Distance Matters: Correlation of Hepatocellular Carcinoma Nodule Distance to Overall Survival.

INTRODUCTION: Hepatocellular carcinoma (HCC) may occur with several simultaneous tumor foci in the liver (multifocal HCC). Molecular biology indicated that the larger the distance between two tumor nodules, the more those two nodules differed in their genetic composition. Therefore, we explored whether the overall survival (OS) of patients with HCC depends on the mutual distance of the HCC nodules. METHODS: In a retrospective study of 92 patients, CT/MRI images and survival data of the patients were collected. Based on the CT or MRI images at the time of diagnosis, the size of each tumor, the distance between the centers (center distance), and adjacent edges (edge distance) of the tumor nodules were measured, respectively. These data, combined with the number of tumor nodules and clinical characteristics, were compared with the patient's OS data. RESULTS: As expected, the average tumor diameter was significantly associated with patient survival in univariate Cox regression analysis (p = 0.00028, hazard ratio [HR] = 1.2). However, in multivariate analysis, the average center distance (p = 0.036, HR = 1.18) and average edge distance (p = 0.033, HR = 0.84) were also significantly associated with survival. CONCLUSION: Thus, not only the size of multiple HCC lesions but also their distance is important for the prognosis of patients with HCC. This may be of particular interest in patients with two nodules and BCLC B and C stages for the selection of therapeutic modalities and/or procedures.

Percutaneous radiofrequency ablation near large vessels in beagle livers: the impact of time and distance on the ablation zone.

PURPOSE: To investigate the effects of ablation time and distance between the radiofrequency ablation (RFA) electrode tip and a large vessel on the ablation zone in beagle livers. METHODS: Sixty-one percutaneous RFA coagulation zones were created near large vessels in 10 beagle livers in vivo. The ablated lesions were divided into four groups based on ablation time and distance between the electrode tip and a large vessel (group A, 3 min 0.5 cm; group B, 3 min 0 cm; group C, 5 min 0.5 cm; group D, 5 min 0 cm). The ablated area, long-axis diameters, short-axis diameters, and vessel wall injury were examined. RESULTS: With a fixed ablation time, the ablation zone created with the electrode tip at 0.5 cm from the large vessel was significantly larger than at 0 cm (p < .05). At a fixed distance between the electrode tip and vessel, the ablation zone created for 5 min was significantly larger than for 3 min (p < .05). The frequency of vessel wall injury in the 0 cm groups was significantly higher than that in the 0.5 cm groups (37.5% vs. 6.9%; p = .003, odds ratio, 7.43). The ratio of width to depth (Dw/Dz) was larger in the 0.5 cm groups than in the 0 cm groups (p < .001). CONCLUSION: The ablation zone increased with longer ablation times and greater distances between the RFA tip and large vessels for perivascular lesions. The distance between the needle tip and blood vessels is an important factor that affects the overall ablation outcome.

Sevoflurane preconditioning attenuates myocardial ischemia/reperfusion injury via caveolin-3-dependent cyclooxygenase-2 inhibition.

BACKGROUND: The inhaled anesthetic sevoflurane has been demonstrated to protect against myocardial ischemia/reperfusion (MI/R) injury via mechanisms involving AMP-activated protein kinase (AMPK) and caveolin-3 (Cav-3). However, the relative contributions of AMPK and Cav-3 to sevoflurane preconditioning (SF-PreCon)-mediated cardioprotection and their precise underlying mechanisms of action remain incompletely understood. METHODS AND RESULTS: SF-PreCon (consisting of 3 cycles of 15-minute exposure to 2% sevoflurane before 30 minutes of MI) decreased MI/R injury in wild-type mice (caspase-3 activity, -29.1%; infarct size, -20.2%; and left ventricular end diastolic pressure, -33.8%). In cardiac-specific AMPKα2 dominant-negative overexpressing mice, the cardioprotective effect of SF-PreCon was largely retained (caspase-3 activity, -26.7%; infarct size, -16.7%; and left ventricular end-diastolic pressure, -25.9%; P<0.01). In contrast, SF-PreCon failed to significantly protect Cav-3 knockout mice against MI/R injury (P>0.05). SF-PreCon significantly decreased MI/R-induced superoxide generation in wild-type (-43.6%) and AMPK dominant-negative overexpressing mice (-35.5%; P<0.01) but not in Cav-3 knockout mice. SF-PreCon did not affect nicotinamide adenine dinucleotide phosphate oxidase expression but significantly inhibited cyclooxygenase-2 expression in wild-type (-38.7%) and AMPK dominant-negative overexpressing mice (-35.8%) but not in Cav-3 knockout mice. CONCLUSIONS: We demonstrate for the first time SF-PreCon mediates cardioprotection against MI/R injury via caveolin-3-dependent cyclooxygenase-2 inhibition and antioxidative effects.

