Objective To explore the effect of different needle track management on Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) on liver cancer after liver biopsy. Methods A retrospective analysis was conducted on the clinical data of 21 patients with liver cancer who underwent Technetium-99m-macroaggregated albumin (^99mTc-MAA) evaluation and ⁹⁰Y-SIRT after liver biopsy from June 2023 to December 2024. The methods of needle track management, hepatic arteriovenous shunting, and lung shunt fraction (LSF) were recorded. The occurrence of hepatic arteriovenous fistula (HAVF), as well as the corresponding countermeasures were analyzed. Results Among the 21 liver cancer patients, 7 cases (medical glue group) underwent embolization of the needle tract with medical glue (N-butyl 2-cyanoacrylate [NBCA]) immediately after biopsy, and no significant HAVF was observed during the ^99mTc-MAA tests; 14 cases (non-medical glue group) were treated with delayed needle extraction or gelatin sponge particle blocking after biopsy, among which 7 cases developed significant HAVF, and the fistulas were treated with NBCA. The LSF of the medical glue group was significantly lower than that of the non-medical glue group ([7.06±2.33] % vs [12.43±7.73] %, P＝0.037). All 21 patients successfully completed ⁹⁰Y-SIRT. Conclusions Liver biopsy may affect ⁹⁰Y-SIRT by causing iatrogenic HAVF. Immediate NBCA-embolization of the needle tract after biopsy or timely NBCA-embolization of fistulas during ^99mTc-MAA tests may reduce the impact.

Objective:To investigate the expression of nuclear matrix protein 4 (NMP4) in hepatocellular carcinoma (HCC), and its relationship with clinicopathological features and survival prognosis of patients.Methods:The clinical data of 100 HCC patients who were treated with radical resection of liver cancer in the Department of Hepatobiliary Surgery of the Third Affiliated Hospital of Wenzhou Medical University from July 1, 2014 to July 1, 2019 were retrospectively analyzed. There were 63 males and 37 females, aged (58.5±10.4) years old. Immunohistochemical method was used to detect the expression of NMP4 protein in HCC cancer tissue and the corresponding adjacent normal tissue. According to the expression of NMP4 in HCC tissues, 100 patients were divided into two groups: the NMP4-positive expression group ( n=62) and the NMP4-negative expression group ( n=32). Univariate analysis was performed on the relationship between NMP4 expression and clinical pathological features as well as overall survival of HCC patients. Cox multivariate analysis was performed on the factors influencing postoperative prognosis of HCC patients. Results:Immunohistochemistry results showed that NMP4 was primarily expressed in the nucleus, the positive expression rate of NMP4 in HCC tissues was higher than that in adjacent non-cancerous tissues [62.0% (62/100) vs. 8.0%(8/100)], and the difference was statistically significant ( χ2=2.12, P=0.003). Univariate analysis revealed that the overall survival of HCC patients was correlated with the degree of tumor differentiation, tumor length, BCLC stage, number of tumor foci, vascular tumor thrombus and expression of NMP4 (all P<0.05). Cox multivariate analysis revealed that low differentiation, high BCLC stage (stage C), number of tumor foci (≥3), and positive expression of NMP4 were independent risk factors affecting postoperative survival and recurrence-free survival of HCC patients. The median overall survival and median recurrence-free survival of HCC patients in the NMP4-positive expression group were 22.3 months and 11.5 months, respectively. In contrast, that in the NMP4-negative expression group were 40.6 months and 19.4 months, respectively. The cumulative survival rate and recurrence-free survival rate of HCC patients in the NMP4-positive expression group were lower than those in the NMP4-negative expression group, and the differences were statistically significant (both P<0.05). Conclusion:Positive NMP4 expression was closely correlated with malignant biological progression and poor prognosis of HCC patients.

