目的 观察微波消融对特殊部位肝脏恶性肿瘤的有效性及安全性.方法 对34例肝脏恶性肿瘤患者的38个病灶行CT和/或超声引导下微波消融治疗,其中毗邻膈肌、毗邻肝包膜各16个,毗邻门静脉一、二级分支3个,毗邻胆囊2个,毗邻肝静脉(下腔静脉旁)1个.消融后1个月复查腹部增强CT或MRI,以改良实体瘤疗效评价标准(mRECIST)评估治疗效果.采用Clavien-Dindo并发症分级法评估并发症.结果 对34例均顺利完成微波消融治疗.术后1个月,腹部增强CT或MRI示37个(37/38,97.37％)消融区域呈边界清晰的低密度/低信号改变,动脉期无明显强化,判定为完全缓解;1个(1/38,2.63％)毗邻下腔静脉病灶可见部分残留,为部分缓解.术后24例出现Clavien-Dindo I级并发症,包括20例腹部隐痛、3例恶心及1例呕吐,经对症处理后均缓解;2例出现Ⅱ级并发症,其中感染、发热各1例,予抗生素及退热治疗后好转;1例Ⅲa级并发症,表现为腹腔积液,经腹腔穿刺引流后缓解.结论 微波消融治疗特殊部位肝脏恶性肿瘤安全、有效.

Circular RNAs (circRNAs) are covalently closed, endogenous molecules that are widespread in eukaryotes. Recent evidence indicates that circRNAs play important roles in carcinogenesis. Several circRNAs have been reported to comprise translatable RNA; however, whether circRNAs encode functional proteins remains unknown. In our study, circRNA sequencing was carried out using five pathologically diagnosed gastric carcinoma (GC) samples and their paired adjacent normal tissues, we characterized the circRNA GSPT1 (circGSPT1), which is expressed at low levels in GC. Antibody detections, and mass spectrometry were used to validate active circRNA translation. The spanning junction open reading frame in circGSPT1, driven by an internal ribosome entry site (IRES), encodes a functional peptide, termed GSPT1-238aa. Interestingly, GSPT1-238aa tends to select the start codon used to initiate translation. This is the first finding of selective translation driven by IRES. CircGSPT1 and GSPT1-238aa halted the proliferation, migration, and invasion in GC cells in vitro. We also confirmed that the vimentin/Beclin1/14-3-3 complex interacts with GSPT1-238aa and modulates autophagy via the PI3K/AKT/mTOR signaling pathway in GC cells. Our study reveals that GSPT1-238aa, a novel protein encoded by circGSPT1, halts GC tumorigenesis. We also provide insights into the function and underlying molecular mechanisms of GSPT1-238aa in GC and suggest that this protein represents a novel target for GC treatment.

我国肝癌患病人数居于世界首位,严重威胁人民生命健康.钇90微球在国外已应用近20年,对原发性肝癌以及转移性肝癌疗效确切、不良反应少.值此钇90即将于国内上市之际,为指导相关临床医护人员更规范地使用钇90微球,国内从事恶性肿瘤治疗的介入放射学专家就钇90微球治疗肝恶性肿瘤的相关管理办法进行充分深入讨论后达成本共识.

目的 观察药物涂层球囊(DCB)治疗股总动脉病变的有效性和安全性.方法 回顾性分析11例接受DCB治疗的股总动脉病变患者.结果 11例中,股总动脉闭塞7例,重度狭窄4例;9例为原发病变引发狭窄,2例为支架内再狭窄;股总动脉病变累及股浅动脉5例,单纯股总动脉病变6例.5例接受减容联合药物球囊、6例接受单纯药物球囊治疗,技术成功率100％.术后均未出现相关并发症,术后30天内无死亡.有效随访10例,随访12个月,累积一期通畅率为85.75％,均未行靶病变重建,2例发生截肢;术后12个月Rutherford分级及踝肱指数(ABI)均较术前明显改善(P均＜0.05).结论 DCB治疗股总动脉病变短期疗效好,安全性高.

