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1.
Cancer Imaging ; 22(1): 23, 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35549776

RESUMO

BACKGROUND: Transcatheter arterial chemoembolization (TACE) is the mainstay of therapy for intermediate-stage hepatocellular carcinoma (HCC); yet its efficacy varies between patients with the same tumor stage. Accurate prediction of TACE response remains a major concern to avoid overtreatment. Thus, we aimed to develop and validate an artificial intelligence system for real-time automatic prediction of TACE response in HCC patients based on digital subtraction angiography (DSA) videos via a deep learning approach. METHODS: This retrospective cohort study included a total of 605 patients with intermediate-stage HCC who received TACE as their initial therapy. A fully automated framework (i.e., DSA-Net) contained a U-net model for automatic tumor segmentation (Model 1) and a ResNet model for the prediction of treatment response to the first TACE (Model 2). The two models were trained in 360 patients, internally validated in 124 patients, and externally validated in 121 patients. Dice coefficient and receiver operating characteristic curves were used to evaluate the performance of Models 1 and 2, respectively. RESULTS: Model 1 yielded a Dice coefficient of 0.75 (95% confidence interval [CI]: 0.73-0.78) and 0.73 (95% CI: 0.71-0.75) for the internal validation and external validation cohorts, respectively. Integrating the DSA videos, segmentation results, and clinical variables (mainly demographics and liver function parameters), Model 2 predicted treatment response to first TACE with an accuracy of 78.2% (95%CI: 74.2-82.3), sensitivity of 77.6% (95%CI: 70.7-84.0), and specificity of 78.7% (95%CI: 72.9-84.1) for the internal validation cohort, and accuracy of 75.1% (95% CI: 73.1-81.7), sensitivity of 50.5% (95%CI: 40.0-61.5), and specificity of 83.5% (95%CI: 79.2-87.7) for the external validation cohort. Kaplan-Meier curves showed a significant difference in progression-free survival between the responders and non-responders divided by Model 2 (p = 0.002). CONCLUSIONS: Our multi-task deep learning framework provided a real-time effective approach for decoding DSA videos and can offer clinical-decision support for TACE treatment in intermediate-stage HCC patients in real-world settings.

2.
Nanoscale ; 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35535767

RESUMO

Semiconductor nanomembranes (NMs) have emerged as an attractive nanomaterial for advanced electronic and photonic devices with attractive features such as transferability and flexibility, enabling heterogeneous integration of multi-functional components. Here, we demonstrate transferable single-layer GeSn NM resonant-cavity-enhanced photodetectors for 2 µm optical communication and multi-spectral short-wave infrared sensing/imaging applications. The single-layer strain-free GeSn NMs with an Sn concentration of 10% are released from a high-quality GeSn-on-insulator (GSOI) substrate with the defective interface regions removed. By transferring the GeSn NMs onto a predesigned distribution Bragg reflector (DBR)/Si substrate, a vertical microcavity is integrated into the device to enhance the light-matter interaction in the GeSn NM. With the integrated cavity and high-quality single-layer GeSn NM, a record responsivity of 0.51 A W-1 at 2 µm wavelength at room temperature is obtained, which is more than two orders of magnitude higher than the reported values of the multiple-layer GeSn membrane photodetectors without cavities. The potential of the device for multi-spectral photodetection is demonstrated by tuning the responsivity spectrum with different NM thicknesses. Theoretical simulations are utilized to analyze and verify the mechanisms of responsivity enhancement. The approach can be applied to other GeSn-NM-based active devices, such as electro-absorption modulators or light emitters, presenting a new pathway towards heterogeneous group-IV photonic integrated circuits with miniaturized devices.

3.
J Cancer Res Ther ; 17(5): 1141-1156, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34850761

RESUMO

The Expert Consensus reviews current literatures and provides clinical practice guidelines for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The main contents include the following: (1) clinical evaluation of GGN; (2) procedures, indications, contraindications, outcomes evaluation, and related complications of thermal ablation for GGN; and (3) future development directions.


