1.Progress in surgical procedures of hepatocellular carcinoma
Chinese Journal of Digestive Surgery 2009;8(2):94-95
The incidence of hepatocellular carcinoma (HCC) has increased worldwide over the past two decades. Surgical resection and liver transplantation have been demonstrated as potentially curative treatment options, which could be considered in 30% -40% of HCC patients. Recent advancements of surgical treatment have focused not only on the surgical techpiques, but also the hepatic functional reserve evaluation, resectability assessment and the effects of biological characteristics of tumor on prognosis. There is no single variable to evaluate the hepatic functional reserve accurately. Combined Child-Pugh classification, ICGI5, portal vein pressure detection and remanent liver volume measurement are required prior to liver resection. The 5-year survival rate after liver resection for HCC is about 50%. The results are acceptable for some selected patients that underwent tumor resection with thrombectomy, including HCC with portal vein tumor thrombus or bile duct thrombosis. The choice of local resection or regular hepatectomy is still controversial although the former is commonly performed to treat HCC with cirrhosis, and the latter is applied to HCC patients without liver cirrhosis. The results of liver transplanta-tion for HCC are better than liver resection, and the Milan criteria is generally accepted. Any attempts to expand the selection criteria should be cautious because of organ shortage. Salvage transplantation for intrabepatic recurrence after liver resection may be a good choice in some resectable HCC. The recurrence and metastasis after surgical treatment are the main obstacles to achieve better results. Identification of predictive factors could be helpful to develop prevention strategies. Due to the importance of biological characteristics in tumor recurrence and metastasis, a molecular classification to predict prognosis of HCC patients will lead to a more personalized medicine. Targeting key molecules of biological pathways could optimize the therapeutic modality in HCC.
2.Translational medicine in primary liver cancer
Chinese Journal of Hepatobiliary Surgery 2011;17(5):357-358
Primary liver cancer is the third most common cause of death from cancer worldwide, and it is the second cause of cancer death in China. A variety of molecular markers and signaling pathways associated with hepatocarcinogenesis and tumor progression have been discovered in basic research in the recent decade. However, the 5 year survival of patients has not been remarkably improved, due in a large part to the late diagnosis and the limited treatment options. It seems that translational medicine should be accelerated to addres this problem. Translational medicine has been shown to bridge basic research and clinical practice in a B2B model: from bench to the bedside and bedside to the bench. It goes from the bench to bedside where theories emerging from preclinical experimentation are tested on patients, and from bedside to the bench, where information obtained from preliminary clinical sciences is used to refine the understanding of the biological principles. In liver cancer, diagnostic markers screening, development of molecular classification, and stratifying patients for targeted therapy are considered as exciting fields of translational medicine. The integration of basic and clinical sciences by translational medicine will improve not only the understanding of the underlying molecular mechanisms, but also the clinical outcomes in patients with primary liver cancer.
3.New perspectives on recurrence and metastasis of liver cancer
Chinese Journal of Digestive Surgery 2010;9(1):10-11
Cancer metastasis is considered as a complex process involving a series of sequential steps and a variety of molecalar signal transduction pathways.Tumor recurrence and metastasis are major obstacles for long-term survival of Liver cancer patients.Although the prognosis after recurrence and metastasis is dismal,the advancement of molecular researches of metastasis of liver cancer seems promising.In studies of origins of metastasis of liver cancer,the primary cancer cell and corresponding metastatic liver cancer cells share similar gene signature,which indicates that genes favoring metastasis progression are initiated in the primary tumors.The metastasis of liver cancer may be an early event in hepatic carcinogenesis and progression.Some molecular signatures have been developed to classify the metastatic potential of liver cancer.Furthermore,a variety of studies demonstrate that the tumor microenvironment instead of tumor cells plays a more important role in liver cancer metastasis.The pre-metastatic niche composed of non-tumoral cells may promote the cancer cell sedimentation and progression.The theory of cancer stem cell speculates that cancer stem cells were the real source of recurrent or metastatic tumors.Cancer stem cells will be one of the main targets of liver cancer treatment.The prevention and treatment of liver cancer recurrence or metastasis are quite difficult because liver cancer is resistant to traditional chemotherapy.Targeting the molecules involved in the metastasis of liver cancer WOuld be promising to cure those diseases.
4.Construction of Medical Digital Resources Information Platform in Big Data Era
Journal of Medical Informatics 2017;38(2):78-82
The paper analyzes the challenge of big data environment to the traditional medical information services,presents the practical significance and basis of constructing the medical information service platform,introduces the construction objectives,architecture,function feature of the platform,describes the medical information service mode based on the digital platform,including medical information resource services,intelligence study services and health decision-making support services,etc.
