1.Short-term efficacy and prognostic factors of donafenib combined with transcatheter arterial chemoembolization in the treatment of spontaneously ruptured hepatocellular carcinoma
Qi ZHANG ; Hezi QING ; Zhenwu LEI
Journal of Practical Radiology 2025;41(7):1198-1202
Objective To investigate the short-term efficacy and prognostic factors of donafenib combined with transcatheter arterial chemoembolization(TACE)in the treatment of spontaneously ruptured hepatocellular carcinoma.Methods A retrospective analysis was conducted on the data of patients diagnosed with spontaneously ruptured hepatocellular carcinoma.According to the treatment meth-ods,patients were categorized into simple group(TACE)and combined group(donafenib combined with TACE).Median progres-sion-free survival(mPFS),objective remission rate(ORR),disease control rate(DCR),and median overall survival(mOS)were calculated,and treatment-related adverse events were counted.Finally,prognostic survival factors were analyzed by Cox regression.Results The mPFS for the simple group was 4.6 months,compared to 13.6 months for the combined group(χ2=9.081,P=0.003).Similarly,the mOS for the simple group was 7.6 months,compared to 17.4 months for the combined group(χ2=6.351,P=0.012).Both mPFS and mOS were significantly lower in the simple group than those in the combined group.The ORR of 25.7%and DCR of 57.1%in the simple group were significantly lower than the ORR of 55.6%and DCR of 81.5%in the combined group,and the difference between the two groups was statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of rebleeding,abdominal pain and fever between the two groups(P>0.05).Additionally,age,portal vein tumor thrombus(PVTT),Child-Pugh grade,tumor diameter,and total biliru-bin(TBIL)were identified as prognostic factors(P<0.05).Conclusion Donafenib combined with TACE is an effective and safe treatment option for spontaneously ruptured hepatocellular carcinoma.Furthermore,factors such as age,PVTT,Child-Pugh grade,tumor diameter,and TBIL serve as prognostic indicators for spontaneously ruptured hepatocellular carcinoma.
2.Short-term efficacy and prognostic factors of donafenib combined with transcatheter arterial chemoembolization in the treatment of spontaneously ruptured hepatocellular carcinoma
Qi ZHANG ; Hezi QING ; Zhenwu LEI
Journal of Practical Radiology 2025;41(7):1198-1202
Objective To investigate the short-term efficacy and prognostic factors of donafenib combined with transcatheter arterial chemoembolization(TACE)in the treatment of spontaneously ruptured hepatocellular carcinoma.Methods A retrospective analysis was conducted on the data of patients diagnosed with spontaneously ruptured hepatocellular carcinoma.According to the treatment meth-ods,patients were categorized into simple group(TACE)and combined group(donafenib combined with TACE).Median progres-sion-free survival(mPFS),objective remission rate(ORR),disease control rate(DCR),and median overall survival(mOS)were calculated,and treatment-related adverse events were counted.Finally,prognostic survival factors were analyzed by Cox regression.Results The mPFS for the simple group was 4.6 months,compared to 13.6 months for the combined group(χ2=9.081,P=0.003).Similarly,the mOS for the simple group was 7.6 months,compared to 17.4 months for the combined group(χ2=6.351,P=0.012).Both mPFS and mOS were significantly lower in the simple group than those in the combined group.The ORR of 25.7%and DCR of 57.1%in the simple group were significantly lower than the ORR of 55.6%and DCR of 81.5%in the combined group,and the difference between the two groups was statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of rebleeding,abdominal pain and fever between the two groups(P>0.05).Additionally,age,portal vein tumor thrombus(PVTT),Child-Pugh grade,tumor diameter,and total biliru-bin(TBIL)were identified as prognostic factors(P<0.05).Conclusion Donafenib combined with TACE is an effective and safe treatment option for spontaneously ruptured hepatocellular carcinoma.Furthermore,factors such as age,PVTT,Child-Pugh grade,tumor diameter,and TBIL serve as prognostic indicators for spontaneously ruptured hepatocellular carcinoma.
