胰腺癌是一种高度侵袭性且预后极差的恶性肿瘤,其五年生存率极低,已成为全球癌症相关死亡的主要原因之一。近年来,研究发现肿瘤微环境(TME)在胰腺癌的发生、发展及治疗抵抗中起着至关重要的作用。TME由肿瘤细胞、基质细胞、免疫细胞、血管内皮细胞及其分泌的多种因子和信号分子组成,这些成分通过复杂的相互作用共同塑造了胰腺癌的侵袭性和治疗反应。研究表明,TME中的缺氧状态、免疫逃逸机制以及基质细胞的异常活化与胰腺癌的侵袭性和转移能力密切相关。此外,转化生长因子-β (TGF-β)和焦点黏附激酶(FAK)等信号通路的异常激活进一步推动了肿瘤的恶性进展。在病理特征方面,TME中的缺氧状态、免疫–基质交互作用及关键分子标志物的表达水平显著影响胰腺癌的病理分级、淋巴结转移及血管生成过程。特别是缺氧诱导因子2 (HIF-2)和Twist的高表达与肿瘤的高级别病理特征和侵袭性密切相关。在生存分析中,TME中的特定标志物和亚型分类为胰腺癌患者的预后评估提供了重要依据。HIF-2、Twist及KRAS突变等分子标志物与患者的生存期显著相关,而基于TME特征的亚型分类揭示了肿瘤的生物学异质性,为个体化治疗策略的制定提供了理论支持。通过深入研究胰腺癌TME与病理特征及生存分析的关系,有望为改善患者预后和开发新型治疗策略提供新的方向。Pancreatic cancer is a highly aggressive malignant tumor with a very poor prognosis, and its five-year survival rate is extremely low, making it one of the leading causes of cancer-related deaths worldwide. In recent years, studies have found that the tumor microenvironment (TME) plays a crucial role in the occurrence, development, and therapeutic resistance of pancreatic cancer. The TME is composed of tumor cells, stromal cells, immune cells, vascular endothelial cells, and various factors and signaling molecules they secrete. These components interact in complex ways to shape the aggressiveness and therapeutic response of pancreatic cancer. Research indicates that hypoxia, immune escape mechanisms, and abnormal activation of stromal cells in the TME are closely related to the invasiveness and metastatic ability of pancreatic cancer. Moreover, the abnormal activation of signaling pathways such as transforming growth factor-β (TGF-β) and focal adhesion kinase (FAK) further promotes the malignant progression of the tumor. In terms of pathological characteristics, the hypoxic state in the TME, immune-stromal interactions, and the expression levels of key molecular markers significantly affect the pathological grading, lymph node metastasis, and angiogenesis of pancreatic cancer. In particular, the high expression of hypoxia-inducible factor 2 (HIF-2) and Twist is closely related to the high-grade pathological features a
在我国,子宫颈癌是女性第5位常见的恶性肿瘤,其发病率和死亡率持续居于高位。子宫颈鳞状上皮内病变作为子宫颈癌的癌前病变,亦受到了临床医师的密切关注。近年来,随着女性体检意识的增强和癌前病变筛查手段的提高,子宫颈鳞状上皮内病变的检出率逐年上升,患病年龄也逐渐趋向年轻化。因此,针对子宫颈鳞状上皮内病变患者采用规范的筛查手段和及时有效的治疗策略,对减少子宫颈癌的发生意义重大。本文对子宫颈鳞状上皮内病变的“三阶梯”筛查内容及相关的治疗策略进行综述,强调了分层管理及个体化管理的重要性,以期为延缓或阻止子宫颈鳞状上皮内病变继续进展并改善患者临床结局提供新的诊疗思路。In China, cervical cancer is the fifth most common malignant tumor in women, and its incidence and mortality continue to be high. As a precancerous lesion of cervical cancer, cervical squamous intraepithelial lesions have also been paid close attention by clinicians. In recent years, with the enhancement of women’s awareness of physical check-up and the improvement of screening methods for precancerous lesions, the detection rate of cervical squamous intraepithelial lesions is increasing year by year, and the age of the disease is gradually tending to be younger. Therefore, adopting of normative screening methods and treatment strategies which are timely and effective for patients suffering from cervical squamous intraepithelial lesions, is of great significance to reduce the occurrence of cervical cancer. The essay summarized the “three-step” screening content of cervical squamous intraepithelial lesions and related treatment strategies, in the meantime, it’s great importance of stratified management and individual management, hoping to provide new train of thoughts for delaying or preventing the progression of cervical squamous intraepithelial lesions and improving the clinical outcome of patients.
