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To investigate the safety, feasibility, and complications of pancreatectomies for pediatric pancreatic tumors. The medical records of pancreatectomy patients from January 2007 to January 2018 were retrospectively analyzed for perioperative factors and complications. Patients were divided into pancreatic head (n = 43), body (n = 18) and tail (n = 43) groups. Seventy-two girls and 32 boys (median age 10 years at diagnosis, range: 0–15 years) were enrolled and had solid pseudopapillary tumors (n = 73), pancreatoblastoma (n = 19), neuroendocrine tumors (n = 9), and others. Primary surgical procedures included pylorus-preserving pancreaticoduodenectomy (n = 10) and distal pancreatectomy with splenectomy (n = 4), and organ-sparing resection procedures included duodenum-preserving pancreas head resection (n = 25), middle segmental pancreatic resection (n = 15), spleen-preserving distal pancreatectomy (n = 37) and local enucleation (n = 13), with a median blood loss of 20 cm3 (range: 10–300 cm3). Short-term complications included pancreatic fistula (35.6%), bile leakage (2.9%), intraabdominal infection (21.2%), delayed gastric emptying (23.1%), and postpancreatectomy hemorrhage (5.8%). After a median follow-up of 38 months (range: 3–143 months), 94 patients (90.4%) were alive without tumor recurrence, 2 were alive after tumor recurrence, 1 pancreatoblastoma patient died from tumor recurrence, and 7 were lost to follow-up. Only 14 patients (14/96, 14.6%) had long-term complications at the outpatient follow-up. Surgical resection was the main treatment for pancreatic tumors. Organ-sparing resection procedures led to good long-term results for pediatric pancreatic tumors, even if these procedures could cause a relatively high incidence of short-term complications (especially pancreatic fistula and postpancreatectomy hemorrhage). Level IV. [ABSTRACT FROM AUTHOR]

Congenital hepatoblastoma is an exceedingly rare neoplasm, predominantly documented as isolated instances, with contentious aspects surrounding its therapeutic approaches and prognostic implications. This study aims to comprehensively summarize and evaluate the management experience of congenital hepatoblastoma (CHB). This cohort comprised five infants diagnosed with hepatoblastoma, confirmed through pathological examination, and with an onset of symptoms before 28 days of age. They were enrolled between November 2019 and May 2022. The treatment course they underwent has been summarized, and their prognosis has been subject to analysis. Distinguishing congenital hepatoblastoma from other medical conditions is typically necessary. Given the patient's tender age, the approach to treatment demands comprehensive assessment, particularly in cases involving unique tumor locations or substantial tumor sizes. The selection of treatment modalities, encompassing preoperative neoadjuvant chemotherapy and surgical techniques, becomes of paramount importance. Furthermore, determining the treatment's endpoint poses a notable challenge and often necessitates a comprehensive evaluation. For pediatric patients afflicted with CHB, the application of preoperative neoadjuvant chemotherapy mitigates surgical risks, while the incorporation of surgical procedures followed by postoperative chemotherapy significantly enhances the overall prognosis. Additionally, AFP-L3% levels may serve as a valuable adjunctive marker signifying the conclusion of treatment. • Congenital hepatoblastoma is primarily documented via case reports. with this study reporting a higher number of cases. • Neoadjuvant chemotherapy is safe and effective for patients with CHB when initial surgical removal is not possible. • Three-dimensional imaging, utilizing contrast-enhanced abdominal CT scans, can facilitate tumor resection. • AFP-L3 can serve as a valuable tool for determining the appropriate treatment endpoint. • In certain cases, tumor block resection may lead to an improved prognosis and obviate the need for liver transplantation. [ABSTRACT FROM AUTHOR]

Desmoplastic small round cell tumor (DSRCT) is a rare sarcoma predominantly afflicting young males. In this current report, a two-year-old boy was admitted to the hospital for the evaluation of a left chest wall mass. Imaging revealed the tumor's presence in the left chest, compressing lung tissue. Subsequently, histological analysis confirmed the DSRCT diagnosis following a biopsy. The patient underwent a comprehensive management strategy centered around surgery, successfully completing the entire treatment course without experiencing relapse during subsequent follow-up assessments. When chest wall tumors are inoperable upon initial diagnosis, a biopsy is essential to clarify the pathology and assist in the diagnostic process. If a patient is diagnosed with DRSCT and conventional chemotherapy fails with surgical resection still not feasible, timely adjustment of the chemotherapy regimen coupled with targeted drug administration can reduce the tumor, enable complete resection, and improve the overall prognosis. DSRCT is a rare malignancy associated with a generally poor prognosis. The administration of a combined treatment approach involving oral targeted medication (anlotinib), chemotherapy, radiotherapy, and aggressive surgical resection holds the potential to enhance the prognosis for pediatric patients with this condition. • This is a very young child (two years old) with a very rare tumor in the chest wall. • The tumor was deemed unresectable when diagnosis, and this status persisted following the chemotherapy of VAIA regimen. • Combining anlotinib with chemotherapy has facilitated tumor removal and has been considered safe. • After successful tumor control, surgical excision was performed without harming adjacent organs. • During the three-year follow-up period that ensued, the child remained devoid of recurrent metastatic lesions. [ABSTRACT FROM AUTHOR]

