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Nano- and microscale morphology endows surfaces that play conspicuous roles in natural or artificial objects with unique functions. Surfaces with dynamic regulating features capable of switching the structures, patterns, and even dimensions of their surface profiles can control friction and wettability, thus having potential applications in antibacterial, haptics, and fluid dynamics. Here, a freestanding film with light-switchable surface based on cholesteric liquid crystal networks is presented to translate 2D flat plane into a 3D nanometer-scale topography. The wettability of the interface can be controlled by hiding or revealing the geometrical features of the surfaces with light. This reversible dynamic actuation is obtained through the order parameter change of the periodic cholesteric organization under a photoalignment procedure and lithography-free mode. Complex tailored structures can be used to encrypt tactile information and improve wettability by predesigning the orientation distribution of liquid crystal director. This rapid switching nanoprecision smart surface provides a novel platform for artificial skin, optics, and functional coatings.
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Cristais Líquidos , Cristais Líquidos/química , MolhabilidadeRESUMO
BACKGROUND: Radiofrequency (RF)-assisted devices are widely used for hemostasis during liver resection. This study compared the use of dual switching (DS) versus single switching (SS) control modes for RF-based liver resections in a pig model. METHODS: The RF-based system comprised a 200-W generator and three electrodes with 4-cm tips arranged in a linear configuration using an adaptor. Eight Lanyu pigs were used to assess ablation outcomes with electrode spacing of 2 or 3 cm, and ablation durations of 1.5, 2 or 3 min. All combinations were tested in DS and SS modes. Procedures were performed on left lateral, caudal and right anterior liver lobes, and after which transections were performed using a scalpel. Blood loss, complete ablation rate and ablation speed were compared. RESULTS: DS mode was shown to induce significantly less blood loss than SS mode when the electrode spacing was set at 2 cm and the ablation duration was 2 min or 3 min (p=.010 and .012, respectively). Extended ablation duration and narrow electrode spacing tended to induce less blood loss, regardless of operating mode. Bloodless resection was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 2-3 min. The highest rate of complete ablation (11.3 cm2/min) was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 1.5 min. CONCLUSION: RF-based hepatic resection using DS mode is safe and feasible, resulting in less blood loss than SS mode with a higher rate of complete ablation (i.e., superior ablation efficiency).
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Ablação por Cateter , Ablação por Radiofrequência , Animais , Eletrodos , Desenho de Equipamento , Hepatectomia , Fígado/cirurgia , SuínosRESUMO
BACKGROUND AND OBJECTIVES: Irreversible electroporation (IRE) is a non-thermal focal therapy that utilizes high voltage electric pulses to permanently rupture the cellular membrane and induce cell death. In this multi-center study, we evaluated the safety and efficacy of IRE in patients with locally advanced pancreatic cancer (LAPC). METHODS: From 2012 to 2015, we performed laparotomic and laparoscopic IRE in a total of 70 patients with stage III LAPC. Either gemcitabine-based or TS-1 (Tegafur, Gimeracil, and Oteracil) chemotherapy was applied for at least 3 months before the IRE. RESULTS: No IRE-related deaths occurred. A median follow-up of 28.1 months showed that six patients (8.6%) experienced local recurrence and 24 (34%) experienced distant progression. The overall median survival from the time of treatment was 22.6 months, and the progression-free survival (PFS) was 15.4 months. The overall survival in the patients who used gemcitabine-based reagents was 19.1 months and that of those who used TS-1 was 28.7 months. The PFS for these two groups were 13.2 months and 26.4 months; the difference is significant. CONCLUSIONS: Our study suggests that IRE is safe and effective for the control of LAPC. We surmise that the addition of IRE to a chemotherapy regimen may provide a survival advantage.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ablação por Cateter/métodos , Eletroquimioterapia/métodos , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Quimioterapia Adjuvante , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Intervalo Livre de Doença , Combinação de Medicamentos , Fluoruracila/administração & dosagem , Humanos , Quimioterapia de Indução , Laparotomia/métodos , Ácido Oxônico/administração & dosagem , Piridinas/administração & dosagem , Taxa de Sobrevida , Tegafur/administração & dosagem , GencitabinaRESUMO
