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1.
Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997 onwards. SIRs for HCC were 80 to 100 in men and women diagnosed with hepatitis C virus and they were also >10 in patients diagnosed with hepatitis B virus, other kind of hepatitis, hepatic autoimmune disease and nonalcohol related liver disease. Many of these risks, as well as alcohol related liver disease, were either specific to HCC or were shared with intrahepatic CCA. For GBC, CCA and ampullary cancer infection of bile ducts was the main risk factor. Gallstone disease, nonhepatic autoimmune diseases and diabetes were associated with all hepatobiliary cancers. The limitations of the study include inability to cover some rare risk factors and limited follow-up time. Many of the considered comorbidities are characterized by chronic inflammation and/or overt immune disturbance in autoimmune diseases. The results suggest that local chronic inflammation and a related immune disturbance is the carcinogenic trigger for all these cancers.  相似文献   
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肾脏是人体最重要的排泄器官。肾单元近端小管细胞具有多种药物转运体和代谢酶,在药物及其代谢物处置中发挥关键作用。近端小管细胞中主要转运体包括有机阴离子转运体、有机阳离子转运体、有机阳离子/肉毒碱转运体、多药及毒素外排转运蛋白、P-糖蛋白、乳腺癌耐药蛋白和多药耐药相关蛋白;主要代谢酶包括细胞色素P450酶,UDP-葡萄糖醛酸基转移酶、磺酸基转移酶、谷胱甘肽S-转移酶。肾脏转运体和/或代谢酶介导药物相互作用(DDIs)是临床关注的重要问题。肾脏转运体和代谢酶存在密切协作关系,在肾脏也存在多种相互作用现象(包括转运-转运相互作用,代谢-代谢相互作用和转运-代谢相互作用),其显著影响药物肾脏处置、临床疗效和肾毒性。本文系统阐述了这些相互作用对药物及其代谢物的肾脏排泄、药动学、DDIs和肾毒性的影响。今后需要进一步阐明肾脏转运-代谢相互作用机制,将有助于研究体内药物肾脏处置和DDIs,促进临床合理用药。  相似文献   
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目的 探究内镜逆行胰胆管造影术(ERCP)在胆囊癌合并恶性梗阻性黄疸中的临床应用价值。方法 回顾性分析2016年1月-2019年9月该院收治的20例胆囊癌合并恶性梗阻性黄疸患者的临床资料,比较ERCP治疗前后总胆红素(TBil)和直接胆红素(DBil)水平,以及病理组织情况。结果 ERCP治疗前后TBil[(230.61±100.73)和(110.10±55.02)μmol/L]和DBil[(190.93±99.72)和(88.13±38.30)μmol/L]比较,差异有统计学意义(P < 0.05),采用活检钳和细胞刷联合活检的阳性率高于单项活检(P = 0.019,P = 0.008)。结论 ERCP对于晚期胆囊癌合并恶性梗阻性黄疸患者有较好的退黄效果,改善了患者生活质量,可在患者无外科手术指征时取活检确诊胆囊癌,为进一步综合治疗提供病理依据。  相似文献   
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Since their inception in the 1960s–70s, mesenchymal stem/stromal cells (MSCs) have gained interest because of their differentiation potential, anti-inflammatory effects, and immune-modulating properties. Both cell-based and cell-free MSC treatments show healing capacity in injured tissues. Cell-based treatment comprises MSCs and all secreted products, whereas cell-free treatments include only the secreted products. MSCs are therapeutically administered to many damaged organs owing to their efficacy. Specifically, the eye is a unique organ system to study the effects of MSCs, as treatment is easily applied and measured owing to its external location. The eye holds an immune-privileged status, wherein inflammation and immune responses are innately down-regulated. As excessive inflammation in the cornea often leads to fibrosis and irreversible corneal hazing, many studies have investigated the anti-inflammatory and immune-modulating capacities of MSCs. Decades of research suggest that MSCs modulate the immune response by secreting cytokines, growth factors, and extracellular matrix proteins that inhibit the infiltration of inflammatory cells following injury and promote a healing phenotype via M2 macrophage polarization. MSCs have also shown trans-differentiation potential into cornea-specific cell types during the wound healing process, such as corneal epithelial, stromal, or endothelial cells. This review discusses recent investigations of MSC treatment in the cornea, focusing on therapeutic efficacy, mechanisms, and future directions.  相似文献   
