Interleukin-4 inhibits the hypothalamic appetite control by modulating the insulin-AKT and JAK-STAT signaling in leptin mutant mice.

Our previous research identified interleukin-4 (IL-4) as a key regulator of glucose/lipid metabolism, circulatory leptin levels, and insulin action, suggesting its potential as a therapeutic target for obesity and related complications. This study aimed to further elucidate the role of IL-4 in regulating hypothalamic appetite-controlling neuropeptides using leptin dysfunctional Leptin145E/145E mice as the experimental model. IL-4 significantly reduces body weight, food intake, and serum glucose levels. Our data demonstrated that IL-4 exhibits multiple functions in regulating hypothalamic appetite control, including downregulating orexigenic agouti-related peptide and neuropeptide Y levels, promoting expression of anorexigenic proopiomelanocortin, alleviating microenvironmental hypothalamic inflammation, enhancing leptin and insulin pathway, and attenuating insulin resistance. Furthermore, IL-4 promotes uncoupling protein 1 expression of white adipose tissue (WAT), suggesting its role in triggering WAT-beige switch. In summary, this study uncovers novel function of IL-4 in mediating food-intake behaviors and metabolic efficiency by regulating hypothalamic appetite-control and WAT browning activities. These findings support the therapeutic potential of targeting hypothalamic inflammation and reducing adiposity through IL-4 intervention for tackling the pandemic increasing prevalence of obesity and associated metabolic disorders.

Spin Unlocked Vortex Beam Generation on Nonlinear Chiroptical Metasurfaces.

Optical vortices with spin and orbital angular momentum (SAM and OAM) states offer multiple degrees of freedom for manipulating optical fields and thus enable great potentials in optical information processing. Recently, the optical metasurface has become an important platform for vortex beam generation and steering. However, the strong spin-orbit interaction on such metasurfaces usually leads to spin locked OAM generation, which limits the complete control of the angular momentum state of light. Here, we propose to solve this constraint using geometric phase controlled nonlinear chiroptical metasurfaces. The metasurface consists of two types of plasmonic meta-atoms which have opposite handedness and exhibit a strong spin-dependent circular dichroism effect. By encoding specific phase singularities and phase gradients to different channels, we experimentally demonstrate the spin unlocked second harmonic beam steering. The proposed nonlinear chiroptical metasurfaces may have important applications in developing multifunctional nonlinear optical devices.

Layer by Layer Spraying Fabrication of Aggregation-Induced Emission Metal-Organic Frameworks Thin Film.

The development of new metal-organic frameworks (MOFs) thin films is important for expanding their functions and applications. Herein, we first report a new kind of MOF thin film by using aggregation-induced emission (AIE) dicarboxyl ligand through a liquid-phase epitaxial (LPE) layer-by-layer (LBL) spraying method (named AIE surface-coordinated metal-organic frameworks thin film, AIE-SURMOF). The obtained AIE-SURMOF Zn4O(TPE)3 (ZnTPE) has highly growth orientation and homogeneous thin film, showing strong fluorescent property. Furthermore, by loading chiral guest in the MOF pore, the formed chiral encapsulated AIE-SURMOF can clearly indicate obvious circularly polarized luminescence performance with glum of 0.01. This study provides new MOF thin film and new strategy for expanding function and application of MOF materials.

Review of electrospun microtube array membrane (MTAM)-a novel new class of hollow fiber for encapsulated cell therapy (ECT) in clinical applications.