Efficacy and Safety of HepaSphere Drug-Eluting Bead Transarterial Chemoembolization Combined with Hepatic Arterial Infusion Chemotherapy as the Second-Line Treatment in Advanced Hepatocellular Carcinoma.

Purpose: Recently, hepatic arterial infusion chemotherapy (HAIC) has also gained popularity for hepatocellular carcinoma (HCC). Several studies have compared HAIC and Transarterial chemoembolization (TACE). However, comparisons between TACE plus HAIC and HAIC are rarely reported. Here, we evaluated the performance of HepaSphere DEB-TACE combined with HAIC (Hepa-HAIC) compared to HAIC in patients with advanced HCC. Patients and Methods: In this retrospective study, we enrolled 167 patients diagnosed with advanced HCC and treated at Peking University Cancer Hospital from May 2018 to May 2022. The cohort comprised 74 patients who received HepaSphere DEB-TACE combined with HAIC-FOLFOX (Hepa-HAIC) and 93 patients who received HAIC-FOLFOX. Over 60% of patients received prior treatments. To avoid selection bias, propensity score matching was applied to the efficacy and safety analyses. The primary endpoints are progression-free survival (PFS) and overall survival (OS); the secondary endpoints include objective response rate (ORR), disease control rate (DCR), and safety. Results: Propensity-matching yielded 48 pairs, and group baselines were almost equal after matching. Median PFS and median OS were both higher in the matched Hepa-HAIC cohort (median PFS: 8.9 vs 5.8 months, p = 0.035; median OS: 22.4 vs 9.5 months, p = 0.027), which was consistent with pre-matching analysis. The ORR in the Hepa-HAIC and HAIC cohorts was 75.0% and 37.5%, respectively; the DCR was 93.8% after Hepa-HAIC and 81.3% after HAIC. There was no treatment-related death. Grade 3-4 ALT elevation was more frequent in the Hepa-HAIC group (33.3% vs 8.3%, p = 0.003), while vomiting was more frequent in the HAIC group (29.2% vs 12.5%, p = 0.084). Conclusion: The Hepa-HAIC group is superior to the HAIC group in metrics of PFS, OS, ORR, and DCR, which indicates the combination of HepaSphere DEB-TACE and HAIC may lead to improved outcomes with a comparable safety profile in advanced HCC.

High-dose oxaliplatin induces severe hypersensitivity reactions and high recurrence rates during rechallenge in patients treated with hepatic arterial infusion chemotherapy.

AIM: To analyze the risk factors for oxaliplatin (OXA)-induced severe hypersensitivity reactions and identify the recurrence rate of the reactions after an OXA rechallenge in patients treated with hepatic arterial infusion chemotherapy (HAIC). METHODS: Among the 2251 patients treated with HAIC (OXA), 84 patients with gastrointestinal cancer who displayed hypersensitivity reactions between May 2013 and May 2022 were included in this study. Among the 84 patients, 23 (27.4%) developed severe anaphylactic reactions (grade III/IV), and 61 (72.6%) developed grade I/II reactions. We explored the risk factors for severe OXA-induced hypersensitivity reactions. Twenty-seven patients with grade I/II reactions underwent retreatment (HAIC with OXA), and the recurrence rate of the hypersensitivity reactions was determined. A multivariate logistic regression model was used to analyze the risk factors for OXA-induced hypersensitivity reaction. RESULTS: In the study, multivariate analysis indicated that the dose of OXA (odds ratio [OR] 3.077, 95 % confidence interval [CI] 1.106-8.558, p = 0.031) was an independent risk factor for OXA-induced severe hypersensitivity reactions. Twenty-seven patients with non-severe hypersensitivity reactions underwent retreatment HAIC with OXA and 14 (51.9 %) experienced HSR recurrence, including 2 (7.4 %) who experienced hypersensitivity shock. CONCLUSIONS: The administration of OXA doses is a risk factor for OXA-induced severe hypersensitivity reactions in patients treated with HAIC (OXA). Rechallenging HAIC with OXA appears to be associated with a higher recurrence rate of the HSR.