Assuntos
Hipertermia Induzida/métodos , Neoplasias Pulmonares/cirurgia , Nódulos Pulmonares Múltiplos/cirurgia , Lesões Pré-Cancerosas/cirurgia , Nódulo Pulmonar Solitário/cirurgia , Consenso , Prova Pericial , Humanos
4.
Int J Hyperthermia ; 38(1): 1541-1547, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727828

RESUMO

PURPOSE: To retrospectively compare the efficacy and safety of surgical resection (SR) and thermal ablation for the treatment of adrenal metastases. METHODS: From January 2008 to December 2018, 133 patients with adrenal metastases who underwent SR (n = 76) or thermal ablation (n = 57) were enrolled. The mean tumor size was 58.00 ± 10.65 mm (22-80 mm) in the SR group and 58.03 ± 12.76 mm (34-89 mm) in the thermal ablation group. Local progression-free survival (LPFS) and safety were compared between the two groups using the Kaplan-Meier method and log-rank tests. Cox proportional hazard regression models were used to evaluate the prognostic factors of LPFS. Complications, hospitalization days, and blood loss were also assessed. RESULTS: The median follow-up was 29.0 months (range, 20.4-37.6 months). No treatment-related mortality was observed. The 1-, 3- and 5-year LPFS rates were 74.0%, 62.8%, and 31.4% in the SR group and 72.8%, 68.7%, and 51.5% in the ablation group, with the median LPFS of 41.5 months (95% CI: 9.3-23.4 months) vs. 47.9 months (95% CI 20.6-75.8 months), respectively (p = 0.784). Tumor size ≥3 cm was the only significant risk factor for LPFS (p = 0.031). The ablation group was superior to the SR group with a lower major complication rate (4.1% vs. 14.5%, p = 0.03), less blood loss (1 ml vs. 100 ml, p < 0.001), and a shorter hospital stay (2 d vs. 6 d, p < 0.001). CONCLUSION: Thermal ablation provided a similar LPFS and less comorbidities than SR, indicating that it is an effective and safe treatment for adrenal metastases.


Assuntos
Neoplasias das Glândulas Suprarrenais , Ablação por Cateter , Hipertermia Induzida , Neoplasias das Glândulas Suprarrenais/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
5.
Front Oncol ; 11: 755341, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804946

RESUMO

AIM: Insulin-like growth factor-1 receptor (IGF-1R) is one of the main members of the tyrosine protein kinase receptor family. This receptor binds insulin-like growth factor-1 (IGF-1) with a high affinity. IGF-1 is a member of a family of proteins involved in mediating growth and development. However, the correlations of IGF-1 and IGF-1R to prognosis and tumor-infiltrating lymphocytes in different cancers remain unclear. METHOD: This research comprehensively analyzed the expression pattern of IGF-1 and IGF-1R and the influence of IGF-1 and IGF-1R on clinical significance in prognosis prediction among 33 types of malignancies using The Cancer Genome Atlas (TCGA) and the Cancer Cell Line Encyclopedia (CCLE) databases. The correlation between IGF-1, IGF-1R, and cancer immunity was explored. RESULTS: IGF-1 and IGF-1R displayed inconsistent gene expression levels among diverse cancer cell lines. Typically, high expression level of IGF-1 and IGF-1R was detected in most malignant tumors. High expression of IGF-1 was closely bound up with the unfavorable overall survival (OS) for patients in BLCA, CHOL, and LAML upon Cox and Kaplan-Meier analyses. While high expression of IGF-1R was closely bound up with the unfavorable overall survival (OS) for patients in BLCA, LIHC, and LUAD. Furthermore, high expression level of IGF-1 and IGF-1R were closely connected with high degrees of tumor infiltrates, including CD4+ T cell, dendritic cells, and macrophages. In addition, we found that IGF-1 was commonly positively correlated with the expression of gene markers including LAIR1, ICOS, CD40LG, CTLA4, CD48, CD28, CD200R1, HAVCR2, and CD86. Whereas, IGF-1R was commonly positively correlated with the expression of gene markers including NRP1 and CD276. More importantly, IGF-1 and IGF-1R expression were correlated with tumor mutation burden (TMB), microsatellite instability (MSI), mismatch repair (MMR), and DNA methyltransferase (DNMT) of different types of cancers. CONCLUSIONS: The impact of high IGF-1 and IGF-1R on prognosis and immune infiltrates differs across cancer types. Anti-IGF-1R therapy may inhibit tumor growth and contribute to immunotherapy in LIHC and KIRC.

