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目的 探讨高频超声对小儿梅克尔憩室所致肠梗阻的诊断价值。方法 选取广州市妇女儿童医疗中心2018年1月—2023年12月经手术证实的由梅克尔憩室引起的肠梗阻患儿41例作为研究对象,回顾性分析患儿临床资料及超声表现,并与术中所见和病理结果进行对照。结果 41例患儿,发病平均年龄为(3.97±3.69)岁,其中男32例、女9例。术前超声诊断肠梗阻38例,诊断符合率为92.7%;诊断梅克尔憩室所致肠梗阻9例,诊断符合率为21.9%。术中诊断梅克尔憩室索带卡压肠管24例,腹内疝8例,肠扭转1例;肠套叠10例;梅克尔憩室炎症、粘连6例,粘连穿孔1例;憩室内异物并穿孔1例。结论 高频超声对小儿肠梗阻有重要的诊断价值,仔细探查可以明显提高梅克尔憩室所致肠梗阻的临床诊断率,为临床尽早手术提供重要依据。
Objective To investigate the diagnostic value of high frequency ultrasound for intestinal obstruction caused by Meckel's diverticulum in children.Methods From January 2018 to December 2023,41 children with intestinal obstruction caused by Meckel's diverticulum were selected as the study objects.The clinical data and ultrasound images of the children were analyzed retrospectively,and compared with the intraoperative and pathological results.Results In 41 patients,the average age of onset was(3.97±3.69)years ,including 32 males and 9 females.Preoperative ultrasonic diagnosis of intestinal obstruction in 38 cases,diagnosis coincidence rate was 92.7%.Intestinal obstruction caused by Meckel's diverticulum was diagnosed in 9 cases,the diagnosis coincidence rate was 21.9%.During the operation,24 cases of Meckel's diverticulum intestinal compression were diagnosed,8 cases of abdominal hernia,1 case of intestinal torsion,and intussusception of 10 cases.Meckel's diverticulum had inflammation and adhesion in 6 cases and adhesion perforation in 1 case.A case of foreign body in diverticulum with perforation.Conclusions High-frequency ultrasound has an important diagnostic value for intestinal obstruction in children.Careful exploration can significantly improve the clinical diagnosis rate of intestinal obstruction caused by Meckel's diverticulum,and provide an important basis for early clinical operation.
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目的 探讨表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKIs)一线治疗耐药后,二线化学治疗(化疗)联合程序性死亡蛋白1及其配体(PD-1/L1)免疫检查点抑制剂方案对晚期非小细胞肺癌(NSCLC)的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期(PFS),化疗前后血清中人细胞角蛋白21-1片段(Cyfra21-1)、糖类抗原125(CA125)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组(P<0.05),对照组PFS为10(2.38,24.13)个月,观察组PFS为14(5.27~,5.27)个月,观察组高于对照组(χ2=4.536,P=0.041);化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[(17.85±3.32)ng/L、(310.51±88.37)ng/L、(51.62±13.66)U/mL、(10.26±3.37)ng/mL]低于对照组[(19.62±3.24)ng/L、(366.26±49.42)ng/L、(59.26±9.35)U/mL、(12.62±2.73)ng/mL],对比差异有统计学意义(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001);两组不良反应发生率对比差异无统计学意义(P>0.05);化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[(98.62±8.24)、(101.53±12.62)、(95.28±11.15)、(97.79±10.47)分]高于对照组[(84.25±7.32)、(93.58±15.75)、(82.24±9.34)、(83.47±8.38)]分,对比差异有统计学意义(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001)。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。
Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer(NSCLC) after epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)resistance in first-line chemotherapy.Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022.Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group.The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live.Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared.Results The ORR and DCR of the observation group were significantly higher than those of the control group(P<0.05).The mean PFS of the control group was 10(2.38-24.13)months,while the mean PFS of the observation group was 14(5.27-35.27)months.The observation group was higher than the control group(χ2=4.536,P=0.041).After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [(17.85±3.32)ng/L,(310.51±88.37)ng/L,(51.62±13.66)U/mL,(10.26±3.37)ng/mL] was lower than the control group [(19.62±3.24)ng/L,(366.26±49.42)ng/L,(59.26±9.35)U/mL,(12.62±2.73)ng/mL],which showed statistically significant difference in the comparison(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[(98.62±8.24),(101.53±12.62),(95.28±11.15),(97.79±10.47)] were higher than the control group scores[(84.25±7.32),(93.58±15.75),(82.24±9.34),(83.47±8.38)],which showed statistically significant difference.(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001).Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients.