5.Analysis of clinical features of fibrosarcomatous dermatofibrosar-coma protuberans
Chinese Journal of Clinical Oncology 2015;(14):695-699
Objective:To investigate the clinical features, therapeutic method, and prognostic factor of fibrosarcomatous dermato-fibrosarcoma protuberans (FS-DFSP). Methods: Data of 18 FS-DFSP cases treated in the Department of General Surgery, Tianjin Huanghe Hospital between June 2004 and June 2014 were retrospectively analyzed. Research indexes included age, sex, pathogenic site, number of previous unplanned surgeries, tumor size, depth, incisal margin of the last surgical procedure, chemotherapy, relapse and metastasis, and survival time. Univariate and multivariate analyses of the research indicators were conducted in these cases. Results:All 18 patients underwent surgery, and the incisal margins were R0 in 17 cases and R1 in 1 case, with local recurrence in 2 of the 18 cas-es. The patient with R1 incisal margin underwent postoperative radiotherapy. Among all the patients, 12 with tumor base depth and/or largest tumor diameter of>5 cm accepted the chemotherapy of mesna, adriamycin, ifosfamide, and dacarbazine, also known as MAID regimen, after surgery. No progression of disease occurred during chemotherapy. After chemotherapy, pulmonary metastasis occurred in 3 of the 12 cases, and pulmonary metastasis with local recurrence existed in 1 case. Two of the 3 patients with pulmonary metastasis were treated with imatinib mesylate, and the therapeutic effect stabilized the disease. Two-year survival rate was 93%, and 5-year sur-vival rate was 79%in total patients. The results of mono-factorial analysis indicated that clinical factors, such as age, sex, pathogenic site, tumor size, depth, recurrence, incisal margin of surgical operation, and chemotherapy, were unrelated to the overall survival (OS) time. The number of previous unplanned surgeries and metastasis are related to OS. The results of multiple factor analysis showed that none of the clinical factors were independent prognostic factors for OS. Conclusion:A thorough removal of tumor can reduce the recur-rence rate, which is the key point in FS-DFSP treatment. Recurrence and metastasis of tumor are significant factors affecting prognosis.
6.Advances of immunotherapy in lymphoma
Journal of Leukemia & Lymphoma 2015;24(10):577-579
Over the past years, the incidence of lymphoma has been increasing, which has become one of the most common cancers around the world.The survival of lymphoma patients has been significantly improved due to advances of therapeutic methods such as new chemotherapy regimens, monoclonal antibodies and small molecular targeted drugs.However, the number of patients with relapsed/refractory lymphoma still account for a large proportion.It is of great significance to find new ways to treat these patients.Cellular immunotherapy could kill tumor cells by causing specific and effective antitumor immune response.Remarkable advances have been made in immunotherapy, such as adoptive immunotherapy, immune checkpoint inhibitors and immunomodulation therapy, for relapsed/refractory lymphoma patients, which will gradually open a new era in the treatment of lymphoma.
7.Effect of enteral nutrition on cardio-pulmonary function in elderly patients with chronic obstructive pulmonary disease
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2014;(6):599-601
ion:Objective To study the effect of enteral nutrition on cardio-pulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods Fifty-eight elderly COPD patients were randomly divided into treatment group (enteral nutrition group ,n=29) and control group (free diet group ,n=29) .Their nutrition parameters (BMI ,serum total protein ,al-bumin and prealbumin) ,LVEF and pulmonary function (FEV1 ,FVC ,FEV1/FVC) were assayed before and after treatment .Results The BMI ,serum levels of total protein ,albumin and prealbu-min were significantly higher in treatment group after treatment than before treatment ( P<0.05) .However ,no significant difference was observed in these parameters in control group after treatment .The LVEF ,FVC ,FEV1 and FEV1/FVC were significantly higher in treatment group than in control group after treatment (P< 0 .05) .Conclusion Enteral nutrition in combination with conventional treatment can improve the nutrition and cardio-pulmonary function in elderly COPD patients ,thus shortening their hospital stay time .
8.Treatment of the acute stage of cerebral infration
Chinese Journal of Practical Internal Medicine 2000;0(11):-
Stroke is a major cause of death and disability in China.Some strategies to reduce the burden of stroke is to attach importance to thrombolytic therapy within 6 hours,to strengthen public education,to implement systems-level improvements in the prehospital and stroke unit,and to use statins and antiplatelet drugs to prevent and treate stroke.
9.Comparative study of three therapies for elderly patients with primary chronic gouty arthritis.
Chinese Journal of Practical Internal Medicine 2001;0(05):-
Objective Study for the security,effectiveness and the related recurrence factors of the elderly primary chronic gouty arthritis with 3 different therapies.Methods Eighty-seven patients in the Huzhou Third Hospital from 2004.3 to 2005.4 with primary chronic gouty arthritis were randomized into 3 groups for a 12-month-observation:31 in group A were given the general therapies;32 in group B and 24 in group C were given the hydroxychloroqine and colchicine respectively besides the general therapy.Results The average of acute attack after treatment in the 3 groups was lower than those before treatment.The levels of blood uric acid decreased significantly(P
10.Application of Serum miRNA-720 and miRNA-484 in the Staging and Early Diagnosis of Colon Cancer
Journal of Modern Laboratory Medicine 2017;32(1):77-79,83
Objective To investigate whether serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers of colon cancer.Methods Real time-polymerase chain reaction was used to detect the expressions of miRNA-720 and miRNA-484 in serum from 104 colon cancer patients(divided intoⅠ~Ⅱ-stage group andⅢ~Ⅳ-stage group)compared with 60 ad-ditional healthy controls.ROC curve was performed to analyse the diagnostic usefulness of both miRNAs distinguishing be-tween different stages of colon cancer patients.Results Compared with healthy controls,the miRNA-720 was upregulated close to 2 times inⅠ~Ⅱ-stage group (t=1.997,P<0.05),and was upregulated about 3 times inⅢ~Ⅳ-stage group (t=2.133,P<0.05).The miRNA-484 was downregulated almost 2 times inⅠ~Ⅱ-stage group (t=2.585,P<0.05),but was upregulated over 3 times in Ⅲ~Ⅳ-stage group (t=3.416,P<0.01).The area under the ROC curve (AUC)for the diag-nosis of colon cancer were 0.76 (95%CI:0.67~0.86)and 0.79 (95%CI:0.69~0.89)respectively.The combined use of both miRNAs could make the AUC up to 0.87 (95%CI:0.77~0.96).Conclusion Serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers to diagnose early colon cancer.They can also distinguish between different stages of co-lon cancer patients.