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PURPOSE: To assess the relationship between dislocation and functional outcomes in supination-external rotation (SER) ankle fractures. METHODS: A retrospective case series study was performed on patients with ankle fractures treated surgically at a large trauma center from January 2015 to December 2021. The inclusion criteria were young and middle-aged patients of 18-65 years with SER ankle fractures that can be classified by Lauge-Hansen classification and underwent surgery at our trauma center. Exclusion criteria were serious life-threatening diseases, open fractures, fractures delayed for more than 3 weeks, fracture sites ≥2, etc. Then patients were divided into dislocation and no-dislocation groups. Patient demographics, injury characteristics, surgery-related outcomes, and postoperative functional outcomes were collected and analyzed. The functional outcomes of SER ankle fractures were assessed postoperatively at 1-year face-to-face follow-up using the foot and ankle outcome score (FAOS) and American orthopedic foot and ankle society score and by 2 experienced orthopedic physicians. Relevant data were analyzed using SPSS version 22.0 by Chi-square or t-test. RESULTS: During the study period, there were 371 ankle fractures. Among them, 190 (51.2%) were SER patterns with 69 (36.3%) combined with dislocations. Compared with the no-dislocation group, the dislocation group showed no statistically significant differences in gender, age composition, fracture type, preoperative complications with diabetes, smoking history, preoperative waiting time, operation time, and length of hospital stay (all p > 0.05), but a significantly higher Lauge-Hansen injury grade (p < 0.001) and syndesmotic screw fixation rate (p = 0.033). Moreover, the functional recovery was poorer, revealing a significantly lower FAOS in the sport/rec scale (p < 0.001). Subgroup analysis showed that among SER IV ankle fracture patients, FAOS was much lower in pain (p = 0.042) and sport/rec scales (p < 0.001) for those with dislocations. American orthopedic foot and ankle society score revealed no significant difference between dislocation and no-dislocation patients. CONCLUSION: Dislocation in SER ankle fractures suggests more severe injury and negatively affects functional recovery, mainly manifested as more pain and poorer motor function, especially in SER IV ankle cases.
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How to effectively improve energy transfer efficiency and luminous intensity inspired us to synthesize a series of SiO2:x%Tb3+@Gd2O3:y%Eu3+ samples, study their luminescence properties and interfacial energy transfer (IET), and compare with SiO2:x%Eu3+@Gd2O3:y%Tb3+. The results show that SiO2:x%Tb3+@Gd2O3:y%Eu3+ can exhibit adjustable multicolor luminescence from red to green at different concentrations of Eu3+ and Tb3+ or under different excitation wavelengths, and there exists efficient IET from Tb3+ to Eu3+ in SiO2:x%Tb3+@Gd2O3:y%Eu3+ and SiO2:x%Eu3+@Gd2O3:y%Tb3+, which improves the energy transfer efficiency and luminous intensity. In addition, the luminescence properties are different between SiO2:3%Tb3+@Gd2O3:3%Eu3+ and SiO2:3%Eu3+@Gd2O3:3%Tb3+, and the energy transfer efficiency of Tb3+ â Eu3+ in SiO2:3%Tb3+@Gd2O3:3%Eu3+ is obviously higher than that in SiO2:3%Eu3+@Gd2O3:3%Tb3+. The present study not only developed a kind of multicolor luminescent phosphor but also offered an important new strategy for improving the energy transfer efficiency and luminescent intensity.
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There is an urgent need for an oral, efficient and safe regimen for high-risk APL under the pandemic of COVID-19. We retrospectively analysed 60 high-risk APL patients. For induction therapy (IT), in addition to all-trans retinoic acid (ATRA) and oral arsenic (RIF), 22 patients received oral etoposide (VP16) as cytotoxic chemotherapy (CC), and 38 patients received intravenous CC as historical control group. The median dose of oral VP16 was 1000 mg [interquartile rage (IQR), 650-1250]. One patient died during IT in the control group, 59 evaluable patients (100%) achieved complete haematological remission (CHR) after IT and complete molecular remission (CMR) after consolidation therapy. The median time to CHR and CMR was 36 days (33.8-44) versus 35 days (32-42; p = 0.75) and 3 months (0.8-3.5) versus 3.3 months (2.4-3.7; p = 0.58) in the oral VP16 group and in the control group. Two (9.1%) and 3 (7.9%) patients experienced molecular relapse in different group respectively. The 2-year estimated overall survival and event-free survival were 100% versus 94.7% (p = 0.37) and 90.9% versus 89.5% (p = 0.97) respectively. A completely oral, efficient and safe induction regimen including oral VP16 as cytoreductive chemotherapy combined with ATRA and RIF is more convenient to administer for patients with high-risk APL.
