Estimating Efficacy of Conversion Therapy on Patients with Initially Unresectable Colorectal Cancer Liver Metastases by using MRI: Development of a Predictive Score.

RATIONALE AND OBJECTIVES: The conversion success rate (CSR) has crucial implication for clinical outcomes of initially unresectable colorectal liver metastases (CRLM) following conversion therapy. This study aimed to develop a simple predictive scoring model for identifying CSR according to baseline magnetic resonance imaging (MRI) features, and confirm its performance and prognostic significance in a validation cohort. METHODS: A total of 155 consecutive patients with initially unresectable CRLM were retrospectively reviewed in the study. A simple MRI-based predictive scoring model for identifying CSR was developed in the development cohort (n = 104) by using multivariable logistic regression analyzes. The diagnostic performance was evaluated for the predictive score. Thereafter, patients in the validation cohort (n = 51) were stratified into groups with predicted high CSR or low CSR according to the score. The progression-free survival (PFS) and overall survival (OS) were compared between two groups using the log-rank test. RESULTS: The predictive score of CSR, named mrNISE, incorporated the number of CRLM ≥ 10, the largest size ≥ 50 mm, poorly defined tumor-liver interface, and peritumoral enhancement. The AUC of the mrNISE score was 0.845 for the development cohort and 0.776 for the validation cohort. According to the score, patients with predicted high CSR had better PFS and OS than those with low CSR in both development and validation cohorts. CONCLUSION: The predictive score demonstrated great performance for identifying CSR of initially unresectable CRLM. Stratifying patients by the score, personalized treatment goals can be formulated before conversion therapy to improve clinical prognosis and reduce adverse events caused by ineffective treatment.

Antifungal Activity and Mechanism of Camphor Derivatives against Rhizoctonia solani: A Promising Alternative Antifungal Agent for Rice Sheath Blight.

Rice sheath blight, caused by the fungus Rhizoctonia solani, poses a significant threat to rice cultivation globally. This study aimed to investigate the potential mechanisms of action of camphor derivatives against R. solani. Compound 4o exhibited superior fungicidal activities in vitro (EC50 = 6.16 mg/L), and in vivo curative effects (77.5%) at 500 mg/L were significantly (P < 0.01) higher than the positive control validamycin·bacillus (66.1%). Additionally, compound 4o exhibited low cytotoxicity and acute oral toxicity for adult worker honeybees of Apis mellifera L. Mechanistically, compound 4o disrupted mycelial morphology and microstructure, increased cell membrane permeability, and inhibited both PDH and SDH enzyme activities. Molecular docking and molecular dynamics analyses indicated a tight interaction of compound 4o with PDH and SDH active sites. In summary, compound 4o exhibited substantial antifungal efficacy against R. solani, serving as a promising lead compound for further optimization of antifungal agents.

Curcumin Supplementation Improves Growth Performance and Anticoccidial Index by Improving the Antioxidant Capacity, Inhibiting Inflammatory Responses, and Maintaining Intestinal Barrier Function in Eimeria tenella-Infected Broilers.

This study was conducted to investigate the effects of dietary curcumin supplementation on growth performance, anticoccidial index, antioxidant capacity, intestinal inflammation, and cecum microbiota in broilers infected with Eimeria tenella. A total of 234 one-day-old broilers were categorized into three treatments, with six replicates per treatment containing 13 broilers each. The three treatments included the control group, Eimeria tenella group, and Eimeria tenella + curcumin (200 mg/kg) group. The feeding trial lasted for 42 days, during which the broilers were orally administered with 0.9% saline or 5 × 104Eimeria tenella oocysts on day 14 of the study. On day 17 and day 21, one bird per replicate was selected for slaughtering. Results indicated an increased survival rate and anticoccidial index and improved productive performance in coccidia-infected broilers with curcumin supplementation. Furthermore, curcumin enhanced the serum antioxidant capacity in Eimeria tenella-infected broilers, evidenced by increased serum catalase activity (3d, 7d), as well as decreased malondialdehyde level (3d, 7d) and nitric oxide synthase activity (7d) (p < 0.05). Curcumin also improved intestinal inflammation and barrier function, evidenced by the downregulation of interleukin (IL)-1ß (3d, 7d), TNF-alpha (TNF-α) (3d, 7d), and IL-2 (7d) and the up-regulated mRNA levels of claudin-1 (7d), zonula occludens (ZO-1; 3d, 7d), and occludin (3d, 7d) in the ceca of infected broilers (p < 0.05). Eimeria tenella infection significantly disrupted cecum microbial balance, but curcumin did not alleviate cecum microbial disorder in broilers infected with Eimeria tenella. Collectively, curcumin supplementation enhanced growth performance and anticoccidial index in Eimeria tenella-infected broilers via improving antioxidant ability and cecum inflammation without affecting cecum microbiota.

