Cryoablation is a local ablation treatment based on the hypothermia effect,which has been widely used in the treatment of various solid tumors throughout the body.However,low freezing efficiency and insufficient accuracy are the problems in clinical cryoablation therapy which need to be solved urgently.With the continuous progress of nanoscience,various types of nanoparticles have been developed and applied in clinical practice.After being loaded into the target area,the nanoparticles can exert functions such as targeted drug delivery as well as image enhancement,which provides the possibility to break through the current clinical application bottleneck of cryoablation therapy.This paper aims to make a comprehensive review about several currently commonly-used nanoparticles for cryoablation therapy,focusing on their main functions and mechanisms,with the hope that the physicians concerned can get a further detailed understanding of the nanoparticles and lay a solid foundation for conducting in-depth researches and achieving clinical transformation.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

According to the International Agency for Research on Cancer (IARC) of the World Health Organization, the number of people with primary liver cancer is predicted to exceed 1 million per year by 2025, making it a major threat to human life and health. According to "Standardization for Diagnosis and Treatment of Hepatocellular Carcinoma (2022 edition) " issued by the National Health Commission of China, locoregional interventional therapy represented by ablation and transcatheter arterial chemoembolization (TACE) has become the main treatment for unresectable intermediate-advanced hepatocellular carcinoma (HCC), in which the indications for TACE include patients with stage Ⅰb to Ⅲb HCC. Locoregional interventional therapy has been proved to have a clear immune activation effect, and with the gradual promotion of immune checkpoint inhibitors in clinical trials and applications at home and abroad, the combination therapy of locoregional intervention and immune checkpoint inhibitors has shown a more effective objective response rate, slower progression time and longer survival, bringing new hope to patients with inoperable intermediate-advanced HCC.

Objective: To assess the interobserver variations in delineating the planning target volume (PTV) and organs at risk (OAR) using different contouring methods during intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), aiming to provide references for the quality control of multi-center clinical trials. Methods: The PTV and OAR of CT image of 1 NPC patient manually delineated by 10 physicians from 8 different radiation centers were defined as the " manual contour group" , and the OAR auto-contoured using the ABAS software and modified by the physicians were defined as the " auto+ manual contour group" . The maximum/minimum ratio (MMR) of the PTV and OAR volumes, and the coefficient of variation (CV) for different delineated contours were comparatively evaluated. Results: Large variation was observed in the PTV and OAR volumes in the manual contour group. The MMR and CV of the PTV were 1.72-3.41 and 0.16-0.39, with the most significant variation in the PTV_nd (MMR=3.41 and CV=0.39 for the PTV_nd-L). The MMR and CV of the manually contoured OAR were 1.30-7.89 and 0.07-0.67. The MMR of the temporal lobe, spinal cord, temporomandibular joint, optic nerve and pituitary gland exceeded 2.0. Compared with the manual contour group, the average contouring time in the auto+ manual group was shortened by 68% and the interobserver variation of the OAR volume was reduced with an MMR of 1.04-2.44 and CV of 0.01-0.37. Conclusions Large variation may occur in the PTV and OAR contours during IMRT plans for NPC delineated by different clinicians from multiple medical centers. Auto-contouring+ manually modification can reduce the interobserver variation of OAR delineation, whereas the variation in the delineation of small organs remains above 1.5 times. The consistency of the PTV and OAR delineation and the possible impact upon clinical outcomes should be reviewed and evaluated in multi-center clinical trials.

