Mr. Liu Jianguo, General Manager of Fuda Cancer Hospital, Awarded Excellent President of Canton Hospital

2016 marks the first year of the implementation of the Thirteenth Five-year Plan. Guangdong provincial party committee and Guangdong provincial government have put forward for the first time the strategy of building “a province with strong public health program”, which marks that the public health program in Guangdong has entered a new era of development. To better implement the requirement of the strategy proposed by Guangdong provincial party committee and Guangdong provincial government and give full play to the advantages and function of industrial association, Guangdong Province Hospital Association held the Second Session of the 9th Representative Congress of Guangdong Province Hospital Association in Guangzhou from March 24 to March 25, 2016 & 2016 Academic Annual Conference.

  

The academic annual conference centered on the theme of how to build a province with strong public health program and discussed the opportunities and challenges that hospitals will face, which has built a learning and communication platform for member units. The annual conference invited Huang Fei, deputy director of the Health and Family Planning Commission of Guangdong Province as the guest speaker, who has made a wonderful interpretation of the public health policy in Guangdong. Dr. Zhu Hengpeng, Deputy Director of the Institute of Economics Chinese Academy of Social Sciences and Director of the Public Policy Research Center was also invited as the guest speaker, who discussed with the participating guests the development of public hospital during the thirteenth-five year plan period from two aspects of policy interpretation and trend analysis.

 

The annual conference also witnessed the prize presentation of the 2015 “Sunny Cup” Excellent President of Canton Hospital. Mr. Liu Jianguo, the General Manager and Secretary of the Party Committee of Guangzhou Fuda Cancer Hospital was awarded Excellent President of Canton Hospital.

 

Award ceremony speech: being a master of scientific management, he has led the medical staffs of the hospital to build an internationalized, high-end and academic specialized cancer hospital with “3C+P” as the core treatment model for cancer, making it a banner of private hospital in Guangdong and China at large. He is the General Manager of Guangzhou Fuda Cancer Hospital.

 

It is reported that Guangdong Provincial Hospital Association has started the selection of "Sunny Cup" Excellent President and Excellent Management Staff of Canton Hospital since 2011. Every year, 15 excellent presidents and 20 excellent management staffs of canton hospital from the member units of Guangdong will be selected by employer reference, the agreement of the superior department, preliminary evaluation of Guangdong Provincial Hospital Association. The selection is designed to commend the management staffs in hospitals who are able to make innovation management and determined reform in the development course of hospital. It is also designed to encourage management staffs of canton hospitals to make continued contribution to improve medical service quality and management level.

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Xu Kecheng’s Ward Round Essays: Four Cases of Pancreatic Cancer

On 26th February, 2016, it’s Friday. I made rounds of the wards and visited 14 patients including four pancreatic cancer patients which made me impressed.

The first case is a female of 58 years old with pancreatic tail ductal adenocarcinoma. She was admitted to FUDA for the first time on November last year. At that time, she suffered from severe pain on lower back. The CA 19-9 in the blood was 8000u/ml. The size of the tumor was 3*4 cm with peripancreatic lymph nodes metastasis. After having ultrasound screen and irreversible electroporation (nanoknife therapy) ablation guided by CT, the pain was relieved. Patient went back to hospital for re-examination this time, and the general condition was good. The patient complained of ambiguous pain on left abdomen, which was relieved by taking non-steriodal pain-killing drugs. And the CA19-9 dropped to 600u/ml. Then, the patient was having peripancreatic lymph nodes absolute alcohol injection guided by ultrasound screen. She was also having NK immunotherapy at the same time.  

The second case is a male of 65 years old. His waist has been painful for a month. Neck of pancreas occupying lesion is 3-5 cm with peripancreatic lymph nodes swelling. The biopsy showed adenocarcinoma. In January this year, under the guidance combined with ultrasound and CT scan, the lump of tail of pancreas and peripancreatic lymph nodes were ablated by percutaneous nanoknife (irreversible electroporation ) surgery. After surgery, abdominal pain was relieved quickly. He went back to FUDA for re-examination a week ago with mild pain on his abdomen. The MR re-examination showed that activity of original lump in the pancreas was cut by 90%. Under the guidance of ultrasound scan, he had local alcohol injection and NK cells injection for taking immunotherapy.

