目的探讨先天性巨尿道症(congenital megalourethra,CM)的产前超声诊断特征及其预后。方法回顾性分析2023年7月至12月在济宁医学院附属医院诊治的2例CM胎儿的临床资料及产前超声特征。以“巨尿道”“先天性巨尿道症”为关键词,检索中国知网、万方、中华医学期刊全文数据库和维普中文期刊数据库;以“megalourethra”“congenital megalourethra”为关键词,检索PubMed、Embase、Web of Science等数据库,检索时间为1955年1月1日至2023年12月31日发表的产前诊断胎儿CM相关文献。采用描述性方法分析和总结所有纳入CM病例的产前超声特征及其结局和预后。结果(1)本院病例:病例1,孕19周超声发现胎儿阴茎部尿道扩张及泌尿系梗阻症状,远端尿道口可见。病例2,孕17周超声发现胎儿尿道全程扩张,以阴茎部尿道扩张为著,前端见尿道口,双肾盂轻度扩张。2例均考虑为胎儿CM。前者上级医院检查后决定终止妊娠。后者2周后复查,胎儿阴茎部尿道呈线性分离,双肾盂扩张明显减轻,后续超声检查未见明显变化。胎龄37周剖宫产娩出一男婴,排尿正常。(2)文献复习:检索到胎儿CM病例共54例,加本院2例,共56例。56例中,49例(88%)中孕期发现;均可见阴茎部尿道扩张。其中,54例(96%)合并泌尿系统异常,30例(54%)合并其他系统异常,24例(43%)羊水过少或无羊水。18例(32%)终止妊娠,1例(2%)胎儿宫内死亡,37例(66%)活产,其中有6例新生儿期死亡(均合并羊水过少,3例肾发育不良,2例肾实质回声增强,1例肾功能受损)。31例存活病例中,6例宫内巨尿道自发性缓解,预后较好。20例肾实质回声增强或肾发育不良病例中,9例(45%)终止妊娠,5例(25%)新生儿期死亡,6例(30%)存活儿中有4例行肾功能检查,均有肾功能损伤。4例早孕期发现的病例中,2例终止妊娠,1例新生儿期死亡,1例患儿终末期肾病。结论胎儿CM超声均表现为阴茎部尿道扩张。早期发现、肾脏回声增强或肾发育不良及羊水过少可能与新生儿死亡或肾功能损伤等不良结局相关。
肝癌作为全球范围内最常见的恶性肿瘤之一,其治疗一直是医学研究的重点。近年来,干细胞研究逐渐成为热点,特别是在治疗晚期肝病领域,干细胞疗法已经取得了显著成就。然而,其在肝癌治疗领域的应用研究相对较少,其安全性问题尚需深入探究。本综述旨在探讨骨髓间充质干细胞(BMSCs)在肝癌治疗中的临床和实验研究现状。As one of the most common malignant tumors in the world, the treatment of liver cancer has been the focus of medical research. In recent years, stem cell research has gradually become a hot spot, especially in the treatment of advanced liver disease, stem cell therapy has made remarkable achievements. However, its application in the field of liver cancer treatment is relatively few, and its safety needs to be further explored. This review aims to investigate the clinical and experimental research status of Bone mesenchymal stem cells (BMSCs) in the treatment of liver cancer.
大部分原发性肝癌转移模式的理论基础是上皮–间质转化(epithelial-mesenchymal transition, EMT),但是在肝细胞肝癌中,发现了一种新的临床亚型——血管包绕肿瘤细胞巢(vessels surrounded tumor clusters, VETC)癌巢型肝细胞肝癌,它具有特殊的血管结构模式,它的转移是一种非依赖EMT转移的方式,癌巢通过外周血液循环进行转移,最后形成新的癌转移灶,具有高复发率,高死亡率的特点。本文将对VETC癌巢型HCC目前研究出的转移方式、诊断及预测价值,治疗方式以及分子学特征四个方面进行阐述。Most of the metastatic models of primary liver cancer are based on Epithelial-mesenchymal transition (EMT). But in hepatocellular carcinoma, a new clinical subtype, vascular enveloping tumor cell nest vessels surrounded tumor clusters (VETC), has been found. It has a special vascular structure pattern, and its metastasis is independent of EMT metastasis, and the cancer nest metastases through peripheral blood circulation. Finally, a new metastatic focus is formed, which has the characteristics of high recurrence rate and high mortality rate. This article will describe the metastasis mode, diagnostic and predictive value, treatment methods and molecular characteristics of VETC cancer nest HCC.
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