Machine learning based on clinical information and integrated CT radiomics to predict local recurrence of stage Ia lung adenocarcinoma after microwave ablation.

PURPOSE: To develop and compare three different machine learning-based models of clinical information and integrated radiomics features predicting the local recurrence of stage Ia lung adenocarcinoma after microwave ablation (MWA) for assisting clinical decision-making. MATERIALS AND METHODS: The data of 360 patients with stage Ia lung adenocarcinoma receiving MWA were included in the training (n = 208), internal test (n = 90), and external test (n = 64) sets based on the inclusion and exclusion criteria. The predictors associated with local recurrence were identified using univariate and multivariate analyses of clinical information. The integrated radiomics features were extracted from pre-MWA and post-MWA (scanned immediately after the ablation) CT images, and ten radiomics features were selected by the t-test and least absolute shrinkage and selection operator (LASSO). The L2-logistic regression of machine learning was applied for the clinical model, CT radiomics model and combined model including clinical predictors and radiomics features. Model performance was evaluated by the receiver operating characteristic (ROC) and decision curve analysis (DCA). RESULTS: The ablative margin was an independent clinical predictor (p = 0.001, odds ratio [OR] = 0.46, 95%CI: 0.29, 0.73). The combined model showed the highest area under the curve (AUC) value among the three models (training: 0.86, 95%CI: 0.81, 0.91; internal test: 0.93, 95%CI: 0.87, 0.98; external test: 0.89, 95%CI: 0.79, 0.96). CONCLUSION: The combined model could accurately predict the local recurrence of stage Ia lung adenocarcinoma after MWA to better support a clinical decision.

A review: structure-activity relationship between saponins and cellular immunity.

Saponins, which exhibit many different biological and pharmacological activities, are present in a wide range of plant species and in some marine organisms. Notably, the researchers have found that saponins can activate the immune system in mammals. The strength of this function is closely related to the chemical structure of saponins. The present study of the structure-activity relationship suggests that aglycones, glycochains on aglycones and special functional groups of saponins affect the immune activity of saponins. This paper reviews the effects of different saponins on cellular immunity. As well as the structure-activity relationship of saponins. It is hoped that the information integrated in this paper will provide readers with information on the effects of saponins on cellular immunity and promote the further study of these compounds.

Health risk assessment of nitrate pollution of drinking groundwater in rural areas of Suihua, China.

In order to investigate the health risks of NO3- in rural drinking groundwater in Suihua, China and provide a basis for healthy drinking water, 40 sets of groundwater samples were collected in the Suihua area, and the average concentration of nitrate in the study area was 71.66 mg/L, statistical analysis software (SPSS19), Hydrogeochemical Analysis Software (AqQA) and groundwater pollution analysis software were used. Through water sample collection, chemical analysis and construction of human health risk model (HHRA), a qualitative and quantitative assessment of NO3- health risk was carried out for people of different ages and sexes, and it was concluded that there was NO3- pollution health risk in rural drinking groundwater in Suihua. Health risk level: infants > children > adult females > adult males. The evaluation provides a scientific basis for the prevention and control of NO3- pollution in groundwater and new ideas for preventing human health risks.

Task-Similarity-Based VNF Aggregation for Air-Ground Integrated Networks.

In a harsh environment, function aggregation of air-ground integrated network service function chaining (SFC) deployment can easily cause network load imbalance, which affects the network security and reliability. In this study, a task-similarity-based virtual network function (VNF) aggregation scheme was proposed. It considered air-ground network resource consumption and load balance before SFC mapping. A model for selecting VNFs to be aggregated based on task similarity was built. The tasks were classified based on their similarity. Furthermore, the VNFs to be aggregated were selected within the class under the constraints of the underlying physical resources. Load balancing was achieved by adjusting the similarity threshold. Moreover, an SFC mapping selection scheme based on network resource awareness was used to obtain the most suitable physical nodes for single-chain and multi-chain mapping according to various attributes of physical network nodes. The simulation results indicated that the proposed scheme with a better load balance design outperformed existing works on VNF aggregation. We also demonstrated that the task-similarity-based scheme was resource-consumption efficient and effective.

