BackgroundCancer stem cells (CSCs) and Circulating tumor cells (CTCs) have been proposed as fundamental causes for the recurrence of hepatocellular carcinoma (HCC). CTCs isolated from patients with HCC illustrate a unique Nanog expression profile analysis. The aim of this study was to enhance the prediction of recurrence and prognosis of the CTC phenotype in patients with HCC by combining Nanog expression into a combined forecasting model.Subjects, Materials, and MethodsWe collected 320 blood samples from 160 patients with HCC cancer before surgery and used CanPatrol™ CTC enrichment technology and in situ hybridization (ISH) to enrich and detect CTCs and CSCs. Nanog expression in all CTCs was also determined. In addition, RT-PCR and immunohistochemistry were used to study the expression of Nanog, E-Cadherin, and N-Cadherin in liver cancer tissues and to conduct clinical correlation studies.ResultsThe numbers of EpCAM mRNA+ CTCs and Nanog mRNA+ CTCs were strongly correlated with postoperative HCC recurrence (CTC number (P = 0.03), the total number of mixed CTCS (P = 0.02), and Nanog> 6.7 (P = 0.001), with Nanog > 6.7 (P = 0.0003, HR = 2.33) being the most crucial marker. There are significant differences in the expression of Nanog on different types of CTC: most Epithelial CTCs do not express Nanog, while most of Mixed CTC and Mesenchymal CTC express Nanog, and their positive rates are 38.7%, 66.7%, and 88.7%, respectively, (P=0.0001). Moreover, both CTC (≤/> 13.3) and Nanog (≤/>6.7) expression were significantly correlated with BCLC stage, vascular invasion, tumor size, and Hbv-DNA (all P < 0.05). In the young group and the old group, patients with higher Nanog expression had a higher recurrence rate. (P < 0.001).ConclusionsThe number of Nanog-positive cells showed positive correlation with the poor prognosis of HCC patients. The detection and analysis of CTC markers (EpCAM and CK8, 18, CD45 Vimentin,Twist and 19) and CSCs markers (NANOG) are of great value in the evaluation of tumor progression.
In this study, active interpass cooling using compressed CO2 was innovatively employed in the wire arc additively manufactured Ti6Al4V process with the aim of mitigating part distortion. A comparative analysis between simulation and experimental results was performed to explore the effects of active interpass cooling on the thermal behaviours, geometric features and distortion levels of deposit. The results show that active interpass cooling with CO2 gas is an effective means of reducing WAAM part distortion by increasing heat dissipation and reducing heat accumulation within the deposition. It can contribute to a maximum reduction of 81% in longitudinal distortion and 69% in transverse distortion for the wall structures produced in this study. Compared to the cooling gas flow rate, cooling time alternation is more effective in mitigating WAAM-part distortion due to more effective heat dissipation per unit time. The findings reveal that using active interpass cooling in WAAM can offer significant cost and build time savings, as well as provide conditions for the improvement of WAAM part quality.
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