Objective To analyze the clinical and pathological factors which can influence the occurrence of the recurrent occlusion of metallic stents in patients with malignant biliary obstruction. Methods The clinical data of 50 patients with malignant biliary obstruction, who suffered repeated metallic stents obstruction and were admitted to authors" hospital during the period of March 2006-September 2008, were retrospectively analyzed. Of 50 patients, liver carcinoma was diagnosed in 12, pancreatic carcinoma in 17 and carcinoma of bile duct in 21. The relevant factors which might bear a relation to the occurrence of repeated metallic stents obstruction were evaluated. Results Single factor analysis of variance indicated that the denomination of carcinoma, clinical stage of carcinoma, location of obstruction, whether infection being accompanied or not, and the anti-tumor therapy after biliary stenting treatment were the significant factors closely linked to the occurrence of repeated metallic stents obstruction in patients with malignant biliary obstruction, Logistic regression analysis demonstrated that clinical stage of carcinoma, location of obstruction and whether infection being accompanied or not were the important factors that determined the occurrence of repeated metallic stents obstruction. Conclusion Clinical stage of carcinoma, location of obstruction and whether infection being accompanied or not are important reference factors for judging the occurrence of occlusion of metallic stents in malignant biliary obstruction.

Objective To investigate the efficacy and safety of different acoustic power of high-intensity focused ultrasound (HIFU) in treating human pancreatic xenograft models. Methods Human pancreatic cancer cells (YY-1) were implanted subcutaneously in nude mice to establish animal models. The tumor bearing mice were divided into low-power HIFU treatment group (200 W,n=10), high-power HIFU treatment group (300 W,n=10) and blank control group (n=10). The change of tumor volume, the tumor growth rate and side effects were recorded. The apoptosis rate of tumor cells of each group was determined by TUNEL method. Results The tumor volume and the tumor growth rate of the low-power group and the high-power group were significantly lower than those of the control group (P<0.05), while no statistically significant differences in the tumor volume and the tumor growth rate existed between the low-power group and the high-power group (P>0.05). Compared with the low-power group, the incidence of side effects in the high-power group was significantly higher (P<0.05), including mainly skin burn (60%) and acoustic channel injury (20%). At the 7th and 14th day after the treatment, the apoptosis rates of tumor cells in both the low-power group and the high-power group were significantly higher than that of the control group (P<0.05), but the difference in the apoptosis rates of tumor cells was not statistically significant between the low-power group and the high-power group (P>0.05). Conclusion For the treatment of human pancreatic xenograft tumor in nude mice models, HIFU with low power is effective and safer.

Objective:This study aimed to analyze the feasibility, safety, and efficacy of cryoablation in treating pain caused by malignant paravertebral and mesenchymal tumor. Methods:Cryoablation was performed in 31 patients with unresectable and painful malignant paravertebral and mesenchymal tumors whose pain was poorly controlled by conventional treatment methods. Tumors ranged in size from 3 cm to 20 cm. Pain experienced by the patient was assessed using the Brief Pain Inventory (BPI) at 0, 1 day, 1 week, 1 month, and 3 months post-cryoablation. Results:BPI scores were divided into two categories, i.e., the influence and the se-verity of pain. Both categories showed downward trend after cryoablation. Pain severity score significantly decreased (P=0.001, t=3.862;P=0.031, t=2.261) 1 day and 1 month after cryoablation. Pain influence score also significantly decreased (P=0.016, t=2.566;P=0.036, t=2.195) 1 day and 1 week after cryoablation. Two patients (6.45%) had mild complications, and no serious complication was ob-served. Conclusion:Cryoablation is a low-risk and well-tolerated topical treatment for pain caused by unresectable malignant paraverte-bral and mesenchymal tumors.