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目的 应用高频超声观察眼轮匝肌的解剖信息和动态特征,探究肉毒毒素注射前超声评估的可行性,为个体化、精准化的治疗提供可能,以实现更加安全、更加高效的治疗效果。方法 采用高频超声获取40名20~30岁健康志愿者的双侧80条眼轮匝肌的长轴、短轴切面声像图,观察其全程形态、内部回声,并测量外眦水平眼轮匝肌最外侧缘与外眦之间的距离、外眦水平眼轮匝肌最厚处的前后径、外眦水平眼轮匝肌最厚处与表皮之间的距离,并对数据进行统计学分析。结果 高频超声可以清晰地显示眼轮匝肌全程的走形和整体肌束结构。微笑时可见外眦外侧的眼轮匝肌向内收缩,并出现不同程度的增厚。男性和女性外眦水平眼轮匝肌最外侧缘与外眦之间的距离分别为左侧(27.50±2.58)(25.32±2.17)mm,右侧(27.35±2.15)(25.11±2.08)mm;外眦水平眼轮匝肌最厚处的前后径分别为左侧(1.055±0.209)(0.770±0.172)mm,右侧(1.010±0.171)(0.775±0.162)mm;外眦水平眼轮匝肌最厚处与表皮之间的距离分别为左侧(2.450±0.274)(2.860±0.375)mm,右侧(2.430±0.252)(2.825±0.424)mm。上述3种指标在左右侧对比差异无统计学意义(P>0.05)。与男性对比,女性外眦水平皮下组织较厚、眼轮匝肌较薄,其最外侧缘与外眦之间的距离较短(P<0.05)。结论 高频超声为观察青年人群眼轮匝肌结构的有效影像学工具,可用于肉毒毒素注射前的面部评估。
Objective To observe the anatomical information and dynamic characteristics of the orbicularis oculi muscle by high-frequency ultrasound,to explor the feasibility of ultrasound evaluation before botulinum toxin injection,and to provide the possibility for personalized and precise treatment to achieve safer and more efficient therapeutic effects.Methods High frequency ultrasound was used to obtain long axis and short axis sectional ultrasound images of 80 bilateral orbicularis oculi muscles from 40 healthy volunteers aged 20-30.The overall morphology and internal echoes were observed,and the distance between the outermost edge of the orbicularis oculi muscle and the outer canthus,the anterior posterior diameter of the thickest part of the orbicularis oculi muscle at the outer canthus level,and the distance between the thickest part of the orbicularis oculi muscle and the epidermis at the outer canthus level were measured.Statistical analysis was performed on the data.Results High frequency ultrasound can clearly display the entire course of the orbicularis oculi muscle and the overall muscle bundle structure.When smiling,the orbicularis oculi muscle on the outer side of the outer canthus can be seen to contract inward and show varying degrees of thickening.The distance between the outermost edge of the orbicularis oculi muscle and the outer canthus of males and females were(27.50±2.58)(25.32±2.17)mm on the left side and(27.35±2.15)(25.11±2.08)mm on the right side,respectively.The anterior posterior diameters of the thickest part of the orbicularis oculi muscle at the level of the outer canthus were left(1.055±0.209)(0.770±0.172)mm and right(1.010±0.171)(0.775±0.162)mm,respectively.The distance between the thickest part of the orbicularis oculi muscle at the level of the outer canthus and the epidermis were(2.450±0.274)(2.860±0.375)mm on the left side and(2.430±0.252)(2.825±0.424)mm on the right side.There was no statistically significant difference in the comparison of the above three indicators on the left and right sides(P>0.05),while there was a statistically significant difference in the mean values of both males and females(P<0.05).Compared with males aged 20-30,females had thicker subcutaneous tissue at the level of the outer canthus and thinner orbicularis oculi muscle,with a shorter distance between the outermost edge and the outer canthus. Conclusions High frequency ultrasound is an effective imaging tool for observing the structure of the orbicularis oculi muscle in young population,and can be used for facial assessment before botulinum toxin injection.
