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Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis

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World Journal of Gastroenterology 2024年第4期30卷 318-331页

作者： Yu-Zhe Cao Guang-Lei Zheng Tian-Qi Zhang Hong-Yan Shao Jia-Yu Pan Zi-Lin Huang Meng-Xuan Zuo department of Minimally invasive Interventional Therapy Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina department of Minimally invasive Interventional Therapy State Key Laboratory of Oncology in South ChinaGuangzhou 510060Guangdong ProvinceChina department of Minimally invasive Interventional Therapy Guangdong Provincial Clinical Research Center for CancerGuangzhou 510060Guangdong ProvinceChina

BACKGROUND Hepatic arterial infusion chemotherapy(HAIC)has been proven to be an ideal choice for treating unresectable hepatocellular carcinoma(uHCC).HAIC-based treatment showed great potential for treating ***,large-scale studies on HAIC-based treatments and meta-analyses of first-line treatments for uHCC are *** To investigate better first-line treatment options for uHCC and to assess the safety and efficacy of HAIC combined with angiogenesis inhibitors,programmed cell death of protein 1(PD-1)and its ligand(PD-L1)blockers(triple therapy)under real-world *** Several electronic databases were searched to identify eligible randomized controlled trials for this ***-level pooled analyses of hazard ratios(HRs)and odds ratios(ORs)were *** was a retrospective single-center study involving 442 patients with uHCC who received triple therapy or angiogenesis inhibitors plus PD-1/PD-L1 blockades(AIPB)at Sun Yat-sen University Cancer Center from January 2018 to April *** score matching(PSM)was performed to balance the bias between the *** Kaplan-Meier method and cox regression were used to analyse the survival data,and the log-rank test was used to compare the suvival time between the *** A total of 13 randomized controlled trials were *** alone and in combination with sorafenib were found to be effective treatments(P values for ORs:HAIC,0.95;for HRs:HAIC+sorafenib,0.04).After PSM,176 HCC patients were included in the *** triple therapy group(n=88)had a longer median overall survival than the AIPB group(n=88)(31.6 months vs 14.6 months,P<0.001)and a greater incidence of adverse events(94.3%vs 75.4%,P<0.001).CONCLUSION This meta-analysis suggests that HAIC-based treatments are likely to be the best choice for *** findings confirm that triple therapy is more effective for uHCC patients than AIPB.

关键词： Unresectable hepatocellular carcinoma Hepatic arterial infusion chemotherapy Angiogenesis inhibitors Programmed cell death protein 1 Programmed death ligand 1

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Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 270-275页

作者： Davina Perini Jacopo Martellucci department of Emergency Emergency and Minimally Invasive Surgery UnitCareggi University HospitalFirenze 50041Italy

Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency *** trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective *** is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been *** present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal ***,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute *** the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute *** then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two *** emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality *** need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures.

关键词： Indocyanine green Fluorescence Navigation surgery Angiography Emergency surgery Decision-making

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Bioinspired Scraper-File Type Frequency-Doubling Ultrasonic Exciter

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Journal of Bionic Engineering 2024年第4期21卷 1801-1816页

作者： Wenshuai Wu Mingshuo Zhang Zeming Li Guang Yao Xinggang Jiang Deyuan Zhang School of Mechanical Engineering and Automation Beihang UniversityBeijing100191China Institute of Bionic and Micro-Nano Systems Beihang UniversityBeijing100191China Guangdong Provincial Key Laboratory of Minimally invasive Surgical Instruments and Manufacturing technology Guangdong University of TechnologyGuangzhou510006China

