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Background Both microwave ablation and robot-assisted hepatectomy are representative minimally invasive treatments for early hepatocellular carcinoma. Our study compares the practicability and medium-term therapeutic efficacy between them. Methods Patients with early HCC treated by MWA or RH from 2013 to 2019 were included. Propensity score matching (PSM) and inverse probability of treatment weight (IPTW) were used to minimize baseline imbalance. Operation trauma, postoperative recovery, complications, cost and oncological efficacy were compared. Results 401 patients with a median follow-up of 28 months were included (MWA n = 240; RH n = 161). After PSM, 3-year recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) of MWA group and RH group were 52.2% vs 65.8%, 91.5% vs 91.3% and 91.5% vs 91.3%, respectively. OS and CSS were comparable (p = 0.44 and 0.96), while RFS of MWA was slightly lower but not significant (p = 0.097). The above results after IPTW followed the same trend. After PSM, MWA showed advantages in operation time and blood loss, while RH performed better in postoperative liver function. There was no significant difference in incidence of severe complications between two groups. Conclusions For early HCC parents, both treatments can achieve good, safe and comparable medium-term therapeutic effects. MWA is more minimally invasive, while RH has better accuracy and causes less damage to liver parenchyma.

Several studies have evaluated the association between thermal insulation (TI) and control after surgery, with various research designs, recruitment and exclusion criteria, and measurements. The current meta-analysis aimed to assess the correlation between TI and stroke during recovery from anesthesia.We searched for full-text articles of us of TI during anesthesia recovery in multiple databases including PubMed, Springer, EMBASE and Chinese journal full-text databases. Two reviewers read each article and extracted the relevant data of into a Microsoft Excel table: name of the first author, publication year, year of onset, sample size (TI/control group), patient age range, and other information related to TI patients and control group. The meta-analysis, sensitivity analysis and bias analysis were performed using Review Manager 5.0.A total of 723 patients from 7 studies met the eligibility criteria and were included in the final analysis. The meta-analysis showed that the recovery time after anesthesia in the TI group was significantly different from that in the control group [mean difference (MD) =-7.02, 95% confidence interval (CI): -10.10 to -3.95, P0.00001; P for heterogeneity0.00001, I2=99%], length of stay in Postanesthesia Care Unit (PACU) score [MD =-20.78, 95% CI: -31.32 to -10.24, P=0.0001; P for heterogeneity0.00001, I2=92%] and shivering rate [relative risk (RR) =0.25, 95% CI: 0.08 to 0.77, P=0.02; P for heterogeneity =0.07, I2=71%].TI is an important measure during recovery from anesthesia.

Objective: Thermal ablation poses challenges in the surgical resection (SR) of small hepatocellular carcinoma (HCC), and its therapeutic outcomes for larger lesions remain debated. Methods: This retrospective study evaluated 729 patients with HCC meeting the Milan criteria, who were treated with curative SR or microwave ablation (MWA) between 2008 and 2014. Overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and local tumor progression (LTP) were compared after propensity score matching (PSM). Co-variates associated with OS, CSS, LTP, and DFS were identified. The risk of death and tumor progression were compared. Results: During the median follow-up of 78.6 months, 253 patients were included in each group after PSM. For tumors ≤ 3.0 cm and 3.1–4.0 cm, MWA achieved comparable results in terms of OS, CSS, DFS, and LTP. For tumors 4.1–5.0 cm, MWA had lower OS, CSS, and DFS rates (all P < 0.05) than SR. Higher LTP rates were observed in the MWA group for tumors 4.1–5.0 cm, although the difference was not significant (P = 0.18). Complication rates (P = 0.41) were similar, but MWA led to less estimated blood loss (P < 0.01) and shorter postoperative hospitalization times (P < 0.01). Conclusions: MWA achieved comparable long-term oncologic outcomes with SR for ≤ 4 cm HCC, with lower complication rates and faster recovery.

We updated the experience on percutaneous microwave ablation for renal cell carcinoma with five-center data and long-term follow-up. This retrospective study reviewed the T1N0M0 renal cell carcinoma patients who underwent microwave ablation between April 2006 and December 2019. Clinicopathological and procedural data were collected. Technical effectiveness and complications were assessed, and the Kaplan-Meier method was used for cancer-specific survival, disease-free survival, overall survival, and local neoplastic process analyses. A total of 323 consecutive patients (mean age, 62.9 years ± 14.0) with 371 biopsy-proved tumors (mean diameter, 2.9 cm ± 1.2) were enrolled, and 42.6% of the tumors were located adjacent to collecting system/bowel and technical effectiveness was achieved in 360 (97.0%) tumors. For 275 cT1a patients, during median follow-up time of 66.0 months (IQR, 58.4–73.6), 10-year local neoplastic processes, cancer-specific survival, disease-free survival, and overall survival rates were 1.9%, 87.4%, 71.8, and 67.5%, respectively. For 48 cT1b patients, during the median follow-up time of 30.4 months (IQR, 17.7–44.8), 5-year local tumor progression, cancer-specific survival, disease-free survival, and overall survival rates were 11.3%, 91.4%, 69.1, and 89.2%, respectively. Major complications showed no differences between cT1a (3.5%) and cT1b (6.9%) patients (p = 0.28). A clinical risk stratification system was developed based on multivariable model to predict DFS and CSS with c-indexes of 0.78 (95% CI: 0.71–0.85) and 0.77 (95% CI: 0.65–0.90), respectively. With matured follow-up at five institutions, ultrasound-guided percutaneous microwave ablation is a reliable treatment option for cT1a renal cell carcinoma even in dangerous location and appears to be promising for cT1b tumors. • To our knowledge, this is the first multicenter cohort of long-term oncologic outcomes with percutaneous MWA of cT1 RCC. • The predicting model we developed is accurate to predict the long-term DFS and CSS, which can help to provide a better MWA prognostication over routinely available clinical information. • The available evidence shows that microwave ablation of clinical stage T1 RCC is safe and reliable with promising long-term oncologic outcomes, especially for cT1a RCC with excellent 10-year results.

To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports. A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Six men (median age 72 years) with prostate cancer and one woman (aged 22 years) undergoing oocyte donation presented with PA between 1990 and 2020. Most presented with within 24 h of the first dose, but two developed PA 1 to 5 months after GnRHa initiation. The main clinical manifestations were headache (100%), nausea and vomiting (86%). While no patients had a previously known pituitary tumor, all had imaging demonstrating sellar mass and/or hemorrhage at presentation. Among those surgically treated (5/7), 80% (4/5) of patients had pathologic specimens that stained positive for gonadotropins; the remaining patient’s pathologic specimen was necrotic. At the time of PA, the most common pituitary dysfunction was hypocortisolism. Central adrenal insufficiency and central hypothyroidism were reversible in a subset. Pituitary imaging remained stable. This is the first report of a case series with PA after GnRHa administration with longitudinal follow-up. Although infrequent, PA can be life-threatening and should be suspected among patients receiving GnRHa, with or without a known pituitary adenoma, who develop acute headache, nausea and/or vomiting. Since hypopituitarism was reversible in a subset, ongoing pituitary function testing may be indicated.