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目的 利用靶向二代测序技术探究天津市发热呼吸道症候群病原特征,分析病原流行特征,总结规律,为发热伴呼吸道症候群患者治疗策略提供指导。方法 收集2023年1月—2023年12月天津地区某四家医院初诊为发热伴呼吸道症候群的4 039例病例,通过tNGS技术检测,分析鉴定病原微生物,研究不同标本类型病原微生物分布、年龄分布、性别分布、不同时间季节感染分布、微生物类型分布趋势等。结果 4 039例经tNGS技术检测,共检测出90种潜在病原体,总阳性率为94.80%(3 829/4 039)。包括36种细菌、29种病毒、5种非典型病原体和20种真菌。不同种类病原体检出频次排序:革兰阴性细菌(G-细菌)>RNA病毒>DNA病毒>革兰阳性细菌(G+细菌)>真菌>非典型病原体。男女性别阳性检出率比较差异无统计学意义(χ2=0.249,P=0.618);不同年龄段人群病原体谱有异质性,且阳性患者多分布在0~10岁和>60岁,阳性也集中在该两类人群,阳性率分别为47.90%(1 834/3 829)和31.24%(1 196/3 829)。在单一感染中,肺炎支原体占比最高,为4.91%,其次为新型冠状病毒,占1.59%,再次为呼吸道合胞病毒,占1.23%。不同季节不同感染类型具有差异,整体呈现夏冬季混合感染率高的特点,即夏季新冠病毒合并细菌(鲍曼不动杆菌、肺炎链球菌),冬季肺炎支原体合并甲型、乙型流感病毒多见。肺炎支原体对大环内酯类药物耐药率随月份呈现增加趋势。结论 tNGS 技术在天津市发热呼吸道症候群样本中获得了较高的病原体检出率,病原体覆盖面广,通过提供更多的病原体信息,可以有效辅助鉴别混合感染和耐药信息。
Objective Using targeted next-generation sequencing technology to explore the composition of the pathogenic spectrum of febrile respiratory syndrome ,analyze the epidemic characteristics of the pathogen,summarize the rules,and provide accurate guidance for the treatment strategy of patients with febrile respiratory syndrome.Methods By tNGS detection of 4039 cases with fever with respiratory diseases in four hospitals in Tianjin in 2023,pathogenic microorganisms were analyzed and identified,and the distribution of pathogenic microorganisms,age distribution,gender distribution,infection distribution in different times and seasons,and distribution trend of microbial types in different specimen types were studied.Results In 4039 cases,90 potential pathogens were detected,the total positive rate was 94.80%(3 829/4 039),including 36 kinds of bacteria,29 kinds of viruses,5 kinds of atypical pathogen and 6 kinds of fungi.The order of detection frequency of different types of pathogens:G-bacteria > RNA virus > DNA virus > G+ bacteria > fungi > atypical pathogens.There was no significant difference in the positive rate of male and female between the two groups(χ2=0.249,P=0.618).The pathogen spectrum of different age groups was heterogeneous. The positive patients were mostly distributed in 0-10 years old [47.90%(1 834/3 829)] and >60 years old [31.23%(1 196/3 829)].Among the single infection,Mycoplasma pneumoniae accounted for the highest proportion,4.91%(188/3829),followed by 2019-nCoV,1.59%(61/3 829),and respiratory syncytial virus,1.23%(47/3 829).There were differences in different infection types in different seasons,and the overall characteristics of mixed infection rate in summer and winter were high. In summer,the new coronavirus was combined with bacteria(Acinetobacter baumannii,Streptococcus pneumoniae),and in winter,Mycoplasma pneumoniae was combined with influenza A and B viruses.The resistance rate of Mycoplasma pneumoniae to macrolides showed an increasing trend with the time.Conclusions The tNGS technology had obtained a high pathogen detection rate in the samples of febrile respiratory syndrome in Tianjin.By providing more pathogen information,it can be effectively applied to the etiological diagnosis of respiratory infectious diseases and assist in the identification of mixed infections and drug resistance information.