Prognostic and Immunotherapeutic Predictive Value of CAD Gene in Hepatocellular Carcinoma: Integrated Bioinformatics and Experimental Analysis.

Hepatocellular carcinoma (HCC) is a common type of cancer that ranks first in cancer-associated death worldwide. Carbamoyl-phosphate synthetase 2, aspartate transcarbamylase, and dihydroorotase (CAD) are the key components of the pyrimidine pathway, which promotes cancer development. However, the function of CAD in HCC needs to be clarified. In this study, the clinical and transcriptome data of 424 TCGA-derived HCC cases were analyzed. The results demonstrated that high CAD expression was associated with poor prognosis in HCC patients. The effect of CAD on HCC was then investigated comprehensively using GO annotation analysis, KEGG enrichment analysis, Gene Set Enrichment Analysis (GSEA), and CIBERSORT algorithm. The results showed that CAD expression was correlated with immune checkpoint inhibitors and immune cell infiltration. In addition, low CAD levels in HCC patients predicted increased sensitivity to anti-CTLA4 and PD1, while HCC patients with high CAD expression exhibited high sensitivity to chemotherapeutic and molecular-targeted agents, including gemcitabine, paclitaxel, and sorafenib. Finally, the results from clinical sample suggested that CAD expression increased remarkably in HCC compared with non-cancerous tissues. Loss of function experiments demonstrated that CAD knockdown could significantly inhibit HCC cell growth and migration both in vitro and in vivo. Collectively, the results indicated that CAD is a potential oncogene during HCC metastasis and progression. Therefore, CAD is recommended as a candidate marker and target for HCC prediction and treatment.

Drug-drug interaction between danshensu and irbesartan and its potential mechanism.

To uncover the effect of danshensu on irbesartan pharmacokinetics and its underlying mechanisms.To investigate the effect of danshensu on the pharmacokinetics of irbesartan, Sprague-Dawley rats (n = 6) were orally administered 30 mg/kg irbesartan alone (control group) or pre-treated with 160 mg/kg danshensu (experimental group). The effect of danshensu on the metabolic stability of irbesartan in RLMs was examined by LC-MS/MS method. The effect of danshensu on CYP2C9 activity was also determined.Danshensu markedly increased the AUC(0-t) (9573 ± 441 vs. 16157 ± 559 µg/L*h) and Cmax (821 ± 24 vs. 1231 ± 44 µg/L) of irbesartan. Danshensu prolonged the t1/2 (13.39 ± 0.98 vs. 16.04 ± 1.21 h) and decreased the clearance rate (2.27 ± 0.14 vs. 1.19 ± 0.10 L/h/kg) of irbesartan. Danshensu enhanced the metabolic stability of irbesartan in vitro with prolonged t1/2 (36.34 ± 11.68 vs. 48.62 ± 12.03 min) and reduced intrinsic clearance (38.14 ± 10.24 vs. 28.51 ± 9.06 µL/min/mg protein). Additionally, the IC50 value for CYP2C9 inhibition by danshensu was 35.74 µM.Danshensu enhanced systemic exposure of irbesartan by suppressing CYP2C9. The finding can also serve as a guidance for further investigation of danshensu-irbesartan interaction in clinical practice.

CT synthesis from MR images using frequency attention conditional generative adversarial network.

Magnetic resonance (MR) image-guided radiotherapy is widely used in the treatment planning of malignant tumors, and MR-only radiotherapy, a representative of this technique, requires synthetic computed tomography (sCT) images for effective radiotherapy planning. Convolutional neural networks (CNN) have shown remarkable performance in generating sCT images. However, CNN-based models tend to synthesize more low-frequency components and the pixel-wise loss function usually used to optimize the model can result in blurred images. To address these problems, a frequency attention conditional generative adversarial network (FACGAN) is proposed in this paper. Specifically, a frequency cycle generative model (FCGM) is designed to enhance the inter-mapping between MR and CT and extract more rich tissue structure information. Additionally, a residual frequency channel attention (RFCA) module is proposed and incorporated into the generator to enhance its ability in perceiving the high-frequency image features. Finally, high-frequency loss (HFL) and cycle consistency high-frequency loss (CHFL) are added to the objective function to optimize the model training. The effectiveness of the proposed model is validated on pelvic and brain datasets and compared with state-of-the-art deep learning models. The results show that FACGAN produces higher-quality sCT images while retaining clearer and richer high-frequency texture information.

