Hydrothermal Assembly, Structural Multiplicity, and Catalytic Knoevenagel Condensation Reaction of a Series of Coordination Polymers Based on a Pyridine-Tricarboxylic Acid.

A pyridine-tricarboxylic acid, 5-(3',5'-dicarboxylphenyl)nicotinic acid (H3dpna), was employed as a adjustable block to assemble a series of coordination polymers under hydrothermal conditions. The seven new coordination polymers were formulated as [Co(µ3-Hdpna)(µ-dpey)]n·nH2O (1), [Zn4.5(µ6-dpna)3(phen)3]n (2), [Co1.5(µ6-dpna)(2,2'-bipy)]n (3), [Zn1.5(µ6-dpna)(2,2'-bipy)]n (4), [Co3(µ3-dpna)2(4,4'-bipy)2(H2O)8]n·2nH2O (5),[Co(bpb)2(H2O)4]n[Co2(µ3-dpna)2(H2O)4]n·3nH2O (6), and [Mn1.5(µ6-dpna)(µ-dpea)]n (7), wherein 1,2-di(4-pyridyl)ethylene (dpey), 1,10-phenanthroline (phen), 2,2'-bipyridine(2,2'-bipy),4,4'-bipyridine(4,4'-bipy),1,4-bis(pyrid-4-yl)benzene (bpb), and 1,2-di(4-pyridyl)ethane (dpea) were employed as auxiliary ligands. The structural variation of polymers 1-7 spans the range from a 2D sheet (1-4, 6, and 7) to a 3D metal-organic framework (MOF, 5). Polymers 1-7 were investigated as heterogeneous catalysts in the Knoevenagel condensation reaction, leading to high condensation product yields (up to 100%) under optimized conditions. Various reaction conditions, substrate scope, and catalyst recycling were also researched. This work broadens the application of H3dpna as a versatile tricarboxylate block for the fabrication of functional coordination polymers.

Coordination Polymers from an Amino-Functionalized Terphenyl-Tetracarboxylate Linker: Structural Multiplicity and Catalytic Properties.

An amino-functionalized terphenyl-tetracarboxylic acid, 2'-amino-[1,1':4',1″-terphenyl]-3,3″,5,5″-tetracarboxylic acid (H4tpta), was used as an adaptable linker to synthesize, under hydrothermal conditions, eight coordination polymers (CPs). The obtained products were formulated as [Co(µ6-H2tpta)]n (1), [Co(µ3-H2tpta)(2,2'-bipy)]n (2), [M3(µ6-Htpta)2(2,2'-bipy)2]n (M = Mn (3), Cd (4)), [Ni2(µ4-tpta)(phen)2(H2O)4]n (5), [Zn2(µ6-tpta)(phen)2]n (6), {[Zn2(µ6-tpta)(µ-4,4'-bipy)]·H2O}n (7), and [Zn2(µ6-tpta)(µ-H2biim)(H2O)2]n (8), wherein 2,2'-bipyridine (2,2'-bipy), 4,4'-bipyridine (4,4'-bipy), 1,10-phenanthroline (phen), or 2,2'-biimidazole (H2biim) are present as additional stabilizing ligands. The structural types of 1-8 vary from one-dimensional (1D) (2, 5) and two-dimensional (2D) (3, 4, 6) CPs to three-dimensional (3D) metal-organic frameworks (MOFs) (1, 7, and 8) with a diversity of topologies. The products 1-8 were investigated as catalysts in the Knoevenagel condensation involving aldehydes and active methylene derivatives (malononitrile, ethyl cyanoacetate, or tert-butyl cyanoacetate), leading to high condensation product yields (up to 99%) under optimized conditions. Various reaction conditions, substrate scope, and catalyst recycling were investigated. This work broadens the application of H4tpta as a versatile tetracarboxylate linker for the generation of diverse CPs/MOFs.

Syntheses, Crystal Structures, and Catalytic Properties of Three Cu(II) and Cobalt(II) Coordination Compounds Based on an Ether-Bridged Tetracarboxylic Acid.