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目的 调查护理人员对预防跌倒知识掌握的情况,以提高其对防跌倒相关知识的认知水平,减少住院患者跌倒的发生。方法 用自编住院患者跌倒相关知识掌握量表对护理人员进行问卷调查。结果 护理人员对跌倒知识的掌握正确率最高为跌倒分级64.04%、最低为跌倒后干预措施17.10%。外科护理人员对患者跌倒风险评估时机的把握为88.69%,妇儿科护理人员的正确率(71.11%)高(χ2=21.319,P=0.003),住院患者发生跌倒后的处理正确率急诊为76.67%,高于门诊的42.67%(χ2=27.651,P<0.001);在把握患者跌倒风险评估的时机方面工作年限<5年的护理人员为 89.81%,比工作年限>20年的护理人员(64.15%)更容易把握患者跌倒风险评估的时机(χ2=18.921,P<0.001),工作年限11~20年的护理人员对住院患者预防跌倒的干预措施正确率为24.66%,比工作年限<5年的护理人员(11.46%)高(χ2=9.678,P=0.022);工作年限>20年的护理人员对住院患者发生跌倒后的处理正确率为58.49%比工作年限<20年以下的护理人员(34.25%)高(χ2=12.787,P=0.005)。结论 护理人员跌倒预防相关知识掌握度总体较低,应加强对护理人员关于患者跌倒预防知识的系统培训,减少住院患者跌倒的发生。
Objective To investigate the mastery of falls prevention knowledge among nursing staffs,in order to improve their cognitive level of falls prevention related knowledge and reduce the occurrence of falls in hospitalized patients.Methods A questionnaire survey was conducted among nursing staffs with a self-designed questionnaire on the mastery of falls related knowledge among hospitalized patients.Results The highest accuracy rate of nursing staffs' mastery of falls knowledge was 64.04% for falling classification,and the lowest was 17.10% for falls intervention measures.Nursing staffs' accuracy of the timing of patient fall risk assessment was 88.69% in surgery,which was higher than 71.11% in nursing staff in obstetrics,gynecology,and pediatrics(χ2=21.319,P=0.003).The accuracy of emergency treatment for hospitalized patients after falls was 76.67%,which was higher than 42.67% in outpatient treatment(χ2=27.651,P<0.001).The accuracy of the timing of patient fall risk assessment in nursing staffs with less than 5 years of work experience was 89.81%,which was better than nursing staff with more than 20 years of work experience(64.15%)(χ2=18.921,P<0.001).Nursing staff with 11-20 years of work experience had a correct intervention rate for preventing falls in hospitalized patients of 24.66%,which was higher than nursing staffs with less than 5 years of work experience(11.46%)(χ2=9.678,P=0.022).The accuracy rate of handling falls in hospitalized patients by nursing staffs with more than 20 years of work experience was 58.49%,which was higher than that of nursing staff with less than 20 years of work experience,which is 34.25%(χ2=12.787,P=0.005).Conclusions Overall,nursing staff had a low level of falls prevention knowledge,and systematic training on patient fall prevention should be strengthened to reduce the occurrence of falls in hospitalized patients.
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目的 探讨人外周血中炎症因子的表达与炎性衰老的相关性。方法 通过招募年轻和老年志愿者,检测外周血中炎症因子IL-6、IL-8、TNF-α和IL-1β的mRNA表达水平和蛋白水平。结果 显示老年个体组中IL-6,IL-8和TNF-α的mRNA表达水平高于年轻组,且蛋白水平呈现相同的趋势,比较差异均有统计学意义(P<0.05)。此外,通过热图分析了炎症因子mRNA和蛋白水平的相对表达谱,也发现相同的结果。结论 当年龄超过65岁以后,随着年龄的增长,体内的炎症因子表达水平会升高,这一结果具有成为炎性衰老生物标志物的潜力,对评估老年人的健康状况和疾病风险具有重要意义。
Objective To explore the correlation between the expression of inflammatory factors in human peripheral blood and inflamm-aging.Methods In this experiment,the young and old volunteers were recruited to detect mRNA and protein levels of IL-6,IL-8,TNF-α and IL-1β in peripheral blood.Results The results indicated that mRNA expression levels of IL-6,TNF-α and IL-8 in the old individuals were higher than the young individuals,and the protein concentration followed the same trend,with acceptable P value suggesting a great statistically significant difference.In addition,the relative expression profiles of mRNA and protein concentrations of inflammatory cytokines were analyzed by heat map,and the same results were found.Conclusions It shows that the expression level of inflammatory cytokines up-regulates along with age goes on over 65,which has the potential of inflammatory biomarkers of aging.