Encapsulated cell therapy (ECT) shows significant potential for treating neurodegenerative disorders including Alzheimer's and Parkinson's, which currently lack curative medicines and must be managed symptomatically. This novel technique encapsulates functional cells with a semi-permeable membrane, providing protection while enabling critical nutrients and therapeutic substances to pass through. Traditional ECT procedures, on the other hand, pose difficulties in terms of cell survival and retrieval. We introduce the Microtube Array Membrane (MTAM), a revolutionary technology that solves these constraints, in this comprehensive overview. Microtube Array Membrane has distinct microstructures that improve encapsulated cells' long-term viability by combining the advantages of macro and micron scales. Importantly, the MTAM platform improves biosafety by allowing the entire encapsulated unit to be retrieved in the event of an adverse reaction. Our findings show that MTAM-based ECT has a great potential in a variety of illness situations. For cancer treatment, hybridoma cells secreting anti-CEACAM 6 antibodies inhibit triple-negative breast cancer cell lines for an extended period of time. In animal brain models of Alzheimer's disease, hybridoma cells secreting anti-pTau antibodies successfully reduce pTau buildup, accompanied by improvements in memory performance. In mouse models, MTAM-encapsulated primary cardiac mesenchymal stem cells dramatically improve overall survival and heart function. These findings illustrate the efficacy and adaptability of MTAM-based ECT in addressing major issues such as immunological isolation, cell viability, and patient safety. We provide new possibilities for the treatment of neurodegenerative illnesses and other conditions by combining the potential of ECT with MTAM. Continued research and development in this subject has a lot of promise for developing cell therapy and giving hope to people suffering from chronic diseases.

Aggregate assembly of ferrocene functionalized indium-oxo clusters.

In this study, we synthesized multi-nuclear indium oxide clusters (InOCs) using 1,1'-ferrocene dicarboxylic acid (H2FcDCA) as the chelating and surface protection ligand. The obtained clusters include the cubane-type heptanuclear InOCs ([In7]) and the sandwich-type thirteen-nuclear InOCs ([In13]). Notably, [In13] represents the highest nuclear number reported within the InOC family. In addition, the presence of labile coordination sites in these clusters allowed for structural modification and self-assembly. A series of [In7] clusters with adjustable band gaps have been obtained and the self-assembly of [In7] clusters resulted in the formation of an Fe-doped dimer, [Fe2In12], and an imidazole-bridged tetramer, [In28]. Similarly, in the case of [In13] clusters, the coordinated water molecules could be replaced by imidazole, methylimidazole, and even a bridged carboxylic acid, allowing the construction of one-dimensional extended structures. Additionally, part of the H2FcDCA could be substituted by pyrazole. This flexibility in replacing solvent molecules offered diverse possibilities for tailoring the properties and structures of the InOCs to suit specific applications.

Structure and optical limiting effects of heterometallic Ag6@Ti12 and Ag8@Ti12 oxo clusters regulated by alkynyl ligands.

Heterometallic Ag6@Ti12 and Ag8@Ti12 oxo clusters were prepared through a strategy of protecting polynuclear silver cores by a hollow Ti-O module. The introduction of alkyne ligands has shown significant influence on their structures and optical limiting effects.

Enhancing Electroreduction CO2 to Hydrocarbons via Tandem Electrocatalysis by Incorporation Cu NPs in Boron Imidazolate Frameworks.

Due to the higher value of deeply-reduced products, electrocatalytic CO2 reduction reaction (CO2 RR) to multi-electron-transfer products has received more attention. One attractive strategy is to decouple individual steps within the complicated pathway via multi-component catalysts design in the concept of tandem catalysts. Here, a composite of Cu@BIF-144(Zn) (BIF = boron imidazolate framework) is synthesized by using an anion framework BIF-144(Zn) as host to impregnate Cu2+ ions that are further reduced to Cu nanoparticles (NPs) via in situ electrochemical transformation. Due to the microenvironment modulation by functional BH(im)3 - on the pore surfaces, the Cu@BIF-144(Zn) catalyst exhibits a perfect synergetic effect between the BIF-144(Zn) host and the Cu NP guest during CO2 RR. Electrochemistry results show that Cu@BIF-144(Zn) catalysts can effectively enhance the selectivity and activity for the CO2 reduction to multi-electron-transfer products, with the maximum FECH4 value of 41.8% at -1.6 V and FEC2H4 value of 12.9% at -1.5 V versus RHE. The Cu@BIF-144(Zn) tandem catalyst with CO-rich microenvironment generated by the Zn catalytic center in the BIF-144(Zn) skeleton enhanced deep reduction on the incorporated Cu NPs for the CO2 RR to multi-electron-transfer products.

Exopolysaccharides from endophytic Glutamicibacter halophytocota KLBMP 5180 functions as bio-stimulants to improve tomato plants growth and salt stress tolerance.