Water pollution has emerged as a major global environmental crisis due to the massive contamination of water resources by the textile dyeing industry, organic waste, and agricultural residue. Since water is fundamental to life, this grave disregard puts lives at risk, making the protection of water resources a serious issue today. Recent research has shown great interest in improving the photocatalytic performance of graphitic carbon nitride (g-C3N4) for wastewater treatment. However, the photocatalytic removal activity of pure g-C3N4 is poor, owing to its minimal surface area, fast recombination of photo-generated electron-hole pairs, and poor light absorption. Recently, titanate perovskites (TNPs) have attracted significant attention in both environmental remediation and energy conversion due to their exceptional structural, optical, physiochemical, electrical, and thermal properties. Accordingly, TNPs can initiate a variety of surface catalytic reactions and are regarded as an emerging category of photocatalysts for sustainability and energy-related industries when exposed to illumination. Therefore, in this review article, we critically discuss the recent developments of extensively developed g-C3N4/TNPs that demonstrate photocatalytic applications for wastewater treatment. The different synthetic approaches and the chemical composition of g-C3N4/TNP composites are presented. Additionally, this review highlights the global research trends related to these materials. Furthermore, this review provides insight into the various photocatalytic mechanisms, including their potential impact and significance. Also, the challenges faced by such materials and their future scope are discussed.
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Nitrogen-doped carbon nanodots (CNDs) were synthesized and utilized as sensing probes to detect different anions and metallic ions within aqueous solutions. The pristine CNDs were developed through a one-pot hydrothermal synthesis. o-Phenylenediamine was used as the precursor. A similar hydrothermal synthesis technique in the presence of polyethylene glycol (PEG) was adopted to form the PEG-coated CND clusters (CND-100k). Through photoluminescence (PL) quenching, both CND and PEG-coated CND suspensions display ultra-high sensitivity and selectivity towards HSO4- anions (Stern-Volmer quenching constant (KSV) value: 0.021 ppm-1 for CND and 0.062 ppm-1 for CND-100k) with an ultra-low detection limit (LOD value: 0.57 ppm for the CND and 0.19 ppm for CND-100k) in the liquid phase. The quenching mechanism of N-doped CNDs towards HSO4- ions involves forming the bidentate as well as the monodentate hydrogen bonding with the sulfate anionic moieties. The detection mechanism of metallic ions analyzed through the Stern-Volmer formulation reveals that the CND suspension is well suited for the detection of Fe3+ (KSV value: 0.043 ppm-1) and Fe2+ (KSV value: 0.0191 ppm-1) ions, whereas Hg2+ (KSV value: 0.078 ppm-1) sensing can be precisely performed by the PEG-coated CND clusters. Accordingly, the CND suspensions developed in this work can be employed as high-performance PL probes for detecting various anions and metallic ions in the liquid phase.
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To explore aggregate-induced emission (AIE) properties, this study adopts a one-pot hydrothermal route for synthesizing polyethylene glycol (PEG)-coated graphene quantum dot (GQD) clusters, enabling the emission of highly intense photoluminescence under blue light illumination. The hydrothermal synthesis was performed at 300 °C using o-phenylenediamine as the nitrogen and carbon sources in the presence of PEG. Three different solvents, propylene glycol methyl ether acetate (PGMEA), ethanol, and water, were used for dispersing the PEG-coated GQDs, where extremely high fluorescent emission was achieved at 530-550 nm. It was shown that the quantum yield (QY) of PEG-coated GQD suspensions is strongly dependent on the solvent type. The pristine GQD suspension tends to be quenched (i.e., QY: ~1%) when dispersed in PGMEA (aggregation-caused quenching). However, coating GQD nanoparticles with polyethylene glycol results in substantial enhancement of the quantum yield. When investigating the photoluminescence emission from PEG-coated GQD clusters, the surface tension of the solvents was within the range of from 26.9 to 46.0 mN/m. This critical index can be tuned for assessing the transition point needed to activate the AIE mechanism which ultimately boosts the fluorescence intensity. The one-pot hydrothermal route established in this study can be adopted to engineer PEG-coated GQD clusters with solid-state PL emission capabilities, which are needed for next-generation optical, bio-sensing, and energy storage/conversion devices.
