Laparoscopic liver resection versus radiofrequency ablation for caudate lobe solitary hepatocellular carcinoma: A propensity score matching study.

OBJECTIVE: This study aimed to compare the clinical efficacy of laparoscopic liver resection (LLR) and radiofrequency ablation (RFA) in treating solitary hepatocellular carcinoma (HCC) of the hepatic caudate lobe. METHODS: Patients with hepatic caudate lobe HCC who underwent LLR or RFA at three hospitals in China between February 2015 and February 2021 were included. In total, 112 patients met the inclusion criteria, of whom 52 underwent RFA and 60 underwent LLR. The outcomes of the two groups were compared and analyzed using propensity score matching (PSM) method. RESULTS: There were no significant differences between the two groups in terms of sex, HBV/HCV positivity, AFP positivity (>100 ng/mL), tumor position, Child-Pugh score, or preoperative liver function tests (ALT, AST, TBIL, ALB, and PT) (p > 0.05). Compared to the LLR group, the RFA group had a shorter operation time, less intraoperative bleeding, and shorter postoperative hospital stay (p < 0.05). There was no statistically significant difference in overall postoperative complications between the two groups (p > 0.05). Despite the larger tumor size, the LLR group had better postoperative recurrence-free survival (RFS) (p = 0.00027) and overall survival (OS) (p = 0.0023) than the RFA group. After one-to-one PSM, 31 LLR patients and 31 RFA patients were selected for further analyses. The advantages of LLR over RFA were observed in terms of RFS (p < 0.0001) and OS (p = 0.00029). CONCLUSION: LLR should probably be recommended as the preferred method for solitary caudate lobe HCC.

Comparative efficacy and safety of systemic therapy for advanced hepatocellular carcinoma: a systematic review and network meta-analysis.

Background: In recent years, there has been rapid development in systemic therapeutic agents for advanced hepatocellular carcinoma. However, most treatment modalities lack head-to-head comparisons, and the distinctions in their efficacy and safety have yet to be elucidated. Consequently, the accurate selection of a treatment regimen poses a significant challenge for clinicians. Methods: This study incorporated twenty-three randomized controlled trials, encompassing fifteen first-line and eight second-line treatments, and involving a total of 14,703 patients with advanced hepatocellular carcinoma. Results: In the context of first-line treatment, it was observed that the combination of a PD-1 inhibitor with bevacizumab (1/15) significantly extended overall survival in patients with advanced HCC. Furthermore, PD-1 inhibitors combined with TKIs (1/15) and PD-1 inhibitors combined with bevacizumab (2/15) exhibited enhanced efficacy in reducing the risk of progression-free survival events. In second-line therapy, the network meta-analysis revealed that all investigational agents prolonged progression-free survival in patients with advanced hepatocellular carcinoma when compared to placebo. Cabozantinib ranked first (1/7) in this regard. However, this translated into an overall survival benefit only for cabozantinib, regorafenib, ramucirumab, and pembrolizumab, with regorafenib achieving the highest ranking (1/7). Conclusion: In the treatment of advanced HCC, the immune checkpoint inhibitor combined with bevacizumab regimen and the immune checkpoint inhibitor combined with TKI regimen stand out as the two most effective first-line treatment options. It is noteworthy that, for patients with absolute contraindications to VEGF inhibitors, dual immunotherapy is the preferred choice. For second-line treatment, regorafenib and cabozantinib are identified as the two most effective options. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42023440173.

Isotopic source identification of nitrogen pollution in the Pi River in Chengdu.

This study used stable isotope (δ15 N- NO 3 - and δ18 O- NO 3 - ) ratios, modeled by means of a Bayesian stable isotope analysis in R (SIAR) approach, to identify nitrate sources in the Pi River, which flows through the megacity Chengdu. The goal was to determine where management resources should be applied to reduce nitrogen pollution. Results revealed that NO 3 - was the primary nitrogen species throughout the study area; that it originated in manure and sewage, as well as nitrification of fertilizer and soil nitrogen; and that the nitrogen in the main stream came primarily from the tributaries. Notably, the nitrogen concentration in the tributaries exhibited no evident seasonal variations, further demonstrating that its source was intensive anthropogenic activity. Results of Bayesian model (SIAR) estimation indicated that manure and sewage were the dominant nitrate contributors in the watershed and that the nitrate concentration decreased from 54.19% to 39.57% in response to water treatment. These results empirically demonstrate that the methodology described in this work can be used effectively in catchments affected by intensive anthropogenic activity to determine where management resources should be applied to reduce nitrogen pollution. Integr Environ Assess Manag 2022;18:1609-1620. © 2022 SETAC.