The third case is a male of 61 years old who comes from Hong Kong. The lump in the head of pancreas was 3cm, which suppressed common bile duct and caused obstructive jaundice. Serum bilirubin concentration was 65mmol/L. The tumor was ablated by nanoknife (irreversible electroporation) with the guidance of ultrasound and CT. After surgery, patient could walk and get ready to come back Hong Kong for having endoscopic common bile duct cathetering.  

The fourth case is female of 62 years old. She accepted surgery at a hospital of a big city which included resection of stomach, duodenum, common bile duct and the head of pancreas. And he had chemotherapy. On 15th February, 2016, he was admitted to our hospital. The CT examination showed that there were multiple metastases in liver and enlarged lymph nodes in the head and neck of pancreas. HepaSpherin microspheres intervention was injected percutaneously to hepatic artery. Recently he had percutaneous cryosurgical ablation on liver with the guidance of CT. At the same time, metastatic lymph nodes were injected with 125 iodine seeds. And he was ready to get NK cell immunotherapy. 

Recent years, the morbidity of pancreatic cancer has been increased obviously, which is the No.4 most common cancer of digestive system. Treating pancreatic cancer is still world’s challenge so far. As for the above four cases, the first three cases were accepting nanoknife (irreversible electroporation) therapy. When three cases were diagnosed as pancreatic cancer, there were metastases in peripancreatic lymph nodes and suppression in blood vessels, which was impossible to remove by surgery. As for unresectable pancreatic cancer, ablation plays an important role as alternative treatment nowadays. Cryosurgery and nanoknife are common ways to ablate tumors. In 2012, after nanoknife (irreversible electroporation) being allowed to apply in treating soft-tissue tumors in America, nanoknife for pancreatic cancer treatment attracts attention all around the world. It can ablate tumors in targeted area clearly without much harm to great vessels and intestinal wall. Nanoknife conducts nanoscale perforation to cells membrane by high voltage and short current pulse. It’s neither hot nor cold, which doesn’t cause obvious inflammation. As we know, inflammation is the main factor causing cancer’s development and metastases. Therefore, nanoknife makes fewer side effects on patients. Patients will recover sooner after surgery. 

According to the reports from ten great hospitals’ reports, nanoknife therapy for pancreatic cancer treatment has been applied in more than 3000 cases, and the therapeutic effects are good. Guangzhou Fuda Cancer Hospital has applied nanoknife therapy since last July, which was the first case of nanoknife application in the mainland of China. More than 50 cases of pancreatic cancer patients accepted nanoknife therapy. Initial follow-up shows that the ablation technique has a good therapeutic effect with slight complications.

The first three cases above accepted nanoknife therapy, which was correct. Of course, the long-term effects need to be further observed. The recent condition was steady and the pain was relieved obviously. The fourth case of pancreatic cancer patient accepted surgery at out-of-town hospital. It’s conventional treatment. Unfortunately, the lesion recurred with liver metastases. Why did it metastasize so quickly? Was it undiscovered before surgery, or was surgery promoting metastases?

In 2007, a report named “Reveal the Mystery about Treating Cancer Causing More Metastases” from America said, treating cancer by surgery, chemotherapy and radiation would probably lead to cancer cells metastases. Surgery can accelerate cancer. I don’t have direct evidence on this topic. Someone has compared the cancer metastases after cryosurgery and surgery in experimental animal mode. He found that cancer metastasis after having surgery was earlier and more severe. And he thought TGF-βincreased after surgery. It’s the factor that leaded to cancer cell proliferation. Cryosurgery and nanoknife therapy are local ablations. The damage of tissue is less, and died cancer cells after ablation release antigen, which stimulates immune cells to generate anti-cancer immunity. Then it reduce the incidence rate of cancer metastasis.   