6.
Front Oncol ; 11: 757149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733791

RESUMO

BACKGROUND: Comparison of patterns of early hepatocellular carcinoma (HCC) recurrence beyond the Milan criteria (HRBM) and identification of the independent risk factors of time to recurrence beyond the Milan criteria (TRBM) after resection or ablation can develop an optimal first-line treatment and provide more opportunities and waiting time for salvage transplantation. METHODS: The patterns of HRBM after first-line resection or ablation in 384 patients with single-nodule HBV-associated HCC of 2-3 cm were retrospectively analyzed by one-to-one propensity score matching (PSM) between December 2008 and December 2017. The median TRBM between the resection group and the ablation group was estimated by Kaplan-Meier curves. The Cox regression analysis and binary logistic regression were used for the identification of the independent risk factors of TRBM and the occurrence of HRBM, respectively. The abilities of HRBM and the recurrence to predict overall survival (OS) were compared by the time-dependent receiver operating characteristic curves and estimated area under the curve. RESULTS: Of 384 patients enrolled in our study, 260 (67.7%) received resection (resection group) and 124 (32.3%) underwent ablation (ablation group). The median TRBM in the resection group was significantly longer than that in the ablation group before PSM (median, not available vs. 101.4 months, P < 0.001) and after PSM (median, not available vs. 85.7 months, P < 0.001). Cox regression showed ablation, older age, CRP ≥1.81 mg/L, and PLT ≤80 × 109/L were the independent risk factors of TRBM. Binary logistic regression also showed that ablation, CRP ≥1.81 mg/L, and PLT ≤80 × 109/L were the independent risk factors of the occurrence of HRBM. The incidences of various phenotypes of HRBM were not significantly different between the two groups, but the incidence of HRBM at the first recurrence in the ablation group was significantly higher than that in the resection group (P < 0.05). Besides, compared with recurrence, HRBM was a better predictor of OS (P < 0.05). CONCLUSIONS: Compared with ablation, resection should be considered as a more appropriate first-line option for patients with single-nodule HBV-associated HCC of 2-3 cm and a more promising bridge for liver transplantation in those patients.

7.
J Phys Chem Lett ; 12(41): 10197-10203, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34644086

RESUMO

Dual-color emission in a single perovskite layer would make perovskite light-emitting devices (PLEDs) more competitive compared with other display technologies. However, due to the carrier dynamics in a blended perovskite film and the low reaction activation energy of the halide exchange reaction, it is very difficult to achieve the dual-color emission in a perovskite layer. Here, dual-color electroluminescence (EL) emission in a single perovskite layer has been realized by slowing the energy transfer from wide-bandgap energy levels to narrow-bandgap energy levels. Moreover, the EL spectra can be controlled by modulating the composition of the perovskite layer. When the amount of CH3NH3I(MAI) in the precursor was varied, white emission with CIE coordinates of (0.33, 0.34) could be achieved. Our work proposes a new strategy for white emission from PLEDs. Also, the analysis and discussion of carrier dynamics in this work may help to enhance our understanding of the working mechanism of PLEDs.