ObjectivesWe aimed to compare the therapeutic outcomes of radiofrequency ablation (RFA) and microwave ablation (MWA) as first-line therapies in patients with small single perivascular hepatocellular carcinoma (HCC).MethodsA total of 144 eligible patients with small (≤ 3 cm) single perivascular (proximity to hepatic and portal veins) HCC who underwent RFA (N= 70) or MWA (N= 74) as first-line treatment were included. The overall survival (OS), disease-free survival (DFS), and local tumor progression (LTP) rates between the two ablation modalities were compared. The inverse probability of treatment weighting (IPTW) method was used to reduce selection bias. Subgroup analysis was performed according to the type of hepatic vessels.ResultsAfter a median follow-up time of 38.2 months, there were no significant differences in OS (5-year OS: RFA 77.7% vs. MWA 74.6%;p= 0.600) and DFS (5-year DFS: RFA 24.7% vs. MWA 40.4%;p= 0.570). However, a significantly higher LTP rate was observed in the RFA group than the MWA group (5-year LTP: RFA 24.3% vs. MWA 8.4%;p= 0.030). IPTW-adjusted analyses revealed similar results. The treatment modality (RFA vs. MWA: HR 7.861, 95% CI 1.642–37.635,p= 0.010) was an independent prognostic factor for LTP. We observed a significant interaction effect of ablation modality and type of peritumoral vessel on LTP (p= 0.034). For patients with periportal HCC, the LTP rate was significantly higher in the RFA group than in the MWA group (p= 0.045). However, this difference was not observed in patients with perivenous HCC (p= 0.116).ConclusionsIn patients with a small single periportal HCC, MWA exhibited better tumor control than RFA.Key Points• Microwave ablation exhibited better local tumor control than radiofrequency ablation for small single periportal hepatocellular carcinoma.• There was a significant interaction between the treatment effect of ablation modality and type of peritumoral vessel on local tumor progression.• The type of peritumoral vessel is vital in choosing ablation modalities for hepatocellular carcinoma.

Non-tuberculous mycobacteria are conditional pathogens that can cause many diseases, among which pulmonary infections are the most common (65–90%). Mycobacterium avium and Mycobacterium abscessus are non-tuberculous mycobacteria most often associated with lung diseases. Mass spectrometry diagnostic techniques were not effective in Mycobacterium avium complex infection. We report a case of Mycobacterium colombiense and Mycobacterium avium complex causing severe pneumonia in an adult with HIV. Our group developed a novel molecular-based method to identify Mycobacterium species. Novel techniques such as molecular cloning which we have described here can make up for the inability of matrix-assisted laser desorption ionization-time of flight mass spectrometry to distinguish the multiple microorganisms present, and may add to the diagnostic toolkit and increase the accuracy and rapidity of diagnosis in the future.

Background Symptomatic aseptic necrosis (SAN) followed by nodule rupture is a kind of severe complications after thermal ablation for benign thyroid nodules (BTN). No studies are available to evaluate its pathologic process, clinical manifestations, risk factors and effectiveness of therapies after microwave ablation (MWA). Methods From 2012 to 2019, 398 patients who received MWA for BTN were retrospectively reviewed. Clinical data included baseline patient characteristics, imaging features (internal vascularity and the proportion of the solid component), ablation power and time, complications and prognosis were collected and documented. Results Ten patients (2.51%) experienced post-MWA SAN, eight patients with nodule rupture and the other two without. The mean time from MWA to SAN symptom was 8.6 days and to rupture was 16.3 days. The initial symptoms of SAN patients were neck bulging, swelling and discomfort. Patients would go through nodule rupture once the nodule contents extended into the extrathyroidal area with the discontinuity of the anterior thyroid capsule, and fistula formed unavoidably in this condition. Incision drainage was effective for rupture and early treatment of non-steroidal anti-inflammatory drug might cure the early-stage SAN. Multivariate analysis showed sex (OR = 0.13; 95% CI: 0.03, 0.61; p=.03) was the risk factor leading to SAN and males were more vulnerable to SAN. Conclusion SAN after MWA came earlier and initially illustrated as neck bulging, swelling and discomfort. Early detection and early treatment might prevent the rupture of nodules. Once the breakdown of thyroid capsule occurred, rupture of ablated nodules out of skin was unavoidable and invasive procedures might be the most effective treatment.

Objective This retrospective study aimed to investigate the efficacy and safety of partial ablation (PA) for benign thyroid nodules (BTNs) using microwave ablation (MWA) in a long-term follow-up. Materials and methods Between February 2015 and April 2019, 236 patients with 236 BTNs (maximum diameter ≥2 cm) treated with ultrasound-guided MWA were enrolled. Contrast-enhanced ultrasound (CEUS) was performed within 3 d after ablation to determine whether there was residual tissue according to which the patients were assigned PA or complete ablation (CA). The volume reduction ratio (VRR) and complications were evaluated during follow-up. Results Eighty-two patients were enrolled in the PA group, and 154 were enrolled in the CA group. Both groups achieved continuous reductions in nodule volume and increases in VRR within 2 years after ablation. Although the VRR of the PA group at 4 years was lower than that of the CA group (65.54 vs. 95.08%; p.05). Conclusions Both PA and CA were safe and effective in reducing the volumes of BTNs in the long-term follow-up. For nodules with a large initial volume and dangerous location, PA with a small amount of residual tissue may be acceptable.

To determine whether albumin–bilirubin (ALBI) grade could be used to predict the outcomes of patients with intrahepatic cholangiocarcinoma (ICC) who underwent ultrasound-guided percutaneous microwave ablation (MWA). This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. We studied 52 treatment-naive patients with 74 ICC lesions according to the Milan criteria who subsequently underwent MWA from April 2011 to March 2018. Overall survival (OS) and recurrence-free survival (RFS) were compared in groups classified by Child–Pugh score and ALBI grade, which were statistically analyzed with the log-rank test. Cox proportional hazard regression analyses were used to determine the prognostic factors for survival in patients with ICC. The median follow-up time was 21.2 months (3.2–78.7 months). Seventeen patients died during this period. After MWA, the cumulative 1-, 3-, and 5-year OS rates were 87.4%, 51.4%, and 35.2%, respectively, and the cumulative 1-, 3-, and 5-year RFS rates were 68.9%, 56.9%, and 56.9%, respectively. The major complication rate was 3.8% (2/52). Stratified according to ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 95.5%, 72.4%, and 72.4% for patients with ALBI grade 1 and 62.5%, 40.6%, and 36.3% for patients with ALBI grade 2, respectively, showing a significant difference (P = 0.006). Multivariate analysis results showed that older age (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.11–2.82; P = 0.002), tumor size ≥ 3 cm in diameter (HR: 11.33, CI: 2.24–34.52; P = 0.021) and ALBI grade (HR: 8.23, CI: 1.58–58.00; P = 0.004) may be predictors of poor OS. ALBI grade was validated as a significant biomarker for predicting survival in ICC patients within the Milan criteria who underwent MWA.

Multimedia cloud storage which saves the huge storage overhead of local devices has attracted considerable attention. However, due to the lack of physical control of data, the privacy protection of data on the multimedia cloud has become one of the main concerns of users. Public-key encryption with keywords search (PEKS) is a technique that can keep the privacy and searchability of data in the cloud. In this paper, we present a PEKS with time-controlled proxy re-encryption model which allows the data owner to delegate the access right of the encrypted multimedia database to other users, to achieve the time-controlled multi-user search. Furthermore, it is designed to resist keywords guessing attack and support conjunctive keywords search. Compared with previous works which require a time server to generate a time seal for the generation of the search token, this model embeds the time information of accessing the encrypted database into public and secret key pairs of data users, which saves the managing overhead and reduces the security risks resulting from an extra server. In addition, most existing PEKS schemes were constructed based on the hardness of classical mathematical problems which can be broken by quantum computers. To address this issue, a lattice-based PEKS scheme based on the above model is proposed, which can be considered as the candidate for protecting multimedia data security in the quantum era.

