Comparison of effectiveness and cost of different HCV testing strategies in high-risk populations in China.

High-risk populations are the predominant populations affected by hepatitis C virus (HCV) infection, and there is an urgent need for efficient and cost-effective HCV testing strategies for high-risk populations to identify potential undiagnosed HCV-infected individuals. This study compared several commonly used testing strategies and conducted effectiveness and cost analysis to select the appropriate testing strategy for diagnosing HCV infection in high-risk populations. Among the 2093 samples from high-risk populations in this study, 1716 were HCV negative, 237 were current HCV infection, 137 were past HCV infection, and three were acute early HCV infection. It was found that out of 237 patients with HCV current infection, Strategy A could detect 225 cases, with a missed detection rate of 5.06%, and the total cost was 33 299 RMB. In addition, Strategy B could detect 237 cases of current HCV infection, and the HCV missed detection rate was 0.00%, and the total cost was 147 221 RMB. While 137 cases of past HCV infection could be distinguished by strategy C, but 14 cases with current HCV infection were missed, with an HCV-positive missed detection rate of 5.91%, and the total cost for Strategy C was 43 059 RMB. In conclusion, in high-risk populations, the HCV positivity rate is typically higher. If feasible, the preferred approach is to directly conduct HCV RNA testing, which effectively minimizes the risk of missing cases. However, in situations with limited resources, it is advisable to initially choose a highly sensitive method for anti-HCV screening, followed by HCV RNA testing on reactive samples.

Development and evaluation of serological screening based on one dried plasma spot for HIV, syphilis, and HCV.

BACKGROUND: In the effort to prevent and control HIV/AIDS, China has established a national sentinel surveillance system. However, some sentinel sites face limitations in environmental resources and accessibility, prompting the exploration of alternative sample strategies. Dried plasma spots (DPS) samples are viewed as promising alternatives to traditional plasma samples due to their advantages, including sample stability, easy storage, and convenient transport. This study aims to develop a method for screening HIV, Treponema pallidum (TP), and Hepatitis C Virus (HCV) using DPS samples and assess their performance. METHODS: Based on existing commercial assay kits, a detection method was established through the optimization of experimental parameters, including the amount of plasma on filter paper, the volume of elution solution applied to dried plasma spots, the size of dried plasma spots, elution solution volume, elution solution components, elution temperature, and elution time. A series of laboratory evaluation panels were constructed for laboratory assessments, including the laboratory basic panel, laboratory interference panel, and laboratory precision panel. Additionally, clinical samples were used for evaluation. RESULTS: Optimal conditions for DPS sample extraction were: plasma volume, 100 µL; DPS size, whole spot; eluent volume, 500 µL; eluent, PBS with 1‰ Tween20; elution time, 2 h; elution temperature, room temperature. A total of 619 paired plasma/DPS samples were tested by both methods. The DPS-based ELISA method exhibited 100% sensitivity/specificity for HIV, 98.6%/100% for TP, and 99.6%/100% for HCV. Kappa values between the plasma samples and DPS samples were 100% for HIV, 99% for TP, and 100% for HCV. The DPS-based ELISA method failed to detect 1 HCV mono-infected sample and TP in 1 HIV/HCV/TP co-infected sample. For the HIV/HCV/TP co-infected sample, the S/CO in the plasma sample was 2.143 and in the DPS sample was 0.5. For HCV, the S/CO (sample OD/cut-off) was 3.049 in the plasma sample and 0.878 in the DPS sample. CONCLUSIONS: A single DPS, following one-time standardized processing, can be used to detect HIV, HCV, and TP. Researching and establishing laboratory testing methods better suited for China's sentinel surveillance have significant practical applications in improving HIV testing in resource-constrained environments.

Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001).

