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
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
BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surg...BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.展开更多
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
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
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
BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that...BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.AIM To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation(RFA)according to the primary tumor location.METHODS This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018.The clinicopathological characteristics,recurrence patterns,and survival outcomes were systematically evaluated.RESULTS A total of 164 patients(mean age:58.0±9.8 years,range:34-83 years)who underwent percutaneous RFA of 325 CLMs(mean size:2.2±1.0 cm,range:0.7-5.0 cm)were included in the study.Eighty-nine(54.3%)patients had wild-type KRAS,and 75(45.7%)patients had mutated KRAS.Compared with wild-type patients,patients with KRAS mutations presented significantly higher local tumor progression rates(30.7%vs 14.6%,P=0.013).Among 126 patients(76.8%)who experienced post-RFA recurrence,61.6%developed intrahepatic metastases,and 53.7%developed extrahepatic metastases.Primary tumor location significantly modified KRASrelated outcomes:Compared with wild-type patients,left-sided colorectal cancer(CRC)patients with KRAS mutations presented higher intrahepatic recurrence rates(77.2%vs 52.5%,P=0.003)and shorter median intrahepatic recurrence-free survival(15 vs 25 months,P=0.007).No significant differences in KRAS expression were detected in right-sided tumors.CONCLUSION KRAS mutation status predicts differential recurrence patterns after CLM ablation,with significant prognostic implications,specifically in left-sided CRCs.These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.展开更多
Radiofrequency ablation(RFA)is a form of minimally invasive procedure that precisely ablates abnormal lesions or hyperplastic tissues through thermal energy generated by the radiofrequency current at the tip electrode...Radiofrequency ablation(RFA)is a form of minimally invasive procedure that precisely ablates abnormal lesions or hyperplastic tissues through thermal energy generated by the radiofrequency current at the tip electrode of the flexible catheter,which aims to partially or fully restore the function of the corresponding tissues or organs.Accurate prediction and control of thermal fields are crucial for clinical thermal ablation to ensure precise control of the ablation lesion size and prevent excessive burning of healthy tissues.In this study,an axisymmetric analytical model is developed for the electrothermal analysis of RFA in the cambered tissue surface and verified with the finite element analysis(FEA),which incorporates both the thermal field induced by the radiofrequency current and Pennes'biothermal effect.This model utilizes analytically derived electric and thermal fields to accurately predict the increase in the tissue temperature and the time-varying size of ablation lesion in the tissue.Furthermore,the parameters such as the input current density,curvature,and convective heat transfer coefficient of blood have a significant effect on the thermal field and thus the ablation lesion size.This electrothermal analytical model with a large curvature may provide a theoretical foundation and guidance for the future RFA applications on large-curvature biological surfaces,thereby enhancing accuracy,reducing the need for re-ablation,and lowering the costs associated with the design and production of ablation catheters.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide.Transarterial chemoembolization(TACE)combined with percutaneous radiofrequency ablation(RFA)has emerged as a promising t...BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide.Transarterial chemoembolization(TACE)combined with percutaneous radiofrequency ablation(RFA)has emerged as a promising treatment strategy for patients with unresectable HCC.AIM To evaluate the effectiveness and safety of TACE combined with RFA compared to TACE alone in the management of primary HCC.METHODS A comprehensive retrospective analysis was conducted at our institution from January 2020 to January 2024,involving 106 patients diagnosed with intermediate to advanced-stage HCC.Patients were divided into two groups:Those receiving TACE alone(n=56)and those undergoing combined TACE and RFA therapy(n=50).Treatment efficacy was assessed