,3 weeks after pancreatic cancer surgery.In October 2017,the patient presented with lower back pain.No abnormalities were detected via computed tomography(CT),colonoscopy,or gastroscopy.However,on March 18,2018,the patient was investigated in a foreign hospital via CT,which suggested occupational lesions in the descending part of the duodenum,and magnetic resonance imaging suggested pancreatic occupancy.He was considered to be suffering from pancreatic cancer.He underwent laparoscopic-assisted pancreatic+duodenum+superior mesenteric vein partial resection and reconstruction under general anesthesia on March 26,2018 at The Affiliated Hospital of Xuzhou Medical University.The pancreas and duodenum were partially resected.Postoperative pathology showed adenocarcinoma of the pancreas(moderately differentiated),partly mucinous carcinoma,invading the mucosal layer of the duodenum;the tumor size was 4.5 cm×4 cm×4 cm.There was no apparent nerve or vascular invasion.There was no cancer or involvement of the pancreas section or expected hepatic duct margins.There was no cancer involvement in the gastric and duodenal sections.There was no cancer metastasis to the peripheral lymph nodes of the pancreas(0/9).No metastasis to the gastric lesser curvature or more significant curvature lymph nodes(0/1,0/5)was detected,and the peri-intestinal lymph nodes showed no cancer metastasis(0/4).Although the gallbladder showed signs of chronic cholecystitis,there was no cancer involvement,and the lymph nodes in Groups 12 and 13 also showed no cancer metastasis(0/6,0/1).His postoperative recovery was acceptable.CT was performed on May 2018 at our hospital and found the following:(1)Double lung bronchial vascular bundles slightly heavier than normal;(2)Postoperative changes in the pancreas and a retention tube shadow in front of the head of the pancreas;(3)Small cysts in the right lobe of the liver;(4)Abdominopelvic effusion;and(5)Para splenic enlargement.pTNM stage:PT3N0M0.The patient was in the second stage of postoperative pancreatic cancer,with a potential risk of recurrence considering the patient's postoperative body quality deviation.The patient was unable to tolerate the standard multidrug combination and underwent six cycles of single-agent gemcitabine chemotherapy from May 10,2018 to August 31,2018(the specific drug dosage was 1.4 g/d1/d8 gemcitabine injection,which was repeated every 21 days).Efficacy was determined to be stable disease after 2,4,and 6 cycles.The side effects during treatment were tolerable.CONCLUSION This case suggests that RFA can serve as a viable local treatment modality for selected patients with PCLM,offering a chance for long-term survival.Such localized interventions,when carefully tailored,may complement systemic therapies in controlling metastatic pancreatic cancer.展开更多
BACKGROUND Flat bone metastases are common in patients with advanced cancers,often resulting in severe pain,limited mobility,and reduced quality of life(QOL).Traditional treatment options,such as radiotherapy or syste...BACKGROUND Flat bone metastases are common in patients with advanced cancers,often resulting in severe pain,limited mobility,and reduced quality of life(QOL).Traditional treatment options,such as radiotherapy or systemic therapies,often fail to provide sufficient pain relief or improve functional outcomes in these patients.Microwave ablation(MWA)offers advantages,such as shorter pro-cedure times and larger ablation zones,while percutaneous osteoplasty(PO)enhances bone stability and prevents pathological fractures.Despite these be-nefits,the combination of these techniques for treating flat bone metastases re-mains underexplored.AIM To evaluate the efficacy and safety of C-arm computed tomography(CT)-guided MWA combined with PO for managing painful flat bone metastases,focusing on pain relief,functional improvement,and QOL enhancement.METHODS A total of 45 patients with refractory moderate-to-severe pain resulting from flat bone metastases who underwent C-arm CT-guided MWA combined with PO between January 2015 and January 2021 were included.The efficacy of the pro-cedure was assessed by changes in the visual analog scale(VAS),Oswestry disability index(ODI),and QOL,as well as the occurrence of complications.Tumor response was evaluated using RECIST v1.1 and mRECIST criteria,with overall response rate(ORR)and disease control rate(DCR)as the primary end-points.RESULTS No serious complications were observed in any of the patients.A significant reduction in VAS and ODI was noted at 1 week,1 month,and 3 months post-procedure.A marked improvement in QOL was observed at all follow-up points.Bone cement extravasation was observed in 10 patients;however,none exhibited significant clinical symptoms.Based on RECIST v1.1,the ORR was 26.7%and the DCR was 88.9%.The mRECIST evaluation revealed a higher ORR of 51.1%and DCR of 88.9%.CONCLUSION C-arm CT-guided MWA with PO provides a dependable and effective strategy for managing flat bone metastases.It demonstrates significant pain relief,improved functional outcomes,and enhanced QOL.This treatment combination also shows promising tumor response rates with a low complication profile.展开更多
文摘The numerical simulation of flow field around Hayabusa capsule loaded with light-weight ablator thermal response coupled with pyrolysis gas flow inside the ablator was carried out. In addition, the radiation from high temperature gas around the capsule was coupled with flow field. Hayabusa capsule reentered the atmosphere about 12 km/sec in velocity and Mach number about 30. During such an atmospheric entry, space vehicle is exposed to very savior aerodynamic heating due to convection and radiation. In this study, Hayabusa capsule was treated as a typical model of the atmospheric entry spacecraft. The light-weight ablator had porous structure, and permeability was an important parameter to analyze flow inside ablator. In this study, permeability was a variable parameter dependent on density of ablator. It is found that the effect of permeability of light-weight ablator was important with this analysis.
