Hepatocellular carcinoma(HCC),commonly known as primary liver cancer,is a major cause of malignant tumors and cancer-related deaths in China,accounting for approximately 85％of all cancer cases in the country.Several guidelines have been used to diagnose and treat liver cancer.However,these guidelines provide a broad definition for classifying advanced liver cancer,with an emphasis on a singular approach,without considering treatment options for individual patients.Therefore,it is necessary to establish a comprehensive and practical expert consensus,specifically for China,to enhance the diagnosis and treatment of HCC using the Delphi method.The classification criteria were refined for Chinese patients with HCC,and the corresponding optimal treatment regimen recommendations were developed.These recommendations took into account various factors,including tumor characteristics,vascular tumor thrombus grade,distant metastasis,liver function status,portal hypertension,and the hepatitis B virus replication status of patients with primary HCC,along with treatment prognosis.The findings and rec-ommendations provide detailed,scientific,and reasonable individualized diagnosis and treatment strategies for clinicians.

Objective To assess the prevalence of mycoplasma genitalium(MG)in patients attending sexually transmitted disease(STD)clinic in Guangzhou,and to provide an epidemiological foundation for clinical treatment and laboratory diagnostics.Methods Utilizing real-time polymerase chain reaction(PCR),we analyzed MG DNA in 2,749 clinical specimens collected from 2,722 outpatients in the Dermatology Hospital of Southern Medical University from July 2019 to December 2021.Concurrent testing for MG,Chlamydia trachomatis(CT),and Neisseria gonorrhoeae(NG)was performed on 2,382 of these specimens.Patient data extracted from medical records were used to investigate the correlation between STD symptoms and MG infection.Results The investigation revealed that the overall prevalence of MG infection was 4.4%among the sampled patients(120 out of 2,722),with a higher prevalence in males(4.9%,or 87 out of 1,790)compared to in females(3.5%,or 33 out of 932).Notably,the prevalence decreased with increasing age.The highest incidence of MG infection was observed in females aged 18～25 years(6.4%,or 18 out of 281),while the lowest was in males aged 46 years and above(1.5%,or 5 out of 342),showing a statistically significant variation across age groups(P<0.05).Among males with urethritis symptoms,MG positive rate was significantly higher at 7.3%(42 out of 574).The rate of single MG infection was prominent,accounting for 89.9%(71 out of 79)in MG-positive male patients and 61.5%(16 out of 26)in MG-positive female patients.Co-infection rate of MG with CT was 1.2%in females and 0.3%in males,indicating a significant dif-ference(P<0.05).Conclusion The findings suggest a relatively high prevalence of MG infection and co-infection with CT among STD clinic attendees in Guangzhou,particularly in the younger demographic.The study underscores the need for early screening and vigilant surveillance of MG to mitigate its transmission among sexually active popula-tions at high risk.

Humans ; Consensus ; Liver Neoplasms/therapy* ; China

The vast majority of patients with hepatocellular carcinoma (HCC) in China originate from hepatitis B cirrhosis, while 90% of cirrhotic patients may develop portal hypertension, and the HCC patients with portal hypertension account for 15%-30%. Portal hypertension is a group of clinical syndromes characterized by elevated portal venous pressure and formation of portal-systemic collateral circulation, and it is one of the most important complications of liver cirrhosis. HCC and portal hypertension affect each other, and portal hypertension seriously affects the prognosis of HCC patients. The development of systemic treatment regimens for HCC provides more treatment options for patients with advanced HCC, including molecular-targeted drug therapy, immunotherapy, and chemotherapy. Different systemic therapeutic drugs for HCC have different impacts on portal hypertension, and this article reviews the effect of commonly used systemic therapeutic drugs for HCC on portal hypertension.

BACKGROUND: To determine the prevalence and prognostic impact of hepatopulmonary syndrome (HPS) in patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS: Fifty-four patients with unresectable HCC undergoing TACE between December 2014 and December 2015 were prospectively screened for HPS and were followed up for a maximum of 2 years or until the end of this prospective study. RESULTS: Nineteen of the 54 (35.2%) patients were considered to have HPS, including one (5.3%) with severe HPS, nine (47.4%) with moderate HPS, and nine (47.4%) with mild HPS. The median overall survival (OS) was 10.1 (95% confidence interval [CI], 3.9-16.3) months for patients with HPS and 15.1 (95% CI, 7.3-22.9) months for patients without HPS, which is not a significant difference ( P  = 0.100). The median progression-free survival was also not significantly different between patients with and without HPS (5.2 [95% CI, 0-12.8] vs. 8.4 [95% CI, 3.6-13.1] months; P  = 0.537). In the multivariable Cox regression analyses, carbon monoxide diffusing capacity (hazard ratio [HR] = 1.033 [95% CI, 1.003-1.064]; P  = 0.028) and Child-Pugh class (HR = 1.815 [95% CI, 1.011-3.260]; P  = 0.046) were identified to be the independent prognostic factors of OS. CONCLUSION Mild or moderate HPS is common in patients with unresectable HCC undergoing TACE, but it does not seem to have a significant prognostic impact.
Humans ; Carcinoma, Hepatocellular/pathology* ; Chemoembolization, Therapeutic ; Prospective Studies ; Liver Neoplasms/pathology* ; Prognosis ; Hepatopulmonary Syndrome/therapy* ; Prevalence ; Treatment Outcome ; Retrospective Studies