based on tumor response rates,serum alphafetoprotein(AFP)levels,and survival outcomes.Statistical analyses,includingχ^(2)tests and Kaplan-Meier survival analysis,were performed to compare the outcomes between the two groups.RESULTS The TACE+RFA group demonstrated significantly higher rates of complete response(15 vs 4,P<0.01)and partial response(23 vs 15,P=0.046)compared to the TACE group.Conversely,the TACE group exhibited higher rates of stable disease(25 vs 7,P<0.01)and progressive disease(12 vs 5,P<0.01).Serum AFP levels decreased over time in the TACE+RFA group,while they increased in the TACE group.Survival analysis revealed superior survival outcomes in the TACE+RFA group,with higher survival rates and a prolonged median survival time compared to the TACE group.CONCLUSION The combination of RFA with TACE could offer enhanced treatment response and prolonged survival in patients with primary HCC compared to TACE alone.These findings might support the adoption of multimodal therapeutic approaches,emphasizing the importance of personalized treatment strategies in the management of HCC.展开更多
The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associat...The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.展开更多
BACKGROUND Aging is an inevitable aspect of human life,characterized by the gradual decline in the function of individual cells and structural components,including bones,muscles,and ligaments.AIM To evaluate the clini...BACKGROUND Aging is an inevitable aspect of human life,characterized by the gradual decline in the function of individual cells and structural components,including bones,muscles,and ligaments.AIM To evaluate the clinical effects of radiofrequency technology in treating facial skin wrinkles and laxity.METHODS This study included 60 female patients,aged 36-58 years(mean age 47.71±1.56 years),who received focused radiofrequency technology treatment for facial wrinkles and laxity in the Department of Medical Cosmetology at our hospital between January 2021 and June 2022.Each patient underwent three treatment sessions,one every two months.Facial photographs were taken before treatment and one week after the final session.A single physician assessed wrinkle severity using a standardized wrinkle severity scale,and patients completed a satisfaction questionnaire one week after the last treatment.RESULTS After three consecutive radiofrequency treatments,performed every two months,patients exhibited significantly reduced wrinkles and skin laxity compared to baseline.One week after the third treatment,the mean facial wrinkle severity score had significantly decreased from 3.00±0.79 to 2.71±0.47(t=2.58,P<0.05).Additionally,88.24%of patients reported noticeable improvements in facial wrinkles and skin laxity.No serious adverse reactions occurred during or follow-ing treatment.CONCLUSION Radiofrequency technology demonstrates significant clinical efficacy in improving facial skin wrinkles and laxity.展开更多
Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in...Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.展开更多
Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the...Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the effects of radiofrequency catheter ablation(RFCA)on blood pressure regulation in patients with paroxysmal atrial fibrilla-tion(PAF)and primary hypertension.Methods This prospective cohort study included 65 patients(44 males,21 females)with PAF and primary hypertension who underwent RFCA.Blood pressure was measured preoperatively and at 3 months postoperatively using 24-hour ambulatory blood pressure monitoring.Changes in blood pressure parameters were compared between male and female patients.Results Significant gender differences were ob-served in 24-hour mean systolic blood pressure(24h SBP)and daytime mean systolic blood pressure(dSBP).In male patients,24h SBP decreased by 5.16 mmHg,and dSBP decreased by 4.30 mmHg,while female patients showed minimal changes,with a decrease of 1.44 mmHg in 24h SBP and 0.39 mmHg in dSBP.These changes were significantly different between genders(P<0.001 for 24h SBP and P=0.005 for dSBP).No significant differences were found between males and females in other blood pressure parameters(P>0.05).Conclusions RFCA signifi-cantly improved blood pressure control in male patients with PAF and primary hypertension,with more pronounced reductions in 24h SBP and dSBP compared to female patients.These findings suggested that gender may influence the effectiveness of RFCA in managing blood pressure in this population,underscoring the importance of consider-ing gender when planning treatment strategies.展开更多
BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellu...BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma(HCC)who AIM To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus(anti-HBV)agents after RFA.METHODS This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital,China,from August 2018 to December 2020,and had complete clinical data.All patients were followed up for at least 144 weeks.Cox regression analysis was performed to identify independent risk factors for HCC recurrence.Recurrence-free survival was analyzed using Kaplan-Meier curves,and Cox regression models were constructed after adjusting for gamma-glutamyl transferase,alpha-fetoprotein,and Barcelona Clinic Liver Cancer staging.RESULTS A total of 319 patients receiving oral anti-HBV therapy were divided into three groups:ETV group(n=191),TDF group(n=76),and TAF group(n=52).At 6 and 12 months,there were no significant differences in recurrence rates between the groups.However,at 24 and 36 months,the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group[24 months:TDF,hazard ratio(HR)=0.51,95%confidence interval(CI):0.29-0.91,P=0.022;TAF,HR=0.54,95%CI:0.28-1.03,P=0.046;36 months:TDF,HR=0.57,95%CI:0.35-0.93,P=0.025;TAF,HR=0.54,95%CI:0.31-0.96,P=0.037].The 3-year mortality rates were similar across the three groups(ETV:21.47%,TDF:18.42%,TAF:23.08%;P=0.790).CONCLUSION Among patients with hepatitis B cirrhosis-related HCC,TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV.However,there were no significant differences in 3-year mortality rates between the ETV,TDF,and TAF groups.展开更多
Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Method...Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Methods:90 patients with lumbar disc herniation who underwent radiofrequency ablation(RFA)combined with ozone interventional therapy in the Orthopedics and Traumatology Department of our hospital from January to December 2019 were included as research samples.They were randomly divided into two groups using a random number table method:the control group(45 cases)received routine perioperative nursing and health education;the experimental group(45 cases)received a comprehensive psychological intervention program consisting of MBSR combined with relaxation training in addition to the control group’s treatment.Changes in pain perception(VAS),sleep quality(PSQI),psychological state(SAS/SDS),and life satisfaction(SWLS)were compared between the two groups before and after the intervention.Results:After the intervention,both groups showed a significant decrease in SAS and SDS scores(P<0.05),with a greater decrease in the experimental group(P<0.05);the experimental group had lower PSQI total scores and scores in each dimension compared to the control group(P<0.05);the experimental group had a significantly lower VAS score(3.56±0.88)compared to the control group(5.94±0.62)(P<0.05);the experimental group had a higher SWLS score(28.59±5.61)compared to the control group(22.46±4.15)(P<0.05).Conclusion:MBSR combined with relaxation training can significantly optimize the perioperative psychological state of patients undergoing RFA combined with ozone interventional therapy,reduce pain sensitivity and stress responses,and simultaneously improve sleep quality and treatment satisfaction.展开更多
Background:Radiofrequency ablation(RFA)is an efficient treatment with unlimited potential for liver cancer that can effectively reduce patient mortality.Understanding the biological process related with RFA treatment ...Background:Radiofrequency ablation(RFA)is an efficient treatment with unlimited potential for liver cancer that can effectively reduce patient mortality.Understanding the biological process related with RFA treatment is important for improving treatment strategy.This study aimed to identify the critical targets for regulating the efficacy of RFA.Methods:The RFA treatment in hepatocellular carcinoma(HCC)tumor models in vivo,was analyzed by RNA sequencing technology.The heat treatment in vitro for HCC tumor cells was also constructed to explore the mechanism after RFA treatment in tumor cells.Nanoparticles with high affinity to tumor cells were applied as a new therapy to interfere with the expression of maternal embryonic leucine zipper kinase(MELK).Results:It was found that RFA treatment upregulated MELK expression,and MELK inhibition promoted RFA efficacy by immunogenic cell death and the antitumor response,including anti-tumoral macrophage polarization and increased CD8+T cell cytotoxicity in HCC.Mechanically,MELK binds to fatty acid-binding protein 5(FABP5),and affects its ubiquitination through the K48R pathway to increase its stability,thereby activating protein kinase B(Akt)/mammalian target of rapamycin(mTOR)signaling axis to weaken the RFA-mediated antitumor effect.In addition,the synthesis of arginylglycylaspartic acid(RGD)-lipid nanoparticles(LNPs)targeting tumor cell-intrinsic MELK enhanced RFA efficacy in HCC.Conclusions:MELK is a therapeutic target by regulating RFA efficacy in HCC,and targeting MELK via RGD-LNPs provides new insight into improving RFA efficacy in HCC clinical treatment and combating the malignant progression of liver cancer.展开更多
