Efficacy and safety analysis of TACE + PEI + lenvatinib compared with TACE + lenvatinib for the treatment of hepatocellular carcinoma with PVTT: a retrospective study

ObjectiveThe aim of this study was to investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with percutaneous ethanol injection (PEI) and lenvatinib in HCC patients with PVTT (Vp2-3), thus providing a safe and effective treatment strategy for advanced HCC patients.Materials and methodsClinical data of 227 patients with unresectable HCC and PVTT treated at the Union Hospital from January 2018 to December 2021 were retrospectively analyzed. The patients were divided into two groups according to their treatment methods: TACE+PEI+lenvatinib group (N=103) and TACE+lenvatinib group (N=124).ResultsThe proportion of patients with disappearance, shrinkage, or no change of PVTT after treatment was significantly higher in the TACE+PEI+lenvatinib group compared to the TACE+lenvatinib group, with statistical significance (P<0.001). The TACE+PEI+lenvatinib group had higher objective response rate (ORR) (50.5% vs. 25.8%, P<0.001) and disease control rate (DCR) (87.4% vs. 74.2%, P=0.013) than the TACE+lenvatinib group. The median progression-free survival (mPFS) of the TACE+PEI+lenvatinib group was longer than that of the TACE+lenvatinib group (8.1 months vs. 6.5 months, P<0.001). Consistently, the median overall survival (mOS) of the TACE+PEI+lenvatinib group was longer than that of the TACE+lenvatinib group (17.1 months vs. 13.9 months, P<0.001).ConclusionAmong HCC patients with PVTT (Vp2-3), TACE+PEI+lenvatinib is more effective comparing to TACE+lenvatinib in prolonging PFS and OS. The control of PVTT in the TACE+PEI+lenvatinib group was significantly more satisfactory than that in the TACE+lenvatinib group. TACE+PEI+lenvatinib is a safe and effective treatment strategy for HCC patients with PVTT (Vp2-3)

Different water and nitrogen level effects on soil microbial properties of spinach

Understanding the interactions of plant soil environment and rhizosphere microbial changes are necessary to develop new strategies for the sustainable agriculture. A field experiment with combination of three water levels and three nitrogen rates was conducted to investigate the effect of water and nitrogen management on the changes of soil microbial properties in non-rhizosphere and rhizosphere soils of spinach. Non-Rhizosphere and rhizosphere microbial diversities were affected by water and nitrogen applications. Evenness index in the no-nitrogen treatment was more than that of 85 and 170 kg ha–1 nitrogen treatments in the non-rhizosphere or rhizosphere soil. Microbial biomass carbon in non-rhizosphere soil or rhizosphere soil decreased with the increase of nitrogen application, but showed the highest value in 16.5% of soil water content, followed by 12.5% and 20.5% of soil water content. Soil microbial biomass phosphorus content of 85 kg ha–1 nitrogen treatment in the non-rhizosphere soil or rhizosphere soil was significantly different for 0 and 170 kg ha–1 nitrogen treatments. Nitrification rate increased with the increase of soil water content in 0 and 170 kg ha–1 treatments. Our results demonstrated that water and nitrogen could impact the soil fertility and microbial activity of spinach

Neural correlates of quantity processing of numeral classifiers.

ObjectiveClassifiers play an important role in describing the quantity information of objects. Few studies have been conducted to investigate the brain organization for quantity processing of classifiers. In the current study, we investigated whether activation of numeral classifiers was specific to the bilateral inferior parietal areas, which are believed to process numerical magnitude.MethodUsing functional MRI, we explored the neural correlates of numeral classifiers, as compared with those of numbers, dot arrays, and nonquantity words (i.e., tool nouns).ResultsOur results showed that numeral classifiers and tool nouns elicited greater activation in the left inferior frontal lobule and left middle temporal gyrus than did numbers and dot arrays, but numbers and dot arrays had greater activation in the middle frontal gyrus, precuneus, and the superior and inferior parietal lobule in the right hemisphere. No differences were found between numeral classifiers and tool nouns.ConclusionThe results suggest that quantity processing of numeral classifiers is independent of that of numbers and dot arrays, supporting the notation-dependent hypothesis of quantity processing