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BACKGROUND: Treating perihilar cholangiocarcinoma (PHCC) is particularly difficult due to the fact that it is usually in an advanced stage at the time of diagnosis. Irreversible electroporation treatment (IRE) involves the local administration of a high-voltage electric current to target lesions without causing damage to surrounding structures. This study investigated the safety and efficacy of using IRE in conjunction with intraoperative biliary stent placement in cases of unresectable PHCC. METHODS: This study enrolled 17 patients with unresectable Bismuth type III/IV PHCC who underwent IRE in conjunction with intraoperative biliary stent placement (laparotomic) in two medical centers in Asia between June 2015 and July 2018. Analysis focused on the perioperative clinical course, the efficacy of biliary decompression, and outcomes (survival). RESULTS: Mean total serum bilirubin levels (mg/dL) on postoperative day (POD) 7, POD30, and POD90 were significantly lower than before IRE (respectively 3.46 vs 4.54, p=0.007; 1.21 vs 4.54, p<0.001; 1.99 vs 4.54, p<0.001). Mean serum carbohydrate antigen 19-9 (CA19-9, U/ml) levels were significantly higher on POD3 than before the operation (518.8 vs 372.4, p=0.001) and significantly lower on POD30 and POD90 (respectively 113.7 vs 372.4, p<0.001; 63.9 vs 372.4, p<0.001). No cases of Clavien-Dindo grade III/IV adverse events or mortality occurred within 90 days post-op. The median progression-free survival was 21.5 months, and the median overall survival was 27.9 months. All individuals who survived for at least one year did so without the need to carry percutaneous biliary drainage (PTBD) tubes. CONCLUSIONS: It appears that IRE treatment in conjunction with intraoperative biliary stent placement is a safe and effective approach to treating unresectable PHCC. The decompression of biliary obstruction without the need for PTBD tubes is also expected to improve the quality of life of patients.
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This study investigates, for the first time, a photoerasable and photorewritable spatially-tunable laser using a dye-doped cholesteric liquid crystal (DDCLC) with a photoisomerizable chiral dopant (AzoM). UV illumination via a photomask with a transmittance-gradient can create a pitch gradient in the cell such that the lasing wavelength can be spatially tuned over a wide band of 134nm. The pitch gradient is generated by the UV-irradiation-induced gradient of the cis-AzoM concentration and therefore the induced gradient of the cell HTP value, resulting in the spatial tunability of the laser. Furthermore, the laser has advantages of photoerasability and photorewritability. The spatial tunability of the laser can undergo more than 100 cycles of photoerasing and photorewriting processes without decay or damage.
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Irreversible electroporation (IRE) is a non-thermal ablation modality that has been shown to be safe and effective in its application to tumors that are close to risky areas. This study aims to assess the safety and efficacy of IRE for unresectable hilar cholangiocarcinoma. Nine patients from two medical centers in Asia received IRE treatment between June 2015 and July 2017. Before IRE treatment, percutaneous biliary decompressions had been performed on eight patients, and internal stenting had been performed on one patient. All patients tolerated the procedure well without high-grade complications. The ablated tumors had constant size without contrast enhancement for more than three months in eight patients and the level of CA19-9 decreased significantly in all patients. The percutaneous biliary drainage tube was removed from two patients with recanalization of the bile duct. The internal stent in one patient was removed without further stenting. The median overall survival period was 26 months, and the progression-free survival was 18 months. Bile ducts remained narrow in the majority (2/3) of the treated patients. Nevertheless, IRE ablation of unresectable hilar cholangiocarcinoma involving vital structures is a safe and feasible primary treatment for local tumor control and is effective in prolonging survival.