Efficacy and safety of CT-guided microwave ablation for stage T1a renal cell carcinoma in patients with a solitary kidney.

OBJECTIVE: To retrospectively evaluate early clinical outcomes of percutaneous microwave ablation (MWA) for stage T1a renal cell carcinomas (RCCs) in solitary kidney patients. MATERIALS AND METHODS: 15 solitary kidney patients with 16 stage T1a N0M0 biopsy-proved RCCs underwent CT-guided percutaneous microwave ablation between October 2016 and July 2020. The patients were followed up with contrast-enhanced computed tomography or magnetic resonance imaging at 1, 3, and 6 months and every 6 months thereafter. Serum creatinine levels of each patient pre MWA, 1 day after MWA and the most recent record were collected. Technical effectiveness, local recurrence, survival rates and complications were accessed. RESULTS: Complete ablation was achieved in all 16 tumors (100%) including 13 clear cell carcinomas and 3 papillary carcinomas. Within the follow-up time (median: 24 months) no tumor recurrence or major complication was detected. No significant change in serum creatinine level was noted. The cancer-specific survival rate was 100% (15 of 15), and 1-, 2-, and 3-year overall survival rates were 100%, 93.3%, and 93.3%, respectively. CONCLUSION: Percutaneous MWA is an effective and safe treatment option for stage T1a RCCs in solitary kidney patients; it can achieve high complete ablation rate in selected lesions of appropriate size and location.

The role of clinical characteristics and pulmonary function testing in predicting risk of pneumothorax by CT-guided percutaneous core needle biopsy of the lung.

BACKGROUND: We aim to analyze the risk factors for pneumothorax associated with computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of the lung. Whether the lung function characteristics are related to pneumothorax is unclear. METHODS: We retrospectively evaluated 343 patients who received CT-guided pulmonary PCNBs and underwent preoperative pulmonary function testing. Demographical, lesion-related, procedure-related features and histopathological diagnosis, as well as results of pulmonary function test were analyzed as risk factors of pneumothorax RESULTS: Variables associated with higher rate of pneumothorax were location of lesion, presence of emphysema, and dwell time. The proportion of middle lobe, lingular, or lower lobe lesions in pneumothorax group (30/50, 60.0%) is higher than non-pneumothorax group (113/293, 38.6%). The incidence of emphysema in pneumothorax group was significantly higher than that in non-pneumothorax group (34.0% vs. 7.5%). Obstructive pulmonary function abnormalities, not restrictive, mixed ventilation function abnormalities and small airway dysfunction, correlated with pneumothorax. Multivariate logistic regression analysis showed lower location of lesion sampled and presence of emphysema were independent predictors of pneumothorax. Although dwell time, FEV1/FVC ratio, FEF50%, FEF75% and FEF25-75% were significantly correlated with pneumothorax on univariate analysis, these were not confirmed to be independent predictors. CONCLUSIONS: Patients with obstructive pulmonary dysfunction have a higher risk of pneumothorax. Presence of emphysema was the most important predictor of pneumothorax, followed by location of lesion.

Efficacy of a virtual reality-based basic and clinical fused curriculum for clinical education on the lumbar intervertebral disc.

OBJECTIVE: Today, minimally invasive procedures have become mainstream surgical procedures. Percutaneous endoscopic transforaminal discectomy for lumbar disc herniation (LDH) requires profound knowledge of the laparoscopic lumbar anatomy. Immersive virtual reality (VR) provides three-dimensional patient-specific models to help in the process of preclinical surgical preparation. In this study, the authors investigated the efficacy of VR application in LDH for training orthopedic residents and postgraduates. METHODS: VR images of the lumbar anatomy were created with immersive VR and mAnatomy software. The study was conducted among 60 residents and postgraduates. A questionnaire was developed to assess the effect of and satisfaction with this VR-based basic and clinical fused curriculum. The teaching effect was also evaluated through a postlecture test, and the results of the prelecture surgical examination were taken as baselines. RESULTS: All participants in the VR group agreed that VR-based education is practical, attractive, and easy to operate, compared to traditional teaching, and promotes better understanding of the anatomical structures involved in LDH. Learners in the VR group achieved higher scores on an anatomical and clinical fusion test than learners in the traditional group (84.67 ± 14.56 vs 76.00 ± 16.10, p < 0.05). CONCLUSIONS: An immersive VR-based basic and clinical fused curriculum can increase residents' and postgraduates' interest and support them in mastering the structural changes and complicated symptoms of LDH. However, a simplified operational process and more realistic haptics of the VR system are necessary for further surgical preparation and application.

