Objective To observe the value of intratumoral tertiary lymphoid structure(TLS)for predicting prognosis of soft tissue sarcomas(STS)after cryoablation combined with immunotherapy.Methods Forty-three STS patients who underwent cryoablation were retrospectively enrolled,including 38 cases underwent cryoablation combined with but 5 cases without immunotherapy,among them 6 cases with but 37 cases without intratumoral TLS.The progression free survival(PFS)were compared between those with and without immunotherapy,as well as those with and without intratumoral TLS.The value of intratumoral TLS for predicting prognosis of STS after cryoablation combined with immunotherapy was analyzed with Cox regression and receiver operating characteristic curves.Results No significant difference of PFS was found between STS patients undwerwent cryoablation combined with and without immunotherapy(P＜0.05).Among 38 cases underwent cryoablation combined with immunotherapy,6 cases were found with but 32 cases without intratumoral TLS,and the median PFS of the former was longer than that of the latter(6 months vs.3 months,P＜0.05).Univariate and multivariate Cox regression analysis revealed that intratumoral TLS and interleukin 2 receptor(IL-R2)were both independent influencing factors of PFS of STS patients after cryoablation combined with immunotherapy(both P＜0.05).The area under the curve(AUC)of intratumoral TLS for predicting PFS of STS patients at 3,6 and 9 months was 0.550,0.577 and 0.699,of IL-R2 was 0.658,0.742 and 0.583,respectively,while of combination of the above two was 0.762,0.787 and 0.881,respectively,all higher than of each intratumoral TLS and IL-R2 alone(all P＜0.05).Conclusion Intratumoral TLS could be used to predict prognosis of STS after cryoablation combined with immunotherapy.Combining with IL-R2 might further improve its predictive efficacy.

Objective To assess potential associations between sarcoma and gut microbiota using Mendelian randomization(MR)analysis.Methods Instrumental variables(IV)for gut microbiota were identified from summary data of a genome-wide association studies(GWAS)involving 18 340 participants from 24 cohorts published by the MiBioGen Consortium.The GWAS on sarcoma from Europe served as an outcome,involving 456 276 sarcoma patients.The inverse-variance weighted(IVW)method was used for primary analysis while sensitivity analysis was made to test the reliability of results of MR analysis.Results IVW results showed that Peptostreptococcaceae(OR=0.353,95％CI 0.127 to 0.979,P=0.045)and Faecalibacterium(OR=0.408,95％CI 0.173 to 0.961,P=0.040)had a negative causal correlation with sarcoma,but the Eubacterium fissicatena group(OR=2.216,95％CI 1.101 to 4.462,P=0.026)and Lachnospiraceae UCG008(OR=1.822,95％CI 1.005 to 3.305,P=0.048)exhibited a positive causal correlation with sarcoma.Sensitivity analysis showed no evidence of pleiotropy and heterogeneity.Conclusion Through two-sample MR,this study identifies a potential causal relationship between four gut microbiota and sarcoma.Peptostreptococcaceae and Faecalibacterium can reduce the risk of sarcoma while the Eubacterium fissicatena group and Lachnospiraceae UCG008 are linked to an increased risk of sarcoma.More research is required to find out more about the way gut microbiota influences the development of sarcoma.

Objective To observe the value of intratumoral tertiary lymphoid structure(TLS)for predicting prognosis of soft tissue sarcomas(STS)after cryoablation combined with immunotherapy.Methods Forty-three STS patients who underwent cryoablation were retrospectively enrolled,including 38 cases underwent cryoablation combined with but 5 cases without immunotherapy,among them 6 cases with but 37 cases without intratumoral TLS.The progression free survival(PFS)were compared between those with and without immunotherapy,as well as those with and without intratumoral TLS.The value of intratumoral TLS for predicting prognosis of STS after cryoablation combined with immunotherapy was analyzed with Cox regression and receiver operating characteristic curves.Results No significant difference of PFS was found between STS patients undwerwent cryoablation combined with and without immunotherapy(P＜0.05).Among 38 cases underwent cryoablation combined with immunotherapy,6 cases were found with but 32 cases without intratumoral TLS,and the median PFS of the former was longer than that of the latter(6 months vs.3 months,P＜0.05).Univariate and multivariate Cox regression analysis revealed that intratumoral TLS and interleukin 2 receptor(IL-R2)were both independent influencing factors of PFS of STS patients after cryoablation combined with immunotherapy(both P＜0.05).The area under the curve(AUC)of intratumoral TLS for predicting PFS of STS patients at 3,6 and 9 months was 0.550,0.577 and 0.699,of IL-R2 was 0.658,0.742 and 0.583,respectively,while of combination of the above two was 0.762,0.787 and 0.881,respectively,all higher than of each intratumoral TLS and IL-R2 alone(all P＜0.05).Conclusion Intratumoral TLS could be used to predict prognosis of STS after cryoablation combined with immunotherapy.Combining with IL-R2 might further improve its predictive efficacy.

Objective To explore the efficacy and safety of high intensity focused ultrasound (HIFU) on pancreatic carcinoma. Methods Forty-four patients with pancreatic carcinoma were treated with HIFU. The response rate, clinical beneficial response, overall survival and side effects were evaluated after the treatment. Results The rate of pain relief was 94.74%, the overall 1-, 3-, and 5-years survival rates were 15.91 %, 6. 82%, 2. 27%, respectively;and the median survival time was 8(3～71) months. No complications, such as pancreatisis and gastrointestinal injury occurred. Conclusion HIFU is an effective, non invasive and safe approach in the treatment of pancreatic carcinoma.For the patients with severe condition and intolerable to other methods, HIFU may be a good choice.

Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.

Objective To analysis complications and its associated risk factors of high intensity focused ultrasound (HIFU) in treatment of uterine leiomyoma for selecting rationale indicated patients and reducing complications. Methods Medical documents of 171 patients with 231 leiomyomas in total treated by HIFU were studied retrospectively. Common complications were categorized and analyzed, the relationship between risk factors and complications were studied. Results Common complications in treatment of uterine leiomyomas by HIFU were 71.9% (123/171) of abdominal pain, 17.5% (30/171) of vaginal bloody discharge, 8.2% (14/171) of sacroiliac or buttock pain, 7. 6% (13/171) of skin blister,4. 7% (8/171) of leg pain, 2. 9% (5/171) of hematuria and 1.8% (3/171) of febrile. By logistic regression analysis, the factor correlated with abdominal pain included diameter of uterine leiomyomas,sonication time and average power (P < 0. 05). The factor correlated with sacroiliac or buttock pain was uterine leiomyomas located in posteriors of uterine wall(P <0. 05); the factors correlated with vaginal bloody discharge were sonication time and type of uterine leiomyomas (submucous > intramural > subserous, P <0. 05); the factors correlated with skin blister was sonication time (P < 0. 05). There were no statistical relationship between multiple factors and leg pain, hematuria, febrile (P > 0. 05). Conclusion The modality of high-power and short-term treatment might reduce complications of HIFU ablation.