In the natural world,leaf-cutting ants cause vibrations through their mutual scraping of file-scraper *** this study,we designed a Biomimetic Ultrasonic Exciter(BUE)that imitates leaf-cutting *** operating characteristics of the BUE were studied through experimental testing and finite element *** results showed that the BUE could generate stable ultrasonic vibrations,and that the excitation frequency only needed to be half the Output Frequency(OF).This frequency-doubling phenomenon was conducive to achieving BUE *** further explore the phenomenon of frequency-doubling vibration output,this study designed scrapers of five different sizes,conducted excitation and first-order natural frequency measurement tests,and the corresponding finite element *** was found that each scraper could operate in frequency-doubling mode,but the operating frequency and natural mode frequencies did not correspond with one *** further explicate experimental and simulation results,a two-degrees-of-freedom vibration model was *** was evident that the contact relationship between the dentate disc and scraper introduced strong nonlinear factors into the system,accounting for the frequency-doubling phenomenon and the difference between the BUE’s operating and mode *** BUE could be expected to facilitate the production of high-power micro-ultrasonic generators and has potential application value in the fields of mechanical processing,industrial production,and medical health.

关键词： Leaf-cutting ants Power ultrasound Nonlinear vibration Ultrasonic scalpel Micro vibrator

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Phytochemical analysis, antioxidant, acetylcholinesterase, and α-amylase inhibitors from Hippeastrum hybridum extract

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Journal of Traditional Chinese Medicine 2024年第3期44卷 496-504页

作者： Naila Sher Mushtaq Ahmed Nadia Mushtaq department of Biotechnology University of Science and Technology department of Botany University of Science and Technology

OBJECTIVE:To investigate the effects of Hippeastrum hybridum（HH） as a free radical scavenger,and an inhibitor of the two enzymes i-e Alpha-amylase（α-amylase） and acetylcholinesterase（AChE）.METHODS:In this study,HH plant was preliminary analyzed for phytochemical screening and then tested for its antioxidant,anti-α-amylase,and anti-AChE efficiency via standard ***:Phytochemical analysis shows the existence of different compounds;while Coumarins and quinones were *** total phenolic,flavonoid,and tannins content were found to be（78.52±0.69） mg GAE/g,（2.01±0.04） mg RUE/g,and（58.12±0.23） mg TAE/g of plant extract respectively.28.02%±0.02% alkaloid and 2.02%±0.05% saponins were present in the HH *** HH extract showed the anti-oxidant property with IC50（50%inhibition） of（151.01±0.13）(HH),（79.01±0.04）(Ascorbic acid) for ferric reducing,（91.48±0.13）(HH),（48.02±0.11）(Ascorbic acid) against Ammonium molybdenum,（156.02±0.31）(HH),（52.38±0.21）(Ascorbic acid) against DPPH,136.01±0.21（HH）,52.02±0.31（Ascorbic acid） against H2O2,and 154.12±0.03（HH）,（40.05±0.15）(Ascorbic acid)μg/mL against ABTS *** analysis indicated that HH caused a competitive type of inhibition of α-amylase(Vmaxremained constant and Km increases from 10.65 to84.37%) while Glucophage caused the un-competitive type of inhibition i-e both Km and Vmaxdecreased from40.49 to 69.15%and 38.86 to 69.61%*** Ki,（inhibition constant）;KI,（dissociation constant）,Km,（Michaelis-Menten constant）,and IC50 were found to be62,364,68.1,and 38.08±0.22 for HH and 12,101.05,195,34.01±0.21 for ***,HH causes an anon-competitive type of inhibition of AChE i-e Km remains constant while Vmaxdecreases from 60.5%to74.1%.The calculated Ki,KI,Km,and IC50 were found to be 32,36.2,0.05,and 18.117±***:From the current results,it is concluded that HH extract contains bioactive compounds,and could be a good alternative to controlling oxidants,Alzheimer‘s and T

关键词： Hippeastrum hybridum acetylcholinesterase alpha-amylase antioxidant phytochemicals

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From macroautophagy to mitophagy:Unveiling the hidden role of mitophagy in gastrointestinal disorders

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World Journal of Gastroenterology 2024年第23期30卷 2934-2946页

作者： Duo-Lun Gao Meng-Ran Lin Nan Ge Jin-Tao Guo Fan Yang Si-Yu Sun department of Gastroenterology Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic TechniquesShengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