3.Hepatic artery infusion chemotherapy combined with lenvatinib for treating Barcelona clinic liver cancer stage B or C hepatocellular carcinoma
Haidong YU ; Yingxing GUO ; Zhenwu LEI ; Haiming YANG ; Shimeng SUN ; Cunkai MA
Chinese Journal of Interventional Imaging and Therapy 2024;21(2):70-74
Objective To observe the efficacy of hepatic artery infusion chemotherapy(HAIC)combined with lenvatinib for treating Barcelona clinic liver cancer(BCLC)stage B or C hepatocellular carcinoma(HCC),and to explore the impact factors of patients'survival time.Methods Data of 104 patients with BCLC stage B or C HCC were retrospectively analyzed.The patients were divided into observation group(n=46,underwent HAIC combined with lenvatinib)and control group(n=58,underwent HAIC alone).The clinical efficacy and adverse reactions of treatments,as well as patients'overall survival(OS)and progression free survival(PFS)were recorded and compared between groups.Cox regressions were used to explore the impact factors of patients'survival time.Results Three months and 6 months after HAIC,the results of modified response evaluation criteria in solid tumors(mRECIST)in observation group were both better than those in control group(both P<0.05),while no significant difference was found between groups one year after HAIC(P>0.05).The overall survival rate in observation group was higher than that in control group(P<0.05),while there was no significant difference of progression free survival rate between groups(P>0.05).The incidence of rash in observation group was higher than that in control group(P<0.05).Multiple Cox regression showed prolonged OS in HCC patients in observation group(hazard ratio[HR]=0.425,95%CI[0.255,0.791])compared with that in control group.Compared with pre-treatment Eastern Cooperative Oncology Group(ECOG)score 1,AFP≥400 μg/ml,the number of tumor foci≥3 and BCLC stage C,pre-treatment ECOG score 0,AFP<400 μg/ml,the number of tumor foci≤2 and BCLC stage B were all independent protective factors of OS in HCC patients(all P<0.05).Conclusion HAIC combined with lenvatinib was safe and effective for treating BCLC stage B or C HCC.Pre-treatment ECOG score,serum AFP level,the number of tumor foci and BCLC stage were all independent impact factors of OS.
4.Correlation analysis of epidemiological characteristics and changes of influenza subtypes in Hefei City in 2015-2021
Zhenwu LIU ; Lei ZHANG ; Xuxiang LIU ; Jinju WU ; Kefu ZHAO ; Wenjin WANG
Journal of Public Health and Preventive Medicine 2022;33(4):20-23
Objective To analyze the correlation between detection of influenza pathogenic subtypes and epidemic situation in Hefei City during the surveillance years of 2015-2021, and to provide references for developing influenza prevention and control strategies. Methods The relevant data of influenza-like illness (ILI) surveillance, influenza etiology, and outbreak/cluster outbreaks reported from influenza surveillance sentinel hospitals in Hefei City from 2015 to 2021 in the China Influenza Surveillance Information System were analyzed. The statistical analysis was carried out. Results A total of 3 332 553 outpatient and emergency visits in 2 sentinel hospitals were reported in Hefei City from 2015 to 2021, of which 139,082 were ILI cases, accounting for 4.17%. The monthly proportion ranged from 1.60% to 7.15%. A total of 14 663 ILI specimens were submitted for detection, the submission rate was 10.54%, and the positive rate of influenza virus detection was 11.30%. There was no correlation between the proportion of monthly influenza like cases and the detection rate (rs=0.176, P=0.107). The composition ratio of each subtype of influenza virus varied greatly, showing diversified seasonality, and the epidemic strains changed constantly. The Victoria subtype (BV subtype) was dominant (40.21%). There was a moderate correlation between the positive rate of ILI in sentinel hospitals and the number of outbreaks per month (rs=0.696, P=0.000). There was a strong correlation between the monthly number of outbreaks and the detection rate (rss=0.696, P=0.000). There was a strong correlation between influenza A virus H3 subtype and BV subtype (rs -H3=0.686, P=0.030; rs -BV=0.632, P=0.000). There was a moderate correlation between the new A1 subtype and B Yamagata subtype (rs -new A H1=0.481, P=0.000 0; rs -BY=0.515, P=0.000). Conclusion There are two epidemic peaks in spring and winter in Hefei. Influenza subtypes are diverse. The results of ILI etiology can predict the outbreaks of different subtypes of influenza. Prediction and surveillance should be used for influenza control and outbreak management in a timely manner.
5.Effect and mechanism of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients
Fuqiang YUAN ; Yanhong FU ; Hui ZHANG ; Lei YU ; Zhiyong ZHANG ; Zhenwu MA ; Yanan XU ; Liqin ZHAO ; Hui YANG ; Xusheng WANG
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(6):513-519
Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.
6.ThesafetyandcurativeeffectofTACEcombinedwithargonheliumknifecryoablation inthetreatmentofadvancedprimaryhepaticcancer
Haiming YANG ; Shimeng SUN ; Haidong YU ; Cunkai MA ; Zhenwu LEI ; Yingxing GUO
Journal of Practical Radiology 2019;35(3):444-447
Objective Toinvestigatethemethod,safetyandefficacyoftranscatheterarterialchemoembolization(TACE)combined withargonheliumknifecryoablationintreatmentofadvancedprimaryhepaticcancer.Methods FiftyGfourpatientswithadvanced primaryhepaticcancerunderwentTACEfirstly,andfollowedbytheargonhelium knifecryoablationunderCT/ultrasoundguiding percutaneouspunctureafter1-2weeks.2-3cyclesofcryotherapywereperformedduringtheoperation.Afteroperation,enhanced CT/MRIwasperformedtofollowGup.Results Themediansurvivaltimewas17.6months.The6Gmonthsurvivalratewas100%,the 12Gmonthsurvivalratewas89.34%,thetumorprogressiontimewas9.3 months,andtheshortestsurvivalperiodwas8 months.Recent curativeeffectevaluationshowedCRin9patients,PRin34patients,SDin6patients,PDin5patients(RR=79.62%,DCR=90.74%). Conclusion TACEcombinedwithargonheliumknifecryoablationisasafeandeffectivetreatment,whichprovidesanewtreatment planforpatientswithprimaryhepaticcancer.
