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2.
Environ Toxicol ; 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39162414

RESUMO

OBJECTIVE: To compare the detection rates of hepatic artery digital subtraction angiography (HA-DSA) and magnetic resonance imaging (MRI) gadolinium diethylenetriaminepentaacetic acid (MRI-Gd-DTPA) and MRI gadolinium diethylenetriaminepentaacetic acid (MRI-Gd-EOB-DTPA) for small (diameter ≤2 cm) hepatocellular carcinoma (HCC) lesions. METHODS: A prospective analysis of patients admitted to the Tumor Hospital of Guangxi Medical University between January 1, 2015, and December 30, 2016, was conducted. The detection rates of the three methods were analyzed. The diameter of small HCC lesions detected using HA-DSA and MRI-Gd-EOB-DTPA were evaluated. The diagnostic value of HCC Barcelona staging for HA-DSA was analyzed. RESULTS: For 107 small lesions detected in 57 patients, the detection rates of HA-DSA and MRI-Gd-DTPA were 86.0% (92/107) and 71.0% (76/107), respectively (p < .05). Of 77 small lesions detected in 42 patients using MRI-Gd-EOB-DTPA and HA-DSA, 67 were detected using HA-DSA, all of which had a rich blood supply, and 72 were detected using MRI-Gd-EOB-DTPA. The minimum diameter of lesions detected using MRI-Gd-EOB-DTPA was approximately 0.4 cm, whereas that of lesions detected using HA-DSA was approximately 0.5 cm. After HA-DSA, a change in the Barcelona staging occurred in 33.3% (62/186) of cases but not after MRI-Gd-DTPA; HA-DSA was significantly better than MRI-Gd-DTPA for staging (p = .03). CONCLUSION: HA-DSA and MRI-Gd-EOB-DTPA have high diagnostic values for the detection of small HCC lesions, which is helpful for accurate staging of HCC and provides the most valuable information for patient treatment and prognosis.

3.
ACS Nano ; 18(33): 22518-22532, 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39109485

RESUMO

The matching of poly(ethylene oxide) (PEO)-based electrolytes with ultrahigh-nickel cathode materials is crucial for designing new-generation high-energy-density solid-state lithium metal batteries (SLMBs), but it is limited by serious interfacial side reactions between PEO and ultrahigh-nickel materials. Here, a high-concentration electrolyte (HCE) interface with a customized Li+ solvation sheath is constructed between the cathode and the electrolyte. It induces the formation of an anion-regulated robust cathode/electrolyte interface (CEI), reduces the unstable free-state solvent, and finally achieves the compatibility of PEO-based electrolytes with ultrahigh-nickel cathode materials. Meanwhile, the corrosion of the Al current collector caused by lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) ions is prevented by lithium difluoro(oxalato)borate (LiDFOB) ions. The synergistic effect of the double lithium salt is achieved by a well-tailored ratio of TFSI- and DFOB- in the first solvation sheath of Li+. Compared with reported PEO-based SLMBs matched with ultrahigh-nickel (Ni ≥ 90%) cathodes, the SLMB in this work delivers a high discharge specific capacity of 216.4 mAh g-1 (0.1C) even at room temperature. This work points out a direction to optimize the cathode/electrolyte interface.

4.
J Hepatocell Carcinoma ; 11: 1641-1652, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39206421

RESUMO

Background: The prognosis of initially unresectable hepatocellular carcinoma (iuHCC) has been improved by TACE with TKIs and PD-1 inhibitors (TTP). However, the role of timing of tumor progression and and early salvage surgery during TTP therapy remains unclear. Patients and Methods: The data of 151 patients who received TTP for iuHCC consecutively between November 2019 and December 2022 were retrospectively analyzed. The X-Tile software was used to determine the optimal threshold of progression timing to differentiate the post-progression survival (PPS) for patients with tumor progression, ultimately yielding 9 months as the optimal cut-off time. Early tumor progression was defined as patients with tumor recurrence (surgical patients) or progressive disease by mRECIST (nonsurgical patients) within 9 months of initial treatment. Accordingly, early salvage surgery was defined as salvage surgery performed within 9 months of the initial treatment. Results: Out of all the patients, 55 (36.4%) patients showed early tumor progression, 33 (34.4%) showed late tumor progression, and 63 (41.7%) showed non-progression. Patients who experienced early tumor progression had a median PPS of 5.2 months, while those with late tumor progression had a median PPS of 16.8 months (P < 0.001). Multivariable analysis revealed a robust independent correlation between early tumor progression and PPS (HR = 3.279, 95% CI: 1.591-6.756; P = 0.001). Patients who received early salvage surgery showed a considerably lower early tumor progression rate when compared with patients who did not receive early surgery (12.5% vs 42.9%, P = 0.002). The multivariable analysis revealed that early salvage surgery was an independent factor influencing early tumor progression (OR = 0.246; 95% CI: 0.078-0.773; P = 0.016). Conclusion: Early tumor progression is associated with worse PPS in patients with iuHCC receiving TTP therapy. Early salvage surgery can further improve patient outcomes by lowering the incidence of early progression.