There is considerable potential for integrating transarterial chemoembolization (TACE), programmed death-(ligand)1 (PD-[L]1) inhibitors, and molecular targeted treatments (MTT) in hepatocellular carcinoma (HCC). It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations. In this nationwide, retrospective, cohort study, 826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT (combination group, n = 376) or TACE monotherapy (monotherapy group, n = 450) were included from January 2018 to May 2021. The primary endpoint was progression-free survival (PFS) according to modified RECIST. The secondary outcomes included overall survival (OS), objective response rate (ORR), and safety. We performed propensity score matching approaches to reduce bias between two groups. After matching, 228 pairs were included with a predominantly advanced disease population. Median PFS in combination group was 9.5 months (95% confidence interval [CI], 8.4-11.0) versus 8.0 months (95% CI, 6.6-9.5) (adjusted hazard ratio [HR], 0.70, P = 0.002). OS and ORR were also significantly higher in combination group (median OS, 19.2 [16.1-27.3] vs. 15.7 months [13.0-20.2]; adjusted HR, 0.63, P = 0.001; ORR, 60.1% vs. 32.0%; P < 0.001). Grade 3/4 adverse events were observed at a rate of 15.8% and 7.5% in combination and monotherapy groups, respectively. Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS, OS, and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice, with an acceptable safety profile.

The signal-to-cutoff ratios to predict HCV infection among people who inject drugs.

People who inject drugs (PWIDs) are primarily the high-risk population for HCV infection. This study aims to determine the optimal cut-off values for predicting HCV infection status based on the Signal-to-Cutoff (S/CO) ratio. In this study, a total of 719 PWIDs' samples were collected, and performed for screening test by ELISA assay, and followed by RIBA assay and NAT assay to detect HCV antibody and HCV RNA levels, respectively. The findings revealed that the prevalence of HCV infection among PWIDs was 54.66% (393/719), and the false-positive rate of HCV antibody detection by ELISA assay among PWIDs was only 3.85% (16/416). In addition, when the optimal cut-off value for S/CO ratio was 2.0, the sensitivity and specificity of HCV antibody were 100.00% and 93.55%, respectively. And when the optimal cut-off value for S/CO ratio was 21.36, the sensitivity and specificity of HCV RNA positive were 89.90% and 72.73%, respectively. In conclusion, the status of HCV infection can be predicted based on the S/CO ratios of the ELISA assay, which can improve diagnosis and facilitate timely treatment to effectively prevent the spread of HCV infection.

Exploration of an Efficient Simultaneous Molecular Detection Method of HIV, HCV, and Syphilis from a Single Dried Blood Spot.

OBJECTIVE: The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma. METHOD: A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma. RESULTS: Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log 10 copies/mL). There were two samples (2/94) with undetectable HCV RNA in DBS, while measurable HCV RNA levels were present in plasma (-5 to 5.99 log 10 copies/mL). The correlation between HIV-1 RNA light chain variable region (VL) values obtained from plasma and DBS showed that r = 0.683 ( P < 0.01), n = 27 and r = 0.612 ( P < 0.01), n = 89 in HCV RNA. Bland-Altman analysis revealed that in HIV-1 RNA, the mean (± SD) difference between HIV-1 RNA in plasma and DBS was 1.00 ± 1.01 log 10 copies/mL, and all samples were within ± 1.96 SD (-0.97 to 2.97 log 10 copies/mL) for DBS. The mean difference (± SD) in HCV RNA was 0.15 ± 1.08 log 10 copies/mL, and 94.38% (84/89) were within ± 1.96 SD (-1.96 to 2.67 log 10 copies/mL). Overall, HIV-1 RNA and HCV RNA levels obtained from a DBS were lower than those obtained from plasma. HIV-1 DNA in a DBS showed concordant results with HIV-1 RNA in plasma. HIV-1 DNA RT-PCR using a DBS showed acceptable performance. CONCLUSION: The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.

Evaluation of seven rapid diagnostic tests for detection of hepatitis C virus antibodies in China.

Rapid diagnostic tests as an attractive alternative to enzyme immunoassay could identify hepatitis C virus (HCV) infected persons more expeditiously. The availability of high performing and quality-assured rapid diagnostic tests are essential to scale-up HCV screening. The study was undertaken to evaluate the performance of seven domestic HCV rapid diagnostic tests kits. The kits were evaluated by using HCV serum panels, including HCV basic panel, analytical specificity panel, mixed titre performance panel, characteristic panel, seroconversion panel, and genotype qualification panel. The results showed that clinical sensitivity, clinical specificity and analytical specificity of seven rapid diagnostic tests kits ranged from 94% (95% CI: 83.2-98.6) to 100% (95% CI: 91.5-100). Furthermore, specimens with HCV genotypes 1b, 2a, 3a, 4a, 5a, 6 could be detected by HCV rapid diagnostic tests kits, whereas specimens with genotypes 1a and 2b could not be detected. Additionally, most HCV rapid diagnostic tests kits had great performance in diagnosing different titres and/or different bands samples, but some low S/CO value specimens may not be fully detected by few rapid diagnostic test kits. In conclusion, seven HCV rapid diagnostic tests reagents presented high sensitivity, specificity, good anti-interference and detection ability of early infection, which could meet the requirements of clinical HCV antibody screening.