To analyze the influence of tumor location, including tumor adjacency and located segments on long-term survival outcomes for patients with solitary hepatocellular carcinoma (HCC) after microwave ablation (MWA). This retrospective study evaluated 850 patients. The hepatic segments where the tumor is located, tumor adjacency (important tissues adjacent to tumor) and other clinical characteristics were collected. Overall survival (OS), local tumor progression (LTP) and disease-free survival (DFS) were compared and analyzed. Influence of tumor location was evaluated by multi-models and the effect of adjacency for OS, LTP, and DFS in different segments was analyzed by stratification analysis. The OS, LTP, and DFS rates were similar in different hepatic segments, so were in high risk and safe locations. In multi-models, HCC in segment 8 showed lower death rate of 43% than that in segment 2 (HR 0.57; P = 0.01) and tumors in segment 6 seemed to have lower LTP rate. Tumors in high-risk locations were risk factors for OS, LTP, and DFS compared with tumors in safe locations, but all differences were not significant in different models. The effects of tumor adjacency on survival outcomes among subgroups of segments were limited. The tumor adjacency was not a prognostic factor of survival outcomes for patients with solitary tumors after MWA, but tumors in segment 8 seemed to better OS rate than tumors in other segments.

Objective: To explore the association between cholecystectomy and the prognostic outcomes of patients with hepatocellular carcinoma (HCC) who underwent microwave ablation (MWA). Methods: Patients with HCC (n = 921) who underwent MWA were included and divided into cholecystectomy (n = 114) and non-cholecystectomy groups (n = 807). After propensity score matching (PSM) at a 1:2 ratio, overall survival (OS) and disease-free survival (DFS) rates were analyzed to compare prognostic outcomes between the cholecystectomy (n = 114) and non-cholecystectomy groups (n = 228). Univariate and multivariate Cox analyses were performed to assess potential risk factors for OS and DFS. Major complications were also compared between the groups. Results: After matching, no significant differences between groups were observed in baseline characteristics. The 1-, 3-, and 5-year OS rates were 96.5%, 82.1%, and 67.1% in the cholecystectomy group, and 97.4%, 85.2%, and 74.4% in the non-cholecystectomy group (P = 0.396); the 1-, 3-, and 5-year DFS rates were 58.4%, 34.5%, and 26.6% in the cholecystectomy group, and 73.6%, 44.7%, and 32.2% in the non-cholecystectomy group (P = 0.026), respectively. The intrahepatic distant recurrence rate in the cholecystectomy group was significantly higher than that in the non-cholecystectomy group (P = 0.026), and the local tumor recurrence and extrahepatic recurrence rates did not significantly differ between the groups (P = 0.609 and P = 0.879). Multivariate analysis revealed that cholecystectomy (HR = 1.364, 95% CI 1.023-1.819, P = 0.035), number of tumors (2 vs. 1: HR = 2.744, 95% CI 1.925-3.912, P < 0.001; 3 vs. 1: HR = 3.411, 95% CI 2.021-5.759, P < 0.001), and γ-GT levels (HR = 1.003, 95% CI 1.000-1.006, P < 0.024) were independent risk factors for DFS. The best γ-GT level cut-off value for predicting median DFS was 39.6 U/L (area under the curve = 0.600, P < 0.05). A positive correlation was observed between cholecystectomy and γ-GT level (r = 0.108, 95% CI -0.001-0.214, P = 0.047). Subgroup analysis showed that the DFS rates were significantly higher in the non-cholecystectomy group than the cholecystectomy group when γ-GT ≥39.6 U/L (P = 0.044). The 5-, 10-, 15-, 20-, and 25-year recurrence rates from the time of cholecystectomy were 2.63%, 21.93%, 42.11%, 58.77%, and 65.79%, respectively. A significant positive correlation was observed between cholecystectomy and the time from cholecystectomy to recurrence (r = 0.205, 95% CI 0.016-0.379, P = 0.029). There were no significant differences in complications between groups (P = 0.685). Conclusions: Patients with HCC who underwent cholecystectomy were more likely to develop intrahepatic distant recurrence after MWA, an outcome probably associated with increased γ-GT levels. Moreover, the recurrence rates increased with time.

To evaluate the clinical efficacy of microwave ablation (MWA) of benign breast lesions (BBLs) and compare the learning curves of international radiologists (IRs) and surgeons. In total, 440 patients with 755 clinicopathologically confirmed BBLs from 5 centers were prospectively enrolled from February 2014 to July 2018. Technical success, complications, volume reduction ratio (VRR), palpability, and cosmetic satisfaction after ablation were analyzed. In addition, the ablation time (AT) and energy (AE) with the number of procedures were analyzed for learning curve evaluation. The mean maximum diameter was 1.7 ± 0.6 cm. The complete ablation rate reached 100%, including 45.8% lesions adjacent to the skin, pectoralis, or areola. After a median follow-up of 13.7 months, the 12-month VRR of all lesions was 97.9%, and that for 1.0- to 2.0-cm and ≥ 2.0-cm lesions was 98.6% and 96.9%, respectively. A total of 55.9% of BBLs became nonpalpable (palpable in 85.7% of cases before MWA) by both the clinician and patient. The cosmetic and minimally invasive satisfaction rates were good or excellent in 98.4% and 94.5% of patients, respectively. The median AT/cm3 and AE/cm3 decreased as experience increased. The AE/cm3 of the IR with 5 years of experience was lower than that of the IR with 1 year of experience and the surgeons, while the AT/cm3 of surgeons was comparable with that of the IR with 5 years of experience at relatively mature phase. Ultrasound-guided percutaneous MWA is a valuable technique for the treatment of BBLs. Trial registration: ClinicalTrials.gov (NCT02860104) • Ultrasound-guided percutaneous microwave ablation has the potential to become a valuable technique for the treatment of benign breast lesions. • A skilled interventional radiologist shows a rapid improvement in mastering the technique.