Three new products, [Cu2(µ3-dppa)(2,2'-bipy)2(H2O)]n·2nH2O (1), [Co4(µ4-dppa)2(phen)4(H2O)4]·2H2O (2), and [Co2(µ6-dppa)(µ-4,4'-bipy)(H2O)2]n·3nH2O (3) were synthesized using a hydrothermal method from Cu(II) and Co(II) metal(II) chlorides, 3-(3,4-dicarboxyphenoxy)phthalic acid (H4dppa), and different auxiliary ligands, namely 2,2'-bipyridine (2,2'-bipy),1,10-phenanthroline (phen), and 4,4'-bipyridine (4,4'-bipy). Products 1-3 were characterized by elemental analysis, FTIR, TGA, PXRD, SEM, and single-crystal X-ray crystallography. The structure of 1 features a 1D chain of the 2C1 topological type. Compound 2 shows a discrete tetrameric complex. Product 3 demonstrates a 3D metal-organic framework (MOF) with the new topology. Their structure and topology, thermal stability, and catalytic activity were studied. In particular, excellent catalytic activity was demonstrated for copper(II)-polymer 1 in the cyanosilylation reaction at 35 °C.

Six metal-organic architectures from a 5-methoxyisophthalate linker: assembly, structural variety and catalytic features.

A methoxy-functionalized isophthalic acid, 5-methoxy isophthalic acid (H2mia), was used a versatile linker for assembling six new metal(ii) compounds under hydrothermal conditions. The obtained products were [Cu2(µ2-mia)2(phen)2(H2O)2]·2H2O (1), [Mn(µ3-mia)(phen)]n (2), [Co(µ2-mia)(2,2'-bipy)(H2O)]n·nH2O (3), [Co(µ3-mia)(µ2-4,4'-bipy)]n·nH2O (4), [Co(µ3-mia)(py)2]n (5), and [Cd(µ2-mia)(py)(H2O)2]n·nH2O (6), where phen(1,10-phenanthroline), 2,2'-bipy(2,2'-bipyridine), 4,4'-bipy(4,4'-bipyridine) or py(pyridine) were incorporated as auxiliary ligands. The crystal structures of 1-6 range from 0D (1) and 1D (2, 3, 5, 6) CPs to a 2D network (4) with a variety of topological types. The catalytic behavior of 1-6 was studied in the cyanosilylation reaction between trimethylsilyl cyanide and aldehydes, resulting in up to 99% yields of products under optimized conditions. Various reaction parameters as well as catalyst recycling and substrate scope were investigated. This study widens the use of H2mia as a versatile dicarboxylate linker for assembling a diversity of functional metal-organic architectures with remarkable structural features and catalytic properties.

An Endogenous Prompting Mechanism for Sulfur Conversions Via Coupling with Polysulfides in Li-S Batteries.

The sluggish kinetics process and shuttling of soluble intermediates present in complex conversion between sulfur and lithium sulfide severely limit the practical application of lithium-sulfur batteries. Herein, by introducing a designated functional organic molecule to couple with polysulfide intermediators, an endogenous prompting mechanism of sulfur conversions has thus been created leading to an alternative sulfur-electrode process, in another words, to build a fast "internal cycle" of promotors that can promote the slow "external cycle" of sulfur conversions. The coupling-intermediators between the functional organic molecule and polysulfides, organophosphorus polysulfides, to be the "promotors" for sulfur conversions, are not only insoluble in the electrolyte but also with higher redox-activity. So the sulfur-electrode process kinetics is greatly improved and the shuttle effect is eliminated simultaneously by this strategy. Meanwhile, with the endogenous prompting mechanism, the morphology of the final discharge product can be modified into a uniform covering film, which is more conducive to its decomposition when charging. Benefiting from the effective mediation of reaction kinetics and control of intermediates solubility, the lithium-sulfur batteries can act out excellent rate performance and cycling stability.

In Situ Constructing a Catalytic Shell for Sulfur Cathode via Electrochemical Oxidative Polymerization.