21世纪已经证明,数据是新的黄金。人工智能(AI)驱动的技术可能会改变包括整形外科在内的所有医学专业的临床实践。人工智能具有广泛的子组件,包括机器学习,它由一个称为深度学习的细分组成。人工智能有可能增加医疗保健服务,改善指征和干预措施,并最大限度地减少错误。在骨科手术中,人工智能支持外科医生对放射图像的评估、外科住院医师的培训以及机器辅助手术的出色表现。人工智能算法改善了医院和诊所的行政和管理流程、电子医疗数据库、监测结果和安全控制。几乎所有骨科亚专科都在开发人工智能模型,包括关节镜、关节成形术、肿瘤、脊柱和儿科手术。本研究讨论了人工智能在足部和踝关节手术中的应用、局限性和未来前景。The twenty-first century has proven that data are the new gold. Artificial intelligence (AI) driven technologies might potentially change the clinical practice in all medical specialities, including orthopedic surgery. AI has a broad spectrum of subcomponents, including machine learning, which consists of a subdivision called deep learning. AI has the potential to increase healthcare delivery, improve indications and interventions, and minimize errors. In orthopedic surgery, AI supports the surgeon in the evaluation of radiological images, training of surgical residents, and excellent performance of machine-assisted surgery. The AI algorithms improve the administrative and management processes of hospitals and clinics, electronic healthcare databases, monitoring the outcomes, and safety controls. AI models are being developed in nearly all orthopedic subspecialties, including arthroscopy, arthroplasty, tumor, spinal and pediatric surgery. The present study discusses current applications, limitations, and future prospective of AI in foot and ankle surgery.
肥胖与高血压等疾病已被确认与骨关节炎(OA)的发病机制有着因果关系。最近的流行病学和临床研究结果证实,脂肪因子通过多种信号通路介导炎症、组织降解和OA发病机制。OA不再被认为只是一种“磨损性”疾病,OA发病机制中代谢相关成分的参与增加了疾病的复杂性。本论文旨在深入探讨肥胖及高血压在骨关节炎的发生与演进中的具体作用。Obesity and hypertension have been confirmed to have a causal relationship with the pathogenesis of osteoarthritis (OA). Recent epidemiological and clinical research results have confirmed that adipokines mediate inflammation, tissue degradation, and the pathogenesis of OA through multiple signaling pathways. OA is no longer considered merely a “wear and tear” disease;the involvement of metabolism-related components in the pathogenesis of OA has increased the complexity of the disease. This paper aims to deeply explore the specific roles of obesity and hypertension in the occurrence and progression of osteoarthritis.
脂肪酸代谢主要包括脂肪酸氧化(fatty acid oxidation, FAO)和脂肪酸合成,脂肪酸代谢的改变会影响心脏的结构和功能,其作用主要体现在心肌能量供应的改变上。既往研究表明,在心力衰竭状态下,心肌中的能量代谢发生显著变化,其中脂肪酸氧化的变化是研究的重点之一。因此本综述回顾了现有文献,深入探讨脂肪酸代谢与心力衰竭之间的相关性,为其临床防治提供新的线索与思路。Fatty acid metabolism mainly includes fatty acid oxidation (FAO) and fatty acid synthesis. The change of fatty acid metabolism will affect the structure and function of the heart, and its effect is mainly reflected in the change of myocardial energy supply. Previous studies have shown that in the state of heart failure, the energy metabolism in the heart muscle changes significantly, among which the change of fatty acid oxidation is one of the key points of the study. Therefore, this paper reviews the existing literature, deeply explores the correlation between fatty acid metabolism and heart failure, and provides new clues and ideas for its clinical prevention and treatment.
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