Treatment of hepatocellular carcinoma: Steps forward but still a long way to go

Hepatocellular carcinoma(HCC) is the fifth most common malignancy and the third cause of tumor associated deaths worldwide. HCC incidence rates are increasing in many parts of the world including developing and developed countries. Potentially curative treatments for HCC are resection and liver transplantation, but these are only suitable for patients with small tumors, meeting strict pre-defined criteria, or well-compensated liver disease. Early diagnosis of HCCcan be achieved by surveillance of at-risk populations. For patients with non-resectable disease treatments modalities include loco-ablative and systemic therapies. In this review we focus on treatment options in HCC and their allocation. Although significant research is in progress, to this date, the results are unsatisfactory with limited long-term survival. In the fight against this deadly disease, there is still a long way to go.     

防治血管钙化，依然任重道远

血管钙化是一个类似于骨、软骨形成且有多因素参与和调控的主动生物学过程。目前临床上对血管钙化的主要治疗策略仍然局限于机械治疗。但随着研究的深入,针对血管钙化的靶向干预已经有越来越多的尝试和探索,包括单纯的化学药物例如磷酸盐结合剂、焦磷酸盐和双膦酸盐、硫代硫酸盐等以及基于OPG/RANK/RANKL信号、破骨细胞等的靶向性干预。但这些干预策略均存在不同程度的缺陷和发展瓶颈,如何能够有效溶解吸收羟基磷灰石结晶、无定形钙沉积,逆转血管壁钙化表型的正常回归,并能充分兼顾骨-血管轴的双向平衡,仍前途漫漫、任重道远。     

Surgical correction of ischaemic mitral regurgitation still a long way to go.

This editorial refers to Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation by S. Gelsomino et al., on page 231.     

Preemptive antifungal therapy: still a way to go

PURPOSE OF REVIEW: Early treatment of invasive mold infections improves the outcome. Therapy is often delayed, however, because available diagnostic tools such as culture, microscopy and conventional radiology lack sensitivity; consequently, empirical initiation of antifungal therapy has been advocated, particularly for patients with prolonged unexplained neutropenic fever. RECENT FINDINGS: Much recent progress has been made in the development and evaluation of nonculture-based assays, including the detection of the fungal antigens galactomannan and beta-D-glucan and the detection of fungal DNA by polymerase chain reaction techniques. These new tools should aid the rapid, early diagnosis of invasive fungal disease, especially when used as screening tools in conjunction with sensitive imaging techniques. SUMMARY: The review will consider these recent developments with the purpose of introducing the concept of preemptive antifungal therapy.