CT-guided percutaneous cryoablation combined with systemic chemotherapy for liver metastases from esophageal carcinoma: Initial experience.

OBJECTIVE: To explore the feasibility, safety and effectiveness of percutaneous cryoablation combined with systemic chemotherapy in the treatment of liver metastases from esophageal carcinoma (ECLM). MATERIALS AND METHODS: We retrospectively collected data of 16 patients who received CT-guided percutaneous cryoablation concurrent systemic chemotherapy for liver metastases after primary esophageal carcinoma resection. Functional Assessment of Cancer Therapy-General (FACT-G) was used for the assessment of quality of life (QOL), and overall survival (OS), progression-free survival (PFS) and complications were also evaluated. RESULTS: The technical success rate was 96%, and no major complications related to cryoablation procedure were detected. Median OS and PFS after cryoablation were 14.5 months (range, 4-51 months) and 7.5 months (range, 1-31 months), respectively. The 1-year, 2-year, and 3-year survival rates were 56.3%, 31.3%, and 18.8%, respectively. The PFS rate at 6-month, 1-year, and 2-year after procedure were 68.8%, 31.3% and 18.8%, respectively. Furthermore, the QOL of patients was improved after cryoablation therapy compared with preoperative scores (P < 0.05). CONCLUSIONS: Percutaneous cryoablation combined with systemic chemotherapy is a safe, feasible and effective method to treat liver metastases from esophageal carcinoma. And to a certain extent, this approach is very efficacious in improving the QOL of patients with ECLM.

[Epidemiological survey on the hepatitis C virus and its genotyping analysis in Henan province in 2012].

OBJECTIVE: To investigate the prevalence and distribution of hepatitis C virus (HCV) genotypes in Henan province in 2012. METHODS: A total of 32 203 permanent residents (1 to 74 years old) in Henan were recruited using multi-stage random samping method from March to June 2012. All participants were asked to complete a questionnaire to collect demographic information, past medical history and the exposure history of risk factors. A blood sample of 5 ml was collected at the same time. The condition of anti-HCV and HCV RNA was determined through the ELISA test and nested RT-PCR. HCV RNA positive samples were further subject to the nonstructural protein 5 region (NS5B) gene amplification and sequencing. The sequence was amplified for the phylogenetic tree and genetic analysis. The differences of the positive rate of anti-HCV and HCV RNA and the HCV genetic subtype distribution in different respondents'characteristics were analyzed. RESULTS: Among 32 203 subjects, the overall positive rate of anti-HCV and HCV RNA were 0.48% (153/32 203) and 0.24% (78/32 203), in which men were 0.42% (65/15 634), and 0.23% (36/15 634), and women were 0.53% (88/16 569) and 0.25% (42/16 596). The differences between men and women were not statistically significant (χ(2) values were 2.26, 0.18, respectively, both P values > 0.05). The results of NS5B genotyping and molecular evolution analysis showed that there were six subtypes in the 71 HCV RNA positive samples.In those six subtypes, the proportion of genotypes 1b, 6a, 3a, 2a, 3b and 1a were 56.3% (40/71), 19.7% (14/71), 11.3% (8/71), 8.5% (6/71), 2.8% (2/71) and 1.4% (1/71), respectively. The HCV genetic subtypes of infestor were mainly present with two branches of 1b and 6a, and the two subtypes Bootstrap values were 0.95. CONCLUSION: The prevalence of HCV infection was high in Henan. The major HCV genotypes in patients with HCV infection were 1b and 6a.

[Clinical efficacy of transcatheter renal arterial embolization plus cryoablation for medium and advanced renal carcinomas].