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Técnicas de Ablação/métodos , Neoplasias dos Ductos Biliares/cirurgia , Eletroporação/métodos , Tumor de Klatskin/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias dos Ductos Biliares/tratamento farmacológico , Ductos Biliares/patologia , Ductos Biliares/cirurgia , Quimioterapia Adjuvante , Terapia Combinada , Constrição Patológica , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Feminino , Seguimentos , Humanos , Tumor de Klatskin/tratamento farmacológico , Laparotomia , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Estudos Retrospectivos , Resultado do Tratamento , GencitabinaRESUMO
A series of conjugated polythiophenes (PTs) having low band gap energies (PDPP, PDPCz21, PDPCz11), with 2-ethylhexyl-functionalized 2,5-thienyl diketopyrrolopyrrole (TDPP) as the electron acceptor and terpyridine-substituted carbazole (TPCz) as the electron donor, have been synthesized and studied for their applicability in polymer-based photovoltaic cells (PVCs). The thermal stability and solvent solubility of PTs increased upon increasing the content of the TPCz derivative. PVCs were fabricated having the following architecture: indium tin oxide/poly(3,4-ethylenedioxythiophene):polystyrenesulfonate/PT:6,6-phenyl-C71-butyric acid methyl ester (PC71BM)/Ca/Ag. The compatibility between the PT and PC71BM improved upon increasing the TPCz content. The photovoltaic properties of the PDPCz21-based PVCs were superior to those of their PDPP- and PDPCz11-based counterparts.
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INTRODUCTION: Irreversible electroporation (IRE) is a modality that utilizes high electric voltage to cause cell apoptosis. IRE has been used to treat locally advanced pancreatic cancer (LAPC). However, studies of IRE via surgical approaches for LAPC are limited. This study aims to analyse the outcomes and related prognostic factors of IRE for Asian patients with LAPC. MATERIALS AND METHODS: From 2012 to 2017, this prospective trial for using IRE through surgical approaches for LAPC was conducted in 11 medical centres in Asia. All related and treatment outcomes were analysed from a prospective database. RESULTS: Seventy-four patients were enrolled. Thirty complications occurred in thirteen (17.6%) patients without mortality. The electrode placement direction (anteroposterior vs. craniocaudal, HR = 14.2, p < 0.01) and gastrointestinal invasion (HR = 15.7, p < 0.01) were significant factors for complications. The progression-free survival (PFS) rate in one year, three years, and five years were 69.1%, 48.7%, and 28.8%, and the overall survival (OS) rate in one year, three years, and five years were 97.2%, 53%, and 31.2%. In univariate analysis, the chemotherapy regimen, local tumour recurrence, axial tumour length, tumour volume, and serum carbohydrate antigen 19-9 levels were all significantly associated with PFS and OS. In multivariate analysis, the chemotherapy regimen was the only significant factor associated with PFS and OS. TS-1 (Tegafur, gimeracil, and oteracil) group has superior survival outcome than gemcitabine group. CONCLUSION: This study showed that combined induction chemotherapy and surgical IRE for LAPC is safe. For well-selected patients, IRE can achieve encouraging survival outcomes.