Histogram analysis based on unenhanced CT for identifying thymoma and lymphoma among prevascular mediastinal incidentalomas.

OBJECTIVE: To determine whether histogram analysis based on unenhanced CT can play a role in the differential diagnosis of thymoma and lymphoma from thymic hyperplasia and cyst (mean CT attenuation > 10 HU). MATERIALS AND METHODS: This retrospective study included consecutive asymptomatic participants who have prevascular mediastinal lesions incidentally detected by unenhanced CT between December 2013 and August 2020, and with definitive diagnosis by pathology or additional radiologic work-ups. A total of thirteen histogram parameters on enhanced CT were calculated for each lesion, then were compared between tumor (thymoma + lymphoma) and non-tumor (hyperplasia + cyst). Receiver operating characteristic analysis was conducted to investigate the performance of histogram parameter for identifying tumor. RESULTS: The study population included 192 patients (106 men and 86 women) with a mean age of 50.5 years at the time of CT examination. Of them, 94 patients have tumor (87 thymomas and 7 lymphoma) and 98 have non-tumor (48 thymic hyperplasia and 50 cysts). Nine of the thirteen histogram parameters revealed significant difference between the two groups, including median, minimum, range, 10th percentile, 90th percentile, kurtosis, skewness, uniformity and entropy. No significant difference was observed in the mean CT attenuation between groups. Higher median was found to be independent predictors for distinguishing tumor from non-tumor, and can achieve an area under the curve (AUC) of 0.785 (95% confidence interval [95% IC], 0.720-0.841). CONCLUSIONS: Histogram analysis based on unenhanced CT may be able to provide some help in the differential diagnosis of incidental lesions in prevascular mediastinal. GRAND SUPPORT: This study was sponsored by Natural Science Foundation of Shanghai (No. 21ZR1459700).

Colorectal liver metastases: Correlations of contrast-enhanced ultrasound features with tumor clinicopathological factors and clinical outcomes following conversion therapy.

OBJECTIVE: To explore the prognostic impact of contrast-enhanced ultrasound (CEUS) features for initially unresectable colorectal liver metastases (CLMs) in a clinical setting of conversion therapy. METHODS: Between March 2015 and November 2020, consecutive patients with CLMs who received conversion treatment were prospectively enrolled. All participants underwent liver CEUS at baseline. The primary endpoint was conversion resection rate (R0 and overall resection). Secondary endpoints were objective response rate (ORR), overall survival (OS), and progression-free survival (PFS). RESULTS: 104 participants who completed conversion treatment were included. CEUS enhancement pattern was correlated with index lesion (size and echogenicity), primary (site, differentiation, perineural invasion, and RAS genotype) and serum (CA19-9 level) characteristics (P = <0.001-0.016). CEUS enhancement pattern was significantly associated with R0 resection rate, ORR, PFS, and OS (P = 0.001-0.049), whereas enhancement degree was associated with PFS and OS (P = 0.043 and 0.045). Multivariate analysis showed that heterogeneous enhancement independently predicted R0 and overall resection (P = 0.028 and 0.024) while rim-like enhancement independently predicted ORR and OS (P = 0.009 and 0.026). CONCLUSION: CEUS enhancement pattern was significantly associated with tumor characteristics and clinical outcomes following conversion therapy, and thus might be of prognosis impact for initially unresectable CLMs.

Should the Baseline MRI Staging Criteria Differentiate Between Mucinous and Classical Rectal Adenocarcinoma?

RATIONALE AND OBJECTIVES: To compare baseline MR imaging features for pre-treatment staging between rectal mucinous adenocarcinoma (RMAC) and rectal classical adenocarcinoma (RCAC), and to investigate whether the subtype of mucinous carcinoma influences MRI evaluation criteria and high-risk tumors identifying. METHODS: A total of 306 patients who underwent surgical rectal cancer resection were retrospectively reviewed in the study. MR imaging parameters of the primary tumor and lymph nodes (LNs) were compared between two subtypes. Logistic regression and receiver operating characteristic analyses were performed to test significant associations between LN imaging parameters and malignant LN status in RMAC and RCAC, respectively. RESULTS: The length of mucinous tumors was larger than RCAC tumors in pT3 and pT4 stage. For pN0 patients, the long and short diameters of the largest LN on MRI were more likely to be larger in RCAC than RMAC. For pN+ patients, the proportion of LNs exhibiting internal heterogeneity in RMAC was obviously greater than that in RCAC. The best cut-off value of the largest short diameter of malignant LNs was 6.05 mm for RMAC and 8.05 mm for RCAC. And the highest AUC for predicting LNs metastases based on the largest short diameter was 0.794 for RMAC using 6 mm size cut-off, and 0.667 for RCAC using 8 mm cut-off. CONCLUSION: The imaging features that were associated with LN metastases were different between RMAC and RCAC, and different size criteria of LNs was suggested to distinguish high-risk tumors. Clinicians should stay vigilant of LN status and take histologic subtypes into consideration before assigning clinical strategies.