Ya Sun,1,2,* Shuo Yang,3,* Erpeng Qi,1 Fangyi Liu,1 Fubo Zhou,1 Yuhan Lu,1 Ping Liang,1 Huiyi Ye,4 Xiaoling Yu1 1Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People’s Republic of China; 2Department of Ultrasound, Aerospace Central Hospital, Beijing 100049, People’s Republic of China; 3Chinese PLA Medical School, Beijing, 100853, People’s Republic of China; 4Radiology Department, Chinese PLA General Hospital, Beijing 100853, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoling YuDepartment of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, People’s Republic of ChinaEmail dyuxl301@aliyun.comPurpose: The purpose of our study was to evaluate the role of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) and computed tomography (CT) in the pathological diagnosis of pancreatic cystic neoplasms (PCNs).Methods: A total of 90 patients (66 women, 24 men) aged 18– 71 years were studied prospectively. CEUS was performed in all patients, whereas MRI was performed in 85 patients and CT in 69 patients. We analyzed the sensitivity and accuracy of these three imaging modalities to diagnose the PCNs. Neoplasm size, location, shape, intralesional mural nodules, septa and duct dilatation were also assessed by different radiologists.Results: There were no significant differences in sensitivity for discriminating PCNs from pancreatic cystic lesions between CEUS and MRI (p=0.614) or between CEUS and CT (p=0.479). The diagnostic accuracy of CEUS for classifying PCNs was 64.4% (58/90), which was higher than that of CT (53.6%, 37/69, P=0.017), and lower than that of MRI (70.6%, 60/85, p=0.791). Regarding tumor size for lesions larger than 3 cm, CEUS was superior to CT in differentiating the specific type of PCN (p=0.041), and CEUS had the same value as MRI (p=0.774). Furthermore, CEUS is valuable for precisely characterizing internal structures, for instance, septa (p=0.003, compared with CT; p=0.443, compared with MRI) and nodules (p= 0.018, compared with CT; p=0.033, compared with MRI). The number of septa (p=0.033) and cyst morphology (p=0.016) were meaningful indicators in differentiating serous and mucinous adenoma. There was no significant difference in evaluating size and detecting duct dilatation among the three imaging methods.Conclusion: CEUS compares favorably with MRI in displaying the inner structure of PCNs and offers advantages over CT. CEUS can contribute in an important way to the diagnosis of pancreatic cystic neoplasms.Keywords: contrast-enhanced ultrasound, computed tomography, magnetic resonance imaging, pancreatic cystic neoplasms, diagnostic evaluation

Objective: To determine the cause and high-risk factors for the development of intestinal fistulas (IFs) after ultrasound-guided microwave ablation (MA) of abdominopelvic lesions, and to identify effective prophylactic and therapeutic actions.Methods: Clinical data were collected from patients with an IF after ultrasound-guided MA of abdominopelvic lesions in our hospital from January 1, 2010 to December 31, 2018. The cause, diagnosis, and treatment of IFs in these patients were analyzed.Results: Among 8,969 patients who underwent ultrasound-guided MA of abdominopelvic lesions, eight patients developed IF after MA, Seven patients were discharged after being cured and one died.Conclusion: Abdominopelvic lesions are close to the intestines, so histories of surgery, radiotherapy, and abdominopelvic infection are high-risk factors for IF development after MA of these lesions. Surgical treatment should be provided as soon as an IF is identified.

In this study, we investigated suitable habitats for the endangered tree fern, Sphaeropteris lepifera (J. Sm. ex Hook.) R.M. Tryon, based on fieldwork, ecological niche modeling, and regression approaches. We combined these data with the characterization of spore germination and gametophytic development in the laboratory to assess the reasons why S. lepifera is endangered and to propose a conservation strategy that focuses on suitable sites for reintroduction and accounts for the ecology and biphasic life cycle of the species. Our methods represent an integration of process- and correlation-based approaches to understanding the distributional patterns of this species, and this combined approach, while uncommonly applied, is a more robust strategy than either approach used in isolation. Our ecological niche models indicated that cold temperature extremes, temperature stability over long- and short-terms, and the seasonality of precipitation were among the most important abiotic environmental factors affecting the distribution of S. lepifera among the variables that we measured. Moreover, distribution of this fern species is also strongly influenced by the timing of development of male and female gametes. Additionally, we observed that slope aspect, specifically south-facing slopes, facilitates more incoming sunlight for mature trees, and simultaneously, provides greater, much-needed shade for fiddleheads on account of the canopy being denser. We believe that our study can provide important guidance on the restoration of S. lepifera in the wild. Specifically, potential restoration areas can be screened for the specific environmental factors that we infer to have a critical impact on the survival of the species.

In the era of network information, the construction and application of Japanese teaching models are facing many difficulties and shortcomings. Internet-based Japanese interactive teaching is a brand-new teaching model, forming in-class and out-of-class, online and offline, independent learning and classroom teaching, which is the interactive complement of other teaching links. This article is designed based on the ideas and methods of software engineering, and provides solutions for the development of Japanese interactive network teaching platform. First, use the case diagram to analyze the requirements and determine the basic functions of the platform; then, use the module structure diagram to go through the functional design, and refine the software functions determined in the requirements analysis stage; finally, the Struts2 architecture is studied to describe the components’ responsibilities and collaborative behaviors between them to improve the efficiency of software development.

The bilingual parallel corpus has the closest relationship with translation teaching. It provides abundant teaching resources and convenient teaching methods, which is conducive to the formation of relatively stable translation skills in a large number of practices. In order to carry out college Japanese translation teaching based on parallel corpus, three subsystems including parallel corpus function, corpus management, query statistics and user management, as well as several functional frameworks under each sub-subsystem are designed; the inverted index file of parallel corpus is designed which is used to improve retrieval efficiency; specific application strategies are proposed: select language materials in a standardized manner, increase language input in the teaching process, cultivate students' technical awareness, apply students’ typical mistakes or translated works to teaching feedback, and make good marks of corpus work with alignment, carry out corpus-based translation collocation teaching, and cultivate students' autonomous learning ability.

Background Psoriasis is a chronic immune‐mediated skin disorder. Systemic inflammation plays an important role in the pathogenesis of psoriasis. Methods A total of 477 patients with psoriasis vulgaris (PsV, n = 347), generalized pustular psoriasis (GPP, n = 37), erythrodermic psoriasis (PsE, n = 45), arthritic psoriasis (PsA, n = 25) and mixed psoriasis (n = 23), and 954 healthy control subjects were included in the study. Demographic, clinical, and laboratory information were collected and compared between subgroups. Results Compared with the healthy control group, patients with psoriasis had higher total white blood cell (WBC), neutrophil, platelet counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), but lower hemoglobin (Hb) levels, lymphocyte and red blood cell (RBC) counts. NLR values in the PsV group were significantly lower than those in the GPP, PsE, and PsA groups, with GPP group being the highest. PLR values in the PsV group were significantly lower than those in the GPP, PsE, and PsA groups. There was no significant correlation between the psoriasis area severity index (PASI) score and either the NLR or PLR in the PsV group. Conclusions Elevated NLR and PLR were associated with psoriasis and differed between subtypes, suggesting that they could be used as markers of systemic inflammation in psoriasis patients.

Purpose Our purpose is to assess the efficacy and safety of percutaneous US-guided microwave ablation (MWA) for cervical metastatic lymph nodes from papillary thyroid carcinomas (PTC). Methods In total, 37 patients with 98 cervical metastatic lymph nodes from PTC were enrolled in this retrospective study. Among them, 8 had subtotal thyroidectomy, 4 lobectomy, 2 no operation, and the rest total thyroidectomy. A multipoint and multiplane fixed ablation method was used. Monitoring of ablation process and clinical follow-up consisted of US or CEUS. Results All 98 metastatic lymph nodes successfully treated in a single session with 100% complete ablation. The average longest and shortest diameter of the tumors were reduced from 13.21 ± 5.86 mm to 6.74 ± 5.66 mm (p =.00) and from 9.29 ± 4.09 mm to 4.31 ± 3.56 mm (p =.00) at the final follow-up. There were no evidence of recurrence at ablated sites. The common intraoperative complications were a burning sensation and pain. Only 3 patients had vagal reflex. Conclusions US-guided MWA can effectively control cervical metastatic lymph nodes from PTC. MWA may become an alternative therapy in selected PTC patients with cervical lymph node metastasis.

