AIM:To evaluate the safety and efficacy of cone-beam CT (CBCT) guided prostatic artery embolization (PAE) combined with transurethral resection of the prostate (TURP) compared with TURP alone in the management of large-volume (>80 mL) benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:This retrospective propensity score matched study included 99 patients with large-volume BPH treated between January 2017 and June 2023. Thirty-three underwent CBCT-guided PAE followed by TURP, and 66 underwent TURP alone. Perioperative parameters, complication rates, and functional outcomes-including International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual urine (PVR)-were compared between groups at baseline and at 3, 6, 12, and 24 months after surgery. RESULTS:The combination group demonstrated significantly shorter operative time (78.9 ± 21.0 vs. 101.4 ± 25.7 min, P<0.001), smaller perioperative hemoglobin decline (10.0 ± 8.6 vs. 15.7 ± 13.3 g/L, P=0.027), shorter bladder irrigation (1.9 ± 0.6 vs. 2.5 ± 0.9 days, P<0.001), and fewer complications (9.1 % vs. 24.2 %, P=0.049). Total hospitalization costs (Chinese Yuan, CNY) did not differ significantly between the two groups (30,231.3 ± 7,946.2 vs.26,514.9 ± 9,954.4, P=0.065). Functional outcomes were significantly better in the combination group from 6 months onward, with lower IPSS and QoL scores, higher Qmax, and reduced PVR at 6, 12, and 24 months (P<0.05). CONCLUSION:CBCT-guided PAE combined with TURP is a safe and effective strategy for large-volume BPH, providing reduced perioperative morbidity and sustained long-term improvements in urinary function compared with TURP alone.

Hepatocellular carcinoma (HCC) at Barcelona-Clinic Liver Cancer (BCLC) stage C poses substantial therapeutic challenges and is typically associated with a poor survival prognosis. Triple therapy regimen comprising hepatic artery infusion chemotherapy (HAIC), programmed death receptor-1 (PD-1) inhibitors, and anti-angiogenic therapy is currently under investigation for this stage of HCC. In this study, nine advanced cases are reported that achieved complete response (CR) following this triple combination therapy. CR was defined by the complete disappearance of all lesions or the absence of arterial-phase enhancement on CT or MRI, no evidence of new lesions, and normalisation of alpha-fetoprotein (AFP) levels. Time to CR, changes in AFP levels during follow-up, and recurrence rates were analysed. Among 214 patients with HCC treated with this triple therapy at the centre from January 2021 to December 2023, 9 (4.2%) patients achieved CR. The time to CR ranged from 2 to 10 months, with a mean duration of 5.3 months. The duration for AFP levels to normalise varied from 79 to 259 days, with a median duration of 118 days. These findings indicate that the triple combination therapy of HAIC, PD-1 inhibitors, and anti-angiogenic agents has a modest probability of inducing CR in advanced HCC, with relatively rapid onset in responders. Key Words: Hepatocellular carcinoma, Hepatic arterial infusion chemotherapy, Programmed death receptor-1 inhibitors, Anti-angiogenic therapy, Complete remission.

Objective To investigate the incidence of complications and their effect on prognosis in patients with post pancreaticoduodenectomy hemorrhage (PPH) after transcatheter arterial embolization (TAE) or covered stent implantation (CSI). Methods The clinical data of patients who underwent common hepatic artery or proper hepatic artery intervention (TAE or CSI) due to PPH were retrospectively analyzed. The intervention method, hemostasis success rate, complications, and mortality were statistically analyzed. Results A total of 113 patients were included (TAE:81, CSI:32). (1) Success rate of hemostasis: 110 patients (97.35%) had successful hemostasis in both groups. (2) Complications: The liver function indexes in the TAE group were worse than those in the CSI group: 88.89% (TAE: 72/81) vs. 53.13% (CSI: 17/32). (3) Mortality: The total mortality rate during hospitalization was 31.86% (36/113). The total mortality rate 1 year after surgery was 40.71% (46/113). Conclusion The risk of liver injury (especially liver failure) and mortality in PPH patients after hepatic artery embolization are significantly higher than those in the CSI group. CSI can better protect liver function while effectively stopping bleeding, and may be a better choice for patients with relatively stable hemodynamics.

