Pancreatic cancer is a common malignant neoplasm of digestive system with a fairly poor prognosis, the diagnosis rate in its early stage is low, and in recent years its incidence rate has become more and more high. Surgical remove is the only radical means, whereas only 20% of patients can get the oppotunity of surgery when the diagnosis is confirmed. More unfortunately, the five-year overall survival rate after the surgery is as low as 15 - 20%. Therefore, it is of clinical significance to improve the survival rate and to prolong survival time. Comprehensive interventional therapy has many advantages, as the technique is safe and mini-invasive with satisfactory short-term efficacy. Nowadays, interventional therapy has become the hot point in the research of pancreatic cancer. This paper aims to make a review about the current situation and progress of interventional treatment for advanced pancreatic cancer.

Liver cancer is one of the most common malignant tumors in the world, and traditional liver cancer treatment methods have their own limitations.Glypican-3 (GPC3) is a cell-surface heparan sulfate proteoglycan and is involved in the regulation of individual development and cell proliferation and differentiation.It is also a hepatoma-specific carcinoembryonic antigen.The mechanism of action of GPC3 in the development and progression of liver cancer has become a hot research topic.GPC3 not only has a unique value in the diagnosis of liver cancer, but also plays an important role in the treatment of liver cancer.This article also introduces the application of GPC3-derived tumor vaccines, GPC3 antibodies, GPC3 gene therapy, and targeted therapy and brings new ideas for the treatment of liver cancer.

0.05). Metastasis of the liver of colorectal cancer occurred higher in the patients with serum CEA concentration ≥15ng/ml than that in those with serum CEA

Objective To investigate the satisfaction of clinicians on clinical research associates (CRA)and its influencing factors,for the purpose of providing rationalized proposals on education of CRAs.Methods 141 clinicians were randomly sampled from tertiary hospital for questionnaire survey,using the 5-point Likert scale.The survey covers 4 levels,i.e.,the work attitude,professional knowledge and ability,communication skills,and project management capabilities,as well as 14 dimensions.Data processing and statistics were analyzed using SPSS 15.0 software.The attribute characteristics of the investigation subjects were analyzed using x2 of the contingency table,along with analysis of its correlation with the general satisfaction on CRAs.Results The mean values of the 12 indicators range 2.28 to 3.75,with low satisfaction in general.Among these indicators,satisfaction of the service attitude of the CRA,and of their familiarity with the pilot program and CRF completion axe the highest,respectively,74.04％and 61.70％.Satisfaction of the rest 10 indicators falls below 50.00％.The chisquare analysis showed no association between satisfaction and gender,education,job titles.The satisfaction is different(P＜0.05)between those trained and those not,while there exists a significant differences(P＜0.01)between those participating in different number of tests.Conclusion Clinicians have a low satisfaction on CRAs.It is recommended to strengthen the training,establish a CRA occupation certification system,and to strengthen the clinicians' emphasis and competency of clinical trials.These actions will normalize the industry of clinical trials and improve the level of clinical trials in China.

ObjectiveTo evaluate the clinical efficacy of gelatin sponge particles chemoembolization for liver metastasis of gastric cancer patients. MethodsThe clinical data of 5 cases from December 2009 to July 2010 with gelatin sponge particles chemoembolization for liver metastasis after radical gastrectomy patients was analyzed retrospectively. ResultsVarious degrees of necrotic lesions were observed in all cases, 6 months after operation, 1 case received complete remission (CR),3 cases with partial remission (PR), 1 case with stable condition (SD), the total effective (CR + PR) rate was 80％(4/5). Conclusion Gelatin sponge particles chemoembelization for liver metastasis of gastric cancer has achieved a good shortterm effect,while the long-term efficacy remains to be identified.

Objective To undertake animal experimentation and clinical study on the safety and efficacy of percutaneous transluminal angioplasty (PTA) and intraarterial papaverine (IAP) infusion for treatment of refractory symptomatic cerebral vasospasm (CVS). Methods In the experimental study, vasospasm was induced in rabbits by double injections of blood into the cisterna magna, IAP infusion was given on either the 4th day or the 7th day after occurrence of subarachnoid hemorrhage (SAH), and then neurological observation, angiography, light and electron microscopy were done. In the clinical study, since September 1996, 22 patients with refractory symptomatic CVS involving 50 vascular territories received dilation therapy by PTA and IAP within 24 hours of clinical neurological deterioration. Results In the experimental study, all the rabbits except two in the 'the 4th day' group showed angiographic dilation in all of the spastic basilar arteries, and neurological improvement; in the ' the 7th day' group angiographic dilation appeared in 4 (57. 1% ) out of 7 rabbits. After 24 hours, 1 rabbit in each group had recurrence of neurological deficits and angiographic constriction. In the clinical study after aneurysm clipping or endovascular coil embolization was done, within 72 hours of SAH all patients underwent endovascular treatment: PTA alone in 3 cases, IAP alone in 14 cases, PTA and IAP in the remaining 5 cases. All vessel segments were dilated satisfactorily after endovascular treatment. Clinical improvement was significant in 13 cases,moderate in 7, minimal or none in 2; 2 cases died on the 7th day after endovascular dilation treatment. Conclusion Endovascular dilating techniques, namely, PTA, IAP and a combination of PTA and IAP, are safe and effective for treatment of symptomatic CVS refractory to medical therapy.

