Background: Hepatocellular carcinoma (HCC) (about 85–90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people. Summary: This guideline presents official recommendations of the National Health and Family Planning Commission of the People’s Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations. Key Messages: The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.

Objective To investigate the role of proteinase‐activated receptor 4 (PAR‐4) in mediating joint inflammation and pain in mice. Methods Knee joint blood flow, edema, and pain sensitivity (as induced by thermal and mechanical stimuli) were assessed in C57BL/6 mice following intraarticular injection of either the selective PAR‐4 agonist AYPGKF‐NH2 or the inactive control peptide YAPGKF‐NH2. The mechanism of action of AYPGKF‐NH2 was examined by pretreatment of each mouse with either the PAR‐4 antagonist pepducin P4pal‐10 or the bradykinin antagonist HOE 140. Finally, the role of PAR‐4 in mediating joint inflammation was tested by pretreating mice with acutely inflamed knees with pepducin P4pal‐10. Results PAR‐4 activation caused a long‐lasting increase in joint blood flow and edema formation, which was not seen following injection of the control peptide. The PAR‐4–activating peptide was also found to be pronociceptive in the joint, where it enhanced sensitivity to a noxious thermal stimulus and caused mechanical allodynia and hyperalgesia. The proinflammatory and pronociceptive effects of AYPGKF‐NH2 could be inhibited by pepducin P4pal‐10 and HOE 140. Finally, pepducin P4pal‐10 ameliorated the clinical and physiologic signs of acute joint inflammation. Conclusion This study demonstrates that local activation of PAR‐4 leads to proinflammatory changes in the knee joint that are dependent on the kallikrein–kinin system. We also show for the first time that PARs are involved in the modulation of joint pain, with PAR‐4 being pronociceptive in this tissue. Thus, blockade of articular PAR‐4 may be a useful means of controlling joint inflammation and pain.

The purpose of this study was to analyse multi-detector row CT (MDCT) signs of peripancreatic arterial and venous invasion in pancreatic carcinoma. Among 101 patients with pancreatic carcinoma examined by MDCT, 54 candidates for surgery were pre-operatively evaluated for vascular invasion based on MDCT signs. The peripancreatic major vessels (including superior mesenteric artery, coeliac artery, common hepatic artery, superior mesenteric vein and portal vein) were examined carefully by surgeons during the operation. At surgical exploration, 78 of 224 vessels were invaded by tumour. The invaded peripancreatic major arteries (n = 29) and veins (n = 49) presented different MDCT signs: 43% of invaded veins (18/42, except for 7 occluded veins) were surrounded by tumour less than 50% of the vessel circumference compared with 97% (28/29) of the invaded arteries, which were surrounded by tumour more than 50% of the vessel circumference or were embedded in tumour (p<0.001). 69% (34/49) of the invaded veins had vascular stenosis or obliteration, compared with 41% (12/29) of the invaded arteries (p<0.05). Irregularity of the vein wall, 74% (31/42, except for 7 occluded veins); occurred more often than that of the artery wall, 45% (13/29) (p<0.05). In conclusion, the MDCT signs of peripancreatic arterial and venous invasion have different characteristics, which should be considered in pre-operative evaluation.