Lymphotoxin-α is a novel adiponectin expression suppressor following myocardial ischemia/reperfusion.

Recent clinical observations demonstrate adiponectin (APN), an adipocytokine with potent cardioprotective actions, is significantly reduced following myocardial ischemia/reperfusion (MI/R). However, mechanisms responsible for MI/R-induced hypoadiponectinemia remain incompletely understood. Adult male mice were subjected to 30-min MI followed by varying reperfusion periods. Adipocyte APN mRNA and protein expression and plasma APN and TNFα concentrations were determined. APN expression/production began to decline 3 h after reperfusion (reaching nadir 12 h after reperfusion), returning to control levels 7 days after reperfusion. Plasma TNFα levels began to increase 1 h after reperfusion, peaking at 3 h and returning to control levels 24 h after reperfusion. TNFα knockout significantly increased plasma APN levels 12 h after reperfusion but failed to improve APN expression/production 72 h after reperfusion. In contrast, TNF receptor-1 (TNFR1) knockout significantly restored APN expression 12 and 72 h after reperfusion, suggesting that other TNFR1 binding cytokines contribute to MI/R-induced APN suppression. Among many cytokines increased after MI/R, lymphotoxin-α (LTα) was the only cytokine remaining elevated 24-72 h after reperfusion. LTα knockout did not augment APN levels 12 h post-reperfusion, but did so by 72 h. Finally, in vitro treatment of adipocytes with TNFα and LTα at concentrations seen in MI/R plasma additively inhibited APN expression/production in TNFR1-dependent fashion. Our study demonstrates for the first time that LTα is a novel suppressor of APN expression and contributes to the sustained hypoadiponectinemia following MI/R. Combining anti-TNFα with anti-LTα strategies may achieve the best effects restoring APN in MI/R patients.

Establishment of a novel system for photothermal removal of ampicillin under near-infrared irradiation: Persulfate activation, mechanism, pathways and bio-toxicology.

One of the most effective ways to address the problems of low solar spectrum utilization in photocatalysis and the high cost of persulfate activation technology is to create a cost-effective synergistic photothermal persulfate system. In this work, a brand-new composite catalyst called ZnFe2O4/Fe3O4@MWCNTs (ZFC) was developed to activate PDS (K2S2O8) from the aforementioned basis. ZFC's surface temperature could unbelievably reach 120.6 °C in 150 s together with the degrading synergistic system solution temperature could reach 48 °C under near-infrared light (NIR) in 30 min, thus accelerating the ZFC/PDS decolorization rate for reactive blue KN-R (150 mg/L) to 95% in 60 min. Furthermore, the ZFC's ferromagnetism bore it with good cycling performance, allowing it to maintain an 85% decolorization rate even after 5 cycles with OH·, SO4-·, 1O2, and O2-· dominating the degrading process. In the meantime, the DFT calculations of the kinetic constants for the entire process of S2O82- adsorption on Fe3O4 in dye degradation solution were in agreement with the outcomes of the experimental pseudo-first-order kinetic fitting. By analyzing the particular degradation route of ampicillin (50 mg/L) and the possible environmental impact of the intermediate using LC-MS and the toxicological analysis software (T.E.S.T.), respectively, it was shown that this system might function as an environmentally friendly method for removing antibiotics. This work may provide some productive research lines for the creation of a photothermal persulfate synergistic system and suggest fresh approaches to water treatment technology.