5.
Int J Nanomedicine ; 19: 7215-7236, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39050875

RESUMO

Introduction: Current therapeutic strategies, including immune checkpoint blockade (ICB), exhibit limited efficacy in treating hepatocellular carcinoma (HCC). Nanoparticles, particularly those that can accumulate specifically within tumors and be activated by sonodynamic therapy (SDT), can induce immunogenic cell death (ICD); however, ICD alone has not achieved satisfactory therapeutic effectiveness. This study investigates whether combining ICB with ICD induced by nanoparticle-mediated SDT could enhance anti-tumor immunity and inhibit HCC growth. Methods: We developed an iron-based micelle nanodelivery system encapsulating the Near-Infrared Dye IR-780, which was surface-modified with a cyclic tripeptide composed of arginine-glycine-aspartic acid (cRGD). This led to the synthesis of targeted IR780@FOM-cRGD nanoparticles. These nanoparticles were specifically engineered to kill tumor cells under sonication, activate immunogenic cell death (ICD), and be used in conjunction with immune checkpoint blockade (ICB) for the treatment of hepatocellular carcinoma (HCC). Results: The synthesized IR780@FOM-cRGD nanoparticles had an average diameter of 28.23±1.750 nm and a Zeta potential of -23.95±1.926. Confocal microscopy demonstrated that IR780@FOM-cRGD could target HCC cells while minimizing toxicity to healthy cells. Upon sonodynamic activation, these nanoparticles consumed significant amounts of oxygen and generated substantial reactive oxygen species (ROS), effectively killing tumor cells and inhibiting the proliferation, invasion, and migration of H22 cells. Hemolysis assays confirmed the in vivo safety of the nanoparticles, and in vivo fluorescence imaging revealed significant accumulation in tumor tissues. Mouse model experiments showed that combining ICB(which induced by Anti-PD-L1) with ICD (which induced by IR780@FOM-cRGD), could effectively activated anti-tumor immunity and suppressed tumor growth. Discussion: This study highlights the potential of IR780@FOM-cRGD nanoparticles to facilitate tumor eradication and immune activation when used in conjunction with Anti-PD-L1 therapy. This combination represents a non-invasive, efficient, and targeted approach for the treatment of hepatocellular carcinoma (HCC). By integrating sonodynamic therapy with immunotherapy, this strategy promises to substantially improve the effectiveness of traditional treatments in combating HCC, offering new avenues for clinical application and therapeutic innovation.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Nanopartículas , Animais , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/imunologia , Camundongos , Nanopartículas/química , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/imunologia , Linhagem Celular Tumoral , Antígeno B7-H1/imunologia , Humanos , Indóis/química , Indóis/farmacologia , Inibidores de Checkpoint Imunológico/farmacologia , Inibidores de Checkpoint Imunológico/química , Terapia por Ultrassom/métodos , Oligopeptídeos/química , Oligopeptídeos/farmacologia , Morte Celular Imunogênica/efeitos dos fármacos , Micelas , Terapia Combinada/métodos , Camundongos Endogâmicos BALB C , Imunoterapia/métodos
7.
Am Surg ; : 31348241257464, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835213