Purpose To identify the beneficial body mass index (BMI) for patients with hepatocellular carcinoma (HCC) to achieve longer survival time following curative microwave ablation (MWA). Methods This retrospective study evaluated 474 patients with solitary primary HCC who underwent MWA. BMI at initial admission and other characteristics were collected. The associations of the BMI with the overall survival (OS) and disease-free survival (DFS) were analyzed by Cox proportional hazards regression analysis in multiple models. A two-piecewise linear regression model was applied to examine the threshold effect of the BMI on OS and DFS by maximized log likelihood method. The threshold level was determined by using trial and error. Results Patients with a normal BMI range achieved improved survival outcomes but similar DFS in multiple models. In the model with adjustments of the age, size, and Charlson score, patients with BMI ≤ 22.9 and ≤24.9 kg/m2 exhibited a lower death rate than patients with BMI ≤18.5 kg/m2 (p

Purpose To compare acute kidney injury (AKI) incidence between nephron sparing surgery (NSS) and microwave ablation (MWA) for T1a RCC patients, reveal the effect of AKI on survival prognosis, construct AKI nomogram and use Law of Total Probability for survival probability (SP) prediction. Materials and methods Patients were studied retrospectively after NSS (n = 1267) or MWA (n = 210) from January 1, 2011 to June 30, 2017. Using one to one Propensity Score Matching (PSM), 158 pairs of patients were identified for the cohort study. AKI incidence, risk factors and impact on survival outcomes were analyzed using Chi-square test, logistic and cox regression analysis. AKI risk and SP were predicted by nomogram and Law of Total Probability. The performance of the nomogram was assessed with respect to its discrimination, calibration, and clinical usefulness. Results AKI occurred more commonly in NSS (27.85%) cohort, when compared to MWA (17.72%) cohort (p = 0.032), but treatment modality was not independently predictive of AKI occurrence (odds ratio [OR]: 0.598; 95% confidence interval [CI]: 0.282–1.265; p = 0.178). The 5-yr overall survival (OS) was lower in AKI patients (73.5%) compared with non-AKI patients (94.8%; p 0.86, excellent calibration and net benefits at the decision curve analysis with probabilities ≥5%. SP predicted by Law of Total Probability was comparable to actual OS. Conclusion AKI was an early indicator for poor overall survival in RCC patients. It can be predicted by several oncological parameters. Nomogram and Law of Total Probability can accurately predict AKI risk and SP.

Objective Hepatocellular carcinoma (HCC) is a notable threat to the longevity of elderly people. However, there is no trial to study the prognosis of these elderly patients after microwave ablation (MWA) treatment. This study investigated whether elderly patients with HCC benefit from MWA similar to younger patients. Materials and methods Patients who underwent ultrasound-guided percutaneous MWA were included and divided into four age groups and the prognosis was compared. The senior group (Group S, ≥75 years) was then compared with the younger group (Group Y

Infectious diseases are a type of disease caused by pathogenic microorganisms. Although the discovery of antibiotics changed the treatment of infectious diseases and reduced the mortality of bacterial infections, resistant bacterial strains have emerged. Anti‐infective therapy based on aetiological evidence is the gold standard for clinical treatment, but the time lag and low positive culture rate of traditional methods of pathogen diagnosis leads to relative difficulty in obtaining the evidence of pathogens. Compared with traditional methods of pathogenic diagnosis, next‐generation and third‐generation sequencing technologies have many advantages in the detection of pathogenic microorganisms. In this review, we mainly introduce recent progress in research on pathogenic diagnostic technology and the applications of sequencing technology in the diagnosis of pathogenic microorganisms. This review provides new insights into the application of sequencing technology in the clinical diagnosis of microorganisms.

Background: The treatment of abdominal wall metastasis presents a challenge, because resection can be followed by poor healing and external radiotherapy is associated with serious adverse ...

To evaluate the effects of ablation strategies on local tumor progression (LTP) after microwave ablation (MWA) of hepatocellular carcinomas (HCCs) measuring 3–5 cm. Between December 2011 and May 2017, 71 HCC patients with 71 nodules treated by ultrasound(US)-guided percutaneous MWA were divided into parallel (group A) and crossed (group B) antenna placement groups. All patients underwent MWA using two antennas with four insertions. LTP and overall survival (OS) rates were compared between the two groups. The median follow-up time was 16.8 months. There was no significant difference in the complete ablation rate and treatment sessions between the two groups. LTP was diagnosed in 8 of 48 nodules (16.7%) in group A and 1 of 23 nodules (4.3%) in group B, with no significant difference between two groups (P = 0.115). The 1-, 2-, and 3-year OS rates were 88.5%, 79%, and 71.8% in group A and 93.8%, 87.5%, and 87.5% in group B, respectively (P = 0.236). Multivariate analysis showed that the tumor diameter (P = 0.017), the distance between the antennas (P = 0.032), and the total emission time (P = 0.015) were associated with LTP. There were trends with lower LTP and improved OS in group B, despite the lack of statistically significant differences between the two strategies at a level of P

Secukinumab, a full human immunoglobulinG1κ(IgG1κ) monoclonal antibody that targets interleukin-17A, has demonstrated remarkable efficacy and appreciable tolerance in patients with moderate-to-severe psoriasis. However, data on its real-life performance, particularly on drug survival in China are limited. To investigate the efficacy, safety, and drug survival of secukinumab in Chinese patients with psoriasis, we conducted a monocentric retrospective study of 66 patients with moderate-to-severe psoriasis to followed-up for 52 weeks. At week 12, 86.4%, 57.6%, and 10.6% of the patients attained 75% improvement in Psoriasis Area and Severity Index (PASI) score from baseline (PASI 75), PASI 90, and PASI 100 responses, respectively. The quality of life of patients markedly improved. The overall survival rate was 74.2%. Adverse events (AEs) occurred in 30 patients (45.5%). The results revealed favorable efficacy, safety, and tolerability of secukinumab in the treatment of patients with psoriasis and provided data on drug survival in real-life clinical setting in China for the first time. This article is protected by copyright. All rights reserved.

Objective: To retrospectively review the safety and efficacy of ultrasound (US)-guided percutaneous microwave ablation (MWA) of bilateral renal cell carcinomas (BRCCs). Patients and Methods: In this study, eight patients of BRCCs with 20 lesions seen from November 2012 to October 2018 were enrolled retrospectively. The patients were treated with US -guided percutaneous MWA and were followed up with contrast-enhanced US and computed tomography or magnetic resonance imaging. Results: Technical success was achieved 20 tumors. The 18 lesions were performed to ablate 90%; 2 lesions were repeated because of detecting residual ablated tumor. Except six patients were noted fever, no severe complications occurred. The median follow-up time was 24 months (range 7–59 months). Among the eight patients, there was no local tumor recurrence in 6 of 8 completely ablated tumor lesions. One patient was retreated by MWA 6 months after ablation, and another was retreated after 19 months due to local tumor recurrence. No patients have obvious change of renal function and lost their life. Conclusion: US-guided percutaneous MWA is a beneficial treatment for BRCC.

Operating condition detection and fault diagnosis are very important for reliable operation of reciprocating compressors. Machine learning is one of the most powerful tools in this field. However, there are very few comprehensive reviews which summarize the current research of machine learning in monitoring reciprocating compressor operating condition and fault diagnosis. In this paper, the recent application of machine learning techniques in reciprocating compressor fault diagnosis is reviewed. The advantages and challenges in the detection process, based on three main monitoring parameters in practical applications, are discussed. Future research direction and development are proposed.

