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OBJECTIVE: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA). MATERIALS AND METHODS: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates. RESULTS: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355). CONCLUSION: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.
Asunto(s)
Microondas , Ablación por Radiofrecuencia , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Humanos , Femenino , Masculino , Cáncer Papilar Tiroideo/cirugía , Cáncer Papilar Tiroideo/patología , Estudios Retrospectivos , Adulto , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/patología , Microondas/uso terapéutico , Ablación por Radiofrecuencia/métodos , Resultado del Tratamiento , Persona de Mediana Edad , Progresión de la Enfermedad , Estadificación de NeoplasiasRESUMEN
Friction as a fundamental physical phenomenon dominates nature and human civilization, among which the achievement of molecular rolling lubrication is desired to bring another breakthrough, like the macroscale design of wheel. Herein, an edge self-curling nanodeformation phenomenon of graphite nanosheets (GNSs) at cryogenic temperature is found, which is then used to promote the formation of graphite nanorollers in friction process towards molecular rolling lubrication. The observation of parallel nanorollers at the friction interface give the experimental evidence for the occurrence of molecular rolling lubrication, and the graphite exhibits abnormal lubrication performance in vacuum with ultra-low friction and wear at macroscale. The molecular rolling lubrication mechanism is elucidated from the electronic interaction perspective. Experiments and theoretical simulations indicate that the driving force of the self-curling is the uneven atomic shrinkage induced stress, and then the shear force promotes the intact nanoroller formation, while the constraint of atomic vibration decreases the dissipation of driving stress and favors the nanoroller formation therein. It will open up a new pathway for controlling friction at microscale and nanostructural manipulation.
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Friction interfaces in liquid-embedded composite lubrication coatings commonly comprise a combination of discontinuous fluid films and rough solid contact surfaces, which together ensure easy shearing and a prolonged wear life. However, achieving high efficacy in mixed lubrication poses a challenge due to the conflicting nature of enhanced migration freedom for the liquid lubricant and increased mechanical strength of the solid matrix. Recent efforts have focused on incorporating reinforcing fillers to develop multicomponent, multiphase composites that can address this paradox. Here, we describe a modified attapulgite (APT) with strong biphasic wettability via the oil decompressive osmosis treatment on APT nanocontainers grafted with long nonpolar alkyl chains. This modified APT enables control over the size, distribution, and mobility of lubricant droplets by constructing a Pickering emulsion and toughens the solid-phase matrix through dispersion strengthening. Additionally, the introduction of APT induces the formation of a solid tribofilm during friction, which possesses a higher oil adsorption capacity, as verified through first-principles calculations based on density functional theory (DFT). Consequently, the fluid films can be replenished by the fracture of nanocontainers and adsorption from the bulk phase; further comprehensive and effective regulation of the friction interface leads to low friction and wear.
RESUMEN
RATIONALE AND OBJECTIVES: To evaluate the feasibility, efficiency, and safety of microwave ablation (MWA) for multifocal papillary thyroid microcarcinoma (PTMC). METHODS: This was a retrospective study, and the data of patients who underwent MWA for multifocal PTMC from October 2016 to December 2021 were reviewed. After ablation, the changes in tumor size and volume, as well as the rates of technical success, tumor disappearance, disease progression, and complications, were assessed. According to the tumor location, the cases were further divided into a unilateral multifocal disease (UMD) subgroup and a bilateral multifocal disease (BMD) subgroup. Further analyses were carried out. RESULTS: There was a total of 94 cases enrolled in the present study, which included 24 males and 70 females. The median age was 40 years (22-66 years); the median follow-up time was 14 months (6-48 months). Complete ablation was achieved in all enrolled cases. Therefore, the technical success rate was 100%. Due to expanding ablation, the MD and volume of the ablation zone increased at the 1st and 3rd months after ablation and decreased from the 12th month after ablation (p < 0.05 for all). The total complete tumor disappearance rates were 45/94 (47.87%) overall, 40.625% (13/32) in the UMD subgroup and 51.61% (32/62) in the BMD subgroup (p = 0.312). The total disease progression rates were 4.26% (4/94) overall, 6.25% (2/32) in the UMD subgroup and 3.23% (2/62) in the BMD subgroup (p = 0.881). The overall complication rate was 4.26% (4/94). CONCLUSION: This preliminary study indicates that MWA is a safe and effective treatment for multifocal PTMC.