2019年12月以来,我国自湖北省武汉市开始出现新型冠状病毒肺炎疫情.为在疫情期间诊治肿瘤患者时减少交叉感染,中国抗癌协会肿瘤介入学专业委员会组织专家编写了此专家共识,针对介入门诊管理、介入病房管理和介入手术室管理等方面制定了具体措施.

The poor prognosis of late gastric carcinomas (GC) underscores the necessity to identify novel biomarkers for earlier diagnosis and effective therapeutic targets. MiRNA-324-5p has been shown to be over-expressed in GC, however the biological function of miRNA-324-5p implicated in gastric cancer and its downstream targets were not well understood. Wnt/β-catenin signaling pathway is aberrantly regulated in GC. We sought to explore if miRNA-324-5p promotes oncogenesis through modulating Wnt signaling and EMT. MiRNA-324-5p is highly expressed in GC based on qRT-PCR and TCGA data. In addition, in vitro cell proliferation, cell migration assays and in vivo animal exenograft were executed to show that miRNA-324-5p is an oncogenic miRNA in GC. MiRNA-324-5p activates Wnt signaling and induces EMT in GC. Further, SUFU was identified as a target of miRNA-324-5p confirmed by western blotting and luciferase assays. Spearson analysis and TCGA data indicate that the expression of SUFU is negatively associated with the expression of miRNA-324-5p. Rescue experiments were performed to determine if SUFU mediates the Wnt activation, EMT and oncogenic function of miRNA-324-5p. MiRNA-324-5p inhibitors plus SUFU siRNAs rescue partially the inhibitory effect on Wnt signaling and EMT caused by miRNA-324-5p inhibitors. Finally, the suppression of cell proliferation, migration, and colony formation ability induced by miRNA-324-5p inhibitors is alleviated by addition of SUFU siRNAs. In summary, miRNA-324-5p is overexpressed in vivo and exerts cell growth and migration-promoting effects through activating Wnt signaling and EMT by targeting SUFU in GC. It represents a potential miRNA with an oncogenic role in human gastric cancer.

Although great progress has been made in surgical techniques, traditional radiotherapy, and chemotherapy, gastric cancer (GC) is still the most common malignant tumor and has a high mortality, which highlights the importance of novel diagnostic markers. Emerging studies suggest that different microRNAs (miRNAs) are involved in tumorigenesis of GC. In this study, we found that miRNA-192 and -215 are significantly upregulated in GC and promote cell proliferation and migration. Adenomatous polyposis coli (APC), a well-known negative regulator in Wnt signaling, has been proved to be a target of miRNA-192 and -215. Inhibition of miRNA-192 or -215 reduced the Topflash activities and repressed the expression of Wnt signaling pathway proteins, while APC small interfering RNAs reversed the inhibitory effects, suggesting that miRNA-192 and -215 activate Wnt signaling via APC. In addition, APC mediates the cell proliferation and migration regulated by miRNA-192 and -215. Furthermore, APC is downregulated in GC tissues and negatively correlated with the expression of miRNA-192 and -215. In summary, miRNA-192 and -215 target APC and function as oncogenic miRNAs by activating Wnt signaling in GC, revealing to be potential therapeutic targets.

Since December 2019, coronavirus disease (COVID-19) has spread rapidly from Wuhan, Hubei province, to other regions of China. To reduce and prevent cross-over infections in the interventional diagnosis and treatment of tumor patients. The Interventional Oncology Branch of the China Anti-Cancer Association organized specialists to compile the corresponding expert consensus. The consensus summarizes the critical points for COVID-19 prevention, focusing on the management of outpatients, inpatients, and interventional operating room in this particular time.

患者男,79岁,因“发现原发性肝癌2月余”入院;既往慢性乙型肝炎病史50余年,3年前开始接受规律抗病毒治疗至今.2019年8月腹部增强CT提示肝右叶占位,结合病史、影像学表现及实验室检查,考虑为肝细胞肝癌(hepatocellular carcinoma,HCC)(图1A).2019年9月行TACE,术中以盐酸吡柔比星30 mg及碘化油混合乳剂10 ml予以栓塞,并以适量明胶海绵颗粒(350～560 μm)进行补充栓塞(图1B、1C).