Discovery of N-Arylsulfonyl-Indole-2-Carboxamide Derivatives as Galectin-3 and Galectin-8 C-Terminal Domain Inhibitors.

Both galectin-3 and galectin-8 are involved in cell adhesion, migration, apoptosis, angiogenesis, and inflammatory processes by recognizing galactose-containing glycoproteins. Inhibiting galectin-3/8 activities is a potential treatment for cancer and tissue fibrosis. Herein, a series of novel N-arylsulfonyl-5-aryloxy-indole-2-carboxamide derivatives was disclosed as dual inhibitors toward galectin-3 and galectin-8 C-terminal domain with Kd values of low micromolar level (Cpd53, gal-3: Kd= 4.12 µM, gal-8C: Kd= 6.04 µM; Cpd57, gal-3: Kd= 12.8 µM, gal-8C: Kd= 2.06 µM), which are the most potent and selective noncarbohydrate-based inhibitors toward gal-3/8 isoforms to date. The molecular docking investigations suggested that the unique amino acids Arg144 in galectin-3 and Ser213 in galectin-8C could contribute to their potency and selectivity. The scratch wound assay demonstrated that Cpd53 and Cpd57 were able to inhibit the MRC-5 lung fibroblast cells migration as well. This class of inhibitors could serve as a new starting point for further discovering structurally distinct gal-3 and gal-8C inhibitors to be used in cancer and tissue fibrosis treatment.

The largest lymph node defined response to neoadjuvant chemotherapy can predict long-term prognosis in locally advanced gastric cancer.

BACKGROUND: The assessment of tumor response to neoadjuvant chemotherapy (NACT) in locally advanced gastric cancer (LAGC) remain challenging. We aimed to explore the potential role of peri-NACT change of the largest lymph node (LN) and primary tumor (P-T) in the prediction of tumor response and patient overall survival (OS) in LAGC. METHODS: A cohort of LAGC patients who underwent NACT followed by radical surgery from a prospective clinical trial were retrospectively analyzed. The percentage change of the largest LN and P-T from initial to post-NACT Computed Tomography (CT) were measured. Tumor response was defined by the change of LN (LN-response) and P-T (P-T-response), respectively. A multivariate Cox model was constructed to examine if P-T- and LN-determined response had significant predictive ability for OS when adjusting with other possible prognostic factors. RESULTS: Of the 41 patients, 28 (68.3%) was defined as LN-responders to NACT, and 17 (41.5%) patients was defined as P-T-responders. When the cohort was stratified by LN response standard, LN-responders showed a significant longer median OS than LN-nonresponders (p = 0.031, 20.6 vs 16.6 months). When stratified by primary tumor response, no significant difference in OS was observed between P-T-responders and P-T-nonresponders (p = 0.377, 18.5 vs 19.0 months). In the multivariate analysis, number of positive LN (p = 0.004, hazard ratio [HR] = 1.284), recurrence (p = 0.024, HR =3556), LN shrinkage (p = 0.022, HR = 0.930) and LN-response (p = 0.033, HR = 0.008) were observed with independent association with OS. CONCLUSIONS: Peri-NACT change of the largest LN could reflect tumor response to NACT, and LN-defined response was useful in predicting the long-term prognosis (OS) of LAGC patients who underwent NACT followed by radical surgery.

Spatial dynamics of pH in the rhizosphere of Leersia hexandra Swartz at different chromium exposure.

The roots of hyperaccumulators can significantly alter soil pH and thus change the chromium (Cr) availability in the rhizosphere. The pH dynamics in the rhizosphere of Cr hyperaccumulator Leersia hexandra Swartz remains unknown. In this study, the spatial dynamics of pH in the rhizosphere of L. hexandra at different Cr exposure were examined using planar optode (PO). The effects of different Cr concentrations on the biomass, physiological parameters, and soil enzyme activity were investigated. The results showed that pH in the rhizosphere of L. hexandra was highly heterogeneous and followed the root shape. There were obvious soil acidification in all groups and the average pH values in the control, Cr50, and Cr100 groups decreased by 0.26, 0.27, and 0.35 pH unit, respectively. At a certain concentration (50 mg kg-1), Cr significantly increased the plant height and biomass of L. hexandra compared to the control (p < 0.05). The concentrations of chlorophyll a, chlorophyll b, and total chlorophyll in the leaves increased with increasing Cr concentrations. The acid phosphatase, urease, and catalase activities in the rhizosphere were higher than those in the bulk soil. These results provide new insights into elucidating the hyperaccumulating mechanism of Cr and improving the phytoremediation efficiency.