Supported photocatalyst for Cr (VI) conversion and removal of organic pollutants.

The photocatalytic property of available semiconductor catalysts still suffers from some urgent problems, such as the high excitation energy, easy agglomeration of powders, or weak recycling property. Therefore, developing novel visible light-supported catalysts and catalyst loading have aroused great attention recently. In this work, a novel Ag3PO4/BiVO4/MWCNTs@Cotton functional fabric was prepared by introducing Ag3PO4 as a plasma resonance photocatalyst and MWCNTs with cotton as composite substrates. Not only did the introduction of Ag3PO4 and MWCNTs effectively strengthen the application ability of BiVO4, but also inhibited the recombination of carriers, and promoted the transport of carriers according to spectroscopic and electrochemical tests. Degradation tests remained that Ag3PO4/BiVO4/MWCNTs @cotton retained the high photocatalytic efficiency of the powder catalyst, along with the degradation degree of active blue KN-R (50mg/L) as well as Cr (VI) (20mg/L) could reach more than 90% within 120 min. What's more, the functional fabric has gained excellent performance in degrading pollutants for 5 cycles. Meanwhile, the prepared BiVO4 is consistent with the band structure and electron density calculated theoretically by the GGA-PBE function. Free radical trapping and scavenging experiments exhibited that functional fabrics could produce active substances such as h+,·O2-, and·OH, among which the first two are the main active substances in the reaction. To sum up, this study is an effective attempt based on the existing problems of photocatalysts together with providing some study directions for the development of photocatalytic technology in the future.

MOFFeCo/B-CN composites achieve efficient degradation of antibiotics in a non-homogeneous concurrent photocatalytic-persulfate activation system.

We synthesized an MFeCoB0.4CNx% (MOF-Fe/Co nanosheets/boron-doped g-C3N4) composite catalyst for enhancing the concurrent photocatalytic-persulfate activation (CPPA) system and achieved efficient degradation of antibiotics. The role of MOF-Fe/Co is to activate persulfate, while boron-doped g-C3N4 can generate photogenerated electrons for the reduction of Co3+/Fe3+ to enhance the regeneration of the active center. The rate constant for Tetracycline degradation by the CPPA system was 4.74 and 7.54 times higher than the photocatalytic and persulfate-activated systems, respectively. This composite was shown to be practical and economically viable for antibiotic degradation. The degradation behavior was explored based on experiments, and molecular orbitals and Fukui functions were obtained by density functional theory calculations. Mechanisms were investigated using reactive oxygen species trapping studies and electron spin resonance, and the process was explained in terms of the charge population and electron density difference of MOF-Fe/Co nanosheets. The CPPA system is an ecologically benign technology for removing antibiotic-related risks to the environment and human health.

A Novel Nomogram for Predicting the Overall Survival in Patients with Unresectable HCC after TACE plus Hepatic Arterial Infusion Chemotherapy.

BACKGROUND AND AIM: Transarterial chemoembolization combined with hepatic arterial infusion chemotherapy (TACE-HAIC) has shown encouraging efficacy in the treatment of unresectable hepatocellular carcinoma (HCC). We aimed to develop a novel nomogram to predict overall survival (OS) of patients with unresectable HCC treated with TACE-HAIC. METHODS: A total of 591 patients with unresectable HCC treated with TACE-HAIC between May 2009 and September 2020 were enrolled. These patients were randomly divided into training and validation cohorts. The independent prognostic factors were identified with Cox proportional hazards model. The model's discriminative ability and accuracy were validated using concordance index (C-index), calibration plots, the area under the time-dependent receiver operating characteristic curve (AUC) and decision curve analyses (DCAs). RESULTS: The median OS was 15.6 months. A nomogram was established based on these factors, including tumor size, vein invasion, extrahepatic metastasis, tumor number, alpha fetoprotein (AFP), and albumin-bilirubin (ALBI), to predict OS for patients with unresectable HCC treated with TACE-HAIC. The C-index of the nomogram were 0.717 in the training cohort and 0.724 in validation cohort. The calibration plots demonstrated good agreement between the predicted outcomes and the actual observations. The AUC values were better than those of three conventional staging systems. The results of DCA indicated that the nomogram may have clinical usefulness. The patients in the low-risk group had a longer OS than those in intermediate-risk and high-risk groups (P<0.001). CONCLUSION: A prognostic nomogram was developed and validated to assist clinicians in accurately predicting the OS of patients with unresectable HCC after TACE-HAIC.