基金funded by the National Key R&D Program of China(Grant No.2023YFA1608400)the National Natural Science Foundation of China(Grant No.12302281).
文摘Hydrodynamic instability growth at the deuterium-tritium(DT)fuel-ablator interface plays a critical role in determining the performance of inertial confinement fusion implosions.During the late stages of implosion,insufficient doping of the ablator material can result in highenergy X-ray preheat,which may trigger the development of a classical-like Rayleigh-Taylor instability(RTI)at the fuel-ablator interface.In implosion experiments at the Shenguang 100 kJ-level laser facility,the primary source of perturbation is the roughness of the inner DT ice interface.In this study,we propose an analytical model to describe the feed-out process of the initial roughness of the inner DT ice interface.The perturbation amplitude derived from this model serves as the initial seed for the late-time RTI during the acceleration phase.Our findings confirm the presence of classical-like RTI at the fuel-ablator interface.Numerical simulations conducted using a radiation hydrodynamic code validate the proposed analytical model and demonstrate the existence of a peak mode number in both the feed-out process and the classical-like RTI.It provides an alternative bridge between the current target fabrication limitations and the unexpected implosion performance.
基金partly supported by the National Natural Science Foundation of China(Grant Nos.22178107,U21A2060,22178116)Xinjiang Uygur Autonomous Region Key Research and Development Program(Grant No.2022B01030)Shanghai Pujiang Program(Grant No.21PJD019)。
文摘Lightweight and high-toughness carbon fiber/phenolic ablator(CFPA)is required as the Thermal Protection System(TPS)material of aerospace vehicles for next-generation space missions.To improve the ablative properties,silica sol with good particle size distribution prepared using tetramethoxysilane(TMOS)was blended with natural rubber latex and deposited onto carbon fiber felt,which was then integrated with phenolic aerogel matrix,introducing nano-silica into the framework of CFPA.The modified CFPA with a low density of 0.28—0.31 g/cm3exhibits strain-in-fracture as high as 31.2%and thermal conductivity as low as 0.054 W/(m·K).Furthermore,a trace amount of nano-silica could effectively protect CFPA from erosion of oxidizing atmosphere in different high-temperature environments.The oxyacetylene ablation test of 3000°C for 20 s shows a mass ablation rate of 0.0225 g/s,a linear ablation rate of 0.209 mm/s for the modified CFPA,which are 9.64%and 24.82%lower than the unmodified one.Besides,the long-time butane ablation test of 1200°C for 200 s shows an insignificant recession with mass and linear ablation rate of 0.079 g/s and 0.039 mm/s,16.84%and 13.33%lower than the unmodified one.Meanwhile,the fixed thermocouple in the test also demonstrates a good thermal insulation performance with a low peak back-face temperature of 207.7°C,12.25%lower than the unmodified one.Therefore,the nano-silica modified CFPA with excellent overall performance presents promising prospects in high-temperature aerospace 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 National Key R&D Pro-gram of China(Grant No.2021YFA0715803)the National Natural Science Foundation of China(Grant Nos.52293373,52130205,and 52302091)+1 种基金the Joint Fund of Henan Province Science and Technol-ogy R&D Program(No.225200810002)the ND Basic Research Funds of Northwestern Polytechnical University(No.G2022WD).