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目的 评价多功能套针浮刺疗法对神经根型颈椎病的临床疗效。方法 选取256例神经根型颈椎病患者,按随机数字表法分为观察组与对照组各128例。观察组应用多功能套针浮刺疗法进行干预,对照组为常规针刺治疗。两组患者均治疗7天。分别于治疗前后观察两组患者的简化McGill疼痛问卷(SF-MPQ)、国际标准颈椎功能障碍指数(NDI)和田中靖久颈椎病症状20分法量表评分,并于治疗结束后3个月观察复发率。结果 两组患者治疗后的SF-MPQ量表评分、NDI量表评分及田中靖久颈椎病症状20分法评分与治疗前相比均有改善(P<0.05),且观察组优于对照组(P<0.05);两组患者于治疗后3个月随访,SF-MPQ量表评分与治疗后相比均有改善,且观察组优于对照组(P<0.05);观察组临床疗效总有效率为96.88%,愈显率为81.25%;对照组总有效率为78.13%,愈显率为46.88%,观察组优于对照组(P<0.05)。结论 应用多功能套针浮刺疗法治疗神经根型颈椎病临床疗效显著,见效较快,可有效降低其复发率,且作用稳定,效果持久,值得临床推广应用。  相似文献   
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膀胱癌是泌尿系统常见的肿瘤,其中90%以上的膀胱癌病理类型为尿路上皮癌,按照肿瘤浸润深度可分为非肌层浸润性尿路上皮癌(Non muscle invasive bladder cancer,NMIBC)和肌层浸润性尿路上皮癌。NMIBC主要是指肿瘤侵及固有层(T1)、粘膜层(Ta)和原位癌(Tis),其预后较好。其中Ta、T1期肿瘤占大多数,两者虽然都属于NMIBC,但生物学特性不同,由于固有层血管和淋巴管丰富,故T1期肿瘤较容易发生扩散和复发。本文将重点针对T1期高级别尿路上皮癌的各种治疗方式,包括手术治疗、介入治疗、药物化疗和免疫治疗等方面做一综述,特别探讨了如何利用手术治疗方式以及手术治疗联合化疗提高治疗效果,减少复发,提高生存时间。  相似文献   
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《Cancer radiothérapie》2022,26(5):717-723
PurposeAnaplastic thyroid carcinomas (ATC) are a heterogenous group of tumors of overall dismal prognosis. We designed models to identify relevant prognostic factors of survival of irradiated ATC patients including radiotherapy modalities (field size, dose).Material and methodsBetween 2000 and 2017, 166 ATC patients’ treatments were divided into surgery and postoperative radiotherapy (poRT) or definitive radiotherapy (RT). Multiple imputation approach was used for missing data. Prognostic factors were identified using Lasso-penalized Cox modelling and predicted risk scores were built.ResultsPatients undergoing RT (n = 70) had more adverse patient and disease characteristics than those undergoing poRT (n = 96). Corresponding median survival rates were 5.4 and 12.1 months, respectively. PoRT patients undergoing poRT more likely received extended-field radiotherapy with prophylactic nodal irradiation, but rather received platinum- vs. adriamycin-based chemoradiotherapy. Radiotherapy was conventionally fractionated, delivered > 60 Gy in 51.9% and 61.7% and used extended fields in 88.5% and 71.2% of patients with poRT or RT. Radiotherapy interruption rates for toxicity were similar in the two groups. The best poRT-group model identified age > 45yo, PS  1, pathologic tumor stage  pT4b, > N1 and R2 resection as poor prognostic factors. The best RT-group model (C-index of 0.72) identified PS  3, > N1 and extended-field radiotherapy with prophylactic nodal irradiation (as opposed to tumour-bed irradiation only) as poor prognostic factors.ConclusionIn patients undergoing poRT, radiotherapy parameters had little influence over their survival irrespective of patient, disease characteristics, and quality of resection. In patients undergoing RT, extended-field radiotherapy improved survival in addition to PS and nodal stage.  相似文献   
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