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Etopósido , Quimioterapia de Inducción , Leucemia Promielocítica Aguda , Humanos , Etopósido/administración & dosificación , Etopósido/uso terapéutico , Masculino , Femenino , Persona de Mediana Edad , Adulto , Administración Oral , Estudios Retrospectivos , Quimioterapia de Inducción/métodos , Infusiones Intravenosas , Leucemia Promielocítica Aguda/tratamiento farmacológico , Leucemia Promielocítica Aguda/mortalidad , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , COVID-19 , Tretinoina/administración & dosificación , Tretinoina/uso terapéutico , SARS-CoV-2 , Inducción de Remisión , Arsénico/administración & dosificación , AncianoRESUMEN
The graph representation of complex materials plays a crucial role in the field of inorganic and organic materials investigations for developing data-centric materials science, such as those using graph neural networks (GNNs). However, the currently prevalent GNN models are primarily employed for investigating periodic crystals and organic small molecule data, yet they still encounter challenges in terms of interpretability and computational efficiency when applied to polymer monomers and organic macromolecules data. There is still a lack of graph representation of organic polymers and macromolecules specifically tailored for GNN models to explore the structural characteristics. The Polymer-unit Graph, a novel coarse-grained graph representation method introduced in study, is dedicated to expressing and analyzing polymers and macromolecules. By incorporating the Polymer-unit Graph into the GNN models and analyzing the organic semiconductor (OSC) materials database, it becomes possible to uncover intricate structure-property relationships involving branched-chain engineering, fluoridation substitution, and donor-acceptor combination effects on the elementary structure of OSC polymers. Furthermore, the Polymer-unit Graph enables visualizing the relationship between target properties and polymer units while reducing training time by an impressive 98% and minimizing molecular graph representation models. In conclusion, the Polymer-unit Graph successfully integrates the concept of Polymer-unit into the field of GNNs, enabling more accurate analysis and understanding of organic polymers and macromolecules.
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PURPOSE: To explore the predictive potential of intratumoral and multiregion peritumoral radiomics features extracted from multiparametric MRI for predicting pathological differentiation in hepatocellular carcinoma (HCC) patients. METHODS: A total of 265 patients with 277 HCCs (training cohort n = 193, validation cohort n = 84) who underwent preoperative MRI were retrospectively analyzed. The risk factors identified through stepwise regression analysis were utilized to construct a clinical model. Radiomics models based on MRI (arterial phase, portal venous phase, delayed phase) across various regions (entire tumor, Peri_5mm, Peri_10mm, Peri_20mm) were developed using the LASSO approach. The features obtained from the intratumoral region and the optimal peritumoral region were combined to design the IntraPeri fusion model. Model performance was assessed using the area under the curve (AUC). RESULTS: Larger size, non-smooth margins, and mosaic architecture were risk factors for poorly differentiated HCC (pHCC). The clinical model achieved AUCs of 0.77 and 0.73 in the training and validation cohorts, respectively, while the intratumoral model achieved corresponding AUC values of 0.92 and 0.82. The Peri_10mm model demonstrated superior performance to the Peri_5mm and Peri_20mm models, with AUC values of 0.87 vs. 0.84 vs. 0.73 in the training cohort and 0.80 vs. 0.77 vs. 0.68 in the validation cohort, respectively. The IntraPeri model exhibited remarkable AUC values of 0.95 and 0.86 in predicting pHCC in the training and validation cohorts, respectively. CONCLUSIONS: Our study highlights the potential of a multiparametric MRI-based radiomic model that integrates intratumoral and peritumoral features as a tool for predicting HCC differentiation. CRITICAL RELEVANCE STATEMENT: Both clinical and multiparametric MRI-based radiomic models, particularly the intratumoral radiomic model, are non-invasive tools for predicting HCC differentiation. Importantly, the IntraPeri fusion model exhibited remarkable predictiveness for individualized HCC differentiation. KEY POINTS: ⢠Both the intratumoral radiomics model and clinical features were useful for predicting HCC differentiation. ⢠The Peri_10mm radiomics model demonstrated better diagnostic ability than other peritumoral region-based models. ⢠The IntraPeri radiomics fusion model outperformed the other models for predicting HCC differentiation.