Release behavior of fertilizers and heavy metals from iron-loaded sludge biochar in the aqueous environment.

In this study, the release behavior of fertilizers (NH4+-N, PO43- and K) and heavy metals (Mn, Zn, Ni, Cu, Pb and Cr) from iron-loaded sludge biochar (ISBC) was investigated to evaluated the feasibility and risks of ISBC as a slow release fertilizer. Their release capacity was significantly enhanced with decreasing initial pH, increasing solid-liquid ratio (RS-L) and rising temperature (p < 0.05). When the initial pH, RS-L and temperature were separately 5 (fertilizers)/1 (heavy metals), 1:5 and 298 K, the final concentrations of NH4+-N, PO43-, K, Mn, Zn and Ni were 6.60, 14.13, 149.4, 53.69, 72.56, and 1.01 mg L-1, while the maximum concentrations of Cu, Pb and Cr were 0.94, 0.77, and 0.22 mg L-1, respectively. Due to the tiny difference between the R2 values, revised pseudo-first-order and pseudo-second-order kinetics models described their release behavior well, suggesting that physical and chemical interactions played an important role. Activation energies greater than 40 kJ mol-1 indicated that the rate-controlling steps of the release of NH4+-N, PO43- and Ni were chemical reactions, while chemical reactions and diffusion together determined the release rates of K, Mn, Zn, Cu, Pb and Cr because their activation energies were in the range of 20-40 kJ mol-1. The increasingly negative ΔG and positive ΔH and ΔS suggested that their release was a spontaneous (except Cr) and endothermic process with an increase of randomness between the solid-liquid interface. The release efficiency of NH4+-N, PO43- and K were in the ranges of 28.21%-53.97%, 2.09%-18.06% and 39.46%-66.14%, respectively. Meanwhile, the pollution index and evaluation index of heavy metals were in the ranges of 33.31-227.4 and 4.64-29.24, respectively. In summary, ISBC could be used as a slow-release fertilizer with low risk when the RS-L was less than 1:40.

Removal of tetracycline in aqueous solution by iron-loaded biochar derived from polymeric ferric sulfate and bagasse.

In this study, the tetracycline (TC) removal performance of iron-loaded biochar (BPFSB) derived from sugarcane bagasse and polymerized iron sulfate was investigated, and the mechanism of TC removal was also explored by study of isotherms, kinetics and thermodynamics and characterization of fresh and used BPFSB (XRD, FTIR, SEM and XPS). The results showed that under optimized conditions (initial pH 2; BPFSB dosage 0.8 g·L-1; TC initial concentration 100 mg·L-1; Contact time 24 h; temperature 298 K), the removal efficiency of TC was as high as 99.03%. The isothermal removal of TC followed well the Langmuir, Freundlich, and Temkin models, indicating that multilayer surface chemisorption dominated the TC removal. The maximum removal capacity of TC by BPFSB at different temperatures was 185.5 mg·g-1 (298 K), 192.7 mg·g-1 (308 K), and 230.9 mg·g-1 (318 K), respectively. The pseudo-second-kinetic model described the TC removal better, while its rate-controlling step was a combination of liquid film diffusion, intraparticle diffusion, and chemical reaction. Meanwhile, TC removal was also a spontaneous and endothermic process, during which the randomness and disorder between the solid-liquid interface was increased. According to the characterization of BPFSBs before and after TC removal, H-bonding and complexation were the major interactions for TC surface adsorption. Furthermore, BPFSB was efficiently regenerated by NaOH. In summary, BPFSB had the potential for practical application in TC removal.

Effect of iron-loaded sludge biochar amendments on phytoremediation potential of Cr-contaminated soils by Leersia hexandra swartz.