Objective To evaluate the effectiveness and safety of rectal ultrasound-guided agon- hilium percutaneous cryoablation in treatment of patients with median and or late-stage prostate cancer patients. Methods Retrospectively analysis of 42 cases of with stage C and D prostate cancer patients treated by rectal ultrasound-guided argon&ilium percutaneous cryoablation during the follow-up of 1--12 months. The prostate specific antigen (PSA), biochemical progression-free survival (bPFS), PSA objective response, transrectal ultrasound of the prostate (TRUS), TRUS-guided biopsy of the prostate, the maximum urinary flow rate(MFR), MRI examination at before, and 3,6,12 months after cryoablatian were recorded and evaluated. The results were statistically evaluated by using variance analysis. Results The PSA value at before and 3, 6, 12 months after cryoablation were (4.48±1.35), (3.54±1.67), (3.18±1.76), (2.87±1.89) ug/L, respectively; TRUS-messured prostate volumes at before and 3, 6,12 months after cryoablation were (59.7± 8.2),(46.9±8.3),(26.2±3.9),(25.9±3.7)mm3, respectively; MFR before and 3, 6,12 months after cryoablation were (10.4±0.8), (14.3±1.2), (18.3±1.3), (18.9±1.3) ml/s, respectively; Compared with before cryoablation, the differences between before and after cryoablation was statistically significant( F = 53.93,747.92,3843.03,respectively, P<0.01). The bPFS rates in 3 months,6 months and 12 months were 95.2% (40/42), 95. 2% (40/42), and 90.5% (38/42), respectively. According to the PSA response, the total effective rate (CR 16 cases, PR 15 cases) at 12 months was 73. 8%, and SD was 16.7% (7/42), PD was 9.5% (4/42). Complications included temporary incontinence 2.4% (1/42), Penile tingling/numbness 2.4% (1/42), pelvic pain 4.9% (2/41) and Scrotum Edema 2.4% (1/42). There was no case with severe complications such as severe infection or urethrorectal fistula, etc. Condusions Rectal ultrasound-guided agon-hilium percutaneous cryoablation showed is a well tolerated and has better early clinical efficacy to the treatment of stage C and D prostate cancer.

Objeetive To investigate the effect of alteration of blood flow in the hepatic artery on the therapeutic effect of cryoablation in VX2 hepatic tumor rabbit model.Methods Thirty rabbits with VX2 hepatic tumor were divided into three groups according to hepatic artery blood flow:complete occlusion of the hepatic artery(group A),paaial occlusion of the hepatic artery(group B),and no occlusion of the hepatic artery(group C).With conventional CT scau and perfusion scan,the values of blood flow(BF)and blood volume(BV)of VX2 tumor were computed and the differences among the three groups were analyzed.After cryoablation,the animals were euthanized and the livers were removed.The hepatic tissue from the cryoablation area and surrounding area underwent both methyl thiazolyl tetrazolium(MTT)diaphorase staining and triphenyl tetrazolium chloride(TTC)staining.The gross pathology and histopathological 3.14)ml/100 g in group C,respectively.There were significant differences among the three groups in the BF and BV(F value was 452.16 and 421.33 in the BF and BV,respectively,P＜0.01);(2)The maximum diameter of cryoablation-induced necrosis was(2.3±0.3)cm in group A,(1.5±0.2)cm in group B,and(0.8±0.1)cm in group C,respectively.The difference was significant among the groups (F value was 315.32,P＜0.01).(3)There were well-defined frozen areas.bordering areas and normal surrounding areas in MTT staining.In group C,positive staining around some blood vessels could be seen.Conclusion Alteration of the blood flow in the hepetatic artery can affect the cryoablation efficacy.With the decrease of hepatic artery blood flow,the efficacy of cryoablation on liver tumor increased.