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Cachexia affects 50-80% of patients with cancer and accounts for 20% of cancer-related death, but the underlying mechanism driving cachexia remains elusive. Here we show that circulating lactate levels positively correlate with the degree of body weight loss in male and female patients suffering from cancer cachexia, as well as in clinically relevant mouse models. Lactate infusion per se is sufficient to trigger a cachectic phenotype in tumour-free mice in a dose-dependent manner. Furthermore, we demonstrate that adipose-specific G-protein-coupled receptor (GPR)81 ablation, similarly to global GPR81 deficiency, ameliorates lactate-induced or tumour-induced adipose and muscle wasting in male mice, revealing adipose GPR81 as the major mediator of the catabolic effects of lactate. Mechanistically, lactate/GPR81-induced cachexia occurs independently of the well-established protein kinase A catabolic pathway, but it is mediated by a signalling cascade sequentially activating Gi-Gßγ-RhoA/ROCK1-p38. These findings highlight the therapeutic potential of targeting GPR81 for the treatment of this life-threatening complication of cancer.
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Caquexia , Ácido Láctico , Neoplasias , Receptores Acoplados a Proteínas G , Caquexia/metabolismo , Caquexia/etiología , Animales , Receptores Acoplados a Proteínas G/metabolismo , Ratones , Humanos , Ácido Láctico/metabolismo , Masculino , Femenino , Neoplasias/metabolismo , Neoplasias/complicaciones , Transducción de SeñalRESUMEN
OBJECTIVES: To establish and verify a prognostic nomogram model for selecting in unresectable hepatocellular carcinoma (uHCC) treated by transarterial chemoembolization plus lenvatinib (TACE-L) with or without PD-1 inhibitor. METHODS: Data of 241 uHCC patients who underwent TACE-L (n = 128) and TACE-L plus PD-1 inhibitor (TACE-L-P, n = 113) were retrospectively reviewed. The differences in tumour responses, progression-free survival (PFS), overall survival (OS), and adverse events (AEs) between two groups were compared, and a prognostic nomogram model was established based on independent clinical-radiologic factors and confirmed by Cox regression analysis for predicting PFS and OS. The treatment selection for uHCC patients was stratified by the nomogram score. RESULTS: Compared to TACE-L, TACE-L-P presented prolonged PFS (14.0 vs. 9.0 months, P < .001), longer OS (24.0 vs. 15.0 months, P < .001), and a better overall objective response rate (54.0% vs. 32.8%, P = .001). There was no significant difference between the rate of AEs in the TACE-L-P and the TACE-L (56.64% vs. 46.09%, P = .102) and the rate of grade ≥ 3 AEs (11.50% vs. 9.38%, P = .588), respectively. The nomogram model presented good discrimination, with a C-index of 0.790 for predicting PFS and 0.749 for predicting OS. Patients who underwent TACE-L and obtained a nomogram score >9 demonstrated improved 2-year PFS when transferred to TACE-L-P, and those with a nomogram ≤25 had better 2-year OS when transferred to TACE-L-P. CONCLUSIONS: TACE-L-P showed significant improvements in efficiency and safety for uHCC patients compared with TACE-L. The nomogram was useful for stratifying treatment decisions and selecting a suitable population for uHCC patients. ADVANCES IN KNOWLEDGE: Prognostic nomogram model is of great value in predicting individualized survival benefits for uHCC patients after TACE-L or/and TACE-L-P. And the nomogram was helpful for selection between TACE-L-P and TACE-L among uHCC patients.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Compuestos de Fenilurea , Quinolinas , Humanos , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Pronóstico , Nomogramas , Inhibidores de Puntos de Control Inmunológico , Estudios RetrospectivosRESUMEN
The construction of silicon-stereogenic silanols via Pd-catalyzed intermolecular C-H alkenylation with the assistance of a commercially available L-pyroglutamic acid has been realized for the first time. Employing oxime ether as the directing group, silicon-stereogenic silanol derivatives could be readily prepared with excellent enantioselectivities, featuring a broad substrate scope and good functional group tolerance. Moreover, parallel kinetic resolution with unsymmetric substrates further highlighted the generality of this protocol. Mechanistic studies indicate that L-pyroglutamic acid could stabilize the Pd catalyst and provide excellent chiral induction. Preliminary computational studies unveil the origin of the enantioselectivity in the C-H bond activation step.