RESUMO

BACKGROUND: This study aimed to evaluate the effectiveness and safety of 2D laparoscopy vs 3D laparoscopy for the treatment of colorectal cancer. METHODS: A literature search was conducted through PubMed, Web of Science, and Embase from their inception to January 2024. Studies investigating different outcomes of colorectal surgery were included. Results are presented as odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42024504902). RESULTS: A total of 10 publications were retrieved in this article. The 3D group is associated with a significant improvement in intraoperative blood loss (MD = -8.04, 95% CI = -14.18 to -1.89, P = 0.01, I2 = 55%), operative time (MD = -17.33, 95% CI = -29.15 to -5.51, P = 0.004, I2 = 90%), and postoperative hospital stay (MD = -0.23, 95% CI = -0.43 to -0.04, P = 0.02, I2 = 48%) compared to that of patients treated in the 2D group, particularly for rectal cancer patients above three results (MD = -10.36, 95% CI = -15.00 to -5.73, P < 0.001, I2 = 0%), (MD = -18.85, 95% CI = -34.88 to -2.82, P = 0.02, I2 = 57%), and (MD = -0.93, 95% CI = -1.53 to -0.34, P = 0.002, I2 = 0%), respectively. There was no significant statistical difference in the time of pass flatus (MD = -0.14, 95% CI = -0.49 to 0.21, P = 0.44, I2 = 79%) and the number of dissected lymph nodes (MD = 0.36, 95% CI = -0.49 to 1.21, P = 0.41, I2 = 45%), but the 3D group had an earlier postoperative pass flatus for rectal cancer patients (MD = -0.46, 95% CI = -0.66 to -0.27, P<0.001, I2 = 0%) and the more number of dissected lymph nodes for colon cancer patients (MD = 1.54, 95% CI = 0.05 to 3.03, P = 0.04, I2 = 69%) than the 2D group. There was no significant difference in postoperative overall complication (OR = 0.94, 95% CI = 0.67 to 1.31, P = 0.71, I2 = 0%) and anastomotic leakage (OR = 0.93, 95% CI = 0.48 to 1.80, P = 0.83, I2 = 0%) in the two groups, regardless of rectal cancer and colon surgery patients. CONCLUSION: This meta-analysis demonstrates that 3D laparoscopy could reduce the amount of blood loss, accelerate postoperative pass flatus, and shorten the operation time and postoperative hospital stay over 2D for radical rectal cancer surgery, without obvious advantage for radical colon cancer surgery. Moreover, 3D laparoscopy increases the number of dissected lymph nodes for radical colon cancer surgery but may not be observed in rectal cancer surgery.

8.
BMC Cancer ; 24(1): 717, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862932

RESUMO

BACKGROUNDS: To compare the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined Lenvatinib plus Camrelizumab (TLC) in unresectable hepatocellular carcinoma (uHCC) with those of TACE alone . METHODS: A retrospective analysis was performed on 222 patients with uHCC who were treated between September 2013 and Jun 2023. One group received TACE + lenvatinib + camrelizumab (TLC) (n = 97) and another group received TACE alone (n = 151). Efficacy and safety were compared after propensity score matching between the TLC and TACE groups. RESULTS: After propensity matching, the TLC group had higher objective response rate (ORR) (88.6% vs. 28.6%, P < 0.001), disease control rate (DCR) (94.3%% vs. 72.9%, P < 0.001), and conversion rates before and after propensity matching were 44.1% and 41.4%, respectively, compared with the TACE group. The median progression free survival (PFS) was longer in the TLC group than in the TACE group (12.7 vs. 6.1 months, P = 0.005). The median overall survival (OS) was longer in the TLC group than in the TACE group (19.4 vs. 13.0 months, P = 0.023). Cox multivariate analysis with different modes of adjustment showed that treatment was an independent influencing factor of PFS and OS. The interaction analysis showed that cirrhosis and Child-Pugh stage an interactive role in the PFS of different treatment. Decreased AFP after treatment portends higher ORR and DCR. CONCLUSION: TACE combined Lenvatinib plus Camrelizumab regimen was safe and superior to TACE alone in improving PFS, OS, and tumor response rates for unresectable recurrent HCC patients.


