diagnosis and treatment

诊断和治疗
  • 文章类型: Journal Article
    口腔鳞状细胞癌(OSCC)被认为是最常见的头颈部鳞状细胞癌(HNSCC),因为它拥有90%的HNSCC病例,这些病例来自口腔中的多个位置。在过去的三十年中,侵袭性肿瘤OSCC的诊断和治疗进展甚微。然而,深入了解OSCC的发病机制,分期和分级,标志,和致病因素是OSCC患者晚期诊断和治疗的首要要求。因此,本综述旨在理解OSCC的患病率,分期和分级,分子发病机制包括癌前阶段,各种标志,病因学,诊断方法,治疗(包括FDA批准的具有作用机制和副作用的药物),和治疗医生。当前的评论更新,为了更好地理解OSCC进展肿瘤促进炎症,持续增殖信号,生长抑制信号/凋亡能力逃避是需要考虑的三个最重要的标志。该综述表明,在所有病因因素中,烟草的消费是导致OSCC高发病率的主要原因。在OSCC诊断中,活检被认为是金标准,然而,甲苯胺蓝染色是最简单、无创、准确度高的方法。虽然有多种治疗剂可用于癌症治疗,然而,只有少数被FDA批准专门用于OSCC治疗。本综述建议在所有可用的OSCC治疗中,基于抗体的CAR-NK是未来癌症治疗的一种有前景的治疗方法.目前的审查还表明,治疗药物促进了癌症诊断和治疗的进步,然而,需要额外的工作来完善治疗与不同方式结合在癌症治疗中的作用。
    Oral squamous cell carcinoma (OSCC) is considered the most common type of head and neck squamous cell carcinoma (HNSCC) as it holds 90 % of HNSCC cases that arise from multiple locations in the oral cavity. The last three decades witnessed little progress in the diagnosis and treatment of OSCC the aggressive tumor. However, in-depth knowledge about OSCC\'s pathogenesis, staging & grading, hallmarks, and causative factors is a prime requirement in advanced diagnosis and treatment for OSCC patients. Therefore present review was intended to comprehend the OSCCs\' prevalence, staging & grading, molecular pathogenesis including premalignant stages, various hallmarks, etiology, diagnostic methods, treatment (including FDA-approved drugs with the mechanism of action and side effects), and theranostic agents. The current review updates that for a better understanding of OSCC progress tumor-promoting inflammation, sustained proliferative signaling, and growth-suppressive signals/apoptosis capacity evasion are the three most important hallmarks to be considered. This review suggests that among all the etiology factors the consumption of tobacco is the major contributor to the high incidence rate of OSCC. In OSCC diagnosis biopsy is considered the gold standard, however, toluidine blue staining is the easiest and non-invasive method with high accuracy. Although there are various therapeutic agents available for cancer treatment, however, a few only are approved by the FDA specifically for OSCC treatment. The present review recommends that among all available OSCC treatments, the antibody-based CAR-NK is a promising therapeutic approach for future cancer treatment. Presently review also suggests that theranostics have boosted the advancement of cancer diagnosis and treatment, however, additional work is required to refine the role of theranostics in combination with different modalities in cancer treatment.
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  • 文章类型: Journal Article
    背景:乳腺癌是一种常见的恶性肿瘤,早期检测和标准化治疗对患者的生存和康复至关重要。本研究旨在对陕西省乳腺癌诊治现状进行综述,提供对当地实践和成果的宝贵见解。
    方法:我们选择了25家医院,这些医院代表了陕西(中国西北部的一个省份)目前乳腺癌的诊断和治疗策略。问卷包括关于基本信息的部分,门诊会诊,保乳手术,新辅助和辅助治疗,前哨淋巴结活检,乳房重建手术。
    结果:2021年,这25家医院共进行了6665例乳腺癌手术。保乳手术(BCS)的总比例为23.6%。乳腺癌年手术量与BCS执行率呈正相关(P=0.004)。2017年新辅助治疗共2882例,占手术治疗乳腺癌患者的43.24%。与其他地区相比,西安市的医院对乳腺癌患者进行了更多的新辅助治疗(P=0.008)。门诊量与前哨淋巴结活检(SLNB)执行率呈显著正相关(P=0.005)。陕西14家医院进行了重建手术。
    结论:保乳手术,陕西省的辅助和新辅助治疗及前哨淋巴结活检已达到全国平均水平。此外,西安的医院已经超过了这个平均水平。然而,与顶级医院相比,乳房再造手术的发展存在差异.