Sluggish multiphase reaction kinetics and severe shuttle effect of lithium polysulfides (LiPSs) are two major challenges facing lithium-sulfur (Li-S) batteries, which largely prevent them from becoming a reality. Herein, a shell with catalytic function for sulfur cathode is in situ constructed through an ingenious electrochemical oxidative polymerization strategy by introducing hexafluorocyclotriphosphazene (HFPN) as additives, which suppresses the shuttle effect and promotes efficient sulfur conversion. The shell with abundant heteroatoms effectively confines polysulfides to the cathode matrix by chemically interacting with them to eliminate capacity degradation. Moreover, the shell exhibits high catalytic activities, which turns Li2S(2) into an activated state and facilitates its dissociation. The functionalized shell substantially advances the performance of Li-S batteries, thanks to efficient lithium-ion transportation and abundant adsorption-catalytic sites. As a result, Li-S batteries demonstrate superb resistance to self-discharge, ultrastable cycle performance, and greatly enhanced rate capability. Impressively, the batteries show an ultralow capacity decay rate of 0.034% throughout 700 cycles at 2C. They deliver a capacity of 517 mAh g-1 even at a 4C rate, exhibiting relieved electrochemical polarization and excellent sulfur utilization. This work provides an ingenious strategy to construct adsorption-catalytic nets for next-generation Li-S batteries with enhanced lifespan and electrochemical performance.

Suppression of the transforming growth factor-ß signaling pathway produces a synergistic effect of combination therapy with programmed death receptor 1 blockade and radiofrequency ablation against hepatic carcinoma in mice.

Primary liver cancer (PLC) significantly affects the health of patients globally owing to its high morbidity and low survival rate. Radiofrequency ablation (RFA) has recently been introduced for the clinical treatment of PLC. However, significant immunosuppressive effects are induced by RFA, which limits its application. This study aimed to explore the potential of combination therapy with RFA by investigating the effects of siRNAs against programmed death receptor 1 (PD-1) and transforming growth factor-ß (TGF-ß) on the antitumor effect induced by RFA. We observed that compared with si-NC, cell viability was reduced, apoptosis rate was elevated, release of inflammatory factors and percentage of CD3+CD8+ cells were increased, and the PI3K/AKT/mTOR pathway was repressed in the co-culture of RFA-treated H22 cells and CD8+ T cells by transfection with si-PD-1 and si-TGF-ß; these effects were further enhanced by co-transfection with si-PD-1 and si-TGF-ß. Additionally, in H22 cell xenograft-bearing mice treated with RFA, compared with the si-NC group, repressed tumor growth, prolonged survival, increased production of inflammatory factors and expression of CD3 and CD8 in tumor tissues, and downregulation of the PI3K/AKT/mTOR pathway were observed in the si-PD-1 and si-TGF-ß groups; these effects were further enhanced in the si-PD-1 + si-TGF-ß group. Taken together, our data revealed that suppression of the TGF-ß signaling pathway produced a synergistic antitumor effect of combination therapy with PD-1 blockade and RFA against PLC. [Figure: see text].

Single-dispersed polyoxometalate clusters embedded on multilayer graphene as a bifunctional electrocatalyst for efficient Li-S batteries.

The redox reactions occurring in the Li-S battery positive electrode conceal various and critical electrocatalytic processes, which strongly influence the performances of this electrochemical energy storage system. Here, we report the development of a single-dispersed molecular cluster catalyst composite comprising of a polyoxometalate framework ([Co4(PW9O34)2]10-) and multilayer reduced graphene oxide. Due to the interfacial charge transfer and exposure of unsaturated cobalt sites, the composite demonstrates efficient polysulfides adsorption and reduced activation energy for polysulfides conversion, thus serving as a bifunctional electrocatalyst. When tested in full Li-S coin cell configuration, the composite allows for a long-term Li-S battery cycling with a capacity fading of 0.015% per cycle after 1000 cycles at 2 C (i.e., 3.36 A g-1). An areal capacity of 4.55 mAh cm-2 is also achieved with a sulfur loading of 5.6 mg cm-2 and E/S ratio of 4.5 µL mg-1. Moreover, Li-S single-electrode pouch cells tested with the bifunctional electrocatalyst demonstrate a specific capacity of about 800 mAh g-1 at a sulfur loading of 3.6 mg cm-2 for 100 cycles at 0.2 C (i.e., 336 mA g-1) with E/S ratio of 5 µL mg-1.

High-intensity focused ultrasound alone or combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with unsuitable indications for hepatectomy and radiofrequency ablation: a phase II clinical trial.

