0.05,Chi-square test).Conclusion:Ribs removal can not improve the effects of HIFU plus TACE in the treatment of middle-late stage primary liver cancer significantly.

Objective To observe the 2-year survival situation of high intensity focused ultrasound(HIFU) treatment in unr esectable advanced pancreatic carcinoma.Methods Thirty-eight patients with unresectable pancreatic cancer received HIFU treatment.After treatment,the changes of laboratory tumor markers examination results,pain score,life quality score and survival situation were recorded.Results Among 35 patients with pain symptom before HIFU treatment,pain was relieved after HIFU treatment in 28 cases,the remission rate was 80.0％.The CA19-9 and CEA levels after HIFU therapy were obviously reduced compared with before treatment.The imaging examination showed the coagulation necrosis in HIFU-treated area.It was found the tumor volume was obviously shrunk during follow-up period.The median survival period was extended to (12.9 ± 6.6) months.Conclusion The HIFU treatment can effectively improve the life quality in the patients with unresectable pancreatic cancer and extends their survival period.

Objective To investigate the influences of heart in patients with hepatocellular carcinoma closed to heart after high intensity focused ultrasound ablation(HIFU). Methods Thirty four patients with hepatocellular carcinoma closed to heart received detecting the values of periphery blood aspartate transarninase(AST), creatine kinase (CK), CK-MB, α-hydroxybutyrate dehydrogenase (α-HBDH), lactate dehydrogenase(LDH), myoglobin(Myo) and troponin I (cTnI) before and 1,3, 7 days after HIFU respectively. ECG was monitored in all patients simultaneously. Results The values of AST,CK,CK-MB,α-HBDH, LDH and Myo increased 1 day after HIFU significantly (P<0.05), which decreased greatly 3 days after HIFU and nearly recovered well (P>0.05) 7 days after HIFU. However, the value of cTnI and ECG were normal before and after HIFU. Conclusions No obvious myocardium injury was found after HIFU in patients with hepatocellular carcinoma dosed to heart, cTnI may be an important marker to evaluate myocardium injury after HIFU.

Objective To investigate the safety and effect of high intensity focused ultrasound ablation(HIFU) on residual liver cancer in patients after radiotherapy. Methods Twenty liver cancer patients with twenty five residual tumors after three-dimensional conformal radiotherapy or stereotactic radiotherapy received HIFU ablation. Liver function and periphery blood cell counts were performed before HIFU and at 1 week after HIFU in all patients. Enhanced MRI and α-fetoprotein (AFP) level were performed before HIFU and at 2 weeks after HIFU to evaluate the effect of HIFU ablation. The survival of all patients was assessed by the Kaplan-Meier method. Results The mean follow-up time was (12.6 ± 8.0)months. The median survival time and 1-year survival rate were 22 months and 87.5% respectively. No skin burns were observed in all patients. As compared with before HIFU,there were no significant differences in the levels of albumin,alanine transarninase, aspartate transarninase, total bilirubin, direct bilirubin, blood red cell counts,blood white cell counts and blood platelet counts at 1 week after HIFU (paired t test, P =0. 156,0. 356,0. 203,0.659,0. 531,0. 519,0. 310,0. 346, respectively). Significant difference in AFP level of 9 patients with AFP＞20 μg/L was observed before HIFU and 2 weeks after HIFU (paired t test, P =0.030). Among 25 residual liver tumors,sixteen with complete ablation and six with ablation volume of ≥80% were observed by enhanced MRI at 2 weeks after HIFU. Conclusions HIFU may be a safe and effective new method to ablate residual liver cancer after three-dimensional conformal radiotherapy or stereotactic radiotherapy.

Objective To investigate the clinical efficacy and feasibility of 125I seeds implantation combined with high intensity focused ultrasound (HIFU) for portal vein tumor thrombus (PVTF) from HCC.Methods Nineteen cases of PVTT from HCC (17 males,2 females;average age:50 years,stage:Ⅰ-Ⅲ)undergoing 125I seeds implantation combined with HIFU from March 2011 to October 2013 were retrospectively studied.The radioactivity of each 125I seed was 18.5 MBq and the matched peripheral dose was 90-120 Gy.HIFU parameters were set as follows:ultrasound wave frequency,0.85 mHz;output power,300-400 W;total treatment duration,33-70 min.During the follow-up of 3-24 months,the change of PVTT size,postoperative complications and survival rate were recorded.Kaplan-Meier method was used to analyze the survival rate.Results The treatment was successfully completed in all patients and no serious complications were observed.After 1 month of follow-up,the tumor thrombi shrank in all patients.Among 19 patients,9 achieved PR,4 SD,6 PD.The one-year and two-year survival rates were 47.4％ and 7.9％,respectively.The mean survival was 11.6±3.0 months (range:3-24 months).The median postoperative survival for stages Ⅰ,Ⅱ,Ⅲ was 13.5,7.0,4.0 months,respectively.Conclusion 125I seeds implantation combined with HIFU could be a safe and effective therapy for PVTT from HCC.

Objective To observe the clinical effect of high intensity focused ultrasound (HIFU ) in treating spontaneous hy-poglycemic insulinoma .Methods Ten patients with typical repeated spontaneous hypoglycemic insulinoma without predisposing causes were treated by HIFU .The changes of insulin and blood sugar were observed after treatment .Results HIFU could non-in-vasively and directly ablate insulinoma .The insulin level and fasting blood glucose level recovered to the normal levels at postopera-tive 1 week and significantly improved compared with before operation (P<0 .05) .Conclusion HIFU is a non-invasive ,safe and ef-fective method for treating insulinoma .