8.
Nanoscale ; 13(36): 15403-15414, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34499063

RESUMO

In recent years, two-dimensional material-based tunneling heterojunctions are emerging as a multi-functional architecture for logic circuits and photodetection owing to the flexible stacking, optical sensitivity, tunable detection band, and highly controllable conductivity behaviors. However, the existing structures are mainly focused on transition or post-transition metal chalcogenides and have been rarely investigated as topological insulator (such as Bi2Se3 or Bi2Te3)-based tunneling heterostructures. Meanwhile, it is challenging to mechanically exfoliate the topological insulator thin nanoflakes because of the strong layer-by-layer interaction with shorter interlayer spacing. Herein, we report Au-assisted exfoliation and non-destructive transfer method to fabricate large-scale Bi2Se3 thin nanosheets. Furthermore, a novel broken-gap tunneling heterostructure is designed by combing 2H-MoTe2 and Bi2Se3via the dry-transfer method. Thanks to the realized band alignment, this ambipolar-n device shows a clear rectifying behavior at Vds of 1 V. A built-in potential exceeding ∼0.7 eV is verified owing to the large band offsets by comparing the numerical solution of Poisson's equation and the experimental data. Carrier transport is governed by the majority carrier including thermionic emission and the tunneling process through the barrier height. At last, the device shows an ultralow dark current of ∼0.2 pA and a superior optoelectrical performance of Ilight/Idark ratio ≈106, a fast response time of 21 ms, and a specific detectivity of 7.2 × 1011 Jones for a visible light of 405 nm under zero-bias. Our work demonstrates a new universal method to fabricate a topological insulator and paves a new strategy for the construction of novel van der Waals tunneling structures.

9.
J Phys Chem Lett ; 12(37): 9086-9093, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34519516

RESUMO

The colloidal semiconductor nanoplatelet (NPL) with broad ligand-semiconductor interface is an ideal system for surface science investigation, but the study regarding depletion effects in NPLs remains lacking. Herein we explore such effects in colloidal CdSe NPLs through Br ligation. Apart from improved brightness and red-shifted optical features, we also experimentally observed abnormal negative thermal quenching phenomena in bromide-ligated CdSe NPLs over 200 K under a cryogenic environment and up to 383 K under an ambient environment, which was absent in pristine NPLs. We speculate that the surface depletion effect shall account for these anomalous phenomena due to the susceptibility of the surface depletion region on photoexcited carrier concentration and surface condition. The existence of the depletion layer in NPLs is also validated quantitatively with k·p simulation. Besides offering an alternative explanation on the red-shifted optical properties of CdSe NPLs by Br-ligation, our findings pave the new route toward solution-processed NPLs-based optoelectronics with boosted thermal resistance.

10.
Small ; 17(36): e2101226, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34323356

RESUMO

Selenium(Se)-based solar cells (SSCs), known as one of the oldest solar cells, have regained intense attention due to the advantages of Se including direct bandgap, good stability, and single absorber. Among all kinds of device structures, conventional n-i-p SSCs with top organic hole transport layers (HTLs) show great potential since organic HTLs could be well-designed to smoothly extract holes from the Se single absorber and protect the Se surface. However, till now, the performance of Se solar cells with organic HTLs is not as good as expected. To address this issue, herein, the SSCs are first presented with organic polymers as the HTLs with the improved efficiency up to 4.3%, which is the highest one in organic HTLs-based SSCs. Additionally, comparing with perovskite solar cells, it is found that the recombination process is the key factor that influences the performance of SSCs. It is believed that the further optimization of the Se active layer and the design of new and suitable organic HTLs for SSCs should be the main focus to suppress the undesired recombination processes of Se films. Such realization would boost the efficiency of the as-fabricated SSCs.

11.
Opt Lett ; 46(15): 3809-3812, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34329287

RESUMO

Germanium-tin-on-insulator (GSOI) has emerged as a new platform for three-dimensional (3D) photonic-integrated circuits (PICs). We report, to our knowledge, the first demonstration of GeSn dual-waveband resonant-cavity-enhanced photodetectors (RCE PDs) on GSOI platforms with resonance-enhanced responsivity at both 2 µm and 1.55 µm bands. 10% Sn is introduced to the GeSn absorbing layer to extend the detection wavelength to the 2 µm band. A vertical Fabry-Perot cavity is designed to enhance the responsivity. The measured responsivity spectra show resonance peaks that cover a wide wavelength range near both the 2 µm and conventional telecommunication bands. This work demonstrates that GeSn dual-waveband RCE PDs on a GSOI platform are promising for CMOS-compatible 3D PICs for optoelectronic applications in 2 µm and telecommunication bands.

