Objective To investigate the clinical effect and to summarize the experience of percutaneous radiofrequency ablation (RFA) of spleen together with splenic artery balloon block in treating hypersplenism due to cirrhosis and portal hypertension. Methods Under the situation of splenic artery occlusion with balloon, RFA of the spleen was performed in 15 patients with hypersplenism caused by cirrhosis and portal hypertension. The mean duration of RFA was (46.4±5.4) min. Routine blood tests were conducted at 3 days, one week, one, 3 and 6 months after the treatment, and abdominal CT angiography was performed one month after RFA. The results were analyzed. Results One patient developed massive bloody pleural effusion at left thorax three days after RFA, which was improved after hemostasis and thoracic drainage. No severe complications occurred in other patients. Abdominal CT angiography performed one month after RFA showed that the ablated extent by RFA was accounted for about 34.3%-71.8% proportion of the spleen, with a mean of (56.20 ±13.09)%. Preoperative blood tests indicated that the count of white blood cells, red blood corpuscles and blood platelets was (3.88±1.75)×109/L, (4.06±0.37) × 1012/L and (48.14± 11.33)×109/L, respectively. One month after RFA the count of white blood cells and blood platelets increased to (5.62±1.61) ×109/L and (132.29±33.20) ×109/L respectively. When compared with the preoperative data, the differences in the count of white blood cells and blood platelets were statistically significant (P<0.05). Conclusion For the treatment of hypersplenism due to cirrhosis and portal hypertension, percutaneous radiofrequency ablation of spleen together with splenic artery balloon block is quite safe and this technique has satisfactory short-term effect.

Objective To investigate the changes in the serum level of vascular endothelial growth factor (VEGF) in experimental Wistar rats with hepatic alveolar echinococcosis (HAE) after hepatic arterial infusion (HAI) of bevacizumab treatment, and to discuss the efficacy of HAI of bevacizumab for hepatic alveolar echinococcosis. Methods Forty Wistar rats with successfully established HAE were randomly and equally divided into two groups with 20 rats in each group: the control group and the study group. Hepatic arterial infusion of saline was performed in the rats of the control group , while hepatic arterial infusion of bevacizumab was carried out in the rats of the study group. Before and 7, 14, 21 and 28 days after the treatment peripheral blood samples were collected from the tail vein, and the serum levels of VEGF, apartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined by the quantitative sandwich enzyme-linked immunosorbent assay (ELISA). All the rats were sacrificed 28 days after the treatment. HAE samples were examined to evaluate the effect of bevacizumab on HAE lesions. Results Seven days after hepatic arterial infusion of bevacizumab, serum VEGF expression level in the study group became gradually decreased, and the difference was statistically significant when compared with the preoperative level or with that in the control group (P = 0.019). Fourteen days after the treatment, the serum VEGF expression level kept going down to its lowest point, and the difference in serum VEGF expression level was statistically significant when compared with the preoperative level (P < 0.01). Twenty-one days after the treatment, serum VEGF expression level started to rise and it returned to normal level in 28 days after the treatment. In the control group no significant changes in serum VEGF expression levels was observed after hepatic arterial injection of saline (P > 0.05). Conclusion In treating hepatic alveolar echinococcosis, hepatic arterial infusion of bevacizumab has certain inhibitory effect on angiogenesis. This therapy is safe and effective.

Objective To explore the clinical efficiency and safety of radiofrequency ablation combined with Tegafur,Gimeracil and Oteracil Porassium Capsules( S-1 capsules) for hepatocellular carcinoma.Methods Sixty HCC patients included in this study were underwent initial radiofrequency ablation and then they were di-vided into RFA+S-1 group and RFA control group according to the metronomic chemotherapy either with S-1 or not.The local tumor control and disease free survival outcome between the two groups were compared.Results Follow-up observation showed that the total control rate after 9 months′treatment was 93.3%in RFA+S-1 group vs.73.4%in RFA control group(P=0.038).During the 18 months of follow up,the median time for dis-ease free survival was 16.25 months in RFA+S-1 group vs.12.25 months in RFA control group( P<0.001) . One-year progression free survival rate in RFA group was 53.3%,which was significantly lower than the RFA+S-1 group(83.3%)(P=0.012).The major complication rate was 13.3%.No procedu rerelated death or severe complications occurred.Conclusion Metronomic chemotherapy with S-1 following initial radiofrequency ablation delays tumor progression and prolongs overall survival of patients with HCC tumors.

Objective:To comprehensively analyze the medical resources and services supply in the cancer field of China.Methods:Data of 2018 were sampled from 41 tertiary public cancer hospitals in China, and the factor analysis method was used to extract common factors in resources or services, scoring respectively. Pearson correlation analysis was used in the collinearity test of the variables of both groups of common factors, while the second-order clustering method was used to analyze characteristic differences between the hospitals, and category difference was compared with t test. Results:Resource evaluation covered the two dimensions of basic resources(medical service and basic assurance resources)and high-end resources(high-end talents and academic resources). Service evaluation covered the two dimensions of medical service assurance(clinical services and basic assurance)and disciplinary sphere of influence(discipline construction and clinical efficiency). The factor of basic manpower and beds was significantly correlated with that of medical service and basic assurance( r=0.811, P<0.001), while the factor of high-end talents and academic resources was significantly correlated with that disciplinary construction and resource efficiency( r=0.906, P<0.001). The second-order cluster analysis found the 41 cancer hospitals as two categories, with the first category of five in Guangdong, Shanghai, Beijing and Tianjin, and the second category of the rest 36 hospitals. Significant differences were found between the two categories in terms of resource scoring, service scoring, high-end resources and disciplinary sphere of influence( P<0.001). Meanwhile, the GDP per capita of the cities in which these hospitals are located also had significant differences( P<0.001). Conclusions:Development of public tertiary cancer hospitals in China was imbalanced, as their differences were mainly found in levels of disciplinary development and efficiency of clinical services, which were closely related to the high-end talents and academic resources of the hospital in question.Furthermore, high quality medical care was mostly located in regions of higher development. The authors recommend to take a balanced consideration of the differences and distribution of cancer care services in China, in terms of performance classification of public hospitals and establishment of regional cancer centers of the country.