Retroperitoneal neuroblastomas predominantly encroach upon critical structures, complicating surgical intervention and yielding elevated rates of surgery-associated complications. The kidney and renal vasculature represent the organs most susceptible to retroperitoneal neuroblastoma infiltration. Prior investigations have revealed high nephrectomy incidence and a paucity of renal-preserving surgical approaches. A retrospective analysis was undertaken, examining patients with retroperitoneal neuroblastoma who underwent surgical procedures from January 2018 to December 2019 at Beijing Children's Hospital. The study encompassed 225 patients, presenting a median age of 37 months. Concomitant nephrectomy and tumor excision were performed in 11 (4.9%) patients, while 214 (95.1%) patients successfully preserved their kidneys during surgery. Among the patients who retained their kidneys, 8 (3.5%) experienced renal atrophy postoperatively. Predominant rationales for simultaneous nephrectomy included tumor invasion into the renal hilum (n = 9), markedly diminished function of the affected kidney (n = 2), and ureteral infiltration (n = 1). Subsequent to a median follow-up duration of 43 months, the outcomes demonstrated no considerable divergence in overall survival (OS) and event-free survival (EFS) between the nephrectomy and renal-preserving cohorts among high-risk (HR) neuroblastoma patients. Among the eight HR children who underwent nephrectomy, four experienced local recurrence. The nephrectomy cohort exhibited a significantly elevated cumulative incidence of local progression (CILP) relative to the renal-preserving group. In high-risk retroperitoneal neuroblastoma patients, nephrectomy does not enhance CILP, EFS, or OS. The guiding surgical tenet involves preserving the kidney while striving for gross total resection of the primary neoplasm, barring instances of severe deterioration of the affected renal function. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors-based immunotherapy offers a new effective modality in the treatment of advanced malignancies. Considering the remarkable efficacy of immune checkpoint inhibitors in clinical trials, the FDA has approved a variety of immune checkpoint inhibitors for the treatment of advanced tumors. However, only limited patients with certain cancers can benefit from monotherapy of immune checkpoint inhibitors. Interventional therapy for cancer can not only destroy the primary tumors, but also regulate the immune system through different mechanisms, which provides a potential possibility for the combination of immune checkpoint inhibitors and interventional modalities in cancer treatment. This article reviews the possible synergistic mechanisms of interventional therapy combined with immune checkpoint inhibitors and summarizes the research progress of the combined therapy in cancer treatment. [ABSTRACT FROM AUTHOR]

Afforestation as an effective measure to control soil erosion has achieved remarkable effects in northern China. However, large scale of artificial afforestation can increase soil water consumption and induce soil desiccation in arid and semi-arid areas. This study analyzed the variations of soil water storage following the conversion of croplands into forests with different species and stand ages on the Loess Plateau. Three most common artificial forests dominated by Salix matsudana , Populus cathayana , and Sophora japonica with stand ages of 5, 10, and 15 years were investigated to determine the variations in soil water storage. The results showed that soil water storage decreased with increasing afforestation ages and soil depth. Salix matsudana mainly consumed shallow soil water (0–100 cm), P. cathayana mainly consumed deep soil water (100–150 cm), while S. japonica had relatively lower water consumption than the other two species. Converting cropland into forest resulted in a significant water deficit. Soil water deficit in the 0–100 cm soil profiles was significantly higher under S. matsudana than under the other two artificial forests. Severe soil water depletion and obvious soil desiccation occurred after 12 years of afforestation. Therefore, artificial forests with less water consumption, e.g. S. japonica , should be given priority in future afforestation practice. To maintain the sustainability of vegetation, changes in land-use patterns should be considered after 12 years of afforestation. [ABSTRACT FROM AUTHOR]

