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.

Objective:The purpose of this study is to analyze the surveillance data of the Integrated HCV surveillance in Shanghai and provide a scientific basis for HCV's elimination strategies.Methods:Descriptive statistical analysis and multivariate logistic regression analysis were performed using the multi-dimension results of the Integrated HCV surveillance in Shanghai from 2014 to 2019. Data related to reported HCV cases, HCV gene subtypes surveillance, HCV behavioral risk factors surveillance and HCV-antibody testing results of the community-based general population and high-risk/key populations.Results:The reported incidence rate of acute hepatitis C in Shanghai decreased from 2014 to 2019 ( Z=-4.07, P<0.01); meanwhile, the reported incidence rate of chronic hepatitis C met an upward trend ( Z=10.26, P<0.01), with an annual average, reported incidence rates of 0.18 per 100 000 and 8.60 per 100 000, respectively. Seven hundred forty-four blood samples were subtyped with 16 subtypes from 4 genotypes (GT1, GT2, GT3, and GT6). Among above, 1b (324 cases, 43.55%), 3a (121 cases, 16.26%), 3b (111 cases, 14.92%) and 6a (47 cases, 6.32%) were the principal subtypes. The composition of genotypes varied with decreased 1b and increased 3b and 6a. The major risk factors for HCV infection were blood transfusion ( OR=4.18, 95% CI: 2.79-6.27), surgery ( OR=1.63, 95% CI: 1.26-2.12), sharing syringe ( OR=4.18, 95% CI: 2.75-6.34), pedicure ( OR=2.01, 95% CI: 1.54-2.62), sharing razors ( OR=4.09, 95% CI:1.24-13.51), and unsafe beauty practices ( OR=3.15, 95% CI: 2.13-4.65). HCV antibody screening of 11 groups of high-risk/key populations showed that drug users had the highest HCV-antibody positive rate of 18.81% (1 008/5 358). The anti-HCV positive rate of the general population was 0.16% (7/4 268), which was significantly lower than that of high-risk/key populations from the same year, 2.50%(501/20 002) ( χ2=94.04, P<0.01). Conclusions:Shanghai is a low-endemic area of HCV. Constantly carrying out integrated surveillance and analysis is of great value for early identification of HCV infected people and its risk factors, timely adjustment of prevention and control strategies, and eliminating the public health threat of HCV.

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.

Objective To investigate the curative effect of transcatheter arterial chemoembolization (TACE) combined with endovascular 125I seed strip implantation for the treatment of primary hepatocellular carcinoma (PHC) complicated by extensive portal vein tumor thrombus. Methods The clinical data of 72 patients with PHC complicated by extensive portal vein tumor thrombus were retrospectively analyzed. The patients were divided into group A (n=32) and group B (n=40). TACE combined with endovascular 125I seed strip implantation was performed for the patients of group A, while only TACE was employed for the patients of group B. The changes of portal vein tumor thrombus, the survival time and procedure-related adverse events were recorded. The preoperative and postoperative measured values were compared using paired samples t test, the count data were evaluated by χ2 test, and the survival time was analyzed with Kaplan-Meier method. Results Technical success rate of portal vein 125I seed strip implantation was 100%. No serious procedure-related adverse events occurred. The median survival periods of group A and group B were 210 days and 141 days respectively, the difference between the two groups was statistically significant (P=0.012). Conclusion For the treatment of primary hepatocellular carcinoma complicated by extensive portal vein tumor thrombus, TACE combined with endovascular 125I seed strip implantation can significantly improve the patient’s survival time.

Percutaneous transhepatic biliary drainage(PTBD) is an effective therapeutic option for obstructive jaundice.With various novel puncture instruments being created,the manipulating technique being improved and medical idea being updated,PTBD has been widely employed in clinical practice for alleviating the biliary tract obstruction.In order to standardize this technique this paper aims to make some suggestions for the PTBD guidelines concerning the indications,contraindications,operative skill,postoperative management,complications and their preventions,points for attention,etc.