    BACKGROUND: Breast cancer is a common malignancy, and early detection coupled with standardized treatment is crucial for patient survival and recovery. This study aims to scrutinize the current state of breast cancer diagnosis and treatment in Shaanxi province, providing valuable insights into the local practices and outcomes.
    METHODS: We selected 25 hospitals that typically represent the current diagnosis and treatment strategy of breast cancer in Shaanxi (a province in northwest China). The questionnaire comprised sections on fundamental information, outpatient consultations, breast-conserving surgery, neoadjuvant and adjuvant therapy, sentinel lymph node biopsy, breast reconstruction surgery.
    RESULTS: A total of 6665 breast cancer operations were performed in these 25 hospitals in 2021. The overall proportion of breast-conserving surgery (BCS) is 23.6%. There was a statistically significant positive correlation between the annual volume of breast cancer surgery and the implementation rate of BCS (P = 0.004). A total of 2882 cases of neoadjuvant treatment accounted for 43.24% of breast cancer patients treated with surgery in 2017. Hospitals in Xi\'an performed more neoadjuvant therapy for patients with breast cancer compared to other districts (P = 0.008). There was a significantly positive correlation between outpatient visits and the implementation rate of sentinel lymph node biopsy (SLNB) (P = 0.005). 14 hospitals in Shaanxi performed reconstructive surgery.
    CONCLUSIONS: Breast conserving surgery, adjuvant and neoadjuvant therapy and sentinel lymph node biopsy in Shaanxi province have reached the China\'s average level. Moreover, hospitals in Xi \'an have surpassed this average. However, a disparity is observed in the development of breast reconstruction surgery when compared to top-tier hospitals.
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  • 文章类型: Journal Article
    作为痴呆症的一种形式,阿尔茨海默病(AD)没有有效的治疗方法,然而,AD治疗仍然势在必行,因为它可以改善症状或防止症状恶化或在最长的程度上保持当前状态。人的大脑是人体最敏感、最复杂的器官,受血脑屏障(BBB)保护。由于药物或纳米材料被大量抑制而无法到达病变部位,因此这仍然导致难以治愈AD。因此,药物递送系统的BBB穿越能力仍然是神经疗法发展中的重大挑战。幸运的是,由于纳米载体的迷人优势,纳米使能递送系统具有实现针对AD各种靶标的多功能诊断/治疗的潜力,包括简单的表面多功能化,具有大有效载荷的高表面体积比,和潜在的跨越血脑屏障的能力,使它们能够克服常规候选药物的局限性。这次审查,重点研究了多功能纳米材料在AD诊断和治疗中的BBB穿越能力,将提供一个有见地的愿景,有利于AD相关纳米材料的发展。
    As a form of dementia, Alzheimer\'s disease (AD) suffers from no efficacious cure, yet AD treatment is still imperative, as it ameliorates the symptoms or prevents it from deteriorating or maintains the current status to the longest extent. The human brain is the most sensitive and complex organ in the body, which is protected by the blood-brain barrier (BBB). This yet induces the difficulty in curing AD as the drugs or nanomaterials that are much inhibited from reaching the lesion site. Thus, BBB crossing capability of drug delivery system remains a significant challenge in the development of neurological therapeutics. Fortunately, nano-enabled delivery systems possess promising potential to achieve multifunctional diagnostics/therapeutics against various targets of AD owing to their intriguing advantages of nanocarriers, including easy multifunctionalization on surfaces, high surface-to-volume ratio with large payloads, and potential ability to cross the BBB, making them capable of conquering the limitations of conventional drug candidates. This review, which focuses on the BBB crossing ability of the multifunctional nanomaterials in AD diagnosis and treatment, will provide an insightful vision that is conducive to the development of AD-related nanomaterials.