Purpose: To evaluate digital subtraction angiography (DSA) imaging features, interventional treatment efficacy, and risk factors for rebleeding in postpancreatectomy hemorrhage (PPH). Methods: This retrospective study analyzed PPH patients undergoing interventional therapy (2013-2022). DSA was performed in all cases, with positive findings prompting intervention. Statistical analysis of DSA angiography manifestations, bleeding sites, success rate of interventional treatment and hemostasis. Univariate and multivariate logistic regression analysis was used to analyze the independent risk factors for rebleeding after interventional treatment for PPH. Results: A total of 192 patients were included. (1) DSA Examination: All 192 patients underwent DSA examination, the positive rate of the initial DSA examination was 78.65 % (151/192). The primary imaging manifestations included contrast medium spillage and pseudoaneurysm formation, with hemorrhage sites being the gastroduodenal artery (60 cases), hepatic artery (35 cases), superior mesenteric artery (38 cases), etc. (2) Interventional Therapy: 142 patients underwent interventional therapy (108 embolizations and 34 stent placements), resulting in a success rate of 90.85 % (129/142). (3) Independent risk factors for rebleeding after intervention in patients with PPH included: the surgical duration (P = 0.035), bleeding volume(P < 0.001), pancreatic fistula(P = 0.001), ECOG score(P = 0.011), pre-interventional leukocyte counts(P = 0.012), and the neutrophil/lymphocyte ratio(P = 0.047). Conclusion: Interventional diagnosis and treatment of PPH can facilitate prompt diagnosis and intervention, resulting in a high success rate of hemostasis and notable outcomes. However, it is important to note that some patients remain at risk for rebleeding after successful interventional hemostasis, necessitating close monitoring of clinical indices and proactive intervention for patients experiencing rebleeding. (c) 2026 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Background: To compare the efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib vs TACE alone in intermediate-stage hepatocellular carcinoma (HCC) patients with hypovascular nodules. Methods: This retrospective study analyzed the clinical data of intermediate-stage HCC patients with hypovascular nodules who underwent TACE. Patients were categorized into the TACE-Lenv combination group and the TACE monotherapy group according to their receipt of lenvatinib therapy. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), progression of hypovascular nodules, and treatment-related adverse events were recorded and analyzed. Results: The study enrolled 75 patients, with 40 allocated to the TACE-Lenv group and 35 to the TACE group. The combination therapy group demonstrated significantly higher ORR and DCR (92.5% vs 74.3%, P = .032; 97.5% vs 82.9%, P = .030) compared with TACE monotherapy. The TACE-Lenv group exhibited significantly prolonged median OS and PFS (41.1 vs 19.7 months, P < .001; 20.2 vs 9.9 months, P < .001). In addition, compared with the TACE group, the TACE-Lenv group extended the median time to nodule progression (37.0 vs 16.5 months, P < .001). After propensity score matching, significant differences remained in the aforementioned outcomes between the 2 groups. No significant differences were observed in liver function parameters or the incidence of grade 3 to 4 AEs between the 2 groups after treatment. Conclusions: The combination therapy of TACE and lenvatinib demonstrated excellent clinical efficacy in intermediate-stage HCC with hypovascular nodules and may therefore emerge as a preferred treatment option for this specific patient population.