Diagnostic value of 3.0 T cardiac MRI in children with suspected myocarditis: multi-parameter analysis for the evaluation of acute and chronic myocarditis.

BACKGROUND: Cardiac magnetic resonance (CMR) is an established tool for detection of myocarditis. However, no comprehensive data for CMR based on the "Lake Louise" criteria in pediatric myocarditis exists to date. PURPOSE: To evaluate the value of multi-parameter CMR in children with suspected acute (AMC) and chronic myocarditis (CMC). MATERIAL AND METHODS: We examined 73 pediatric patients with clinically suspected AMC (n = 25) and CMC (n = 48). We compared them to 17 controls. All individuals underwent CMR, including function analyses, T2 ratio, early gadolinium enhancement ratio (EGEr), and late gadolinium enhancement (LGE). RESULTS: In AMC, 19 (76%) patients were abnormal in any two of three parameters (T2 ratio, EGEr, and LGE). There was a significant difference between AMC and controls in LVEF (51.2% vs. 61.3%), mass (130.2 ± 14.0 vs. 120.5 ± 13.9 g), T2 ratio (1.96 ± 0.2 vs. 1.69 ± 0.13), and EGEr (4.1 ± 0.27 vs. 3.4 ± 0.39) (P < 0.05). In CMC, 26 (54.1%) patients were abnormal in any two of three parameters. There was no significant difference between CMC and controls in LVEF and mass, but there was a statistical difference in T2 ratio (1.88 ± 0.18 vs. 1.69 ± 0.13) and in EGEr (3.93 ± 0.22 vs. 3.4 ± 0.39) (P < 0.05). There was an increase in LVEF while both T2 ratio and EGEr significantly decreased (P < 0.05) during follow-up of acute fulminant myocarditis. CONCLUSION: Comprehensive CMR may serve as a powerful tool in children with suspected AMC. CMR in assessment of CMC may be valuable, but it is not satisfactory.

Comparison of outcomes of arthrodesis and reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (Kidner procedure) in type 2 accessory navicula.

BACKGROUND: The therapeutic outcome of the local arthrodesis surgery for type 2 accessory navicula (AN) is rarely reported. This study aimed to compare the clinical outcomes between Kidner and arthrodesis procedures for type 2 AN. METHODS: Sixteen patients (20 feet) with symptomatic type 2 AN receiving surgical treatment in our hospital between November 2013 and December 2015 were retrospectively included. Ten patients (13 feet) underwent the Kidner surgery (Kidner group) and 6 patients received local arthrodesis procedure (arthrodesis group). Radiographic indices before/after surgery were compared between the two groups. Patient's satisfaction with surgery outcome was evaluated by patient self-assessment questionnaire. RESULTS: The calcaneal pitch angle was significantly increased after surgery in both groups (bothp<0.01), while the talocalcaneal coverage angle and lateral talo-first metatarsal angle were not significantly changed after surgery. There was no significant difference regarding the postoperative changes in the three radiographic indices between the two groups. In the arthrodesis group, 3 patients (4 feet) had an excellent outcome, 2 patients (2 feet) a good outcome, and 1 patient (1 foot) had a fair outcome. In the Kidner group, 6 patients (8 feet), 2 patients (3 feet), 1 patient (1 foot) and 1 patient (1 foot) had excellent, good, fair, and poor treatment outcomes, respectively. The rate of good-to-excellent outcomes was comparable between the arthrodesis group and Kidner group (83% vs. 80%, p=0.696). CONCLUSION: Our results suggested that both the Kidner surgery and arthrodesis surgery were an effective treatment for symptomatic type 2 AN.

