应警惕免疫检查点抑制剂潜在的促进非酒精性脂肪性肝病相关肝细胞癌进展的风险

原发性肝癌(primary liver cancer,PLC)严重危害人类健康,根据世界卫生组织公布数据显示,2020年全球PLC新发及死亡病例分别为91 万例及83 万例[1].PLC主要包括肝细胞癌(hepatocellular carcinoma,HCC)及肝内胆管细胞癌,其中HCC约占PLC患者的80％～85％...     

非酒精性脂肪性肝病相关肝细胞癌流行病学与筛查

原发性肝癌( primary liver cancer,PLC)是全球常见的恶性肿瘤之一,主要包括肝细胞癌( hepatocel-lular carcinoma,HCC)和肝内胆管细胞癌,其中HCC占75％ ～85％ [1,2].2020 年,全球新发PLC病例为905677例(居恶性肿瘤的第6 位) ,死亡83018...     

AFP阴性肝癌的肿瘤标志物诊断的研究进展

甲胎蛋白(alpha-fetoprotein,AFP)是肝细胞癌(hepatocellular carcinoma,HCC)的主要标志物,测定血清AFP水平是目前诊断HCC的主要手段.约1/3的HCC患者血清AFP水平正常,即所谓的AFP阴性肝癌,这部分患者的诊断是目前肝癌诊断中需解决的关键问题.多年来,人们一直在寻找能弥补AFP不足的肝癌标志物,以提高HCC的诊断水平.本文综述了有关AFP阴性肝癌的肿瘤标志物诊断研究进展,主要内容包括传统肝癌标志物对AFP阴性肝癌的诊断价值,新肝癌标志物对AFP阴性肝癌的诊断价值,以及对AFP阴性HCC具有潜在诊断价值的生物标志物.     

高尔基体蛋白73在肝癌诊断中的意义

肝细胞癌(HCC)是我国常见的恶性肿瘤之一,其恶性程度高、进展快、预后差、侵袭性强,死亡率高,临床诊断时多属中晚期,及早诊断发现对提高患者存活率至关重要.甲胎蛋白(AFP)被认为是诊断HCC的重要指标,但其敏感性并不理想,30％～40％ HCC患者呈阴性或低浓度.高尔基体蛋白73( GP73)是一种新近发现的HCC相关蛋白,研究表明其是肝癌诊断和鉴别诊断中一种潜在的肿瘤标志物[1-2].本研究通过分析HCC患者血清GP73( GP73)和AFP水平,探讨它们在HCC诊断中的意义.     

哺乳动物雷帕霉素靶蛋白与C-Jun信号通路在原发性肝癌中的作用及其相关性研究进展

原发性肝癌(primary liver cancer,简称肝癌)是原发于肝细胞或肝内胆管上皮细胞的恶性肿瘤之一,包括肝细胞癌(hepatocellular carcinoma,HCC)、胆管细胞癌和混合性肝癌,在我国HCC约占90％以上[1].HCC与慢性肝炎病毒感染密切相关,其发病率和死亡率分别占全球恶性肿瘤的第5位和第3位,占我国恶性肿瘤的第3位和第2位,在全球每年新增的60余万病例中我国病例占50％以上.     

肝癌肿瘤标记物在超声筛查监测早期肝细胞癌中的作用不可或缺

<正>原发性肝癌(PLC)目前是世界第六大最常见的癌症,居癌症相关死亡的第四位[1]。肝细胞癌(HCC)是PLC的主要病理类型(约占75%～85%),是全球面临的一个主要健康问题[1-2]。HCC的早发现、诊断及有效的治疗是改善HCC患者生存预后的关键,而HCC的筛查监测是实现HCC早期诊断的有效途径[2]。随着超声(US)等影像技术在肝癌筛查监测中的广泛应用,甲胎蛋白(AFP)等肝癌肿瘤标记物在肝癌筛查中的作用受到一些质疑。本文通过回顾近年     

基于5-hmC的液体活检在早期肝细胞癌诊断中的应用价值

正原发性肝癌是我国最常见的恶性肿瘤之一,居癌症相关死亡原因的第二位,近年来发病率持续增长,严重威胁我国人民的生命健康~([1])。肝细胞癌(HCC)是原发性肝癌的主要病理类型,占原发性肝癌的85%～90%~([1])。HCC的早期发现、诊断及治疗是改善患者生存预后的关键。我国85%以上的HCC与慢性HBV感染有关,因此在慢性乙型肝炎(CHB)、肝硬化(LC)患者中进行HCC筛查和监测是实现HCC早诊断的最有效途径~([1-2])。目前临床上用于HCC检测和诊断的血液学指标主要有血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、异常凝血酶原(DCP)等,其中AFP为肝癌诊断和疗效监测中最常用且重要的     

甲胎蛋白对肝衰竭肝细胞再生及预后判定价值的研究

甲胎蛋白(alpha fetoprotein,AFP)作为肿瘤标志物,临床上主要用于原发性肝癌、生殖腺胚胎癌、胃癌、胰腺癌等的诊断参考指标。我国最新的《慢性乙型肝炎防治指南》就明确提出AFP明显升高往往提示肝细胞癌(HCC),可用于监测HCC的发生。但AFP升高也可提示大量肝细胞坏死后的肝细胞     

原发性肝癌诊疗规范(2011年版)摘要

原发性肝癌主要包括肝细胞癌(HCC)、肝内胆管细胞癌(intrahepatic cholangio-carcinoma,ICC)和肝细胞癌-肝内胆管细胞癌混合型等不同病理类型,由于HCC占到90％以上,故本规范所指的"肝癌"主要是指HCC. 一、诊断技术和应用 1.血液生物化学检查:HCC患者可以出现血清AST、ALT、ALP、乳酸脱氢酶或胆红素的升高,白蛋白降低等肝功能异常,以及淋巴细胞亚群等免疫指标的改变. 2.肿瘤标志物检查:血清甲胎蛋白(AFP)及其异质体是诊断HCC的重要指标和特异性最强的肿瘤标记物,对于AFP≥400μg/L超过1个月,或≥200 μg/L持续2个月,排除妊娠、生殖腺胚胎癌和活动性肝病,应该高度怀疑HCC;应同期进行影像学检查(CT/MRI)是否具有肝癌特征性占位.     

趋化因子/受体轴调控肝癌免疫细胞招募及转移的研究进展

<正>肝癌是一种常见的消化系统恶性肿瘤,主要包括三种不同的病理类型,分别为肝细胞癌(HCC)、肝内胆管细胞癌(ICC)和混合性肝细胞和胆管细胞癌(HCC-ICC)。在所有原发性肝癌中,HCC是最常见的类型,占所有原发性肝癌的85%～90%,其次是ICC,占所有原发性肝癌的15%^[1]。2020年的一项研究所示,在全球范围内,每年肝癌的新发病例数在所有恶性肿瘤中排名第7,在癌症相关死亡病例中排名第3^[2]。肝癌的早期往往没有明显症状,     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.