OBJECTIVES: This study aims to evaluate the efficacy and safety of high-intensity focused ultrasound (HIFU) alone or combined with transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) but were contraindicated for hepatectomy and radiofrequency ablation (RFA). METHODS: Patients between 20 and 80 years of age with 1-3 foci of HCC were selected. Included patients have had primary or recurrent liver lesions with no evidence of extra-hepatic metastasis prior to the study. Patients were treated with ultrasound-guided HIFU alone or HIFU combined with TACE (treated with TACE once within 4 weeks prior to receiving HIFU). RESULTS: Thirty-seven patients were enrolled, for a total of 45 lesions. The 2-year local control (LC) rate was 73.0% and the median LC time was 22 months. The 2-year progression-free survival (PFS) was 29.7% and the median PFS time was 9 months. Finally, the 2-year overall survival (OS) was 70.3%, and the median OS time was 24 months. The most common adverse events (AEs) were elevated liver enzymes, followed by fatigue, and pain, no grade 4 AEs or death occurred. Multivariate analysis showed that age, Child-Pugh class, and the number of tumors were independent prognostic factors for PFS and that the AFP levels and the number of tumors were significantly correlated with the OS. CONCLUSIONS: This study indicates that the HIFU/HIFU combined with TACE treatment is safe, and is capable of achieving both a good LC rate and a considerably good prognosis. The procedure should be considered for patients who were deemed unsuitable for other local treatments.

A carbon-based material with a hierarchical structure and intrinsic heteroatom sites for sodium-ion storage with ultrahigh rate and capacity.

The storage of sodium ions with carbon materials has huge potential for large-scale application due to its resource-rich and environmental advantages. However, how to realize high power density, high energy density and long cycle life are the bottlenecks restricting its development. Herein, by using a facile synthesis strategy, a carbon-based framework with a hierarchical structure and intrinsic heteroatom sites which are the characteristics contributing to ultrahigh rate and capacity has been achieved. As a result, the hierarchical carbon-based material exhibits excellent performance when used as both the anode and cathode for sodium-ion capacitors (SICs), which can deliver a high energy density of 224 W h kg-1 (at 180 W kg-1), an ultrahigh power density of 17 160 W kg-1 (at 128 W h kg-1) and ultralong cycle life (91% capacity retention after 10 000 cycles at 2 A g-1), outperforming most of the previously reported SICs with other configurations.

Regulatory Network Analysis of Mutated Genes Based on Multi-Omics Data Reveals the Exclusive Features in Tumor Immune Microenvironment Between Left-Sided and Right-Sided Colon Cancer.

Left-sided colon cancer (LCC) and right-sided colon cancer (RCC) have distinct characteristics in tumor immune microenvironment (TIME). Although existing studies have shown a strong association between gene mutations and TIME, whether the regulatory mechanisms between gene mutations and TIME are different between RCC and LCC is still unclear. In this study, we showed the fractions of CD8+ T cells were higher while those of regulatory T cells were lower in RCC. Besides, a stronger association between gene mutations and TIME was observed in RCC. Specifically, using multi-omics data, we demonstrated the mutations of most top mutated genes (TMGs) including BRAF, PCLO, MUC16, LRP2, ANK3, KMT2D, RYR2 made great contributions to elevated fraction of immune cells by up-regulating immune-related genes directly or indirectly through miRNA and DNA methylation, whereas the effects of APC, TP53 and KRAS mutations on TIME were reversed in RCC. Remarkably, we found the expression levels of several immune checkpoint molecules such as PD-1 and LAG3 were correlated with corresponding DNA methylation levels, which were associated with the mutations of TMGs in RCC. In contrast, the associations between gene mutations and TIME were less significant in LCC. Besides, survival analyses showed APC mutation had adverse impact on immunotherapy while patients with BRAF mutation were more suitable for immunotherapy in colon cancer. We hope that our results will provide a deeper insight into the sophisticated mechanism underlying the regulation between mutations and TIME, and thus boost the discovery of differential immunotherapeutic strategies for RCC and LCC.

HIFU for the treatment of gastric cancer with liver metastases with unsuitable indications for hepatectomy and radiofrequency ablation: a prospective and propensity score-matched study.

