Microwave ablation of multifocal primary liver cancer guided by real-time 3.0T MRI.

OBJECTIVE: To investigate the feasibility and efficacy of real-time 3.0 T magnetic resonance imaging (MRI) guided percutaneous microwave ablation (MWA) in the treatment of multifocal liver cancer. METHODS: A total of 76 lesions in 26 patients with multifocal liver cancer who underwent 3.0 T MRI-guided microwave ablation in our hospital from April 2020 to April 2022 were retrospectively analyzed. The technical success rate, average operation time, average ablation time, and complications were evaluated. The upper abdomen was reviewed by pre- and post-contrast enhanced MRI scan every 1 months after the operation. The short-term curative effect was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria (2020 version), and the local control rate was calculated. RESULTS: All 76 lesions were successfully operated. The technical success rate was 100%, the average operation time was 103.58 ± 18.57 min, the average ablation time of a single lesion was 11.00 ± 4.05 min, and the average ablation power was 43.03 ± 4.45 W. There were no serious complications such as massive bleeding, liver failure, and infection after the operation, except in one case with a small amount of pleural effusion and one case with right upper abdominal pain. The average follow-up time was 13.88 ± 6.62 months. One patient died due to liver failure, and one lesion developed a local recurrence. The local control rate was 98.7%. CONCLUSIONS: MWA of multifocal liver cancer guided by real-time 3.0 T MRI is a safe and feasible technique and has excellent short-term efficacy.

Prognostic value of the SYNTAX score on myocardial injury and salvage in STEMI patients after primary percutaneous coronary intervention: a single-center retrospective observational study.

BACKGROUND: SYNTAX score (SS) was shown to positively correlate with postprocedural myocardial injury in patients after elective coronary artery intervention, but evidence about the association of SS with myocardial salvage in ST-segment elevation myocardial infarction (STEMI) patients is still needed. This study aimed to evaluate the prognostic value of SS for myocardial injury and salvage assessed by cardiac magnetic resonance (CMR) after primary percutaneous coronary intervention (PCI) in STEMI patients. METHODS: This single-center retrospective study consecutively enrolled STEMI patients who had undergone primary PCI within 12 h from symptom onset. Both angiography and CMR were performed during hospitalization, and patients were divided into low SS (SS ≤ 22), mediate-high SS (SS > 22) groups. Correlation and multivariable analyses were performed. RESULTS: A total of 149 STEMI patients (96 low SS, 53 mediate-high SS) were included. In terms of myocardial injury parameters, there was a positive correlation (p < 0.001, Spearman r = 0.292) between SS and infarct size (IS), and a negative correlation (p < 0.001, Spearman r = - 0.314) between SS and myocardial salvage index (MSI). In the multivariable model, SS (> 22 as categorical variable, OR = 2.245, 95% CI [1.002-5.053], p = 0.048; as continuous variable, OR = 1.053, 95% CI [1.014-1.095], p = 0.008) was significantly associated with high IS (≥ mean 35.43). The areas under the receiver operating characteristic (ROC) curves of SS for high IS and low MSI (≤ median 28.01) were 0.664 and 0.610. CONCLUSIONS: In STEMI patients undergoing primary PCI, SYNTAX score positively correlated with infarct size and negatively with myocardial salvage, indicating an independent predictive value of the myocardial injury.

Impact of deep basin terrain on PM2.5 distribution and its seasonality over the Sichuan Basin, Southwest China.

The terrain effect on atmospheric environment is poorly understood in particular for the polluted region with underlying complex topography. Therefore, this study targeted the Sichuan Basin (SCB), a deep basin with severe PM2.5 pollution enclosed by the eastern Tibetan Plateau (TP), Yunnan-Guizhou Plateaus (YGP) and mountains over Southwest China, and we investigated the terrain effect on seasonal PM2.5 distribution and the meteorological mechanism based on the WRF-Chem simulation with stuffing the basin topography. It is characterized that the three-dimensional distribution of topography-induced PM2.5 concentrations over the SCB with the seasonal shift of regional PM2.5 averages from approximately 30 µg m-3 in summer to 90 µg m-3 in winter at surface layer and from summertime 10 µg m-3 to wintertime 30 µg m-3 in the lower free troposphere. Such basin-forced PM2.5 changes presented the vertically monotonical declines concentrated within the lower troposphere below 3.6 km in spring, 2.3 km in summer, 2.6 km in autumn and 4.8 km in winter. Impacts of deep basin aggravated PM2.5 accumulation within the SCB and transport toward the surrounding plateaus contributing approximately 50-90% to PM2.5 levels over the regions of eastern TP and northern YGP. In the SCB, atmospheric thermal structure in the lower troposphere could build a vertical convergence layer between the boundary layer and free troposphere, acting as a lid inhibiting air diffusion, which was regulated by the terrain effects on interactions of westerlies and Asian monsoons, especially the wintertime strong warm lid deteriorating air pollution in the SCB. Furthermore, warm and humid air conditions within the basin prompted sulfur oxidation ratio by +0.02 and nitrogen oxidation ratio by +0.22 effectively producing the secondary PM2.5 in atmospheric environment.