It doesn’t deny surgery certainly. Surgery is still the main means of treating early-stage cancer with mastering indication. It’s hard to say whether the 4th case has surgical indication. The diagnosis of pancreatic cancer is often with metastases. Therefore, it should be especially cautious of evaluating patient’s condition and grasping surgical indication.

The February 26th ward-round was to solve the problem about subsequent treatment. The first three cases all accepted nanoknife therapy. It’s impossible to ablate all tumors. I am not advocating chemotherapy for its function of prolonging patient’s life is limited, especially to pancreatic cancer patient of middle and advanced stage.

Famous book Sun Tzu’s The Art of War once said that a cornered animal is a dangerous foe, which is full of philosophy. In other words, it means that not hotly pursuing an enemy who is caught in a hopeless situation. Fierce attacks make enemy to resist strongly, which leads to great cost inevitably. The right way is inducing it to capitulate and making it safe. Then, live peace with each other.

A great number of evidence shows that chemotherapy has opposite effect which not only kills no cancer cells, but makes cancer cells growing. No.4 case had chemotherapy after surgery. I can’t claim whether the opposite effect of chemotherapy promotes metastases.

I suggest the former patients taking immunotherapy mainly. At present, CIK-DC and NK cell immunotherapy are most practical among all immunotherapy adopted in our hospital.

Recently, I read a report of World J Gastrointest Pharmacol Ther.2016. It said that scholars from five units reported their result of applying DC cell-based vaccine in treating pancreatic cancer. They processed DC cell with streptococcus immunoadjuvent OK432 and made Vaccel vaccine. They found DC vaccine could promote Th1 at a favorable situation and generate IL-12 in the way they processed DC vaccine, which had a better effect on fighting against cancer. 255 inoperable pancreatic cancer patients injected the vaccine. It’s discovered that patients with positive DTH had longer survival time than patients with negative DTH. Then, the author added HLAI restrictive WT1-II and restrictive WT1-I into DC cell, which was proved to prolong survival time of pancreatic cancer patient. In Japan, OK432 is most common potentiator for boosting immunity in cancer treatment. There are medicines like OK432 at home. Such as highly agglutinative staphylococcin (HASL), it’s extracted from staphylococcin. It should be sublingual medicine for lots of sublingual lymph nodes absorbing and stimulating immunity directly. I suggest giving patient this medicine.

There is always one thing conquering another in nature. Snake is the enemy of rat; bat is the enemy of mosquito; and bird is the enemy of grasshopper. The same as in human body, to fight against cancer cells, we also can use the natural enemy of cancer cell. That is NK cell.

I read lots of literature, which demonstrated that in-vitro amplificatory and highly activated NK cell shows strong activity of fighting against cancer in vitro and vivo. Another clinical test shows that allograft NK cell is effective in treating lymphoma and progressive, recurrent and solid tumors. The author injected continually NK cell to the patients three times, and the highest number of NK cell was 3*107 (about 30 billion) per kilogram. Among 17 evaluable patients, eight patients’ condition (47.1%) tended to be steady. CD8+T cells which have killing effect on cancer cells increased and T cells correlated cytokines was up regulated. On the contrary, T cells, myeloid-derived suppressor cells and TGF-β(transforming growth factor-β) which have regulatory rather than inhibitory effect on cancer diseased. The author thought a great number of allograft NK cell injections not only were safe and available but also were important method to maintain organism’s effective immune response (Cancer Immunol Res.2016).
　　
Therefore, as to the four cases of pancreatic cancer above, I suggest giving cells adoptive immunotherapy. At meanwhile, I suggest adopting traditional Chinese medicine to adjust intestine and stomach, which also helps improve immunity. A few days ago, I offered eight kinds of TCM including salvia miltiorrhizae, astragalus, dried wolfberry, dried hawthorn, dried tangerine and Mangnolia officinalis etc. to the four patients above. After taking these TCM, distending pain of upper abdomen was relieved and the eating was improved.