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Both cis- and trans- tetracyclic spiroindolines are the core of many important biologically active indole alkaloids, but the divergent synthesis of these important motifs is largely hampered by the limited stereoselectivity control. A facile stereoinversion protocol is reported here in Michael addition-initiated tandem Mannich cyclizations for constructing tetracyclic spiroindolines, providing an easy access to two diastereoisomeric cores of monoterpene indole alkaloids with high selectivity. The mechanistic studies including in situ NMR experiments, control experiments, and DFT calculations reveal that the reaction undergoes a unique retro-Mannich/re-Mannich rearrangement including a C-C bond cleavage that is very rare for a saturated six-membered carbocycle. Insights into the stereoinversion process have been uncovered, and the major effects were determined to be the electronic properties of N-protecting groups of the indole with the aid of Lewis acid catalysts. By understanding these insights, the stereoselectivity switching strategy is also smoothly applied from enamine substrates to vinyl ether substrates, which are enriched greatly for the divergent synthesis and stereocontrol of monoterpene indole alkaloids. The current reaction also proves to be very practical and was successfully applied to the gram-scale total synthesis of strychnine and deethylibophyllidine in short routes.
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Bombesin receptor subtype-3 (BRS3) is an orphan G-protein coupled receptor (GPCR) that is involved in a variety of pathological and physiological processes, while its biological functions and underlying regulatory mechanisms remain largely unknown. In this study, a quantitative phosphoproteomics approach was employed to comprehensively decipher the signal transductions that occurred upon intracellular BRS3 activation. The lung cancer cell line H1299-BRS3 was treated with MK-5046, an agonist of BRS3, for different durations. Harvested cellular proteins were digested and phosphopeptides were enriched by immobilized titanium (IV) ion affinity chromatography (Ti4+-IMAC) for label-free quantification (LFQ) analysis. A total of 11,938 phosphopeptides were identified, corresponding to 3,430 phosphoproteins and 10,820 phosphosites. Data analysis revealed that 27 phosphopeptides corresponding to six proteins were involved in the Hippo signaling pathway, which was significantly regulated by BRS3 activation. Verification experiments demonstrated that downregulation of the Hippo signaling pathway caused by BRS3 activation could induce the dephosphorylation and nucleus localization of the Yes-associated protein (YAP), and its association with cell migration was further confirmed by kinase inhibition. Our data collectively demonstrate that BRS3 activation contributes to cell migration through downregulation of the Hippo signaling pathway.