Objective To analyze the risk factors that affect the early recurrence (recurrence occurring within 3 months after surgical resection) of hepatocellular carcinoma (HCC), and to discuss the risk factors influencing the survival after hepatectomy. Methods The clinical data of 257 HCC patients, who were admitted to authors' hospital during the period from January 1, 2007 to March 31, 2014 to receive cTACE within 3 months after surgical resection of hepatocellular carcinoma, were retrospectively analyzed. According to DSA findings (lipiodol CT scan was performed in part of patients with undetermined diagnosis), the patients were divided into recurrence group and non-recurrence group. By using univariate analysis and multiple logistic regression analysis, the correlation of the clinical and pathological data with the early recurrence was analyzed. The patients were followed up, the survival time was recorded. The relationship between patient's clinical data and postoperative survival was evaluated. Results ① Of the 257 patients, early recurrence was detected in 150 patients (58. 4％, recurrence group) and no recurrence was observed in 107 patients (41. 6％, non-recurrence group). ②The presence of satellite nodules and the integrity of tumor encapsulation were two independent factors associated with the postoperative residual lesions. ③The maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus were the independent risk factors affecting survival. ④The median survival time of patients in recurrence group was markedly shortened than that of patients in non-recurrence group (39 months vs. 93 months). Conclusion The early recurrence (within 3 months after resection) of hepatocellular carcinoma is associated with the presence of satellite nodules and the integrity of tumor encapsulation. The survival of patients after hepatectomy is related to the maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus. The median survival time in patients having early recurrence is significantly shortened than that in patients having no early recurrence. (J Intervent Radiol, 2018, 27: 215-222)

Objective To explore the effectiveness,safety and influencing factors of arterial infusion of oxaliplatin for the treatment of colorectal l1iver metastases after surgery.Methods Totally 68 colorectal liver metastases after surgery patients pathologically confirmed received at least two course of arterial infusion of oxaliplatin combined with TACE.According to postoperative intravenous chemotherapy,the patients were divided into group A (no chemotherapy) and group B (chemotherapy).Survival time of patients were followed up.According to the efficacy of solid tumor evaluation criteria the objective effect was evaluated,the adverse reactions were compared between two groups.Cox regression analysis was performed to assess the possible factors influencing survival time.Results The median overall survival (OS) of all the 68 patients was 18 months,with complete remission 16 cases,partial remission 26 cases,stable diseasse 21 cases,stable diseasse 5 cases,the response rate (RR) was 61.76％ (42/68).The median progression-free survival (PFS) was 10 months.The RR,OS and PFS had no statistical difference (all P＞0.05).The variables that eventually entered the Cox regression model were tumor differentiation (P=0.003,hazard ratio 2.202).Conclusion Arterial infusion of oxaliplatin and TACE is effective in treating colorectal liver metastases after surgery,with high objective response rate.

Malignant hepatopancreatobiliary tumors are highly malignant and have poor prognosis. 125I seed implantation combined with other minimally invasive therapies for radical treatment of early liver cancer has achieved a good clinical effect in preventing early recurrence after liver cancer surgery. It is also used in the treatment of advanced liver cancer and portal vein tumor thrombosis. 125I seed has achieved a good local control rate in the treatment of tumors with a lack of blood supply, such as intrahepatic cholangiocellular carcinoma and metastatic liver cancer. 125I seed combined with biliary stenting can significantly relieve the symptoms of malignant biliary obstruction and extend the time to restenosis. Comprehensive interventional treatment based on 125I seed can significantly improve quality of life and extend survival time in patients with pancreatic cancer. Therefore, 125I seed implantation is safe and convenient in clinical practice and holds promise for clinical application.

