Imaging update on soft tissue sarcoma

Soft tissue sarcomas (STS) are rare tumours presenting as soft tissue lumps. Ultrasound is often the primary modality for the initial assessment, with MRI the mainstay for lesion characterisation. PET/CT along with other emerging MRI sequences are used in certain situations as an adjunct and problem solving tool in STS staging and assessment of disease recurrence. Recent advances include the promise of whole body MRI, hybrid PET/MRI, diffusion weighted imaging, dynamic contrast enhanced MRI and advances in artificial intelligence. This article discusses current concepts in extremity STS imaging and highlights recent advances.     

Diagnosis of inflammatory bowel disease: Potential role of molecular biometrics

Accurate diagnosis of predominantly colonic inflammatory bowel disease(IBD) is not possible in 30% of patients. For decades, scientists have worked to find a solution to improve diagnostic accuracy for IBD, encompassing Crohn’s colitis and ulcerative colitis. Evaluating protein patterns in surgical pathology colectomy specimens of colonic mucosal and submucosal compartments, individually, has potential for diagnostic medicine by identifying integrally independent, phenotype-specific cellular and molecular characteristics. Mass spectrometry(MS) and imaging(I) MS are analytical technologies that directly measure molecular species in clinical specimens, contributing to the in-depth understanding of biological molecules. The biometric-system complexity and functional diversity is well suited to proteomic and diagnostic studies. The direct analysis of cells and tissues by Matrix-Assisted-Laser Desorption/Ionization (MALDI) MS/IMS has relevant medical diagnostic potential. MALDI-MS/IMS detection generates molecular signatures obtained from specific cell types within tissue sections. Herein discussed is a perspective on the use of MALDI-MS/IMS and bioinformatics technologies for detection of molecular-biometric patterns and identification of differentiating proteins. I also discuss a perspective on the global challenge of transferring technologies to clinical laboratories dealing with IBD issues. The significance of serologic-immunometric advances is also discussed.     

隐匿性肝性脑病的诊疗进展

隐匿性肝性脑病(minimal hepatic encephalopa-thy,MHE)又称亚临床肝性脑病(subclinicalhepatic encephalopathy,SHE),是慢性肝病和肝硬化最常见的严重并发症,是一种具有渐进性、可逆性的神经精神病学异常和运动功能失调特点的疾病.尽管其发病机制仍未明确,血清和中枢神经系统(central nervoussystem,CNS)血氨升高仍被认为是肝性脑病(hepatic encephalopathy,HE)的致病机制和治疗核心,并受血脑屏障改变、神经递质紊乱、氨基丁酸和苯二氮异常等因素影响.因此明确其诱发因素是HE治疗的关键.治疗药物包括抗生素、二糖类、益生菌、门冬氨酸鸟氨酸(L-ornithine-L-aspartate,LOLA)、苯甲/苯乙酸盐等.因此,对MHE的发病机制、临床诊断和治疗研究进展进行归纳,为临床诊疗提供前沿性、系统性信息,具有重要意义.     

超声弹性成像评估组织热消融范围的研究进展

肿瘤热消融技术是在现代影像学基础上诞生、发展的新技术。实时监测与术后即刻评估消融范围是保证治疗安全、取得良好疗效的关键。超声弹性成像作为一种新的超声组织定征技术,在肿瘤热疗监测方面正受到越来越多的关注。本文介绍了弹性成像在离体实验、动物实验、临床实验肿瘤热疗无创监测中的应用研究,概述了国内外研究现状,并讨论了弹性成像技术在肿瘤无创监测中的未来研究方向。     

蜂毒致急性肾损伤的研究进展

蜂毒成分复杂多样,群蜂蛰伤由于大量毒液的注入,将导致人体多系统脏器功能的损伤,肾脏损伤最常见.蜂毒致急性肾损伤的主要临床表现为血红蛋白尿、少尿甚至无尿及肾功能异常,同时也可出现水、电解质及酸碱平衡的紊乱.目前蜂毒中毒尚无特异的治疗方案,除了积极的对症支持治疗外,及时的血液净化联合肾上腺素和大剂量糖皮质激素冲击治疗对于缩短患者住院时间,改善预后非常重要.免疫治疗对蜂毒过敏的患者亦是有效的治疗方案.     

~(131)Ⅰ治疗甲状腺功能亢进症的进展

近年来国内外发表了一些~(131)Ⅰ治疗甲状腺功能亢进症(甲亢)的临床指南.这些指南表明了~(131)Ⅰ治疗甲亢在5方面的进展,包括:(1)~(131)Ⅰ治疗亚临床甲亢;(2)~(131)Ⅰ治疗Graves甲亢合并甲状腺摄碘率升高的慢性淋巴细胞性甲状腺炎;(3)~(131)Ⅰ治疗儿童和青少年甲亢;(4)~(131)Ⅰ治疗Graves眼病;(5)~(131)Ⅰ治疗难治性重度甲亢.本文简要介绍并评价有关内容.     

非AIDS患者与肺孢子菌肺炎

肺孢子菌属于真菌,随着器官移植的广泛开展、糖皮质激素和免疫抑制剂的广泛运用以及肿瘤放化疗的施行,肺孢子菌的感染出现在非AIDS患者中。鉴于近年来肺孢子菌肺炎(PCP)发病率的不断上升及较高的致死率,高危患者进行早期预防、及时得到诊断治疗对于改善其预后具有重要意义。本文旨在对非AIDS患者发生PCP的高危因素及诊治进展作一综述。     

胆管癌免疫检查点抑制剂治疗研究进展

胆管癌是一种罕见的恶性肿瘤,总体预后较差。根治性手术治疗是目前唯一可使早期胆管癌病人获得长期生存的策略。对于多数晚期胆管癌病人,系统治疗成为主要手段,但目前可用于治疗胆管癌的一线药物选择有限,疗效有限。近年来,免疫检查点抑制剂等免疫治疗策略利用宿主免疫系统进行有效的抗肿瘤反应,在多种实体肿瘤中取得令人鼓舞的结果。笔者回顾并总结免疫检查点抑制剂在治疗胆管癌中的研究进展。     

胃食管反流病的病理生理基础研究及中医外治进展

胃食管反流病(GERD)随着社会的发展,饮食结构的改变及心理压力的加重,其发病率日渐增多。迄今为止,GERD的病理生理学目前尚未完全阐明,其治疗尚无突破性的进展。近年来中医外治在此领域有所发展,就近年来有关GERD的病理生理基础研究近况作一总结,并对中医外治作一综述。