文摘Multicomponent(Hf-Zr-Ta)B_(2)potentially provides improved ablation resistance compared with silicon-based ceramics.Here we deposited(Hf_(0.5-x/2)Zr_(0.5-x/2)Ta_(x))B_(2)(x=0,0.1,and 0.2)coatings onto C/C com-posites,and investigated their ablation behaviors under an oxyacetylene torch with a heat flux of 2.4 MW m^(-2).It was observed that the x=0.1 oxide scale bulged but was denser,and the x=0.2 oxide scale was blown away due to the formation of excessive liquid.Based on these findings,we further de-veloped a duplex(Hf-Zr-Ta)B_(2)coating that showed a linear recession rate close to zero(0.11μm s^(-1))after two 120-s ablation cycles.It is identified that the resulting oxide scale is mainly composed of(Hf,Zr)_(6)Ta_(2)O_(17)and(Hf,Zr,Ta)O_(2)by performing aberration-corrected(scanning)transmission electron microscopy.The protective mechanism is related to the peritectic transformation of orthorhombic-(Hf,Zr)_(6)Ta_(2)O_(17)to tetragonal-(Hf,Zr,Ta)O_(2)plus Ta-dominated liquid.This study contributes to the develop-ment of Ta-containing multicomponent UHTC bulk and coatings for ultra-high temperature applications.
文摘This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.
文摘Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.
文摘Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors.It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity.Recently,this technique has also been used in the treatment of intrahepatic cholangiocarcinoma for patients who are not eligible for surgical resection.There are several types of thermal ablation techniques.Radiofrequency ablation and microwave ablation are two common methods that induce necrosis of the lesions.Irreversible electroporation is a relatively new non-thermal technique and is suitable in cases where thermal ablation would be ineffective or dangerous(e.g.,malignant tumors close to vascular or biliary structures).Irreversible electroporation can induce tumoral necrosis without damage to vascular and biliary structures.The aim of this minireview was to describe the safety,efficacy,and clinical indications of these techniques in the treatment of patients with intrahepatic cholangiocarcinoma who are ineligible for surgery.
基金Open Fund of Zhijian Laboratory,Rocket Force University of Engineering(2024-ZJSYS-KF02-09)National Natural Science Foundation of China(51902028,52272034)+1 种基金Key Research and Development Program of Shaanxi(2023JBGS-15)Fundamental Research Funds for the Central Universities(Changan University,300102313202,300102312406)。
文摘To improve the compactness and properties of C/C-SiC-ZrC composites produced by precursor infiltration and pyrolysis(PIP)method,the low-temperature reactive melt infiltration(RMI)process was used to seal the composites using Zr_(2)Cu as the filler.The microstructure,mechanical properties,and ablation properties of the Zr_(2)Cu packed composites were analyzed.Results show that during Zr_(2)Cu impregnation,the melt efficiently fills the large pores of the composites and is converted to ZrCu due to a partial reaction of zirconium with carbon.This results in an increase in composite density from 1.91 g/cm^(3)to 2.24 g/cm^(3)and a reduction in open porosity by 27.35%.Additionally,the flexural strength of Zr_(2)Cu packed C/C-SiC-ZrC composites is improved from 122.78±8.09 MPa to 135.53±5.40 MPa.After plasma ablation for 20 s,the modified composites demonstrate superior ablative resistance compared to PIP C/C-SiC-ZrC,with mass ablation and linear ablation rates of 2.77×10^(−3)g/s and 2.60×10^(−3)mm/s,respectively.The“selftranspiration”effect of the low-melting point copper-containing phase absorbs the heat of the plasma flame,further reducing the ablation temperature and promoting the formation of refined ZrO_(2)particles within the SiO_(2)melting layer.This provides more stable erosion protection for Zr_(2)Cu packed C/C-SiC-ZrC composites.
基金Supported by the Joint Medical Scientific Research Project of Chongqing Science and Technology Committee and Chongqing Health Committee,No.2021MSXM308.
