Totally Implantable Venous Access Ports (TIVAP) are specialized devices designed for long-term venous therapy, widely used in oncology and other groups requiring prolonged intravenous access. Since their introduction into routine clinical practice in China, they have significantly enhanced the safety and comfort of vascular access management. However, substantial challenges remain in TIVAP utilization as China lacks a unified regulatory framework and standardized full-lifecycle management protocols. Significant disparities also exist among medical institutions in terms of surgical techniques, complication management, and surveillance, leading to inconsistent outcomes and patient satisfaction. This narrative review presents a review of TIVAP clinical applications and maintenance, incorporating the latest evidence-based strategies for implantation and complication mitigation. The objective is to provide a comprehensive reference for optimizing clinical decision-making, minimizing adverse events, and improving patient quality of life.

OBJECTIVE:To evaluate the 12-month symptom relief rate of super-selective haemorrhoidal artery embolisation (HAE) for Grade I-IV internal haemorrhoids and analyse the impact of haemorrhoid grading and embolisation site on treatment efficacy. METHODS:A retrospective analysis was conducted on 32 patients with internal haemorrhoids who underwent HAE at the Interventional Radiology Department of The Second Affiliated Hospital of Soochow University between April 2020 and January 2025. Efficacy was assessed using Visual Analogue Scale (VAS) and French Bleeding Scale (FBS) scores at 1, 3, 6, and 12 months postoperatively. RESULTS:The clinical success rate at 1 month post-procedure (defined as clinical success: ≥ 50% reduction in VAS or FBS from baseline without requiring any reintervention during follow-up) was 87.5% (28/32). The rates at 3 months, 6 months, and 12 months were 68.8% (22/32), 59.4% (19/32), and 56.2% (18/32). The VAS score decreased from 4.25 ± 1.08 preoperatively to 3.53 ± 1.39 at 1 month postoperatively (p < 0.001), rising to 3.72 ± 1.46 at 12 months postoperatively (p < 0.001). The FBS score decreased from 6.09 ± 1.84 preoperatively to 2.06 ± 1.41 at 1 month postoperatively (p < 0.001), and rebounded to 3.84 ± 2.10 at 12 months postoperatively (p < 0.001). The 12-month efficacy rate remained at 100% for Grade I haemorrhoids, 54.5% for Grade II, 50% for Grade III, and 40% for Grade IV. Minor complications occurred in 9.4% of patients, all resolving without intervention. CONCLUSION:HAE demonstrates reliable short-term efficacy for bleeding from Grade I-III internal haemorrhoids. As follow-up duration increases and severity grades rise, symptom relief rates gradually decline. The procedure is safe and reproducible, serving as an alternative minimally invasive option for patients unwilling or unable to undergo excision for Grade I-III internal haemorrhoids. However, patients should be informed of the recurrence risk, and long-term efficacy requires further investigation.

Globally, hepatocellular carcinoma (HCC) is among the most prevalent malignancies and is the third most common cause of cancer-related mortality. Thermal ablation therapies for hepatocellular carcinoma, such as microwave ablation (MWA) and radiofrequency ablation (RFA) guided by imaging devices, have been widely used in clinical practice and have achieved good therapeutic efficacy but still face the difficult problems of high dependence on the experience of the operator's puncture and damage caused by the tissue puncture. In this study, magnetothermal microspheres (MMs) loaded with Fe3O4 nanoparticles, featuring a uniform particle size (45-55 μm) and a good eddy current heating effect, were prepared from polyvinyl alcohol (PVA) via Shirasu Porous Glass (SPG) membrane emulsification. Under the action of a high-frequency alternating magnetic field (AMF), the PVA@Fe3O4 MMs could be rapidly warmed in vitro and effectively inhibited the activity of tumor cells. We successfully constructed a rabbit VX2 orthotopic liver tumor model. Under DSA guidance, the microspheres were enriched precisely in the tumor tissue, and in vivo animal experiments confirmed that the therapeutic effect of the MMs was similar to that of puncture ablation under the effect of an AMF, and further sections of important organ tissues showed good in vivo safety. Compared with traditional percutaneous ablation, microsphere-mediated magnetic thermal ablation (MTA) significantly reduces puncture trauma and is applicable to other blood-rich solid tumors, demonstrating favorable clinical prospects.

