[Efficacy, prognosis and influencing factors of transcatheter arterial embolization in the treatment of neuroendocrine neoplasm liver metastases]

Objective: To evaluate the efficacy of transcatheter arterial embolization (TAE) in the treatment of neuroendocrine neoplasm liver metastases (NENLM), analyze the prognosis and related factors. Methods: Clinical data of NENLM patients treated with TAE in the First Affiliated Hospital of Nanjing Medical University from January 2018 to March 2022 were retrospectively analyzed. Objective response rate (ORR), disease control rate (DCR), and adverse event rate after TAE were evaluated according to the Response Evaluation Criteria In Solid Tumors and the Common Terminology Criteria for Adverse Events. The prognosis was evaluated by median overall survival (mOS) and median progression-free survival (mPFS). The survival curve was plotted by Kaplan-Meier method. Multivariate Cox regression was used to analyze prognostic factors. Results: A total of 39 NENLM patients were included in this study, aged (53.3±10.3) (23-74) years old, including 23 males and 16 females. Among them, 9 cases had functional neuroendocrine neoplasms. There were 31 cases with primary sites locating in the digestive system, 32 cases with WHO G1 and G2 primary sites, 27 cases with abundant blood supply for liver metastases and 13 cases with liver tumor load >50%. Thirty patients received treatment of long-acting somatostatin analogue(SSA). A total of 123 TAE were performed in 39 cases, with an ORR of 38.5% (15/39) and a DCR of 76.9% (30/39). There were no serious adverse events of level 4-5 during the perioperative period. The median follow-up was 38.7 (95%CI: 31.3-46.1) months, with mOS of 37.3(95%CI: 27.0-47.5) months and mPFS of 12.6 (95%CI: 7.1-18.1) months. Multivariate Cox regression analysis found that the combination of long-term SSA treatment was an influencing factor for overall survival of patients (HR=0.207, 95%CI: 0.076-0.567, P=0.002). Conclusions: TAE can effectively reduce the load of liver metastases in patients with NENLM, and the combination of long-term SSA treatment can improve the ovreall survival of patients.

[Selenium Geochemical Characteristics and Influencing Factors of Paddy Fields in Du'an County, Guangxi]

This study used 21 rock samples and 193 sets of paddy soil and rice grain samples collected form Baiwang Town, an area of clastic sedimentary rocks in Guangxi, China, to evaluate the potential for selenium-rich agriculture. We analyzed the concentrations of selenium and heavy metals in the soil and rice samples, and discuss the influencing factors by means of statistics and correlation analysis. The results showed that the selenium-rich rate of paddy soil and rice grain in Baiwang Town were 67.4% and 64.8%, respectively, but the content of cadmium in the selenium-rich soil samples was generally higher than the baseline value for China and the background value for Guangxi. In comparison to the screening value of soil pollution risk for agricultural land(GB 15618-2018), the over-standard rate of cadmium was 46.1%, while the over-standard rates of other heavy metals were negligible. The comparison shows that the selenium-rich rate of rice was 61.1% in the southern area of Baiwang Town with a negligible heavy metal content, and the advantages of green selenium-rich rice planting were clear. The correlation analysis showed that secondary enrichment was the main form of selenium enrichment in the study area. The soil pH and texture of the root-zone soil also affected the selenium content of the soil. The selenium content of rice seeds was mainly affected by the selenium content, active selenium content, pH, and aluminum oxide content of the root-zone soil. The risk assessment showed that the level of dietary exposure to cadmium is generally within safe limits, but it is still necessary to strengthen the monitoring of cadmium in rice and control cadmium pollution to reduce the levels of dietary exposure, especially in the central region of Baiwang Town.

[Analysis of the short-and medium-term curative effect of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis]

Objective: To evaluate the short- and medium-term clinical efficacy of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis. Methods: 63 cases with acute portal vein thrombosis treated in our center from May 2017 to July 2019 were studied retrospectively, including 49 males and 14 females, aged 35-61 (46 ± 5) years. TIPS approach (with/without) combined with Angiojet thrombus aspiration and gastroesophageal varices embolization was performed simultaneously according to the patient's condition. Regular follow-up for 3-33 (22 ± 3) months after surgery was used to observe the curative effect. Results: The technical success rate was 100%. Portal vein and superior mesenteric vein blood flow were returned to normal after the operation. Two cases of biliary tract injury were untreated. Simultaneously, two cases of intrahepatic arteriovenous fistula were treated with superselective arterial embolization. During the follow-up period, 47 cases (74.61%) had complete portal vein recanalization, 13 cases (20.63%) had partial recanalization, 3 cases (4.76%) had complete portal cavernoma, 7 cases (11.11%) had symptomatic hepatic encephalopathy, 1 case had received artificial liver treatment (1.59%), 1 case had peptic ulcer (11.11%), 6 cases (9.52%) had lost to follow-up, and there was no portal hypertension-related bleeding or death. Conclusion: TIPS approach combined with AngioJet thrombus aspiration technology is safe, effective and feasible in the treatment of acute portal vein thrombosis, and the short- and medium-term clinical effects are satisfactory.