BACKGROUND Percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients w...BACKGROUND Percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients with unresectable malignant obstructive jaundice,yet the safety and effect of endobiliary radiofrequency ablation(EB-RFA)combined PTCD is rarely reported,in this article,we report our experience of EB-RFA combined PTCD in such patients.AIM To retrospectively study the efficacy and safety of EB-RFA combined PTCD in patients with unresectable malignant obstructive jaundice.METHODS Patients with unresectable malignant obstructive jaundice treated with EB-RFA under PTCD were selected,the bile ducts of the right posterior lobe was selected as the target bile ducts in all cases.The general conditions of all patients,preoperative tumour markers,total bilirubin(TBIL),direct bilirubin(DBIL),albumin(ALB),alkaline phosphatase(ALP),and glutamyl transferase(GGT)before and on the 7th day after the procedure,as well as perioperative complications,stent patency time and patient survival were recorded.RESULTS All patients successfully completed the operation,TBIL and DBIL decreased significantly in all patients at the 7th postoperative day(P=0.009 and 0.006,respectively);the values of ALB,ALP and GGT also decreased compared with the preoperative period,but the difference was not statistically significant.Perioperative biliary bleeding occurred in 2 patients,which was improved after transfusion of blood and other conservative treatments,pancreatitis appeared in 1 patient after the operation,no serious complication and death happened after operation.Except for 3 patients with loss of visits,the stent patency rate of the remaining 14 patients was 100%71%and 29%at the 1^(st),3^(rd),and 6^(th)postoperative months respectively,with a median survival of 4 months.CONCLUSION EB-RFA under PTCD in patients with unresectable malignant obstructive jaundice has a satisfactory therapeutic effect and high safety,which is worthy of further clinical practice.展开更多
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.
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.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.
文摘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.
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 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 Capital Health Development Research Project,No.2020-2-2152National Natural Science Foundation of China,No.82472002.
文摘BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.AIM To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation(RFA)according to the primary tumor location.METHODS This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018.The clinicopathological characteristics,recurrence patterns,and survival outcomes were systematically evaluated.RESULTS A total of 164 patients(mean age:58.0±9.8 years,range:34-83 years)who underwent percutaneous RFA of 325 CLMs(mean size:2.2±1.0 cm,range:0.7-5.0 cm)were included in the study.Eighty-nine(54.3%)patients had wild-type KRAS,and 75(45.7%)patients had mutated KRAS.Compared with wild-type patients,patients with KRAS mutations presented significantly higher local tumor progression rates(30.7%vs 14.6%,P=0.013).Among 126 patients(76.8%)who experienced post-RFA recurrence,61.6%developed intrahepatic metastases,and 53.7%developed extrahepatic metastases.Primary tumor location significantly modified KRASrelated outcomes:Compared with wild-type patients,left-sided colorectal cancer(CRC)patients with KRAS mutations presented higher intrahepatic recurrence rates(77.2%vs 52.5%,P=0.003)and shorter median intrahepatic recurrence-free survival(15 vs 25 months,P=0.007).No significant differences in KRAS expression were detected in right-sided tumors.CONCLUSION KRAS mutation status predicts differential recurrence patterns after CLM ablation,with significant prognostic implications,specifically in left-sided CRCs.These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.
