Single medium-sized hepatocellular carcinoma treated with sequential conventional transarterial chemoembolization (cTACE) and microwave ablation at 4 weeks versus cTACE alone: a propensity score.

BACKGROUND: Microwave ablation (MWA) is a potentially curative treatment for unresectable patients with hepatocellular carcinoma (HCC) ≤ 3 cm, while its therapeutic efficacy decreases significantly for HCC > 3cm. Previous studies have demonstrated that conventional transarterial chemoembolization (cTACE) combined with MWA (cTACE-MWA) may improve local tumor control rate and reduce the recurrence rate for HCC > 3cm. However, there have been few study designs to analyze the clinical efficacy of cTACE-MWA for medium-sized HCC (3-5cm). Therefore, this study aims to compare the clinical efficacy and safety of cTACE-MWA with cTACE alone for a single medium-sized HCC of 3-5 cm in diameter. METHODS: We retrospectively investigate the data of 90 patients with a single medium-sized HCC who were referred to our hospital and underwent cTACE-MWA or cTACE alone from December 2017 to March 2020. Then, patients were identified with propensity score-matched (1:1). The local tumor response to treatment and time to progression (TTP) were compared using mRECIST criteria between the cTACE-MWA group and the cTACE group. RESULTS: A total of 42 patients were included after matching (cTACE-MWA: 21; cTACE: 21). Comparing with cTACE, cTACE-MWA demonstrate significantly better local tumor control (ORR: 95.2% vs 61.9%, p = 0.02; DCR: 95.2% vs 66.7%, p = 0.045) and TTP (median 19.8 months vs 6.8 months, p < 0.001). The 1- and 2-year cumulative probabilities of OS were 100% and 95% in the cTACE-MWA group, which were significantly higher than those in the cTACE group (95% and 76%) (p = 0.032). Multivariate Cox regression analysis illustrates that cTACE-MWA was associated with better TTP (hazard ratio, 0.28; 95% CI: 0.1, 0.76; p = 0.012), but tumor size was associated with worse TTP (hazard ratio, 1.71; 95% CI: 1.01, 2.89; p = 0.045). CONCLUSIONS: cTACE followed by MWA improved TTP and OS in patients with a single medium-sized HCC, and no major complication was observed in this study.

[Establishment of an Animal Model of Vesicoureteral Reflux Renal Injury through Partial Bladder Outlet Obstruction].

OBJECTIVE: To establish an animal model of reflux renal damage through bladder outlet obstruction. METHODS: Sixty male C57BL/6 mice aged 6-8 weeks were randomly assigned to a control group, a sham operation group, and a partial bladder outlet obstruction (PBOO) group, with 20 mice in each group. Laparotomy were performed on the PBOO mice under anesthesia in order to separate the bladder necks and to perform guided partial ligation of the bladder neck with a metal rod of 0.3 mm diameter. Mice in the sham operation group had laparotomy and had their bladder necks separated without ligation. The control group did not receive any treatment. 7 days after the surgery, 12 surviving mice were randomly selected from each group to observe the general changes of the bladder, ureter, renal pelvis and kidney. Retrograde urography was performed through the bladder. Kidney tissues were extracted for histopathological analysis. The expression levels of Vimentin, proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were examined with Western blot, immunohistochemistry and immunofluorescence staining tests, respectively. RESULTS: Compared with the control and sham operation group, the bladder, ureter, and renal pelvis of the mice in the PBOO group were significantly enlarged, vesicoureteral reflux was more obvious, the kidney volume and mass increased ( P<0.001), and renal parenchyma became thinner ( P<0.000 1). Histopathological staining showed glomerular atrophy, renal tubule expansion, tubulointerstitial inflammatory cell infiltration, glomerular basement membrane hyperplasia and obvious interstitial fibrosis. Western blot, immunofluorescence and immunohistochemistry staining showed that the expression levels of Vimentin, PCNA and α-SMA in kidney tissue were elevated ( P<0.000 1). CONCLUSION: After PBOO, the bladder, ureter, and kidney of the mice showed obvious morphological alteration and presented reflux renal fibrosis-like damage. This can be used as an animal model to study the pathological alteration mechanism and therapeutic measures of renal fibrosis caused by bladder outlet obstruction.

Effects of RF Magnetron Sputtering Power on the Mechanical Behavior of Zr-Cu-Based Metallic Glass Thin Films.