In this study, the effect of iron-loaded sludge biochar (ISBC) with different amendment dosages (mass ratio of biochar to soil equal to 0, 0.01, 0.025 and 0.05) on the phytoremediation potential of Leersia hexandra swartz (L. hexandra) to Cr-contaminated soil was investigated. With increasing ISBC dosage from 0 to 0.05, plant height, aerial tissue biomass and root biomass increased from 15.70 cm, 0.152 g pot-1 and 0.058 g pot-1 to 24.33 cm, 0.304 g pot-1 and 0.125 g pot-1, respectively. Simultaneously, the Cr contents in aerial tissues and roots increased from 1039.68 mg kg-1 to 2427.87 mg kg-1 to 1526.57 mg kg-1 and 3242.62 mg kg-1, respectively. Thus, the corresponding bioenrichment factor (BCF), bioaccumulation factor (BAF), total phytoextraction (TPE) and translocation factor (TF) values were also increased from 10.52, 6.20, 0.158 mg pot-1 (aerial tissue)/0.140 mg pot-1 (roots) and 0.428 to 15.15, 9.42, 0.464 mg pot-1 (aerial tissue)/0.405 mg pot-1 (roots) and 0.471, respectively. The significant positive effect of ISBC amendment was primarily attributed to the following three aspects: 1) the root resistance index (RRI), tolerance index (TI) and growth toxicity index (GTI) of L. hexandra to Cr were increased from 100%, 100% and 0%-216.88%, 155.02% and 42.18%, respectively; 2) the bio-available Cr content in the soil was decreased from 1.89 mg L-1 to 1.48 mg L-1, while the corresponding TU (toxicity units) value was declined from 0.303 to 0.217; 3) the activities of urease, sucrase and alkaline phosphatase in soil were increased from 0.186 mg g-1, 1.40 mg g-1 and 0.156 mg g-1 to 0.242 mg g-1, 1.86 mg g-1 and 0.287 mg g-1, respectively. In summary, ISBC amendment was able to significantly improve the phytoremediation of Cr-contaminated soils by L. hexandra.

[Removal Performance and Mechanism of Potassium Permanganate Modified Coconut Shell Biochar for Cd(â ¡) and Ni(â ¡) in Aquatic Environment].

In this study, coconut shell biochar modified by KMnO4 (MCBC) was used as the adsorbent, and its removal performance and mechanism for Cd(Ⅱ) and Ni(Ⅱ) were discussed. When the initial pH and MCBC dosage were separately 5 and 3.0 g·L-1, respectively, the removal efficiencies of Cd(Ⅱ) and Ni(Ⅱ) were both higher than 99%. The removal of Cd(Ⅱ) and Ni(Ⅱ) was more in line with the pseudo-second-order kinetic model, indicating that their removal was dominated by chemisorption. The rate-controlling step for Cd(Ⅱ) and Ni(Ⅱ) removal was the fast removal stage, for which the rate depended on the liquid film diffusion and intraparticle diffusion (surface diffusion). Cd(Ⅱ) and Ni(Ⅱ) were mainly attached to the MCBC via surface adsorption and pore filling, in which the contribution of surface adsorption was greater. The maximum adsorption amounts of Cd(Ⅱ) and Ni(Ⅱ) by MCBC were individually 57.18 mg·g-1 and 23.29 mg·g-1, which were approximately 5.74 and 6.97 times that of the precursor (coconut shell biochar), respectively. The removal of Cd(Ⅱ) and Zn(Ⅱ) was spontaneous and endothermic and had obvious thermodynamic characteristics of chemisorption. Cd(Ⅱ) was attached to MCBC through ion exchange, co-precipitation, complexation reaction, and cation-π interaction, whereas Ni(Ⅱ) was removed by MCBC via ion exchange, co-precipitation, complexation reaction, and redox. Among them, co-precipitation and complexation were the main modes of surface adsorption of Cd(Ⅱ) and Ni(Ⅱ). Additionally, the proportion of amorphous Mn-O-Cd or Mn-O-Ni in the complex may have been higher. These research results will provide important technical support and theoretical basis for the practical application of commercial biochar in the treatment of heavy metal wastewater.

Distinct radiological features of lymphoepithelioma-like intrahepatic cholangiocarcinoma: comparison with classical intrahepatic cholangiocarcinoma.