基金Project supported by the National Natural Science Foundation of China(Nos.U23A20111 and 12372160)。
文摘Radiofrequency ablation(RFA)is a form of minimally invasive procedure that precisely ablates abnormal lesions or hyperplastic tissues through thermal energy generated by the radiofrequency current at the tip electrode of the flexible catheter,which aims to partially or fully restore the function of the corresponding tissues or organs.Accurate prediction and control of thermal fields are crucial for clinical thermal ablation to ensure precise control of the ablation lesion size and prevent excessive burning of healthy tissues.In this study,an axisymmetric analytical model is developed for the electrothermal analysis of RFA in the cambered tissue surface and verified with the finite element analysis(FEA),which incorporates both the thermal field induced by the radiofrequency current and Pennes'biothermal effect.This model utilizes analytically derived electric and thermal fields to accurately predict the increase in the tissue temperature and the time-varying size of ablation lesion in the tissue.Furthermore,the parameters such as the input current density,curvature,and convective heat transfer coefficient of blood have a significant effect on the thermal field and thus the ablation lesion size.This electrothermal analytical model with a large curvature may provide a theoretical foundation and guidance for the future RFA applications on large-curvature biological surfaces,thereby enhancing accuracy,reducing the need for re-ablation,and lowering the costs associated with the design and production of ablation catheters.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide.Transarterial chemoembolization(TACE)combined with percutaneous radiofrequency ablation(RFA)has emerged as a promising treatment strategy for patients with unresectable HCC.AIM To evaluate the effectiveness and safety of TACE combined with RFA compared to TACE alone in the management of primary HCC.METHODS A comprehensive retrospective analysis was conducted at our institution from January 2020 to January 2024,involving 106 patients diagnosed with intermediate to advanced-stage HCC.Patients were divided into two groups:Those receiving TACE alone(n=56)and those undergoing combined TACE and RFA therapy(n=50).Treatment efficacy was assessed based on tumor response rates,serum alphafetoprotein(AFP)levels,and survival outcomes.Statistical analyses,includingχ^(2)tests and Kaplan-Meier survival analysis,were performed to compare the outcomes between the two groups.RESULTS The TACE+RFA group demonstrated significantly higher rates of complete response(15 vs 4,P<0.01)and partial response(23 vs 15,P=0.046)compared to the TACE group.Conversely,the TACE group exhibited higher rates of stable disease(25 vs 7,P<0.01)and progressive disease(12 vs 5,P<0.01).Serum AFP levels decreased over time in the TACE+RFA group,while they increased in the TACE group.Survival analysis revealed superior survival outcomes in the TACE+RFA group,with higher survival rates and a prolonged median survival time compared to the TACE group.CONCLUSION The combination of RFA with TACE could offer enhanced treatment response and prolonged survival in patients with primary HCC compared to TACE alone.These findings might support the adoption of multimodal therapeutic approaches,emphasizing the importance of personalized treatment strategies in the management of HCC.
文摘The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.
文摘BACKGROUND Aging is an inevitable aspect of human life,characterized by the gradual decline in the function of individual cells and structural components,including bones,muscles,and ligaments.AIM To evaluate the clinical effects of radiofrequency technology in treating facial skin wrinkles and laxity.METHODS This study included 60 female patients,aged 36-58 years(mean age 47.71±1.56 years),who received focused radiofrequency technology treatment for facial wrinkles and laxity in the Department of Medical Cosmetology at our hospital between January 2021 and June 2022.Each patient underwent three treatment sessions,one every two months.Facial photographs were taken before treatment and one week after the final session.A single physician assessed wrinkle severity using a standardized wrinkle severity scale,and patients completed a satisfaction questionnaire one week after the last treatment.RESULTS After three consecutive radiofrequency treatments,performed every two months,patients exhibited significantly reduced wrinkles and skin laxity compared to baseline.One week after the third treatment,the mean facial wrinkle severity score had significantly decreased from 3.00±0.79 to 2.71±0.47(t=2.58,P<0.05).Additionally,88.24%of patients reported noticeable improvements in facial wrinkles and skin laxity.No serious adverse reactions occurred during or follow-ing treatment.CONCLUSION Radiofrequency technology demonstrates significant clinical efficacy in improving facial skin wrinkles and laxity.
文摘Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.
