综述
腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。
In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain.This pain not only impacts the patient's postoperative experience,but can also worsen the body's internal environment and hinder recovery.Visceral pain originates from internal organs and tissues.It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs.In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals.At present,there are multiple clinical treatment options available for postoperative pain management.However,clinicians must overcome the challenge of controlling postoperative visceral pain.This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements.
综述
Wnt/β-catenin信号通路是一种在胚胎发育,细胞增殖分化、迁移,干细胞更新等中起关键作用的蛋白质家族。Wnt/β-catenin信号通路的失调常常会导致各种严重的疾病,例如肿瘤、心脏疾病、肺部疾病、肝脏疾病、骨骼疾病、神经疾病等。大量研究表明,Wnt/β-catenin信号通路在心肌纤维化发病机制中起重要作用,本文结合最新研究成果,从心肌纤维化相关疾病的角度对Wnt/β-catenin通路进行综述,为预防心肌纤维化提供新的思路,进一步达到防治心血管疾病的目的。
The Wnt/β-catenin signaling pathway is a family of proteins that play a key role in embryonic development,cell proliferation and differentiation,migration,stem cell renewal,etc.Dysfunctions of Wnt/β-catenin signaling pathway often lead to various serious diseases,such as tumor,heart,lung,liver,bone and neurological diseases,etc.Numerous studies have shown that the Wnt/β-catenin signaling pathway plays an important role in the pathogenesis of cardiac fibrosis.This article,in combination with the latest research findings,presents a review of the Wnt/β-catenin pathway from the perspective of myocardial fibrosis-related diseases,in order to provide new ideas for preventing myocardial fibrosis and achieving the goal of combating cardiovascular disease.
专家综述
通过筛查和早期发现,可以降低结直肠癌(CRC)的发病率,有效切除肿瘤病变可以降低CRC的病死率。虽然对CRC的危险因素、发病机制和前体病变的了解已经取得进展,但最近年轻人群CRC发病率升高,原因尚不清楚。在过去十年中,出现了多种侵入性、半侵入性和非侵入性筛查方式。目前对结肠镜检查质量的重视提高了筛查的有效性,人工智能等影像新技术在肿瘤检测中的作用正在迅速显现。而且,CRC有效干预措施,如保肛治疗新术式、靶向治疗及免疫治疗领域的新进展,被证明可以提高CRC患者的生存率。该文旨在总结目前国内外CRC筛查方式和指南的证据,并综述CRC治疗领域的进展。
The incidence of colorectal cancer(CRC)can be reduced through screening and early detection.Effective resection of tumor lesions reduces mortality from CRC.Although progress has been made in understanding the risk factors,pathogenesis and precursor lesions of CRC,the reasons for the recent increase in the incidence of CRC in young adults are largely unknown.A variety of invasive,semi-invasive and non-invasive screening modalities have emerged in the last decade.The current emphasis on the quality of colonoscopy has improved the effectiveness of screening,and the role of new imaging technologies such as artificial intelligence in tumor detection is rapidly emerging.Moreover,there are effective interventions for CRC,such as new surgical modalities for anal preservation therapy,and new advances in the field of targeted therapy and immunotherapy,which have been shown to improve the survival rate of CRC.The aim of this article is to summarize the current evidence on CRC screening modalities and guidelines both nationally and internationally,and to provide an overview of advances in the field of CRC treatment.