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Adenocarcinoma/terapia , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Eletroporação/métodos , Neoplasias Pancreáticas/terapia , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia , Antígeno CA-19-9/metabolismo , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Ácido Oxônico/uso terapêutico , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Prognóstico , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Piridinas/uso terapêutico , Tegafur/uso terapêutico , Adulto Jovem , GencitabinaRESUMO
INTRODUCTION: Hepatocellular carcinoma (HCC) often develops on a background of chronic inflammation and a complex immunosuppressive network with increased regulatory T cells, impaired CD8⺠T cells and the secretion of immunosuppressive cytokines. Previous clinical studies have reported a superior disease-free survival (DFS) following a radiofrequency-based ablation or resection in HCC tumours compared to conventional liver resection techniques. The aim of this study was to investigate whether there is any correlation with the use of a radiofrequency-assisted liver resection and clinical outcome. MATERIAL AND METHODS: Patients' peripheral blood was collected prior and 7 days following surgery from patients undergoing a liver resection for HCC. There were 5 liver resections performed using CUSA and 6 liver resections with the RF-based device, HabibTM 4X. The primary endpoint of the study was to assess the immunological parameters of circulating immune cell populations as well as serum cytokines. The Student's t-test, chi-square or Fisher's Exact test were applied for statistical comparisons, as appropriate. RESULTS: Patients undergoing an RF-assisted liver resection with HabibTM 4X had a significant decrease in the inhibitory Treg cells (p = 0.002) and a significant increase in CD8⺠T lymphocytes (p = 0.050) and CD4âºCD45ROâº/CD4⺠memory T cells (p = 0.002) compared to those patients undergoing a liver resection with CUSA. It was also noted that the RF-assisted liver resection group had a significant decrease in circulating TGF-ß (p = 0.000), IL10 (p = 0.000) and a significant increase in IFN-gamma (p = 0. 027) and IL-17 compared to the CUSA group. CONCLUSION: A liver resection with RF-based device HabibTM 4X was associated with positive immunomodulatory changes in circulating immune cells and circulating cytokines which could explain the significant improvement in DFS.
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This paper gathered studies on multistimulus-responsive sensing and self-assembly behavior of a novel amphiphilic diblock copolymer through a two-step reverse addition-fragmentation transfer (RAFT) polymerization technique. N-Isopropylacrylamide (NIPAM) macromolecular chain transfer agent and diblock copolymer (poly(NIPAM-b-Azo)) were discovered to have moderate thermal decomposition temperatures of 351.8 and 370.8 °C, respectively, indicating that their thermal stability was enhanced because of the azobenzene segments incorporated into the block copolymer. The diblock copolymer was determined to exhibit a lower critical solution temperature of 34.4 °C. Poly(NIPAM-b-Azo) demonstrated a higher photoisomerization rate constant (kt = 0.1295 s-1) than the Azo monomer did (kt = 0.088 s-1). When ultraviolet (UV) irradiation was applied, the intensity of fluorescence gradually increased, suggesting that UV irradiation enhanced the fluorescence of self-assembled cis-isomers of azobenzene. Morphological aggregates before and after UV irradiation are shown in scanning electron microscopy (SEM) and dynamic light scattering (DLS) analyses of the diblock copolymer. We employed photoluminescence titrations to reveal that the diblock copolymer was highly sensitive toward Ru3+ and Ba2+, as was indicated by the crown ether acting as a recognition moiety between azobenzene units. Micellar aggregates were formed in the polymer aqueous solution through dissolution; their mean diameters were approximately 205.8 and 364.6 nm at temperatures of 25.0 and 40.0 °C, respectively. Our findings contribute to research on photoresponsive and chemosensory polymer material developments.
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We report the responsive fluorescence chemosensory phenomena of a carbazole-functionalized crosslinked polymer (PCaT) with pendent terpyridine (tpy) groups as receptors of metal ions. The polymer was synthesized using Heck polymerization between 3,6-dibromide groups in a carbazole-based polymer (PC2Br) and divinyl tpy monomer. The effects of the polymeric structure on the optical and chemosensory properties of the PCaT were compared with those of a carbazole-tpy alternating conjugated polymer (PCT). Photoluminescence titrations demonstrated that the PCaT and PCT had the high sensing ability toward Fe3+ ions, with Sternâ»Volmer constants of 8.10 × 104 and 6.68 × 104 M-1, respectively. The limit of detection (LOD) toward Fe3+ of the PCaT and PCT was estimated to be 1.31 × 10-6 and 1.81 × 10-6 M, respectively, and the superior LOD of the PCaT was ascribed to its lowly crosslinked structure. The fluorescence of the solutions of these polymers that were quenched by Fe3+ ions recovered when trace CN- anions were added because of the high stability constant of the CN-â»Fe3+ complex. Micellar aggregates with a mean diameter of approximately 239.5 nm were formed by dissolving the PCaT in tetrahydrofuran (THF) solution. Our results suggest that the PCaT is a promising material for chemosensory applications.
