Concurrent chemoradiotherapy improves prognosis and quality of life of patients with metastatic and recurrent hepatocellular carcinoma.

OBJECTIVE: This study retrospectively analyzed the effect of concurrent chemoradiotherapy on prognosis and quality of life of patients with metastatic and recurrent hepatocellular carcinoma (HCC). METHODS: This is a retrospective analysis. Data from 60 patients with metastatic and recurrent HCC admitted from Oct. 2020 to Feb. 2021 were chosen and grouped according to the treatment plans. Each group contained 30 cases. The control group was treated with chemotherapy, and the observation group received concurrent chemoradiotherapy. The two groups were treated continuously for two rounds, with 21 days in each round. The therapeutic efficacy, toxic side effects, pre- and post-treatment quality of life, changes in vascular endothelial growth factor (VEGF) and cyclooxygenase-2 (COX-2), and survival during follow-up were compared between the two groups. RESULTS: The total therapeutic efficacy of the observation group was higher than that of the control group (P<0.05). The post-treatment Karnofsky score in the observation group was higher than that in the control group (P<0.05). The post-treatment protein expressions of VEGF and COX-2 and peripheral blood mononuclear cells were lower than those before treatment in the two groups (P<0.05), and were lower in the observation group than those in the control group (P<0.05). The observation group had superior survival times than the control group (P<0.05). CONCLUSION: Concurrent chemoradiotherapy has good short-term and long-term efficacy for patients with metastatic and recurrent HCC. It greatly improves patients' quality of life and down-regulates VEGF and COX-2 expression.

Structural and Acidic Characteristics of Multiple Zr Defect Sites in UiO-66 Metal-Organic Frameworks.

Although defects are prevalent in metal-organic frameworks (MOFs) and usually play a crucial role in modulating their performance in various applications, detailed structural characterizations of various defects remain a challenging task mainly due to their disordered, heterogeneous, and local nature. In this work, by using solid-state nuclear magnetic resonance spectroscopy (SSNMR) techniques in conjunction with density functional theory (DFT) calculations, it is clearly elucidated that the trimethylphosphine (TMP)-assisted 31P NMR strategy is capable of greatly facilitating the qualitative and quantitative description of the detailed structural and acidic characteristics as well as the evolution process of various Zr defects with subtle distinctions in UiO-66 upon moderate thermal treatment, hence surpassing most conventional analytical techniques. These results offer a fundamental understanding of the defect chemistry in MOFs.

Intensive insulin therapy on infection rate, days in NICU, in-hospital mortality and neurological outcome in severe traumatic brain injury patients: a randomized controlled trial.

OBJECTIVES: Evaluate the impact of an intensive insulin therapy and conventional glucose control protocol during staying in neurological intensive care unit (NICU) on infection rate, days in NICU, in-hospital mortality and long-term neurological outcome in severe traumatic brain injury (TBI) patients. METHODS: A total of 240 patients with severe TBI (GCS score 3-8) admitted to NICU were prospectively enrolled and randomly assigned either to conventional insulin therapy or to intensive insulin therapy. Patients in intensive glucose control group (n=121) received continuous insulin infusion to maintain glucose levels between 4.4 m mol/l (80 mg/dl) and 6.1 m mol/l (110 mg/dl). Patients in the conventional treatment group (n=119) were not given insulin unless glucose levels were greater than 11.1 m mol/l (200mg/dl). Both groups were treated with insulin infusion to maintain normoglycemia after leaving NICU. Comparison was made against conventional insulin therapy using a randomized trial design. The primary outcomes is the mortality rate at 6 months follow-up. The second outcomes including ICU infection rate, duration of ICU stay, in-hospital mortality rate and neurologic outcome at 6 months follow-up. RESULTS: There was no significant difference in gender (66% vs. 67% male), age (46+/-11 years vs. 45+/-10 years), APACHE II score (30 vs. 29), TISS-28 score (47 vs. 46), and Glasgow Coma Score (GCS, 5.3 vs. 5.3) between the two groups. Overall mortality rates at 6 months follow-up were similar in the 2 groups (61 of 117, 52.1% vs. 62 of 116, 53.4%; P=0.8). The infection rate during the study was significantly higher in patients who received conventional insulin therapy than that in patients who received intensive insulin therapy (46.2% vs. 31.4%; P<0.05). The days stay in NICU was shorter in intensive insulin control group than that in conventional therapy group [4.2 days vs. 5.6 days (medians) P<0.05]. The in-hospital mortality during the study was similar in conventional and intensive therapy groups (34 of 119, 28.6% vs. 35 of 121, 28.9% in the conventional and intensive insulin therapy groups; P=0.85). The neurologic outcome according to Glasgow Outcome Score (GOS) at 6 months (GOS 5 and 4) was better in the intensive insulin therapy group (34 of 117, 29.1%) than that in the conventional therapy group (26 of 116, 22.4%, P<0.05). CONCLUSIONS: Mortality rates at 6 months follow-up are not affected by intensive glucose control in patients with severe TBI. Intensive insulin therapy decreases infection rate and days in NICU and improves the neurological outcome at 6 months follow-up, while has no obvious influence on in-hospital mortality of severe TBI patients.