Prediction of the therapeutic efficacy of uterine artery embolization (UAE) for adenomyosis (AM) using an MRI-based radiomics model combined with clinical characteristics. A retrospective analysis was conducted on 126 patients with AM who underwent UAE at the Interventional Radiology Department of the Second Affiliated Hospital of Soochow University. Radiomics features were extracted from uterine lesions using axial T2-weighted imaging with fat suppression (T2WI-FS) sequences obtained prior to treatment. Following feature selection using the mRMR and LASSO algorithms, radiomics models were developed to predict the lesion necrosis rate in AM after UAE. These models employed the following classifiers: C-SVC, Nu-SVC, Logistic Regression (LR), Random Forest (RF), AdaBoost, and XGBoost. The optimal radiomics model was subsequently identified through receiver operating characteristic (ROC) curve analysis. Relevant clinical characteristics were screened using univariate logistic regression analysis and the LASSO algorithm to identify variables for constructing the clinical model. Finally, a combined model integrating radiomics features and clinical characteristics was developed. The dataset was partitioned into training (n = 100) and test (n = 26) sets at an 8:2 ratio. The predictive performance of the models was evaluated using ROC curves, while their clinical utility was assessed through decision curve analysis (DCA). Total of 1874 radiomics features were extracted from axial T2WI-FS sequences. Following dimensionality reduction and feature selection, 14 radiomics features were identified as valuable. Among the radiomics models, the RF model demonstrated the highest predictive performance and generalizability, achieving AUC values of 0.796 in the training set and 0.740 in the test set. Subsequently, a clinical model was constructed using clinical characteristics, with the RF model exhibiting superior predictive performance and generalizability, yielding AUC of 0.876 (training set) and 0.817 (test set). Ultimately, the combined model integrating radiomics features and clinical characteristics demonstrated optimal predictive ability. The LR model achieved an AUC of 0.944 in the training set and 0.870 in the test set, while DCA confirmed its optimal clinical utility. The combined model integrating radiomics features and clinical characteristics demonstrated significant predictive performance and robustness in evaluating lesion necrosis extent following UAE for AM. Its discriminative capability surpassed that of single-modality prediction models, potentially offering a non-invasive objective assessment tool to optimize clinical decision-making pathways.

Gasdermin-mediated pyroptosis represents a promising immunotherapeutic strategy, yet requires precise tumor-specific activation. Magnetic hyperthermia therapy (MHT) has the potential to induce pyroptosis in hepatocellular carcinoma (HCC), while its efficacy is limited by suboptimal heating efficiency and tumor resistance. Herein, we developed an innovative magnetic-metallo-immunotherapeutic platform by engineering nanomicro pyroptosis generators, thereby enhancing transarterial embolization (TAE). Through compositional and structural optimization, Zn-Fe3O4@Co-Fe3O4 core-shell nanocubes (ZnCo-Fe3O4 CSNCs) with enhanced magnetothermal properties were obtained, which exhibited significantly improved saturation magnetization (Ms) and coercivity (Hc). These nanocubes were further assembled via microfluidic technology into magnetic microspheres (MSs) with tunable sizes, integrating the therapeutic functions of TAE and MHT. Under an alternating magnetic field (AMF), the ZnCo-Fe3O4 MSs demonstrated temperature-dependent ion release and localized hyperthermia while simultaneously inhibiting heat shock protein (HSP) upregulation through metabolic interference. This orchestrated therapeutic cascade effectively triggered pyroptosis in cancer cells, subsequently activating the immune response and thereby enhancing the efficacy of magnetic-metallo-immunotherapy. The strategic combination of this platform with immune checkpoint blockade (ICB) therapy provoked comprehensive systemic immune activation, markedly enhancing treatment efficacy and suppressing the progression of both primary tumors and distant tumors. Notably, ZnCo-Fe3O4 MSs demonstrated an exceptional capacity to modulate the immunosuppressive tumor niche while substantially improving TAE performance through their unique embolization-immunomodulation functionality. Overall, this study highlights new avenues for exploring pyroptosis-mediated magnetic-metallo-immunotherapy for effective cancer therapy.