FUDA Completed 100 Cases of NanoKnife (IRE), The Number of Which Ranks the First in Mainland China

In the morning of March 16, 2016, Guangzhou Fuda Cancer Hospital held a press conference, announcing that FUDA has completed 100 cases of NanoKnife, the number of which ranks the first in mainland China. Journalists from over ten media, including Xinhua News Agency, China News, Yangcheng Evening News, Nanfang Daily, Guangdong TV witnessed the moment. Two patients, Ms. Lu Mingying, winner of Rank Prize in England and Ms. Gregerson Gurli, a teacher from Denmark, who have gained benefits from Nanoknife  shared with the journalists their anti-cancer experience at the press conference.

Prof. Niu Lizhi, President of FUDA, announced that Guangzhou Fuda Cancer Hospital has completed 100 cases of NanoKnife

  

A memorable moment

At 1:30 p.m., March 8, 2016, Prof. Niu Lizhi, President of Guangzhou Fuda Cancer Hospital walked into the operation room in the dark green surgical gown to perform one case of NanoKnife.

It was a memorable moment as it marks the 100th case of NanoKnife that Guangzhou Fuda Cancer Hospital has done. The patient lying on the operating table was Ms. Gregerson Gurli, a 68-year-old retired teacher from Denmark--a legendary woman. In 2007, she was diagnosed with pancreatic cancer with liver metastases. Her doctor in Denmark said she only had two to three months to live. As she found no other good treatment in several European hospitals, she came to Guangzhou Fuda Cancer Hospital for treatment in February 2008. Gurli has undergone cryoablation, iodine seeds implantation therapy and other comprehensive treatments at FUDA from 2008 till now. Despite that cancers are still present in her body, she has survived for over 8 years since diagnosis. It is the concept of living with cancer that has rendered her a prolonged life. 

Prof. Niu noted that the 100th case of NanoKnife was done on liver tumors. “Recently, Ms. Gurli has been found to have multiple neuroendocrine tumors in liver. There are three tumors detected, the largest is about 5cm in size and the other two are about 4cm and 2cm in size respectively. Considering that the masses are big in size and are close to important structures as hepatic diaphragm dome and hepatic hilus, NanoKnife therapy will be able to deliver higher safety and less side effects. ”

All was ready and the treatment got started. The medical team led by Prof. Niu performed ablation on the biggest mass first. The mass was located at the S7 of liver and had high activity. Under the guidance of ultrasound and CT scan, Prof. Niu punctured the two NanoKnife probes into the base of tumor for ablation. Then the probes were relocated to ablate the other two masses. The screen clearly showed that the masses became necrosis and gasification after ablation; small bubbles were formed; the previous high-density echo became lower...

Prof. Niu was satisfied with the ablation result. He noted, “As NanoKnife is a highly secure and mini-invasive treatment, the multiple masses in liver can be ablated at one time. Today, three masses in her liver have been ablated. The procedure went smoothly.”

Five great leaps achieved by FUDA in the research on and clinical application of NanoKnife

At the press conference, Prof. Niu Lizhi introduced to the reporters that NanoKnife is currently the latest cutting-edge ablation technology for tumor in the world. During the procedure, high electric-field and ultra-short pulses are given to destroy lipid bilayer structure of cancer cell membrane and form numerous irreversible nano-sized pores in the cell membrane. Cell membrane permeability will be changed to allow molecules of different sizes free access to cells, which will lead to cell death. NanoKnife has been approved by America FDA in April, 2012 and has been certified to CE certification of EU. In June 2015, NanoKnife was approved by Chinese FDA for clinical application. Guangzhou Fuda Cancer Hospital has been five No. 1 in terms of the research on and clinical application of NanoKnife.