文摘Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablation and cryoablation and highlights its clinical efficacy,safety,and technical considerations.MWA offers significant benefits,including higher intratumoral temperatures,larger ablation zones,and reduced susceptibility to the heat-sink effect,which make it particularly suitable for tumors near large blood vessels.This review details the patient selection criteria,procedural approaches,and the use of advanced imaging techniques to improve the precision and effectiveness of MWA.Clinical outcomes indicate that MWA achieves high rates of complete tumor ablation and long-term survival with a favorable safety profile.This review is significant because it provides updated insights into the expanding role of MWA in treating unresectable CRLM and its potential as an alternative to surgical resection for resectable tumors.By summarizing recent studies and clinical trials,this review highlights the comparative effectiveness,safety,and integration with systemic therapies of MWA.In conclusion,MWA is a promising treatment option for CRLM and offers outcomes comparable to or better than those of other ablative techniques.Future research should focus on optimizing technical parameters,integrating MWA with systemic therapies,and conducting large-scale randomized controlled trials to establish standardized treatment protocols.Advancing our understanding of MWA will enhance its application and improve long-term survival and quality of life for patients with CRLM.
基金supported by the 2024 University Scientific Research Project of Guangzhou Education Bureau(Project No.24312286Certificate No.gd20249983112).
文摘Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.
基金supported by the Key Program of the National Natural Science Foundation of China(No.52032003)the Major Program of the National Natural Science Foundation of China(No.52293372)+2 种基金the National Natural Science Foundation of China(No.51972082)the National Natural Science Foundation of China(No.52102093)the National Natural Science Foundation of China(No.52172041)and the science foundation of national key laboratory of science and technology on advanced composites in special environments.
文摘The current generation of ultrahigh temperature ceramic precursors typically encounters obstacles in achieving high ceramic yields(<40 wt.%)due to the challenges in integrating significant amounts of boron,which hampers their conversion into boride-based ultrahigh temperature ceramics.To tackle these challenges,a serious of pioneering liquid multi-component hafnium-containing ceramic SiHfCB precursors(with different Hf/Si ratios)have been developed.These novel precursors are featured with stable molec-ular structure and high ceramic yield which were successfully created through a novel one-pot polymer-ization process.They present in liquid form and their structure is characterized by C-C bonds forming its main chain with branched chains of O-Si-O,Si-O-Hf,Si-O-B,and B-O-Hf which have untapped advantages including uniform component dispersion,and excellent fluidity.The ceramic yield of SiHfCB precursor with Hf/Si of 0.2 is remarkably up to 68.6 wt.%at 1500℃,and their Hf content exceeded 50 wt.%.Of particular interest,the pyrolyzed product HfB_(2)-SiC nanopowders derived from the SiHfCB precursor with Hf/Si of 0.2,consist of nanopowders in the 40-60 nm range with a density of 5.23 g cm^(−3).Remarkably,this material demonstrates exceptional performance in ultrahigh temperature oxygen-containing environ-ments at 2500℃,showing near-zero ablation with a linear ablation rate of just 2.5×10^(−4) mm s^(−1).Post-ablation analysis of the microstructure reveals that the formation of a lava-like HfO_(2) and HfO_(2)-SiO_(2) oxide layer effectively blocks oxygen penetration and provides excellent oxidation resistance.The inno-vative SiHfCB hafnium-containing ceramic precursor offers a groundbreaking solution for the preparation of lightweight ultrahigh-temperature ceramics.This development is poised to provide robust technical support for the use of ultrahigh temperature ceramics in non-ablative thermal protective systems,partic-ularly in the construction of hypersonic vehicles,where ultrahigh temperature resilience is crucial.
基金supported by the National Major Scientific Instruments and Equipment Development Project Funded by the National Natural Science Foundation of China(81827803)the Jiangsu Province Key Research and Development Program(Social Development)Project(BE2020705).