Facile fabrication of BiOIO3/MIL-88B heterostructured photocatalysts for removal of pollutants under visible light irradiation.

In this work, a Z-scheme heterojunction of BiOIO3/MIL-88B was constructed via two steps solvothermal method. Various characterization techniques showed that this Z-scheme heterojunction is an effective strategy to promote spatial charge separation, and the catalytic performance was evaluated by degrading simulated organic pollutants. Herein, the BiOIO3/MIL-88B composites exhibited an exceptional removal rate for Reactive Blue 19 and tetracycline hydrochloride (TC) under visible light irradiation, which was approximately 3.28 and 4.22 times higher than the pristine BiOIO3, respectively. Additionally, the analysis of photocatalysis mechanism showed that the active species O2- and OH could strongly affect the degradation of tetracycline hydrochloride (TC) in the studied system. Furthermore, the degradation process of TC was tracked and detected by identifying intermediates produced in the reaction system. It is anticipated that this research can deepen the understanding of BiOIO3/MIL-88B heterojunction structure to remove organic contaminants and provide a strategy for applying photocatalytic technology in the practical industry.

Recent advances in Co-based co-catalysts for efficient photocatalytic hydrogen generation.

Recent progress in photocatalytic hydrogen generation reaction highlights the critical role of co-catalysts in enhancing the solar-to-fuel conversion efficiency of diverse band-matched semiconductors. Because of the compositional flexibility, adjustable microstructure, tunable crystal phase and facet, cobalt-based co-catalysts have stimulated tremendous attention as they have high potential to promote hydrogen evolution reaction. However, a comprehensive review that specifically focuses on these promising materials has not been reported so far. Therefore, this present review emphasizes the recent progress in the pursuing of highly efficient Co-based co-catalysts for water splitting, and the advances in such materials are summarized through the analysis of structure-activity relationships. The fundamental principles of photocatalytic hydrogen production are profoundly outlined, followed by an elaborate discussion on the crucial parameters influencingthe reaction kinetics. Then, the co-catalytic reactivities of various Co-based materials involving Co, Co oxides, Co hydroxides, Co sulfides, Co phosphides and Co molecular complexes, etc, are thoroughly discussed when they are coupled with host semiconductors, with an insight towards the ultimateobjective of achieving a rationally designed photocatalyst for enhancing water splitting reaction dynamics. Finally, the current challenge and future perspective of Co-based co-catalysts as the promising noble-metal alternative materials for solar hydrogen generation are proposed and discussed.

Construction of perylene diimide/CuS supramolecular heterojunction for the highly efficient visible light-driven environmental remediation.

Developing photocatalysts that are inexpensive and efficient in degrading pollutants are essential for environmental remediation. Herein, a novel system of perylene diimide (PDI)/CuS p-n heterojunction was synthesized by a two-step self-assembly strategy for removal of tetracycline in waste water. Results showed that PDI/CuS-10% exhibited highest photocatalytic behavior. The apparent rate constants for tetracycline (TC) degradation for the blend were 5.27 and 2.68 times higher than that of CuS or PDI, respectively. The enhancement of photocatalytic activity was mainly attributed to the π-π stacking and p-n junction, which can accelerate the separation of the photo-generated h+-e- pairs. Besides, the light absorption of PDI/CuS from 800 to 200 nm was significantly enhanced and the absorption edge even reached the near-infrared region, which also played an important role in providing desired photocatalytic properties. Surprisingly, PDI/CuS could maintain high catalytic activity even after 5 cycles under simulated conditions, indicating that the composite had high potential for practical applications. Owing to high efficiency, low cost and wide application range, the PDI/CuS nanocomposites are promising candidates for environmental remediation.

