原发性肝癌基因治疗进展

针对原发性肝癌的传统治疗方法疗效欠佳、预后较差,基因治疗成为新的研究方向和热点。新的基因治疗策略不断涌现,载体系统不断更新,导人方法不断优化,动物模型不断改进,本研究就以上方面进行综述。     

肝癌基因治疗现状与展望

肝癌的治疗,由于现有的几种方法(包括化疗、放疗及手术等)疗效差,基因治疗被认为是其治疗的第五种模式。本文对肝癌基因治疗的几个方面:免疫基因治疗、反义基因治疗、抑癌基因治疗、自杀基因治疗、联合基因治疗、载体与存在的问题及展望进行了综述。     

原发性肝癌治疗概述

原发性肝癌是常见的恶性肿瘤之一,死亡率较高,如何发展新的治疗手段延长患者的生存期和降低远期复发率和转移率一直是医学界关注的重点,经过多年的基础和临床研究,对原发性肝癌的治疗取得很大的进展,表现在手术治疗,介入治疗,靶向治疗,基因治疗,化疗和中医中药治疗的进步,同时,提倡对肝癌进行综合治疗,选择优化的综合治疗方案以提高疗效.     

肝癌基因治疗现状与展望

肝癌的治疗，由于现有的几种方法（包括化疗、放疗及手术等）疗效差，基因治疗被认为是其治疗的第五种模式。本文对肝癌基因治疗的几个方面：免疫基因治疗、反义基因治疗、抑癌基因治疗、自杀基因治疗、联合基因治疗、载体与存在的问题及展望进行了综述。     

慢性乙型肝炎抗病毒治疗的发展趋势

抗病毒治疗是慢性乙型肝炎的最根本的治疗.干扰素和各种核苷(酸)类药物是目前用于治疗HBV感染的主要药物,已在临床广泛推广应用.近年,免疫调节药物、新的靶点抗HBV药物、基因治疗也不断发展,成为HBV抗病毒治疗新的发展方向.本文就各类HBV抗病毒药物研究发展加以阐述,以加深对抗病毒治疗的认识,明确发展趋势和研究方向.     

基因治疗进展及应用前景

基因治疗的关键技术是基因转移，包括治疗基因的选择，基因导入系统的选择，同时还包括治疗基因的高效靶向表达及对此表达的调控，而导入系统是基因治疗的核心技术，是基因治疗是否能够进入临床的关键之一。因而始终是基因治疗研究的重点和难点，基因治疗从1989年开始进行临床试验到今年已走过了整整10年，10年的基因治疗临床试验已表明，基因治疗不仅作为一个新的生物医学概念为人们所接受，而且作为一种新的治疗手段和方法被广大研究人员和临床工作者所实践，到目前为止所进行的多数研究表明，基因治疗临床试验总体上是安全，有效和易于操作的，本文就基因转移系统近年来的研究进展及10年来基因治疗的发展，应用前景和可能存在的问题作一介绍。     

放射治疗在原发性肝癌中的应用

原发性肝癌（primary hepaticcarcinoma，PHC）是我国常见的恶性肿瘤之一。目前对于PHC及其并发症的治疗手段有手术治疗、介入治疗、放疗、化疗、生物治疗、基因治疗及中医药等。其中最有效且有根治可能的治疗方法仍为手术切除。但随着对PHC生物学特性的不断认识和放射设备及技术的持续发展，放射治疗在PHC治疗中的作用已日益受到重视。     

原发性肝癌临床诊断及治疗方法

原发性肝癌是我国常见的恶性肿瘤之一,严重威胁人民群众的生命及健康.临床病理学研究发展迅速,原发性肝癌的诊断更为直观,治疗率不断提高.     

亚临床肝癌的诊治近况——亚临床肝癌研究的进展与展望

亚临床肝癌(SCHCC)是指无明确肝癌症状与体征的肝癌。绝大多数是甲胎蛋白(AFP)或超声显像普查发现,病变大多为≤5cm的小肝癌。手术切除率高,死亡率明显下降,使肝癌预后大为改观。一、研究亚临床肝癌的意义:1.证明肝癌是可能治愈的,不少已恢复工作,结婚并生育,同时也是获得肝癌长生存者的最有效途径。2.是提高肝癌总预后的最重要途径。对比我院1958～1966年,1967～1975年和1976～1984年三个阶段,因SCHCC在全组中所占比例由0％,7.2％增至21.2％,全组5年生存率亦由1.7％,7.1％增至19.5％。3.效益提高10倍。全组5年生存率临床肝癌仅4.2％,而SCHCC则达43.9％。4.SCHCC的研究导致了对肝癌三早、肝癌预后,肝癌自然病程、肝癌发生与发展等一系列概念的更新。5.SCHCC研究有力促进了临床与基础研究,反映了对肝癌认识与治疗上的重大进     