Bilateral primary adrenal tumors are rare, and the majority of cases present the same histology. Bilateral adrenal tumors with different histology are extremely uncommon. A 6-month-old male presented with abdominal distension and excessive crying. Physical examination revealed a blood pressure (BP) of 108/80 mmHg, centripetal obesity, a "full moon" facial appearance, mild abdominal distension, tenderness to palpation, and no palpable masses. Bilateral adrenal tumors were found ultrasound. Contrast-enhanced computed tomography (CT) showed a soft tissue mass of 3.2 cm in diameter in the right adrenal gland and a mass of 2.1 cm in diameter in the left adrenal gland. Serum cortisol was 1563 nmol/L (normal: 96–551 nmol/L). After ruling out distant metastases, the patient underwent a right-sided adrenalectomy and a left adrenal tumor enucleation to preserve as much normal tissue as possible on the left adrenal gland. Pathology revealed a right adrenal cortical carcinoma and left adrenal poorly differenciated neuroblastoma. Post-surgery, the patient received hydrocortisone supplementation as needed and neuroblastoma-targeted chemotherapy. Hydrocortisone replacement was progressively reduced and eventually weaned off. No recurring lesions have been detected at 1 year of follow-up period. Bilateral adrenal tumors should never be assumed to be of similar type because, while extremely rare, bilateral tumors of different types are possible. All efforts should be made to preserve the normal adrenal tissue in cases of bilateral adrenal masses. [ABSTRACT FROM AUTHOR]

[Display omitted] • The diversity and biomass of understory plant increased by plantation dieback. • The SWS recovered significantly in 1–5 m soil profile under dieback plantations. • SOC was accumulated after plantation dieback in the 5–10 m soil profile. • Understory plants may play a key role in sustaining plantation ecosystem functions. Shrub plantation is an effective approach for controlling soil erosion and land degradation. However, the extensive dieback on shrubs as a result of climatic changes or soil drought may impair shrub plantations' ecosystem functions in arid and semi-arid regions. In this study, we sampled brown C. korshinskill plantations (shrub dieback > 90%), green plantations (shrub dieback was rarely < 10%) and an over-100 years' natural grassland as the reference. The changes in plant biomass and diversity of understory vegetation, soil water storage (SWS) and carbon storage (SOCs) across of 0–10 m soil profile were analyzed. The results showed that, (i) the understory herbaceous biomass in brown plantations was 134.1 g m−2 and significantly higher by 49.5% than green plantations. The biomass and diversity of perennial forbs and annual/biennial grasses in brown plantations was also increased significantly; (ii) shrub dieback replenished soil water within 1–5 m depth. The SWS under brown plantations was significantly increased by 44.6% compared with green plantations, and reached 84.7% of that in natural grassland; (iii) the SOCs was notably higher in shrub plantations in the 0–10 m soil profile, increasing by 6.68% and 10.3% compared with natural grassland, respectively. SOC accumulation was mostly occurred at depths below 5 m under brown plantations. Overall, beyond shrub dieback, ecosystem functions of plantations were enhanced unexpectedly. The findings suggest that it was a blessing in shrub dieback disguise, understory herbaceous vegetation may maintain ecosystem functions of plantations in the semi-arid region alternatively. [ABSTRACT FROM AUTHOR]

Extensive studies have been conducted on the environmental degradation of multiwall carbon nanotubes (MWCNTs), but primarily focused on the extent and rate of MWCNTs mineralization. Few studies have explored possible structural changes that may occur to MWCNTs during natural or engineered processes. We systematically examined MWCNTs in oxidative coupling reactions in the presence of a common contaminant tetrabromobisphenol A (TBBPA). MWCNTs was modified by the radicals of TBBPA resulting from peroxidase-mediated coupling reaction. Interactions between TBBPA radicals and MWCNTs were definitely confirmed by analyzing the characteristic mass spectrometry response of bromine in TBBPA and the structures of MWCNTs. After reaction with TBBPA radicals for 60 min, the content of bromine contained in MWCNTs was 6.84(±0.12)%, a quantity equivalent to a 501.65(±2.19) mg loading of TBBPA per gram MWCNTs. Modified MWCNTs had better stability and smaller sizes than that of MWCNTs and TBBPA-adsorbed MWCNTs. Assessment using zebrafish embryos revealed that the modified MWCNTs passed through the chorion and entered the embryo inducing acute toxicity, while the MWCNTs/TBBPA-adsorbed MWCNTs was trapped by chorion. These findings indicated that MWCNTs was modified in peroxidase-mediated coupling reactions, and suggested that such modifications may have an influence on the ecological risks of MWCNTs. [ABSTRACT FROM AUTHOR]