OBJECTIVE: To investigate the clinical efficacy of transcatheter renal arterial embolization (TRAE) plus cryoablation in the treatment of medium and advanced stage renal carcinomas. METHODS: The patients with medium and advanced stage renal carcinomas were randomized into 2 groups: TRAE group (A, n = 53) and TRAE plus cryoablation group (B, n = 51) undergoing cryoablation 2 - 3 weeks after TRAE. A total of 128 tumors (8.7 ± 3.2) (4.0 - 19.8) cm in diameter were detected. And the largest tumor in a specific patient with multiple lesions was selected for observation. At pre- and post-treatment, their clinical symptoms, kidney function and tumor diameters (computed tomography or magnetic resonance imaging) were observed. And their post-treatment profiles of tumor necrosis and survival were assessed. RESULTS: There was no difference in gender, age, size and Robson stage between two groups. The tumor necrosis of Group B was significantly higher than that of Group A (61% vs 35%, t = 6.784, P < 0.01). The median survival duration of Group B was significantly longer than that of Group A (24 vs 15 months, P < 0.05). There was no significant change of kidney function at pre- and post-treatment (P > 0.05). The quality-of-life scores improved at post-treatment (P < 0.01). CONCLUSION: As compared with TRAE therapy alone, the combination of TRAE and cryoablation may improve the tumor necrosis rate and prolong the patient survival duration.

[A sero-epidemiological study on hepatitis C in China].

OBJECTIVE: To better understand and measure the status of hepatitis C virus (HCV) infection, we conducted a sero-epidemiological study using the remaining blood samples and data of the nationwide survey of hepatitis B in Chinese residents which was carried out in 2006. METHODS: The anti-HCV reagent was screened out from the reagents by the HCV infection blood serum plate with anti-HCV positives or negatives. This plate recognized the Murex 3.0 and Ortho 3.0 reagents as gold standards. Anti-HCV in the blood samples were tested using this reagent and confirmed by Chiron HCV RIBA 3.0 reagents. RESULTS: Among the population aged 1 year to 59 year-olds, the overall prevalence rate of anti-HCV was 0.43% (95%CI: 0.33% - 0.53%), with the rates of anti-HCV among males and females as 0.46% and 0.40%, respectively. The prevalence rate of anti-HCV in urban area was 0.43%, and in rural area it was 0.43%. The prevalence rate of anti-HCV in the Eastern, Middle and Western areas were 0.37% (95%CI: 0.21% - 0.53%), 0.67% (95%CI: 0.40% - 0.94%) and 0.31% (95%CI: 0.20% - 0.42%) respectively. The prevalence rates of anti-HCV for the three areas did not show significant differences, statistically. The prevalence rate of anti-HCV in the South and North areas were 0.29% (95%CI: 0.21% - 0.52%) and 0.53% (95%CI: 0.38% - 0.64%) respectively. CONCLUSION: Our data revealed that China was in the low prevalence area for hepatitis C infection and the results also suggested that the comprehensive measures for HCV control and prevention had been successfully achieved in the country.

[A preliminary clinical study of targeted cryoablation of prostate in the treatment of T3N0M0 prostate cancer].

OBJECTIVE: To evaluate the clinical efficacy, safety and application value of rectal ultrasound-guided targeted cryoablation of prostate (TCAP) in the treatment of T3N0M0 prostate cancer. METHODS: Transrectal ultrasound (TRUS)-guided TCAPs were performed. And prostate-specific antigen (PSA), TRUS-measured prostate volume, endorectal magnetic resonance imaging (MRI) and spectroscopic imaging (MRSI) at before, 12, 24, 36 months after TCAP were recorded and evaluated. The biochemical relapse free survival (bRFS) and clinical progression (local recurrence and distant metastasis) at 1, 2 and 3 years post-cryoablation were also recorded. The post-TCAP quality of life was also observed by the EORTC questionnaire QLQ-PR25. RESULTS: The suess rate of this technique was 100%. The follow-up period had a range of 10 to 45 months. The PSA level decreased dramatically (P < 0.01). The TRUS-measured prostate volumes significantly decreased (P < 0.01) versus those at pre-cryoablation. The bRFS at 1, 2 and 3 years post-TCAP was 92.5% (37/40), 87.1% (27/31) and 73.3% (11/15) respectively. The result of quality of life showed that the sexuality scores decreased at 6 months post-TCAP, but there was no statistical significance (P = 0.06) and recovered to baseline level at 12 months. Urinary symptoms improved significantly (P < 0.01). The clinical progression rate in this study at 3 years was 24.4% (11/45). To be specific, local recurrence rate was 54.5% (6/11) and distant metastasis rate 45.5% (5/11). Repeated cryoablation was performed for the patients with local recurrence and satisfactory results were achieved during a follow-up of 10 - 15 months. Endocrine treatment was adopted for the patients with distant metastasis and appeared to have biochemical progression free survival during a follow-up of 6 - 13 months. The therapy was safe. Most of side effects were mild and there was no occurrence of severe complications such as urethral fistulas, etc. CONCLUSION: Treating T3N0M0 prostate cancer with TCAP as a monotherapy can obtain a satisfactory outcome during a follow-up of 3 years. But its clinical application value deserves further studies.

