Yttrium-90 selective internal radiation therapy (⁹⁰Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of ⁹⁰Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.

Microspheres are commonly used as embolic materials in vascular interventional operations.However,due to the limitation of materials,almost all microspheres cannot be detected by imaging equipment in vivo.The visualization of microspheres refers to the addition of various materials to the microspheres that enable the microspheres to be displayed on the images of imaging equipment.In order to optimize the embolization process and facilitate postoperative follow-up,a lot of visualized microspheres have been reported so far,such as X-ray visualized microspheres,MRI visualized microspheres,ultrasonic visualized microspheres,etc.Clinical experience has shown that these microspheres can provide true spatial distribution and real-time intraoperative feedback,which contributes to the optimization,personalization,and improvement of vascular embolization technology.This paper aims to make a comprehensive review about the recent advances in researches about the above mentioned visualized microspheres.

Portal hypertension is a pathological elevation of portal pressure gradient(PPG),often leading to severe complications.Interventional shunting such as transjugular intrahepatic portosystemic shunt(TIPS)has gradually become an important means of treatment,but the postoperative hemodynamic changes are uncertain,therefore,individualized treatment scheme with precision shunting is needed.The purpose of precision shunting is to balance the amount of shunting blood with the amount of blood perfusion in the liver tissue,which can minimize the incidence of complications while relieving symptoms.The determination of hemodynamic goals after interventional shunting is influenced by various factors,and the procedural differences and individual variances should be taken into consideration when making reasonable postoperative hemodynamic targets(optimal PPG).The preliminary results of clinical practice of precision shunting indicates that accurate measurement of preoperative portal pressure and effective monitoring of postoperative hemodynamic status should be emphasized.Future studies should further improve the interventional shunting technique to achieve a more individualized precision treatment.

Objective:To discuss the effects of transjugular intrahepatic portosystemic shunt (TIPS) procedure on hemodynamics in cirrhotic patients.Methods:A total of 23 cirrhotic patients for TIPS insertion were enrolled from January 2018 to October 2018. Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), transthoracic echocardiography and non-invasive cardiac output measurement based on impedance cardiogram were carried out before and 24h, 1 month, 6 months after TIPS in order to observe cardiac function and hemodynamic changes after TIPS.Results:Significant increases in right atrial area [(17.2±4.0) cm 2 vs. (15.0±3.4) cm 2, P<0.05], right ventricular area [(15.1±3.8) cm 2 vs. (13.7±3.5) cm 2, P<0.05] and left ventricular volume [(97.4±21.5) ml vs. (91.1±22.7) ml, P<0.05] were observed 24 h after TIPS. These changes were accompanied with significant reduction in collapsible index of inferior vena cava [(20.7± 8.1)% vs. (28.6±11.3)%, P<0.01] and elevation in pulmonary arterial systolic pressure [(36.0±8.4) mmHg (1 mmHg=0.133 kPa) vs. (31.8±5.4) mmHg, P<0.01]. There also existed significantly elevated serum NT-proBNP [(551.2±325.1) ng/L vs. (124.2±94.4) ng/L, P<0.01], cardiac output [(5.82±0.96) L/min vs. (5.12±1.28) L/min, P<0.01], cardiac index [(3.47±0.64) L·min -1·m -2 vs. (3.05±0.78) L·min -1·m -2, P<0.01], early diastolic filling rate [(59.0±14.3)% vs. (54.5±11.0)%, P<0.05], and reduced systemic vascular resistance index (SVRi) [(1 798.4±357.3) dyne·s·cm -5·m -2 vs. (2 195.7±508.7) dyne·s·cm -5·m -2, P<0.01] 24 h after TIPS. At the end of 6-month follow-up, all these parameters, but not SVRi, returned towards baseline values. Moreover, peak early to late diastolic tissue velocity ratio at the level of lateral mitral annulus (E′/A′) was significantly higher at the end of 6-month follow-up than that at baseline (1.06±0.32 vs. 0.90±0.45, P<0.05). Neither the right ventricular fractional area changes nor the left ventricular ejection fractions during the follow-up period were different from those at baseline ( P>0.05). Conclusion:Cirrhotic patients who had no cardiovascular pathologies had adequate adaptation and good compensation ability to reach a new hemodynamic homeostasis for the increased volume load after TIPS insertion.