PurposeTo compare the therapeutic outcomes between open surgical resection (OSR) and percutaneous microwave ablation (PMWA) for colorectal liver metastasis (CRLM) ≤3 cm.MethodsIn this retrospective study, 200 consecutive patients with 306 CRLMs were reviewed. Overall survival (OS), disease-free survival (DFS), local tumour progression (LTP), intrahepatic distant recurrence, and extrahepatic metastasis were analysed to compare the therapeutic efficacy. Cox proportional hazards regression analysis was used to identify the prognostic factors for OS and DFS. Major complications and postoperative hospital stay were also assessed.ResultThe 1-, 3-, and 5-year OS rates were 91.6%, 64.1%, and 46.3%, respectively, in the PMWA group and 89.7%, 62.4% and 44.7%, respectively, in the OSR group (P=0.839). The 1-, 3-, and 5-year DFS rates were 61.9%, 44.8%, and 41.3%, respectively, in the PMWA group and 58.1%, 24.4%, and 18.3%, respectively, in the OSR group (P =0.066). The two groups had comparable 5-year cumulative rates of intrahepatic distant recurrence (P=0.627) and extrahepatic metastasis (P=0.884). The 5-year cumulative LTP rate was lower in the OSR group than in the PMWA group (P=0.023). The rate of major complications was higher in the OSR group than in the PMWA group (P =0.025), and the length of hospital stay after treatment was shorter in the PMWA group (PConclusionThere were no significant differences in OS or DFS between the two groups. PMWA was associated with increased LTP, fewer postoperative days and fewer major complications.

The individual decision-making reference of Microwave ablation (MWA) for T1a RCC treatment is not clear, and it may not benefit all the patients equally. Therefore, we quantitatively evaluated the distinct survival benefits of patients with T1a RCC stratified by survival predictors.A total of 237 patients with T1a RCC who underwent MWA over the last 16 years were retrospectively reviewed for survival benefit analysis. Cox proportional hazard models were used to control for the prognostic variables of OS, CSS, and PFS. Survival rates were calculated using the Kaplan-Meier method and compared by log-rank analysis. Linear extrapolation was used to compute median survival periods.The OS benefit was significantly dependent on age (HR:2.499, 95% CI: 1.245-5.016, p = 0.010) and age-adjusted Charlson comorbidity index (CCI) score (HR:3.956, 95% CI, 1.409-11.110, p = 0.009). OS in patients aged75 years or with an age-adjusted CCI score7 was significantly prolonged (44.68, 65.55 months) compared to OS in patients aged ≥75 years or with CCI score ≥7 (p 0.001 for both). PFS benefit was significantly dependent on age-adjusted CCI (HR:3.325, 95% CI, 1.390-7.956, p = 0.007), patient type (HR:0.4, 95% CI, 0.214-0.745, p = 0.004), and tumour growth pattern (HR:12.562, 95% CI, 1.552-101.696, p = 0.018). PFS in incipient patients was significantly prolonged (33.75 months) compared to that in the relapsed patients (p = 0.037). Patients with an age-adjusted CCI score7 or without tumour protruding into the renal pelvis, lived free from recurrence or metastasis (55.69 or 101.61 months) longer than that in patients with an age-adjusted CCI score ≥7 or with tumour protruding into the renal pelvis (p 0.01 for both). None of the variables was associated with CSS benefit.The OS and PFS benefits from MWA were not equal for all T1a RCC patients. Age ≥75 years and age-adjusted CCI ≥ 7 significantly shortened OS. Age-adjusted CCI ≥ 7, relapsed RCC, and RCC protruding into the renal pelvis significantly shortened the PFS period. For a better survival prognosis, appropriate patient triage is still needed.

Hepatocellular carcinoma (HCC) is a cancer with a poor prognosis and a low survival rate. Previous studies have found that microRNA-1266 (miR-1266) is associated with tumorigenesis and progression of several types of cancer, such as breast cancer and gastric cancer. The aim of the present study was to investigate the effects of miR-1266 on the clinical prognosis and biological behavior of HCC. For this purpose, reverse transcription-quantitative PCR was used to detect the expression of miR-1266 in HCC tissues and HCC cell lines. In addition, Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the prognostic value of miR-1266. Cell Counting Kit-8 (CCK-8) and Transwell assays were used to analyze the effect of miR-1266 on the biological behavior of cells. The aforementioned assays demonstrated that the examined HCC tissues had a significant upregulation of miR-1266 expression compared with normal tissues (P

The survival of children with recurrent hepatoblastoma (RHB) is still unsatisfactory and the treatment for relapsed patients is challenging. To compare short-term results between open liver resection (OLR) and percutaneous thermal ablation (TA) in the treatment of RHB and provide evidence to support the treatment options for such patients. A retrospective data of 21 patients with RHB in two Chinese centers were analyzed from January 2013 to May 2019. The baseline indicators and clinical effect of the two groups of children were compared. There was no statistical difference in baseline indicators between the two groups of children, and complete remission (CR) was achieved after comprehensive treatment. The median follow-up time was 30 months (IQR 38.5 months) in the TA group, and 23 months (IQR 21.7 months) in OLR group (p = .57). The 2-year OS rates were 92.3% in the percutaneous TA group and 87.5% in the OLR group (p = .68, HR = 1.6, 95% confidence interval [CI]: 0.2–12.4). The 2-year EFS rates were 66.7%, in the TA group and 50.0% in the OLR group (p = .51, HR = 0.6, 95% CI: 0.2–2.6). Compared with the OLR group, TA group had shorter operation time (3.5 ± 1.8 vs. 0.5 ± 0.1, p < .001) and postoperative hospitalization time (11.8 ± 3.0 vs. 9.5 ± 6.8 d, p = .045). No major complications occurred in both groups. Ultrasound-guided percutaneous TA for RHB is a safe and effect treatment option for children. It has comparable effect with surgery within 2 years after treatment. Particularly, due to its minimally invasive advantage, it needs shorter operation and hospitalization time. Percutaneous ablation may be an alternative minimally invasive treatment for RHB children.

Purpose: To investigate the accuracy and robustness of machine learning(ML) model using clinical data extracted directly from electronic health records for predicting the recurrence risk after microwave ablation(MWA). Methods: Between August 2005 and December 2019, 1574 HCC patients who subsequently underwent MWA from four hospitals were reviewed. Data were assigned to the training, internal and external validation set, respectively. Apart from traditional logistic regression(LR), three ML models including (Random Forest, Support Vector Machine and eXtreme Gradient Boosting[XGBoost]) were built and validated in the predictive ability with area under receiving operator characteristic (AUC). SHapley Additive exPlanations (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME) algorithm were performed to realize their interpretability. Results: After 26.2 months of median follow-up period(interquartile range, 6.3, 160.7 months), 51.9%(817/1574) patients occur recurrence. The predictive abilities of three ML models outperformed LR (P < 0.05 for all). When 9 variables were trained simultaneouly using recursive feature elimination with cross-validation, the XGBoost model achieved top predictive ability with AUC value (0.75, 95% CI [confidence interval]: 0.72-0.78) in training set, (0.74, 95% CI: 0.69-0.80) in internal set and (0.76, 95% CI: 0.70-0.82) in external validation set among all models, and it was interpreted depending on the visualization of risk factors by the SHAP and LIME algorithms. The predictive system of post-ablation recurrence risk stratification was provided on online (http://114.251.235.51:8001/) based on XGboost analysis. Conclusions: The XGBoost model based on clinical data can effectively predict recurrence risk after MWA, which can contribute to surveillance, prevention and treatment strategies for HCC. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: This retrospective, multi-center study protocol was approved by the Ethics Committee of all participating institutions