Efficacy and Radiation Exposure of Ultra-Low-Dose Chest CT at 100 kVp with Tin Filtration in CT-Guided Percutaneous Core Needle Biopsy for Small Pulmonary Lesions Using a Third-Generation Dual-Source CT Scanner.

PURPOSE: To prospectively investigate efficacy and radiation dose of ultra-low-dose CT-guided percutaneous core needle biopsy (PCNB) at 100 kVp with tin filtration (100Sn kVp) for small pulmonary lesions. MATERIALS AND METHODS: Study enrolled and randomly assigned 210 patients to standard-dose CT (n = 70) or ultra-low-dose CT (n = 140; 1:2 randomization scheme) protocol. Standard-dose CT settings were reference 110 kVp and 50 mAs, and ultra-low-dose CT settings were fixed at 100Sn kVp and 70 mAs. All PCNBs in patients with small pulmonary lesions (< 3 cm) were performed on a third-generation dual-source CT scanner. Diagnostic performance, complication rate, image quality, and radiation dose were compared. RESULTS: Sensitivity, specificity, and accuracy for diagnosis of malignancy were 95.7%, 100%, and 96.9% with standard-dose CT and 93.8%, 100%, and 95.4% with ultra-low-dose CT (P > .05). Complication rate showed no significant differences between protocols (P > .05). Mean volume CT dose index) and total dose-length product were significantly lower in ultra-low-dose CT compared with standard-dose CT (0.24 mGy vs 3.3 mGy ± 1.1 and 9.84 mGy-cm ± 0.70 vs 110.5 mGy-cm ± 45.1; P < .001). Effective dose for ultra-low-dose CT was significantly lower than that for standard-dose CT (0.14 mSv ± 0.02 vs 1.78 mSv ± 0.76; -92.1%; P < .001). Image quality of ultra-low-dose CT met the requirements of PCNB. CONCLUSIONS: Ultra-low-dose CT-guided PCNB at 100Sn kVp spectral shaping significantly reduced radiation dose on a third-generation dual-source CT, while maintaining high diagnostic accuracy and safety for small pulmonary lesions.

Simultaneous analysis of 2-methylimidazole, 4-methylimidazole, and 5-hydroxymethylfurfural potentially formed in fermented soy sauce by "quick, easy, cheap, effective, rugged, and safe" purification and UHPLC with tandem mass spectrometry.

2-Methylimidazole, 4-methylimidazole and 5-hydroxymethylfurfural are harmful by-products potentially formed via Maillard reaction in fermented soy sauce. The present study proposed a new method based on "quick, easy, cheap, effective, rugged, and safe" purification and ultra high performance liquid chromatography with tandem mass spectrometry for the simultaneous analysis of 2-methylimidazole, 4-methylimidazole and 5-hydroxymethylfurfural in fermented soy sauce. The sample was dissolved in water after addition of internal standard 4-methylimidazole-d6 and extracted with acetonitrile. After dehydration, it was centrifuged and the supernatant was subsequently purified using two sorbents namely primary-secondary amine and multi-walled carbon nanotube. Three target analytes were separated by gradient elution and determined under multiple reactions monitoring mode. The limit of detection, matrix effect, recovery and precision of the developed method were investigated. Results found that three target analytes displayed excellent linearity in concentration range of 1-250 µg/L. Limit of detection was in the range of 0.3-1 µg/kg for three target analytes. The mean recoveries for fermented soy sauce samples at three spiked concentrations were in the range of 91.2-112.5%, and the intra- and interday precision were in the ranges of 3.6-9.2 and 7.1-10.8%, respectively. This validated method was successfully applied to determine 2-methylimidazole, 4-methylimidazole and 5-hydroxymethylfurfural concentrations in fermented soy sauce.