[Distribution and Bioavability of Phosphorus in Surface Sediments in Megalopolis: A Case Study of Chengdu].

A total of 33 surface sediments were collected from rivers in Chengdu. The content of phosphorus species was measured with the chemical continuous extraction method (SMT) and in situ monitoring techniques (DGT). Multivariate statistical analysis was used to analyze the spatial distribution of phosphorus species in sediments. The release flux of DGT-P in sediments and their pore water was calculated in this study. It is helpful to understand the influence of sediment endogenous pollution and human activities on the environment. The results show that the phosphorus species have a spatial variability. The average content of TP in the surface sediments is 1132.41 mg·kg-1, which is higher than the background value of 365.00 mg·kg-1 in Chengdu. The Ca-P is the most dominant species, accounting for 70.58% of the TP on average. The study area is divided into three groups based on spatial clustering. Groups 1 and 3 show large differences of phosphorus morphological structures, while Group 2 is small. The contents of phosphorus in the surface sediment of Groups 1 and 3 are generally higher than those of Group 2. The DGT-P concentration has a good correlation with the soluble DTP concentration, bioavailable Fe/Al-P, and OP concentration, respectively. The DGT technology can be used as a fast, in situ, reliable method for measurements of the bioavailable content of sediments. The higher release fluxes of bioavailable phosphorus are N8, W11, and N2, which are 20.05, 17.13, and 14.79 mg·(m2·d)-1 respectively. The available phosphorus release capacity is closely related to human activities.

Historical and seasonal dynamics of phosphorus mobility in Sancha Lake of Southwest China's Sichuan Province.

Phosphorus (P) fractionations in the surface sediment of Sancha Lake in China's southwestern Sichuan Province were examined to assess the potential P release at the water-sediment interface and to understand its seasonal (2009-2010) and historical dynamics (1989-2010) in the surface water. Elevated P concentrations were detected in the sediment at main reservoir inflow, south canal of the Dujiangyan irrigation network, and intensive cage fish farming area, accounting for 32 and 40% of current total P discharges. The highest total P concentration (11,200 µg P g-1) was observed in the upper sediment below intensive fish farming area with a specific enrichment of HCl-P (51% of total P) mainly from fish feeds and feces. These sediments had larger MgCl2-P pools with higher diffusive P fluxes (0.43-0.47 mg m-2 d-1) from surface sediment than those from other areas (0.25-0.42 mg m-2 d-1). The general small proportion of MgCl2-P (5.7-10%) and low diffusive P fluxes from surface sediment (<0.02% of sediment P storage (0-1 cm)) indicate low mobility and slow release of P from sediments. The sediment as an internal P source led to a 3-4-year lag for P concentration decrease in the surface water after restriction of anthropogenic P discharges since 2005. Thus, the peak P concentration in April and September could be explained as a combined effect of supplementing internal loading via reductive processes in sediments and seasonal water vertical circulation in the early spring and fall. Policy played a crucial role in reducing P inputs to the lake.

Impact of Fish Farming on Phosphorus in Reservoir Sediments.

Fish farming has seriously influenced the aquatic environment in Sancha reservoir in SW China since 1985 and has been strongly restricted since 2005. Thus, phosphorus speciation in a sediment core dated between 1945 and 2010 at cm-resolution and in surface sediments from Sancha reservoir may allow us track how fish farming impacts phosphorus dynamics in lake sediments. Fish farming shifts the major binding forms of phosphorus in sediments from organic to residual phosphorus, which mostly originated from fish feed. Sorption to metal oxides and association with organic matters are important mechanisms for phosphorus immobilisation with low fish farming activities, whereas calcium-bound phosphorous had an essential contribution to sediment phosphorus increases under intensive fish framing. Notwithstanding the shifting, the aforementioned phosphorus fractions are usually inert in the lake environment, therefore changing phosphorus mobility little. The use of fish feed and water-purification reagents, the most important additives for fish farming, introduce not only phosphorus but also large amounts of sand-sized minerals such as quartz into the lake, to which phosphorus weakly sorbs. The sand-sized minerals as additional sorbents increase the pool of easily mobilisable phosphorus in sediments, which will slow down the recovery of reservoir water due to its rapid re-mobilisation.