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目的 建立针对炎症性肠病患者的运动锻炼方案。方法 通过系统检索Web of Science、Embase、Cochrane Library等数据库,综合相关文献并由两名研究者独立提取信息,制定出指导患者运动锻炼的方案。检索时间从建库截至2023年9月1日。结果 共筛选出12篇文献,包括指南、专家共识、Meta分析以及RCT试验。最终总结出运动的必要性、作用、适合人群、评估及筛选、运动方式选择、监测以及限制因素等7个方面,共计37条证据。结论 这些证据为轻中度炎症性肠病患者提供了有氧运动联合抗阻运动的最佳实践依据,可指导临床实践,规范运动训练,从而延缓疾病进展。
Objective To establish an exercise program for patients with inflammatory bowel disease(IBD).Methods A systematic search was conducted in databases such as Web of Science,Cochrane Library,and Embase,with relevant literature being comprehensively reviewed.Information was independently extracted by two researchers to develop a program guiding patients' exercise.Searching terms included both Chinese and English keywords,with the searching period covering from the inception of the databases to September 1,2023.Results A total of 12 articles were screened,including guidelines,expert consensuses,Meta-analyses,and randomized controlled trials.Ultimately,37 pieces of evidence were summarized across seven aspects:the importance of exercise,suitable populations,assessment and screening,choice of exercise modes,monitoring and limiting factors.Conclusions These evidences provide the best practice basis for aerobic and resistance exercises in patients with mild to moderate IBD,guiding clinical practice,standardizing exercise training,and thus delaying disease progression.
论著
目的 探讨Yes1相关蛋白(YAP)及p65在弥漫大B细胞淋巴瘤(DLBCL)中与临床特征的相关性及对DLBCL治疗和预后的意义。方法 收集65例DLBCL和10例反应性增生淋巴结患者组织进行免疫组织化学染色,分析两组差异;对多种临床特征与YAP、p65的相关性进行统计学和生存差异性分析。结果 YAP、p65染色评分在两组间比较差异有统计学意义(P<0.05);YAP评分与疗效分组呈正相关,与治疗前乳酸脱氢酶(LDH)、Ann-Arbor分期、国际预后指数(IPI)呈负相关(P<0.05);p65表达与疗效分组呈负相关,与治疗前LDH水平、Ann-Arbor分组、美国东部肿瘤协作组活动状态评分(ECOG)ECOG分组、结外侵犯、IPI评分、巨大包块呈正相关(P<0.05)。IPI及p65评分是DLBCL患者总生存期(OS)的独立危险因素(P<0.05)。共表达分层中YAP-/p65+组患者OS均值最低。结论 对于DLBCL,YAP低表达或p65高表达提示患者瘤荷较大、较差的疗效和预后。
Objective To investigate the correlation of YAP and p65 with clinical features in diffuse large B-cell lymphoma(DLBCL)and the significance for treatment and prognosis.Methods Tissues from 65 patients with DLBCL and 10 patients with reactive hyperplasia lymph node were collected for immunohistochemistry staining to analyze the differences between the two groups;statistical analysis and survival difference analysis of the correlation between various clinical features and YAP,p65 were performed.Results YAP and p65 staining scores were significantly different between the two groups(P<0.05).YAP scores were positively correlated with efficacy subgroups,and negatively correlated with LDH levels before treatment,Ann-Arbor staging,and International Prognostic Index(IPI)scores before treatment(P<0.05);p65 expression was negatively correlated with efficacy subgroups,and positively correlated with pretreatment LDH levels,Ann-Arbor subgroup,ECOG subgroup,extra-nodal invasion,IPI scores,and huge mass(P<0.05).IPI and p65 score were independent prognostic risk factors for overall survival(OS) in DLBCL patients(P<0.05).The mean value of OS was the lowest in patients in the YAP-/p65+ group in the co-expression stratification.Conclusions Low expression of YAP or high expression of p65 suggests larger tumor load and poorer outcome and prognosis in patients for DLBCL.