BACKGROUND: The purpose of this study was to explore the efficacy and safety of high intensity focused ultrasound (HIFU) in gastric cancer with liver metastasis (GCLM) patients who were contraindicated for either hepatectomy or radiofrequency ablation (RFA). METHODS: This is a prospective, observational study on GCLM patients with 1-3 liver metastases. The primary gastric lesions were thoroughly resected and any case that exhibited extra-hepatic metastasis was excluded. A 1:2:2 propensity score-matching analysis was performed using a logistic regression model on the HIFU group, best supportive care (BSC) group, and palliative chemotherapy (PC) group. The primary endpoints include progression-free survival (PFS) and overall survival (OS). RESULTS: Forty patients were finally included, there were 8 cases in HIFU group, 16 cases in BSC group, and 16 cases in PC group. The median follow-up time for the entire cohort was 10 months. The median PFS was 16.5 months in HIFU group, 2 months in BSC group, and 5 months in PC group. The median OS was 27.5 months in the HIFU group, 7 months in the BSC group, and 11.5 months in the PC group. Additionally, no grade 3 or higher adverse events occurred in the HIFU group. CONCLUSION: The results of this study showed that HIFU treatment could improve the long-term prognosis of GCLM patients without a significant increase in the occurrence of adverse events. Compared with PC and BSC, HIFU is the preferred treatment option when GCLM patients without extra-hepatic metastasis are unable to undergo either surgery or RFA.

HIFU for the treatment of difficult colorectal liver metastases with unsuitable indications for resection and radiofrequency ablation: a phase I clinical trial.

BACKGROUND: The goal of this study is to evaluate the safety and efficacy of high intensity focused ultrasound (HIFU) for patients with colorectal liver metastases (CRLM) but were contraindicated for resection and radiofrequency ablation. METHODS: Patients between 20 and 80 years of age with 1-3 liver metastases from colorectal cancer were selected. Included patients have had their primary lesions removed with no evidence of extrahepatic metastasis prior to the study. Ultrasound-guided HIFU was employed and target regions' ablation was achieved with repeated sonications from the deep to shallow regions of the tumors section by section. RESULTS: Thirteen patients were enrolled. The most common adverse events (AEs) were pain (n = 8), followed by fatigue (n = 7), increased aspartate aminotransferase (AST) (n = 7), increased alanine aminotransferase (ALT) (n = 5), and skin edema (n = 4). No grade ≥ 3 AEs occurred and while most patients (76.9%) achieved a complete response, three patients achieved a partial response. The objective response rate was 100% after the first HIFU treatment. Nine patients relapsed but the tumors were mostly isolated to the liver (8/9). The median follow-up period was 25 months. The 2-year progression-free survival (PFS) was 16.7%, and the median PFS was 9 months. Notably, the 2-year overall survival (OS) was 77.8%, and the median OS was 25 months. CONCLUSION: This study indicates that the HIFU treatment is safe, is able to achieve a good tumor response rate and long-term prognosis even when the foci were in high-risk locations, and should be considered for patients who were considered unsuitable for other local treatments.

Turning Soluble Polysulfide Intermediates Back into Solid State by a Molecule Binder in Li-S Batteries.

The shuttle effect of dissolved polysulfides produced during the operation of lithium-sulfur batteries is the most serious and fundamental problem among many challenges. We propose a strategy via in situ formation of a functionalized molecule with a dual-terminal coupling function to bind the dissolved polysulfide intermediates, thus turning them back into solid-state organopolysulfide complexes by molecule binding, and then the polysulfides can be pinned on the cathode firmly. The dual-terminal coupling functional molecule binder (MB), which is formed in situ by reaction between quinhydrone (QH) and lithium, can not only bind polysulfides by reversible chemical coordination but also promote the conversion of polysulfides during cycling synchronously. In theory, with the dual-terminal coupling function, MB can bind polysulfide intermediates to copolymerize them, forming -[MB-Li2Sn]- that has faster reaction activity and redox conversion kinetics in comparison with simple Li2Sn. With the MB, the Li-S battery exhibits a large initial capacity of 1347 mAh g-1 at 0.1 C. The remaining capacity of 963 mAh g-1 at 1 C shows no obvious decay for more than 400 cycles, and the retention of the first 300 cycles can reach 96.9%, in particular. This study delivers an alternative approach to resolving the shuttle effect and achieving excellent Li-S battery performance, with the potential significance going way beyond battery systems.

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma.