Objective: To analyze the effect of Argon-Helium cryosurgery (AHCS) on CD4+ CD25+ regulatory T cells (Treg) and its implication in patients with advanced renal carcinoma.Methods:,Peripheral venous blood samples were ob-tained from 32 patients with advanced renal cell carcinoma before and after AHCS.The proportions of Treg cells and T lym-phocyte subsets (CD3+ T, CD4+ T, CD8+ T, CD4+ T/CD8+ T, and NK cells) in the peripheral blood were measured by flow cytometry.Enhanced CT or enhanced MRI was used to observe the necrosis of tumor at 1 month after AHCS.The areas with no imaging enhancement in tumor were regarded as tumor necrosis.The necrosis rate was measured by Cavalieri method and the tumor burden was evaluated.Results: At 3 months after AHCS, the percentages of Treg cells were gradual-ly decreased from 4.18%±1.58% to 1.96%±0.54%, with a significant difference (P=0.001).At 3 months after AHCS, the pro-portions of CD3+ T, CD4+ T, NK and CD4+ T/CD8+ T were gradually increased from 19.26%±7.52%, 43.54%±12.99%, 1.15%±0.57%, and 17.49%±8.36% to 30.83%±5.69%, 49.58±10.76%, 1.84%±0.12%, and 27.63%±8.20%, with a statistical significance (P=0.000, P=0.003, P=0.02, and P=0.001).The proportion of CD8 + T was decreased from 40.86%±8.89% to the lowest ratio (26.74%±4.29%) at 3 months after AHCS, with a significant difference (P=0.000).At 3～6 months after cryo-therapy, there was only a slight change in the proportions of CD3 + T, CD4 + T, CD4 + T/CD8 + T, NK, CD8 + T, and Treg cells, with no significant difference (P>0.05).Correlation analysis showed that the decrease in tumor burden was positively correlated with the decrease of the proportion of Treg cells (r=0.793, P<0.01).Conclusion: After AHCS, the distribution of T-lymphocyte subsets can be improved and the anti-tumor immune response was strengthened.The percentage of Treg cells is correlated with tumor burden.

Objective To discuss the clinical significance of peripheral neutrophil-to-lymphocyte ratio (NLR) changes in patients with castration-resistant prostate cancer (CRPC) after receiving argon-helium cryoablation.Methods A total of 33 CRPC patients,who were treated with argon-helium cryoablation at Tianjin Medical University Cancer Hospital,were included in this study.The clinical and pathological data were collected and analyzed.The following factors that might affect the postoperative overall survival (OS) of patients were analyzed with univariate and multivariate analysis:age,baseline PSA level,hemoglobin,white blood cell count,platelet count,albumin,alkaline phosphatase,NLR,platelet-to-lymphocyte ratio (PLR),hormone sensitive time,chemotherapy,bone metastasis,Gleason score,ECOG score,PSA effective rate.Results A total of 33 patients were enrolled in this study,the average age was 69 years (50-82 years) and the median survival time was 28 months (6-55 months).Univariate analysis showed that the baseline PSA level,alkaline phosphatase,NLR,hormone sensitive time,chemotherapy,bone metastases,Gleason score and PSA effective rate were significantly correlated with OS of CRPC patients after receiving cryoablation (P＜0.05).Multivariate analysis showed that the baseline PSA level (P=0.003),NLR (P=0.009),Gleason score (P＜0.001) were independent predictive factors for OS of CRPC patients after cryoablation therapy.Conclusion NLR can be used as a prognostic predictor for CRPC patients undergoing argon-helium cryoablation,and the increased NLR indicates a poor prognosis.(J Intervent Radiol,2017,26:237-242)

Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.

OBJECTIVETo survey the application of PCR for screening HCV RNA from blood donations within the window period.

METHODSAccording to a standardized method, 12 blood banks organized by the National Center for Clinical Laboratories collected and prepared about ten thousands specimens. The specimens were tested with two different kits.

RESULTSAmong the 7173 specimens A group, 21 were PCR positive for HCV RNA. The positive rate was 0.29%. There were not positive for HCV RNA among 7477 specimens (B group).

CONCLUSIONSIt is feasible to use the PCR screening for the detection of HCV RNA of blood donations but is unnecessary to standardize the specimen collection and the kit selection.

Blood Donors ; Blood Transfusion ; Hepacivirus ; genetics ; isolation & purification ; Hepatitis C ; prevention & control ; Humans ; Mass Screening ; Polymerase Chain Reaction ; RNA, Viral ; analysis

Symptomatic venous thromboembolism (VTE) has a six-to seven-fold risk of occurring in cancer patients compared with non-cancer patients. VTE is the second most common cause of death among patients with cancer, and cancer-associated VTE is be-coming increasingly prevalent. Therefore, early diagnosis and treatment of cancer-associated VTE is particularly important. This study presents a pancreatic cancer-associated deep vein thrombosis (DVT) patient who engaged in a multidisciplinary comprehensive discus-sion in the Interventional Therapy Department, Tianjin Medical University Cancer Hospital to enhance concern, interdisciplinary com-munication, and cooperation in terms of cancer-associated VTE diagnosis and treatment strategies.