Assuntos
Anticorpos Monoclonais Humanizados , Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Compostos de Fenilureia , Pontuação de Propensão , Quinolinas , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Quinolinas/uso terapêutico , Quinolinas/administração & dosagem , Quinolinas/efeitos adversos , Masculino , Feminino , Quimioembolização Terapêutica/métodos , Quimioembolização Terapêutica/efeitos adversos , Pessoa de Meia-Idade , Estudos Retrospectivos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Compostos de Fenilureia/uso terapêutico , Compostos de Fenilureia/administração & dosagem , Compostos de Fenilureia/efeitos adversos , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Resultado do Tratamento , Terapia Combinada , Adulto
9.
Exp Ther Med ; 28(2): 308, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38873040

RESUMO

Diabetes mellitus and lipid metabolism disorders are increasingly recognized as key contributors to the development of chronic kidney disease (CKD). The lipid accumulation product (LAP) index, a novel marker of lipid accumulation, has potential implications for CKD risk assessment. The present meta-analysis aimed to assess the association between LAP index and CKD, with an emphasis on varying impacts in diabetic and non-diabetic populations. A comprehensive search for relevant publications was performed using PubMed/MEDLINE, Scopus, Cochrane Library, ScienceDirect and Google Scholar databases, and a meta-analysis of 17 studies was performed to investigate the relationship between LAP index and CKD. The random-effects inverse-variance model employing the DerSimonian-Laird estimator for τ² was utilized to calculate pooled odds ratios (ORs). Diagnostic accuracy was assessed using summary receiver operating characteristic (ROC) curves, with calculations of the area under the ROC curve (AUROC), sensitivity, specificity, likelihood ratios and diagnostic OR. The pooled OR for the association between higher quintiles or tertiles of LAP index and CKD was 1.098 (95% CI: 1.043-1.152), with substantial heterogeneity (I²=91.2%) and evidence of publication bias. Subgroup analysis revealed a stronger association in non-diabetic (OR=2.422, 95% CI: 1.802-3.042) compared with diabetic patients (OR=1.018, 95% CI: 0.993-1.043). The diagnostic accuracy of LAP index for CKD was moderate (AUROC=0.64), with sensitivity and specificity estimates of 0.58 and 0.63, respectively. In conclusion, in the present study, LAP index demonstrated a modest but significant association with CKD, particularly in non-diabetic patients. Despite its moderate diagnostic accuracy, the LAP index could serve as a valuable tool in CKD risk stratification, particularly when integrated with other clinical markers.

10.
BMC Cancer ; 24(1): 764, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918786

RESUMO

OBJECTIVE: Clinically significant portal hypertension (CSPH) seriously affects the feasibility and safety of surgical treatment for hepatocellular carcinoma (HCC) patients. The aim of this study was to establish a new surgical scheme defining risk classification of post-hepatectomy liver failure (PHLF) to facilitate the surgical decision-making and identify suitable candidates for individual hepatectomy among HCC patients with CSPH. BACKGROUNDS: Hepatectomy is the preferred treatment for HCC. Surgeons must maintain a balance between the expected oncological outcomes of HCC removal and short-term risks of severe PHLF and morbidity. CSPH aggravates liver decompensation and increases the risk of severe PHLF thus complicating hepatectomy for HCC. METHODS: Multivariate logistic regression and stochastic forest algorithm were performed, then the independent risk factors of severe PHLF were included in a nomogram to determine the risk of severe PHLF. Further, a conditional inference tree (CTREE) through recursive partitioning analysis validated supplement the misdiagnostic threshold of the nomogram. RESULTS: This study included 924 patients, of whom 137 patients (14.8%) suffered from mild-CSPH and 66 patients suffered from (7.1%) with severe-CSPH confirmed preoperatively. Our data showed that preoperative prolonged prothrombin time, total bilirubin, indocyanine green retention rate at 15 min, CSPH grade, and standard future liver remnant volume were independent predictors of severe PHLF. By incorporating these factors, the nomogram achieved good prediction performance in assessing severe PHLF risk, and its concordance statistic was 0.891, 0.850 and 0.872 in the training cohort, internal validation cohort and external validation cohort, respectively, and good calibration curves were obtained. Moreover, the calculations of total points of diagnostic errors with 95% CI were concentrated in 110.5 (range 76.9-178.5). It showed a low risk of severe PHLF (2.3%), indicating hepatectomy is feasible when the points fall below 76.9, while the risk of severe PHLF is extremely high (93.8%) and hepatectomy should be rigorously restricted at scores over 178.5. Patients with points within the misdiagnosis threshold were further examined using CTREE according to a hierarchic order of factors represented by the presence of CSPH grade, ICG-R15, and sFLR. CONCLUSION: This new surgical scheme established in our study is practical to stratify risk classification in assessing severe PHLF, thereby facilitating surgical decision-making and identifying suitable candidates for individual hepatectomy.