Purpose We assessed the association between the R.E.N.A.L., PADUA and centrality index scores and perioperative outcomes, and determined the efficacy of each scoring system over the simple parameter of tumor size. Materials and Methods We conducted a retrospective review of the records of patients who underwent laparoscopic radio frequency ablation of renal tumors from February 2006 to April 2014 at our institution. Tumors were categorized using the R.E.N.A.L., PADUA and centrality index score, which were determined by analyzing preoperative imaging. The relationships between each variable and change in glomerular filtration rate, estimated blood loss, operative time and postoperative complications were examined. Results Laparoscopic radio frequency ablation was performed in 215 selected patients with preoperative imaging available. The interclass correlations coefficient of the 3 observers was 0.87, 0.84 and 0.82 for the C-Index, the R.E.N.A.L. and the PADUA scoring system, respectively. R.E.N.A.L. score, PADUA score and PADUA complexity were significantly associated with postoperative complications (p=0.040, 0.015 and 0.006, respectively). However, major complications were only associated with high PADUA complexity (chi-square 23.851, p <0.05). Each scoring system had a significant association with operative time and estimated blood loss (p <0.05), except that the C-index score had no relationship with estimated blood loss (p=0.083). The accuracy of each scoring system in predicting perioperative outcomes and postoperative complications was superior to that of tumor size. Conclusions Each scoring system has an advantage over tumor size in describing tumor complexity and may help with surgical decision making. Further studies are required to validate their efficacy in evaluating the intraoperative and postoperative results after renal laparoscopic radio frequency ablation. [ABSTRACT FROM AUTHOR]

Purpose We compared outcomes in patients treated with radio frequency ablation or partial nephrectomy for clinical cT1b renal cell carcinoma. Materials and Methods We retrospectively reviewed the records of all patients who underwent radio frequency ablation or nephrectomy between February 2006 and December 2010. Radiographic followup with contrast imaging was performed 7 days, 3 and 6 months, and every 6 months thereafter after radio frequency ablation sequentially. The followup protocol for partial nephrectomy was every 6 months in the initial 3 years and annually thereafter. The Kaplan-Meier method was used to generate survival curves, which were compared with the log rank test. Multivariable regression analysis was done to determine predictors of survival. Results A total of 56 patients who met selection criteria were included in study. Patients in the radio frequency ablation group had relatively higher mean age and a higher mean ASA® score than those in the partial nephrectomy group. Mean tumor diameter was significantly larger in the partial nephrectomy cohort. For radio frequency ablation vs partial nephrectomy 5-year overall, cancer specific and disease-free survival was 85.5% (95% CI 72.2–98.8) vs 96.6% (95% CI 95.9–97.3), 92.6% (95% CI 82.4–98.1) vs 96.6% (95% CI 95.9–97.3) and 81.0% (95% CI 66.2–95.8) vs 89.7% (95% CI 78.5–97.9), respectively. The percent decrease in the glomerular filtration rate was significantly lower in the radio frequency ablation group at early and last followup. Conclusions In appropriately selected patients with stage cT1b renal cell carcinoma radio frequency ablation is an effective treatment option that provides 5-year overall, cancer specific and disease-free survival comparable to that of partial nephrectomy as well as better renal function preservation than partial nephrectomy. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the safety and efficacy of zero ischemia, radio frequency ablation assisted tumor enucleation for renal cell carcinoma. We report the incidence of complications, positive surgical margins, local recurrence, and progression-free and disease specific survival rates. Materials and Methods: We retrospectively reviewed data on 42 patients with renal cell carcinoma treated with zero ischemia laparoscopic radio frequency ablation assisted tumor enucleation between March 2006 and November 2009. Median age was 60 years (range 37 to 82) and 31 patients (73.8%) were male. The median greatest tumor dimension was 3.4 cm (range 1.8 to 6.1). The Mann-Whitney U, chi-square and Fisher exact tests were used to compare bleeding and complications. The paired t and Mann-Whitney U tests were used to compare glomerular filtration rates. The Kaplan-Meier method was used to calculate survival. Results: We found 32 tumors with a greatest dimension of 4 cm or less and 10 with a greatest dimension of 4 to 7 cm. Median blood loss was 82.5 ml (range 15 to 210). Overall 7 complications (16.6%) occurred, including postoperative fever in 4 cases (Clavien grade II) and prolonged urinary leakage in 3 (Clavien grade III). The PADUA (preoperative aspects and dimensions used for an anatomical) score was associated with prolonged urinary leakage (p = 0.03) but not with overall complications. No patient had positive surgical margins. The glomerular filtration rate did not differ before vs 12 months after surgery. Three-year cancer specific, cumulative and progression-free survival was 100%, 97.3% and 96.4%, respectively. Conclusions: Zero ischemia, laparoscopic radio frequency ablation assisted tumor enucleation of renal cell carcinoma is a safe, effective nephron sparing treatment that provides excellent oncological and functional outcomes. [Copyright &y& Elsevier]