Objective: To develop S1-4 aptamer-conjugated citric acid-coated Fe3O4 nanoparticles and evaluate their targeting ability and magnetic hyperthermia effect against MCF-7 breast cancer cells.Methods: Citric acid-coated Fe3O4 nanoparticles were synthesized by chemical co-precipitation and subsequently conjugated with the S1-4 aptamer to fabricate S1-4 aptamer-conjugated citric acid-coated Fe3O4 nanoparticles. The nanoparticles were characterized by X-ray diffraction, transmission electron microscopy, dynamic light scattering, zeta potential analysis, Fourier transform infrared spectroscopy, and vibrating sample magnetometry. Biocompatibility was assessed in MCF-7 and MEF cells; cellular targeting was examined by Prussian blue staining; and the magnetic hyperthermia effect under an alternating magnetic field was evaluated by cell viability, live/dead staining, and apoptosis assays.Results: Compared with citric acid-coated Fe3O4 nanoparticles, S1-4 aptamer-conjugated citric acid-coated Fe3O4 nanoparticles exhibited a larger hydrodynamic diameter (17 ± 4 nm vs. 8 ± 3 nm) and a more negative surface charge (-26.7 ± 0.3 mV vs. -19.7 ± 0.5 mV). Fourier transform infrared spectroscopy confirmed successful aptamer conjugation. Both nanoparticles demonstrated good biocompatibility in MCF-7 and MEF cells. Prussian blue staining demonstrated stronger cellular uptake of S1-4 aptamer-conjugated citric acid-coated Fe3O4 nanoparticles in MCF-7 cells. Under alternating magnetic field exposure, S1-4 aptamer-conjugated citric acid-coated Fe3O4 nanoparticles produced a significantly greater hyperthermia effect than the controls, resulting in reduced cell proliferation and increased apoptosis in MCF-7 cells (P < 0.01).Conclusions: S1-4 aptamer-mediated Fe3O4 nanoparticles demonstrated active targeting ability and enhanced the antitumor effect of alternating magnetic field-mediated magnetic hyperthermia in breast cancer cells and maintained low cytotoxicity under the tested conditions, suggesting that they may be a feasible platform for targeted magnetic hyperthermia.

PURPOSE:To compare the safety and efficacy of hepatic arterial infusion chemotherapy followed by transarterial embolization (HAIC+TAE) to transarterial chemoembolization (TACE) for the treatment of unresectable hepatocellular carcinoma (uHCC). MATERIALS AND METHODS:The clinical data of patients who received HAIC+TAE or TACE between April 2020 and April 2022 was collected. Propensity score-matching was used to balance the baseline characteristics of the two groups. Tumor response according to mRECIST, median time to progression (TTP) and overall survival (OS) were investigated. ALBI score was applied to evaluate the changes of liver function and other relative adverse reactions were recorded. RESULTS:A total of 98 patients with uHCC were enrolled in the study, including 71 in the TACE group and 27 in the HAIC+TAE group. After propensity score matching, 23 pairs of patients were investigated. The HAIC+TAE group showed a longer median TTP and OS than TACE group (mTTP 316 vs. 235 days, P=0.023; mOS 580 vs. 493 days, P=0.020). Objective response rates in HAIC+TAE group and TACE group were 65.2% and 47.8% (P=0.234). Disease-control rates were 87.0% and 82.6% (P=1.000). No significant difference was found in the incidence of adverse events between the two groups (P>0.05). CONCLUSION:The combination treatment strategy of HAIC+TAE in patients with uHCC appears to be a safe regimen, with the potential to prolong mTTP and mOS relative to TACE. The sequential application of this therapy merits consideration as an innovative treatment strategy for individuals with uHCC.