Assuntos
Carcinoma Hepatocelular , Hepatectomia , Hipertensão Portal , Neoplasias Hepáticas , Nomogramas , Humanos , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Hepatectomia/métodos , Hepatectomia/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Hipertensão Portal/cirurgia , Hipertensão Portal/etiologia , Idoso , Fatores de Risco , Complicações Pós-Operatórias/etiologia , Falência Hepática/etiologia , Falência Hepática/cirurgia , Estudos Retrospectivos , Adulto
11.
J Affect Disord ; 359: 394-402, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38806066

RESUMO

BACKGROUND: Both depression and constipation are universal disorders that seriously affect quality of life. But the phenotypic relationship and causality between depression and constipation are still unclear. METHODS: We first assessed phenotypic relationships by logistic regression analysis using large-scale data extracted from the National Health and Nutrition Examination Survey (N = 11,585). We then evaluated causality by bidirectional two-sample mendelian randomization (MR) analysis using Genome-wide association study (GWAS) data (depression: N = 807,553; constipation: N = 377,277). To investigate whether depression severity affects the causal relationship between depression and constipation, we conducted a further MR study on GWAS data of major depression (N = 480,359). RESULTS: About 11.31 % of the participants in the constipation group suffered from depression, which was significantly higher than the normal bowel group (6.09 %). The observational study showed a positive correlation between depression and constipation (OR = 1.968, 95%CI = 1.530-2.532). Besides, the risk of constipation was higher in participants with severe depression (OR = 2.294, 95%CI = 1.538-3.422) than in participants with mild depression (OR = 1.549, 95%CI = 1.242-1.932). Bidirectional MR analysis revealed an obviously causal effect of depression on constipation, but no causal effect of constipation on depression. In addition, the MR analysis also revealed a causal relationship between major depression and constipation. LIMITATION: The exact mechanism by which depression affects constipation is still unclear. CONCLUSION: This study reveals a positive correlation between depression and constipation and the causal effect of depression on constipation. Clinicians should keep the risk of constipation in mind when treating patients with depression.


Assuntos
Constipação Intestinal , Depressão , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Humanos , Constipação Intestinal/epidemiologia , Constipação Intestinal/genética , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Depressão/epidemiologia , Depressão/genética , Transtorno Depressivo Maior/genética , Transtorno Depressivo Maior/epidemiologia , Inquéritos Nutricionais , Idoso
12.
Transl Oncol ; 45: 101979, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38728873

RESUMO

BACKGROUND: The prognosis of hepatocellular carcinoma (HCC) is universally poor. Early diagnosis plays a pivotal role in determining the outcome of HCC. METHODS: We employed a comparative proteomics approach to identify potential biomarkers and validated the application of retinol-binding protein 4 (RBP4) as a biomarker for HCC. RBP4 protein expression was examined in liver tissues from 80 HCC patients through immunohistochemical analysis. Serum RBP4 concentrations were measured by ELISA in a cohort comprising 290 HCC patients, matched 202 chronic hepatitis B patients and 269 healthy controls. Survival data were collected from HCC patients. The diagnostic and prognostic values of RBP4 were evaluated using receiver operating curve (ROC) analysis. RESULTS: The validation results demonstrated a significant reduction in RBP4 levels in both liver tissues and serum samples from HCC patients. ROC analysis of the diagnostic value of RBP4 revealed an AUC of 0.879 (95 % CI: 0.854∼0.903) for HCC. When combined with AFP, the AUC increased to 0.919, with a sensitivity of 87.9 % and specificity of 80 %. Survival analysis revealed significantly reduced overall survival time in individuals with low-expression of RBP4 compared to those with high-expression. The joint prognostic model exhibited an AUC of 0.926 (95 % CI: 0.888∼0.964), which was significantly higher than that of AFP alone (AUC=0.809; P <0.0001). CONCLUSIONS: RBP4 shows a great potential as a biomarker with appreciable diagnostic value, complementing the AFP in HCC diagnosis. Additionally, it holds promise as a prognostic biomarker that, when integrated into a combined prognostic model, could greatly improve HCC prognosis efficiency.