肾血管平滑肌脂肪瘤(AML)是肾脏良性肿瘤,对有症状或病灶直径＞4 cm患者,既往推荐采用部分肾切除术和选择性动脉栓塞术进行治疗.近年来,经皮消融疗法用于治疗肾AML,具有对肾功能影响小、并发症少、复发率低等优点,但证据尚不充分.本文主要对射频消融、微波消融和冷冻消融治疗肾AML的研究进展进行综述.

目的 采用Meta分析评价骨髓间充质干细胞(BMSCs)治疗下肢缺血性疾病的疗效.方法 对PubMed、EMbase及Cochrane Library数据库进行检索,收集与BMSCs治疗下肢缺血性疾病相关的临床对照研究,按照制定的纳入和排除标准进行文献筛选、提取资料.以RevMan 5.3软件对纳入文献进行Meta分析,比较BMSCs治疗组与对照组相关指标,包括截肢率、无截肢生存率、踝肱指数、溃疡愈合率、疼痛评分以及无痛行走距离.结果 最终纳入5篇文献.Meta分析结果显示,与对照组比较,BMSCs组患者踝肱指数[均数差(MD) =0.15,95 ％CI(0.12,0.18),P＜0.000 01]、疼痛评分[MD=-1.38,95％CI(-1.65,-1.11),P＜0.000 01]、无痛行走距离[MD=202.20,95％CI(154.30,250.10),P＜0.000 01]及溃疡愈合率[相对危险度(RR)=1.42,95％CI(0.82,2.46),P=0.021]均明显改善;但两组患者截肢率RR=0.52,95％CI(0.24,1.10),P=0.09]、无截肢生存率[RR=1.09,95％CI(0.98,1.21),P=0.12]差异均无统计学意义.结论 BMSCs治疗下肢缺血性疾病虽不能显著降低截肢率和提高无截肢生存率,但可以改善患者的临床症状.

Objective To evaluate the efficacy and safety of super-selective renal arterial embolization (SRAE) for treatment of huge renal angiomyolipoma (RAML).Methods Data of 16 patients with huge RAML treated with SRAE were retrospectively analyzed.The clinical symptoms,tumor size,serum creatinine and complications were compared before and after SRAE.Results A total of 26 SRAE treatments were performed on 16 patients with huge RAML.The technical success rate of SRAE was 100％ (26/26).Seven cases (7/16,43.75 ％) received one SRAE treatment,whereas 8 (8/16,50.00％) required two SRAE treatments.Only one case (1/16,6.25％) received three SRAE treatments.The mean follow-up period was (16.60± 15.60) months.The maximum diameter of the tumor reduced significantly after SRAE at final follow-up than before embolization ([9.00±2.80]cm vs [12.60±2.40]cm,t=12.41,P＜0.01).The symptoms of flank pain and hematuria gradually relieved after SRAE.And there was no statistical difference of mean serum creatinine before and after SRAE ([76.00±14.90]μmol/L] vs [79.10±12.80]μmol/L,t=0.89,P=0.39).Fourteen cases (14/ 16,87.50％) experienced post-embolization syndrome including varying degrees of fever,local pain or nausea on 1-3 days after embolization.No serious complications occurred.Conclusion SRAE is an effective method for stopping bleeding of ruptured huge RAML,as well as relieving symptoms and reserving nephron.