Conformational Regulation and Crystalline Manipulation of PLLA through a Self-Assembly Nucleator.

Self-assembly nucleators have been increasingly used to manipulate the crystallization of PLLA due to their strong intermolecular interaction with PLLA, while the molecular mechanism of such interaction is still unrevealed. In present work, one special self-assembly nucleator (TMC-300) with relatively high solubility in PLLA matrix, is chosen to investigate how the interaction works at molecular level to promote the crystallization of PLLA mainly through time-resolved spectroscopy. The results indicate that due to the dipole-dipole NH···O═C interaction between dissolved TMC-300 and PLLA, PLLA chains are transformed into gt conformer before TMC-300 phase-separating from PLLA melt, resulting in low energy barrier to pass for the following formation of PLLA α-crystal (α-crystal is consisted of gt conformer). Once the dissolved TMC-300 starts to self-assemble into frameworks upon cooling, the transformed PLLA chains with high population of gt conformer form the primary nuclei on the surface of such self-assembling TMC-300 frameworks. For the first time, not only the heterogeneous nucleation but also the conformational regulation of PLLA chains are proved to be responsible for the high efficiency of the self-assembly nucleators (TMC-300) in promoting the crystallization of PLLA. Therefore, conformational regulation is proposed for crystalline manipulation of PLLA, and this work brings new insight on promoting the crystallization of PLLA even other polymers by regulating their molecular conformation.

Regulation of a disintegrins and metalloproteinase with thrombospondin motifs 7 during inflammation in nucleus pulposus (NP) cells: role of AP-1, Sp1 and NF-κB signaling.

AIM: The objective of this study is to explore the effect of inflammatory cytokines on a disintegrins and metalloproteinase with thrombospondin motifs 7 (ADAMTS7) and to demonstrate the role of Sp1, AP-1 and NF-κB signaling on the ADAMTS7 regulation during inflammation in NP cells. METHODS: Real-time PCR was to detect the effect of ADAMTS7 knockdown on the expression of catabolic enzymes during inflammatory condition in NP cells. Real-time PCR, western blot, immunofluorescence and transfection experiments were used to observe the effect of tumor necrosis factor-α (TNF-α) or interleukin-1ß on the expression and the activity of ADAMTS7, and demonstrated the role to Sp1, AP-1 and NF-κB in the regulation of ADAMTS7 during inflammation. RESULTS: As other cells, ADAMTS7 knockdown suppressed the mRNA expression of catabolic factors during inflammation in human NP cells. However, the expression of ADAMTS7 mRNA and protein and the activity of ADAMTS7 promoter were refractory to inflammatory cytokines. In addition, Sp1, AP-1, not NF-κB signaling sustained the expression of ADAMTS7 mRNA, protein, as well as promoter activity during inflammation in NP cells. CONCLUSION: ADAMTS7 played a crucial role in the expression of catabolic genes in the presence of TNF-α and AP-1, Sp1, not NF-κB signaling were critical for the maintenance of ADAMTS7 expression during inflammation in NP cells.

SIRT1 expression is refractory to hypoxia and inflammatory cytokines in nucleus pulposus cells: Novel regulation by HIF-1α and NF-κB signaling.

Hypoxia and a marked increase in inflammatory cytokines are common hallmarks of intervertebral disc degeneration; these events disrupt the normal balance between extracellular matrix (ECM) degradation and synthesis in degenerative intervertebral discs. SIRT1, one of the NAD+-dependent class III histone deacetylases, controls cellular processes and is regulated by hypoxia and inflammatory cytokines in a cell-type-dependent manner. SIRT1 protects degenerative human nucleus pulposus cells against apoptosis. However, the role of SIRT1 in inflammation in intervertebral discs is still unclear. The current study showed that in rat NP cells, as in other cells, SIRT1 suppressed the induction of the mRNA expression of proteases that degrade ECM induced by TNF-α. Moreover, real-time PCR, transfection, and loss- and gain-of-function experiments revealed that SIRT1 mRNA and protein expression were refractory to hypoxia and HIF-1α. Additionally, SIRT1 mRNA and protein expression and the activity of the SIRT1 promoter were not affected by inflammatory cytokines but were sustained by NF-κB signaling in the presence or absence of TNF-α. In summary, the present study suggested that SIRT1 is not affected by hypoxia and inflammatory cytokines in rat intervertebral discs. Moreover, not HIF-1α but NF-κB signaling is critical for the maintenance of SIRT1 expression in NP cells under physiologic and pathophysiologic conditions.