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Vía de Señalización Hippo , Receptores de Bombesina , Receptores de Bombesina/metabolismo , Fosfopéptidos , Transducción de Señal/fisiología , Movimiento Celular , Fosfoproteínas/metabolismoRESUMEN
BACKGROUND: It is of great importance to predict the early recurrence (ER) of hepatocellular carcinoma (HCC) after hepatectomy using preoperative imaging modalities. Nevertheless, no comparative studies have been conducted to determine which modality, CT or MRI with radiomics analysis, is more effective. METHODS: We retrospectively enrolled 119 HCC patients who underwent preoperative CT and MRI. A total of 3776 CT features and 4720 MRI features were extracted from the whole tumor. The minimum redundancy and maximum relevance algorithm (MRMR) and least absolute shrinkage and selection operator (LASSO) regression were applied for feature selection, then support vector machines (SVMs) were applied for model construction. Multivariable logistic regression analysis was employed to construct combined models that integrate clinical-radiological-pathological (CRP) traits and radscore. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to compare the efficacy of CT, MRI, and CT and MRI models in the test cohort. RESULTS: The CT model and MRI model showed no significant difference in the prediction of ER in HCC patients (p = 0.911). RadiomicsCT&MRI demonstrated a superior predictive performance than either RadiomicsCT or RadiomicsMRI alone (p = 0.032, 0.039). The combined CT and MRI model can significantly stratify patients at high risk of ER (area under the curve (AUC) of 0.951 in the training set and 0.955 in the test set) than the CT model (AUC of 0.894 and 0.784) and the MRI model (AUC of 0.856 and 0.787). DCA demonstrated that the CT and MRI model provided a greater net benefit than the models without radiomics analysis. CONCLUSIONS: No significant difference was found in predicting the ER of HCC between CT models and MRI models. However, the multimodal radiomics model derived from CT and MRI can significantly improve the prediction of ER in HCC patients after resection.
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High-performance organic semiconductors (OSCs) can be designed based on the identification of functional units and their role in the material properties. Herein, we present a polymer-unit fingerprint (PUFp) generation framework, "Python-based polymer-unit-recognition script" (PURS), to identify the subunits "polymer unit" in the polymer and generate polymer-unit fingerprint (PUFp). Using 678 collected OSC data, machine learning (ML) models can be used to determine structure-mobility relationships by using PUFp as a structural input, and the classification accuracy reaches 85.2%. A polymer-unit library consisting of 445 units is constructed, and the key polymer units affecting the mobility of OSCs are identified. By investigating the combinations of polymer units with mobility performance, a scheme for designing OSCs by combining ML approaches and PUFp information is proposed. This scheme not only passively predicts OSC mobility but also actively provides structural guidance for high-mobility OSC material design. The proposed scheme demonstrates the ability to screen materials through pre-evaluation and classification ML steps and is an alternative methodology for applying ML in high-mobility OSC discovery.
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BACKGROUND: Several previous studies demonstrated that the combination of self-expandable metallic stents (SEMS) and 125I seed implantation might prolong stent patency and obtain survival benefits for malignant obstructive jaundice (MOJ) patients. However, these studies rarely mentioned a comparison between CT-guided intratumoral 125I seed implantation and intraluminal 125I seed strand insertion combined with stenting for the management of MOJ. This study aimed to further evaluate the safety and efficacy of SEMS combined with 125I brachytherapy in the management of unresectable MOJ. METHODS: Fifty-nine patients with unresectable MOJ were retrospectively included from March 2018 to June 2021. The main therapeutic outcomes were evaluated in terms of stent patency, and overall survival. Cumulative stent patency and overall survival rates were calculated by Kaplan-Meier survival analysis. Both clinical and treatment factors associated with survival were analyzed. RESULTS: Technical success was achieved in all patients. The clinical success rate was 94% (32/34) in the seeds group and 92% (23/25) in the control group, no significant difference was found (p =1.000). The median duration of stent patency was significantly longer in the 125I brachytherapy group compared with the control group (289 days vs. 88 days, respectively, p =0.001). The 125I brachytherapy group demonstrated a significantly better median overall survival rate than the control group (221 days vs. 78 days, respectively, p =0.001). In multivariate analysis, stents with 125I brachytherapy (p =0.004) was a significant favorable prognostic factor that affected patient survival. No significant difference was observed between CT-guided 125I seed implantation and 125I seed strand insertion in stent patency (p =0.268), and overall survival (p =0.483). CONCLUSION: SEMS combined with 125I brachytherapy is safe and effective for treating MOJ. 125I brachytherapy may help to maintain stent patency and prolong overall survival. There was no significant difference between CT-guided 125I seed implantation with SEMS and 125I seed strand insertion with SEMS in stent patency and overall survival.