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    在中国,年轻女性的乳腺癌是一种相对常见的疾病。年轻乳腺癌具有侵袭性的临床和病理特点。在治疗年轻女性乳腺癌期间,涉及手术方法选择的问题,早期闭经,和生育保护可能有身体,心理,和社会影响。因此,诊断和治疗的多学科模式是必不可少的。国家肿瘤质量控制中心乳腺癌专家委员会组织国内相关领域专家编制了这份共识,为合理诊断提供科学可行的解决方案,治疗,和乳腺癌年轻女性的生育管理。这一共识是基于文献数据,有关国际准则的意见,以及不同领域专家的临床实践经验。
    Breast cancer in young females is a relatively common disease in China. Young breast cancer has aggressive clinical and pathological features. During the treatment of young females with breast cancer, issues involving the choice of surgical methods, early amenorrhea, and fertility protection may have physical, psychological, and social impacts. Thus, a multidisciplinary model of diagnosis and treatment is indispensable. The breast cancer expert committee of the National Cancer Quality Control Center organized experts in related fields in China to compile this consensus as to provide scientific and feasible solutions for rational diagnosis, treatment, and fertility management for young females with breast cancer. This consensus is based on the literature data, the views of relevant international guidelines, and the clinical practice experience of experts in different fields.
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  • 文章类型: Journal Article
    胶质瘤是颅内最常见的恶性肿瘤,治疗困难严重,患者生存率低。由于肿瘤的异质性和侵袭性,缺乏个性化的临床治疗设计,和生理障碍,通常很难准确区分胶质瘤,这极大地影响了随后的诊断,成像治疗,和预后。幸运的是,近年来,纳米递送系统在诊断和治疗神经胶质瘤方面表现出前所未有的能力。它们已被修饰和表面修饰,以有效地穿越BBB/BBTB,靶病变部位,并智能地释放治疗剂或造影剂,从而实现精确的成像和治疗。在这次审查中,我们专注于纳米递送系统。首先,我们概述了临床实践中神经胶质瘤的标准和新兴诊断和治疗技术。经过归纳和分析,重点总结了给药系统的给药方法,纳米粒子的设计,以及近年来他们在胶质瘤成像和治疗方面的新进展。最后,我们讨论了药物递送系统在诊断和治疗胶质瘤中的前景和潜在挑战。
    Glioma is the most common intracranial malignant tumor, with severe difficulty in treatment and a low patient survival rate. Due to the heterogeneity and invasiveness of tumors, lack of personalized clinical treatment design, and physiological barriers, it is often difficult to accurately distinguish gliomas, which dramatically affects the subsequent diagnosis, imaging treatment, and prognosis. Fortunately, nano-delivery systems have demonstrated unprecedented capabilities in diagnosing and treating gliomas in recent years. They have been modified and surface modified to efficiently traverse BBB/BBTB, target lesion sites, and intelligently release therapeutic or contrast agents, thereby achieving precise imaging and treatment. In this review, we focus on nano-delivery systems. Firstly, we provide an overview of the standard and emerging diagnostic and treatment technologies for glioma in clinical practice. After induction and analysis, we focus on summarizing the delivery methods of drug delivery systems, the design of nanoparticles, and their new advances in glioma imaging and treatment in recent years. Finally, we discussed the prospects and potential challenges of drug-delivery systems in diagnosing and treating glioma.