Background: To investigate the efficacy of laparoscopic combined with microwave ablation therapy in treating multiple uterine fibroids and its impact on patients' quality of life. Materials and Methods: This study included a total of 100 patients with uterine fibroids, divided into a laparoscopic group (50 cases) and a laparoscopic combined with microwave ablation group (50 cases), treated with either laparoscopic surgery alone or laparoscopic combined with microwave ablation therapy. General information of the patients, MRI images before and after treatment, contrast-enhanced ultrasound before and after treatment, intraoperative blood loss, operation time, length of hospital stay, time to postoperative ambulation, VAS score, and ovarian function were collected and analyzed. Results: Compared with laparoscopic surgery alone, the laparoscopic combined with microwave ablation group had lower postoperative pain scores, less intraoperative blood loss, and faster postoperative recovery. There was no significant difference in ovarian function indicators after surgery compared with before surgery, indicating no difference in ovarian function and reserve between the two surgical methods. Additionally, the total effective rate of the combined treatment group reached 98%, significantly higher than the 92% in the laparoscopic group. Imaging analysis showed that the structure of surrounding tissues and vascular layout were restored closer to the normal state after combined treatment. Conclusion: Laparoscopic combined with microwave ablation therapy shows superior efficacy and safety in treating multiple uterine fibroids compared to laparoscopic surgery alone, making it an effective method for treating multiple uterine fibroids, worthy of further clinical promotion and application.

BACKGROUND:This study aimed to assess how embolization endpoints affect the efficacy of uterine artery embolization (UAE) for adenomyosis. METHODS:In this single-center retrospective cohort study, patients treated with UAE from 2014-2018 received the standard embolization endpoint (SEE), while those from 2019-2022 received the delayed embolization endpoint (DEE). Clinical outcomes, including embolic microsphere volume, uterine volume, CA125 levels, hemoglobin, menstrual flow, dysmenorrhea, and postoperative complications, were compared between the groups. RESULTS:At six months post-procedure, all patients showed significant improvement in clinical indicators (p < 0.01). Group DEE used significantly more embolic microspheres than Group SEE (p < 0.01) and achieved greater reductions in CA125, menstrual volume, and dysmenorrhea (p < 0.05). There were no significant differences in postoperative uterine volume, hemoglobin, or complication rates between the groups (p > 0.05). CONCLUSIONS:UAE is a safe and effective treatment for adenomyosis. Compared to the standard approach, the delayed embolization endpoint provides superior symptom relief and warrants broader clinical adoption.

Renal cell carcinoma (RCC) is a highly malignant tumor with a poor prognosis, underscoring the urgent need for novel therapeutic strategies. RCC cells exhibit rapid proliferation and high metabolic demands, leading to hypoglycemic and hypoxic conditions within the tumor microenvironment (TME). Our study reveals that the fructose transporter Glut5 is prominently expressed in RCC, facilitating increased fructose uptake. This compensatory mechanism supports RCC survival under glucose deprivation and hypoxia. Fructose utilization sustains RCC proliferation, migration, and colony formation in vitro, significantly reduces apoptosis, and accelerates renal cancer growth in vivo. Mechanistically, fructose activates the cAMP/PKA signaling pathway, driving metabolic reprogramming and promoting tumor progression. Furthermore, 2,5-dehydro-D-mannitol (2,5-AM), a competitive inhibitor of fructose transport, significantly inhibits RCC growth both in vivo and in vitro. These findings provide new insights into the role of fructose metabolism in RCC progression and suggest potential therapeutic targets.

