Diagnostic value of liver contrast-enhanced ultrasound in early hepatocellular carcinoma: a systematic review and meta-analysis.

Background: Hepatocellular carcinoma is the sixth most common cancer in the world, and its incidence rate will continue to increase. Contrast-enhanced ultrasound (CEUS) is feasible as a rapid examination for early hepatocellular carcinoma diagnosis. However, considering the possible causes of false positives caused by ultrasound, its diagnostic value is still controversial. Therefore, the study conducted a meta-analysis to evaluate the application value of CEUS in the early diagnosis of hepatocellular carcinoma. Methods: The PubMed, Cochrane Library, Embase, Ovid Technologies (OVID), China National Knowledge Infrastructure (CNKI), Chongqing VIP Information (VIP), and Wanfang databases were searched to retrieve articles on the use of CEUS for the early diagnosis of hepatocellular carcinoma. The literature quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) quality assessment tool. The meta-analysis was performed using STATA 17.0 to fit the bivariate mixed effects model, calculated sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and corresponding 95% CI, summary receiver operating characteristic curves (SROC), area under the curve (AUC), and 95% confidence interval (CI). The publication bias of the included literature was evaluated using the DEEK funnel plot. Results: Ultimately, 9 articles, comprising 1,434 patients, were included in the meta-analysis. The heterogeneity test found that I2>50%, using a random effects model. The results of the meta-analysis showed that the CEUS had a combined sensitivity of 0.92 (95% CI: 0.86-0.95), a combined specificity of 0.93 (95% CI: 0.56-0.99), a combined PLR of 13.47 (95% CI: 1.51-120.46), a combined NLR of 0.09 (95% CI: 0.05-0.14), a combined DOR of 154.16 (95% CI: 15.93-1,492.02), a diagnostic score of 5.04 (95% CI: 2.77-7.31), and a combined AUC of 0.95 (95% CI: 0.93-0.97). The correlation coefficient of the threshold-effect analysis was 0.13 (P>0.05). The results of the regression analysis showed that the country of publication (P=0.14) and the size of the lesion nodules (P=0.46) were not sources of heterogeneity. Conclusions: Liver CEUS has an advantage in the early diagnosis of hepatocellular carcinoma, with high sensitivity and specificity, and has clinical application value.

DPEP1 is a direct target of miR-193a-5p and promotes hepatoblastoma progression by PI3K/Akt/mTOR pathway.

Hepatoblastoma (HB) is the most common hepatic neoplasm in childhood and the therapeutic outcomes remain undesirable due to its recurrence and metastasis. Increasing evidence shows that dipeptidase 1 (DPEP1) has pivotal function in tumorigenesis in multiple tumors. However, the expression pattern, biological function, and underlying mechanism of DPEP1 in HB have not been reported. Here we showed that DPEP1 was significantly upregulated and was associated with poor prognosis in HB patients. In vitro and in vivo assays indicated that silencing DPEP1 significantly suppressed HB cell proliferation, migration, and invasion, while DPEP1 overexpression exhibited the opposite effect. In addition, we identified that DPEP1 was a direct target of microRNA-193a-5p (miR-193a-5p). Functional experiments demonstrated that overexpression of miR-193a-5p significantly inhibited cell proliferation and invasion of HB cells, while the inhibitory effect could be reversed by DPEP1 overexpression. Moreover, miR-193a-5p was decreased in HB tumor tissues and associated with a poor clinical prognosis. Mechanistically, our results indicated that the miR-193a-5p/DPEP1 axis participated to the progression of HB via regulating the PI3K/Akt/mTOR (phosphatidylinositol-3-kinase/Akt/mammalian target of rapamycin) signaling. In conclusion, our findings suggest that the miR-193a-5p /DPEP1 axis might be a good prognostic predictor and therapeutic target in HB.

Biodegradation Assessment of Poly (Lactic Acid) Filled with Functionalized Titania Nanoparticles (PLA/TiO2) under Compost Conditions.