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  • 文章类型: Journal Article
    妊娠期高血压(PIH),尤其是先兆子痫(PE),是怀孕的常见并发症。这种情况对母亲和胎儿的健康都构成重大风险。新出现的证据表明表观遗传修饰,特别是DNA甲基化,可能在启动PIH的最早病理生理学中起作用。本文介绍了DNA甲基化与胎盘滋养细胞功能的关系,与胎盘微环境相关的基因,胎盘血管系统,以及母体血液和血管功能,在PIH的发病和进展中,脐带血和血管功能异常,以及PIH子代DNA甲基化的变化,在母性方面,胎儿,和后代。我们还探索了基于DNA甲基化的早期检测的最新研究,PIH的诊断和潜在治疗策略。这将使DNA甲基化研究领域继续增强我们对PIH基因表观遗传调控的理解并确定潜在的治疗靶标。
    Gestational hypertension (PIH), especially pre-eclampsia (PE), is a common complication of pregnancy. This condition poses significant risks to the health of both the mother and the fetus. Emerging evidence suggests that epigenetic modifications, particularly DNA methylation, may play a role in initiating the earliest pathophysiology of PIH. This article describes the relationship between DNA methylation and placental trophoblast function, genes associated with the placental microenvironment, the placental vascular system, and maternal blood and vascular function, abnormalities of umbilical cord blood and vascular function in the onset and progression of PIH, as well as changes in DNA methylation in the progeny of PIH, in terms of maternal, fetal, and offspring. We also explore the latest research on DNA methylation-based early detection, diagnosis and potential therapeutic strategies for PIH. This will enable the field of DNA methylation research to continue to enhance our understanding of the epigenetic regulation of PIH genes and identify potential therapeutic targets.
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  • 文章类型: Journal Article
    实体器官移植(SOT)受者特别容易受到多药耐药生物(MDRO)引起的感染,并且通常是第一个受到新出现的耐药病原体的影响。不幸的是,高收入国家以及低收入和中等收入国家(HIC和LMIC)没有系统地报告它们的患病率以及根据移植物类型对发病率和死亡率的影响.因此,SOT接受者的MDRO流行病学可能会受到报告偏见的影响。此外,筛查实践和诊断资源可能因国家而异,以及新药的可用性。在这次审查中,我们旨在描述HIC和LMIC中SOT患者的主要革兰氏阴性MDRO负担,并概述当前的诊断和治疗资源.
    Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources.
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  • 文章类型: Journal Article
    目的:探讨超声造影引导下内镜下逆行阑尾炎治疗(ERAT)对单纯性阑尾炎的诊断和治疗价值。
    方法:对2020年1月至2023年12月期间收集的105例单纯性阑尾炎患儿的临床和超声数据进行了回顾性分析。治疗前后的超声检查结果,以及术后随访和复发率,进行了总结和分析。
    结果:96例患者(91.4%)成功插管。常规超声阑尾显示率为39.6%(38/105),而超声造影引导下阑尾可视化率为75%(72/105)。超声造影显示89例阑尾的各种形态学改变,比如扭曲,弯曲,刚度,粗糙的内壁,扩张直径,管腔变窄。此外,局部充填缺陷,这表明存在粪便结石或碎屑沉积,在68例患者中发现。没有发生造影剂的泄漏。治疗后评价显示阑尾直径改善,管腔,和填充缺陷(P<0.01)。89例患者的随访率为82例(92.1%),他们都恢复得很好,没有复发。复发率为7.9%(7/89)。在复发的患者中,5例患者经药物治疗后痊愈,2例患者经手术治疗后康复。
    结论:超声造影引导下ERAT治疗单纯性阑尾炎是安全有效的。具体来说,附录增加了,这有助于评估治疗效果。ERAT作为一个有价值的补充方式来确定需要手术治疗急性阑尾炎。具有重要的临床价值。
    OBJECTIVE: To determine the diagnostic and therapeutic value of contrast-enhanced ultrasound-guided endoscopic retrograde appendicitis treatment (ERAT) in patients with uncomplicated appendicitis.
    METHODS: A retrospective analysis was performed on clinical and ultrasound data collected from 105 pediatric patients with uncomplicated appendicitis between January 2020 and December 2023. The ultrasound findings before and after treatment, as well as postoperative follow-up and recurrence rates, were summarized and analyzed.