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Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. Radical treatment of HCC in early stages results in a long disease-free period and improved overall survival. The choice of optimal management strategy for HCC mainly depends on the severity of the underlying liver disease. For patients with decompensated liver cirrhosis and HCC within Milan criteria (MC), liver transplant (LT) is the choice of treatment. However, for patients with good residual liver reserve and HCC within MC, selection of other curative treatments such as liver resection (LR) or radiofrequency ablation may be a reasonable alternative. For patients without cirrhosis, LR can result in an overall survival similar to that provided by LT. Therefore, it is an accepted alternative to LT especially in areas with organ shortage. However, the cumulative 5-year recurrence rate of HCC post LR might be as high as 70%. For initial transplant-eligible (within MC) patients with recurrent HCC post LR, salvage liver transplant (SLT) was first proposed in 2000. However, most patients with recurrent HCC considered for SLT are untransplantable cases due to HCC recurrence beyond MC or comorbidity. Thus, the strategy of opting for SLT results in the loss of the opportunity of LT for these patients. Some authors proposed the concept of "de principe liver transplant" (i.e., prophylactic LT before HCC recurrence) to prevent losing the chance of LT for these potential candidates. Factors associated with the failure of SLT will be dissected and discussed in three parts: Patient, tumor, and underlying liver disease. Regarding patient-related factors, the rate of transplantability depends on patient compliance. Patients without regular follow-up tend to develop HCC recurrence beyond MC at the time of tumor detection. Advancing age is another factor related to severe comorbidities when LT is considered for HCC recurrence, and these elderly candidates become ineligible as time goes by. Regarding tumor-related factors, histopathological features of the resected specimen are used mostly for determining the prognosis of early HCC recurrences. Such prognostic factors include the presence of microvascular invasion, poor tumor differentiation, the presence of microsatellites, the presence of multiple tumors, and the presence of the gene-expressing signature associated with aggressive HCC. These prognostic factors might be used as a selection tool for SLT or prophylactic LT, while remaining mindful of the fact that most of them are also prognostic factors for post-transplant HCC recurrence. Regarding underlying liver disease-related factors, progression of chronic viral hepatitis and high viral load may contribute to the development of late (de novo) HCC recurrence as a consequence of sustained inflammatory reaction. However, correlation between the severity of liver fibrosis and tumor recurrence is still controversial. Some prognostic scoring systems that integrate these three factors have been proposed to predict recurrence patterns after LR for HCC. Theoretically, after excluding patients with high risk of post-transplant HCC recurrence, either by observation of a cancer-free period or by measurement of biological factors (such as alpha fetoprotein), prophylactic LT following curative resection of HCC could be considered for selected patients with high risk of recurrence to provide longer survival.