This paper presents a biodegradation study conducted for 90 days under standardized controlled composting conditions of poly (lactic acid) (PLA) filled with functionalized anatase-titania nanofiller (PLA/TiO2 nanocomposites). The surface morphology, thermal properties, percentage of biodegradation, and molecular weight changes at different incubation times were evaluated via visual inspection, scanning electron microscopy (SEM), X-ray diffraction (XRD), differential scanning calorimetry (DSC), and gel permeation chromatography (GPC) by taking degraded samples from compost at the end of target biodegradation time interval. The rapid increase of crystallinity indicated that the PLA and PLA/TiO2 nanocomposites had heterogeneous degradation mechanisms under controlled composting conditions. The biodegradation rate of PLA/TiO2 nanocomposites was higher than that of pure PLA because water molecules easily penetrated the nanocomposites. The dispersion of the nanoparticles in the PLA/TiO2 nanocomposites affected the biodegradation rate of PLA. Moreover, the biodegradation of PLA could be controlled by adding an amount of dispersed TiO2 nanofillers under controlled composting conditions.

Advances in the Surgical Treatment of Neuroblastoma.

OBJECTIVE: This study was to review the efficacy of surgical resections in different clinical situations for a better understanding of the meaning of surgery in the treatment of neuroblastoma (NB). DATA SOURCES: The online database ScienceDirect (201-2018) was utilized. The search was conducted using the keywords "neuroblastoma," "neuroblastoma resection," "neuroblastoma surgery," and "high-risk neuroblastoma." STUDY SELECTION: We retrospectively analyzed of patients who underwent surgical resections in different clinical situations. The article included findings from selected relevant randomized controlled trials, systematic reviews, and meta-analyses or good-quality observational studies. Abstracts only, letters, and editorial notes were excluded. Full-text articles and abstracts were extracted and reviewed to identify key articles discussing surgery management of NB, which were then selected for critical analysis. RESULTS: A total of 7800 English language articles were found containing references to NB (201-2018). The 163 articles were searched which were related to the surgical treatment of NB (201-2018). Through the analysis of these important articles, we found that the treatments of NB at low- and intermediate-risk groups were basically the same. High-risk patients remained controversial. CONCLUSIONS: NB prognosis varies tremendously based on the stage and biologic features of the tumor. After reviewing the relevant literature, patients with low-risk disease are often managed with surgical resection or observation alone with tumors likely to spontaneously regress that are not causing symptoms. Intermediate patients are treated with chemotherapy with the number of cycles depending on their response as well as surgical resection of the primary tumor. High-risk patients remain controversial. Multidisciplinary intensive treatment is essential, especially for patients who received subtotal tumor resection. Minimally invasive surgery for the treatment of NBs without image-defined risk factors in low- to high-risk patients is safe and feasible and does not compromise the treatment outcome. We conclude that ≥90% resection of the primary tumor is both feasible and safe in most patients with high-risk NB. New targeted therapies are crucial to improve survival.

Preparation and ageing-resistant properties of polyester composites modified with functional nanoscale additives.

This study investigated ageing-resistant properties of carboxyl-terminated polyester (polyethylene glycol terephthalate) composites modified with nanoscale titanium dioxide particles (nano-TiO2). The nano-TiO2 was pretreated by a dry coating method, with aluminate coupling agent as a functional grafting additive. The agglomeration resistance was evaluated, which exhibited significant improvement for the modified nanoparticles. Then, the effects of the modified nano-TiO2 on the crosslinking and ageing-resistant properties of the composites were studied. With a real-time Fourier transform infrared (FT-IR) measurement, the nano-TiO2 displayed promoting effect on the crosslinking of polyester resin with triglycidyl isocyanurate (TGIC) as crosslinking agent. Moreover, the gloss retention, colour aberration and the surface morphologies of the composites during accelerated UV ageing (1500 hours) were investigated. The results demonstrated much less degree of ageing degradation for the nanocomposites, indicating an important role of the nano-TiO2 in improving the ageing-resistant properties of synthetic polymer composites.