Objective:To investigate impact of atractylolidⅠ(ATR-Ⅰ)on liver function of hepatitis B virus(HBV)infection rats by regulating cGAS-STING pathway.Methods:Ten rats were randomly selected as control group(NC),rest rats were injected with HBV antigen via tail vein to construct HBV model.Rats successfully modeled were randomly grouped into HBV group,ATR-Ⅰgroup(50 μg/kg),inhibitor of cGAS-STING pathway(RU.521)group(450 μg/kg),ATR-Ⅰ+RU.521 group(50 μg/kg ATR-Ⅰ+450 μg/kg RU.521),with 10 rats in each group.NC group and HBV group were injected with same amount of normal saline once a day for 1 week.Serum aspartate aminotransferase(AST),alanine aminotransferase(ALT),hyaluronic acid(HA),laminin(LN),procolla-gen type Ⅲ(PC Ⅲ),IFN-γ,IL-2,TNF-α,hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg)were detected by ELISA;HE staining was applied to detect liver histopathology;Masson staining was applied to detect degree of liver fibrosis;Western blot was applied to detect expressions of cGAS-STING pathway proteins in liver tissue.Results:Collagen volume fraction,ALT,AST,HBsAg,HBeAg contents,HA,LN and PC Ⅲ,IFN-γ,TNF-α and IL-2 levels in HBV group were higher than NC group,levels of cGAS,STING,p-TBK1/TBK1,p-IRF3/IRF3 and IFN-β were decreased(P<0.05);compared with HBV group,degree of liver injury and liver fibrosis in ATR-Ⅰ group were improved,collagen volume fraction,ALT,AST,HBsAg,HBeAg contents,HA,LN,PC Ⅲ,IFN-γ,TNF-α and IL-2 levels were decreased,levels of cGAS,STING,p-TBK1/TBK1,p-IRF3/IRF3 and IFN-β were in-creased(P<0.05),RU.521 group showed opposite trend,RU.521 eliminated improvement effect of ATR-Ⅰ on liver function of HBV rats.Conclusion:ATR-Ⅰmay improve liver function of HBV rats by activating cGAS-STING pathway.

Purpose To identify hepatocellular carcinoma that responds to repetitive transcatheter arterial chemoembolization(TACE)based on CT radiomics.Materials and Methods A total of 96 patients diagnosed as hepatocellular carcinoma in the First Affiliated Hospital of Xinjiang Medical University from February 2018 to May 2024 were randomly divided into a training group(n=67)and internal validation group(n=29)at a ratio of 7∶3.All patients received three or more TACE treatments.Radiomics features were extracted from lipiodol of the target-lesions by semi-automatic segmentation on the axial CT image after TACE within 24 hours.The radiomics model were constructed by five features for differentiating non-response group from response group.Receiver operating characteristic curve analysis and decision curve were performed to evaluate the performance of the model.Results Child-Pugh classification(OR=2.737,P<0.05),BCLC stage(OR=2.907,P<0.05),multifocal tumors(OR=4.505,P<0.01)and alpha-fetoprotein(OR=1.002,P<0.01)were independent risk factors for predicting tumor response after TACE.The area under the curve of the non-contrast CT based model and the arterial-enhanced CT based model were 0.813 and 0.831 in the experimental group;0.748 and 0.788 in the validation group,respectively.Both of the two models showed good prediction performance.Conclusion The radiomics model based on CT imaging features after first TACE is effectively for differentiating non-response group from response group,lipiodol retention patterns from the target lesion can be the imaging biomarkers for TACE response prediction.

Objective:To investigate impact of atractylolidⅠ(ATR-Ⅰ)on liver function of hepatitis B virus(HBV)infection rats by regulating cGAS-STING pathway.Methods:Ten rats were randomly selected as control group(NC),rest rats were injected with HBV antigen via tail vein to construct HBV model.Rats successfully modeled were randomly grouped into HBV group,ATR-Ⅰgroup(50 μg/kg),inhibitor of cGAS-STING pathway(RU.521)group(450 μg/kg),ATR-Ⅰ+RU.521 group(50 μg/kg ATR-Ⅰ+450 μg/kg RU.521),with 10 rats in each group.NC group and HBV group were injected with same amount of normal saline once a day for 1 week.Serum aspartate aminotransferase(AST),alanine aminotransferase(ALT),hyaluronic acid(HA),laminin(LN),procolla-gen type Ⅲ(PC Ⅲ),IFN-γ,IL-2,TNF-α,hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg)were detected by ELISA;HE staining was applied to detect liver histopathology;Masson staining was applied to detect degree of liver fibrosis;Western blot was applied to detect expressions of cGAS-STING pathway proteins in liver tissue.Results:Collagen volume fraction,ALT,AST,HBsAg,HBeAg contents,HA,LN and PC Ⅲ,IFN-γ,TNF-α and IL-2 levels in HBV group were higher than NC group,levels of cGAS,STING,p-TBK1/TBK1,p-IRF3/IRF3 and IFN-β were decreased(P<0.05);compared with HBV group,degree of liver injury and liver fibrosis in ATR-Ⅰ group were improved,collagen volume fraction,ALT,AST,HBsAg,HBeAg contents,HA,LN,PC Ⅲ,IFN-γ,TNF-α and IL-2 levels were decreased,levels of cGAS,STING,p-TBK1/TBK1,p-IRF3/IRF3 and IFN-β were in-creased(P<0.05),RU.521 group showed opposite trend,RU.521 eliminated improvement effect of ATR-Ⅰ on liver function of HBV rats.Conclusion:ATR-Ⅰmay improve liver function of HBV rats by activating cGAS-STING pathway.