A mounting body of evidence has revealed that microRNAs (miRs) serve pivotal roles in various developmental processes, and in tumourigenesis, by binding to target genes and subsequently regulating gene expression. Continued activation of the Wnt/β‑catenin signalling is positively associated with human malignancy. In addition, miR‑194 dysregulation has been implicated in gastric cancer (GC); however, the molecular mechanisms underlying the effects of miR‑194 on GC carcinogenesis remain to be elucidated. The present study demonstrated that miR‑194 was upregulated in GC tissues and SUFU negative regulator of Ηedgehog signaling (SUFU) was downregulated in GC cell lines. Subsequently, inhibition of miR‑194 attenuated nuclear accumulation of β‑catenin, which consequently blocked Wnt/β‑catenin signalling. In addition, the cytoplasmic translocation of β‑catenin induced by miR‑194 inhibition was mediated by SUFU. Furthermore, genes associated with the Wnt/β‑catenin signalling pathway were revealed to be downregulated following inhibition of the Wnt signalling pathway by miR‑194 suppression. Finally, the results indicated that cell apoptosis was markedly increased in response to miR‑194 inhibition, strongly suggesting the carcinogenic effects of miR‑194 in GC. Taken together, these findings demonstrated that miR‑194 may promote gastric carcinogenesis through activation of the Wnt/β‑catenin signalling pathway, making it a potential therapeutic target for GC.

目的 探讨无血清内皮细胞生长培养基套装(EGM-2 BulletKit)对骨髓间充质干细胞(MSC)向血管内皮细胞分化的诱导作用.方法 通过贴壁培养获取MSC,用流式细胞仪检测MSC表面标志物表达.将获得的MSC随机分为对照组与诱导组.对照组用无血清EGM-2基础培养基进行培养,诱导组选用无血清EGM-2基础培养基+BulletKit进行诱导.于诱导第2、6、10、14天用流式细胞仪、细胞免疫荧光法检测内皮细胞表面分子CD31表达.采用DiI标记的乙酰化低密度脂蛋白吞噬实验检测MSC诱导分化后的吞噬功能,用基底膜基质胶成管实验检测细胞体外成管功能.结果 贴壁培养获得的MSC呈长梭形,流式细胞仪检测结果显示MSC标志物表达阳性的比例均大于95％,而内皮细胞标志物无表达.诱导组诱导第2天CD31开始表达,随诱导时间增加,CD31表达量逐渐升高,诱导第14天CD31表达量最高,CD31表达阳性的内皮细胞比例为55.8％;对照组无CD31表达.诱导第14天,诱导组能够摄取脂质,而对照组无摄取现象.诱导组细胞能够形成典型的管状结构;对照组细胞未形成典型的线状、管状结构.结论 无血清EGM-2Bullet Kit可诱导MSC分化为血管内皮细胞,且具有内皮细胞的特性、功能.

根治性治疗只适用于部分肝细胞癌(HCC)患者,多数中晚期患者常需要接受其他治疗,现有方法远不能满足肝癌患者的需求.除索拉菲尼外的抗血管生成药可作为二线药物治疗HCC.动物实验或临床试验已初步证实了程序性细胞死亡分子-1抗体、DC-细胞因子诱导的杀伤细胞(CIK)和嵌合抗原受体(CAR-T)技术治疗HCC的疗效,且靶向免疫治疗联合介入疗法可能获得更佳疗效.本文对HCC的靶向免疫治疗及其在介入领域的应用进展进行综述.

症状性子宫肌瘤可降低女性生活质量.近年来,越来越多的患者选择接受介入治疗,以缓解症状.本文针对目前临床应用的三大类介入治疗方法——子宫动脉栓塞术、高强度聚焦超声、消融治疗的适用范围、疗效、不良反应以及介入治疗症状性子宫肌瘤的前景进行综述.