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Radiofrequency thermal ablation (RFA) is widely used for local solitary liver tumor control. However, the benefit of RFA for colorectal cancer with liver metastases, which is refractory to chemotherapy, remains unknown.We retrospectively enrolled 70 consecutive colorectal adenocarcinoma patients, who had synchronous liver metastases, who were refractory to chemotherapy, and whose life expectancy was >6 months, into this study to investigate the outcomes of RFA and associated prognostic factors. RFA was introduced to all of these patients during the enrollment. The time interval from RFA to recurrence of liver metastases and overall survival was recorded. Age, sex, carcinoembryonic antigen level, primary tumor location, postoperative adjuvant chemotherapy regimens, and the size and number of metastatic liver lesions were recorded. Cox regression analysis was used to determine the prognostic significance.Thirty-nine patients accepted RFA during chemotherapy, whereas 31 chose to receive chemotherapy alone. Patients with ≤5 and >5 liver metastases had median survival durations of 28 and 17 months, respectively (Pâ=â0.018). The dominant liver tumor size (<5 vs ≥5âcm) was significantly associated with median survival (30 vs 17 months, respectively; Pâ=â0.038), as was the carcinoembryonic antigen level (35 vs 16 months for ≤200 vs >200âng/mL respectively; Pâ=â0.029). Besides, radiofrequency thermal ablation plus chemotherapy was associated with a better median overall survival than chemotherapy alone (29 vs 12 months, respectively; Pâ=â0.002). In multivariate analysis, only radiofrequency thermal ablation treatment and number of liver tumors were significant prognostic factors for survival. Our result further revealed that patients treated with radiofrequency thermal ablation had longer progression-free intervals than those treated with chemotherapy alone (18 vs 9 months, respectively; Pâ=â0.001). Hence, radiofrequency thermal ablation is a safe and effective adjunct treatment to chemotherapy.
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Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Ablação por Cateter , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Reactivation of hepatitis B virus replication is a known complication of immunosuppressive therapy, which can lead to hepatocellular injury, liver failure, and death. In this report, we describe the case of a 44-year-old man with chronic hepatitis B and a dilated cardiomyopathy status after a heart transplant. Reactivation of the patient 's hepatitis B virus occurred 4 months after the heart transplant. Despite prompt administration of antiviral therapy, he developed fulminant hepatitis with hepatic encephalopathy. A successful living-related liver transplant was performed 7 months after the heart transplant. The patient was followed up for 1 year, and during that time was free of hepatitis B virus. We suggest that routine antiviral therapy should be administered to patients with chronic hepatitis B receiving immunosuppressive therapy.
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Transplante de Coração/efeitos adversos , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/complicações , Falência Hepática Aguda/cirurgia , Transplante de Fígado/métodos , Doadores Vivos , Ativação Viral , Adulto , Antivirais/uso terapêutico , Encefalopatia Hepática/virologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/imunologia , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/imunologia , Hepatite B Crônica/virologia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Falência Hepática Aguda/diagnóstico , Falência Hepática Aguda/virologia , Masculino , Resultado do Tratamento , Ativação Viral/efeitos dos fármacosRESUMO
There is much evidence indicating that human leukemic cells and monocytes/macrophages synthesize, and secrete, several matrix metalloproteinases (MMPs), and participate in the degradation of extracellular matrix components in tissue lesions. In this study, we investigated the effects and mechanisms of andrographolide, extracted from the herb Andrographis paniculata, on human monocytic MMPs expression and activation. Andrographolide (1-50 µM) exhibited concentration-dependent inhibition of MMP-9 activation, induced by either tumor necrosis factor-α (TNF-α), or lipopolysaccharide (LPS), in THP-1cells. In addition, andrographolide did not present an inhibitory effect on MMP-9 enzymatic activity at a concentration of 50 µM. By contrast, enzyme-linked immunosorbent assay (ELISA) showed that andrographolide partially affect TIMP-1 levels. Western blot analysis showed that both TNF-α, and LPS stimulators attenuated MMP-9 protein expression in a concentration-dependent manner. Using reverse transcription polymerase chain reaction (RT-PCR), we found that andrographolide suppressed expression of MMP-9 messenger RNA. Furthermore, we also found that andrographolide could significantly inhibit the degradation of inhibitor-κB-α (IκB-α) induced by TNF-α. We used electrophoretic mobility shift assay and reporter gene detection to show that andrographolide also markedly inhibited NF-κB signaling, anti-translocation and anti-activation. In conclusion, we demonstrate that andrographolide attenuates MMP-9 expression, and its main mechanism might involve the NF-κB signal pathway. These results provide new opportunities for the development of new anti-inflammatory and leukemic therapies.