专家述评
腺苷至肌苷RNA编辑(AIRE)是指转录前体RNA在腺苷酸脱氨酶的作用下,某些位点的腺苷发生脱氨反应转变成肌苷的过程,在碱基配对时,肌苷被识别作鸟苷,导致转录组重编写。随着高通量测序技术的不断进步,大量异常的AIRE被发现可导致氨基酸编码改变、RNA剪切异常以及microRNA-mRNA重定向等过程,从而参与肿瘤的发生发展。绝大部分的AIRE位点均位于基因非编码区,解析它们的生物学功能仍存在一定的挑战。本综述旨在描述AIRE的生物学机制和AIRE位点在不同肿瘤发生发展作用的进展,为AIRE与肿瘤的研究提供思路。
Adenosine-to-inosine RNA editing(AIRE)is catalysed by adenosine deaminases acting on RNA(ADARs),which converts adenosine to inosine in nascent RNA.Since inosine is recognized as guanosine in post-transcriptional process,AIRE is functionally approximate to an A-to-G mutation and results in transcriptome recoding.With the continuous advancement of high-throughput sequencing technology,a large number of abnormal AIRE events have been found to exert different biological mechanisms such as amino acid changes,RNA splicing abnormalities and microRNA-mRNA redirection,which plays an important role in the development of human tumorigenesis.Most of AIRE sites are located in non-coding region,which brings challenges in analyzing their biological functions.This review aims to describe the biological mechanisms of AIRE and the relationship between AIRE sites and the development of different tumor types,providing ideas for the study of AIRE and tumors.
综述
阿尔茨海默病(Alzheimer's disease,AD)是一种复杂的、起病隐秘的、病因不明的、缺乏特异性诊断方式的神经退行性病变。面对与日俱增的患病率,却缺乏有效的治疗方式。中医药治疗方式具有多层次、多靶点、多通路的独特优势,中西医结合方式的互补,非药物疗法的辅助,干细胞疗法、新的分子药物、抗体及蛋白疫苗、γ感官刺激等新颖的实验阶段新疗法等方式治疗AD。本文综述近年来的不同治疗方式治疗AD研究新进展,旨在为临床上治疗AD提供新思路、新方法及参考价值。
Alzheimer's disease is a complex,secrectly onset neurodegenerative disease with unknown etiology,and lacking of specific diagnosis.In the face of the increasing prevalence,there is a lack of effective treatment ways.The treatment of traditional Chinese medicine has the unique advantages of multi-level,multi-target,and multi-channel.With the combination of traditional Chinese and Western medicine and supplement to non-drug therapy,stem cell therapy,new molecular drugs,antibodies and protein vaccines,γ sensory stimulation,and other novel experimental stage new therapies are uesd in the treatment of AD.The article focuses on the new progress of different treatment methods in the treatment of AD in recent years,aiming to provide new ideas,new methods,and reference value for the clinical treatment of Alzheimer's disease.
综述
心血管疾病是导致我国居民死亡的首要原因。在2006—2019年间,我国每年因心血管疾病死亡的人数从215万人增加到328万人。斑马鱼因个体小、成本低廉、体外发育、身体透明、基因组与人类高度同源等特点,近年来被广泛应用于医学研究。斑马鱼模型有利于推动心血管疾病领域的基础性研究。该文通过对前期研究进行综述,重点介绍了斑马鱼模型在心血管疾病中基因筛选、心脏再生、药物筛选、毒性评估等方面的研究进展。
Cardiovascular disease is the leading cause of death in China.Between 2006 and 2019,the annual number of deaths due to cardiovascular diseases increased from 2.15 million to 3.28 million.Zebrafish has been widely used in medical research in recent years because of its small individual size,low cost,in vitro development,transparent body and high homology of genome with human.The zebrafish model is conducive to promoting basic research in the field of cardiovascular disease.Based on the review of previous studies,this paper focuses on the research progress of zebrafish model in gene screening,cardiac regeneration,drug screening,toxicity assessment and other aspects of cardiovascular diseases.