[Percutaneous verterbreplasty combined with radiotherapy treating malignant vertebrate metastasis].

OBJECTIVE: To evaluate retrospectively the treatment effects and side effects of malignant vertebrate metastasis who had received radiotherapy or percutaneous verterbreplasty (PVP) or PVP combined with radiotherapy. METHODS: Two hundred and sixty-three patients who had been diagnosed as malignant tumor with vertebrate metastasis received PVP (87 patients) or radiotherapy (111 patients) or PVP combined with radiotherapy (65 patients). Radiotherapy was done one week after PVP procedure in PVP combined with radiotherapy group. All patients received regular follow-up. The changes of pain scale were analyzed by NRS. The improvement of quality of life was evaluated by inquiry questionnaire of EORTC QLQ-C30. The side effects were also observed. RESULTS: All defects in vertebrate metastasis in PVP treating were fully filled by polymethylmethacrylate (PMMA) under CT examination. The NRS number decreased significantly after 6 hours after treating in PVP Group and PVP combined with radiotherapy Group (P < 0.01), which shows basement of pain was rapid. The NRS number decreased significantly after one month after treating in radiotherapy Group (P < 0.01), which shows basement of pain was slow. The score of EORTC QLQ-C30 inquiry questionnaire in three Groups reduced, which indicated that the quality of life had been improved. In PVP Group and PVP combined with radiotherapy Group, the score of EORTC QLQ-C30 changed most significantly (P < 0.01). There were no severe clinical complications. CONCLUSIONS: It is safe and effective to treat malignant tumor patients with vertebrate metastasis by PVP combined with radiotherapy and quality of life had been improved significantly with long catabasis.

[Effect of transcatheter renal arterial embolization combined with cryoablation on regulatory CD4+ CD25+ T lymphocytes in the peripheral blood of patients with advanced renal carcinoma].

OBJECTIVE: To analyze the effect of Argon-Helium cryosurgery (AHCS) combined with transcatheter renal arterial embolization (TRAE) on the differentiation of regulatory CD4+ CD25+ T cell (Treg) and its implication in patients with renal carcinoma. METHODS: 77 patients were called in the study, and were divided into two groups: TRAE group (n = 45, receiving TRAE only) and TRAE + cryoablation group (n = 32, receiving cryoablation 2-3 weeks after TRAE). The percentage of Treg cells and T lymphocyte subsets (CD3+T, CD4+T, CD8+T, and CD4+T/CD8+ T) in the peripheral blood was measured by flow cytometry before and 3 months after therapy. Meanwhile, the extent of tumor necrosis was measured by MRI or CT 1 month after therapy. RESULTS: The percentages of Treg cells of patients in TRAE + cryoablation group were decreased from 6.6% +/- 1.2% to 3.9% +/- 1.2%, (t = 42.768, P < 0.01), and the percentages of CD3+ T, CD4+ T, CD8+T, NK and CD4+T/CD8+T were significantly increased (P < 0.01). However, among the patients in TRAE group, the percentages of Treg, CD3+ T, CD4+ T, CD8+T, NK and CD4+T/CD8+T were increased (P > 0.05). The tumor necrosis rates of TRAE + cryoablation groups were 57.5%, significantly higher than those of TRAE group, which shows 31.6% (t = 6.784, P < 0.01). The median survival duration of the TRAE + cryoablation group was 20 months, significantly longer than that of the TRAE group (chi(2) = 7.368, P < 0.01). The decreasing extent of Treg cells is correlated with tumor necrosis rates (r = 0.90 P < 0.01) and life time (r = 0.67 P < 0.01). CONCLUSION: The therapy of TRAE combined with cryoablation contributed to reduce the percentage of Treg cells and improve the immune situation of patients with renal cell carcinoma, consequently increase tumor necrosis rate and prolongs the patients' survival duration.