文摘Purpose:The major limitation of tumor microwave ablation(MWA)operation is the lack of predictability of the ablation zone before surgery.Operators rely on their individual experience to select a treatment plan,which is prone to either inadequate or excessive ablation.This paper aims to establish an ablation prediction model that guides MWA tumor surgical planning.Methods:An MWA process was first simulated by incorporating electromagnetic radiation equations,thermal equations,and optimized biological tissue parameters(dynamic dielectric and thermophysical parameters).The temperature distributions(the short/long diameters,and the total volume of the ablation zone)were then generated and verified by 60 cases ex vivo porcine liver experiments.Subsequently,a series of data were obtained from the simulated temperature distributions and to further fit the novel ablation coagulated area prediction model(ACAPM),thus rendering the ablation-dose table for the guiding surgical plan.The MWA clinical patient data and clinical devices suggested data were used to validate the accuracy and practicability of the established predicted model.Results:The 60 cases ex vivo porcine liver experiments demonstrated the accuracy of the simulated temperature distributions.Compared to traditional simulation methods,our approach reduces the long-diameter error of the ablation zone from 1.1 cm to 0.29 cm,achieving a 74%reduction in error.Further,the clinical data including the patients'operation results and devices provided values were consistent well with our predicated data,indicating the great potential of ACAPM to assist preoperative planning.
基金Supported by National Natural Science Foundation of China,No.82027803 and No.81971623Key Research and Development Project of Zhejiang Province,No.2024C03092.
文摘BACKGROUND The feasibility and safety of radiofrequency ablation(RFA)for oligometastatic colorectal liver metastases(CRLM)have been well established.However,the role of RFA in multiple metastases after first-line chemotherapy failure remains underexplored.AIM To assess long-term survival and factors affecting outcomes of RFA in patients with multiple refractory CRLM.METHODS A retrospective study was conducted on patients who underwent ablation of CRLM at our institution between January 2015 and June 2024.A total of 80 patients were included,with 42 individuals receiving single-session ablation and 38 underwent repeat ablation.Enhanced computed tomography imaging was utilized to evaluate procedural efficacy 24 hours post-RFA,followed by follow-up scans every 3-4 months.Progression-free survival(PFS)and overall survival(OS)rates were compared at endpoint using Kaplan-Meier curves.Cox regression was used to identify the factors associated with OS and PFS.RESULTS The technical success rate was recorded at 98.7%.At endpoint,42(52.5%)patients achieved tumor-free survival,while 28(35%)remained alive with residual tumors present.No significant OS/PFS differences existed between single-session(median follow-up 29.5 months,median PFS 24.5 months)and repeat ablation(30 months,14 months)cohorts(P>0.05).Multivariate analysis showed that larger tumor size(P<0.001)and older age(P=0.01)were associated with worse OS.The median PFS was 13.5 months,with tumor size emerging as the only independent predictor(P=0.04).CONCLUSION For patients with multiple refractory CRLM,both single-session ablation and repeat ablation can increase the proportion of patients achieving tumor-free status.However,careful consideration is necessary for ablation of metastases larger than 2.7 cm.
基金supported by grants from the National S&T Ma-jor Project of China (2018ZX10301201)National Natural Sci-ence Foundation of China (82027803)。
文摘To the Editor:Irreversible electroporation(IRE)is a promising ablative technique for hepatobiliary cancers.IRE has unique advantages,including no detrimental heat sink effect[1]and no injury of the surrounding tissues[2].For lesions in complex areas,bile duct[3],and large blood vessels[4],IRE has been developed as an alternative to thermal ablation such as radiofrequency and microwave.The IRE tumor ablative technique combines cell biology and pulsed high-voltage engineering.Repeated high-voltage,high-frequency and transient pulses can create irreversible electroporation in the phospholipid bilayer of the cell membrane and nuclear envelope,resulting in cell apoptosis.Compared with radiofrequency ablation and microwave ablation[5],IRE does not cause damage to important vessels and ducts.IRE has some unique shortcomings in delivering high currents,which has limited its clinical applications in the past.In animal and clinical studies,side effects including muscle contraction,procedural hypertension,and arrhythmia are frequently reported[6].However,during the ablation process,if the pulse is synchronized with the heart rhythm,the risk of arrhythmia is reduced.Sufficient muscle relaxant eliminates muscle contraction.Still,arrhythmia[7],hypertension[8],and myocardial infarction[9]are potential risks requiring proper precautions.These adverse events are mostly moderate and self-limiting,but they may have serious consequences for patients with coronary artery disease.Due to the potential risks,patients with a history of cardiovascular disease are not recommended for IRE treatment.