In this editorial,we comment on an article titled“Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases”,which was published in a recent issue of the World Journal of *** focused on the statement that“autophagy is closely related to the digestion,secretion,and regeneration of gastrointestinal cells”.With advancing research,autophagy,and particularly the pivotal role of the macroautophagy in maintaining cellular equilibrium and stress response in the gastrointestinal system,has garnered extensive ***,the significance of mitophagy,a unique selective autophagy pathway with ubiquitin-dependent and independent variants,should not be *** recent decades,mitophagy has been shown to be closely related to the occurrence and development of gastrointestinal diseases,especially inflammatory bowel disease,gastric cancer,and colorectal *** interplay between mitophagy and mitochondrial quality control is crucial for elucidating disease mechanisms,as well as for the development of novel treatment *** the pathogenesis behind gastrointestinal diseases and providing individualized and efficient treatment for patients are subjects we have been *** article reviews the potential mechanism of mitophagy in gastrointestinal diseases with the hope of providing new ideas for diagnosis and treatment.

关键词： Mitophagy Gastrointestinal diseases Parkin Autophagic receptor Colorectal cancer Gastric cancer Inflammatory bowel disease

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A Hybrid Optimization Approach of Single Point Incremental Sheet Forming of AISI 316L Stainless Steel Using Grey Relation Analysis Coupled with Principal Component Analysiss

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Journal of Wuhan University of technology(Materials Science) 2024年第1期39卷 160-166页

作者： A Visagan P Ganesh department of Production technology Madras Institute of TechnologyChennai-600044India

We investigated the parametric optimization on incremental sheet forming of stainless steel using Grey Relational Analysis(GRA) coupled with Principal Component Analysis(PCA). AISI 316L stainless steel sheets were used to develop double wall angle pyramid with aid of tungsten carbide tool. GRA coupled with PCA was used to plan the experiment conditions. Control factors such as Tool Diameter(TD), Step Depth(SD), Bottom Wall Angle(BWA), Feed Rate(FR) and Spindle Speed(SS) on Top Wall Angle(TWA) and Top Wall Angle Surface Roughness(TWASR) have been studied. Wall angle increases with increasing tool diameter due to large contact area between tool and workpiece. As the step depth, feed rate and spindle speed increase,TWASR decreases with increasing tool diameter. As the step depth increasing, the hydrostatic stress is raised causing severe cracks in the deformed surface. Hence it was concluded that the proposed hybrid method was suitable for optimizing the factors and response.

关键词： single point incremental forming AISI 316L taguchi grey relation analysis principal component analysis surface roughness scanning electron microscopy

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Role of albumin-bilirubin score in non-malignant liver disease

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World Journal of Gastroenterology 2024年第9期30卷 999-1004页

作者： Shi-Xue Xu Fan Yang Nan Ge Jin-Tao Guo Si-Yu Sun department of Gastroenterology Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic TechniquesShengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary cholangitis,liver cirrhosis,hepatitis,liver transplantation,and liver *** ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction *** is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection *** increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease;additionally,it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases,such as decompensation *** article presents a review of the application of ALBI scores in various non-malignant liver diseases.

关键词： Albumin-bilirubin score Liver cirrhosis Primary biliary cholangitis Hepatitis Liver transplantation Liver injury

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Skill enhancement learning with knowledge distillation

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Science China(Information Sciences) 2024年第8期67卷 206-220页

作者： Naijun LIU Fuchun SUN Bin FANG Huaping LIU department of Computer Science and technology Tsinghua University

Skill learning through reinforcement learning has significantly progressed in recent years. However, it often struggles to efficiently find optimal or near-optimal policies due to the inherent trial-and-error exploration in reinforcement learning. Although algorithms have been proposed to enhance skill learning efficacy, there is still much room for improvement in terms of skill learning performance and training stability. In this paper, we propose an algorithm called skill enhancement learning with knowledge distillation(SELKD), which integrates multiple actors and multiple critics for skill learning. SELKD employs knowledge distillation to establish a mutual learning mechanism among actors. To mitigate critic overestimation bias,we introduce a novel target value calculation method. We also perform theoretical analysis to ensure the convergence of SELKD. Finally, experiments are conducted on several continuous control tasks, illustrating the effectiveness of the proposed algorithm.