Real-world study of hepatic artery infusion chemotherapy combined with anti-PD-1 immunotherapy and tyrosine kinase inhibitors for advanced hepatocellular carcinoma.

Aim: We investigated the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) combined with anti-PD-1 immunotherapy and tyrosine kinase inhibitors (TKIs) for advanced hepatocellular carcinoma (HCC). Method: This retrospective study included HCC patients treated with HAIC, TKIs and anti-PD-1 antibodies between May 2019 and November 2020 in our hospital. Primary end points were progression-free survival and safety. Results: Twenty-seven advanced HCC patients were analyzed. The median follow-up was 12.9 months (range: 4.0-24.0 months) and the median progression-free survival was 10.6 months. The objective response rate and disease control rate were 63.0 and 92.6%, respectively. No treatment-related deaths occurred. Conclusion: In patients with advanced HCC, treatment with HAIC, anti-PD-1 antibodies and oral TKIs was effective and safe.

Lay abstract Some tyrosine kinase inhibitors (TKIs) that inhibit tumor vessel growth, such as sorafenib and lenvatinib, have been recommended as first-line treatment for advanced hepatocellular carcinoma (HCC). In hepatic artery infusion chemotherapy, chemotherapeutic drugs can be delivered via a microcatheter to the tumor-supplying artery to increase the local drug concentration, leading to higher local disease control rates and less toxicity than systemic chemotherapy. The combination of anti-PD-1 immunotherapy plus TKIs was shown in a previous study to be a safe and effective treatment for advanced HCC. This study explored the safety and effectiveness of hepatic artery infusion chemotherapy, TKIs and an anti-PD-1 antibody for the treatment of advanced HCC and found that combination therapy is effective, with good tolerability.

Combination Therapy of Chemoembolization and Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Compared with Chemoembolization Alone: A Propensity Score-Matched Analysis.

BACKGROUND: Survival of patients with portal vein tumor thrombosis (PVTT) is extremely poor; transarterial chemoembolization (TACE) is a treatment for patients with HCC and PVTT. Some studies showed that hepatic arterial infusion chemotherapy (HAIC) might improve the survival of HCC with PVTT. There were few researches of combining TACE with HAIC for patients with HCC and PVTT. AIM: This study was aimed at comparing overall survival (OS) and progression-free survival (PFS) following treatment with conventional transarterial chemoembolization plus hepatic arterial infusion chemotherapy (cTACE-HAIC) or conventional transarterial chemoembolization (cTACE) alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). METHODS: From January 2011 to December 2016, 155 patients with HCC and PVTT who received cTACE-HAIC (cTACE-HAIC group) (n = 86) or cTACE alone (cTACE group) (n = 69) were retrospectively evaluated. Propensity score matching (PSM) reduced the confounding bias and yielded 60 matched patient pairs. The tumors' responses were evaluated using the modified response evaluation criteria in solid tumors (mRECIST). OS and PFS of groups were compared using the Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models. RESULTS: The median follow-up duration was 93 months (range: 1-93 months). The cTACE-HAIC group's OS (9.0 months) and PFS (6.0 months) were significantly longer than the cTACE group's OS (5.0 months) and PFS (2.0 months) (p = 0.018 and p = 0.045, respectively) in the matched cohort. Multivariate analyses showed that cTACE-HAIC was independently associated with OS (hazard ratio (HR) 0.602, p = 0.010) and PFS (HR 0.66, p = 0.038). The matched groups did not differ regarding grade 3 or 4 adverse events. CONCLUSION: cTACE-HAIC was superior to cTACE alone regarding OS and PFS in patients with HCC and PVTT. Treatment-associated toxicities were generally well tolerated.

Sorafenib combined with embolization plus hepatic arterial infusion chemotherapy for inoperable hepatocellular carcinoma.