卵巢癌抗增殖基因的研究进展

卵巢癌是威胁妇女生命的常见妇科恶性肿瘤之一,虽然发病率在女性生殖系统恶性肿瘤中居第2位,但由于约70%的卵巢癌临床发现时已属晚期,卵巢癌的死亡率居女性生殖系统恶性肿瘤的首位.肿瘤发生为多步骤过程,包括癌基因的激活和/或抑癌基因的失活作用而导致细胞增殖增强与凋亡受到抑制,卵巢癌的发生亦是与细胞增殖分化相关的癌基因、抑癌基因多阶段相互作用的结果 .基因功能的异常导致肿瘤发生,由于正常细胞在其发生、发展、分化的各阶段均可发生基因异常,这就导致新的治疗策略-基因治疗的产生.基因治疗在肿瘤领域的成功应用为卵巢癌的基因治疗奠定了基础.对于卵巢癌治疗的最新探索中,基因治疗令人瞩目,在动物实验及对一些卵巢癌Ⅰ、Ⅱ和Ⅲ期临床患者的研究中取得了一定疗效,成为继手术、化疗、放疗之后全新且前景广泛的一种治疗模式.     

Gene therapy in liver diseases

The basic principles of gene therapy, ex vivo and in vivo gene transfers and various vectors have been reviewed first in the paper. Then the models for clinical application are shown, including the recent results of experimental studies, with special regard to the treatment of liver diseases and amongst them hepatocellular carcinoma. Gene therapy is still in preclinical stage. Due to the ongoing intensive genetic studies and if the existing problems being resolved in this field, we can predict that the early years of this millennium gene therapy will be a useful modality in the clinical hepatology as well.     

基因敲除技术及其在肝病研究中的应用

基因敲除技术是研究基因功能的重要手段,是探讨基因在疾病中作用机制的一个非常有效的研究工具.近年来该技术在肝病研究领域得到普遍应用,尤其是条件性基因敲除技术及RNA干扰的出现,进一步深化了肝病的研究.此文介绍基因敲除的基本原理及其在肝病研究中的应用.     

CRISPR/Cas9基因编辑技术的应用研究进展

近年来,CRISPR/Cas9基因编辑技术经过不断完善和改造,正逐步取代锌指核酸酶(ZFN)技术和转录激活因子样效应物核酸酶(TALEN)技术,成为具有广阔应用前景的第三代基因编辑技术。CRISPR/Cas9技术目前已广泛应用于细胞的基因编辑和基因调节、基因敲除动物模型的构建、人类疾病动物模型的治疗研究等领域。此外,已有相关实验证实该技术能够在人类胚胎中发挥基因编辑的作用,并且国内外已有2项CRISPR/Cas9临床试验正在开展,未来应用于临床靶向治疗前景广阔。现就CRISPR/Cas9系统的基本结构、作用原理及其应用的最新研究进展进行综述。     

人乳头瘤病毒治疗性疫苗综合疗法的研究现状与临床潜力

近年来,人乳头瘤病毒(HPV)治疗性疫苗的研究一直处于非常热门的地位,不少研究已经进入临床试验。HPV是宫颈癌的主要诱因,除了肿瘤细胞逃逸免疫机制外,HPV本身也有其特殊的逃逸机制,因此单一有效的治疗性疫苗研发有其一定的难度。从研究趋势上看,HPV治疗性疫苗联合其他治疗方式的综合性治疗或许成为有效的最新的研究热点而被认...     