To establish and validate a novel prognostic model to predict outcomes for intermediate hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). Clinical data from intermediate-stage HCC patients who underwent TACE between January 2007 and December 2020 were retrospectively analyzed. Patients were divided into a training cohort and a validation cohort. Univariate and multivariate analyses identified risk factors associated with overall survival (OS), leading to the development of a predictive model. The model's accuracy, consistency, and clinical utility were validated both internally and externally and compared with the Albumin-Bilirubin (ALBI) grading, Platelet-Albumin-Bilirubin (PALBI) grading, Child-Pugh grading, mChild-Pugh grading, and the Model for End-Stage Liver Disease (MELD). A total of 737 intermediate-stage HCC patients were included, with 481 in the training cohort and 256 in the validation cohort. Multivariate analysis identified maximum tumor diameter, tumor number, prealbumin, and total bilirubin as independent factors for OS. A prealbumin-bilirubin (PABI) predictive model was developed. The PABI model's concordance indices (C-index) in the training and validation cohorts were 0.730 (95% CI 0.701-0.759) and 0.706 (95% CI 0.661-0.751), respectively. The area under the curve (AUC) values at 6, 12, 18, and 24 months in both cohorts were above 0.7. Among the six models, the PABI model had the highest C-index (0.713) and the lowest Akaike information criterion (AIC) value (5897.814) and the best performance in clinical decision curve analysis, suggesting better predictive performance and potential clinical utility. The PABI nomogram model appears to accurately predict survival in intermediate-stage HCC patients treated with TACE, providing clinicians with a valuable tool for candidate selection and prognosis stratification.

Recently, Reconfigurable Intelligent Surfaces (RIS) have attracted considerable attention among researchers, especially in their applications within the terahertz domain. In this paper, we propose a method to reduce the ratio of unit cells’ size to wavelength by inducing Fano resonances with asymmetric structures and realizing the two-dimensional (2D) beam steering with the reduced-size unit cells. The smaller size of the unit cells allows the sub-array to have enough room for the decoupling structure and bias lines and facilitates the implementation of beam steering in two dimensions. Based on this, a liquid-crystal (LC)-integrated terahertz (THz) reflective programmable metasurface at 0.216THz is designed, manufactured, and measured. The measured results demonstrate that the metasurface can realize the 2D beam steering function and are in good agreement with the simulation results. This study creatively proposes a new application of asymmetric structures in phase modulation of terahertz waves, thereby significantly reducing the ratio of unit cells’ size to wavelength, and providing much freedom in the metasurface design. It is believed this study has potential applications in imaging, terahertz wireless communication, radar, and related fields.

Purpose:To evaluate the efficacy and safety of a multimodal therapeutic approach involving transarterial chemoembolization (TACE) in conjunction with helical iodine-125 (I-125) seed implant, lenvatinib, and programmed cell death-1(PD-1) inhibitors for hepatocellular carcinoma (HCC) complicated by main portal vein tumor thrombus (MPVTT). Material and methods:HCC patients with MPVTT treated with TACE coupled with helical I-125 implant, lenvatinib, PD-1 inhibitors between September 2019 and August 2022 were retrospectively analyzed, and constituted as study group. Those treated with TACE, helical I-125 seed implant, and sorafenib between December 2016 and August 2020 served as the historical control group. All patients received sorafenib or lenvatinib combined with PD-1 inhibitors within 3-7 days after TACE and helical I-125 seed implantation. The longest follow-up period for all patients in both groups was 36 months from the date of helical I-125 seed implantation. Primary outcome was overall survival time (OS), and secondary outcomes were progression free survival time (PFS), objective response rate (ORR), and disease control rate (DCR). The Cox proportional hazards regression model was employed to identify independent prognostic factors influencing OS and PFS. The value P < 0.05 was deemed statistically significant. Results:A total of 53 patients were enrolled, with 22 assigned to the study group and 31 to the control group. The study group exhibited superior overall ORR(54.5% vs. 25.8%, P = 0.033) and overall DCR (77.3% vs. 64.5%, P = 0.319). Notably, the ORR and DCR of MPVTT were higher in the study group (86.4% vs. 51.6%, P = 0.008; and 95.5% vs. 83.9%, P = 0.382, respectively). Median OS (16.1 ± 6.1 months vs. 10.2 ± 0.8 months, P = 0.008) and PFS (13.6 ± 3.0 months vs. 6.1 ± 0.6 months, P = 0.014) were prolonged in the study group. The maximal tumor size, alpha fetoprotein level, and treatment modality were independent predictors for OS, while the maximal tumor size and treatment modality were independent determinants for PFS. Study group showed frequent hypothyroidism and reactive cutaneouscapillary (P < 0.01), with comparable grade 3/4 adverse events between groups. Conclusions:The integration of the helical I-125 seed implant with TACE, lenvatinib, and PD-1 inhibitors is the safe and efficacious approach in the management of HCC complicated by MPVTT.