Hepatocellular carcinoma(HCC)is a worldwide highly prevalent malignant tumor,and patients with advanced HCC often lose opportunity for surgery.The effect of TACE alone for treating advanced HCC is limited.Comprehensive treatment strategy,including TACE combined with ablation,hepatic arterial infusion chemotherapy,molecular targeted drugs and immune checkpoint inhibitors can promote tumor necrosis,reverse the immunosuppressive microenvironment and prolong patient's survival period through synergistic mechanisms.The research progresses of combination therapy strategy of TACE and other methods for advanced HCC were reviewed in this article.

Hepatocellular carcinoma(HCC)is a worldwide highly prevalent malignant tumor,and patients with advanced HCC often lose opportunity for surgery.The effect of TACE alone for treating advanced HCC is limited.Comprehensive treatment strategy,including TACE combined with ablation,hepatic arterial infusion chemotherapy,molecular targeted drugs and immune checkpoint inhibitors can promote tumor necrosis,reverse the immunosuppressive microenvironment and prolong patient's survival period through synergistic mechanisms.The research progresses of combination therapy strategy of TACE and other methods for advanced HCC were reviewed in this article.

Purpose To identify hepatocellular carcinoma that responds to repetitive transcatheter arterial chemoembolization(TACE)based on CT radiomics.Materials and Methods A total of 96 patients diagnosed as hepatocellular carcinoma in the First Affiliated Hospital of Xinjiang Medical University from February 2018 to May 2024 were randomly divided into a training group(n=67)and internal validation group(n=29)at a ratio of 7∶3.All patients received three or more TACE treatments.Radiomics features were extracted from lipiodol of the target-lesions by semi-automatic segmentation on the axial CT image after TACE within 24 hours.The radiomics model were constructed by five features for differentiating non-response group from response group.Receiver operating characteristic curve analysis and decision curve were performed to evaluate the performance of the model.Results Child-Pugh classification(OR=2.737,P<0.05),BCLC stage(OR=2.907,P<0.05),multifocal tumors(OR=4.505,P<0.01)and alpha-fetoprotein(OR=1.002,P<0.01)were independent risk factors for predicting tumor response after TACE.The area under the curve of the non-contrast CT based model and the arterial-enhanced CT based model were 0.813 and 0.831 in the experimental group;0.748 and 0.788 in the validation group,respectively.Both of the two models showed good prediction performance.Conclusion The radiomics model based on CT imaging features after first TACE is effectively for differentiating non-response group from response group,lipiodol retention patterns from the target lesion can be the imaging biomarkers for TACE response prediction.

Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100％.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P＜0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7％,75.9％,75.9％ and 52.5％,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100％,66.9％,66.9％ and 33.4％,respectively.The incidence of hepatic encephalopathy was 13.8％(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective To analyze the differences in the treatment patterns,clinical characteristics,treatment outcomes and prognostic factors between breast cancer patients with ductal carcinoma in situ (DCIS) and ductal carcinoma in situ with microinvasion (DCIS-MI).Methods Clinical data of 866 female patients including 631 DCIS cases and 235 DCIS-MI cases treated in our institution between 1999 and 2013 were retrospectively analyzed.The local control (LC),disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival analysis.The prognostic factors were identified by Log-rank test.Results Similar LC,DFS and OS rates were obtained between two groups (all P＞ O.05).The univariate analysis demonstrated that Her-2-positive patients had worse OS and DFS than Her-2-negative counterparts.Patients undergoing breast-conserving surgery without radiotherapy had lower LC and DFS rates compared with those receiving radical mastectomy.Conclusions DCIS and DCIS-MI patients have similar clinical prognosis in terms of OS,LC and DFS.Her-2 positive is an unfavorable prognostic factor for DFS and OS.The LC and DFS rates in the breast-conserving surgery alone group are worse than those in the mastectomy group.