Objective: The aim of this study was to comparatively analyze the therapeutic effects of uterine artery embolization (UAE) and laparoscopic myomectomy (LM) on uterine fibroids to determine which treatment method is more beneficial for patients. Materials and Methods: A retrospective study was conducted on 396 patients who underwent UAE(n=153)or LM (n=243)treatment from April 2010 to September 2019. After 1:1 propensity score matching(PSM), a comparative analysis was conducted on surgical trauma magnitude, postoperative recovery time, improvement in associated symptoms and quality of life, surgical adverse events, recurrence rates, and further interventions. Results: In PSM, 66 pairs (132 patients) were successfully matched. Both treatments significantly alleviated symptoms and enhanced quality of life. Compared to the LM group, the UAE group had less intraoperative bleeding (P<0.001), a lower rate of hemoglobin decrease (P<0.001), shorter operation, postoperative, and overall hospital stays (P<0.001), and a lower postoperative recurrence rate (P<0.05), all statistically significant. Moreover, the UAE group showed notable advantages in postoperative activities (P<0.05). However, UAE patients faced higher hospitalization costs (P<0.001). Adverse event rates (7.6% vs. 9.1%) and postoperative reintervention rates (7.6% vs. 7.6%) were relatively low and not significantly different between groups (P>0.05). Conclusion: Both UAE and LM can significantly improve patient symptoms and enhance their quality of life, and both treatment methods have low rates of adverse events and reinterventions. Compared to LM, UAE treatment for uterine fibroids presents advantages such as lesstrauma, faster recovery, and lower recurrence rate,but has higher treatment costs.

Objective:Hepatocellular carcinoma is one of the most challenging malignancies and has high incidence and mortality rates worldwide. Digital subtraction angiography (DSA)-guided hepatic arterial infusion of the standard chemotherapeutic agent oxaliplatin (OXA) has the advantages of both precision and efficacy, making it an important therapeutic strategy for advanced-stage liver cancer. However, patients receiving this treatment still face severe systemic toxicity and poor tolerability of oxaliplatin. Methods:In this study, we compared oxaliplatin with novel albumin-formulated oncolytic peptide nanoparticles, Ir-cR8 (abbreviated as iPep), in the treatment of orthotopic liver cancer in a mouse model by intravenous injection and in a rabbit model via DSA-guided hepatic arterial infusion. Results:The results showed that intravenous Ir-cR8-BSA-NPs had enhanced inhibitory effects to the growth of H22 ectopic liver tumors in mice and also with reduced toxicity in animals compared to OXA treatment. Specifically, Ir-cR8-BSA-NPs-treated mice showed approximately 92% tumor growth inhibition compared to approximately 88% for OXA. In the rabbit VX2 ectopic hepatocellular carcinoma model, Ir-cR8-BSA-NPs demonstrated significantly stronger inhibition (P<0.01) of tumor size compared to OXA, as assessed by PET/CT imaging, with SUV values decreasing from 5.15±0.46 to 2.52±0.57, compared to OXA-treated group, which decreased from 5.44±0.43 to 3.90±0.24. Furthermore, Ir-cR8- BSA-NPs significantly improved stability by albumin encapsulation and reduced hemolytic toxicity (P<0.001), resulting in improved therapeutic efficacy. Conclusion:This study demonstrated the combined advantages of a novel membrane-active oncolytic peptide nanomedicine and precise drug delivery enabled by arterial infusion technology for the interventional treatment of liver cancer.

Transarterial radioembolization (TARE) is an established clinical therapy for treating patients with intermediate to advanced hepatocellular carcinoma (HCC) or those who cannot undergo radical treatment. However, the delivery of a high radiation dose is associated with several adverse effects, such as radiation pneumonitis. Additionally, the available radioactive microspheres (MSs) are dense and unsuitable for interventional delivery. This study proposes the use of commercial CalliSpheres polyvinyl alcohol (PVA) gel MSs coated with polydopamine (PDA) as a carrier for radioactive iodine (131I) labeled using the iodogen method, denoted as 131I-PDA@PVA MSs, which can be for radioembolization combined photothermal therapy (PTT) of HCC. In vitro experiments have demonstrated that 131I-PDA@PVA MSs have high radiolabeling stability and photothermal properties. Single photon emission computed tomography (SPECT)/computed tomography (CT) imaging and biodistribution experiments have shown that 131I-PDA@PVA MSs remain stable in vivo without any radioactive leakage. The results of the antitumor study suggest that 131I-PDA@PVA MSs are an effective treatment for inhibiting tumor growth through a combination of radioembolization and PTT while avoiding significant side effects. These multifunctional MSs have great potential for clinical application in the treatment of HCC.