Purpose:This study aimed to investigate the predictive value of the Tumor Burden Score (TBS) combined with Serum Prealbumin (PALB) and the Neutrophil-to-Lymphocyte Ratio (NLR) for the long-term prognosis of patients with unresectable hepatocellular carcinoma (uHCC) following transcatheter hepatic artery chemoembolization (TACE) therapy, and to elucidate its significance in guiding treatment planning. Patients and Methods:Clinical data from 940 patients with unresectable HCC who underwent TACE treatment at three hospitals in the Jiangsu Province between 2007 and 2018 were retrospectively analyzed. TBS was calculated using the formula: TBS2 = (maximum tumor diameter)2 + (number of tumors)2 (The diameter of the tumor is measured in centimeters). The optimal cutoff values for TBS and NLR were determined using R software. Patients were risk-stratified based on their TBS-PALB-NLR (TPN) score. Independent predictors associated with survival were identified using univariate and multivariate Cox proportional hazards regression analyses. Results:Independent risk factors identified through univariate Cox analysis included age, cirrhosis, ascites, BCLC stage, vascular invasion, NLR, TBS, PALB, AFP, Bilirubin, AST, and ALT. Multivariate analysis revealed that BCLC stage, NLR, TBS, and PALB were significant independent risk factors affecting overall survival (P < 0.05). The TPN score was established based on TBS, PALB, and NLR, and patients were stratified into low-TPN, intermediate-TPN, and high-TPN groups. Conclusion:The TPN score is a low-cost, readily available prognostic tool that can effectively risk-stratify patients with uHCC. It may guide personalized adjuvant therapy (eg, systemic therapy for high-risk patients), particularly in resource-limited medical centers.

BackgroundStent patency is a critical outcome after thrombolysis, thrombectomy and stenting of subacute thrombotic iliac vein lesions (TIVL) and there is currently no consensus regarding post-procedural antithrombotic therapy. This study aims to investigate the differences between anticoagulant combined with antiplatelet therapy (dual-pathway inhibitors therapy, DPI) and anticoagulant therapy alone (AC) in reducing the incidence of occlusion after stenting for subacute TIVL.MethodsA retrospective cohort study collected data from patients treated with stent insertion for iliac vein lesion (IVL) after thrombolysis and thrombectomy from June 2018 to December 2022. 180 patients were included based on inclusion and exclusion criteria, and were divided into two groups based on their antithrombotic prophylaxis: the DPI group and the AC group. A 1:1 propensity score matching (PSM) was performed to balance confounding covariates between the groups. Risk factors for the primary stent patency were assessed with univariate and multivariate Cox regression. Kaplan-Meier analysis and log-rank tests were used to evaluate survival difference.ResultsAfter PSM, 45 patients were included in the DPI and in the AC groups, and baseline characteristics were comparable. Cox regression analysis indicated that DPI therapy was associated with better primary stent patency (HR = 0.363, 95% CI: 0.149∼0.881) (p = .025). Kaplan-Meier curves showed that the 2-years primary stent patency rate in DPI group was 84.4% (38/45), while the rate in AC group was 62.2% (28/45), with a significant difference in survival between the groups (log-rank test p = .017). Only minor bleeding occurred in both cohorts, and event rates did not differ significantly between groups [(9/45) versus (5/45), p = .384].ConclusionFor patients with subacute TIVL undergoing stent insertion, anticoagulant combined with antiplatelet therapy was associated with better stent patency compared to anticoagulant alone. This novel finding may have implications for optimizing medical management following venous stenting after endovascular therapy of subacute iliofemoral deep vein thrombosis.