文摘Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the effects of radiofrequency catheter ablation(RFCA)on blood pressure regulation in patients with paroxysmal atrial fibrilla-tion(PAF)and primary hypertension.Methods This prospective cohort study included 65 patients(44 males,21 females)with PAF and primary hypertension who underwent RFCA.Blood pressure was measured preoperatively and at 3 months postoperatively using 24-hour ambulatory blood pressure monitoring.Changes in blood pressure parameters were compared between male and female patients.Results Significant gender differences were ob-served in 24-hour mean systolic blood pressure(24h SBP)and daytime mean systolic blood pressure(dSBP).In male patients,24h SBP decreased by 5.16 mmHg,and dSBP decreased by 4.30 mmHg,while female patients showed minimal changes,with a decrease of 1.44 mmHg in 24h SBP and 0.39 mmHg in dSBP.These changes were significantly different between genders(P<0.001 for 24h SBP and P=0.005 for dSBP).No significant differences were found between males and females in other blood pressure parameters(P>0.05).Conclusions RFCA signifi-cantly improved blood pressure control in male patients with PAF and primary hypertension,with more pronounced reductions in 24h SBP and dSBP compared to female patients.These findings suggested that gender may influence the effectiveness of RFCA in managing blood pressure in this population,underscoring the importance of consider-ing gender when planning treatment strategies.
基金Supported by Tianjin Health Project of China,No.TJWJ2022XK029.
文摘BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma(HCC)who AIM To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus(anti-HBV)agents after RFA.METHODS This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital,China,from August 2018 to December 2020,and had complete clinical data.All patients were followed up for at least 144 weeks.Cox regression analysis was performed to identify independent risk factors for HCC recurrence.Recurrence-free survival was analyzed using Kaplan-Meier curves,and Cox regression models were constructed after adjusting for gamma-glutamyl transferase,alpha-fetoprotein,and Barcelona Clinic Liver Cancer staging.RESULTS A total of 319 patients receiving oral anti-HBV therapy were divided into three groups:ETV group(n=191),TDF group(n=76),and TAF group(n=52).At 6 and 12 months,there were no significant differences in recurrence rates between the groups.However,at 24 and 36 months,the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group[24 months:TDF,hazard ratio(HR)=0.51,95%confidence interval(CI):0.29-0.91,P=0.022;TAF,HR=0.54,95%CI:0.28-1.03,P=0.046;36 months:TDF,HR=0.57,95%CI:0.35-0.93,P=0.025;TAF,HR=0.54,95%CI:0.31-0.96,P=0.037].The 3-year mortality rates were similar across the three groups(ETV:21.47%,TDF:18.42%,TAF:23.08%;P=0.790).CONCLUSION Among patients with hepatitis B cirrhosis-related HCC,TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV.However,there were no significant differences in 3-year mortality rates between the ETV,TDF,and TAF groups.
基金General Project,Scientific Research Project Plan for Traditional Chinese Medicine in Hebei Province(Project No.:T2025117)。
文摘Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Methods:90 patients with lumbar disc herniation who underwent radiofrequency ablation(RFA)combined with ozone interventional therapy in the Orthopedics and Traumatology Department of our hospital from January to December 2019 were included as research samples.They were randomly divided into two groups using a random number table method:the control group(45 cases)received routine perioperative nursing and health education;the experimental group(45 cases)received a comprehensive psychological intervention program consisting of MBSR combined with relaxation training in addition to the control group’s treatment.Changes in pain perception(VAS),sleep quality(PSQI),psychological state(SAS/SDS),and life satisfaction(SWLS)were compared between the two groups before and after the intervention.Results:After the intervention,both groups showed a significant decrease in SAS and SDS scores(P<0.05),with a greater decrease in the experimental group(P<0.05);the experimental group had lower PSQI total scores and scores in each dimension compared to the control group(P<0.05);the experimental group had a significantly lower VAS score(3.56±0.88)compared to the control group(5.94±0.62)(P<0.05);the experimental group had a higher SWLS score(28.59±5.61)compared to the control group(22.46±4.15)(P<0.05).Conclusion:MBSR combined with relaxation training can significantly optimize the perioperative psychological state of patients undergoing RFA combined with ozone interventional therapy,reduce pain sensitivity and stress responses,and simultaneously improve sleep quality and treatment satisfaction.