Hepatocellular carcinoma (HCC) remains a formidable clinical challenge due to its aggressive nature, high recurrence rate, and limited therapeutic options, particularly for intermediate-advanced stage patients who are ineligible for surgical resection. Current transarterial chemoembolization (TACE) and conventional transarterial radioembolization (TARE) often face challenges such as incomplete tumor necrosis and radioresistance. To address these critical clinical issues, we develop an innovative polydopamine-coated 177Lu-labeled magnetic microspheres (177Lu-MMS@PDA) that synergistically combines TARE with magnetic hyperthermia therapy (MHT), which enable non-invasive, deep-tissue-penetrating hyperthermia while significantly enhancing radiostability. This dual-modality approach not only overcomes the limitations of single therapy but also demonstrates the unique clinical advantages including addressing the problem of uneven drug distribution in conventional embolization, overcoming tumor radioresistance and reducing off-target effects. Importantly, our large animal studies using beagle dogs have confirmed the outstanding biosafety profile of 177Lu-MMS@PDA, meeting essential criteria for clinical translation. With its combined advantages of enhanced therapeutic efficacy and minimized systemic toxicity, 177Lu-MMS@PDA represents a breakthrough solution for HCC treatment, particularly promising for patients with advanced or treatment-refractory disease.

IntroductionThis study aimed to evaluate non-tumor liver parenchymal injury in advanced gastric cancer patients undergoing transarterial infusion chemotherapy (TAI) using imaging parameters and liver injury biomarkers, providing objective evidence for early detection of drug-induced liver injury.MethodsA retrospective analysis was conducted on 52 advanced gastric cancer patients who received TAI at our center from July 2015 to July 2023. Abdominal CT images and laboratory data were collected before and after treatment. Imaging postprocessing software was used to measure the liver-to-spleen (L/S) attenuation ratio and spleen volume. Liver fibrosis indices (APRI, FIB-4) and liver function scores (Child-Pugh, ALBI) were calculated. Statistical analysis included Wilcoxon rank-sum test and paired t-test for pre- and post-treatment comparisons.ResultsPatients received an average of 2.80 TAI cycles over 8.3 weeks. Post-treatment, 76.92% (40/52) showed a significant reduction in L/S attenuation ratio (1.23 ± 0.13 vs. 1.12 ± 0.1, P < 0.01), and 73.1% (38/52) exhibited increased spleen volume (151,219.33 mm³ vs. 202, 171.32 mm³, P < 0.01). Liver fibrosis indices significantly increased: APRI (0.19 ± 0.15 vs. 0.37 ± 0.27) and FIB-4 (1.29 ± 0.88 vs. 2.24 ± 1.38) (P < 0.01). No significant changes were observed in ALBI (-2.7 ± 0.41 vs. -2.58 ± 0.43) or Child-Pugh scores (5.31 ± 0.47 vs. 5.38 ± 0.64) (P > 0.05).DiscussionTransarterial infusion chemotherapy for advanced gastric cancer results in short-term damage to the non-tumor liver parenchyma, with imaging findings showing hepatic steatosis (reduction in L/S ratio) and splenomegaly. Serum markers suggest progression of hepatic fibrosis, consistent with the pathological features of hepatic sinusoidal obstruction syndrome. The combination of CT imaging and APRI/FIB-4 provides a sensitive method for detecting subclinical liver injury, reflecting pathological changes earlier than traditional liver function scores.

With the rapid advancement of radiation technology in nuclear safety, industrial inspection, and medical applications, there is a growing and urgent demand for biocompatible radiation-shielding coatings. This study addresses the challenge of filler sedimentation at high loadings by utilizing a shear-thinning precursor. This precursor, comprising acrylamide (AM), cross-linker, thermal initiator, sodium alginate, and hyaluronic acid, exhibits liquid behavior under shear but solidifies without force due to dynamic Fe3+-carboxyl coordination cross-linking facilitated by an Fe3+-EDTA complex. This property enables the homogeneous dispersion of high-content X-ray shielding fillers (Bi2O3 and BaSO4) within the precursor and allows for its uniform coating onto substrates with complex geometries. Subsequent thermal curing initiates polymerization of AM, forming a covalently cross-linked polyacrylamide second network, resulting in a robust double-network composite hydrogel. Systematic investigation revealed that a hydrogel containing 40 wt % Bi2O3 and BaSO4 achieved optimal X-ray shielding performance. With a 5 mm thickness, it attained complete attenuation of X-rays below 80 kV and achieved 92.2% shielding efficiency at 100 kV. Meanwhile, it exhibits excellent mechanical properties, stretching to 2000% of its original length while maintaining a stress of 1.30 MPa. Furthermore, the developed hydrogel coating demonstrated favorable biocompatibility and antibacterial properties, supporting its potential for biomedical applications.