BACKGROUND: Lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEICC) has been recently introduced as a genetically distinct of intrahepatic cholangiocarcinoma (ICC). We aimed to investigate whether LEICC has distinct radiological characteristics in comparison with classical ICC, and to determine MRI features that can be used to differentiate LEICC from classical ICC. METHODS: Five hundred and sixty-seven consecutive patients who underwent surgical resection or liver transplantation for ICC between 2014 and 2021 were retrospectively identified. Among them, 30 patients with LEICC (LEICC-cohort) and 116 with stage-matched classical ICC (control-cohort) were finally included. Pre-operative MRI data were compared between the two cohorts. Multivariable logistic regression analysis was performed to determine relevant imaging features suggesting the diagnosis of LEICC over classical ICC. RESULTS: LEICCs showed significantly higher frequencies of a non-rim arterial phase hyperenhancement (APHE), washout on post-arterial images and a smooth margin, as well as less frequencies of perilesional enhancement and liver capsular retraction when compared with classical ICCs (P < 0.05 for all). The multivariate analysis revealed that non-rim APHE (odds ratio, 10.863; 95% CI [3.295-35.821]; P < 0.001) and the absence of perilesional enhancement (odds ratio, 3.350; 95% CI [1.167-9.619]; P = 0.025) are significant independent imaging features that suggest the diagnosis of LEICCs over classical ICCs. CONCLUSIONS: Compared with classical ICCs, LEICCs do have distinct radiological characteristics. A smooth margin, non-rim APHE, washout on post-arterial images, absent perilesional enhancement and absent liver capsular retraction are useful MRI features that could help to differentiate LEICCs from classical ICCs.

Heterogeneous Fenton system driven by iron-loaded sludge biochar for sulfamethoxazole-containing wastewater treatment.

In this study, the treatment performance of a heterogeneous Fenton system (Fe-BC + H2O2) driven by iron-loaded sludge biochar (Fe-BC) on wastewater containing sulfamethoxazole (SMX) was investigated using the CODcr removal efficiency (φ) as an indicator. The batch experimental results showed that the optimal operating conditions were as follow: initial pH 3, H2O2 concentration 20 mmol L-1, Fe-BC dose 1.2 g L-1, temperature 298 K. The corresponding φ was as high as 83.43%. The removal of CODcr was better described by BMG model and revised BMG (BMGL) model. According to the BMGL model, the φmax could be 98.37% (298 K). Moreover, the removal of CODcr was a diffusion-controlled process, while liquid film diffusion and intraparticle diffusion together determined its removal rate. The removal of CODcr should be a synergistic effect of adsorption and Fenton oxidation (real heterogeneous Fenton and homogeneous Fenton) and other pathways. Their contributions were 42.79%, 54.01% and 3.20%, respectively. For homogeneous Fenton, there seemed to be two simultaneous SMX degradation pathways: SMX→4-(pyrrolidine-11-sulfonyl)-aniline→N-(4-aminobenzenesulfonyl) acetamide/4-amino-N-ethyl benzene sulfonamides→4-amino-N-hydroxy benzene sulfonamides; SMX→N-ethyl-3-amino benzene sulfonamides→4-methanesulfonylaniline. In summary, Fe-BC had potential for practical application as a heterogeneous Fenton catalyst.

Preoperative Local Staging of Colon Cancer by CT: Radiological Staging Criteria Based on Membrane Anatomy and Visceral Adipose Tissue.