 1. FUDA is the first cancer hospital in mainland China to have introduced NanoKnife.

2. As early as in August 2014, Xu Kecheng and Niu Lizhi compiled and published New Technique of Cancer Ablation Irreversible Electroporation--the first monograph on NanoKnife in China.

3. On July 2, 2015, the first case of NanoKnife in mainland China was completed at FUDA. The patient was a 61-year-old pancreatic cancer patient from a Middle East country.

4. As of March 8, 2016, 100 cases of NanoKnife have been done for patients with advanced pancreatic cancer, liver cancer etc. It has ablated the lesions and improved the quality of life for cancer patients. The cases of NanoKnife that has been done at FUDA rank the first in mainland China.

5. The number of papers on NanoKnife published on authoritative magazines, including Journal of Interventional Radiology and Chinese Journal of Radiology, etc. ranks the first in China.

Prof. Niu Lizhi noted, “NanoKnife can achieve complete ablation on small tumors and control and shrink big tumors. Looking back on the 100 cases of NanoKnife we have done, we found that NanoKnife has been delivering good curative effect for pancreatic cancer and liver cancer patients. The remission rate exceeds 80%, approaching the world level. With the development of the technology and the accumulation of experience, I’m convinced that NanoKnife will bring benefits to more cancer patients.”

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Prof. Niu Lizhi, President of Fuda Cancer Hospital, Attended Singapore Congress of Radiology by Invitation

On February 18, 2016, Prof. Niu Lizhi, President of Fuda Cancer Hospital, Guangzhou, China attended Singapore Congress of Radiology & the 25th Annual Scientific Meeting of the Singapore Radiological Society at the invitation of the chairman of the conference. Around 100 renowned experts in the field of radiotherapy from China, America, England, France, Australia, Japan, South Korea and etc. are also invited to the congress for exchanges of and discussion on the achievement made and the future development of interventional radiology.

 

Picture 1

Picture 2

A group photo of Prof. Niu Lizhi (R) with participating expert (picture 1 and picture 2)

 

 

A group photo of Prof. Niu Lizhi (L) and participating experts　　

In recent years, American doctors have been increasingly enthusiastic about cryotherapy for cancer. Many of them from world first class hospitals such as Mayo Clinic, Johns Hopkins Hospital, Memorial Sloan-Kettering Cancer Center were also gathered at the congress. Only two experts from mainland China were invited to the congress, one is Prof. Liang Ping from Chinese PLA General Hospital and the other is Prof. Niu Lizhi from Fuda Cancer Hospital, Guangzhou. Prof. Niu also served as the paper reviewer in charge of reviewing papers submitted by participating representatives.

At the conference, several well-known professors delivered reports on cryotherapy. Prof. Matthew shared his experience in treating about 1,000 cases of cancer with cryotherapy. Johns Hopkins Hospital and hospitals in France and Singapore have also applied cryoablation for cancer. Prof. Niu Lizhi presided over the penal discussion of ablation society and shared the experience of Fuda Cancer Hospital in conducting about 10,000 cases of cryosurgery.

A group photo of Prof. Niu Lizhi (M) with other participating guests at the welcome party　

In the evening of February 20, 2016, Prof. Niu attended the welcome party held by Singapore China Friendship Association. He introduced to Singaporean businessman and political officials the advanced technology and featured service offered by Fuda Cancer Hospital and then presented the book Living with Cancer wrote by Xu Kecheng, the chief President of FUDA, to the participating guests.

During the sidelines of the meeting, Prof. Niu visited a Singaporean patient who once hospitalized at Fuda Cancer Hospital. The patient had had primary lung cancer and the right lung had been removed. Unfortunately, left lung cancer recurrence was detected later. The Singaporean doctors were at a loss what to do. In August, 2014, the patient came to Fuda Cancer Hospital and underwent cryosurgery operated by Prof. Niu. The patient went back to Singapore after cryosurgery and he is in stable condition now.

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