文摘Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United States,over 73%were solid organ tumors.Ablative therapies offer minimally invasive solutions for malignant tissue destruction in situ,often with reduced cost and morbidity compared to surgical resection.This review examines the current Food and Drug Administration-approved locoregional ablative therapies(radiofrequency,microwave,cryogenic,high-intensity focused ultrasound,histotripsy)and their evolving role in cancer care.Data were collected through a comprehensive survey of the PubMed-inde-xed literature on tumor ablation techniques,their clinical indications,and outco-mes.Over time,emerging clinical data will help establish these therapies as the standard of care in solid organ tumor treatment,supported by improved long-term outcomes and progression-free survival.
文摘Pancreatic neoplasms present a significant therapeutic challenge due to their complex anatomy and poor prognosis.In recent years,endoscopic ultrasound guided radiofrequency ablation(EUS-RFA)has emerged as a promising minimally invasive therapeutic option,aiming to provide targeted treatment with improved patients’outcomes.This review aims to shed light on current evidence about the efficacy,safety,and clinical outcomes of EUS-RFA in the management of pancreatic neoplasms.We conducted a comprehensive search of literature,reviewing studies that document the application of EUS-RFA in pancreatic masses.The key metrics for efficacy included tumor size reduction,pain relief,and overall survival,while safety outcomes focused on procedural complications and post-operative recovery.EUS-RFA has demonstrated potential in effectively managing both benign and malignant pancreatic neoplasms,with several studies reporting significant reductions in tumor size and symptomatic relief.The technique is associated with a favorable safety profile,characterized by a low incidence of major complications.EUS-RFA represents a valuable addition to the therapeutic arsenal for pancreatic neoplasms,offering a viable alternative to surgical interventions,especially in patients with contraindications for surgery.Further studies are needed to establish standardized protocols and long-term outcomes,enhancing its applicability and success in clinical practice.
基金supported by the Natural Science Foundation of China[grant numbers 52302093]Natural Science Foundation of Jiangxi Province[grant numbers 20224BAB204021].
文摘In materials science,a significant correlation often exists between material input parameters and their corresponding performance attributes.Nevertheless,the inherent challenges associated with small data obscure these statistical correlations,impeding machine learning models from effectively capturing the underlying patterns,thereby hampering efficient optimization of material properties.This work presents a novel active learning framework that integrates generative adversarial networks(GAN)with a directionally constrained expected absolute improvement(EAI)acquisition function to accelerate the discovery of ultra-high temperature ceramics(UHTCs)using small data.The framework employs GAN for data augmentation,symbolic regression for feature weight derivation,and a self-developed EAI function that incorporates input feature importance weighting to quantify bidirectional deviations from zero ablation rate.Through only two iterations,this framework successfully identified the optimal composition of HfB_(2)-3.52SiC-5.23TaSi_(2),which exhibits robust near-zero ablation rates under plasma ablation at 2500℃ for 200 s,demonstrating superior sampling efficiency compared to conventional active learning approaches.Microstructural analysis reveals that the exceptional performance stems from the formation of a highly viscous HfO_(2)-SiO_(2)-Ta_(2)O_(5)-HfSiO_(4)-Hf_(3)(BO_(3))_(4) oxide layer,which provides effective oxygen barrier protection.This work demonstrates an efficient and universal approach for rapid materials discovery using small data.