Zirconium-based metallic glass films are promising materials for nanoelectronic and biomedical applications, but their mechanical behavior under different conditions is not well understood. This study investigates the effects of radio frequency (RF) power and test temperature on the nanostructure, morphology, and creep behavior of Zr55Cu30Al10Ni5 metallic glass films prepared by RF magnetron sputtering. The films were characterized by X-ray diffraction and microscopy, and their mechanical properties were measured by a bulge test system. The results show that the films were amorphous and exhibited a transition from noncolumnar to columnar morphology as the RF power increased from 75 W to 125 W. The columnar morphology reduced the creep resistance, Young's modulus, residual stress, and hardness of the films. The creep behavior of the films was also influenced by the test temperature, with higher temperature leading to higher creep strain and lower creep stress. The findings of this study provide insights into the optimization of the sputtering parameters and the design of zirconium-based metallic glass films for various applications.

The Effects of Stresses and Interfaces on Texture Transformation in Silver Thin Films.

Thin metal films are critical elements in nano- and micro-fabricated technologies. The texture orientation of thin films has a significant effect on applied devices. For Face-Centered Cubic (FCC) metal thin films, when the critical thickness is reached, the texture orientation can transform from (111) to (100) based on the model related to the balance between interfacial energy and strain energy. This research focused on the texture transformation of thin films under two conditions: (1) with or without an adhesion layer in the thin film and (2) with or without initial stress applied through a four-point bending load. In the experiment, two samples (silicon/silver and silicon/titanium/silver) were used to apply different initial stress/strain values and different annealing times. After annealing, an X-ray Diffractometer (XRD) was used to ascertain the preferred orientation of the thin films and the percentage of (111) and (100). Finally, Electron Back-Scattered Diffraction (EBSD) was used to observe the grain size of the thin films. The results showed that, regardless of the existence of an adhesion layer, texture transformation occurred, and this was relatively significant with Ti adhesion layers. Further, the initial stress was found to be small compared to the internal stress; thus, the initial stress imposed in the tests in this research was not significantly influenced by the texture transformation.

Size Effects in Internal Friction of Nanocrystalline Aluminum Films.

Al thin film is extensively used in micro-electromechanical systems (MEMS) and electronic interconnections; however, most previous research has concentrated on their quasi-static properties and applied their designs on larger scales. The present study designed a paddle-like cantilever specimen with metal films deposited on the upper surface to investigate the quasi-static properties of Al thin film at room temperature under high vacuum conditions at microscopic scales. Energy loss was determined using a decay technique in the oscillation amplitude of a vibrating structure following resonant excitation. Grain size and film thickness size were strictly controlled considering the quasi-static properties of the films. This study found that the internal friction of ultra-thin and thin Al films was more dependent on the grain boundaries than film thickness.

Measurement of Effects of Different Substrates on the Mechanical Properties of Submicron Titanium Nickel Shape Memory Alloy Thin Film Using the Bulge Test.

This study investigated the effects of different substrates on the mechanical properties of Ti-60at%Ni shape memory alloys (SMA). Two types of samples were prepared for this experiment: (1) a Ti-60at%Ni deposited on SiNx, and (2) a Ti-60at%Ni deposited on SiNx/Cr; both had a 600 nm thick film of Ti-60at%Ni. Deposition was done using the physical vapor deposition (PVD) process, and the microstructural changes and crystallization phase changes were observed through scanning electron microscopy (SEM) and X-ray diffraction (XRD). The results showed that the TiNi thin film with a Cr adhesion layer had better mechanical properties. The bulge test showed that TiNi thin film with a Cr adhesion had a higher Young's modulus and lower residual stress. From the thermal cycling experiment, it was found that the Cr adhesion layer buffered the mismatch between TiNi and SiNx. Additionally, the thermal cycling test was also used to measure the thermal expansion coefficient of the films, and the fatigue test showed that the Cr layer significantly improved the fatigue resistance of the TiNi film.

Using Digital Image Correlation on SEM Images of Strain Field after Ion Beam Milling for the Residual Stress Measurement of Thin Films.

The residual stress of thin films during the deposition process can cause the components to have unpredictable deformation and damage, which could affect the service life and reliability of the microsystems. Developing an accurate and reliable method for measuring the residual stress of thin films at the micrometer and nanometer scale is a great challenge. To analyze the residual stress regarding factors such as the mechanical anisotropy and preferred orientation of the materials, information related to the in-depth lattice strain function is required when calculating the depth profiles of the residual strain. For depth-resolved measurements of residual stress, it is strategically advantageous to develop a measurement procedure that is microstructurally independent. Here, by performing an incremental focused ion beam (FIB) ring-core drilling experiment with various depth steps, the digital image correlation (DIC) of the specimen images was obtained. The feasibility of DIC to FIB images was evaluated after the translation test, and an appropriate procedure for reliable results was established. Furthermore, the condition of the film in the function of residual stress was assessed and compared to elucidate the applicability of this technology.