[Characteristics and Origins of Heavy Metals in Soil and Crops in Mountain Area of Southern Sichuan]

Excessive heavy metals in soils and crops will affect the human living environment and health. In order to study the enrichment characteristics and causes of heavy metals in soils and crops in a mountainous area of southern Sichuan, 1699 cultivated soil samples, 30 rice seed samples, 31 corn seed samples, 15 tea samples, and 76 crop root soil samples were collected. The enrichment characteristics and origins of heavy metals in the soil were studied using mathematical statistics, principal component analysis, and correlation analysis. The enrichment characteristics of heavy metals in crops and their correlations with root soil were discussed. The results showed that the content of heavy metals in cultivated soil was higher than the national soil background value, and many sampling points exceeded the risk screening value. Among them, 770 points of Cd, 176 points of Cu, 116 points of Cr, and 106 points of Ni exceeded the standard. Combining the factor analysis results, it was found that Cd, Cr, Cu, Ni, and Zn in cultivated soil mainly originated from the geological background, and Cd was also affected by soil organic matter and pH. Meanwhile, Hg and Pb were mainly related to human activities. The results showed that the contents of heavy metals in the crops were lower than the national standards; the enrichment coefficients of heavy metals in crops were generally small, and were mainly in the following order: tea > rice > corn. The correlation analysis of the heavy metal contents in the root soil and crops showed that there was no significant correlation among them. Thus, the heavy metals in the soil generally had a high content and low activity, which did not affect the quality and safety of the three crops. However, Cu in corn and CaO in root soil, As in corn seed and Fe₂O₃ in root soil, and Ni in corn seed and Fe₂O₃ in root soil showed significant correlations, whereas As in rice seed and CaO in root soil and Hg in rice seed and MgO in root soil showed significant correlations, and no significant correlations were found in tea.

[Ecological Risk Assessment of Heavy Metals at Township Scale in the High Background of Heavy Metals, Southwestern, China]

Heavy metals (HMs) are naturally occurring elements that have high natural background levels in the environment. Therefore, it is important to conduct ecological risk assessment and identify potential sources of HMs. In the past, studies were conducted at the regional scale. The accuracy of those studies could not meet the needs of spatial planning and natural resource management. Therefore, it is necessary to conduct ecological risk assessment at the township scale. In this study, 1092 soil samples (from 0-20 cm depth) were collected in the town of Reshui, an area with high background levels of soil HMs with the parent material of carbonatite, which is commonly found in Southwest China. The town of Reshui is a multi-ecological risk superimposed area where the ecological risk is high. In this study, concentrations of HMs (Cd, Cr, As, Hg, Pb, Cu, Zn, and Ni) in the topsoil were analyzed, and statistical analysis (SA), geographic information system (GIS) modeling, and positive matrix factorization (PMF) analysis were performed. The geoaccumulation index (I_geo) and potential ecological risk index (PERI) were applied for the ecological risk assessment and quantification of the sources of the soil HMs. The mean values of HM concentrations in the topsoil were 18.1, 1.18, 174.1, 202.2, 0.09, 71.1, 34.9, and 167.2 mg ·kg^-1for As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, respectively, which were considerably higher than the average background value (ABV) in soils in Yunnan Province except for As and Pb. The average concentrations of Cd, Cr, Cu, and Ni exceeded the screening values specified in the soil contamination risk in agricultural land (GB 15618-2018) by 5.82, 1.16, 4.04, and 1.02 times, respectively. The I_geo value shows that the major pollutant is Cu in the surface soil of the study area, followed by Cr, and Cd. Speciation analysis of HMs indicates that HMs (Cr, As, Pb, Cu, Zn, and Ni) mainly exist in the residual form, mostly from the geological background with low bioavailability. The potential effective components of Hg have higher levels, but the total amount of Hg and its pollution risk are lower. Cd has a high bioavailability ratio, is easy to enter the soil solution and be absorbed by crops, and is the HM with the highest pollution risk in the study area. The PERI shows that the proportions of low ecological risk, moderate risk, and high risk soil samples are 44.23%, 54.40%, and 1.37% of the total number of samples, respectively. Hg and Cd were the major sources of risk because of their high toxicity coefficient. The PMF analysis indicates that there are four major sources of HMs in the study area: human activity, natural sources, coal mining and traffic emissions, and agricultural sources with the risk contribution ratios of 9.29%, 53.67%, 11.23%, and 25.81%, respectively. The PMF analysis effectively quantified the ecological risk from these sources, providing a reference for further pollution control and prevention measures.