ABSTRACT
OBJECTIVE: The purpose of the study described was to establish prediction models to initially screen the beneficiary patients with unresectable hepatocellular carcinoma (HCC) in the treatment of anti-vascular endothelial growth factor (VEGF) agents plus anti-programmed cell death-1 (PD-1) antibody. METHODS: A total of 62 patients were enrolled in this study. All patients underwent ultrasound (US), color ddoppler flowing imaging (CDFI), contrast-enhanced ultrasound (CEUS) and laboratory examinations within 2 wk before the treatment. Tumor response was assessed according to mRECIST criteria. Univariate and multivariate analyses were used to select the independent predictors. US + CDFI, CEUS and FULL models were established. Three models were displayed by nomography. Receiver operating characteristic (ROC) and calibration curves were drawn to evaluate the predictive ability of models. Decision curve analysis (DCA) was used to assess the clinical utility of models. RESULTS: On univariate and multivariate analysis, the US boundary (p = 0.037), halo (p = 0.002) and CDFI (p = 0.024) were included in the US + CDFI model. CEUS boundary (p = 0.001) and washout time (p < 0.001) were included in the CEUS model. The number of lesions (p = 0.104), halo on US (p = 0.014), CDFI (p = 0.057) and washout time on CEUS (p = 0.015) were incorporated into the FULL model. The C indices of the US + CDFI, CEUS and FULL models were 0.918, 0.920 and 0.973. CEUS and FULL models yielded a good net benefit for almost all threshold probabilities. CONCLUSION: Nomograms based on US, CDFI, CEUS and clinical characteristics could help to non-invasively predict the response to treatment with anti-PD-1 antibodies plus anti-VEGF agents.
ABSTRACT
Under rapid industrialization and urbanization, the conservation and management of agricultural heritage systems is facing many threats and challenges, such as the massive outflow of working labor, land abandonment, and the difficulty in maintaining traditional knowledge systems. Promoting land transfer and carrying out moderate-scale management play an active role in the conservation of agricultural heritage systems. While land transfer brings economic benefits to heritage sites, its environmental impacts to heritage sites are worthy of attention. However, empirical studies are scarce. This study took Qingtian rice-fish culture system in Zhejiang Province as an example, which was designated as Globally Important Agricultural Heritage Systems (GIAHS) in 2005. Small farmer management model and land scale management model were distinguished, while the life cycle method was used to calculate the carbon footprints of two models. The results showed that the carbon footprints of small farmer management model and land scale management model were 6510.80 and 5917.00 kg CO2-eq·hm-2, respectively, while the carbon footprints per unit output were 0.13 and 0.10 kg CO2-eq·yuan-1, respectively. Compared with small farmer management model, land scale management model had lower greenhouse gas emission and lower environmental impact of per unit output. As farmers expanded the scale of land management, local greenhouse gas emissions had been reduced by 4097.20 kg CO2-eq. Furthermore, the accumulation of CH4 in agricultural production accounted for the largest proportion of carbon footprint. The input of compound fertilizer among agricultural production materials was next to CH4 accumulation, becoming the second largest source of greenhouse gas emission. Corn and wheat being used as fish feed also had a significant impact on greenhouse gas emission in small farmer management model. Therefore, the promotion of moderate scale land management is conducive to the win-win of economic and environmental benefits of traditional agricultural systems and plays an important role in the conservation of agricultural heritage systems.
Subject(s)
Carbon Footprint , Oryza , Agriculture , Animals , Fertilizers , TriticumABSTRACT
This study aimed to investigate the clinical application value of the 5-fluorouracil (5-FU) sustained-release particles implanted along the cardiac tangent direction into malignant pericardial effusion (MPCE). A total of 81 MPCE patients underwent pericardiocentesis, and were implanted with 5-FU sustained-release particles into the pericardial cavity under ultrasound guidance. The puncturing path was along the cardiac tangent direction. Ultrasound examinations were performed every week, and the efficacy was evaluated 4 weeks after treatment. The 45 patients who were treated with pericardial catheter drainage and simultaneous intracavitary chemotherapy were used as the control group. The success rate of pericardiocentesis was 100%. Ultrasound reviews performed 4 weeks after treatment showed that 71 cases achieved complete remission and eight cases achieved partial remission, while treatment was completely ineffective in two cases. The total remission rate was 97.53%, which was significantly higher than that of the control group (77.78%, p < 0.01). The implantation of 5-FU sustained-release particles along the cardiac tangent direction was safe, and demonstrated good efficacy and fewer adverse reactions. Thus, this method could be ideal for the treatment of MPCE.
