Hepatocellular carcinoma is one of the most common malignant tumors in clinical practice, and China has the highest incidence in the world. Spontaneous rupture of hepatocellular carcinoma is a serious complication of hepatocellular carcinoma. Its mechanism and risk factors are complex, including tumor size, location, hypertension, cirrhosis, HBsAg positivity, obesity and receiving targeted therapy with sorafenib, which may be its influencing factors. In recent years, the treatment methods of rupture and hemorrhage of hepatocellular carcinoma have been continuously improved and developed, including conservative treatment, transcatheter arterial chemoembolization, emergency hepatectomy, staged hepatectomy, etc.Transcatheter arterial chemoembolization followed by selective surgery is the most effective treatment at present. This article reviews the risk factors and treatment progress of rupture and hemorrhage of hepatocellular carcinoma, in order to provide reference for the direction of research on rupture and hemorrhage of hepatocellular carcinoma, so as to improve the prognosis and prolong the survival time of patients with early detection, early prevention and early treatment.

Objective:To study the effects of rolling blood pump parameters and blood concentration on hemolysis during extracorporeal circulation.Methods:According to the extracorporeal hemolysis experiment standard, an extracorporeal circulation experimental device was built to analyze the influences of circulation time (0 ~ 90 min), blood flow rate (1~4 L/min), and blood volume fraction (60%, 70%) on the hemolysis of blood samples in the circulatory system. The results of hemolysis were analyzed using first-order linear regression.Results:The longer the blood pump circulation time, the greater the hemolysis rate; the higher the blood flow rate, the greater the hemolysis rate. When the flow rate is 1 and 2 L/min, the hemolysis rate curve has an inflection point that changes with time, i.e. when the circulation time exceeds 30 min, the slope of the hemolysis rate curve suddenly increases. However, when the flow rate is 3 and 4 L/min, the hemolysis mutation phenomenon is not obvious. Compared to the blood sample with blood volume fraction of 70%, a blood sample with a blood volume fraction of 60% is less prone to hemolysis.Conclusions:The longer the blood pump circulation time and the higher the blood flow rate, the more easily the red blood cells are destroyed, i.e. the hemolysis rate is directly proportional to the circulation time and blood flow rate. When the circulation time increases to a certain degree, an inflection point appears in the hemolysis rate curve, and the hemolysis trend will be significantly enhanced.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive tract in the world, with high malignancy, strong invasion, high postoperative recurrence rate and low overall survival rate. Transcatheter arterial chemoembolization (TACE) has been recognized as one of the most commonly used local treatment methods for liver cancer. For high risk of recurrence (such as the diameter of the tumor larger (> 5 cm in diameter), preoperative AFP levels, and large vascular invasion, with microvascular invasion, etc.) after radical resection of liver cancer patients, Postoperative adjuvant transarterial chemoembolization (PA-TACE) can bring benefits to the prognosis of patients with liver cancer.At the same time, TACE combined with other therapies such as antiviral therapy, molecular targeted therapy, immunotherapy, ablative radiation therapy and traditional Chinese medicine therapy have shown good efficacy. This article reviews the research progress of adjuvant therapy based on PA-TACE after radical resection of hepatocellular carcinoma.

Objective: To evaluate the residual radioactivity after ¹³¹I treatment in postoperative inpatients with differentiated thyroid carcinoma (DTC) using service robot in nuclear medicine ward, and assess the time for patients to be released from isolation. Methods: From September 2017 to June 2018, 297 patients (94 males, 203 females, age: 19-80 years) with DTC who underwent ¹³¹I treatment after surgery were included. According to the purpose of treatment and the prescription dosage of ¹³¹I, patients were divided into 8 groups: 4 groups accepted ¹³¹I remnant ablation therapy (RAT) with different dosages, which were 3 700 MBq (RAT1, n=34), 4 440 MBq (RAT2, n=122), 5 550 MBq (RAT3, n=81) and 7 400 MBq (RAT4, n=27), respectively; 4 groups had ¹³¹I treatment for recurrent/metastatic lesions (RMLT), and the dosages were 3 700 MBq (n=1), 4 440 MBq (n=2), 5 550 MBq (n=14) and 7 400 MBq (n=16). At 4, 24, 48 and 72 h after ¹³¹I administration, the dose equivalent rates at 2 cm away from the patient′s neck and at 1 m away from the body were measured by the robot designed for nuclear medicine ward. Kruskal-Wallis rank sum test and Mann-Whitney U test were used to analyze the data. Results: Neck dose equivalent rates for patients with RAT at different time points (4, 24, 48 and 72 h) after ¹³¹I administration were significantly different among 4 groups (H values: 20.889-46.410, all P<0.05), as well as the body dose equivalent rates (H values: 27.181-35.497, all P<0.05). The neck dose equivalent rates at 24, 48 and 72 h after ¹³¹I administration were statistically different between group 3 and 4 for patients with RMLT (z values: 2.328-3.076, all P<0.05; data in group 1 and 2 were too limited to be compared), while there was no statistical difference for the body dose equivalent rates (z values: 0.333-1.621, all P>0.05). The radioactivity retention in patients decreased rapidly within 24 h, then slowed down gradually and became extremely low at 72 h. At 72 h after ¹³¹I administration, 96.6%(255/264) patients with RAT and 100%(33/33) patients with RMLT were lower than 23.3 μSv/h, which meant the patients could be discharged from hospitalization. Conclusions Nuclear medicine ward service robots may dynamically measure residual radioactivity in DTC patients who take ¹³¹I treatment, providing individualized isolation solutions.