12.
J Hematol Oncol ; 14(1): 118, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34325726

RESUMO

Although chimeric antigen receptor (CAR)-engineered T cells have shown great success in the treatment of B cell malignancies, this strategy has limited efficacy in patients with solid tumors. In mouse CAR-T cells, IL-7 and CCL19 expression have been demonstrated to improve T cell infiltration and CAR-T cell survival in mouse tumors. Therefore, in the current study, we engineered human CAR-T cells to secrete human IL-7 and CCL19 (7 × 19) and found that these 7 × 19 CAR-T cells showed enhanced capacities of expansion and migration in vitro. Furthermore, 7 × 19 CAR-T cells showed superior tumor suppression ability compared to conventional CAR-T cells in xenografts of hepatocellular carcinoma (HCC) cell lines, primary HCC tissue samples and pancreatic carcinoma (PC) cell lines. We then initiated a phase 1 clinical trial in advanced HCC/PC/ovarian carcinoma (OC) patients with glypican-3 (GPC3) or mesothelin (MSLN) expression. In a patient with advanced HCC, anti-GPC3-7 × 19 CAR-T treatment resulted in complete tumor disappearance 30 days post intratumor injection. In a patient with advanced PC, anti-MSLN-7 × 19 CAR-T treatment resulted in almost complete tumor disappearance 240 days post-intravenous infusion. Our results demonstrated that the incorporation of 7 × 19 into CAR-T cells significantly enhanced the antitumor activity against human solid tumor. Trial registration: NCT03198546. Registered 26 June 2017, https://clinicaltrials.gov/ct2/show/NCT03198546?term=NCT03198546&draw=2&rank=1.


Assuntos
Quimiocina CCL19/imunologia , Proteínas Ligadas por GPI/análise , Glipicanas/análise , Imunoterapia Adotiva/métodos , Interleucina-7/imunologia , Neoplasias/terapia , Animais , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/terapia , Feminino , Proteínas Ligadas por GPI/imunologia , Glipicanas/imunologia , Células Hep G2 , Humanos , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/terapia , Camundongos , Neoplasias/imunologia , Neoplasias/patologia , Neoplasias Ovarianas/imunologia , Neoplasias Ovarianas/terapia , Neoplasias Pancreáticas/imunologia , Neoplasias Pancreáticas/terapia , Linfócitos T/imunologia , Resultado do Tratamento
13.
Front Oncol ; 11: 621834, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277397

RESUMO

In China, the majority of patients with hepatocellular carcinoma (HCC) result from long-term infection of hepatitis B. Pathologically, HCC is characterized by rich blood supply, multicentric origins, early vascular invasion and intrahepatic metastasis. Therefore, HCC is not a local disease but a systemic disease at the beginning of its occurrence. For this reason, a comprehensive treatment strategy should be adopted in the management of HCC, including local treatments (such as surgical resection, radiofrequency ablation, microwave ablation, chemical ablation and cryoablation, etc.), organ-level treatments [such as transcatheter arterial infusion of chemotherapy and transcatheter arterial chemoembolization (TACE)], and systemic treatments (such as immunotherapy, antiviral therapy and molecular targeted therapy, etc.). This consensus sets forth the minimally-invasive and multidisciplinary comprehensive guideline of HCC, focusing on the following eight aspects (1) using hepaticarteriography, CT hepatic arteriography (CTHA), CT arterial portography (CTAP), lipiodol CT (Lp-CT), TACE-CT to find the intrahepatic lesion and make precise staging (2) TACE combined with ablation or ablation as the first choice of treatment for early stage or small HCC, while other therapies are considered only when ablation is not applicable (3) infiltrating HCC should be regarded as an independent subtype of HCC (4) minimally-invasive comprehensive treatment could be adopted in treating metastatic lymph nodes (5) multi-level subdivision of M-staging should be used for individualized treatment and predicting prognosis (6) HCC with severe hepatic decompensation is the only candidate criterion for liver transplantation (7) bio-immunotherapy, traditional Chinese medicine therapy, antiviral therapy, and psychosocial and psychopharmacological interventions should be advocated through the whole course of HCC treatment (8) implementation of multicenter randomized controlled trials of minimally-invasive therapy versus surgery for early and intermediate stage HCC is recommended.

