晚期卵巢癌治疗的标准方案为初始肿瘤细胞减灭术,术后补充以铂类为基础的联合化疗,近年来新的一种治疗方案应用愈加广泛,即行新辅助化疗后再行中间型肿瘤细胞减灭术。制定治疗方案前,须由妇科肿瘤医师基于实现满意减瘤的可能性和患者机体状况进行详细评估。目前有很多研究提出了术前评分模型以判断晚期卵巢癌患者接受初次肿瘤细胞减灭术的可能性,旨在实现满意减瘤结局、不影响生存预后的同时尽量降低手术并发症发生率,包括主要评估盆腹腔播散程度的腹膜癌指数和Eisenkop评分、评估手术复杂程度的手术复杂性评分、术前经腹腔镜探查评估肿瘤负荷的Fagotii腹腔镜评分和相应的术后并发症评分系统、以术前CT为基础的Suidan评分、预测R0切除可能的R0评分,以及结合多种评分模型的综合预测模型。The standard treatment for advanced ovarian cancer is primary debulking surgery followed by platinum-based combination chemotherapy. In recent years, a new treatment approach has become increasingly popular, which involves neoadjuvant chemotherapy followed by interval debulking surgery. Before formulating a treatment plan, a detailed assessment is necessary, based on the possibility of achieving satisfactory cytoreduction and the patient’s overall condition. Currently, many studies have proposed preoperative scoring models to predict the possibility of primary cytoreductive surgery for advanced ovarian cancer patients, aiming to achieve satisfactory cytoreduction outcomes without affecting survival prognosis while minimizing the incidence of surgical complications. These models include the peritoneal cancer index and Eisenkop score for evaluating the extent of pelvic and abdominal dissemination, the surgical complexity score for assessing the complexity of the surgery, the Fagotii laparoscopic score and the corresponding postoperative complication scoring system for evaluating tumor burden through preoperative laparoscopy, the Suidan score based on preoperative CT, the R0 score for predicting the possibility of R0 resection, and comprehensive predictive models combining multiple scoring systems.
原发性肝癌是常见的严重威胁人类健康的恶性肿瘤之一,老年人群中发病率逐渐上升,但老年患者存在着治疗不足的风险。随着科学技术的不断进步,临床上原发性肝癌的治疗方法发展迅速,FUAS作为唯一的体外的非侵入性的肿瘤局部治疗方式,现广泛应用于早期肝癌、中晚期肝癌、困难部位的肝癌等方面。现就FUAS在老年原发性肝癌患者中的治疗机制、临床应用及研究进展方面进行综述。Primary liver cancer is a common and aggressive malignancy that significantly impacts human health, with its incidence steadily increasing among the elderly population. However, elderly patients are often at risk of receiving suboptimal treatment. With ongoing advancements in medical science and technology, the clinical management of primary liver cancer has seen rapid progress. Focused ultrasound ablation surgery (FUAS) stands out as the only extracorporeal, non-invasive, and localized tumor treatment, and has become widely adopted for early-stage hepatocellular carcinoma, as well as for intermediate- and advanced-stage cases, and tumors located in challenging anatomical sites. This article provides an overview of the therapeutic mechanisms, clinical applications, and research advancements of FUAS in elderly patients with primary liver cancer.
结直肠癌(Colorectal cancer, CRC)是全球第三大最常见的恶性肿瘤,大约50%的患者在随访期间发生结直肠癌肝转移(Colorectal cancer liver metastasis, CRLM),肝转移是其最常见的远处转移部位;并且肝转移是结直肠癌患者死亡的主要原因。C...