专家述评
乳腺癌是女性最常见的原发恶性肿瘤之一。目前,通过采用综合治疗手段,包括手术、新辅助治疗、辅助放化疗等多种手段,乳腺癌已成为疗效最佳的实体肿瘤之一。其中,新辅助治疗(NAT)包括新辅助化疗、靶向治疗和内分泌治疗,目的是使肿瘤降期、保乳、保腋窝,并可观察药物敏感性,是当前乳腺癌综合治疗中非常重要的组成部分,其治疗疗效对患者手术方式的选择和预后至关重要。尽管病理学评价在评估NAT疗效方面被公认为金标准,但其局限性在于只能通过有创手段在治疗后进行,无法在治疗前对患者做出准确预测。磁共振成像(MRI)作为一项广泛使用的乳腺成像技术,在评估NAT疗效中扮演着关键角色。近年来,人工智能技术,尤其是影像组学(Radiomics)和深度学习(Deep Learning),在医学影像分析领域取得了显著进展。这些技术能够从医学图像中提取大量肉眼难以识别的特征,揭示病变内部的微观结构和生物学行为,全面反映肿瘤的异质性,这不仅有助于临床医生更准确地区分良、恶性肿瘤,还能对恶性肿瘤的预后进行更为精确的评估。本文系统综述了近年来基于MRI的人工智能技术在乳腺癌新辅助治疗疗效评估中的应用研究,旨在促进人工智能在NAT临床实践中的应用和发展,为乳腺癌NAT治疗策略的优化和个性化医疗的实现提供科学依据。
Breast cancer is one of the most common primary malignant tumors in women.Currently,breast cancer has become one of the most effective solid tumors by using comprehensive treatment methods,including surgery,neoadjuvant therapy,adjuvant radiotherapy and chemotherapy.Among them,neoadjuvant therapy(NAT),including neoadjuvant chemotherapy,targeted therapy and endocrine therapy,is a very important part of the current comprehensive treatment of breast cancer.It aims to reduce the tumor stage,preserve the breast,preserve the armpit,and observe the drug sensitivity.Its therapeutic effect is crucial to the choice of surgical methods and prognosis of patients.Although pathological evaluation is recognized as the gold standard in evaluating the response to NAT,its limitation is that it can only be performed after treatment by invasive means,and cannot accurately predict response before treatment.As a widely used breast imaging technology,magnetic resonance imaging(MRI)plays a key role in evaluating the response to NAT.However,traditional MRI evaluation methods are limited by the individual differences of interobserver and the low repeatability of evaluation results,which affects the accuracy of efficacy evaluation to a certain extent.In recent years,artificial intelligence technology,especially radiomics and deep learning,has made significant progress in the field of medical image analysis.These techniques can extract a large number of features that are difficult to be recognized by the naked eye from medical images,reveal the internal microstructure and biological behavior of the lesion,and fully reflect the heterogeneity of the tumor.This not only helps clinicians to distinguish benign and malignant tumors more accurately,but also makes a more accurate assessment of the prognosis of malignant tumors.This article reviews the application and progress of MRI-based artificial intelligence technology in evaluating the response to neoadjuvant therapy for breast cancer in the past five years,aiming to promote the application and development of artificial intelligence in NAT clinical practice,and provide a scientific basis for the optimization of NAT treatment strategy and the realization of personalized medicine for breast cancer.
综述
蒜氨酸为大蒜氨基酸成分,对机体无毒副作用,在体内代谢酶作用下分解成大蒜素,具有多种药理作用和广阔的临床应用前景。本文就蒜氨酸的分离提取、制剂及生物活性研究现状进行综述,以供参考。
Alliin is an amino acid component of garlic, no toxic side effects to the body. It breaks down into allicin by metabolic enzymes in the body, has a variety of pharmacological effects and broad clinical application prospects. In this paper, the isolation, extraction, preparation and biological activity of alliin were reviewed for reference.