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  • 深在性囊性胃炎诊断和治疗进展
    Author: 郭慧宇 马瑞军 keyword: 深在性囊性胃炎 发病机制 诊断 治疗
    深在性囊性胃炎(GCP)是临床罕见的胃黏膜下病变,术前确诊困难,其发病机制尚不明确,可能与手术、慢性炎性反应、EB病毒感染、胃动力异常等因素相关。GCP临床症状无特异性,超声内镜(EUS)、EUS引导下穿刺活检(EUS-FNA/B)和CT检查对诊断GCP意义较大,病理检查仍是金标准。GCP主要通过手术切除,术式的选择遵循黏膜下肿瘤的治疗原则。文章从GCP的发病机制、诊断及治疗等方面进行综述,为GCP的诊疗提供理论依据。
  • 氯硝柳胺纳米晶潜在的治疗胃肠间质瘤的研究进展
    Author:任迎政 韩翔宇 许兆万 董永红 keyword:胃肠间质瘤 酪氨酸激酶抑制剂 氯硝柳胺 耐药机制 联合用药
    胃肠间质瘤是最常见的间叶源性肿瘤,手术切除是治疗局限性胃肠间质瘤的主要方法。目前针对胃肠间质瘤的病理性突变,临床上研发了数代酪氨酸激酶抑制剂,均取得一定的成效。然而,酪氨酸激酶抑制剂用药2~3年后,常常会产生耐药性,导致治疗失败。近年来,氯硝柳胺作为一种抗肿瘤活性的药物出现在公众视野,由于其溶解度差等原因,晶体制剂则应运而生,更好地发挥了抗肿瘤特性。文章结合目前的实验基础及相关机制,探讨在酪氨酸激酶抑制剂耐药的胃肠间质瘤中联合给药的可能性,以期开发胃肠间质瘤的新治疗方案。
  • 幽门螺杆菌感染根除方案研究进展
    Author: 杜凤 杨杰 武胜 keyword: 幽门螺杆菌感染 根除方案 研究现状
    幽门螺杆菌(Hp)是一种革兰阴性菌,患者感染后可出现餐后嗳气、恶心、腹胀、腹部不适的胃肠疾病症状,具有引发胃癌的风险,因此,根除Hp是预防胃癌的一项措施。近年来,有关根除Hp的治疗方案研究报道诸多,包括双联疗法、序贯疗法、伴同疗法、镶嵌疗法以及中药联合疗法等,文章就国内外的研究进展作一综述,以期为根除Hp感染患者个体化精准治疗方案的选择提供理论依据和指导。
  • 光学相干断层扫描血管成像技术在高度近视中的应用研究进展
    Author: 李鲜 李雁杰 keyword:高度近视 光学相干断层扫描血管成像技术 临床应用
    高度近视在亚洲人群中常见,发病率约4%,多为轴性近视,眼球后极部前后轴伸长。眼轴增长会使视网膜血管系统变化,如血管变窄、流速降低、毛细血管丢失,还会因视网膜薄弱导致脉络膜新生血管长入。因此,诊治时要考虑其对黄斑区、视盘区血流的影响。光学相干断层扫描血管成像技术能分层显示视网膜、脉络膜血管形态结构,为诊断和随访评估提供依据。文章对此技术在高度近视中的应用研究作一综述,为诊疗提供思路​
  • The expression levels and clinical significance of miR-605-5p and TNFAIP3 in non-small cell lunccancer tissues
    Author:Yu Feng Li Liang Li Hongyan Chu Xin keyword:Non-small cell lung cancer; MicroRNA-605-5p; Tumor necrosis factor-α-induced protein 3;Survival rate;
    Objective To investigate micro RNA-605-5p(miR-605-5p) and tumor necrosis factor α in non-small cell lung cancer(NSCLC) tissue and relationship between the expression level of inducible protein 3(TNFAIP3) and the 5-year survival of patients. Methods From February 2014 to January 2018, 87 patients with NSCLC who underwent surgical resection in Jiangbei Hospital, Affiliated Zhongda Hospital of Southeast University were selected. During the operation, NSCLC tissue and normal tissue adjacent to the cancer were taken. Immunohistochemical method was used to detect the expression of TNFAIP3 in NSCLC tissue and normal tissue adjacent to cancer. Real time fluorescence quantitative PCR was used to detect the expression of miR-605-5p and TNFAIP3 mRNA in NSCLC tissue and normal tissue adjacent to cancer; Follow up for 5 years after surgery and calculate the overall survival rate; Compare the expression levels of miR-605-5p and TNFAIP3 mRNA in NSCLC tissues between the survival group and the death group; Analyze the relationship between miR-605-5p, TNFAIP3 mRNA expression and clinical pathological characteristics in NSCLC tissue, the correlation between miR-605-5p and TNFAIP3 mRNA expression levels, the relationship between miR-605-5p, TNFAIP3 mRNA expression and patient survival, factors affecting 5-year survival of NSCLC patients, and the predictive value of miR-605-5p, TNFAIP3 mRNA expression levels on 5-year survival of patients. Results The positive rate of TNFAIP3 in NSCLC tissue was 25.29%, significantly lower than 57.47% in normal tissues adjacent to cancer(χ2/P=18.575/<0.001); The expression level of miR-605-5p in NSCLC tissue was significantly higher than that in normal tissue adjacent to cancer, while the expression level of TNFAIP3 mRNA was significantly lower than that in normal tissue adjacent to cancer(t/P=16.316/<0.001, 26.746/<0.001); The proportion of stage III and lymph node metastasis in TNM staging in the high expression group of miR-605-5p was significantly higher than that in the low expression group of miR-605-5p(χ2/P=21.611/<0.001, 6.472/<0.001); The proportion of stage III and lymph node metastasis in TNM staging was significantly higher in the low expression group of TNFAIP3 mRNA than in the high expression group of TNFAIP3 mRNA(χ2/P=15.783/<0.001, 13.839/<0.001); There is a negative correlation between miR-605-5p and TNFAIP3 mRNA expression level in NSCLC tissue(r/P=-0.453/<0.001); The 5-year overall survival rate of the miR-605-5p low expression group was 52.38%(22/42), significantly higher than the 26.67%(12/45) of the miR-605-5p high expression group, and the difference was statistically significant(χ2/P=6.034/0.014); The 5-year overall survival rate of the low expression group of TNFAIP3 mRNA was 21.95%(9/41), significantly lower than 54.35%(25/46) of the high expression group of TNFAIP3 mRNA, and the difference was statistically significant(χ2/P=9.557/0.002); The expression level of miR-605-5p in NSCLC tissue of the death group was significantly higher than that of the survival group, while the expression level of TNFAIP3 mRNA was significantly lower than that of the survival group(t/P=2.515/0.014, 6.678/<0.001); TNM stage III, lymph node metastasis, high expression of miR-605-5p, and low expression of TNFAIP3 mRNA are risk factors affecting 5-year survival in NSCLC patients [OR(95% CI)=1.998(1.326-3.010), 2.845(1.577-5.132), 1.760(1.206-2.569), 2.534(1.618-3.969)]; The AUC predicted by miR-605-5p, TNFAIP3 mRNA, and their combination for 5-year survival in patients were 0.761, 0.837, and 0.910, respectively. The combined AUC of miR-605-5p and TNFAIP3 mRNA was higher than the AUC predicted by miR-605-5p and TNFAIP3 mRNA alone(Z/P=2.716/0.007, 1.986/0.047). Conclusion High expression of miR-605-5p and low expression of TNFAIP3 in NSCLC tissue may jointly affect the 5-year survival of NSCLC patients, which has high predictive value for 5-year survival.