14.
J Cancer Res Ther ; 17(3): 740-748, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34269308

RESUMO

CONTEXT AND AIMS: The identification of inflammation-related prognostic heterogeneity in intermediate-stage hepatocellular carcinoma (HCC) can reveal more effective first-line treatments. Our study aimed to compare the intermediate-stage HCC patients' different inflammation-based scores in predicting their progression-free survival (PFS) after transarterial chemoembolization (TACE). MATERIALS AND METHODS: We analyzed retrospectively a total of 128 intermediate-stage HCC patients who received first-line TACE treatment. We used the Cox-proportional hazards modeling to identify the independent prognostic factors. We compared the inflammation-based scores abilities to predict the PFS through the time-dependent receiver operating characteristic curves and area under the curves. RESULTS: The multivariate analysis showed that tumor size and platelet-to-lymphocyte ratio (PLR) were the independent prognostic factors for PFS (P < 0.05). The PLR predicted the intermediate-stage HCC patients' PFS receiving the TACE treatment better than other inflammation-based scores (e.g., the neutrophil-to-lymphocyte ratio, the Glasgow Prognostic Score (GPS), the modified GPS, the Prognostic Index, the Prognostic Nutritional Index, the lymphocyte-to-monocyte ratio, and the systemic immune-inflammation index) (P < 0.05). An easy-to-use novel inflammation score based on tumor size - PLR-size score significantly improved the PFS prediction performance (P < 0.05). CONCLUSIONS: As a first-line treatment, TACE was not well suitable for all intermediate-stage HCC patients, while the PLR was a better inflammation-based score than others. Tumor size should be regarded as an essential variable in affecting intermediate-stage HCC patients' first-line treatment strategies.


Assuntos
Carcinoma Hepatocelular/mortalidade , Quimioembolização Terapêutica , Neoplasias Hepáticas/terapia , Idoso , Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/terapia , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Inflamação/imunologia , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Intervalo Livre de Progressão , Curva ROC , Estudos Retrospectivos , Medição de Risco/métodos , Índice de Gravidade de Doença
15.
Nano Lett ; 21(13): 5555-5563, 2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34105972

RESUMO

We demonstrate Ge0.95Sn0.05 p-channel gate-all-around field-effect transistors (p-GAAFETs) with sub-3 nm nanowire width (WNW) on a GeSn-on-insulator (GeSnOI) substrate using a top-down fabrication process. Thanks to the excellent gate control by employing an aggressively scaled nanowire structure, Ge0.95Sn0.05 p-GAAFETs exhibit a small subthreshold swing (SS) of 66 mV/decade, a decent on-current/off-current (ION/IOFF) ratio of ∼1.2 × 106, and a high-field effective hole mobility (µeff) of ∼115 cm2/(V s). In addition, we also investigate quantum confinement effects in extremely scaled GeSn nanowires, including threshold voltage (VTH) shift and IOFF reduction with continuous scaling of WNW under 10 nm. The phenomena observed from experimental results are substantiated by the calculation of GeSn bandgap and TCAD simulation of electrical characteristics of devices with sub-10 nm WNW. This study suggests Ge-based nanowire p-FETs with extremely scaled dimension hold promise to deliver good performance to enable further scaling for future technology nodes.

16.
Zhongguo Fei Ai Za Zhi ; 24(5): 305-322, 2021 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-33896152

RESUMO

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
.