Objective:To investigate the expression characteristics of mucin 5B (MUC5B) protein and programmed cell death factor 4 (PDCD4) protein in patients with intrahepatic cholangiocarcinoma (ICC), and to construct a nomogram model for prognosis prediction.Methods:Clinical data of 100 patients who underwent radical surgical resection and were diagnosed as ICC by postoperative pathology from September 2009 to September 2020 in the Third Affiliated Hospital of Wenzhou Medical University were retrospectively selected, including 46 males and 54 females, aged (56.9±12.2) years old. Immunohistochemistry was used to detect the expression of MUC5B and PDCD4 protein in 100 cases of ICC and corresponding adjacent tissues respectively, and the relationship between them and clinicopathological factors of ICC patients was analyzed. Univariate and multivariate Cox regression analysis were performed to analyze the influencing factors on postoperative prognosis of ICC patients. The nomogram model was constructed using rms package and performed internal verification.Results:The positive expression rate of MUC5B protein in ICC was 76.0% (76/100), which was higher than that in para-cancer tissues 27.0%(27/100), and the difference was statistically significant ( χ2=11.33, P=0.015). While the positive expression rate of PDCD4 protein in ICC was 21.0%(21/100), which was lower than that in normal tissues 73.0% (73/100), and the difference was statistically significant ( χ2=15.57, P=0.007). Multivariate Cox regression analysis showed that ICC patients with carbohydrate antigen 19-9>37 kU/L, tumor length>5 cm, tumor TNM stage Ⅱ/Ⅲ, tumor medium/low differentiation, MUC5B positive expression, and PDCD4 negative expression had a high risk of short survival after resection (all P<0.05). The nomogram model was constructed based on the above indicators, and the C-index was 0.801. The postoperative survival calibration curve showed that the high predictive survival fit of the nomogram model, and the area under the receiver operating characteristic curve was 0.862. Conclusions:Positive expression of MUC5B protein and negative expression of PDCD4 protein in ICC tissue suggest poor prognosis of ICC patients. The nomogram model constructed on the basis of MUC5B and PDCD4 protein is well distinguished and has ideal predictive efficacy.

Purpose: The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is extremely poor, and systemic therapy is currently the mainstream treatment. This study aimed to assess the efficacy and safety of lenvatinib combined with anti–programmed cell death-1 antibodies and transcatheter arterial chemoembolization (triple therapy) in patients with HCC and PVTT. Materials and Methods: This retrospective multicenter study included patients with HCC and PVTT who received triple therapy, were aged between 18 and 75 years, classified as Child-Pugh class A or B, and had at least one measurable lesion. The overall survival (OS), progression-free survival (PFS), objective response rates, and disease control rates were analyzed to assess efficacy. Treatment-related adverse events were analyzed to assess safety profiles. Results: During a median follow-up of 11.23 months (range, 3.07 to 34.37 months), the median OS was greater than 24 months, and median PFS was 12.53 months. The 2-year OS rate was 54.9%. The objective response rate and disease control rate were 69.8% (74/106) and 84.0% (89/106), respectively; 20.8% (22/106) of the patients experienced grade 3/4 treatment-related adverse events and no treatment-related deaths occurred. The conversion rate to liver resection was 31.1% (33/106), with manageable postoperative complications. The median OS was not reached in the surgery group, but was 19.08 months in the non-surgery group. The median PFS in the surgery and non-surgery groups were 20.50 and 9.00 months, respectively. Conclusion Triple therapy showed promising survival benefits and high response rates in patients with HCC and PVTT, with manageable adverse effects.