关键词： skill learning enhancement learning reinforcement learning knowledge distillation

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Transfer force perception skills to robot‐assisted laminectomy via imitation learning from human demonstrations

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CAAI Transactions on Intelligence technology 2024年第4期9卷 903-916页

作者： Meng Li Xiaozhi Qi Xiaoguang Han Ying Hu Bing Li Yu Zhao Jianwei Zhang Harbin Institute of technology ShenzhenChina Shenzhen Institute of Advanced technology Chinese Academy of SciencesShenzhenChina Shenzhen Key Laboratory of Minimally invasive Surgical Robotics and System Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenChina Beijing Jishuitan Hospital Capital Medical UniversityBeijingChina department of Orthopedics Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina University of Hamburg Hamburg22527Germany

A comparative study of two force perception skill learning approaches for robot‐assisted spinal surgery,the impedance model method and the imitation learning(IL)method,is *** impedance model method develops separate models for the surgeon and patient,incorporating spring‐damper and bone‐grinding *** surgeons'feature parameters are collected and mapped using support vector regression and image navi-gation *** imitation learning approach utilises long short‐term memory networks(LSTM)and addresses accurate data labelling challenges with custom *** results demonstrate skill recognition rates of 63.61%-74.62%for the impedance model approach,relying on manual feature ***,the imitation learning approach achieves a force perception recognition rate of 91.06%,outperforming the impedance model on curved bone *** findings demonstrate the potential of imitation learning to enhance skill acquisition in robot‐assisted spinal surgery by eliminating the laborious process of manual feature extraction.

关键词： learning(artificial intelligence) medical applications medical signal processing robotics

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Percutaneous transhepatic cholangioscopy-assisted biliary polypectomy for local palliative treatment of intraductal papillary neoplasm of the bile duct

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1821-1832页

作者： Xu Ren Yong-Ping Qu Chun-Lan Zhu Xiao-Hong Xu Hong Jiang Yi-Xia Lu Hong-Peng Xue Digestive Disease Hospital of Heilongjiang Provincial Hospital Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina Digestive Endoscopy Center of Heilongjiang Provincial Hospital Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina Second department of Gastroenterology Digestive Disease Hospital of Heilongjiang Provincial Hospitaland Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina department of Pathology Heilongjiang Provincial HospitalHarbin 150001Heilongjiang ProvinceChina

BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a premalignant biliarytype epithelial neoplasm with intraductal papillary or villous *** reported local palliative therapeutic modalities,including endoscopic nasobiliary drainage,stenting and biliary curettage,endoscopic biliary polypectomy,percutaneous biliary drainage,laser ablation,argon plasma coagulation,photodynamic therapy,and radiofrequency ablation to relieve mechanical obstruction are limited with weaknesses and *** have applied percutaneous transhepatic cholangioscopy(PTCS)-assisted biliary polypectomy(PTCS-BP)technique for the management of IPNB including mucin-hypersecreting cast-like and polypoid type tumors since *** To assess the technical feasibility,efficacy,and safety of PTCS-BP for local palliative treatment of *** Patients with mucin-hypersecreting cast-like or polypoid type IPNB and receiving PTCS-BP between September 2010 and December 2019 were ***-BP was performed by using a half-moon type snare with a soft stainless-steel wire,and the tumor was snared and resected with *** primary outcome was its feasibility,indicated by technical *** secondary outcomes were efficacy,including therapeutic success,curative resection,and clinical success,and *** Five patients(four with mucin-hypersecreting cast-like type and one with polypoid type IPNB)were ***-and high-grade intraepithelial neoplasia(HGIN)and recurrent IPNB with invasive carcinoma were observed in one,two,and two patients,*** cholangitis and/or obstructive jaundice were presented in all four patients with mucin-hypersecreting cast-like type *** five patients achieved technical success of *** patients(three with mucin-hypersecreting cast-like type and one with polypoid type IPNB)obtained therapeutic success;one with mucin-hypersecreting cast-like type tumors in the intrahepatic small bile duct and HGIN h

关键词： Intraductal papillary neoplasm of the bile duct Percutaneous transhepatic cholangioscopy Biliary polypectomy Feasibility Efficacy

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