BACKGROUND: Drug-eluting beads transarterial chemoem-bolization (DEB-TACE) has the advantages of slow and steady release, high local concentration, and low incidence of adverse drug reactions compared to the traditional TACE. DEB-TACE combined with sequentially ultrasound-guided radiofrequency ablation (RFA) therapy has strong anti-cancer effects and little side effects, but there are fewer related long-term studies until now. AIM: To explore the outcome of DEB-TACE sequentially combined with RFA for patients with primary hepatocellular carcinoma (HCC). METHODS: Seventy-six patients with primary HCC who underwent DEB-TACE sequentially combined with RFA were recruited. Forty patients with untreated HCC were included in Group A, and 36 patients with recurrent HCC were included in Group B. In addition, 40 patients with untreated HCC who were treated with hepatectomy were included in Group C. The serological examination, preoperative magnetic resonance imaging examination, and post-treatment computed tomography enhanced examination were performed for all patients. The efficacy was graded as complete remission (CR), partial remission (PR), stable disease and progressive disease at the 3rd, 6th, and 9th. All patients were followed up for 3 years and their overall survival (OS), disease-free survival (DFS) were assessed. RESULTS: The efficacy of Group A and Group C was similar (P > 0.05), but the alanine aminotransferase, aspartate aminotransferase and total bilirubin of Group A were lower than those of Group C (all P < 0.05). The proportions of CR (32.5%), PR (37.5%) were slightly higher than Group A (CR: 27.5%, PR: 35%), but the difference was not statistically significant (χ 2 = 0.701, P = 0.873). No operational-related deaths occurred in Group A and Group C. The OS (97.5%, 84.7%, and 66.1%) and the DFS (75.0%, 51.7%, and 35.4%) of Group A at the 1st, 2nd, and 3rd year after treatment were similar with those of Group C (OS: 90.0%, 79.7%, and 63.8%; DFS: 80.0%, 59.7%, and 48.6%; P > 0.05). The OS rates in Group A and Group B (90%, 82.3%, and 66.4%) were similar (P > 0.05). The DFS rates in Group B (50%, 31.6%, and 17.2%) were lower than that of Group A (P = 0.013). CONCLUSION: The efficacy of DEA-TACE combined with RFA for untreated HCC is similar with hepatectomy. Patients with recurrent HCC could get a longer survival time through the combined treatment.

Network analysis of KLF5 targets showing the potential oncogenic role of SNHG12 in colorectal cancer.

BACKGROUND: KLF5 is a member of the Kruppel-like factor, subfamily of zinc finger proteins that are involved in cancers. KLF5 functions as a transcription factor and regulates the diverse protein-coding genes (PCGs) in colorectal cancer (CRC). However, the long non-coding RNAs (lncRNAs) regulated by KLF5 in CRC are currently unknown. METHODS: In this study, we first designed a computational pipeline to determine the PCG and lncRNA targets of KLF5 in CRC. Then we analyzed the motif pattern of the binding regions for the lncRNA targets. The regulatory co-factors of KLF5 were then searched for through bioinformatics analysis. We also constructed a regulatory network for KLF5 and annotated its functions. Finally, one of the KLF5 lncRNA targets, SNHG12, was selected to further explore its expression pattern and functions in CRC. RESULTS: We were able to identify 19 lncRNA targets of KLF5 and found that the motifs of the lncRNA binding sites were GC-enriched. Next, we pinpointed the transcription factors AR and HSF1 as the regulatory co-factors of KLF5 through bioinformatics analysis. Then, through the analysis of the regulatory network, we found that KLF5 may be involved in DNA replication, DNA repair, and the cell cycle. Furthermore, in the cell cycle module, the SNHG12 up-regulating expression pattern was verified in the CRC cell lines and tissues, associating it to CRC invasion and distal metastasis. This indicates that SNHG12 may play a critical part in CRC tumorigenesis and progression. Additionally, expression of SNHG12 was found to be down-regulated in CRC cell lines when KLF5 expression was knocked-down by siRNA; and a strong correlation was observed between the expression levels of SNHG12 and KLF5, further alluding to their regulatory relationship. CONCLUSIONS: In conclusion, the network analysis of KLF5 targets indicates that SNHG12 may be a significant lncRNA in CRC.

Clinical value and application of contrast-enhanced ultrasound in the differential diagnosis of malignant and benign breast lesions.