BACKGROUND: Chemotherapy is a common treatment for advanced hepatocellular carcinoma, but the effect is not satisfactory. The study aimed to retrospectively evaluate the effects of adding all-trans-retinoic acid (ATRA) to infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) for advanced hepatocellular carcinoma (HCC). METHODS: We extracted the data of patients with advanced HCC who underwent systemic chemotherapy using FOLFOX4 or ATRA plus FOLFOX4 at the Eastern Hepatobiliary Surgery Hospital, First Hospital of Jilin University, and Zhejiang Sian International Hospital and retrospectively compared for overall survival. The Cox proportional hazards model was used to calculate the hazard ratios for overall survival and disease progression after controlling for age, sex, and disease stage. RESULTS: From July 2013 to July 2018, 111 patients with HCC were included in this study. The median survival duration was 14.8 months in the ATRA plus FOLFOX4 group and 8.2 months in the FOLFOX4 only group ( P  < 0.001). The ATRA plus FOLFOX4 group had a significantly longer median time to progression compared with the FOLFOX4 group (3.6 months vs. 1.8 months, P  < 0.001). Hazard ratios for overall survival and disease progression were 0.465 (95% confidence interval: 0.298-0.726; P  = 0.001) and 0.474 (0.314-0.717; P  < 0.001) after adjusting for potential confounders, respectively. CONCLUSION ATRA plus FOLFOX4 significantly improves the overall survival and time to disease progression in patients with advanced HCC.
Humans ; Carcinoma, Hepatocellular/drug therapy* ; Retrospective Studies ; Liver Neoplasms/pathology* ; Oxaliplatin/therapeutic use* ; Fluorouracil/adverse effects* ; Disease Progression ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Leucovorin/adverse effects* ; Colorectal Neoplasms/drug therapy*

Objective:To explore the acceptance of advanced breast cancer patients to the advance care planning, and analyze its potential influencing factors.Methods:From October 2019 to January 2021, convenience sampling was used to select 75 advanced breast cancer patients in the Oncology Department of the Second Affiliated Hospital of Xi'an Jiaotong University as the research object. The patients were investigated with the General Information Questionnaire, Patient's Advance Care Planning Acceptance Questionnaire (ACPQ), Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC) and the Social Support Rating Scale (SSRS). Univariate analysis, Pearson correlation analysis and multiple linear regression analysis were used for data analysis.Results:A total of 75 questionnaires were distributed and 72 valid questionnaires were returned. The total ACPQ score of advanced breast cancer patients was (70.60±4.46). The results of univariate analysis showed that there were statistically significant differences in the ACPQ scores of patients with different education levels, residence, marital status, bereavement experience, hospitalization experience, and knowledge of the time of disease diagnosis ( P<0.05). Multiple linear regression analysis showed that the social support was an influencing factor of patients' acceptance of the advance care planning, and the difference was statistically significant ( P<0.01) . Conclusions:The acceptance of advanced breast cancer patients to the advance care planning is mainly related to the patient's social support. Medical and nursing staff should strengthen the understanding and utilization of patients' social support, and promote patients' participation in advance care planning.

Objective To obsOrvO thO safOty and OffOct of intraopOrativO cOll salvagO and autologous blood transfusion during cOsarOan sOction with cOntral placOnta prOvia.Methods From April 2015 to March 2016, 25 prOg-nants with cOntral placOnta prOvia diagnosOd by MRI and ultrasound and undOrwOnt sOlOctOd caOsarOan sOction in thO POoplO′s Hospital of WOnzhou wOrO includOd. WhOn thO amount of blood in thO rOcovOry tank was 450 mL or thO obstOtrician rOquirOd, thO wash and rOtransfusion dOvicO was startOd-up. Hb and Hct wOrO mOasurOd bOforO and aftOr thO parturiOnt, and thO blood was rOcovOrOd. ThO blood loss, rOcovOry of blood, blood transfusion, allogOnOic RBC infusion and thO sidO OffOcts aftOr transfusion and 42 d of postpartum wOrO rOcordOd.Results No sOrious complica-tions wOrO rOcordOd in all prOgnants. FivO casOs(20% ) wOrO only rOcovOrOd and thO autologous blood transfusion and transfusion of thO allogOnOic RBC wOrO not carriOd out. In 14 casOs(56% ),only thO autologous blood was rOturnOd to thO puOrpOra. ThO volumO of blood transfusion was 705 mL(430,1 535). Six casOs(24% ) had massivO blOOding during thO opOration,3690 mL(1 900,8 750),and thO autologous blood transfusion volumO was 2939 mL(1 167, 4 206),and thO allogOnOic RBC transfusion was 3.5U(1.5,11.5).Conclusion Autologous blood transfusion can bO usOd safOly in thO caOsarOan sOction of thO cOntral placOnta prOvia, and can rOducO thO allogOnOic RBC transfusion.