Assuntos
Neoplasias Pulmonares/cirurgia , Nódulo Pulmonar Solitário/cirurgia , Técnicas de Ablação , Tomografia Computadorizada Quadridimensional , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem
17.
Int J Hyperthermia ; 38(1): 120-129, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33541160

RESUMO

OBJECTIVES: Hepatocellular carcinoma (HCC) is a heterogeneous disease. This study aimed to identify the heterogeneity related to the prognosis of ablation in patients with single-nodule hepatitis B virus (HBV)-associated HCC ≤3 cm. METHODS: A total of 359 patients with single-nodule HBV-associated HCC ≤3 cm treated with curative thermal ablation were retrospectively investigated. Hierarchical cluster analysis was applied to obtain more homogeneous patient clusters concerning demographic and physiological characteristics. Discriminant analysis was performed to identify the relatively important variables for cluster analysis. Multiple correspondence analysis (MCA) was used to clarify the relationship between clusters and categorical variables. Overall survival (OS) was compared among clusters using the Kaplan-Meier model. RESULTS: A two-cluster model was identified. Cluster 1 (n = 85) showed a higher percentage of female and older patients, higher inflammation response (higher prognostic nutritional index [PNI] and Glasgow prognostic score [GPS]), worse liver function (higher albumin-bilirubin grade and Child-Pugh grade), and relatively poorer immune status (higher neutrophil-to-lymphocyte ratio [NLR]) than cluster 2 (n = 274). NLR and GPS were the two most influential variables for cluster analysis (p < .0001). Cluster 2 had a significantly better prognosis than cluster 1. MCA revealed a clear negative correlation between inflammation status and liver function. Compared with cluster 1, the hazard ratios for OS of cluster 2 were 0.47 and 0.52 before and after adjusting for age, respectively (p < .05). CONCLUSIONS: This study identified two sub-phenotypes of patients with single-nodule HBV-associated HCC ≤3 cm and their association with the outcome of thermal ablation alone as the first-line therapy. Key points Thermal ablation alone as the first-line therapy is not suitable for all patients with single-nodule hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) ≤3 cm. Patients with single-nodule HBV-associated HCC ≤3 cm can be identified as two sub-phenotypes associated with the outcome of thermal ablation alone as the first-line therapy, based on key preoperative clinical characteristics, especially inflammatory response and immune status. Patients with single-nodule HBV-associated HCC ≤3 cm characterized by late-onset disease, worse liver function, poorer immune status, and higher inflammatory response (with higher inflammatory response being the most important factor) are not suitable for thermal ablation alone as the first-line therapy. In contrast, patients with single-nodule HBV-associated HCC ≤3 cm characterized by early-onset disease, better liver function, lower inflammatory response, and good immune status (with lower inflammatory response being the most important factor) are particularly suitable for thermal ablation alone. Implications for patient care In the treatment of patients with single-nodule HBV-associated HCC ≤3 cm, thermal ablation alone as the first-line therapy should be carefully considered after recognizing the key clinical characteristics, among which inflammatory response and immune status are the two most important factors involved in clinical heterogeneity, and inflammatory response is closely related to the prognosis of thermal ablation alone as the first-line therapy for these patients.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Análise por Conglomerados , Feminino , Vírus da Hepatite B , Humanos , Fenótipo , Prognóstico , Estudos Retrospectivos
18.
J Immunother Cancer ; 9(2)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33637599

RESUMO

BACKGROUND: The advent of immune checkpoint therapy has been a tremendous advance in cancer treatment. However, the responses are still insufficient in patients with soft tissue sarcoma (STS). We aimed to identify rational combinations to increase the response to immune checkpoint therapy and improve survival. METHODS: Whole-exome sequencing (WES) was performed in 11 patients with liposarcoma. Somatic copy number alterations (SCNAs) were analyzed at the gene level to identify obvious amplification patterns in drug-target genes. The expression and prognostic value of class I histone deacetylases (HDACs) was evaluated in 49 patients with sarcoma in our center and confirmed in 263 sarcoma samples from The Tumor Cancer Genome Atlas (TCGA) database. Q-PCR, flow cytometry and RNA-seq were performed to determine the correlations between class I HDACs, chidamide and PD-L1 in vitro and in vivo. The efficacy of combining chidamide with PD-1 blockade was explored in an immunocompetent murine model and a small cohort of patients with advanced sarcoma. Western blot, ChIP assay and dual luciferase assessment were applied in the mechanistic study. RESULTS: The HDAC gene family was frequently amplified in STS. SCNAs in the HDAC gene family were extensively amplified in 8 of 11 (73%) patients with liposarcoma, based on a drug-target gene set, and we verified amplification in 76.65% (197/257) of cases by analyzing TCGA sarcoma cohort. Class I HDAC expression is associated with a poor prognosis for patients with STS, and its inhibition is responsible for promoting apoptosis and upregulating of programmed cell death ligand 1 (PD-L1). The HDAC class I inhibitor chidamide significantly increases PD-L1 expression, increased the infiltration of CD8+ T cells and reduced the number of MDSCs in the tumor microenvironment. The combination of chidamide with an anti-PD-1 antibody significantly promotes tumor regression and improves survival in a murine model. Moreover, chidamide combined with the anti-PD-1 antibody toripalimab is effective in patients with advanced and metastatic sarcoma, and the side effects are tolerable. Mechanistically, chidamide increases histone acetylation at the PD-L1 gene through the activation of the transcriptional factor STAT1. CONCLUSIONS: The combination of chidamide and anti-programmed cell death 1 (PD-1) therapy represents a potentially important strategy for STS.


