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BackgroundHepatectomy is the recommended option for radical treatment of BCLC stage A/B hepatocellular carcinoma (HCC) that has progressed beyond the Milan criteria. This study evaluated the efficacy and safety of preoperative neoadjuvant transcatheter arterial chemoembolization (TACE) for these patients.MethodsIn this prospective, randomized, open-label clinical study, BCLC stage A/B HCC patients beyond the Milan criteria were randomly assigned (1:1) to receive either neoadjuvant TACE prior to hepatectomy (NT group) or hepatectomy alone (OP group). The primary outcome was overall survival (OS), while the secondary outcomes were progression-free survival (PFS) and adverse events (AEs).ResultsOf 249 patients screened, 164 meeting the inclusion criteria were randomly assigned to either the NT group (n = 82) or OP group (n = 82) and completed follow-up requirements. Overall survival was significantly greater in the NT group compared to the OP group at 1 year (97.2% vs. 82.4%), two years (88.4% vs. 60.4%), and three years (71.6% vs. 45.7%) (p = 0.0011) post-treatment. Similarly, PFS was significantly longer in the NT group than the OP group at 1 year (60.1% vs. 39.9%), 2 years (53.4% vs. 24.5%), and 3 years (42.2% vs. 24.5%) (p = 0.0003). No patients reported adverse events of grade 3 or above in either group.ConclusionsNeoadjuvant TACE prolongs the survival of BCLC stage A/B HCC patients beyond the Milan criteria without increasing severe adverse events frequency.Clinical trial registrationhttps://www.chictr.org.cn/, identifier ChiCTR2200055618.

Astragalus sinicus L. (milk vetch), a versatile plant that has a soil-enriching effect as green manure, is widely planted in the temperate zone of China. In previous experiments, milk vetch incorporated into the soil as green manure showed potential for goosegrass control. However, “what exactly happens at the chemical level?” and “what are the compounds that are potentially responsible for the phytotoxic effects observed during those previous assays?” In a recent study, in vitro phytotoxicity bioassays and chemical analyses of milk vetch decomposition leachates were carried out to explore the relationship between the temporal phytotoxic effects and the dynamics of chemical composition. For that, milk vetch decomposition leachates with a decay time of 12 h, 9 days, 12 days, 15 days, and 18 days were analyzed for organic compounds by liquid chromatography. The main results were as follows: (1) three compounds with goosegrass suppression potential produced during the decomposed process, i.e., 4-ethylphenol, N-acrylimorpholine, and allyl isothiocyanate. 2-Hydroxyethyl acrylate was present in the 12-h decomposition leachates but was at its highest concentration of 127.1 µg ml−1 at 15 days. (2) The cultures were configured according to the four concentrations of goosegrass-resistant active substances measured in the 15-day decomposition leachate and, as with the 15-day decomposition leachate, the mixture cultures inhibited 100% of goosegrass germination at the high concentrations (≥ 30%), which suggests that these substances have goosegrass suppression potential. (3) The high total phenolic content (302.8–532.3 mg L−1), the total flavonoid content (8.4–72.1 mg L−1), and the reducing activity of the decomposition leachates for different decay times may explain why the incorporation of milk vetch into the soil did not lead to peroxidation of goosegrass in the previous study. (4) Finally, the changes in acid fraction and total content (1.9–4.2 mg ml−1) for different decay times explain the variations in pH of the decomposition leachates, which, when discussed in conjunction with previous studies, may lead to changes in soil nutrient effectiveness and consequently affect crop growth. This study can provide a reference for green weed control research.

Astragalus sinicus L. (milk vetch), one of the most widespread green manure species, is widely planted in the temperate zone. Eleusine indica L. (goosegrass), a serious annual weed in the world, has evolved resistance to some non-selective herbicides. The use of milk vetch as green manure for weed control in paddy fields was proposed. Aqueous extracts of milk vetch are known to exert a different level of phytotoxicity on weeds and crops. Phytotoxic substances contained in green manure were released into the soil by leaching at the initial stage and decomposition at the later stage after the return of green manure. Considering the need for searching new sustainable strategies for weed control, a question arises: “if milk vetch could be applied in goosegrass control, which stage is the most important to control goosegrass after milk vetch returned to the field, and at the same time, will the subsequent crop, corn (Zea mays L.), be affected by the side effects from milk vetch phytotoxicity?” In this study, the potential of milk vetch for goosegrass control was approached by repeated laboratory experiments, which include the aqueous extract experiment, decomposed experiment, and pot experiment. The effects of milk vetch returning to the field on maize were simulated by a pot experiment. The extract of milk vetch could significantly inhibit the germination of goosegrass at 2% concentration, and the inhibition enhanced with the increase of concentration. In the decomposed liquid experiment, decay time within 15 days, with the increase of decay days or concentration, goosegrass inhibition effect of decomposed liquid was enhanced. When decay time was more than 15 days, the inhibition ability of the decomposed liquid to goosegrass decreased. According to the RI accumulated value, aqueous extract and decomposed liquid have a “hormesis effect” on the germination and growth of goosegrass. Pot experiment proved that the addition of 1–10% (w/w) of milk vetch significantly reduced the germination and growth of goosegrass. On the contrary, the comprehensive analysis showed that the participation of milk vetch was conducive to the growth of corn. Our results constitute evidence that the incorporation of milk vetch into the soil could be a feasible practice to reduce weed infarctions in the corn-based cropping system.