Microbial exopolysaccharides (EPSs) can promote plants growth and protect them against various abiotic stresses, but the role of actinobacteria-produced EPSs in plant growth promoting is still less known. Here, we aim to explore the effect of EPSs from an endophyte Glutamicibacter halophytocota KLBMP 5180 on tomato seeds germination and seedlings growth under salt stress. Our study revealed that 2.0 g/L EPSs resulted in increased seed germination rate by 23.5 % and 11.0 %, respectively, under 0 and 200 mM NaCl stress conditions. Further pot experiment demonstrated that EPSs significantly promoted seedlings growth under salt stress, with increased height, root length and fibrous roots number. Plant physiological traits revealed that EPSs increased chlorophyll content, enhanced the activity of antioxidant enzymes, soluble sugar, and K+ concentration in seedlings; malondialdehyde and Na+ contents were reduced. Additionally, auxin, abscisic acid, jasmonic acid, and salicylic acid were accumulated significantly in seedlings after EPSs treatment. Furthermore, we identified 1233 differentially expressed genes, and they were significantly enriched in phytohormone signal transmission, phenylpropanoid biosynthesis, and protein processing in endogenous reticulum pathways, etc. Our results suggest that KLBMP 5180-produced EPSs effectively ameliorated NaCl stress in tomato plants by triggering complex regulation mechanism, and showed application potentiality in agriculture.

Enhancing Methane Removal Efficiency of ZrMnFe Alloy by Partial Replacement of Fe with Co.

High-purity hydrogen is extensively employed in chemical vapor deposition, and the existence of methane impurity significantly impacts the device performance. Therefore, it is necessary to purify hydrogen to remove methane. The ZrMnFe getter commonly used in the industry reacts with methane at a temperature as high as 700 ∘C, and the removal depth is not sufficient. To overcome these limitations, Co partially substitutes Fe in the ZrMnFe alloy. The alloy was prepared by suspension induction melting method, and was characterized by means of XRD, ICP, SEM and XPS. The concentration of methane at the outlet was detected by gas chromatography to characterize the hydrogen purification performance of the alloy. The removal effect of the alloy on methane in hydrogen increases first and then decreases with the increase in substitution amount, and increases with the increase in temperature. Specifically, the ZrMnFe0.7Co0.3 alloy reduces methane levels in hydrogen from 10 ppm to 0.215 ppm at 500 ∘C. ZrMnFe0.7Co0.3 alloy can remove 50 ppm of methane in helium to less than 0.01 ppm at 450 ∘C, demonstrating its excellent methane reactivity. Moreover, Co substitution reduces the formation energy barrier of ZrC, and Co in the electron-rich state demonstrates superior catalytic activity for methane decomposition.

Enhancing Third-Order Nonlinear Optical Property by Regulating Interaction between Zr4(embonate)6 Cage and N, N-Chelated Transition-Metal Cation.

Herein, the combination of anionic Zr4L6 (L = embonate) cages and N, N-chelated transition-metal cations leads to a series of new cage-based architectures, including ion pair structures (PTC-355 and PTC-356), dimer (PTC-357), and 3D frameworks (PTC-358 and PTC-359). Structural analyses show that PTC-358 exhibits a 2-fold interpenetrating framework with a 3,4-connected topology, and PTC-359 shows a 2-fold interpenetrating framework with a 4-connected dia network. Both PTC-358 and PTC-359 can be stable in air and other common solvents at room temperature. The investigations of third-order nonlinear optical (NLO) properties indicate that these materials show different degrees of optical limiting effects. It is surprising that increasing coordination interactions between anion and cation moieties can effectively enhance their third-order NLO properties, which can be attributed to the formation of coordination bonds that facilitate charge transfer. In addition, the phase purity, UV-vis spectra, and photocurrent properties of these materials were also studied. This work provides new ideas for the construction of third-order NLO materials.

Comparison of intraoperative imaging guided versus microelectrode recording guided deep brain stimulation for Parkinson's disease: A meta-analysis.