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结直肠癌(Colorectal cancer, CRC)是全球第三大最常见的恶性肿瘤,大约50%的患者在随访期间发生结直肠癌肝转移(Colorectal cancer liver metastasis, CRLM),肝转移是其最常见的远处转移部位;并且肝转移是结直肠癌患者死亡的主要原因。CRLM的管理最好通过多学科方法实现,诊断和治疗决策过程很复杂。为了优化患者的生存和生活质量,必须克服几个未解决的挑战。这些主要包括及时诊断和确定可靠的预后因素。早期识别结直肠癌肝转移的危险因素可能是降低肝转移发生率的有效策略。炎症细胞及乳酸在肿瘤微环境中发挥着重要作用,对肿瘤细胞转移机制至关重要。本文将探讨炎症细胞及乳酸在结直肠癌异时性肝转移中的作用,这是对手术后发生异时性肝转移的结直肠癌患者进行有效干预的前提,对改善患者生活质量、延长患者生命具有重要意义。Colorectal cancer (CRC) is the third most common malignant tumor worldwide, and approximately 50% of patients develop colorectal cancer liver metastasis (CRLM) during follow-up, making it the most common distant metastatic site. Liver metastasis is the main cause of death in patients with CRC. The management of CRLM is best achieved through a multidisciplinary approach, and the process of diagnosis and treatment decision-making is complex. To optimize patient survival and quality of life, several unresolved challenges must be overcome. These include the timely diagnosis and the identification of reliable prognostic factors. Early identification of risk factors for CRLM may be an effective strategy to reduce the incidence of liver metastasis. Inflammatory cells and lactic acid play a significant role in the tumor microenvironment and are crucial for the metastatic mechanism of tumor cells. This paper will explore the role of inflammatory cells and lactic acid in the metachronous liver metastasis of colorectal cancer, which is a prerequisite for effective intervention in patients with metachronous liver metastasis of colorectal cancer after surgery, and has important significance for improving patient quality of life and extending patient life.
炎症性肠病(IBD)是一组主要发生在胃肠道粘膜的慢性炎症性疾病,包括溃疡性结肠炎(UC)和克罗恩病(CD)。除了影响胃肠道,IBD还具有多种肠外表现(EIM),其中肾脏受累是常见的并发症之一。研究表明,IBD可导致多种肾脏疾病,包括肾小球肾炎、肾小管间质性肾炎、肾结石、肾细胞癌、淀粉样变性、急性肾损伤和慢性肾脏病等。本文就IBD与肾脏疾病之间的研究进展进行综述,探讨IBD对肾脏健康的影响及其潜在机制。Inflammatory bowel disease (IBD) is a group of chronic inflammatory disorders primarily affecting the gastrointestinal mucosa, including ulcerative colitis (UC) and Crohn’s disease (CD). In addition to gastrointestinal involvement, IBD is associated with various extraintestinal manifestations (EIM), with renal involvement being one of the common complications. Studies have shown that IBD can lead to multiple kidney diseases, including glomerulonephritis, interstitial nephritis, kidney stones, renal cell carcinoma, amyloidosis, acute kidney injury, and chronic kidney disease. This article reviews the research progress on the relationship between IBD and kidney diseases, exploring the impact of IBD on renal health and its potential mechanisms.
代谢综合征(MS)是一个包括中心性肥胖、血糖、血脂及血压异常的多症候群综合征,实质是心血管疾病危险因素的聚集,可增加心血管疾病和心源性猝死的风险。围绝经期及绝经后期是女性从性成熟过渡到老年期的特殊阶段,女性随着卵巢功能的进行性衰退,性激素发生一系列变化,导致内分泌和代谢紊乱,血管、肌肉等多种组织细胞在结构上和功能上出现异常,使机体易患各种代谢性疾病。目前国内外研究尚未明确围绝经期及绝经后代谢综合征的发生机制,可能与卵巢激素变化、炎症因子影响、基因调控等相关。围绝经期及绝经后期代谢综合征防治原则为综合干预及个体化治疗,其目的为提升该时期女性生活质量,预防心血管疾病,使其有尊严、有质量地度过该特殊时期。目前,治疗性生活方式改变、降压降脂降糖及激素替代治疗可以一定程度上对围绝经期及绝经后期女性代谢综合征所致心血管等危害起到防治作用。Metabolic Syndrome (MS) is a multi-symptom complex syndrome that includes central obesity, abnormal blood glucose, blood lipids, and blood pressure. Its essence is the aggregation of cardiovascular disease risk factors, which can increase the risk of cardiovascular disease and sudden cardiac death. The perimenopausal and postmenopausal periods are special stages for women transitioning from sexual maturity to old age. As women experience a progressive decline in ovarian function, a series of changes occur in sex hormones, leading to endocrine and metabolic disorders. Various tissue cells, such as blood vessels and muscles, exhibit abnormalities in structure and function, making the body prone to various metabolic diseases. Current research both domestically and internationally