    RESULTS: Successful intubation was achieved in 96 patients (91.4%). The conventional ultrasound appendix visualization rate was 39.6% (38/105), while the appendix visualization rate after contrast-enhanced ultrasound-guidance was 75% (72/105). Contrast-enhanced ultrasound revealed various appendiceal morphologic changes in 89 patients, such as twisting, tortuosity, stiffness, rough inner wall, dilated diameter, and narrowing of the lumen. Additionally, local filling defects, which indicated the presence of fecal stones or debris deposition, were noted in 68 patients. No leakage of the contrast agent occurred. Post-treatment evaluation showed improvement in appendiceal diameter, lumen, and filling defects (P < .01). The follow-up rate was 82 of 89 patients (92.1%), all of whom recovered well without a recurrence. The recurrence rate was 7.9% (7/89). Among the patients with recurrences, five patients resolved after medical treatment and two patients recovered after surgical treatment.
    CONCLUSIONS: Contrast-enhanced ultrasound-guided ERAT for uncomplicated appendicitis is safe and effective. Specifically, the appendix is increased, which facilitates an evaluation of therapeutic effectiveness. ERAT serves as a valuable supplementary modality to determine the need for surgical treatment of acute appendicitis, which is of significant clinical value.
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  • 文章类型: Journal Article
    马粒细胞无形体病(EGA)是一种蜱传疾病,影响全世界的马,由吞噬细胞无性体引起。该疾病的范围从非特异性临床体征到致命结果。本文旨在分析同行评审期刊上报道的EGA病例,特别是临床病理发现,诊断,和治疗管理。总的来说,该研究包括来自31篇出版物的189例临床病例。报告了EGA病例的广泛症状,其中主要是发烧(90.30%),其次是肢体水肿(48.51%),厌食症(41.79%),抑郁症(32.84%),黄疸(22.39%),共济失调(17.91),心动过速(16.42%),嗜睡(15.67%)。实验室检查显示血小板减少症(90.32%),贫血(75%),血细胞比容降低(70.59%),白细胞减少症(55.88%),淋巴细胞减少(58.14%),和中性粒细胞减少症(41.67%)为最常见的血液学异常。对于被测试动物的子集,高胆红素血症(20/29),高纤维蛋白原血症(13/15),低钠血症(10/10)也有报道。诊断是通过显微镜鉴定桑树(153例),和/或PCR(120例),隔离(1例),或血清学(56例)。为了治疗,大多数(52.24%)EGA病例使用土霉素,但在没有抗生素治疗的情况下也有恢复(10.34%)。总之,各种临床和病理结果以及报道的具有挑战性的治疗方法提示,发生发热时,应将EGA纳入鉴别诊断.
    Equine granulocytic anaplasmosis (EGA) is a tick-borne disease affecting horses worldwide, caused by Anaplasma phagocytophilum. The disease ranges from non-specific clinical signs to fatal outcomes. This paper aimed to analyze EGA cases reported in peer-reviewed journals, particularly on clinico-pathological findings, diagnosis, and therapeutic management. Overall, 189 clinical cases from 31 publications were included in the study. Extensive symptomatology for the EGA cases was reported, of which mostly was fever (90.30%), followed by limb edema (48.51%), anorexia (41.79%), depression (32.84%), icterus (22.39%), ataxia (17.91), tachycardia (16.42%), and lethargy (15.67%). Laboratory tests revealed thrombocytopenia (90.32%), anemia (75%), decreased hematocrit (70.59%), leukopenia (55.88%), lymphopenia (58.14%), and neutropenia (41.67%) as the most common hematological abnormalities. For a subset of tested animals, hyperbilirubinemia (20/29), hyperfibrinogenemia (13/15), and hyponatremia (10/10) were also reported. The diagnosis was established by microscopic identification of morulae (in 153 cases), and/or PCR (120 cases), isolation (1 case), or serology (56 cases). For treatment, oxytetracycline was used in the majority (52.24%) of EGA cases, but recovery without antibiotherapy (10.34%) was also noted. In conclusion, the variety of clinical and pathological findings and the challenging therapeutic approaches reported suggest that EGA should be included in the differential diagnosis when fever occurs.
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