As the key features of tumor, metastasis has multiple mechanisms and could cause poor survival. Accumulated evidences indicate that platelet plays an important role in tumor metastasis. Platelet count had become a significant indicator for predicting tumor prognosis,and antiplatelet therapy is an effective way for tumor treatment. Here, the recent advancements of the relationship between platelets and tumor metastasis are reviewed.

Objective:To investigate the effects of Mor-platin, a novel mitochondrial platinum complex, on proliferation and migration of human hepatoma carcinoma HepG2 cells. Methods:Cell counting kit-8 (CCK-8) assay was used to analyze cell proliferation of Mor-platin and classic anticancer drugs, particularly cisplatin, in HepG2 cells. A laser confocal microscope was used to observe whether Mor-platin can target mitochondria. The morphological changes in cellular mitochondria after treatment with Mor-platin were ob-served on a transmission electron microscope. Cell apoptosis was measured by flow cytometry, and cell invasion was evaluated by three-dimensional tumor spheroid model. Results:Mor-platin can inhibit cell proliferation and is dose dependent. The half inhibitory concentration (IC50) of Mor-platin is lower than that of cisplatin. Laser confocal images showed that Mor-platin can target cell mito-chondria and enrich cell mitochondria. Transmission electron microscopy images showed that cell mitochondrial morphology changed after Mor-platin treatment. Furthermore, cell mitochondrial membrane is incomplete and mitochondrial cristae are reduced. Cell apoptosis caused by Mor-platin is dose dependent. The three-dimensional tumor spheroid model showed that the cell areas of the group subjected to Mor-platin treatment are smaller than those of the control group. Conclusion:Mor-platin can target cell mitochon-dria, change the cell mitochondrial morphology, inhibit cell proliferation, and thus promote cell apoptosis. It also showed better anti-cancer effects than cisplatin. Furthermore, Mor-platin can inhibit three-dimensional tumor spheroid invasion. These results suggest that Mor-platin is a potential antitumor drug.

Objective To observe the efficacy of asarone injection combined with inhalation on the treatment of COPD acute phase.MethodsAccording to chronic obstructive pulmonary disease diagnosis and treatment guidelinesin the diagnostic criteria for chronic obstructive pulmonary disease in acute phase, 81 patients were randomized double-blindly divided into observation group of 40 cases and a control group 41 cases.Administering inhalation nebulizer patients in the control group, asarone injection combined with inhalation treatment in the observation group.Serum levels of interleukin-8 (IL-8), interferon-γ (IFN-γ), tumor necrosis factor (TNF-α) levels before and after treatment, using a blood gas analyzer patients arterial oxygen pressure (PaO2) and arterial carbon dioxide tension (PaCO2) level, measured using a spirometer patients accounted for one second forced expiratory percentage of predicted value (FEV1% pred) and total airway resistance, and a separate determination combination therapy regimen based on the above indicators Comparative efficacy.Results①IL-8, IFN-γ, TNF-α: After treatment, the observation group was significantly lower than the control group (t=11.498;t=10.279;t=11.576), the differences were statistically significant (P<0.05).②blood gas PaO2 and PaCO2: post-treatment observation group than the control group (t=11.021;t =8.868), the differences were statistically significant (P<0.05).③lung function FEV1% pred and total airway resistance: After treatment, the observation group than the control group (t=7.182;t=6.341), the differences were statistically significant (P<0.05).The total effective rate was significantly higher (χ2 =4.742) after ④observation group, the difference was significant (P<0.05).ConclusionAsarone injection combined with inhalation can reduce chronic inflammation in the body in patients with acute obstructive pulmonary disease, the body adjust blood gas, improve lung function, improve the treatment of patients with acute COPD.