Does the Use of Antidepressants Accelerate the Disease Progress in Creutzfeldt–Jakob Disease Patients With Depression? A Case Report and A Systematic Review

Background: Creutzfeldt–Jakob disease (CJD) is a fatal neurodegenerative disorder characterized by rapidly progressive dementia. Growing evidence suggests that antidepressant usage was associated with dementia. Given the commonality of depression in CJD, it is necessary to investigate the effect of antidepressants on CJD.Methods: First, we report a case of sporadic CJD (sCJD) with depression where the condition worsened rapidly after using a serotonin and noradrenaline reuptake inhibitor (SNRI) antidepressant. Second, a systematic literature survey was conducted to investigate the effect of antidepressants on the survival time of sCJD patients with depression. Thirteen cases plus our case were included for qualitative analysis. Twelve subjects were included in the Kaplan–Meier survival and Cox regression analysis. Finally, we provide a postulation of pathophysiological mechanism in CJD.Results: The median survival time of all patients was 6.0 months, of which patients with SNRIs were significantly shorter than those with first-generation antidepressants (2.0 vs. 6.0 months; log rank, P = .008) and relatively shorter than those with nonselective serotonin reuptake inhibitors (SSRIs; 4.0 vs. 6.0 months; log rank, P = .090). In comparison with first-generation antidepressants, the use of SNRIs [hazard ratio (HR), 23.028; 95% confidence interval (CI), 1.401 to 378.461; P = .028] remained independently associated with shorter survival time.Conclusions: The use of antidepressants, especially SNRIs, was associated with a shorter survival time of sCJD patients. The possible changes in neurotransmitters should be emphasized. Scientifically, this study may provide insights into the mechanism of CJD. Clinically, it may contribute to the early diagnosis of CJD

Neurotensin Receptor 1 Gene (NTSR1) Polymorphism Is Associated with Working Memory

BACKGROUND: Recent molecular genetics studies showed significant associations between dopamine-related genes (including genes for dopamine receptors, transporters, and degradation) and working memory, but little is known about the role of genes for dopamine modulation, such as those related to neurotensin (NT), in working memory. A recent animal study has suggested that NT antagonist administration impaired working memory in a learning task. The current study examined associations between NT genes and working memory among humans. METHODS: Four hundred and sixty healthy undergraduate students were assessed with a 2-back working memory paradigm. 5 SNPs in the NTSR1 gene were genotyped. 5 ANOVA tests were conducted to examine whether and how working memory differed by NTSR1 genotype, with each SNP variant as the independent variable and the average accuracy on the working memory task as the dependent variable. RESULTS: ANOVA results suggested that two SNPs in the NTSR1 gene (rs4334545 and rs6090453) were significantly associated with working memory. These results survived corrections for multiple comparisons. CONCLUSIONS: Our results demonstrated that NTSR1 SNP polymorphisms were significantly associated with variance in working memory performance among healthy adults. This result extended previous rodent studies showing that the NT deficiency impairs the working memory function. Future research should replicate our findings and extend to an examination of other dopamine modulators

Endovascular embolization of very small cerebral aneurysms

Background : Very small cerebral aneurysms are considered to be one of the challenges for endovascular treatment, with difficulty for catheterization and high risk for intraoperative rupture. We report the treatment of very small (< 3-mm) cerebral aneurysms by coil embolization. Materials and Methods : We performed a retrospective analysis of 11 consecutive patients with very small aneurysms treated by coil embolization in our institute between February 2007 and February 2009. Results : Three-dimensional rotational angiography (3DRA) was most accurate in the detection of these aneurysms; 3DRA revealed the aneurysms in two patients in whom conventional angiography failed to demonstrate the aneurysms. The Hunt-Hess (HH) grade was grade 0 (unruptured aneurysm) in one patient and grade I in ten patients. Coil embolization was successfully performed in 11 patients. Complete (n = 8) or near complete (n = 3) immediate occlusion was obtained. One or three soft coils were used in all the patients with the shortest available length. Balloon assistance was used in one patient and stent assistance was used in seven patients. Although coil migration into the MCA was seen in one patient and intraoperative aneurismal rupture occurred in one patient, no untoward clinical complication was seen. Follow-up DSA in 11 patients demonstrated persistent occlusion (n = 9) or progressive thrombosis (n = 2) of the aneurysms. All the patients with available follow-up had a modified Rankin Score (mRS) of 0. Conclusion : HH grade 0 and I very small cerebral aneurysms can be treated by endovascular coil embolization. Use of short, soft coils and balloon/stent assistance is useful