BACKGROUND: Traditionally, most centers would use microelectrode recording (MER) to refine targeting in deep brain stimulation (DBS) surgery. In recent years, intraoperative imaging (IMG) guided DBS has become an alternative way to verify lead placement. Currently, there is still controversy surrounding the necessity of MER or IMG for DBS. This meta-analysis aims to explore lead accuracy, clinical efficacy and safety between IMG and MER guided DBS for Parkinson's disease (PD). METHODS: PubMed, Embase, Web of Science, Cochrane Library were searched up to Mar, 2021 for studies reporting comparisons between IMG and MER guided DBS for PD. Subgroup analysis was conducted to assess effects of different IMG technology and DBS targeting site. RESULTS: Six studies, comprising of 478 patients were included in our analysis. The mean difference between the two implantation techniques in stereotactic accuracy, lead passes per trajectory, improvement% of Unified Parkinson's Disease Rating Scale part III and levodopa equivalent daily dose were -0.45 (95% confidence interval, CI=-1.11 to 0.20), -0.18 (95% CI=-0.41 to 0.06), 3.40 (95% CI=-5.36 to 12.16), and 5.00 (95% CI=-1.40 to 11.39), respectively. No significant differences were observed in each adverse event and operation/procedure time between the two implantation techniques. CONCLUSIONS: Both IMG and MER guided DBS offered effective control of motor symptoms for PD. Besides, IMG guided is comparable to MER guided DBS, in terms of safety, accuracy and efficiency. It is recommended for each hospital to select DBS guidance technology based on available resources and equipment.

Effects of Self-Administered Acupressure on Fatigue Following Traumatic Brain Injury: A Randomized Controlled Trial.

BACKGROUND: Fatigue is a common symptom after a traumatic brain injury (TBI) and may persist for weeks or years. However, nonpharmacological management strategies for fatigue alleviations are almost nonexistent; thus, effective fatigue management programs are needed urgently. PURPOSES: We aimed to evaluate the effects of self-administered acupressure programs on post-TBI fatigue and heart rate variability and identify the possible correlation between the improvements in fatigue symptoms and the changes in heart rate variability. DESIGN: This randomized controlled trial included 2-point acupressure (TPA; n = 27), 5-point acupressure (FPA; n = 27), and usual care (UC, control; n = 27) groups who underwent several assessments before and after the study intervention. Heart rate variability was evaluated at baseline, weeks 2 and 3, and treatment completion. METHODS: The TPA and FPA groups self-administered acupressure (3 minutes per acupoint; bilateral), thrice daily for 4 weeks, whereas the UC group received routine treatment without acupressure. RESULTS: Both the TPA and FPA groups exhibited substantial improvements in fatigue symptoms compared with the baseline findings in the UC group. In addition, the TPA and FPA groups exhibited increased high-frequency power and mean number of times per hour in which the changes in successive normal sinus intervals (RR) gradually exceeded 50 ms (pNN50). Changes in high-frequency power and pNN50 were correlated with improvements in post-TBI fatigue symptoms. CONCLUSION: Acupressure may alleviate chronic fatigue and enhance parasympathetic activity in TBI survivors. The enhancement of parasympathetic activity may be correlated with improvements in post-TBI fatigue symptoms. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should incorporate self-administered acupressure into the care plans for TBI survivors to improve their fatigue symptoms.

Correlation between B-cell lymphoma 6 with the balance of T helper-1/2 and severity of allergic rhinitis.

OBJECTIVE: Allergic rhinitis (AR) is a prevailing immune disorder affecting the nasal mucosa. B-cell lymphoma 6 (BCL6) imposes essential roles in immunity. This study probed into the serum expression of BCL6 and its effect on AR diagnosis and patients' quality of life (QOL). METHODS: A total of 113 patients with AR including 38 cases with mild AR (MAR) and 75 cases with moderate-severe AR (MSAR) were enrolled, with 101 healthy people enrolled as control. Serum expression of BCL6 was detected by RT-qPCR and the diagnostic efficacy of BCL6 for AR was analyzed using the receiver operating characteristic curve. The proportion of T helper-1/2 (Th1/Th2) cells in CD4+ T cells in peripheral blood mononuclear cells was detected using flow cytometry. The correlation between BCL6 and Th1/Th2 cells and the effects of BCL6 expression on patients' QOL were assessed by Pearson analysis and Mini-RQLQ questionnaire. RESULTS: BCL6 was downregulated in patients with AR, serum BCL6 level < 0.8450 had certain auxiliary diagnostic values for AR, and serum BCL6 level < 0.5400 could assist the diagnosis of AR severity. Th1 cell proportion in CD4+ T cells was decreased, whereas Th2 cell proportion was increased with AR severity. BCL6 was positively-linked with Th1 cells but inversely-correlated with Th2 cells in patients with AR. Patients with AR with low BCL6 expression had a poorer QOL compared with high BCL6 expression. The domains most affected by BCL6 expression were practical problems, nasal symptoms, and lacrimation. CONCLUSION: Serum BCL6 is downregulated and low BCL6 expression greatly deteriorates QOL in patients with AR.