Human immunodeficiency virus-1 genotypic drug resistance among volunteer blood donors in Yunnan, China.

BACKGROUND: Drug resistance profiles of human immunodeficiency virus-1 (HIV-1) in treatment-naïve infections have been reported in developed countries. However, little is known in developing countries, including China, especially in treatment-naïve volunteer blood donors. STUDY DESIGN AND METHODS: Fifty-two HIV-1-positive samples of blood donors were collected from 2005 to 2006 in Yunnan, China. Recent and long-term infections were distinguished by the HIV-1 subtypes B, E, and D immunoglobulin G-capture enzyme immunoassay assay. The nucleotide sequences of pol genes were amplified and sequenced. Phylogenetic tree and drug resistance analyses were performed. RESULTS: Of 49 samples successfully analyzed, circulating strains were circulating recombinant form (CRF)08_BC (51.0%), CRF07_BC (24.5%), CRF01_AE (20.4%), and B (4.1%). No protease inhibitors (PI) major drug resistance mutation (DRM) was detected. Six samples (12.2%) displayed seven minor PI DRMs. Nine samples (18.4%) displayed 10 nucleoside reverse transcriptase inhibitor DRMs, and DRMs to nonnucleoside reverse transcriptase inhibitors were present in one sample (2.0%). There was only one sample of the 49 (2.0%) in which the DRMs were of sufficient magnitude to result in a clinical change to drug susceptibility, but even in this sample, the clinical effect of these DRMs was predicted to be low. Significant differences were not observed between the long-term and recent infected population. Differences in DRMs were not observed between peripheral blood mononuclear cells and plasma within an individual. CONCLUSIONS: CRF_BC was the dominant subtype circulating in HIV-1-infected donors in Yunnan. Prevalence of genotypic drug resistances among donors in Yunnan was low in this study. Surveillance on HIV-1 infections among blood donors should be continued in China.

[Experimental study of hepatic bloodflow to the effect of cryoablation].

OBJECTIVE: To investigate the bloodflow of hepetatic artery to the effect of cryoablation. METHODS: Twenty dogs were divided into four groups randomly according to hepatic artery blood flow: completely occlusion of the hepatic artery(A), partial occlusion of the hepatic artery(B), increasing the hepatic artery blood flow(C) ,and no occlusion(D). Two areas of necrosis near portal hepatis (a)and far from it (b)were created in each of the 20 dog livers. Ultrasound was used to measure the blood flow. After cryoablation, the animals were euthanized, the livers were examined and the cryoablation areas were separated into two halves the maximum diameter of necrosis was assessed by vital staining for nicotinamide adenine dinucleotide (NADH) diaphorase and Triphenyl tetrazolium chloride (TTC) staining. RESULTS: The peak speed and volflow of hepatic artery from group A to group D measured by ultrasound were 0 cm/s and 0 mL/min, (22.8+/-0.6) cm/s and (31.4+/-0.9) mL/min, (99.6+/-1.6) cm/s and (70.4+/-1.5) mL/min and (69.5+/-0.7) cm/s and (52.6+/-1.2) mL/min, respectively. The mean longest diameter of ice-ball in areas a from group A to group D were (4.5+/-0.4) cm,(3.5+/-0.1) cm,(2.0+/-0.3) cm,(2.6+/-0.2) cm and the areas b were (4.6+/-0.3) cm,(3.6+/-0.2) cm,(1.9+/-0.1) cm,(2.6+/-0.2) cm; the mean longest necroseis diameter in TTC staining in areas a were (4.0+/-0.3) cm,(2.7+/-0.2) cm, (2.0+/-0.2) cm, (2.3+/-0.1) cm, and in areas b were (3.9+/-0.3) cm, (2.6+/-0.3) cm, (2.1+/-0.1) cm,(2.5+/-0.2) cm; the mean longest necroseis diameter in NADH staining in areas a were (4.1+/-0.4) cm,(2.6+/-0.2) cm,(2.1+/-0.2) cm,(2.3+/-0.3) cm, in areas b were (4.0+/-0.3) cm, (2.7+/-0.3) cm,(2.1+/- 0.1) cm,(2.4+/-0.2) cm. CONCLUSION: The bloodflow of hepetatic artery can affect the cryoablation rate. When the bloodflow increases, the cryoablation rate decreases.