7.Superselective cystic arterial perfusion embolization for the treatment of invasive bladder cancer with hemorrhage
Zhenwu LEI ; Shimeng SUN ; Yu WU ; Wenming WEI ; Haojie WANG ; Yubiao LI
Journal of Practical Radiology 2019;35(6):960-962
Objective To investigate the efficacy of transcatheter selective cystic arterial infusion chemotherapy embolization in the treatment of invasive bladder cancer with hemorrhage.Methods 81 cases of with invasive bladder cancer and hemorrhage treated by superselective intervention in hospital were selected,as well as postoperative complications and tumor volume changes were recorded in followG up.Results The success rate of intubation and embolization was 100%,the immediate hemostasis rate was 97.53%,and the preoperative bladder tumor volume (4.08±1.66)cm was significantly larger than that of the six months after surgery (3.45±1.33)cm.Conclusion Superselective cystic arterial perfusion embolization is a safe and effective treatment for patients with invasive bladder cancer complicated with hemorrhage.
8.ChangesofhepatichemodynamicsinpatientstreatedwithTIPS+GCVEcombinedwithPSE
Shimeng SUN ; Yu WU ; Yubiao LI ; Zhenwu LEI ; Haiming YANG ; Cunkai MA ; Yingxing GUO
Journal of Practical Radiology 2019;35(7):1132-1135
Objective ToexploretheeffectofTIPS+GCVEcombinedwithPSEonhemodynamicsinpatientswithlivercirrhosis,portal hypertensionandsplenomegaly.Methods 56patientswereincludedfromJanuary2015toDecember2016 whounderwentTIPS+GCVEcombinedwithPSE.Patientswerefollowed-upon1month,3months,6monthsand1yearaftersurgery,andstatisticanalysis weredoneonportalveinhemodynamicindex:portalveintrunkdiameter(PVD),portalveinvelocity(PVV),portalvenousbloodflow (PVF),splenicveintrunkdiameter(SVD)andvelocityofbloodflowinsplenicvein(SVV).Results Thereweresignificantdifferencesinportal veinpressurebeforeandafterthebypassinall56patients.PVDandPVV weresignificantlydifferentbetween3and6 monthsafter surgeryandpre-surgery.PVF wassignificantlydifferentcomparing6 monthsand1yearaftersurgery withpre-surgery.SVDand SVV weresignificantlydifferentbetween3 months,6 monthsand1yearaftersurgeryandpre-surgery.Conclusion TIPS+GCVE combinedwithPSEcouldeffectivelyreduceportalveinpressure,improveportalveinandspleenveinbloodflow,increaseportalvenousblood flow,andimprovepatients’liverfunction.
9.Partial splenic artery embolization for the treatment of patients with hypersplenism at high altitude region: clinical analysis
Zhenwu LEI ; Haojie WANG ; Yubiao LI ; Shimeng SUN ; Yu WU
Journal of Interventional Radiology 2018;27(3):271-273
Objective To investigate the clinical curative effect and significance of partial splenic artery embolization (PSE) for the treatment of patients with hypersplenism at high altitude region. Methods The clinical data of 66 patients with cirrhosis complicated by portal hypertension and hypersplenism, who lived in Xining City of Qinghai Province, the high altitude region in China, and were admitted to authors' hospital during the period from March 2015 to December 2016 to receive PSE, were retrospectively analyzed. White blood cell (WBC) count, red blood cell (RBC) count and platelet (PLT) count were calculated at one day before operation as well as at one, 7, 30 and 90 days after operation. Results The technical success rate of PSE was 100%. The mean WBC count determined at one, 7, 30 and 90 days after PSE was obviously different from that determined at one day before PSE, the differences were statistically significant (P<0. 05). Conclusion For the treatment of patients with cirrhosis complicated by portal hypertension and hypersplenism, who live at high altitude region, PSE has reliable curative effect, therefore, this therapy is worth promoting in clinical practice. (J Intervent Radiol, 2018, 27: 271-273)
10.TACE for the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus: recent progress in research
Shimeng SUN ; Yingxing GUO ; Zhenwu LEI ; Haojie WANG
Journal of Interventional Radiology 2017;26(7):668-671
At present,the combined interventional therapy that is based on transcatheter arterial chemoembolization (TACE) technique can control the progression of primary hepatocellular carcinoma (PHC)in different degrees,at the same time the clinical objectives,such as relieving portal hypertension,eliminating portal vein occlusion,controlling refractory ascites and lowering upper gastrointestinal bleeding probability,can be reliably achieved.Thus,the quality of life of the patients can be effectively improved and the survival time will be reliably prolonged.This paper aims to make a comprehensive review about the medical articles concerning TACE combined with other interventional therapies for PHC complicated by portal vein tumor thrombus,which have been published both at home and abroad in recent years,in order to provide practical help for clinical diagnosis and treatment of PHC.


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