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective:To evaluate the diagnostic and therapeutic effect of percutaneous intranodal lymphography in patient with chylous leakage.Methods:The clinical data of percutaneous intranodal lymphography in patients with chylous leakage from January 2019 to November 2019 in Cancer Hospital Chinese Academy of Medical Sciences were retrospectively analyzed. A total of 8 patients (5 males and 3 females, median age 64 years old) were enrolled. Four patients were iatrogenic chylothorax, 3 patients iatrogenic chyloperitoneum, and 1 patient chyloperitoneum with unknown cause. All 8 patients were received inguinal lymph nodes puncture under ultrasound guidance, and contrast agent iodinated oil was injected for lymphography. The procedure complications were recorded and the follow-up data were collected for efficacy assessment.Results:The percutaneous intranodal lymphography was successfully performed in all patients (8/8). The median amount of iodinated oil used was 17.5 ml; the median operation time was 88 min, without complications found during the procedure. The results of percutaneous intranodal lymphography was positive in 5/8 cases, of which chylothorax and chyloperitoneum was 4/4 and 1/4, respectively. Four cases with chylothorax showed contrast extravasation at different level of thoracic duct, and 1 case after pancreatic cancer resection showed contrast extravasation at L3-4 level. The chylous leakage was treated in 5 patients (5/8) during and resolved after percutaneous intranodal lymphography, with 3 chylothorax and 2 chyloperitoneum cases, respectively.Conclusion:Percutaneous intranodal lymphography is a safe and effective lymphography method for the diagnosis of chylous leakage, and also has application values in the treatment of chylous leakage.

Objective Toexploretheeffectivenessandsafetyofballoonocclusionofthelowerabdominalaortaincesareansection forpatientswithperniciousplacentaprevia.Methods Theclinicaldataof59patientswithperniciousplacentapreviawhounderwent cesareansectionwereevaluatedretrospectively.35casesweretreatedwithcesareansectionassistedwiththelowerabdominalaorta balloonocclusion (studygroup),24casesweretreatedwithcesareansectiontoterminatethepregnancy(controlgroup).Theoperation time,intraoperativebloodloss,intraoperativebloodtransfusion,bloodlosswithinpostoperative24h,hysterectomyrate,hospitalstay aftercesareansection,Apgarscoreandbirthweightofthetwogroupswerecompared.Results Theintraoperativebloodloss(778.5± 566.3)mL,intraoperativebloodtransfusion(288.5±392.2)mLandhysterectomyratewerelowerinthestudygroupthanthosein thecontrolgroup,withstatisticalsignificance(P＜0.05).Therewasnosignificantdifferencebetweentwogroupsinoperationtime, bloodlosswithinpostoperative24h,hospitalstayaftercesareansection,Apgarscoreandbirthweight(P＞0.05).Conclusion Incesarean sectionassistedwithballoonocclusionoflowerabdominalaortaforpatientswithperniciousplacentapreviaisasafeandeffective technique,whichcanreduceintraoperativebloodlossandbloodtransfusiontodecreasetheriskofhysterectomy.

Objective To discuss the effect of body posture change on the catheter tip position of totally implantable venous access port (TIVAP).Methods Under ultrasound guidance,implantation of TIVAP was carried out through bedside puncturing of internal jugular vein or subclavian vein.After the implantation of TIVAP,X-ray chest films of both erect position and supine position were taken to check the catheter tip position.The distance from the upper edge of the first thoracic vertebra to the catheter tip was separately measured on the erect position and supine position chest films.The shift of the catheter tip position was judged by the difference in the distance measured on chest films as well as by the comparison with the bony anatomic marks.Results Successful implantation of TIVAP was accomplished in 86 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP moved caudally in 71 patients,with the mean displace distance being (12.29±7.48) mm;the catheter tip of TIVAP moved cephalad in 31 patients,with the mean displace distance being (5.00±3.79) mm;and the catheter tip of TIVAP remained in the same position in 2 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP had a tendency to move toward the foot side,the average displace distance was (-9.32±9.36) mm,the difference in catheter tip location between two photographic positions was statistically significant (P＜0.000 1).No statistically significant correlation existed between the changes of catheter tip position and the sex,age,height,weight as well as body mass index (P＞0.05).Conclusion After the implantation of TIVAP,the position of catheter tip will change with patient's body posture.When patient's posture changes from erect position to supine position the tip of the catheter tends to shift towards the atrium.

Objective To compare the curative effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) with that of simple TACE in treating large liver cancers.Methods A computer-based search assisted by manual searching for TACE+MWA vs simple TACE clinical control trials for large liver cancers was conducted.The patient survival,tumor response and complications were enrolled in the scope of analysis.Results A total of 16 papers met the inclusion criteria,which included 1199 patients in total.Meta-analysis indicated that one-,2-and 3-year survival rates of TACE+MWA group were better than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The complete response (CR) rate and partial response (PR) rate of TACE+MWA group were higher than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The stable disease (SD) rate and progressive disease (PD) rate of TACE+MWA group were lower than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).Conclusion For the treatment of large liver cancers,TACE +MWA is superior to simple TACE.(J Intervent Radiol,2017,26:225-231)