Objective To evaluate the safety and efficacy of brachytherapy with 125I seed strand in treating implanted main portal vein tumor thrombus (MPVTT) in experimental rabbits.Methods VX2 tumor cell line was implanted in the main portal vein (MPV) of 32 New Zealand white rabbits to establish MPVTT models.The rabbits were randomly divided into the treatment group (group T,n=16) and the control group (group C,n=16).125I seed strand was implanted in the MPVTT of the rabbits of group T,while blank seed strand was implanted in the MPVTT of the rabbits of group C.After the implantation,the changes in general condition,body weight and laboratory testing results were recorded.Two weeks after the treatment,every 8 rabbits from each group were sacrificed,and the specimens were collected and sent for pathological examination.The remaining rabbits were fed till they died,and then autopsy was conducted.Multi-slice spiral CT manifestations,histopathological findings,Ki-67 labeling index and apoptosis index were used to assess the curative effect,and the results were compared between the two groups.Results At each observation time point after brachytherapy,the weight loss of the experimental rabbits was more obvious in group C than in group T.No statistically significant differences in liver functions and white blood cell count existed between the two groups (P＞0.05).The mean MPVTT volume of group T and group C were (565.40±220.90) mm3 and (2 269.90±437.00) mm3 respectively (P＜0.001);the Ki-67 labeling indexes were (4.14±1.84)％ and (33.82± 6.07)％ respectively (P=0.001);the median survival days were (39.50±2.37) d and (27.38±1.22) d respectively (P=0.001).Conclusion For the treatment of implanted MPVTT in experimental rabbits,brachytherapy with 125I seed strand is safe and effective.

With the progress of imaging techniques, the diagnosis rate for portal vein thrombosis (PVT), that is used to be considered as a rare disease, has been rapidly increasing. PVT can be caused by systemic reasons such as various thrombophilic risk factors as well as a lot of local reasons such as cirrhosis, abdominal trauma and infection, malignant tumor, etc. At present, PVT is classified into acute and chronic entities based on the duration of clinical symptoms as well as on the presence or absence of portal cavernous transformation. The clinical manifestations and the treatment principles of the acute and chronic PVT are quite different. For acute PVT, the principle of treatment is to reopen the obstructed portal vein and to prevent the thrombus from entering into the superior mesenteric vein, while for chronic PVT the principle of treatment is focused on the management of the complications due to portal hypertension. The interventional management of portal thrombus plays an important role in reopening portal vein, reducing complications caused by portal hypertension, and restoring portal blood flow, etc. This paper aims to make a comprehensive review about the etiology and management of portal vein thrombosis.

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Objective To investigate the effect of endothelial progenitor cells (EPCs) on the growth of C6 glioma cells in vitro.Methods EPCs were obtained from the spleen of healthy SD rats with density gradient centrifugation and adherence screening.The obtained EPCs were identified through morphologic characteristics,specificity to DiI-acLDL uptaking and Lectin binding,and positive expressions of CD34 and CD31 by immunofluorescence assay.The EPCs-conditional medium was added into the convention medium of C6 glioma cells to assess its effect on the proliferation of glioma cells.After cultured for 36 or 48 h with the EPCs-conditional medium or conventional medium (control),MTT assay was employed to measure the cell proliferation and flow cytometry was used to detect the cell cycle.Results In 10 d after culture,the attached cells presented a "line-like" structure,and the adherent cells were double positive to DiI-acLDL uptaking and FITC-UEA-1 binding by direct flourescence staining under a laser scanning confocal microscope.Those cells were differentiated EPCs,and expressed wholly expressed CD34 and CD31.MTT assay showed that the OD value of each group at both the 2 time points were increased with the increasing of EPCs content in conditioned medium.The OD value of the group containing 50% of EPCs conditional medium of 36 h(2.018?0.220) and 48 h (2.388?0.448) was markedly higher than those of the control group (1.163?0.103,1.106?0.174) with significant difference (P