Progress of research and application of Heyndrickxia coagulans (Bacillus coagulans) as probiotic bacteria.

Probiotics are defined as living or dead bacteria and their byproducts that maintain the balance of the intestinal microbiome. They are non-toxic, non-pathogenic, and do not release any toxins either within or outside the body. Adequate consumption of probiotics can enhance metabolite production, increase immunity, maintain a balanced intestinal flora, and stimulate growth. Probiotics do not have negative antibiotic effects and help maintain the natural flora in animals in a balanced state or prevent dysbacteriosis. Heyndrickxia coagulans (H. coagulans) is a novel probiotic species that is gradually being used for the improvement of human health. Compared to commonly used probiotic lactic acid bacteria, H. coagulans can produce spores, which provide the species with high resistance to adverse conditions. Even though they are transient residents of the gut, beneficial bacteria can have a significant impact on the microbiota because they can outnumber harmful germs, and vice versa. This article discusses the probiotic mechanisms of H. coagulans and outlines the requirements for a substance to be classified as a probiotic. It also addresses how to assess strains that have recently been discovered to possess probiotic properties.

Research progress on pharmacological properties and application of probiotics in the fermentation of Scutellaria baicalensis Georgi.

Scutellaria baicalensis Georgi is a medicinal herb with a rich history of use in traditional Chinese medicine. This review concentrates on the chemical constituents of Scutellaria baicalensis Georgi, with a particular emphasis on flavonoids such as baicalin, baicalein, and wogonin. Additionally, it examines the effects of probiotic fermentation on the plant's chemical profile and pharmacological actions. Evidence suggests that probiotic fermentation markedly modifies the bioactive components of Scutellaria baicalensis Georgi, thereby augmenting its medicinal potency. The paper delves into the mechanisms by which the primary active constituents of Scutellaria baicalensis Georgi are altered during fermentation and how these changes influence its pharmacological properties. This review aims to lay a theoretical groundwork for the clinical utilization of Scutellaria baicalensis Georgi and the formulation of innovative therapeutic approaches.

Percutaneous Image-Guided Microwave Ablation for Treating Postsurgical Intrapulmonary Oligometastases or Oligorecurrence.

OBJECTIVE: To assess the clinical efficacy of microwave ablation (MWA) in treating tumour patients with postsurgical intrapulmonary oligometastases or oligorecurrence (PIORO). STUDY DESIGN: Descriptive study. Place and Duration of the Study: Departments of Thoracic Surgery and Oncology, Jinan Central Hospital and Qilu Hospital, Jinan, China, from January 2014 to June 2023. METHODOLOGY: Clinical data of 31 patients with PIORO receiving treatment with MWA were retrospectively analysed. After undergoing MWA, the patients were followed up for computed tomography (CT) examination on the 7th day, 1st month, and every 3 months, respectively. The Kaplan-Meier method was conducted to evaluate the clinical outcomes; overall survival (OS), progression-free survival (PFS), and time to local progression (TTLP). RESULTS: All patients with PIORO were successfully treated with MWA. The 3-year survival rate of patients was 35.5%. The median OS was 26.0 months, the median PFS was 11.1 months, and the median TTLP was 14.4 months. Patients with oligometastatic or oligorecurrent tumours ≤3 cm in diameter showed better PFS (≤3 cm, 14.261 m vs. >3 cm, 7.786 m; p <0.01) and TTLP (≤3 cm, 19.522 m vs. >3 cm, 12.214 m; p <0.05) than those with tumours >3 cm in diameter. Clinical characteristics of the patients were not significantly correlated with OS. CONCLUSION: MWA, as a topically therapeutic method, is an effective procedure for tumour patients with PIORO, especially in cases of oligometastatic or oligorecurrent tumours ≤3 cm in diameter. KEY WORDS: Microwave ablation, Thermal ablation, Oligometastases, Oligorecurrence, Progression-free survival, Survival.