Chemoresistance and immunosuppression serve as major obstacles that compromise the therapeutic efficacy of chemoimmunotherapy. Herein, we reported a novel chemoimmunotherapy strategy employing metal fluoride to modulate Wnt/β-catenin signaling, effectively remodeling treatment resistance and eliciting pyroptosis-mediated immune activation. Through systematic screening of various nonmetallic anions (F−, Cl−, Br−, I−, CO32−, PO43−, S2−, and Se2−), we identified F− as an effective inhibitor of β-catenin expression and tumor stemness. The synergistic combination of F− with chemotherapy significantly attenuated tumor stemness and enhanced treatment efficacy. We further engineered 5-Fu@FeF2 nanomedicine (FFN-5) and investigated its chemoimmunotherapeutic effects. FFN-5 potently suppressed β-catenin expression, effectively diminishing cancer stemness while augmenting the cytotoxicity of 5-Fu, ultimately triggering pyroptosis. Local administration of FFN-5 not only inhibited tumor growth but also remodeled the immunosuppressive tumor microenvironment (TME), thereby promoting antitumor immunity. When combined with immune checkpoint blockade (ICB), this combined approach triggered a potent systemic immune response, effectively controlling both primary and distant lesions. Furthermore, the unique stemness-modulating properties of F-based nanomodulators significantly suppressed tumor metastasis. In summary, we demonstrated that F− effectively suppressed tumor stemness, and developed an innovative FFN-5 nanoplatform that enhanced chemoimmunotherapy by modulating stemness-dependent cell death mechanisms, suggesting a promising strategy to overcome resistance to cancer treatment.

This study aimed to assess the feasibility and safety of robotic-assisted navigation system for percutaneous transthoracic needle biopsy (PTNB), compare it with conventional freehand technique, and evaluate its generalizability across operators with varying experience levels. After excluding 5 patients in whom robotic-assisted PTNB could not be performed due to technical problems, a total of 50 patients with robotic-assisted PTNB and 200 patients who performed freehand puncture were included. Using propensity score matching (PSM) to match two groups of patients and simulate a randomized controlled scenario. The results showed that robotic-assisted PTNB significantly reduced the number of punctures, CT scans, and total procedure time (P < 0.05). These reductions were accompanied by a significantly lower rate of pneumothorax (P = 0.05), a common complication in PTNB procedures. While the overall adverse event rates remained similar between the two groups, the robotic-assisted technique demonstrated a more favorable safety profile, particularly with regard to reduced pneumothorax and hemorrhage rates. Additionally, there were no significant differences in the number of punctures, CT scans, total procedure time, and radiation dose administered to patients during robotic-assisted PTNB, irrespective of the operator. This suggests that operator experience does not significantly influence the outcomes of robotic-assisted PTNB, further highlighting the potential of the robotic system to minimize the impact of operator variability. Thus, we think robotic-assisted PTNB is feasible, safe, and less dependent on operator experience, suggesting its potential for clinical promote.