Type 2 diabetes (T2DM) patients are at high risk for non-alcoholic fatty liver disease (NAFLD). Studies show SVD3 and dietary inflammatory index (DII) are associated with NAFLD. It’s unknown if they interact in T2DM patients with NAFLD. We collected data from 110 hospitalized T2DM patients, measured physiological and biochemical indicators, conducted dietary surveys, and converted data into DII and NFS, FIB-4, and BARD indices. We used logistic regression, mediation effect analysis, and moderation effect analysis to explore the relationship between DII and SVD3 with NAFLD and liver fibrosis in T2DM patients. DII was not significant in either NAFLD incidence in T2DM patients or liver fibrosis in NAFLD patients. SVD3 was positively correlated with NAFLD incidence in T2DM patients, but this correlation became insignificant as DII increased towards pro-inflammation. SVD3 is positively correlated with NAFLD incidence in T2DM patients, but this correlation becomes less significant as DII increases towards pro-inflammation.

ObjectiveThis study aimed to investigate the cutoff value of quantitative and volumetric response evaluation criteria for patients with hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) and compare the performance of the modified criteria to one-dimensional criteria in survival prediction.MethodsA retrospective single-center study was performed for treatment-naive patients with HCC who underwent initial TACE between June 2015 and June 2019. Treatment response assessment was performed after the first observation by contrast CT or MRI, with the measurement of diameters by modified Response Evaluation Criteria in Solid Tumors (mRECIST) and volumes by quantitative European Association for Study of the Liver (qEASL). Overall survival (OS) was the primary endpoint of this study. The new cutoff value for volumetric response evaluation criteria was created using restricted cubic splines. The performance of modified qEASL (mqEASL, with the new cutoff value) and mRECIST on survival prediction was compared by Cox regression models in internal and external validation.ResultsA total of 129 patients (mean age, 60 years ± 11 [standard deviation]; 111 men) were included and divided into training (n=90) and validation (n=39) cohorts. The cutoff value for the viable volume reduction was set at 57.0%. The mqEASL enabled separation of non-responders and responders in terms of median OS (p<0.001), 11.2 months (95% CI, 8.5–17.2 months) vs. 31.5 months (95% CI, 25.5–44.0 months). Two multivariate models were developed with independent prognostic factors (tumor response, metastasis, portal vein tumor thrombus, and subsequent treatment) to predict OS. Model 2 (for mqEASL) had a greater Harrel’s C index, higher time-dependent area under the receiving operator characteristic curve (AUROC), and more precise calibration on 6-month survival rates than Model 1 (for mRECIST).ConclusionsWith the modified cutoff value, the quantitative and volumetric response of HCC patients to TACE becomes a precise predictor of overall survival. Further studies are needed to verify this modification before application in clinical practice.

PurposeTo explore the safety and efficacy of transarterial chemoembolization (TACE) in combination with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) for the treatment of unresectable hepatocellular carcinoma (uHCC).Materials and MethodsFrom August 2019 to July 2020, patients who received TACE combined with ICIs and TKIs were retrospectively analyzed. Treatment-related adverse events (AEs) were recorded. The Kaplan–Meier method was used to estimate time to progression (TTP) and progression-free survival (PFS).ResultsIn total, 31 patients with uHCC were included. Eleven patients were classified as BCLC-C. Nineteen patients had multiple lesions, and the cumulative targeted lesions were 69 mm (range, 21-170 mm) according to mRECIST. Twenty-nine (93%) patients experienced at least one AE during the treatment. Four (12.9%) patients developed AEs of higher grade (grade≥3). The objective response rate (ORR) and disease control rate (DCR) were 64.5% and 77.4%, respectively. The median time to response was 7 weeks (range, 4-30 w), and the duration of response was 17.5 weeks (range, 2-46 w). From the first ICIs, TTP and PFS were 6.5 months (95% CI, 3.5-11) and 8.5 months (95% CI, 3.5-NE), respectively.ConclusionsTACE combined with ICIs and TKIs shows an acceptable safety profile and considerable efficacy in patients with HCC.