has not yet clearly defined the mechanism of metabolic syndrome during the perimenopausal and postmenopausal periods. It may be related to changes in ovarian hormones, the influence of inflammatory factors, and gene regulation. The principles of prevention and treatment for metabolic syndrome during the perimenopausal and postmenopausal periods are comprehensive intervention and individualized treatment, with the aim of improving the quality of life for women during this period, preventing cardiovascular disease, and enabling them to pass through this special period with dignity and quality. Currently, therapeutic lifestyle changes, blood pressure and lipid-lowering, blood sugar reduction, and hormone replacement therapy can, to some extent, play a role in preventing and treating the cardiovascular and other harms caused by metaboli
肥胖作为一种全球性慢性代谢疾病,对女性生育力存在诸多不利影响。肥胖可通过干扰下丘脑–垂体–性腺轴功能、降低卵母细胞质量、损害子宫内膜容受性等多途径影响女性生育力。减重干预,涵盖生活方式干预、药物治疗、中医疗法及代谢手术,对女性生育力有积极作用。通过对这些内容的综述,本文旨在为临床实践提供有价值的参考依据。As a global chronic metabolic disease, obesity has many adverse effects on female fertility. Obesity can affect female fertility by interfering with hypothalamus pituitary gonad axis function, reducing oocyte quality, and impairing endometrial receptivity. Weight loss intervention, including lifestyle intervention, drug therapy, traditional Chinese medicine therapy and metabolic surgery, has a positive effect on female fertility. By synthesizing these elements, this article aims to provide a valuable reference for clinical practice.
B族链球菌(group B Streptococcus, GBS)是一种导致新生儿败血症和脑膜炎的重要致病菌。在世界范围内,GBS在孕妇体内广泛定植,可定植在孕妇的正常胃肠道和泌尿生殖系统中,并在某些条件下转变为感染状态,给围产期妇女及新生儿的健康产生...
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B族链球菌(group B Streptococcus, GBS)是一种导致新生儿败血症和脑膜炎的重要致病菌。在世界范围内,GBS在孕妇体内广泛定植,可定植在孕妇的正常胃肠道和泌尿生殖系统中,并在某些条件下转变为感染状态,给围产期妇女及新生儿的健康产生巨大影响。所以早期诊断GBS感染,并在及时给予适当的干预,可降低新生儿的感染率。本文就妊娠期B族链球菌感染的发病机制、感染高危因素及患者的筛查和防治方面的研究进展进行阐述。Group B Streptococcus (GBS) is one of the important pathogenic bacteria which can cause neonatal sepsis and meningitis. Worldwide, Group B Streptococcus (GBS) is widely colonized in pregnant women, commonly residing in the normal gastrointestinal tract and the urogenital system. Under certain conditions, it can transition from colonization to an infectious state, posing significant health risks to both perinatal women and newborns. Therefore, early diagnosis of GBS infection and giving appropriate intervention in time can reduce the infection rate of newborns. This paper describes the pathogenesis of group B streptococcal infection, high-risk factors for infection, and strategies for screening and prevention and treatment of patients.
急性T淋巴细胞白血病(T-ALL)起源于未成熟的胸腺细胞,患者的总体预后较急性B淋巴细胞白血病(B-ALL)患者差,生存时间短,尤其难治/复发T-ALL (R/R T-ALL)。虽然新型化疗药物、靶向治疗等治疗方案使该类患者的预后得到了一定程度的改善,但患者的获益仍有限。随着肿瘤免疫治疗时代的到来,嵌合抗原受体T细胞(CAR-T)疗法引入了血液肿瘤的治疗,一定程度上改善了R/R T-ALL患者的预后,本文就CAR-T细胞治疗R/R T-ALL的进展进行综述,以探讨其可行性及潜能。T cell acute lymphoblastic leukemia (T-ALL) originates from immature thymocytes, and the overall prognosis for patients is poorer compared to those with acute B-lymphoblastic leukemia (B-ALL), with shorter survival times, especially in cases of refractory or relapsed T-ALL (R/R T-ALL). Although novel chemotherapeutic agents and targeted therapies have improved the prognosis for these patients to some extent, the benefits remain limited. With the advent of the era of tumor immunotherapy, chimeric antigen receptor T-cell (CAR-T) therapy has been introduced into the treatment of hematologic malignancies, which has improved the prognosis of R/R T-ALL patients to a certain extent. This article reviews the progress of CAR-T cell therapy for R/R T-ALL, so as to explore this therapy’s feasibility and potential.
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