文摘BACKGROUND According to the GLOBCAN2022 database,pancreatic cancer has become the 6th leading cause of cancer-related death worldwide.The latest statistics suggest that the incidence of pancreatic cancer is increasing at a rate of 0.5%to 1.0%per year,and it is expected to become the 2nd leading cause of tumor-related deaths in the United States by 2030.More than 50%of pancreatic cancer patients have already developed distant metastases at the time of diagnosis,with the liver being the most common site.Patients with pancreatic cancer with liver metastasis(PCLM)have a worse prognosis than those with locally progressed pancreatic cancer,with a median survival of less than six months.Therefore,the outcome of liver metastases is often a vital determinant of the prognosis of patients with PCLM.There are few successful cases of localized treatment for PCLM patients.Our department recently performed local radiofrequency ablation(RFA)treatment for a PCLM patient through an evidence-based medicine approach,with remarkable therapeutic effects.CASE SUMMARY The patient was admitted to the hospital on May 03,2018,3 weeks after pancreatic cancer surgery.In October 2017,the patient presented with lower back pain.No abnormalities were detected via computed tomography(CT),colonoscopy,or gastroscopy.However,on March 18,2018,the patient was investigated in a foreign hospital via CT,which suggested occupational lesions in the descending part of the duodenum,and magnetic resonance imaging suggested pancreatic occupancy.He was considered to be suffering from pancreatic cancer.He underwent laparoscopic-assisted pancreatic+duodenum+superior mesenteric vein partial resection and reconstruction under general anesthesia on March 26,2018 at The Affiliated Hospital of Xuzhou Medical University.The pancreas and duodenum were partially resected.Postoperative pathology showed adenocarcinoma of the pancreas(moderately differentiated),partly mucinous carcinoma,invading the mucosal layer of the duodenum;the tumor size was 4.5 cm×4 cm×4 cm.There was no apparent nerve or vascular invasion.There was no cancer or involvement of the pancreas section or expected hepatic duct margins.There was no cancer involvement in the gastric and duodenal sections.There was no cancer metastasis to the peripheral lymph nodes of the pancreas(0/9).No metastasis to the gastric lesser curvature or more significant curvature lymph nodes(0/1,0/5)was detected,and the peri-intestinal lymph nodes showed no cancer metastasis(0/4).Although the gallbladder showed signs of chronic cholecystitis,there was no cancer involvement,and the lymph nodes in Groups 12 and 13 also showed no cancer metastasis(0/6,0/1).His postoperative recovery was acceptable.CT was performed on May 2018 at our hospital and found the following:(1)Double lung bronchial vascular bundles slightly heavier than normal;(2)Postoperative changes in the pancreas and a retention tube shadow in front of the head of the pancreas;(3)Small cysts in the right lobe of the liver;(4)Abdominopelvic effusion;and(5)Para splenic enlargement.pTNM stage:PT3N0M0.The patient was in the second stage of postoperative pancreatic cancer,with a potential risk of recurrence considering the patient's postoperative body quality deviation.The patient was unable to tolerate the standard multidrug combination and underwent six cycles of single-agent gemcitabine chemotherapy from May 10,2018 to August 31,2018(the specific drug dosage was 1.4 g/d1/d8 gemcitabine injection,which was repeated every 21 days).Efficacy was determined to be stable disease after 2,4,and 6 cycles.The side effects during treatment were tolerable.CONCLUSION This case suggests that RFA can serve as a viable local treatment modality for selected patients with PCLM,offering a chance for long-term survival.Such localized interventions,when carefully tailored,may complement systemic therapies in controlling metastatic pancreatic cancer.
文摘BACKGROUND Flat bone metastases are common in patients with advanced cancers,often resulting in severe pain,limited mobility,and reduced quality of life(QOL).Traditional treatment options,such as radiotherapy or systemic therapies,often fail to provide sufficient pain relief or improve functional outcomes in these patients.Microwave ablation(MWA)offers advantages,such as shorter pro-cedure times and larger ablation zones,while percutaneous osteoplasty(PO)enhances bone stability and prevents pathological fractures.Despite these be-nefits,the combination of these techniques for treating flat bone metastases re-mains underexplored.AIM To evaluate the efficacy and safety of C-arm computed tomography(CT)-guided MWA combined with PO for managing painful flat bone metastases,focusing on pain relief,functional improvement,and QOL enhancement.METHODS A total of 45 patients with refractory moderate-to-severe pain resulting from flat bone metastases who underwent C-arm CT-guided MWA combined with PO between January 2015 and January 2021 were included.The efficacy of the pro-cedure was assessed by changes in the visual analog scale(VAS),Oswestry disability index(ODI),and QOL,as well as the occurrence of complications.Tumor response was evaluated using RECIST v1.1 and mRECIST criteria,with overall response rate(ORR)and disease control rate(DCR)as the primary end-points.RESULTS No serious complications were observed in any of the patients.A significant reduction in VAS and ODI was noted at 1 week,1 month,and 3 months post-procedure.A marked improvement in QOL was observed at all follow-up points.Bone cement extravasation was observed in 10 patients;however,none exhibited significant clinical symptoms.Based on RECIST v1.1,the ORR was 26.7%and the DCR was 88.9%.The mRECIST evaluation revealed a higher ORR of 51.1%and DCR of 88.9%.CONCLUSION C-arm CT-guided MWA with PO provides a dependable and effective strategy for managing flat bone metastases.It demonstrates significant pain relief,improved functional outcomes,and enhanced QOL.This treatment combination also shows promising tumor response rates with a low complication profile.