Exosomes are extracellular vesicles with relatively specific expression of CD63 transmembrane protein. In this study, We designed and constructed a multisite-targeting polymer which has both fluorescence and targeting recognition. It can bond to the hydrophilic group of CD63 by connecting with hydrogen. The chemical structure and the ability to combine with CD63 of fluorescent monomer and polymer were characterized and confirmed by FTIR and 1H NMR. MTT assay was performed to detect the cytotoxicity and biocompatibility of this polymer. Then we found the cell viability was 80.64% and the hemolysis rate of erythrocyte was only 0.101% even at F concentration of 20 µM. In vitro, the proposed polymer showed better ability to enter cells after linking exosomes via CD63; in vivo, it showed the ability to bind stably to exosomes and target tumor implants.

Objective: This study aimed to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) in combination with immune checkpoint inhibitors (ICIs) plus tyrosine kinase inhibitors (TKIs) (TACE+IT) versus ICIs plus TKIs (IT) for advanced hepatocellular carcinoma (HCC).Materials and Methods: Data of consecutive advanced HCC patients receiving TACE+IT or IT between January 2019 and December 2021 were included and were retrospectively analyzed. Propensity score matching (PSM) was performed to reduce bias due to confounding variables. The primary outcome of the study was overall survival (OS). The secondary outcomes were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs), respectively.Results: Sixty-four patients were enrolled in the study, among which 24 and 40 received TACE+IT and IT, respectively. The PSM cohort included 24 patients receiving TACE+IT (TACE+IT group) and 24 patients receiving IT (IT group) alone. During a median follow-up of 23 months, patients in TACE+IT group had significantly longer OS (median, 17.3 vs 11.8 months, P = 0.023), better ORR (41.7% vs 12.5%, P = 0.023) and DCR (79.2% vs 50.0%, P = 0.035) than those in the IT group, whereas a non-significant trend in PFS (median, 7.4 vs 6.7 months, P = 0.23) was observed. According to multivariable cox regression analysis, it was found that treatment modality was the only independent risk factor for OS (HR = 0.404, 95% CI = 0.179-0.911, P < 0.05). There were no remarkable differences in AEs associated with ICIs and TKIs between the two groups, with the exception of gastrointestinal reaction.Conclusion: TACE combined with ICIs plus TKIs significantly improved OS, ORR, and DCR and showed a relatively longer PFS trend over ICIs combined with TKIs for advanced HCC.

BackgroundLocoregional therapy combined with systemic therapy can further improve the prognoses for HCC. However, the efficacy of TACE combined with ICIs and TKIs for HCC and whether this triple therapy can activate systemic immune response are still unknown.PurposeTo identify the efficacy of TACE+ICIs+TKIs for unresectable hepatocellular carcinoma (uHCC) and its effect on systemic immunity.Materials and MethodsThis single-center retrospective study was approved by the Institutional Review Board. From August 1, 2019, to March 30, 2021, patients with uHCC who received the combination therapy of TACE+ICIs+TKIs were included. Peripheral blood samples were collected at baseline and once a month for 4 months after treatment. Lymphocyte subsets were measured by flow cytometry. Immunoglobulins were measured using the immune turbidimetric method. The dynamic change trend of circulating parameters was tested using simple linear regression.ResultsFifty-three patients with a mean age of 59 ± 10.6 years were included. TTP was 8.0 months (95% CI, 5.5–10.5) and PFS was 8.5 months (95% CI, 5.4–11.5). ORR was 52.8% and DCR was 81.1%. Twenty patients had completed analysis of biomarkers in peripheral blood. For cellular immune response, the level of circulating CD8+, CD3+ T cells and NK cells increased, the frequency of CD4+T cells and the CD4+/CD8+ ratio decreased, and among them, CD8+ T cells increased significantly. For humoral immune response, there was a significant decrease in B cells and a significant increase in Ig G, Ig κ, and Ig λ. Moreover, Ig G, Ig κ, and Ig λ were related to tumor response.ConclusionTACE+ICIs+TKIs showed considerable efficacy in patients with uHCC. This triple therapy activated not only cell immune but also humoral immune activation. Circulating Ig G, Ig λ, and Ig κ can serve as potential biomarkers.