专家述评
胶质瘤是颅内最常见的原发性恶性肿瘤,其分级对患者治疗方式的选择和预后至关重要。尽管目前组织病理学仍是其最为可靠的分级手段,但需通过有创性手术以获取组织样本,存在一定的风险。相较之下,磁共振成像(MRI)作为一种非侵入性影像诊断工具,在胶质瘤分级中发挥着不可或缺的作用。然而,传统MRI评估受限于医师个体主观性强和可重复性差的问题,一定程度上影响了准确的分级结果。近年来,影像组学技术的崭露头角为解决上述难题开辟了新视角,通过高通量提取影像数据特征捕捉并量化肿瘤的影像学表现,避免因主观因素而导致的不确定性,协助医师更准确地评估肿瘤的恶性程度。本文对近五年来MRI影像组学在胶质瘤术前分级预测方面的相关研究进行了简要综述,旨在为相关领域研究者提供有益的参考和借鉴,以推动MRI影像组学在临床实践中的应用。
Glioma is the most common primary malignant brain tumor,and its grading is crucial for treatment decisions and prognosis.Currently,histopathology remains the gold standard for grading,but it requires invasive procedures and carries inherent risks.In contrast,magnetic resonance imaging(MRI),a non-invasive diagnostic tool,plays an indispensable role in glioma grading.However,traditional MRI assessment is hampered by interobserver subjectivity and limited repeatability,which compromise grading accuracy.In recent years,radiomics,a burgeoning field,has offered a promising solution to address these challenges.By extracting high-dimensional imaging data features,radiomics enables the quantification of tumor radiological characteristics and elimination of subjectivity-related discrepancies.This technology assists clinicians in more precisely assessing the malignancy of gliomas.This article summarizes relevant studies in the past five years on the application of MRI radiomics in preoperative glioma grading,aiming to provide valuable insights and guidance to researchers in the field and promote the clinician implementation of MRI radiomics.
综述
脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。
Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients.Warm needling is a characteristic therapy of traditional Chinese medicine.In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice.This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application.
专家述评
血友病是一种由于X染色体上凝血因子基因突变所致的遗传性出血性疾病,目前主要的治疗方法是凝血因子替代疗法。但长期频繁的注射用药往往导致患者依从性差,容易产生抑制性抗体,从而影响治疗效果。虽然现在延长半衰期的新型凝血因子药物、人源化双特异性抗体以及抗组织因子途径抑制剂单克隆抗体等用于疾病治疗,在给药方式和作用持续时间上已有很大进步,但它们仍无法治愈血友病。因此,以疾病根治为重要目标的基因治疗被设计出来,近年来受到了广泛的关注。该文介绍了血友病基因治疗的原理、基因治疗载体的选择、基因治疗预处理方案,总结了现阶段基因治疗临床应用的安全性和有效性;最后讨论基因治疗目前存在的问题以及未来发展方向。
Hemophilia is a genetic bleeding disorder resulting from mutations in coagulation factor genes on the X chromosome.The mainstay of current treatment is coagulation factor replacement therapy.However,frequent and long-term injections often lead to poor patient compliance,easy inhibitor development,and compromised therapeutic efficacy.Despite advancements in delivery methods and prolonged action of novel agents such as extended half-life coagulation factor concentrates,humanized bispecific antibodies,and anti-tissue factor pathway inhibitor monoclonal antibodies,these approaches still fall short of curing hemophilia.Consequently,gene therapy,aiming for disease eradication,has garnered significant attention in recent years.This review delves into the principles of gene therapy,the selection of gene therapy vectors,and gene therapy preconditioning regimens.It summarizes the safety and efficacy of gene therapy in current clinical applications and discusses challenges and future directions in this field.
综述
肝癌患者因食欲降低、进食减少导致不同程度的营养不良,引发厌食症,甚至恶病质,严重影响患者生存质量。食欲评估是降低营养风险的基础,医护人员可通过食欲症状的评估调整患者饮食及营养指导措施,以改善患者营养状态,提高生存质量。该文对食欲的评估工具、方法及干预在肝癌营养不良患者中的应用现状进行阐述,为肝癌患者的食欲干预提供科学依据。
Hepatocellular carcinoma patients suffer from different degrees of malnutrition due to decreased appetite and eating,which triggers anorexia and even cachexia,seriously affecting the quality of patient survival.Appetite assessment is the basis for reducing nutritional risk,and healthcare professionals can adjust patients’ diet and nutritional guidance measures through the assessment of appetite symptoms in order to improve patients’ nutritional status and survival quality.In this paper,the current status of the assessment tools,methods and interventions of appetite in malnutrition patients with hepatocellular carcinoma are described to provide a scientific basis for appetite interventions.