Gene therapy in The Netherlands

Extensive research is ongoing worldwide on the clinical utility of gene therapy, particularly for the treatment of cancer and genetic disorders. Two gene therapy products have already been approved recently in China. Clinical experience with gene therapy has also been accumulating in the Netherlands: over 200 Dutch patients have now been treated in clinical trials. Published results indicate that gene therapy is generally safe. Gene therapy appears to be effective for some genetic disorders, such as severe combined immune deficiency and haemophilia B. The efficacy of gene therapy, particularly in the treatment of cancer, appears to be limited up till now.     

microRNAs在肿瘤中的研究与进展

MicroRNAs（miRNAs）是一类分布广泛的小片段内源性非编码蛋白质的单链RNAs,其功能是下调靶基因表达。miRNA序列、结构、丰度和表达方式的多样性,使其可能作为蛋白质编码mRNA的强有力的调节子或者其他形式的调节机制来抑制靶基因的表达,产生基因沉默。最新的研究表明,miRNAs参与了包括肝癌、肺癌、乳腺癌、结肠癌、脑肿瘤及白血病在内的多种肿瘤的发生、发展。miRNAs可以起到肿瘤抑制基因或者癌基因的功能研究表明miRNAs可以抑制重要的肿瘤相关基因的表达,对癌症的靶基因治疗有着重要的意义。因此本研究对阐明miRNA在肿瘤发生、发展过程中的作用机制以及在肿瘤治疗中的应用前景作一综述。     

卵黄抗体及其在抗感染中的应用

用抗原免疫禽类,可以从其卵黄中提取特异性卵黄抗体。随着蛋白纯化技术的发展,卵黄抗体的应用范围已越来越广泛,在基础研究、临床检测和治疗中都发挥着重要的作用。此文对卵黄抗体的免疫学特性、制作方法以及卵黄抗体在免疫诊断和抗感染中的应用作了综述。     

Choice of surgical strategy for colorectal liver metastases depending on clinical and pathological response to neoadjuvant chemo- and targeted therapy

Surgical strategy of colorectal liver metastases depends on clinical and pathological response to neoadjuvant chemo- and target therapy. Recently, surgical treatment of advanced colorectal cancer appears as an everyday challenge for surgeons and oncologists. The new oncologic procedures invented last years led to significant therapeutic improvement. Combination of neoadjuvant chemotherapy with biological answer modifiers increased greatly the clinical response rate given to cytoreductive therapy. Due to these facts the complete disappearance of liver metastases can be observed more and more frequently after 2000. Literature of metastasis surgery clarified the exact difference between clinical and pathological response, at the same time exact criteria of the connections between two responses have been set. In complex treatment of colorectal liver metastases complete pathological response became the end point of treatment. Aims and Methods: Between January, 2009 and August, 2010, 39 patients with originally non resectable liver metastases (colorectal cancer origin) have been studied. All patients were treated by neoadjuvant chemo- and targeted therapy before the resection of liver. Results: Complete pathological response has been observed in 3 patients, major pathological response (necrosis: >50%) in 11 patients, minor pathological answer (necrosis <50%) in 22 patients and finally no necrosis at all in 3 patients. Conclusions: Complete pathological response can be regarded as the final goal of neoadjuvant targeted therapy. Pathological response seems to be the most important prognostic factor which reflects long-term survival after the R0 resection of liver metastases. Complete disappearance of liver metastases is an undesirable side effect of oncological therapy, which causes difficulties during surgical intervention. In this term the overtreatment of patients resulting in a disappearance of metastases should be avoided. Multidisciplinary team is responsible for the indication of resection of liver metastases in time before their disappearance.     

Von der Grundlagenforschung in die Klinik

The discovery of human embryonic stem cells at the end of 1998 had a strong influence on the development of stem cell research and led to controversial discussions. The first therapeutic application of adult blood stem cells began after their discovery in 1963 and was accepted as an authorized therapy in the early 1980s. The way from basic research to therapeutic use needed about 20 years and was also discussed in a controversial way similar to the discussions of today. The regulatory environment at that time, however, allowed a quick translation of the results from basic research to the clinic. Today many new stem cell therapies for a multitude of diseases are under development. Their clinical realization is regulated by the AMG (Arzneimittelgesetz). For nonclinical research as well as for clinical research, specific regulations are enacted to guarantee a structured and safe launch. Time, know how and money for planning, request for authorization and conduction of a clinical trial should not be underestimated. For clinical application of stem cell products authorization by the proper authorities is mandatory.     

p53基因在膀胱肿瘤中的研究进展

p53基因与膀胱肿瘤相关性研究很多,绝大多数研究认为p53的突变与膀胱肿瘤的发生有关。为对其做进一步深入研究,本文综述了近3年有关化学致癌物质引起p53基因突变机制、p53基因的分子生物学行为以及用于膀胱肿瘤基因治疗的最新研究进展。