Fine-Tuning Tridentate Ligands for the Construction of Nanotube-Based Boron Imidazolate Frameworks with High Chemical Stability.

Two unusual nanotube-based boron imidazolate frameworks (BIF-134 and BIF-135) were synthesized by a dual-ligand synthetic strategy under solvothermal conditions. In the structure of BIF-134 ([Co(BH(2-mim)3)(BTC)1/3](HBH(2-mim)3)1/3(NMA); 2-mim = 2-methylimidazole, NMA = N-methylacetamide, and BTC = 1,3,5-benzene tricarboxylate), one part of boron imidazolate ligands participate in the structural skeleton coordination, while another part of boron imidazolate ligands act as guest molecules that are located between adjacent nanotubes, which enhance the stability of the framework by the host-guest interaction and the pore space partition effects. It was found to be highly stable in air, water, organic solvents, and a wide pH range (pH 0-12). However, in the structure of BIF-135 ([Zn(BH(2-mim)3)(CHTC)1/3]; CHTC = 1,3,5-cyclohexanetricarboxylate), all boron imidazolate ligands participate in the structural skeleton coordination; there is no boron imidazolate guest molecule in the pores. The topology of BIF-135 is similar to that of BIF-134 by replacing BTC with CHTC and replacing Co with Zn. Furthermore, the obtained BIFs exhibited third-order nonlinear optical properties and potential optical limiting applications demonstrated by reverse saturable absorption.

Bark-stripping Behavior of Formosan Sambar (Rusa unicolor swinhoii) at Tataka, Yushan National Park in Taiwan.

The bark-stripping behavior of Formosan sambar, Rusa unicolor swinhoii, has become conspicuous in recent years in the Tataka area of Yushan National Park in Taiwan and a cause for concern to visitors and ecologists. We conducted a monthly survey of 537 tagged trees of 21 species and monitored the abundance of sambar using camera traps from October 2018 to January 2021, aiming to interpret possible causes of the bark-stripping behavior in Tataka. We also used a generalized linear model to evaluate factors that may affect the probability of a tree having its bark stripped. Both our observations and the model predictions showed that sambar has a strong preference for bark of Pinus armandii, Photinia niitakayamensis, and Salix fulvopubeseens and for trees with diameter at breast height around 14 cm. Bark stripping mainly occurred between July and October when major forage was most abundant. However, sambar's need for bark surged in May when sambar abundance was moderate and decreased in October when sambar abundance was high. The seasonality of bark stripping was synchronized with the peak periods of antler development, fawn nursing, and spread of gastrointestinal parasites, suggesting that sambar strips bark to ingest minerals for their physiological needs and/or to acquire plant secondary metabolites to repel gastrointestinal parasites. Sambar abundance alone was not sufficient to predict the overall intensity of bark stripping. Rather, the product of sambar abundance and the necessity index (average wound size) were strongly correlated with the overall bark-stripping intensity. Therefore, controlling sambar abundance is essential but it alone may not be the optimal strategy for controlling bark stripping. A combination of population control and relaxing of sambar's parasite loading and/or physiological needs for minerals is an important strategy to control the overall bark stripping. Future research could use the necessity index to investigate the synchronicity of the bark-stripping behavior, deer's physiological state, environmental factors and phenology to better understand the cause of this behavior.

The Relationship between Self-Perceived Health and Clinical Symptoms in Patients with Frozen Shoulders.