OBJECTIVE:To prepare ion exchange doxorubicin-loaded poly (acrylic acid) microspheres (DPMs) and evaluate the properties of these chemoembolic agents.METHODS:Poly (acrylic acid) microspheres (PMs) without drug were prepared by inverse suspension polymerization method and then doxorubicin was loaded by ion exchange mechanism to prepare DPMs. Optical microscope was used to investigate the morphology and particle size distribution of PMs and DPMs; fluorescence microscope and confocal microscope were used to observe the distribution of doxorubicin after drug loading. Elasticities of both the microspheres were evaluated by texture analyzer. High performance liquid chromatography (HPLC) method was established to determine the drug loading behavior of PMs and releasing behavior of DPMs. The in vivo embolic property was evaluated by embolizing the hepatic artery of a rabbit with 0.1 mL of DPMs.RESULTS:PMs and DPMs were both spherical in shape, smooth in surface and dispersed well. Doxorubicin was mainly in the outer area inside of DPMs and distributed evenly. The average particle size of PMs and DPMs were (283±136) μm and (248±149) μm, respectively. PMs and DPMs both had good compression ability with the Young's modulus of (62.63±1.65) kPa and (93.94±1.10) kPa separately. PMs reached the drug loading balance at 12 h, and the entrapment efficiency was greater than 99%. Drug loading of PMs in doxorubicin solution at the concentration of 5.0 g/L and 12.5 g/L was (19.78±0.27) g/L and (49.45±0.37) g/L, respectively. Doxorubicin released slowly from DPMs in PBS and the accumulative release percentages of DPMs with corresponding drug loading were 6.82%±0.02% and 2.83%±0.10% after 24 h, respectively. Arterial angiograms showed that the hepatic artery of the rabbit was successfully embolized with DPMs.CONCLUSION:DPMs with good performance of loading doxorubicin could be a potential embolic agent for transcatheter arterial chemoembolization.

Objective To explore the impact of local lipiodol deposition in liver of miniature pigs on the shape and size of the necrotic area after microwave ablation (MWA).Methods Ten healthy miniature pigs were selected and equally divided into experimental group and control group (each n=5).In experimental group,transcatheter hepatic arterial embolization with lipiodol was done before microwave ablation,while only standard microwave ablation was performed in control group.Immediate post-ablation CT images were obtained.Long-axis diameter (LAD),short-axis diameter (SAD),sphericity index (SI=SAD/LAD) and volume of ablation zone were calculated.The size and shape of the ablated areas were compared between two groups.Results The mean LAD,SAD,SI and volume of ablation zone in experimental group ([4.21 ± 0.52]cm,[2.87±0.38]cm,0.69±0.10,[18.72±6.08]cm3) were larger than those in control group ([3.71±0.42]cm,[2.19±0.42]cm,0.60±0.09,[9.44±2.29] cm3;all P＜0.05).Conclusion Local deposition of lipiodol in liver parenchyma of miniature pigs can help to produce larger and rounder necrosis in the ablation zone.

Objective To investigate the effect of catheter-based peripheral sympathetic denervation (CPSD) on peripheral artery sympathetic tone of New Zealand rabbits.Methods Twenty New Zealand rabbits were randomly divided into CPSD group and control group (each n =10).Endovascular radiofrequency ablation above the bifurcation of the abdominal aorta was performed on the rabbits in CPSD group.Norepinephrine was infused with continuous trans-arterial pumping in both two groups.And laser Doppler flowmetry was used to measure the peripheral microperfusion and temperature of right hindlimb of rabbits.The changes of the peripheral microperfusion and temperature before (resting state) and after norepinephrine infused (norepinephrine load state) were compared between the two groups.Results Eight rabbits completed the procedure in each group.The change of peripheral microperfusion between resting and norepinephrine load states in CSPD group was lower than that in control group ([-37.19±22.56]％ vs [-57.02％±10.12]％,P=0.04),whereas the change of temperature was not significantly different between the two groups ([0.35±0.50]℃ vs [-0.21± 1.83]℃,P=0.43),while significant difference was noticed when two rabbits with abnormal temperature change in control group were neglected ([0.34± 0.50] ℃ vs [-1.14 ±0.72] ℃,P＜0.01).Conclusion CPSD can be used to decrease the peripheral artery sympathetic tone of New Zealand rabbits,and may play an important role in relieving symptoms of critical limb ischemia.

In this article,2017 Fleischner society lung nodules guidelines for management of lung nodules accidentally discovered and lung nodule measurement were briefly introduced.Electronic questionnaires were sent to doctors nationwide,and their familiarity and consistency with these recommendations were assessed.The results showed relatively high familiarity with the guideline,but the consistency in clinical practice was still unsatisfactory,suggesting that further promotion of these guidelines is necessary in the future.