BACKGROUND: Accuracy of preoperative T staging for colon cancer remains disappointing. OBJECTIVE: This study aimed to propose specially designed radiological staging criteria based on membrane anatomy and visceral adipose tissue and compare the staging performance with the routinely used method. DESIGN: This is a prospective observational study. SETTING: This study was conducted at a high-volume colorectal center. PARTICIPANTS: Consecutive patients with colonoscopy-proven colon carcinoma referred for clinical staging and elective resection were enrolled. INTERVENTION: The preoperative CT data were separately reviewed by 2 teams of radiologists for assigning T-stage categories (T1-2, T3, or T4) using the routine staging method or the newly proposed radiological criteria. MEASURES: Diagnostic performance for T staging was compared between the 2 criteria. RESULTS: Between October 2019 and August 2020, 190 patients were included. Compared with pathological results, T stage was correctly determined in 113 of 190 patients (59.5%) with the conventional CT criteria. With the newly developed criteria, 160 patients (84.2%) were found to be correctly staged. Accuracies between the 2 criteria significantly differed ( p < 0.001). For T1-2 staging, there were no significant differences between the sensitivities of conventional and new criteria (57.1% vs 61.9%; p = 0.990) or between their specificities (95.3% vs 98.2%; p = 0.131). However, for T3 and T4 staging, the newly developed CT criteria exhibited significantly higher sensitivity (T3: 85.2% vs 57.4%; p < 0.001; T4: 90.7% vs 64.8%; p < 0.001) and specificity (T3: 82.7% vs 64%; p = 0.006; T4: 89.7% vs 69.1%; p < 0.001) than the conventional criteria. Moreover, the new criteria (area under the curve = 0.902) performed significantly better than the conventional criteria (area under the curve = 0.670; p < 0.001), for identifying the T4-stage tumor. LIMITATIONS: The limitations are that it is a single-center study and there was no external validation. CONCLUSIONS: The specially designed radiological criteria can offer more accurate T staging than the routine method in colon cancer. See Video Abstract at http://links.lww.com/DCR/B992 . PREDICCIN DE LA MORTALIDAD A DAS POSTERIORES A LA PRIMERA CIRUGA EN PACIENTES CON CNCER DE COLON OBSTRUCTIVO DEL LADO IZQUIERDO: ANTECEDENTES:Se cree que la resección aguda para el carcinoma de colon obstructivo del lado izquierdo está asociada con un mayor riesgo de mortalidad que un enfoque puente a la cirugía que utiliza un estoma de descompresión o un stent metálico autoexpandible, pero faltan modelos de predicción.OBJETIVO:Determinar la influencia de la estrategia de tratamiento sobre la mortalidad dentro de los 90 días desde la primera intervención utilizando un modelo de predicción en pacientes que presentan carcinoma de colon obstructivo del lado izquierdo.DISEÑO:Un estudio de cohorte multicéntrico nacional, utilizando datos de una auditoría nacional prospectiva.ENTORNO CLINICO:El estudio se realizó en 75 hospitales holandeses.PACIENTES:Se incluyeron los pacientes que se sometieron a una resección con intención curativa de un carcinoma de colon obstructivo del lado izquierdo entre 2009 y 2016.INTERVENCIONES:La primera intervención fue resección aguda, puente a cirugía con stent metálico autoexpandible o puente a cirugía con estoma descompresor.PRINCIPALES MEDIDAS DE VALORACIÓN:La principal medida de resultado fue la mortalidad a los 90 días después de la primera intervención. Los factores de riesgo se identificaron mediante análisis logístico multivariable. Posteriormente se desarrolló un modelo de riesgo.RESULTADOS:En total se incluyeron 2395 pacientes, siendo la primera intervención resección aguda en 1848 (77%) pacientes, estoma como puente a la cirugía en 332 (14%) pacientes y stent como puente a la cirugía en 215 (9%) pacientes. En general, 152 pacientes (6,3%) fallecieron dentro de los 90 días posteriores a la primera intervención. Un estoma de descompresión se asoció de forma independiente con un menor riesgo de mortalidad a los 90 días (HR: 0,27, IC: 0,094-0,62). Otros predictores independientes de mortalidad fueron la edad, la clasificación ASA, la ubicación del tumor y los niveles índice de creatinina sérica y proteína C reactiva. El modelo de riesgo construido tuvo un área bajo la curva de 0,84 (IC: 0,81-0,87).LIMITACIONES:Solo se incluyeron pacientes que se sometieron a resección quirúrgica.CONCLUSIONES:La estrategia de tratamiento tuvo un impacto significativo en la mortalidad a los 90 días. Un estoma descompresor reduce considerablemente el riesgo de mortalidad, especialmente en pacientes mayores y frágiles. Se desarrolló un modelo de riesgo, que necesita una mayor validación externa. Consulte Video Resumen en http://links.lww.com/DCR/B992 . (Traducción-Dr. Ingrid Melo ).

Prognostic value of preoperative CT features for disease-free survival in patients with primary gastric gastrointestinal stromal tumors after resection.

PURPOSE: Tumor size is an important prognostic factor without consideration of the necrotic and cystic components within tumor for patients with gastrointestinal stromal tumors (GISTs). We aimed to extract the enhancing viable component from the tumor using computed tomography (CT) post-processing software and evaluate the value of preoperative CT features for predicting the disease-free survival (DFS) after curative resection for patients with primary gastric GISTs. METHODS: 132 Patients with primary gastric GISTs who underwent preoperative contrast-enhanced CT and curative resection were retrospectively analyzed. We used a certain CT attenuation of 30 HU to extract the enhancing tissue component from the tumor. Enhancing tissue volume and other CT features were assessed on venous-phase images. We evaluated the value of preoperative CT features for predicting the DFS after surgery. Univariate and multivariate Cox regression analyses were performed to find the independent risk factor for predicting the DFS. RESULTS: Of the 132 patients, 68 were males and 64 were females, with a mean age of 61 years. The median follow-up duration was 60 months, and 28 patients experienced disease recurrence and distant metastasis during the follow-up period. Serosal invasion (p < 0.001; HR = 5.277) and enhancing tissue volume (p = 0.005; HR = 1.447) were the independent risk factors for predicting the DFS after curative resection for patients with primary gastric GISTs. CONCLUSION: Preoperative contrast-enhanced CT could be useful for predicting the DFS after the surgery of gastric GISTs, and serosal invasion and enhancing tissue volume were the independent risk factors.