Current healthcare is centered on the perception of people's health. The purpose of this study was to investigate the relationship between self-perceived health (physical, psychological, social, and environmental dimensions) and two main clinical symptoms (shoulder pain and restricted shoulder motion) in patients with frozen shoulders. A total of 49 patients diagnosed with frozen shoulders were recruited and divided into high- and low-disability groups according to the severity of their frozen shoulders. Participants were measured for shoulder passive range of motion, pain intensity, and self-perceived health, using a brief version of the World Health Organization Quality of Life questionnaire. The results showed that the high-disability group had poorer self-perceived health (lower quality of life scores) than the low-disability group (p < 0.05). There was no significant correlation between the quality of life scores and the two clinical symptoms in either the high- or low-disability group. Our findings revealed that the multidimensional self-perceived health of frozen shoulder patients could not be inferred from the severity of shoulder pain and restricted shoulder motions. This study suggests that healthcare providers should pay more attention to patients' self-perceived health needs while addressing the clinical symptoms in patients with frozen shoulders.

Highly Active Ni-Ru Bimetallic Catalyst Integrated with MFI Zeolite-Loaded Cerium Zirconium Oxide for Dry Reforming of Methane.

The dry reforming of methane (DRM) is a new potential technology that converts two major greenhouse gases into useful chemical feedstocks. The main challenge faced by this process is maintaining the catalyst with high catalytic activity and long-term stability. Here, a simple and effective preparation route for the synthesis of functional nanomolecular sieve catalysts (NiRuxCZZ5) from kaolinite tailings was developed for dry reforming of methane with CO2. The silica monoliths with flower-like spherical and micropore structures (ZSM-5) were prepared by crystal growth method, and the metal components were loaded by ultrasonic-assisted impregnation method. The NiRu0.5CZZ5 catalyst exhibited excellent catalytic performance (maxmium CO2 and CH4 conversions up to 100 and 95.6%, respectively) and very good stability (up to 100h). The interfacial confinement and the strong support interaction are principally responsible for the excellent catalytic activity of the catalyst. The in situ DRIFTS was used to elucidate the possible carbon conversion steps, and stable surface intermediates were also identified.

Abundant and diverse endophytic bacteria associated with medicinal plant Arctium lappa L. and their potential for host plant growth promoting.

Arctium lappa L. is one of the medicinal and food homologous plants in China, which is rich in nutrients and medicinal ingredients. The use of plant growth-promoting (PGP) endophytic bacteria is an alternative to reducing chemical fertilizers in agricultural production. The aim of this study was to analyze the diversity of endophytic bacteria in different cultivars of A. lappa L. collected from two geographical locations in China and evaluate PGP traits of the isolates and their potential PGP ability in greenhouse condition. Endophytic bacterial community was investigated by culture-dependent and culture-independent methods. Isolates were screened and investigated for multiple PGP traits, and representative strains were inoculated host seedlings to evaluate the growth promoting effect. A total of 348 endophytic bacteria were obtained and they were distributed into 4 phyla and 30 genera. In addition, high throughput sequencing revealed more abundant bacterial community, including 17 bacterial phyla and 207 genera. A high proportion of PGP traits were detected, including production of indole acetic acid, siderophore, ammonia and phosphate solubilization. Four representative strains with multiple PGP traits of the most dominant genera (Bacillus, Pantoea, Microbacterium and Pseudomonas) were further selected for host inoculation and growth promoting evaluation, and they significantly increase seedlings length, root length and fresh weight. This study demonstrated that A. lappa L. harbors abundant endophytic bacteria, and some endophytic bacteria showed good potential for the development of microbial fertilizer in the future.

Efficacy of TACE+Radiofrequency Ablation+Sorafenib in the Treatment of Patients with Recurrent Liver Cancer and Construction of Prediction Model.