BACKGROUND: There is little evidence of combining sorafenib with hepatic arterial infusion chemotherapy (HAIC) after transarterial chemoembolization (TACE) for intermediate and advanced hepatocellular carcinoma (HCC). It is important to identify that patients with intermediate and advanced HCC are most likely to benefit from this combination therapy. AIM: To investigate the safety and clinical outcomes of sorafenib combined with HAIC with folinic acid, 5-fluorouracil (5-FU), and oxaliplatin (FOLFOX) after TACE for intermediate and advanced HCC. METHODS: This prospective phase II study enrolled patients with intermediate and advanced HCC who underwent treatment with sorafenib combined with TACE-HAIC. All patients initially received the standard 400 mg dose of sorafenib twice daily before TACE-HAIC. Participants at our institute with intermediate and advanced HCC underwent routine TACE. Then, the catheter used for embolization was kept in place in the hepatic artery, and oxaliplatin was intra-arterially administered for 6 h, followed by 5-FU for 18 h, and folinic acid was intravenously administered for 2 h. The primary endpoints were safety, as evaluated by the Common Terminology and Criteria for Adverse Events version 4.0, and 12-mo progression-free survival (PFS), as analyzed by the Kaplan-Meier method. As secondary endpoints, the objective response rate (ORR) was evaluated by the modified Response Evaluation Criteria for Solid Tumors, and survival time [overall survival (OS)] was analyzed by the Kaplan-Meier method. RESULTS: Sixty-six participants at our institute with intermediate and advanced HCC were enrolled in this prospective study (mean age, 53.3 ± 11.7 years). Approximately 56.1% of participants had Barcelona Clinic Liver Cancer (BCLC) stage C disease, and 43.9% had BCLC stage B disease. The ORR was 42.4%. The disease control rate was 87.9%. The grade 3-4 toxicities consisted of thrombocytopenia (4.5%), neutropenia (3.0%), and elevated aspartate aminotransferase (12.2%). Hand-foot skin reaction was also observed (40.9%). The median PFS was 13.1 mo (13.5 mo in the BCLC stage B participants and 9.4 mo in the BCLC stage C participants). The 6-mo, 12-mo, and 24-mo PFS rates were 75.0%, 54.7%, and 30.0%, respectively. The median OS was 21.8 mo. CONCLUSION: Sorafenib combined with HAIC (FOLFOX) after TACE may be a feasible treatment choice for intermediate and advanced HCC because this treatment met the prespecified endpoint of a 6-mo PFS rate exceeding 50% and had good patient tolerance. Prospective randomized controlled trials are needed to confirm the effect of this combination therapy.

17 beta-estradiol biodegradation by anaerobic granular sludge: Effect of iron sources.

Steroid estrogens, as typical endocrine disrupting chemicals (EDCs), have raised an increasing concern due to their endocrine disrupting effects on aquatic animals and potential hazards on human health. Batch experiments were conducted to study 17 beta-estradiol (E2) removal and Estradiol Equivalent Quantity (EEQ) elimination by anaerobic granular sludge (AnGS) combined with different valence iron sources. Results showed that E2 was effectively biodegraded and transformed into E1 by AnGS. The addition of different valence iron sources all promoted E2 degradation, reduced E2 Equivalent Quotient (EEQ) concentration, and increased methane production in the batch experiments. The enhancement effect of zero-valent iron (ZVI) on E2 removal and EEQ elimination was stronger than that of Fe2+ and Fe3+ in our experiments. The enhancement effect proportion of ZVI corrosion, Fe2+, and Fe3+ in the process of E2 degradation by AnGS combined with ZVI were 42.26%, 40.21% and 17.53%, respectively.

Synthesis of Novel Ternary Photocatalyst Ag3PO4/Bi2WO6/Multi-Walled Carbon Nanotubes and Its Enhanced Visible-Light Photoactivity for Photodegradation of Norfloxacin.