The aim of the present study was to assess the performance of contrast-enhanced ultrasound in distinguishing between malignant and benign breast lesions and the diagnostic value of its clinical application. A total of 52 cases with malignant breast tumors and 73 cases with benign breast lesions were included in the study. Time-intensity curves (TICs) for contrast-enhanced ultrasound were recorded, and the perfusion parameters were obtained and analyzed. Typical features of malignant breast tumors included irregular shape and vascular morphology, uneven contrast agent distribution, filling defects and contrast agent retention, 'fast-out' wash-out mode, unclear boundaries and uneven internal echo. Benign lesions were characterized by 'slow-out' or synchronous wash-out mode. Regarding perfusion, the starting time of the perfusion of the Sone-Vue microbubble contrast (always 20-30 sec) and time to peak (TTP) were significantly earlier for the malignant lesions, while the wash-out time was later. A significantly greater peak intensity, rising slope and area under the TIC were observed for the malignant breast lesions. All of the malignant breast lesions exhibited an enlarged focus scope on ultrasound, while no obvious focus scope enhancement was observed for benign breast lesions. Furthermore, the TICs of 88.4% of malignant breast lesions were of the fast-rising and slow-declining type, while the TICs of 75.3 and 17.8% of the benign breast lesions were of the slow-rising and fast-declining, and fast-rising and fast-declining type, respectively. Receiver operating characteristics analysis indicated that the TTP, wash-out time and rising slope might contribute to the differential diagnosis between malignant and benign breast lesions. In conclusion, TIC parameters of contrast-enhanced ultrasound have promising clinical value in differentiating between malignant and benign breast lesions. The TTP, wash-out time and rising slope may contribute to the diagnosis of patients with breast lesions to facilitate timely treatment and prognostication of breast cancer patients.

Clinical analysis of ultrasound-guided radiofrequency ablation for recurrent colorectal liver metastases after hepatectomy.

BACKGROUND: RFA is designed to produce localized tumor destruction by heating the tumor and surrounding liver tissue, especially suitable for patients who do not qualify for hepatic resection. Many studies have reported that RFA was inferior to hepatectomy in the treatment of recurrent colorectal liver metastases. However, strong evidence is lacking in the literature. This study aimed to investigate the effect and clinical outcome of percutaneous ultrasound-guided RFA and repeat hepatic resection for recurrent colorectal liver metastases after hepatectomy. METHODS: From January 2007 to January 2014, 194 patients with recurrent colorectal liver metastases after hepatectomy diagnosed in our hospital was performed, and then divided into two groups based on different regimens: repeat hepatic resection group and RFA group. The clinical data of the two groups were analyzed. After treatment, the liver function-related indexes, complication rate, survival rate, and tumor recurrence of the two groups were recorded. The difference in short-term and long-term effects between repeat hepatic resection and RFA was identified by propensity score analysis. RESULTS: The number of metastases and the proportion of left and right lobe involved by tumor and preoperative chemotherapy in the RFA group were higher than those in the repeat hepatic resection group. The clinical data showed no significant difference between the two groups after using propensity score analysis. Compared with the RFA group, the liver function of the repeat hepatic resection group was significantly improved. After adjustment for potential confounders, no significant difference in liver function-related indexes was found between RFA and repeat hepatic resection, and the incidence of complications in the RFA group was lower. In survival analysis, there was no significant difference in OS and DFS between the two groups. CONCLUSIONS: RFA is a safe and effective therapeutic option for patients with recurrent colorectal liver metastases after hepatectomy.

Ultrasound-guided secondary radiofrequency ablation combined with chemotherapy in gastric cancer with recurrent liver metastasis.

BACKGROUND: The incidence and mortality of gastric cancer are in the second and third place of malignant tumor in China, respectively. Liver metastasis is an important cause of death of these patients. This study is to explore whether the secondary radiofrequency ablation (RFA) treatment can prolong the survival period and improve the life quality of patients with gastric cancer and recurrent liver metastases. METHODS: A total of 87 patients with gastric cancer and recurrent liver metastases were retrospective analyzed, 46 cases were assigned into study group and 41 cases in control group. The efficacy of the two groups was observed, and the prognostic factors were analyzed. RESULTS: The median survival time in the study group was significantly longer than that in the control group (P<0.05). The survival rate of the study group was significantly higher than that of the control group (both P<0.05). The life quality scores of the study group were significantly higher than the control group (both P<0.05). CONCLUSIONS: Ultrasound-mediated secondary RFA combined with chemotherapy is superior to chemotherapy alone in the treatment of gastric cancer with recurrent liver metastases.