Objective: This study is aimed at exploring the efficacy of transarterial chemotherapy embolization (TACE)+radiofrequency ablation+sorafenib in the treatment of patients with recurrent liver cancer and at constructing its prediction model. Methods: A total of 60 patients with recurrent liver cancer treated in our hospital from March 2020 to March 2022 were enrolled and divided into two groups according to treatment methods, with 30 patients in each group. Group A adopted TACE+radiofrequency ablation+sorafenib therapy while group B adopted TACE+radiofrequency ablation therapy. Clinical efficacy, complications, and adverse reactions of the two groups were observed. A total of 30 patients with nonrecurrent liver cancer in the same period were enrolled. 60 patients with recurrent liver cancer and 30 patients with nonrecurrent liver cancer were taken as the recurrence group and the nonrecurrence group, respectively. The baseline data and clinical data of the patients were queried by the Hospital Information System. The data included age, gender, Child-Pugh grade, HBV/HCV infection, portal vein tumor thrombus, degree of differentiation, vascular invasion, serum alpha fetal protein (AFP) level, number of tumors, maximum diameter of tumors, and number of nodules. The logistic regression analysis was used to analyze the independent risk factors for liver cancer recurrence. The Hosmer-Lemeshow test was used to analyze the degree of fitting between the prediction model and the standard curve. The ROC curve was used to analyze the predictive value of the model for liver cancer recurrence. Results: The objective effective rate and disease control rate in group A (33.33% and 70.00%) were higher than those in group B (10.00% and 43.33%), and the differences were statistically significant (both P < 0.05). There were no significant differences in the incidence of complications such as embolism syndrome, hand and foot skin reaction, gastrointestinal reaction, hypertension, diaphragmatic injury and bleeding, and biliary leakage and fever between the two groups (all P > 0.05). The proportions of patients in the recurrence group with portal vein tumor thrombus (PVTT), medium and high degree of differentiation, combined with vascular invasion, serum AFP level ≥ 400 ng/dL, multiple tumors, maximum tumor diameter ≥ 5 cm, combined with cirrhosis, and polynodules were all higher than those in the nonrecurrence group; the differences were statistically significant (all P < 0.05). Complication of PVTT, the degree of medium and high differentiation, and the maximum tumor diameter ≥ 5 cm were independent risk factors for recurrence of liver cancer (all P < 0.05). The prediction model of liver cancer recurrence was obtained by multiple regression analysis, P = 1/[1 + e -(-5.441 + 6.154∗PVTT + 3.475∗differentiateddegree + 3.001∗maximumdiameteroftumor)]. The Hosmer-Lemeshow test showed that χ 2 = 1.558 (P = 0.992). According to the ROC curve analysis, the AUC, SE, and 95% CI value of the prediction model for liver cancer recurrence were 0.977, 0.012, and 0.953-1.000, respectively. Conclusion: TACE+radiofrequency ablation+sorafenib is effective in the treatment of recurrent liver cancer, and the prediction model established based on the risk factor has high predictive value for patients with recurrent liver cancer.

Diagnosis of infantile subglottic hemangioma and the effect of oral propranolol.

OBJECTIVES: To investigate the clinical characteristics of infantile subglottic hemangioma (SGH), and to observe the safety and efficacy of propranolol in the treatment of SGH. METHODS: The data of 21 children diagnosed with SGH and treated with propranolol in our hospital from March 2013 to January 2021 were retrospectively analyzed and followed up. RESULTS: Among the 21 cases, there were 7 males and 14 females. SGH was found 11 left-sided, 9 right-sided and 1 bilateral-sided. The clinical manifestations included stridor (13/21), respiratory distress (6/21), barking cough (5/21), feeding difficulty (4/21), three concave sign (4/21), cyanosis (2/21) and hoarseness (1/21). 8 patients had multiple cutaneous hemangiomas. The age of presentation ranged from 1 to 8 months, with a median of 1.1 months. 18 cases (85.7 %) had a history of misdiagnosis, 14 bronchitis/pneumonia, 5 laryngomalacia, 2 laryngeal obstruction and 1 asthma. The median ages at diagnosis were 3 months, with a range of 1.2-28 months. The treatment duration ranged from 6 to 25.6 months, with an average of (14.3 ± 4.9) months. Age at termination of treatment ranged from 9 to 38 months, with a median of 18.6 months, and only 2 cases were beyond 2 years old at that time. No adverse side effects from propranolol therapy occurred and all 21 cases were cured. CONCLUSIONS: We advocate a strong index of suspicion for SGH presenting with respiratory symptoms under 2 years old who has poor effect or repeated condition after routine treatment. Laryngoscopy combined with contrast-enhanced CT can confirm the diagnosis of SGH. Oral propranolol is safe and effective, and that early diagnosis and intervention of propranolol without further delay are crucial to the successful management. We advocate continue propranolol treatment beyond 18 months of age, furthermore, 2 years old may be the best time for therapy termination.