Efficacy and safety analysis of dexamethasone-lipiodol emulsion in prevention of post-embolization syndrome after TACE: a retrospective analysis

Abstract Background To investigate the efficacy and safety of dexamethasone-lipiodol emulsion in the prevention of post-embolization syndrome after TACE. Method The data of 255 patients who underwent TACE in the interventional department from June 2017 to June 2020 were collected. This is a retrospective assessment of patients who were non-randomly treated with dexamethasone in TACE. The patients were divided into two groups: TACE using lipiodol + chemotherapeutic emulsion group (TACE group, N = 133); TACE using lipiodol + dexamethasone + chemotherapeutic emulsion group (TACE + dexamethasone group, N = 122). Primary study endpoint: incidence of abdominal pain, fever, nausea and vomiting 0–72 h after TACE in both groups. Secondary study endpoints: incidence of infection after TACE in both groups. Results Incidence of post-embolization syndrome after TACE (TACE group vs TACE + dexamethasone group): abdominal pain, 55.6% versus 36.1% (P value 0.002); fever, 37.6% versus 13.1% (P value 0.000); nausea, 60.9% versus 41.0% (P value 0.001); vomiting, 48.1% versus 21.3% (P value 0.000). Incidence of infection after TACE (TACE group vs TACE + dexamethasone group): 1.5% versus 2.5% (P value 0.583). Conclusion The lipiodol + dexamethasone emulsion can significantly reduce the incidence rate of post-embolization syndrome after TACE, with exact effect and high safety

Intraprocedural cerebral aneurysm rupture during endovascular coiling

Background : Intraprocedural aneurysm rupture is considered to be one of the most formidable complications of the endovascular treatment of cerebral aneurysms and is associated with high mortality. Objective : To report the clinical outcomes of cerebral aneurysms that ruptured during endovascular coiling. Patients and Methods : Over a period of six years, 559 endovascular embolizations were performed in 467 patients, with 507 cerebral aneurysms. Intraprocedural aneurysm rupture occurred in 14 cases (mean aneurysm size, 3.8 mm). Follow-up angiograms, at a minimum of three months post embolization, were available in 11 living patients. Acute and follow-up results were reviewed. Results : The difference in the rates of aneurysm perforation during endovascular coiling between ruptured and unruptured aneurysms was significant (P < 0.05). There were three (21.4%) deaths related to this complication and three (21.4%) patients developed new deficits (modified Rankin Scale scores 1 to 2). Acute results of embolization were: complete occlusion in eight (57.1%), neck remnant in two (14.3%), and incomplete occlusion in four (28.6%) patients. Long-term follow-up results in 11 living patients were: major recanalization in one (9.1%), minor recanalization in one (9.1%), and stable occlusion in nine (81.8%). Conclusion : Intraprocedural aneurysm rupture frequently occurs in small aneurysms and appears to be associated with relatively high rates of mortality

Retrieval practice facilitates memory updating by enhancing and differentiating medial prefrontal cortex representations.

Updating old memories with new, more current information is critical for human survival, yet the neural mechanisms for memory updating in general and the effect of retrieval practice in particular are poorly understood. Using a three-day A-B/A-C memory updating paradigm, we found that compared to restudy, retrieval practice could strengthen new A-C memories and reduce old A-B memory intrusion, but did not suppress A-B memories. Neural activation pattern analysis revealed that compared to restudy, retrieval practice led to stronger target representation in the medial prefrontal cortex (MPFC) during the final test. Critically, it was only under the retrieval practice condition that the MPFC showed strong and comparable competitor evidence for both correct and incorrect trials during final test, and that the MPFC target representation during updating was predictive of subsequent memory. These results suggest that retrieval practice is able to facilitate memory updating by strongly engaging MPFC mechanisms in memory integration, differentiation and consolidation