Assuntos
Aminopiridinas/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Antígeno B7-H1/metabolismo , Benzamidas/administração & dosagem , Histona Desacetilase 1/genética , Histona Desacetilase 2/genética , Histona Desacetilases/genética , Inibidores de Checkpoint Imunológico/administração & dosagem , Lipossarcoma/tratamento farmacológico , Aminopiridinas/farmacologia , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Benzamidas/farmacologia , Linhagem Celular Tumoral , Amplificação de Genes , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Inibidores de Checkpoint Imunológico/farmacologia , Lipossarcoma/genética , Lipossarcoma/metabolismo , Camundongos , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Análise de Sequência de RNA , Sequenciamento Completo do Exoma , Ensaios Antitumorais Modelo de Xenoenxerto
19.
Nanoscale ; 13(7): 4092-4102, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33570061

RESUMO

Engineering the spectral lineshape of plasmonic modes by various electromagnetic couplings and mode interferences enables significant improvements for plasmonic sensing. However, bulk and surface sensitivities remain constrained by a trade-off arising from their respective dependence on the interaction volume and decay length of the plasmonic mode, making higher bulk sensitivity realized at the expense of reduced surface sensitivity. We propose a new approach to overcome this trade-off by combining near-field and far-field coupling in an intercalated 3-disk plasmonic crystal, where ∼10× higher figure of merit (FoM) and ∼2× higher surface sensitivity can be achieved, in comparison with those achievable by localized surface plasmons. A plasmonic mode with a Q-factor up to ∼110 is demonstrated based on gold 3-disk arrays in the visible spectrum, with a bulk FoM of ∼24 and a surface sensitivity prefactor of ∼13.56. The design and fabrication simplicity of the 3-disk structure highlight its potential for a robust plasmonic sensing platform with a high figure of merit.

20.
Sensors (Basel) ; 21(3)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33498424

RESUMO

Flame monitoring of industrial combustors with high-reliability sensors is essential to operation security and performance. An ion current flame sensor with a simple structure has great potential to be widely used, but a weak ion current is the critical defect to its reliability. In this study, parameters of the ion current sensor used for monitoring flames on a Bunsen burner are suggested, and a method of further improving the ion current is proposed. Effects of the parameters, including the excitation voltage, electrode area, and electrode radial and vertical positions on the ion current, were investigated. The ion current grew linearly with the excitation voltage. Given that the electrodes were in contact with the flame fronts, the ion current increased with the contact area of the cathode but independent of the contact area of the anode. The smaller electrode radial position resulted in a higher ion current. The ion current was insensitive to the anode vertical position but largely sensitive to the cathode vertical position. Based on the above ion current regularities, the sensor parameters were suggested as follows: The burner served as a cathode and the platinum wire acted as an anode. The excitation voltage, anode radial and vertical positions were 120 V, 0 mm, and 6 mm, respectively. The method of further improving the ion current by adding multiple sheet cathodes near the burner exit was proposed and verified. The results show that the ion current sensor with the suggested parameters could correctly identify the flame state, including the ignition, combustion, and extinction, and the proposed method could significantly improve the magnitude of the ion current.

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