Interim fluorine 1 8 fluorodeoxyglucose (1 8 F-FDG)positron emission tomography (PET) integrated with computed tomography (CT) provides both metabolic and morphologic information,which becomes one of the most sensitive tools to evaluate the efficacy of the therapy and predict the prognosis of patients with lymphoma.Meanwhile,it is the basis for guiding trial design and changing clinical practice.How-ever,it is still a controversial issue in the ideal utilization of interim 1 8 F-FDG PET-CT imaging for the patients with lymphoma.

Objective To evaluate the safety and efficacy of combined transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and lobaplatin (GSPs-TACE) and oral Chinese herb medication Huaier granules in patients with hepatocellular carcinoma (HCC).Methods This is a case-control,single-institution clinical trial.31 HCC patients receiving GSPs-TACE (group A) were matched with 31 patients receiving GSPs-TACE and Huaier granules (group B).Tumor response was evaluated by CECT using response evaluation criteria in solid tumors at 1 month after initial GSPs-TACE.The overall survival was calculated from the data of initial GSPs-TACE using the Kaplan-Meier method.Results The overall mean follow-up period was 28.7 (range 12-42) months.The overall 6-and 12-month survival rates in group A and group B were 90.3％ and 80.6％ vs 100％ and 93.5％,respectively.There was statistically significant difference in 12-month survival rates (x2 =5.213,P ＜0.05).Median survival time respectively was 17.1 and 20.6 months(x2 =0.745,P ＞0.05).The average TACE times were (4.1 ±7.3) and (2.9 ±8.7) respectively in group A and group B (P =0.01).Tumor objective response rate was statistically different in 6-and 12-month in two arms(x2 =5.945,6.384,P ＜0.05).There was no statistically significant difference in complications (respectively x2 =0.435,0.485,2.037,0.137,0.325,all P ＞ 0.05).Conclusions Huaier granules combined with transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and carboplatin for HCC is safe and effectively prolongs patients' survival.

Objective To discuss interventional procedures before feeding tube placed in the DSA guidance,influence postoperative enteral nutrition support for the presence of nutritional risk of clinical outcomes in elderly patients with hepatocellular carcinoma. Methods 33 patients acquired with interventional therapy of hepatic carcinoma were selected as the study group.All of patients un-derwent preoperatively the nutritional risk screening and insertion of nasogastric feeding tube under DSA.Enteral nutritional support by the nasogastric feeding tube was used after interventional therapy.33 similar patients underwent parenteral nutritional support af-ter international therapy were selected as the control group.The change of the nutritional indexes,the incidence of the systemic in-flammatory response syndrome,the incidence of infection,and the length of hospital stay after operation were compared between the two groups.Results There were no significant differences in the plasma albumin levels and body weight changes compared between the two groups (P >0.05).However,the incidence of infection and the length of hospital stay were lower significantly in the study group than in the control group (P >0.05).Conclusion The nutritional risk screening before interventional treatment is necessary for the elder patients with hepatic carcinoma.The patients with nutritional risk can be placed the nasogastric feeding tube preopera-tively under DSA,and perform combined nutritional support to promote the recovery of nutritional state after operation.

Objective To compare the safety and efficacy between flexible ureteroscope lithtripsy (FURL) and percutaneous nephrolithotomy (PCNL) in treating the renal calculus.Methods From Jan.2012 to Oct.2013,120 male and 87 female patients with renal calculus were accepted FURL (n =108)or PCNL (n=99) in our hospital.In FURL group,108 cases were classified according to the diameter of the stone,including 33 patients with the diameter of renal stone more than 20mm (range 20-39 mm,mean 29.2±5.6 mm)and 75 patients with the diameter of renal stone less than 20 mm (range 13-19 mm,mean 16.8± 1.3 mm).In PCNL group,99 cases were also classified according to the diameter of the stone,including 51 patients with the diameter of renal stone more than 20 mm (range 20-45 mm,mean 30.4±6.6 mm)and 48 patients with the diameter of renal stone less than 20 mm (range 14-19 mm,mean 17.2±1.4mm).There were no significant differences between the groups FURL and PCNL in the stone size(P＞0.05).Demographic data,operative duration,postoperative hospital stay,complication rate,and stone-free rate were recorded and compared.Results The overall stone free rate in group FURL was significantly lower 80.6％ (87/108) than that in group PCNL 91.9％ (91/99) (P＜0.05).In those patients with the diameter of stones less than 20 mm,the stone free rate was 88.0％ (66/75) in group FURL vs 93.8％ (45/48) in group PCNL (P＞0.05).The operative time was 30-65 (mean 49.5±6.9) min and 30-65 (mean 46.9±7.2) min in FURL and PCNL group,respectively (P＞0.05).In those patients with the diameter of stones more than 20 mm,the stone free rate was 63.6％ (21/33) in group FURL,which was lower than that in group PCNL 90.2％ (46/51) (P＜0.05).The operative time was 60-115 min (85.0±16.3) min and 30-95 min (68.3± 16.7) min in FURL and PCNL group,respectively (P＜0.05).The overall complication rate was significantly lower in group FURL 2.8％ (3/108) compared to group PCNL 8.1％ (8/99) (P＜0.05).Postoperative hospitalization stay were 2-6 d (3.5±1.4) d and 3-9 d (5.8±1.9) d in FURL and PCNL group,respectively (P＜0.05).Conclusions Both PCNL and FURS are efficacy and safe surgical alteration for patients with renal calculus.As to the FURS,its merits were faster recovery,less invasiveness than those in PCNL.Therefore,it can be considered as the first-line treatment for renal calculus ＜20 mm.However,for renal calculus ≥20 mm stones,FURS is still effective.