Hepatocellular carcinoma (HCC) has an insidious onset and when a confirmed diagnosis is made,most patients lose the chance for surgery and are given transarterial chemoembolization (TACE) as palliative treatment.However,repeated TACE may lead to overexpression of hypoxia-inducible factor 1 α (HIF-1 α) and vascular endothelial growth factor (VEGF),liver injury,and reduced immune function and has poor long-term efficacy.The introduction of Huai'er granules may help to change the current status.Studies in China and foreign countries have shown that Huai'er granules exert a remarkable anti-tumor effect by blocking cell cycle,inducing cell apoptosis,inhibiting cell proliferation and invasion,and blocking the hepatitis B-hepatocellular carcinoma pathway.Meanwhile,as an adjuvant drug for HCC,Huai'er granules cover the shortcomings of TACE from multiple aspects and can effectively inhibit the overexpression of HIF-1o and VEGF,improve liver injury and immunity,enhance the effect of chemotherapy drugs,and reverse drug resistance.Many clinical studies have confirmed the remarkable advantages of Huai'er granules combined with TACE,and their synergistic effect helps to enhance anti-tumor effect and improve short-and long-term survival rates.

Objective To observe the value of energy spectrum CT angiography(CTA)optimal single energy imaging combined with adaptive statistical iterative reconstruction V(ASIR-V)for optimizing visualization of thoracodorsal artery(TDA).Methods Energy spectrum CTA was prospectively performed in 60 patients to observe TDA.The images were reconstructed as 120 kVp-like combined with 40%post-set ASIR-V(group A),as well as totally 18 kinds of single energy images ranging from 45 to 70 keV(with interval of 5 keV)combined with 40%,60%and 80%post-set ASIR-V(group B),and the subjective and objective evaluation results of the images were compared between and within groups.Results Under the same post-set ASIR-V weight,significant differences of subjective scores of axial and 3D images were found among different keV levels(all P＜0.001).With the increase of keV level,subjective scores of axial images increased first and then decreased,among which subjective score of 50 keV was the highest(all P＜0.001).Under the same keV levels,with the increase of ASIR-V weight,the subjective scores of overall axial images and 3D images for displaying the main trunk of TDA,as well as contrast-to-noise ratio of axillary artery increased(all P＜0.01).Conclusion Performing CTA using 50 keV single energy imaging combined with 80%ASIR-V reconstruction could balance image contrast and noise better,hence improving visualization of TDA and its branches.

Objective: To investigate the clinical value of preoperative selective arterial embolization for spinal tumors. Methods: The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed. Patients were divided into embolization group (20 cases) and non-embolization group (22 cases) according to whether they underwent arterial embolization before tumor resection. Two surgical treatments including vertebral resection and laminectomy were performed. The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy; while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy. The difference of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time and hospitalization time were compared using independent sample t test. Results: Twenty patients in the embolization group underwent successful interventional embolization without serious complications. There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time, and hospitalization time (P>0.05). Among the patients who underwent vertebral resection, intraoperative estimated blood loss, total number of transfused packed red blood cell and calibrated estimated blood loss were (1 966.7±898.8) ml, (7.42±3.27) U and (91.3±39.2) g/L in the embolization group, and (2 838.5±1 143.5) ml, (11.04±4.08) U and (133.0±46.4) g/L in the non-embolization group, respectively, with statistically significant differences (t=-2.107, -2.436, -2.419, P<0.05). However, there was no significant difference in the operation time and hospitalization time between the two subgroups (t=-0.780, -0.549, P>0.05). Among the patients who underwent laminectomy, there were no significant differences in the above-mentioned indicators between the embolization group and the non-embolization group (P>0.05). Conclusion Selective arterial embolization for spinal tumors is a relatively safe interventional procedure. Preoperative embolization does not significantly reduce the amount of blood loss during surgical procedures. After the surgical procedures were differentiated, preoperative embolization significantly reduces the amount of blood loss in patients underwent vertebral resection, while patients who underwent laminectomy do not benefit significantly.