Seismic response of mountain tunnel induced by fault slip.

With the rapid development of Chinese transportation networks, such as the Sichuan-Tibet railway, numerous tunnels are under construction or planned in mountainous regions. Some of these tunnels must traverse or be situated near active fault zones, which could suffer damage from fault slip. In this study, the seismic response of a mountain tunnel subjected to coseismic faulting was analyzed using a fault-structure system in a two-step process. Firstly, a nonuniform slip model was proposed to calculate the ground deformations and internal displacements induced by a specific active fault on a geological scale, considering nonuniform slips on the fault plane. The 1989 Loma Prieta and 2022 Menyuan earthquakes were chosen as case studies to validate the proposed slip model. Secondly, the calculated displacement of the Menyuan earthquake was used as the input load for the discrete-continuous coupling analysis of the Daliang tunnel on an engineering scale. The simulated deformation of the Daliang tunnel aligned with the on-site damage observations following the Menyuan earthquake. Lastly, the effects of different fault conditions on the tunnel seismic response were investigated. The results indicate that the distribution of the peak longitudinal strain of the lining is governed by fault mechanisms, and the degree of fault slip significantly influences the response of the tunnel. A tunnel passing through an active fault with a wider fault fracture zone and smaller dip angle experience less damage.

Clinical outcomes of percutaneous microwave ablation for pulmonary oligometastases from hepatocellular carcinoma: a retrospective, multicenter study.

BACKGROUND: Pulmonary oligometastases are common in hepatocellular carcinoma (HCC), however, the existing therapeutic options have several limitations. This study aimed to assess the safety and efficacy of microwave ablation (MWA) in the treatment of HCC-originating pulmonary oligometastases. METHODS: A total of 83 patients, comprising 73 males and 10 females with a median age of 57 years, who had pulmonary oligometastases from HCC, underwent MWA treatment at four different medical institutions. Inclusion criteria for patients involved having primary HCC under control and having less than three oligometastases with a maximum diameter of ≤ 5 cm in the unilateral lung or less than five oligometastases with a maximum diameter of ≤ 3 cm in the bilateral lung. A total of 147 tumors were treated with MWA over 116 sessions. The primary endpoints assessed included technical success, treatment efficacy, and local progression rate, while secondary endpoints encompassed complications, clinical outcomes, overall survival (OS), local progression-free survival (LPFS), and prognostic factors. RESULTS: The technical success rate for MWA was 100% (116/116 sessions), and the treatment efficacy rate was 82.3% (121/147 tumors). Six months after MWA, the local progression rate was 23.1% (18/147 tumors). Complications were observed in 10.3% (major) and 47.4% (minor) of the 116 sessions, with no cases of ablation-related deaths. The median follow-up period was 21.6 months (range: 5.7-87.8 months). Median OS was 22.0 months, and the 1-, 2-, and 3-year OS rates were 82.6%, 44.5%, and 25.2%, respectively. Median LPFS was 8.5 months. Multivariate Cox regression analysis identified α-fetoprotein (AFP) levels during initial diagnosis and the number of oligometastases as potential independent prognostic factors for OS (p = 0.017 and 0.045, respectively). CONCLUSION: Percutaneous MWA is a safe and effective treatment modality for pulmonary oligometastases originating from HCC.

Expert consensus on the multidisciplinary diagnosis and treatment of multiple ground glass nodule-like lung cancer (2024 Edition).

ABSTRACT: This expert consensus reviews current literature and provides clinical practice guidelines for the diagnosis and treatment of multiple ground glass nodule-like lung cancer. The main contents of this review include the following: ① follow-up strategies, ② differential diagnosis, ③ diagnosis and staging, ④ treatment methods, and ⑤ post-treatment follow-up.