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Braquiterapia , Ictericia Obstructiva , Humanos , Ictericia Obstructiva/terapia , Estudios Retrospectivos , Braquiterapia/métodos , Resultado del Tratamiento , StentsRESUMEN
Thermoelectric (TE) materials can directly convert heat to electricity and vice versa and have broad application potential for solid-state power generation and refrigeration. Over the past few decades, efforts have been made to develop new TE materials with high performance. However, traditional experiments and simulations are expensive and time-consuming, limiting the development of new materials. Machine learning (ML) has been increasingly applied to study TE materials in recent years. This paper reviews the recent progress in ML-based TE material research. The application of ML in predicting and optimizing the properties of TE materials, including electrical and thermal transport properties and optimization of functional materials with targeted TE properties, is reviewed. Finally, future research directions are discussed.
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Heavy metals in soils can migrate into the food chain and affect human health. In particular, they can be released into water supplies through interactions between soils and water. It is therefore important to study the concentrations of heavy metals in soils surrounding sources of drinking water, but there is a lack of research in this area. A total of 7656 topsoil samples surrounding the core water source of Danjiangkou Reservoir in China were collected and analyzed for As, Hg and Pb. Moran's I index and semivariograms were used to analyze the spatial correlation and variation of these heavy metals. The potential ecological risk index was used to evaluate heavy metal pollution. Fifteen natural and human factors were selected to explore the sources of heavy metal pollution using the GeoDetector model. The positive matrix factorization (PMF) model verified the reasonableness of the main factors identified by the GeoDetector model and further quantified two main sources of soil heavy metals. As, Hg and Pb were enriched to varying degrees in the soils. The potential ecological risk of Hg in soils was the most serious, with 24.67% of the area at high or very high risk. As and Pb both had a low potential ecological risk. The results of GeoDetector model and PMF model showed that the contributions of factor 1 (fertilizer application and automobile exhaust emissions) and factor 2(industrial waste) of soil heavy metal pollution were 49.8% and 50.2%, respectively. At last, the zoning control strategies were proposed in order to provide scientific reference for the management of soil heavy metal pollution.
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Mercurio , Metales Pesados , Contaminantes del Suelo , Humanos , Suelo , Plomo , Medición de Riesgo , Contaminantes del Suelo/análisis , Monitoreo del Ambiente , Metales Pesados/análisis , Residuos Industriales , ChinaRESUMEN
Melanoma-associated antigen D1 (Maged1) has critical functions in the central nervous system in both developmental and adult stages. Loss of Maged1 in mice has been linked to depression, cognitive disorder, and drug addiction. However, the role of Maged1 in Parkinson's disease (PD) remains unclear. In this study, we observed that Maged1 was expressed in the dopaminergic (DA) neurons of the substantia nigra in mice and humans, which could be upregulated by the in vivo or in vitro treatment with 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or 1-Methyl-4-phenylpyridinium iodide (MPP+). Genetic ablation of Maged1 in mice attenuated motor deficits, the loss of DA neurons, and disease progression induced by MPTP. Moreover, Maged1 deficiency protected DA neurons against MPP+-induced toxicity in primary cultured cells. Mechanistically, loss of Maged1 upregulated the Akt signaling pathway and downregulated the mTOR signaling pathway in SH-SY5Y cells, which may in turn attenuate the cell apoptosis and impairment of autophagy. Consistent with it, the degeneration of midbrain and striatum among elderly Maged1 knockout mice was relatively mild compared to those in wild-type mice under physiological conditions. Taken together, this study suggested that Maged1 deficiency inhibited apoptosis and enhanced autophagy, which may provide a new potential target for the therapy of PD.