The authors report one case of primary hepatic neuroendocrine carcinoma associated with multiple liver metastases. A patient was a 41-year-old female. In 2010, B-ultrasound examination revealed that there were multiple space-occupying lesions in the liver, and hepatic hemangiomas was considered to be the diagnosis. Then, the patient was followed up regularly. In Aug. 2013, B-ultrasound examination indicated that the hepatic lesions were significantly enlarged. Multi-detector CT scanning and MRI examination were performed, and still the diagnosis of multiple hepatic hemangiomas was suggested. On CT and MRI the lesion presented as a well-circumscribed hypervascular tumor with “fast-in and slow-out” enhancement pattern. On MRI, the lesion was characterized by multiple nodules. Needle biopsy was carried out, and the pathological and immunohistochemical diagnosis was metastatic neuroendocrine tumor. Systemic examination did not find the primary lesion. Therefore, primary hepatic neuroendocrine carcinoma associated with intra- hepatic metastases was diagnosed. The patient was treated with transcatheter arterial chemoembolization. The drugs used were 100 mg Oxaliplatin+one bottle of gelatin sponge particles(300-500μm)+10 ml iodized oil, and micro-pump infusion of 100 mg oxaliplatin(99 mg/h) through catheter was also employed. Clinically, primary hepatic neuroendocrine carcinoma is extremely rare. In combination with the medical literatures, the authors attempt to make a preliminary discussion on the clinical characteristics, differential diagnosis, treatment and prognosis of primary hepatic neuroendocrine carcinoma.

Objective To assess the effect of ultrasound-guided percutaneous 125I seed implantation for the treatment of osteolytic metastases. Methods From February 2011 to December 2013, a total of 18 patients with advanced cancer complicated by osteolytic metastases received ultrasound-guided percutaneous implantation of 125I seeds. According to visual analog score (VAS) the pain was estimated before and 3 days as well as one month after the treatment. One month after the treatment follow-up CT scan was performed in all patients to check the tumor size and the distribution of 125I seeds, and the therapy was repeated if necessary. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). Results A total of 33 times of procedure were carried out in the 18 patients. Three days after the treatment, local pain was obviously relieved in all cases. Compared with preoperative VAS, the postoperative VAS was significantly improved (P=0.000). The pain was well controlled even one month after the treatment (P=0.000). One month after the last treatment the complete remission (CR) rate was 0% (n=0), partial remission (PR) rate 61.1% (n=11), stable disease (SD) 33.3% (n=6) and progress disease (PD) 5.6% (n=1), and local control rate (CR+PR) was 61.1%. No severe brachytheray-related complications occurred. Conclusion Ultrasound-guided percutaneous 125I seed implantation brachytherapy is technically simple and repeatable, it can safely and effectively guide the performance of percutaneous 125I seed implantation for the treatment of osteolytic metastases. Even in the circumstance of not using TPS, this technique can also obtain satisfactory local control rate and significant pain relief.

Objective To discuss the effect and safety of modified XELOX regimen for the treatment of colorectal cancer with he-patic metastases.Methods A retrospective analysis on the clinical data in 18 patients with colorectal cancer with hepatic metastases was performed in our hospital.The diagnosis in all patients was confirmed by biopsy and colonoscopy,and the primary lesion was not resected but with at least 2 courses treatment with modified XELOX regimen (intravenous infusion of oxaliplatin changed into ar-terial perfusion and 1-hour slow perfusion with indwelling catheter).The intrahepatic metastases were detected by CT and/or MRI and the primary focus was examined by enteroscopy every 2 months.A follow-up on survival time was performed and the objective response was evaluated in accordance with RECIST criteria.SPSS 1 9.0 was used for an analysis by Kaplan-Meier method.Results (1)Curative effect was evaluated in all 18 patients and TACE has been used for 1 1 5 times.The median OS was 14.0 months with 95% CI (9.6,18.4),and the median PFS was 8.0 months with 95% CI (5.2,10.8)including CR in 2,PR in 7,SD in 4 and PD in 5.The efficiency rate (RP)was 50.0% and the clinical benefit rate (CBR)was 72.2%;(2)The post-treatment adverse reactions mainly included fever,nausea,emesis,pain,impaired liver function,myelosuppression and peripheral sensory neuropathy,most of which were at Level Ⅰ-Ⅱ without treatment-related death.Fever with different degrees occurred in all patients,and nausea and emesis in 13.Pain and abnormal liver function occurred within 3-5 days after TACE with less than Level 2.Conclusion Modified XELOX regimen is practically effective in treating colorectal cancer with hepatic metastases.With a high objective response rate,it can improve patients'living quality and increase excision rate with tolerable adverse reactions.