Ethnopharmacological relevance Clinical trials have demonstrated that Trametes robinophila Murr (Huaier granule) can inhibit recurrence and metastasis after hepatocellular carcinoma (HCC) resection, but its efficacy as an adjuvant therapy after thermal ablation of early HCC is unknown. Aim of the study To analyze the prognostic value and side effects of Huaier granules in HCC patients undergoing thermal ablation. Materials and methods Clinical information from 340 eligible subjects with early-stage HCC who were admitted to our department from September 1, 2008 to January 1, 2019 was extracted from the electronic medical record database. They were divided into the thermal ablation + TCM group and the thermal ablation group. Differences in their overall survival (OS), progression-free survival (PFS), extrahepatic metastatic rate (EMR), and therapeutic side effects (TSEs) between the two groups were compared. Beneficiaries of the integrated treatment and adequate treatment length were predicted. Results The median follow-up was 32.5 months (range 2–122 months). The 1-year, 3-year and 5-year OS rates in the integrated treatment group and the control group were 93.2% vs. 92.6%, 54.5% vs. 51.4% 23.5% vs. 19.7% (P = 0.110, HR 0.76(0.54–1.07)). The 1-year, 3-year and 5-year PFS rates were 78.8% vs. 69.4%, 50.6% vs. 40.6%, 35.3% vs. 26.5%, respectively (P = 0.020, HR 0.67(0.48–0.94)). The median OS (35 vs. 31 months) and PFS (24 vs. 12.5 months) were longer in the integrated treatment group. The EMR in the integrated treatment group was significantly lower than that in the control group (p = 0.018, HR 0.49 (0.27–0.89)). Patients with any two of the following three factors might be predicted to be beneficiaries of the integrated treatment, including younger than 65 years (p = 0.039, HR 0.704 (0.504–0.983)), single tumor (p = 0.035, HR 0.698 (0.499–0.975), and tumor size ≤3 cm (p = 0.029, HR 0.690 (0.495–0.964). Patients with continuous oral administration of TCM following ablation had a lower probability of recurrence and metastasis within 2 years (p = 0.015, HR 0.67 (0.49–0.93)). Although the integrated treatment group reported a higher incidence of nausea and emesis, there were no significant differences between the two groups. Conclusion TCM following ablation may prolong PFS and suppress recurrence in patients with HCC, with continuous oral administration for more than 2 years maybe experience a greater benefit. The TSEs of the treatment are mild and can be tolerated.

As the increasingly prominent environmental problems caused by energy development and the urgent need for high-quality power supply, renewable energy and DC distribution network technologies have been rapidly developed. A large number of applications of converter products will inevitably become a development trend. The test technology of converters should also receive more attention. This paper designs a scheme of multi-functional converter electrical tests system based on full/half bridge hybrid MMC technology, and verifies the feasibility of its function based on digital simulation. It can conveniently meet the electrical test requirements of DC/DC converters, DC/AC and AC/DC converters (single-phase and three-phase). And based on its own characteristics, it can meet the test requirements of unidirectional converter and bidirectional converter.

Mobile learning has the characteristics of portability, personalization, real-time and interaction, which brings new opportunities for the development of modern education. Traditional college Japanese teaching has the characteristics of exam-oriented education, and cannot meet the needs of higher education that keeps pace with the times and changes. Develop a university Japanese learning resource platform to provide rich resources for Japanese university Japanese learning, and improve the individuality and autonomy of students. This article designs the basic SSI framework structure, taking advantage of the combined advantages of Struts2, Spring, and iBatis. Based on previous research results, it designed a university Japanese learning resource platform structure composed of a user layer, a function layer, and a data layer. Based on a collaborative filtering model, it designed a personalized learning resource recommendation algorithm and process. The research results of this paper provide a complete solution for the development of a university Japanese mobile learning resource platform, which can reduce the risk of system requirements and improve development efficiency

This study aimed to investigate the predictive power of the combination of Systemic Immune-Inflammation Index (SII) and albumin-bilirubin (ALBI) grade in prognosis outcomes of early-stage hepatocellular carcinoma (HCC) after thermal ablation.This retrospective study was reviewed and approved by our institutional review board, and written informed consent was obtained from each patient. According to the Milan criteria, a total of 405 treatment-naïve patients with clinicopathologically confirmed HCC were enrolled who subsequently underwent thermal ablation from 2011 to 2016. The outcomes of overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were statistically analyzed.The median follow-up time of this study was 45.1 months (range, 1.3-83.2 months). After thermal ablation in patients with SII-ALBI Grades 1, 2, and 3, the cumulative 5-year OS rates were 81.7%, 63.2%, and 26.9%; the 5-year CSS rates were 82.4%, 67.5%, and 26.9%; and the 5-year RFS rates were 49.3%, 44.6%, and 25.3%, respectively (all P0.001). On multivariate Cox regression analyses, SII-ALBI was independently associated with the three outcomes after adjustment for various confounders (all P0.05). In addition, SII-ALBI played a predictive role in OS, CSS, and RFS for patients with negative alpha-fetoprotein (AFP) (P0.05). Compared with SII and ALBI, the AUCs for the prediction of OS and CSS using SII-ALBI were superior to single indicator (bothP0.05).Elevated preablation SII-ALBI is associated with shorter OS, CSS, and RFS in patients with early-stage HCC. Our indicator showed the potential to be a supplement tool for patients with negative AFP during follow-up.

Context: Microwave ablation (MWA) has been proven as a promising method to treat solid tumors. Aims: This study aims to evaluate the efficacy and safety of ultrasound (US)-guided MWA for treating adrenal metastasis and to explore the factors affecting survival. Settings and Design: This was a retrospective study performed on patients treated at our department. Subjects and Methods: A total of 43 patients with adrenal metastasis (22 hepatocellular carcinoma, eight renal cell carcinoma, five non-small cell lung cancer, four colorectal cancer, three liposarcoma, and one malignant fibrous histiocytoma) were enrolled. All patients were treated at our department at least once. The treatment protocol for each patient, the technique used, and the survival details were recorded. Statistical Analysis Used: Statistical analyses were performed using SPSS 26.0 software. Results: Technical success was achieved in all cases. MWA was a safe technique for treating all types of metastasis. No major complications were observed. The pathology of adrenal lesions was the significant risk factor contributing to overall survival (OS) (P = 0.040). The 1-year and 3-year OS rates for all patients were 0.828 and 0.389, respectively. Conclusions: Percutaneous US-guided MWA is safe and effective in terms of local control and survival of adrenal metastasis.