13.
ACS Appl Mater Interfaces ; 16(23): 30088-30096, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38814617

RESUMO

Silicon (Si) anodes offer significant potential due to their high capacity. However, their drastic volume change limits their utility, resulting in a shorter cycling life. In this paper, microsilicon particles and 6H-SiC particles were ball-milled and subsequently coated a layer of amorphous carbon, yielding Si/SiC@C composites. Computational and experimental results reveal that this heterostructure formed between Si and 6H-SiC enhances the electronic conductivity of the Si/SiC@C composites dramatically, as well as the Li ion diffusion rate. Thereby, the Si/6H-SiC heterostructure increases capacity and enhances the rate capability of the Si-based anode. Significantly, the conductivity of Si/SiC@C composites surpasses that of Si@C composites by a factor of around 330. Furthermore, tough, evenly distributed, and electrochemically inert 6H-SiC serves as a rigid framework. By reducing the expansion rate of Si-based anodes and mitigating mechanical stress during cycles, this improves the cycling stability. Additionally, the Si/SiC@C anodes demonstrate superior cycle performance (814.6 mAh g-1 at 1 A g-1 after 400 cycles with capacity retention of 88.0%) and excellent rate capability (762 mAh g-1 at 5 A g-1).

14.
Langenbecks Arch Surg ; 409(1): 97, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38488934

RESUMO

BACKGROUND: This study was recruited to compare the efficacy and safety of radiotherapy (RT) and transarterial chemoembolization (TACE) as postoperative adjuvant therapy after narrow-margin hepatectomy in hepatocellular carcinoma (HCC) patients. METHODS: This single-center prospective randomized study was conducted in the Cancer Hospital, Guang Xi Medical University, Nanning. A total of 72 patients who received treatment in this hospital between August 2017 and July 2019 were included and randomly allocated to TACE group (n = 48) and RT group (n = 24). Next, overall survival (OS) and progression-free survival (PFS) rates, recurrence patterns, financial burden, and safety were evaluated. RESULTS: The difference between the RT and TACE groups was not significant in one-, three-, and five-year OS (87.5%, 79.0%, and 62.5% vs. 93.8%, 75.9%, and 63.4%, respectively, P = 0.071) and PFS rates (79.0%, 54.2%, and 22.6% vs. 75.0%, 47.9%, and 32.6%, respectively, P = 0.071). Compared to the TACE group, the RT group had significantly lower intrahepatic recurrence rate (20.8% vs. 52.1%, P = 0.011), higher extrahepatic recurrence rate (37.5% vs. 14.6%, P = 0.034), and no marginal and diffuse recurrences (0% vs. 16.7%, P < 0.05). The mean overall treatment cost was higher (¥62,550.59 ± 4397.27 vs. ¥40,732.56 ± 9210.54, P < 0.01), the hospital stay (15.1 ± 3.7 vs. 11.8 ± 4.1 days, P < 0.01) was longer, and the overall treatment stay (13.3 ± 5.3 vs. 41.29 ± 12.4 days, P < 0.01) was shorter in the TACE group than in the RT group. Besides, both groups did not exhibit significant differences in the frequency and severity of adverse events. CONCLUSION: Both adjuvant TACE and RT can better the OS and PFS of patients with HCC. However, RT has a significantly better performance than TACE in terms of improving intrahepatic recurrence rate, treatment cost and hospital stay.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Hepatectomia , Estudos Prospectivos , Quimioembolização Terapêutica/efeitos adversos , Resultado do Tratamento , Estudos Retrospectivos
15.
ACS Appl Mater Interfaces ; 16(11): 13948-13960, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38441538