Hepatocellular carcinoma (HCC) are some of the most difficult malignant tumors to treat, due to their high rates of metastasis and recurrence. Image-guided percutaneous ablation, which serves as an important means in HCC treatment. However, drawbacks such as puncture injury, metastasis, and a limited ablation range still exist. Therefore, A highly effective and non-invasive magnetic thermal ablation (MTA) scheme for HCC was proposed by precisely embolizing magnetic microspheres into tumor-feeding arteries. In this study, polyacrylamide (PAM) and ferric oxide (Fe3O4) were utilized to prepare uniformly sized PAM@Fe3O4 microspheres with excellent eddy current heating effects. Additionally, a combined approach of MTA and immunotherapy was suggested. MTA combined with immune checkpoint blockade therapy efficiently ablated primary tumors and inhibited simulated metastatic tumors in mice. Further arterial embolization experiments in rabbit ears and renal arteries demonstrated the effective retention of PAM@Fe3O4 microspheres in blood vessels for MTA. Finally, we successfully applied PAM@Fe3O4 microspheres for efficient MTA therapy in a rabbit VX2 in situ liver tumor model. The aim of research is to provide new strategies for clinical HCC treatment, promoting the transition from image-guided percutaneous minimally invasive ablation to noninvasive ablation. This significant transition holds the potential for clinical applicability.

INTRODUCTION:The study aims to compare the accuracy and safety of robotic-assisted navigation puncture to freehand puncture during computed tomography (CT)-guided percutaneous needle insertion in the chest and abdomen. METHODS:A total of 60 patients required percutaneous puncture procedures, with 40 involving the chest and 20 involving the abdomen. Eligible patients were randomly assigned to two groups. The test group punctured using a robotic-assisted navigation system, whereas the control group punctured manually. The primary outcome assessment standards are single puncture success rates, with the number of needle modifications and CT scan timings during the procedure serving as supplementary outcome evaluation standards. The Wilcoxon rank sum test is used for the comparison. RESULTS:The puncture procedure's success rates after just one puncture: The test group punctures accurately without adjusting the puncture needle, while the control group uses an average number of 1.73 ± 1.20 pins. The once-puncture success rate of robot navigation puncture is considerably higher than that of bare-handed puncture (P < 0.001). The times of CT scan are necessitated when the puncture is in place: the average times in the test group is 3.03 ± 0.18 times, while the control group is 4.70 ± 1.24 times. CONCLUSION:In conclusion, the robotic-assisted navigation system improves puncture accuracy while reducing the need for needle corrections during percutaneous puncture procedures. It also shortens CT scans and reduces radiation exposure from X-rays.

ABSTRACT:This expert consensus reviews current literature and provides clinical practice guidelines for the diagnosis and treatment of multiple ground glass nodule-like lung cancer. The main contents of this review include the following: ① follow-up strategies, ② differential diagnosis, ③ diagnosis and staging, ④ treatment methods, and ⑤ post-treatment follow-up.

Hepatocellular carcinoma is one of the most challenging malignancies with high incidence and mortality rates in the world. Digital subtraction angiography (DSA)-guided hepatic arterial infusion of the standard chemotherapeutic agent oxaliplatin has the advantages of both precision and efficacy, making it an important therapeutic strategy for advanced-stage liver cancer. However, patients undergoing this treatment still face severe systemic toxicity and poor tolerability of oxaliplatin. In this study, we compared oxaliplatin with a novel albumin nanoparticle-formulated oncolytic peptide Ir-cR8 (Ir-cR8-BSA-NP) in the treatment of orthotropic liver cancers in a mouse model by intravenous injection and in a rabbit model by DSA-guided hepatic arterial infusion. The oncolytic peptide Ir-cR8, containing a cationic octa-arginine ring and a hydrophobic domain, was found to interact with bovine serum albumin and further assemble into spherical nanoparticles with an average diameter of 150 nm. Such albumin opsonisation significantly increases the stability of the peptide and reduces its haemolytic toxicity. In vivo experiments in mice showed that intravenous administration of Ir-cR8-BSA-NP had excellent inhibitory effects on H22 orthotopic liver tumours and reduced toxicity in the animals than oxaliplatin. Furthermore, in the rabbit VX2 orthotopic liver cancer model, oxaliplatin or Ir-cR8-BSA-NP was administered by hepatic artery infusion under DSA guidance, followed by PET/CT assessment of treatment efficacy. The results showed that Ir-cR8-BSA-NP significantly outperformed oxaliplatin in reducing tumour size. Thus, this study demonstrated the combined advantages of a novel membrane-active oncolytic peptide nanomedicine and precise drug delivery enabled by arterial infusion technology for the interventional treatment of liver cancer.