OBJECTIVES: Compared with nipple sparing mastectomy (NSM), microwave ablation (MWA) is one relatively new modality indicated for selected breast cancer with nipple sparing, and with little of evidence-based medical research for decision-making. The objective of this study was to compare the effect of ultrasound-guided percutaneous MWA and NSM for breast cancer. MATERIALS AND METHODS: A retrospective cohort study was conducted in a single institution from 2014 to 2020. Women with invasive ductal carcinoma of the breast ≤ 5 cm treated by MWA or NSM were enrolled. The primary end point was tumor progression in the intention-to-treat population. Secondary end points included survival, cosmetic results, and complications. RESULTS: 21 patients in MWA group and 43 in NSM group were evaluated. The mean tumor size was 2.3 cm (range, 0.3-5.0 cm). Median follow-up was 22.7 months (range, 10.6–58.5 months). The mean age of MWA was 24 years older than that of NSM group. All the patients achieved technique effectiveness. One local tumor progression and one ipsilateral breast recurrence occurred at 42 and 28 months after MWA, respectively. One ipsilateral breast recurrence and one bone metastasis occurred at 31.2 and 34 months after NSM. Two groups had no significant difference in tumor progression (P = 0.16). No participants in both groups developed cancer related death (P > 0.99) and major complications (P > 0.99). However, MWA needed less hospitalization time (P

BackgroundPostoperative pulmonary complications (PPCs) and hypoxaemia are associated with morbidity and mortality. We aimed to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxaemia after general anaesthesia and compare the results to those of thoracic computed tomography (CT).MethodsAdult patients who received general anaesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analysed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO2) less than 92% for more than 30 s under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 h before returning to the ward.ResultsFrom January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%).ConclusionsLung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU.Trial registrationCurrent Controlled TrialsNCT03802175, 2018/12/05,www.ClinicalTrials.gov

BackgroundSince the end of 2019 to the present day, the outbreak of the coronavirus disease 2019 (COVID-19) has had an immense impact on China and on other countries worldwide. This outbreak represents a serious threat to the lives and health of people all around the world. The epidemic first broke out in Wuhan, where the Chinese government was unable to prevent the spread of the disease by implementing home quarantine measures. Mobile cabin hospitals were used to relieve pressure on hospitals due to the need for beds while also isolating the sources of the infection through a centralized quarantine and treatment of mild cases.MethodThis paper reviewed and summarized the treatment of patients with mild illness and symptoms during the period from the construction to the closing of the Hanyang Mobile Cabin Hospital in Wuhan, China, and presented the operational elements and possible improvements of running this hospital.ResultsMobile cabin hospitals helped China to curb the epidemic in only 2 incubation periods in 28 days.The basic conditions required for a normal operation of mobile cabin hospitals included the selection of the environment, medical staff to patient ratio, organizational structure, management model, admission criteria, treatment approaches, discharge process, livelihood guarantee, security, and other safeguarding measures. All of these components were performed carefully in Wuhan Hanyang Mobile Cabin Hospital, without medical staff being infected.ConclusionThe mobile cabin hospital compulsory quarantine for mild patients was an alternative method to combat COVID-19. It is hoped that the presented work in this manuscript can serve as a reference for the emergency prevention and control measures for global epidemic outbreaks.

The change of the transient indoor temperature is crucial to evaluate electrical power consumption of a heat pump and thermal comfort of the room. Computational Fluid Dynamics (CFD) model can provide the most comprehensive information in transient indoor temperature simulations. In CFD models, the transient flow and temperature fields are fully coupled. This coupling leads to high computation cost and time, which limits the CFD application in practice. A segregated CFD model was then proposed to speed up the computation. However, such model is not very accurate during the transient analysis. In this paper, a semi-coupled CFD model combining advantages of the fully-coupled CFD model and the segregated CFD model was proposed. In this CFD model, the flow and the temperature fields are firstly solved by fully coupled simulation during the transient start up period and then the segregated CFD is used for the transient temperature rising simulation. This method can reduce the computation time without losing the simulation accuracy. The transient indoor temperature is studied using the proposed method and the results are compared with those obtained from both fully-coupled and segregated CFD models. The hot air temperature is first calculated using a lumped-parameter method, and then it is applied as an initial boundary condition in the CFD models. The comparison results show that the proposed semi-coupled CFD model shows a promising capability of capturing the critical transient thermal responses for the air-conditioning room, and it can effectively reduce the computing time with an acceptable accuracy.

Background: Breast cancer is the most common malignant disease among women. At present, more and more attention has been paid to long non-coding RNAs (lncRNAs) in the field of breast cancer research. We aimed to investigate the expression profiles of lncRNAs and construct a prognostic lncRNA for predicting the overall survival (OS) of breast cancer.Methods: The expression profiles of lncRNAs and clinical data with breast cancer were obtained from The Cancer Genome Atlas (TCGA). Differentially expressed lncRNAs were screened out by R package (limma). The survival probability was estimated by the Kaplan‑Meier Test. The Cox Regression Model was performed for univariate and multivariate analysis. The risk score (RS) was established on the basis of the lncRNAs’ expression level (exp) multiplied regression coefficient (β) from the multivariate cox regression analysis with the following formula: RS=exp a1 * β a1 + exp a2 * β a2 +……+ exp an * β an. Functional enrichment analysis was performed by Metascape.Results: A total of 3404 differentially expressed lncRNAs were identified. Among them, CYTOR, MIR4458HG and MAPT-AS1 were significantly associated with the survival of breast cancer. Finally, The RS could predict OS of breast cancer (RS=exp CYTOR * β CYTOR + exp MIR4458HG * β MIR4458HG + exp MAPT-AS1 * β MAPT-AS1). Moreover, it was confirmed that the three-lncRNA signature could be an independent prognostic biomarker for breast cancer (HR=3.040, P=0.000).Conclusions: This study established a three-lncRNA signature, which might be a novel prognostic biomarker for breast cancer.

Photocurable hydrogel scaffolds for tissue engineering must have excellent biocompatibility, tunable mechanical characteristics, and be biodegradable at a controllable rate. Hydrogels developed as ink for 3D printing require several other properties such as optimal viscosity and shorter photocrosslinking time to ensure continuous extrusion and to avoid untimely collapse of the printed structure. Here, a novel photocurable hydrogel made of acrylated poly(ethylene glycol)-co-poly(xylitol sebacate) (PEXS-A) is developed for tissue engineering and 3D printing applications. Synthesis of PEXS-A hydrogel with equilibrated water content above 90% is achieved via a quick and facile photopolymerization process. Changing the acrylation ratio of the PEXS-A hydrogel has an impact on its crosslinking density, mechanical properties and degradation rate, thus highlighting PEXS-A tunability. PEXS-A could be employed as ink as demonstrated by the 3D printing of a 30-layers cubic grid with high structural integrity. Furthermore, 3T3 fibroblast cells encapsulated into PEXS-A during photocrosslinking maintain a viability of 93.76% after seven days, which showed the good biocompatibility of this novel hydrogel. These results indicate that PEXS-A hydrogel could have multiple applications including as 3D printing ink and as tissue engineering scaffold.

Searchable encryption plays a vital role in keeping data privacy of current cloud storage. Considering the security threat of trapdoor exposure, Emura et al. introduced a formal definition of keywords revocable public-key encryption with keywords search (KR-PEKS), which satisfies trapdoor exposure resistance (TER) and trapdoor re-generability. However, there is little work on lattice-based searchable encryption schemes to have the above properties, while it was widely accepted that cryptosystem on lattice has the potential to resist quantum computing attack. In this paper, we give a model of KR-PEKS with novel security, called bounded TER, i.e., a bounded number (previously set) of trapdoors for per keyword are exposed, which cannot affect other keywords. Then, we propose a lattice-based KR-PEKS scheme with bounded TER and trapdoor re-generability and show that this scheme is secure under the hardness assumption of learning with errors (LWE) problem. Finally, we conduct some simulation experiments on our scheme and give a comparison, which indicates that our scheme has less computational cost than the prior arts.