RESUMO

Cobalt-free (Co-free) and nickel-rich (Ni-rich) cathode materials have attracted significant attention and undergone extensive studies due to their affordability and superior energy density. However, the commercialization of these Co-free materials is hindered by challenges such as cation disorder, irreversible phase changes, and inadequate high-voltage performance. To overcome these challenges, a Co-free ternary cathode material of Mg/Al double-pillared LiNiO2 (NMA) synthesized via a wet-coating and lithiation-sintering technique is proposed. Fundamental studies reveal that Mg and Al have the potential to form a distinctive double-pillar structure within the layered cathode, enhancing its structural stability. To be specific, the strategic placement of Mg and Al in Li and Ni layers, respectively, effectively reduces Li+/Ni2+ disorder and prevents irreversible phase transitions. Additionally, the inclusion of Mg and Al refines the primary grains and compacts the secondary grains in the cathode material, reducing stress from cyclic usage and preventing material cracking, thereby mitigating electrolyte erosion. As a result, NMA demonstrates exceptional electrochemical performance under a high charge cutoff voltage of 4.6 V. It maintains 70% of initial specific capacity after 500 cycles at 1 C and exhibits excellent rate performance, with a capacity of 162 mAh g-1 at 5 C and 149 mAh g-1 at 10 C. As a whole, the produced NMA achieves a high structural stability in cases of excessive delithiation, providing a groundbreaking solution for the development of cost-effective and high-energy-density cathode materials for lithium-ion batteries.

16.
Proc Natl Acad Sci U S A ; 121(8): e2319696121, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38346181

RESUMO

The phylogeny and divergence timing of the Neoavian radiation remain controversial despite recent progress. We analyzed the genomes of 124 species across all Neoavian orders, using data from 25,460 loci spanning four DNA classes, including 5,756 coding sequences, 12,449 conserved nonexonic elements, 4,871 introns, and 2,384 intergenic segments. We conducted a comprehensive sensitivity analysis to account for the heterogeneity across different DNA classes, leading to an optimal tree of Neoaves with high resolution. This phylogeny features a novel Neoavian dichotomy comprising two monophyletic clades: a previously recognized Telluraves (land birds) and a newly circumscribed Aquaterraves (waterbirds and relatives). Molecular dating analyses with 20 fossil calibrations indicate that the diversification of modern birds began in the Late Cretaceous and underwent a constant and steady radiation across the KPg boundary, concurrent with the rise of angiosperms as well as other major Cenozoic animal groups including placental and multituberculate mammals. The KPg catastrophe had a limited impact on avian evolution compared to the Paleocene-Eocene Thermal Maximum, which triggered a rapid diversification of seabirds. Our findings suggest that the evolution of modern birds followed a slow process of gradualism rather than a rapid process of punctuated equilibrium, with limited interruption by the KPg catastrophe. This study places bird evolution into a new context within vertebrates, with ramifications for the evolution of the Earth's biota.


Assuntos
Fósseis , Magnoliopsida , Gravidez , Feminino , Animais , Magnoliopsida/genética , Placenta , Filogenia , Aves/genética , Mamíferos/genética , DNA Mitocondrial/genética , Evolução Biológica
17.
Small ; 20(23): e2310318, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38183374

RESUMO

Low-cost and high-efficiency non-precious metal-based oxygen reduction reaction (ORR)/oxygen evolution reaction (OER) bifunctional catalysts are the key to promoting the commercial application of metal-air batteries. Herein, a highly efficient catalyst of Fe0.18Co0.82 alloy anchoring on the nitrogen-doped porous carbon hollow sphere (FexCo1-x/N-C) is intelligently designed by spray pyrolysis (SP). The zinc in the SP-derived metal oxides and metal-organic framework volatilize at high temperature to construct a hierarchical porous structure with abundant defects and fully exposes the FeCo nanoparticles which uniformly anchor on the carbon substrate. In this structure, the coexistence of Fe0.18Co0.82 alloy and binary metal active sites (Fe-Nx/Co-Nx) guarantees the Fe0.2Co0.8/N-C catalyst exhibiting an excellent half-wave potential (E1/2 ═ 0.84 V) superior to 20% Pt/C for ORR and a suppressed overpotential (280 mV) than RuO2 for OER. Assembled rechargeable Zn-air battery (RZAB) demonstrates a promising specific capacity of 807.02 mAh g-1, peak power density of 159.08 mW cm-2 and durability without electrolyte circulation (550 h). This work proposes the design concept of utilizing an oxide core to in situ consume the porous carbon shell for anchoring metal active sites and construct defects, which benefits from spray pyrolysis in achieving precise control of the alloy structure and mass preparation.