基金supported by the National Natural Science Foundation of China(82072025,82072026,82102162,and 82303886)the“Leading Goose”Research and Development Program of Zhejiang Province(2023C03062)+1 种基金the National Natural Science Foundation of Zhejiang Province(LY22H160040 and LQ22H180010)the Key Research and Development Project of Lishui City(2022ZDYF12,2022ZDYF20,and 2022ZDYF20).
文摘Background:Radiofrequency ablation(RFA)is an efficient treatment with unlimited potential for liver cancer that can effectively reduce patient mortality.Understanding the biological process related with RFA treatment is important for improving treatment strategy.This study aimed to identify the critical targets for regulating the efficacy of RFA.Methods:The RFA treatment in hepatocellular carcinoma(HCC)tumor models in vivo,was analyzed by RNA sequencing technology.The heat treatment in vitro for HCC tumor cells was also constructed to explore the mechanism after RFA treatment in tumor cells.Nanoparticles with high affinity to tumor cells were applied as a new therapy to interfere with the expression of maternal embryonic leucine zipper kinase(MELK).Results:It was found that RFA treatment upregulated MELK expression,and MELK inhibition promoted RFA efficacy by immunogenic cell death and the antitumor response,including anti-tumoral macrophage polarization and increased CD8+T cell cytotoxicity in HCC.Mechanically,MELK binds to fatty acid-binding protein 5(FABP5),and affects its ubiquitination through the K48R pathway to increase its stability,thereby activating protein kinase B(Akt)/mammalian target of rapamycin(mTOR)signaling axis to weaken the RFA-mediated antitumor effect.In addition,the synthesis of arginylglycylaspartic acid(RGD)-lipid nanoparticles(LNPs)targeting tumor cell-intrinsic MELK enhanced RFA efficacy in HCC.Conclusions:MELK is a therapeutic target by regulating RFA efficacy in HCC,and targeting MELK via RGD-LNPs provides new insight into improving RFA efficacy in HCC clinical treatment and combating the malignant progression of liver cancer.
文摘BACKGROUND Percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients with unresectable malignant obstructive jaundice,yet the safety and effect of endobiliary radiofrequency ablation(EB-RFA)combined PTCD is rarely reported,in this article,we report our experience of EB-RFA combined PTCD in such patients.AIM To retrospectively study the efficacy and safety of EB-RFA combined PTCD in patients with unresectable malignant obstructive jaundice.METHODS Patients with unresectable malignant obstructive jaundice treated with EB-RFA under PTCD were selected,the bile ducts of the right posterior lobe was selected as the target bile ducts in all cases.The general conditions of all patients,preoperative tumour markers,total bilirubin(TBIL),direct bilirubin(DBIL),albumin(ALB),alkaline phosphatase(ALP),and glutamyl transferase(GGT)before and on the 7th day after the procedure,as well as perioperative complications,stent patency time and patient survival were recorded.RESULTS All patients successfully completed the operation,TBIL and DBIL decreased significantly in all patients at the 7th postoperative day(P=0.009 and 0.006,respectively);the values of ALB,ALP and GGT also decreased compared with the preoperative period,but the difference was not statistically significant.Perioperative biliary bleeding occurred in 2 patients,which was improved after transfusion of blood and other conservative treatments,pancreatitis appeared in 1 patient after the operation,no serious complication and death happened after operation.Except for 3 patients with loss of visits,the stent patency rate of the remaining 14 patients was 100%71%and 29%at the 1^(st),3^(rd),and 6^(th)postoperative months respectively,with a median survival of 4 months.CONCLUSION EB-RFA under PTCD in patients with unresectable malignant obstructive jaundice has a satisfactory therapeutic effect and high safety,which is worthy of further clinical practice.