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Proteínas de Neoplasias , Enfermedad de Parkinson , Animales , Humanos , Ratones , 1-Metil-4-fenilpiridinio , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Neuronas Dopaminérgicas/metabolismo , Ratones Endogámicos C57BL , Proteínas de Neoplasias/metabolismo , Enfermedad de Parkinson/genética , Transducción de SeñalRESUMEN
PURPOSE: To develop and validate a preoperative nomogram model that incorporates clinical factors, serological markers and liver imaging reporting and data system (LI-RADS v2018) MRI features for predicting early recurrence (ER) of hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). METHODS: One hundred and fourteen patients with HCC who underwent MRI scanning before TACE were enrolled retrospectively and divided into a training cohort (n=80) and a test cohort (n=34). The clinical factors, serological markers and LI-RADS v2018 MRI features associated with ER were determined by univariable and multivariable analyses. A nomogram model predicting ER after TACE was developed, and its discriminatory ability, goodness-of-fit and clinical application were evaluated by receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. RESULTS: In total, 74 (64.9%) patients were diagnosed with ER according to the follow-up results. Increased alpha fetoprotein (AFP) levels, larger tumor size, nonsmooth margin, mosaic architecture satellite nodules and corona enhancement were independent predictors associated with ER (p < 0.05). For the established nomogram model that incorporated these six significant predictors, the AUC values were 0.94 (95% CI: 0.89-0.99) and 0.95 (95% CI: 0.88-1.00) for predicting ER after TACE in the training and test cohorts, respectively. The calibration curve and DCA results demonstrate the good goodness-of-fit and clinical benefits of this nomogram. CONCLUSION: A preoperative nomogram model based on serological markers and LI-RADS v2018 MRI features could adequately predict ER in HCC patients after TACE, which may provide personalized guidance for predicting prognosis.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patología , Nomogramas , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Estudios Retrospectivos , Quimioembolización Terapéutica/métodos , Imagen por Resonancia Magnética/métodosRESUMEN
The upconversion (UC) emission intensity of Ln3+-doped CaF2 nanomaterials is not ideal, which limits their application in some advanced scientific fields. Hence, it is extremely imperative to enhance the emission intensity of UC nanocrystals. In this work, an ionic-liquid-assisted hydrothermal method based on an ethylene glycol (EG) and ionic liquid (IL) two-phase system was used to synthesize CaF2 doped with Yb3+ and Ho3+. The influence of the amount of IL and the reaction time as well as the concentration of Gd3+ doping on morphology and size was studied in detail, and the growth mechanism was proposed. Green UC luminescence materials were obtained through co-doping Yb3+ and Ho3+ ions. Furthermore, the luminescence of UC was increased monotonically with the introduction of Gd3+ ions. The effect mechanism of Gd3+ doping on the UC luminescence was put forward, which might provide a new method for the promotion of UC luminescence. In addition, the temperature sensing of CaF2: Yb3+/Ho3+/Gd3+ was investigated, which demonstrated that the phosphor has a potential application prospect in thermal sensing. Meanwhile, CaF2: Yb3+/Ho3+/Gd3+ also exhibited a paramagnetic property at room temperature. Therefore, these multifunctional nanocrystals may have prospective applications in optical bioimaging, magnetic resonance imaging, and temperature sensing.
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Líquidos Iónicos , Nanopartículas , Cristalización , Glicoles de Etileno , Luminiscencia , Nanopartículas/química , TemperaturaRESUMEN
Background: Ankle fracture-dislocations are one of the most severe types of ankle injuries. Compared to the simple ankle fractures, ankle fracture-dislocations are usually more severely traumatized and can cause worse functional outcomes. The purpose of this study was to review the previous literatures to understand the anatomy, mechanisms, treatment, and functional outcomes associated with ankle fracture-dislocations. Methods: The available literatures from January 1985 to December 2021 in three main medical databases were searched and analyzed. The detailed information was extracted for each article, such as researchers, age, gender, groups, type of study, type of center research, level of evidence, significant findings, study aim, cause of injury, time from injury to surgery, type of fracture, direction of dislocation, follow-up, postoperative complications and functional evaluation scores. Results: A total of 15 studies (1,089 patients) met the inclusion criteria. Only one study was a prospective randomized trial. The top-ranked cause of injury was high-energy injury (21.3%). Moreover, the most frequent type of fracture in ankle dislocations was supination-external rotation (SER) ankle fracture (43.8%), while the most common directions of dislocation were lateral (50%) and posterior (38.9%). Conclusions: Collectively, most ankle fracture-dislocations are caused by high-energy injuries and usually have poor functional outcomes. The mechanism of injury can be dissected by the ankle anatomy and Lauge-Hansen's classification. The treatment of ankle fracture-dislocations still requires more detailed and rational solutions due to the urgency of occurrence, the severity of injury, and the postoperative complications.