18.
Small ; 20(5): e2305618, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37753872

RESUMO

Planar gliding along with anisotropic lattice strain of single-crystalline nickel-rich cathodes (SCNRC) at highly delithiated states will induce severe delamination cracking that seriously deteriorates LIBs' cyclability. To address these issues, a novel lattice-matched MgTiO3 (MTO) layer, which exhibits same lattice structure as Ni-rich cathodes, is rationally constructed on single-crystalline LiNi0.9 Co0.05 Mn0.05 O2 (SC90) for ultrastable mechanical integrity. Intensive in/ex situ characterizations combined with theoretical calculations and finite element analysis suggest that the uniform MTO coating layer prevents direct contact between SC90 and organic electrolytes and enables rapid Li-ion diffusion with depressed Li-deficiency, thereby stabilizing the interfacial structure and accommodating the mechanical stress of SC90. More importantly, a superstructure is simultaneously formed in SC90, which can effectively alleviate the anisotropic lattice changes and decrease cation mobility during successive high-voltage de/intercalation processes. Therefore, the as-acquired MTO-modified SC90 cathode displays desirable capacity retention and high-voltage stability. When paired with commercial graphite anodes, the pouch-type cells with the MTO-modified SC90 can deliver a high capacity of 175.2 mAh g-1 with 89.8% capacity retention after 500 cycles. This lattice-matching coating strategy demonstrate a highly effective pathway to maintain the structural and interfacial stability in electrode materials, which can be a pioneering breakthrough in commercialization of Ni-rich cathodes.

19.
Small ; 20(14): e2307116, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37988688

RESUMO

Iron trifluoride (FeF3) is attracting tremendous interest due to its lower cost and the possibility to enable higher energy density in lithium-ion batteries. However, its cycle performance deteriorates rapidly in less than 50 cycles at elevated temperatures due to cracking of the unstable cathode solid electrolyte interface (CEI) followed by active materials dissolution in liquid electrolyte. Herein, by engineering the salt composition, the Fe3O4-type CEI with the doping of boron (B) atoms in a polymer electrolyte at 60 °C is successfully stabilized. The cycle life of the well-designed FeF3-based composite cathode exceeds an unprecedented 1000 cycles and utilizes up to 70% of its theoretical capacities. Advanced electron microscopy combined with density functional theory (DFT) calculations reveal that the B in lithium salt migrates into the cathode and promotes the formation of an elastic and mechanic robust boron-contained CEI (BOR-CEI) during cycling, by which the durability of the CEI to frequent cyclic large volume changes is significantly enhanced. To this end, the notorious active materials dissolution is largely prohibited, resulting in a superior cycle life. The results suggest that engineering the CEI such as tuning its composition is a viable approach to achieving FeF3 cathode-based batteries with enhanced performance.

20.
Adv Mater ; 36(11): e2311153, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38095834

RESUMO

The narrow electrochemical stability window, deleterious side reactions, and zinc dendrites prevent the use of aqueous zinc-ion batteries. Here, aqueous "soggy-sand" electrolytes (synergistic electrolyte-insulator dispersions) are developed for achieving high-voltage Zn-ion batteries. How these electrolytes bring a unique combination of benefits, synergizing the advantages of solid and liquid electrolytes is revealed. The oxide additions adsorb water molecules and trap anions, causing a network of space charge layers with increased Zn2+ transference number and reduced interfacial resistance. They beneficially modify the hydrogen bond network and solvation structures, thereby influencing the mechanical and electrochemical properties, and causing the Mn2+ in the solution to be oxidized. As a result, the best performing Al2 O3 -based "soggy-sand" electrolyte exhibits a long life of 2500 h in Zn||Zn cells. Furthermore, it increases the charging cut-off voltage for Zn/MnO2 cells to 2 V, achieving higher specific capacities. Even with amass loading of 10 mgMnO2 cm-2 , it yields a promising specific capacity of 189 mAh g-1 at 1 A g-1 after 500 cycles. The concept of "soggy-sand" chemistry provides a new approach to design powerful and universal electrolytes for aqueous batteries.

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