Background: Previous studies suggest protection of a single dose of rifampicin(SDR) from developing leprosy among close contacts. This study aimed to evaluate the effectiveness of a single dose of rifapentine(SDL) to prevent leprosy in household contacts (HHCs) of leprosy cases in areas of low epidemic leprosy in China.Methods: In this cluster-randomised controlled trial, we randomised and allocated 207 clusters (counties) into three arms, the eligible HHCs of patients diagnosed with leprosy since 2010 received SDL, SDR or no post-exposure prophylaxis (PEP) interventions, respectively. The primary outcome was the incidence density of leprosy by the end of 4 th year of annual follow-up. The preventive effect of the interventions was estimated by generalized estimating equations with possion distribution for family function and reported as incidence density ratio (IDR). Safety and economic evaluation of the interventions were done in parallel with the trial. Findings: Enrolled counties were randomly allocated to the rifapentine group (n=68, 2004 participants), the rifampicin group (n=71, 2609 participants), and the control group (n=68, 2837 participants). A total of 22 new leprosy cases occurred during the 4-year follow-up, 1 in the rifapentine group (incidence rate 0.14 per 1000 person-years), 4 in the rifampicin group (0.43 per 1000 person-years), and 17 in the control group (1.71 per 1000 person-years), respectively. The reduction of incidence density in the rifapentine and rifampicin groups was 92.6% (IDR 0.100, 95% CI 0.013 to 0.755, P=0.026), and 78.1% (IDR 0.265, 95% CI 0.089 to 0.794, P=0.018), respectively. No severe adverse event was observed in the three groups. In total, 12 incremental leprosy cases were prevented, resulting in an incremental cost-effectiveness ratio (ICER) of $175·7 in the rifapentine group and $20·3 in the rifampicin group per one additional prevented leprosy case.Interpretation: SDL or SDR is effective, safe, cost-efficient in preventing the development of leprosy in HHCs of leprosy patients under low endemic situations in China. Rifapentine could effectively reduce the incidence density of leprosy in HHCs, especially in HHCs of MB index cases, HHCs of new diagnosed index cases, and spouse of index cases.Trial Registration Details: This study was registered with www.chictr.org.cn. ChiCTR-IPR-15007075.Funding Information: This study was funded by the Ministry of Health of China (201502008) and CAMS Innovation Fund for Medical Science (2016-I2M-1-005, 2017-I2M-B&R-14).Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The protocol and informed consent forms (2014-KY-003) were approved by the Research Ethics Board of the Hospital of Dermatology, the Chinese Academy of Medical Science, and the four other participating units. The written informed consent was required before enrolment.

Realization of flexible supercapacitors with tunable capacitance, high mechanical performance, and superior electrochemical performance has been achieved by precisely controlling the volume of vacuum filtration of reduced graphene oxide/tannin (RGO/TA) mixture slurry in this study. The TA coating on the surface of RGO can not only prevent RGO sheets from aggregation, but also provide extra pseudocapacitance and facilitate the reduction of graphene oxide at the same time owing to the abundant redox-active groups of TA. The capacitance of the RGO/TA film electrode can be continuously adjusted in the range of 40.69 to 234.13 mF cm-2. The flexible all-solid-state supercapacitor (FASC) based on RGO/TA film electrode exhibits a good capacitance of 40.37 mF cm-2, superior cycling stability, and good energy density of 3.60 mu W h cm-2 at a power density of 107.6 mu W cm-2. Due to the 3D network structure of the RGO/TA film electrode and good mechanical properties of the substrate (nylon filter membrane), the FASC also shows acceptable performance at various bending states, which is conducive to expand its application in wearable and portable electronics. Besides, this simple and reliable method can be also applied to fabricate other supercapacitors/electrodes with desired shapes and capacitance, which can more effectively meet the practical needs.