Novel nanocomposites of Ag3PO4/Bi2WO6/MWCNTs were prepared via a facile hydrothermal method and in-situ precipitation without the addition of any spherical template. The composites exhibited excellent catalytic activity under visible-light irradiation. Compared with pure Ag3PO4, Bi2WO6, Bi2WO6/MWCNTs, and Ag3PO4/Bi2WO6, ternary Ag3PO4/Bi2WO6/MWCNTs nanocomposites showed the best photocatalytic performance due to the narrow band gap, large specific surface area, high charge separation efficiency, and strong light absorbance in the visible region. Degradation experiments involving norfloxacin (NOR) antibiotics under visible-light irradiation confirmed ideal photocatalytic activity of Ag3PO4/Bi2WO6/MWCNTs nanocomposites. Degradation products of NOR were identified via LC-MS/MS analysis, and a potential photodegradation mechanism of NOR was discussed; results indicated that these antibiotics could be degraded via three pathways. The piperazinyl ring was the most reactive site for hydroxyl radical attacks, followed by stepwise oxidation and further ring-opening. Overall, the composites appear to be promising materials for removing contaminants from water.

Preliminary clinical efficacy of iodine-125 seed implantation for the treatment of advanced malignant lung tumors.

AIMS: This study aims to observe the preliminary clinical efficacy of percutaneous interstitial brachytherapy using iodine-125 seeds for the treatment of advanced malignant lung tumors. SUBJECTS AND METHODS: This retrospective study enrolled 24 patients in our hospital with advanced malignant lung tumors between June 2013 and November 2017. Computed tomography (CT)-guided iodine-125 seed implantation therapy was administered to these patients. All patients were followed up at 3, 6, and 12 months after the operation. The clinical efficacy was evaluated by CT. RESULTS: Among the 24 patients, the objective response rates at 3, 6, and 12 months after the procedure were 50.0%, 50.0%, and 33.3%, respectively. Recent occurrence of adverse reactions were observed, including four cases of pneumothorax, three cases of hemoptysis, and two cases of particle displacement. CONCLUSIONS: CT-guided percutaneous interstitial brachytherapy with iodine-125 seeds can be used for the treatment of lung malignant tumors. Its clinical curative effect is remarkable and it results in limited trauma, reducing the incidence of adverse reactions and improving patient quality of life.

Safety and efficacy of hepatic arterial infusion chemotherapy with raltitrexed and oxaliplatin post-transarterial chemoembolization for unresectable hepatocellular carcinoma.

OBJECTIVE: To investigate the safety, efficacy, and prognostic factors of hepatic arterial infusion chemotherapy (HAIC) with raltitrexed and oxaliplatin post-transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (uHCC). METHODS: Thirty-seven patients with uHCC who received HAIC with raltitrexed and oxaliplatin post-TACE between June 2014 and December 2016 at our hospital were recruited. The primary endpoint was overall survival (OS), and secondary endpoint was progression-free survival (PFS). The overall response rate (ORR) was evaluated using the modified Response Evaluation Criteria in Solid Tumors. Toxicity was assessed according to the Common Terminology Criteria for Adverse Events (v4.0). The OS and prognostic factors were analyzed using the Kaplan-Meier method, log-rank test, and Cox regression models. RESULTS: Three (8.1%) patients achieved complete response, 17 (46.0%) patients achieved partial response, and the ORR was54.0%.The median OS and median PFS were 19.0 months and 12.0 months, respectively. The common toxicities included grade 3-4 increased aspartate aminotransferase levels (8/37,21.6%), grade 1-2 hyperbilirubinemia (75.7%, 28/37), nonspecific abdominal pain and fever, and grade 2-3 thrombocytopenia (18.9%, 7/37); no patients developed grade 3-4 neutropenia. Univariate analysis showed that the tumor diameter (≤50 mm, p = 0.028), Barcelona Clinic Liver Cancer (BCLC) stage (p = 0.012), hepatitis B virus DNA level (p = 0.033), and derived neutrophil-to-lymphocyte ratio (dNLR; derived neutrophils/leukocytes minus neutrophils) (p = 0.003) were predictive factors for prognosis. Multivariate analysis showed that patients with BCLC stage B disease (p = 0.029) and dNLR≤2 before therapy (p = 0.004) had better prognosis. CONCLUSIONS: HAIC with raltitrexed and oxaliplatin post-TACE is a safe and efficacious therapy for patients with uHCC; in particular, those with BCLC stage B and dNLR≤2 have better prognosis.