Extensive hepatectomy can achieve a higher chance of radical resection of lesions in the hepatobiliary system, but the risk of fatal complications of severe liver failure after surgery also increases accordingly. Therefore, enhancing the liver’s regenerative capacity has always been a hot topic in clinical research. Portal vein blood supply is of great significance for maintaining the normal function of the liver and promoting the repair and proliferation of damaged liver tissue. After selectively altering the blood flow distribution in the portal vein, atrophy or proliferation will occur in different liver lobes. The discovery of the important physiological phenomenon of liver regeneration induced by deportalized blood flow of portal vein has made it possible to promote the volume growth and functional enhancement of the residual liver lobes before hepatectomy, and various technical schemes have been applied and developed in clinical practice. The interim research results show that the portal vein embolization technique is mature, has less trauma, but the induction speed is relatively slow. Portal vein combined with hepatic vein embolization has better induction efficacy and does not increase embolism-related complications, and has a wider range of applications. The induction ability of associating liver partition and portal vein ligation for staged hepatectomy is significant, but the surgical trauma is large, and there are higher requirements for perioperative management. There is a clear correlation between high surgical volume centers and technical improvements and a significant reduction in complications. Resection and partial liver transplantation with delayed total hepatectomy not only break through the bottlenecks of safety and ethical requirements for living donor liver transplantation in adults, but also innovate and enrich the second-stage extensive hepatectomy schemes. However, their technical standards and application scope still need more high-quality research evidence to support them.
Lung cancer is a complex disease with its own challenges, and is considered to be one of the most common causes of cancer death worldwide. The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exacerbated these challenges. The aim of this review is to explore the impact of the COVID-19 pandemic on the screening, diagnosis and treatment of lung cancer. We hope to provide some experience and help for the whole process management of lung cancer patients.
Pathological and molecular testing of gastric cancer is a prerequiste for precise treatment. Routine testing for human epidermal growth factor receptor 2 (HER2), microstatellite instability/mismach repair, programmed cell death ligand 1 combined positive score, Claudin18.2 are recommended. Locally advanced gastric cancer progress to metastasis or positive free cancer cells in abdoimnal cavity is greater than 20%, laparoscopic exploration and staging is recommended before neoadjuvant therapy. Positive free cancer cells in the peritoneal cavity are one of the main forms of peritoneal metastasis in gastric cancer. Rapid frozen section examination of peritoneal lavage fluid can significantly increase the positive rate. Accurate ex vivo dissection of lymph nodes after D2 radical gastrectomy is an important meansure to ensure surgical quality, precisely evaluate prognosis, and formulate individualized adjuvant therapy regimens. Perioperative SOX chemotherapy for locally advanced gastric cancer has become a Chinese paradigm, and perioperative immunotherapy has emerged as a new standard. Preliminary results have also been achieved in the exploration of neoadjuvant target-immuno-chemotherapy for HER2 positive locally advanced gastric cancer, as well as neoadjuvant therapy with bispecific antibody (AK104) combined with SOX for HER2 negative gastric cancer. For advanced gastric cancer with peritoneal metastasis, paclitaxel dual-path chemotherapy can improve the R0 resection conversion rate and long-term survival of patients. For patients with potentially resectable gastric cancer with liver metastasis, active comprehensive treatment based on multidisciplinary team model an significantly imporve the R0 resection conversion rate. Target-immuno-chemotherapy for conversion therapy in stage Ⅳ gastric cancer can significantly improve the pathological complete response rate and long-term survival of patients after conversion surgery.
Objective To cultivate human retinal capillary endothelial cells (HRECs) and establish two-dimensional model of human retinal vessels in vitro. Methods In a fibronectincoated raising pound, HRECs were cultured by non-serum human-endothelial-cells substrate and two-dimensional model of human retinal vessels was established. Horseradish peroxidase was used to detect the permeability. Some of the vascular models were cultivated with 5 ng/ml vascular endothelial growth factor (VEGF), whose changes of permeability was compared with which of the models without cultivation with VEGF. The effect of VEGF on vascular permeability was observed. Results Meshy vascular structure came into being due to the confluent HRECs after 2 to 4 days. Comparatively complete two-dimensional vascular model after about 6 days. VEGF increased vascular permeability and promoted the formation of blood vessels. Conclusion HRECs can be cultivated successfully with human-endothelial-cells substrate; standard retinal two-dimensional vascular model in vitro can be established by using cellular raising pound and non-serum human-endothelial-cells substrate. (Chin J Ocul Fundus Dis, 2006, 22: 110-112)
Thoracic duct is the largest lymphatic vessel in the body. It originates from the chyle pool in the abdominal cavity, upward across aortic hiatus of the diaphragm into the right thoracic cavity, and finally importing into the left jugular vein angle. Thoracic duct plays a very important role in the transporting process of the body's lymph and chylous fluid. More than 70% of the lymph and chylous fluid transport through it into the blood. If the thoracic duct was damaged, it would lead to fluid and electrolyte imbalance, immune dysfunction, malnutrition and the patient's life would be endangered when it was serious. Therefore, the clinical significance of the thoracic duct is always a hot research issue. Through unremitting exploration in recent years, we have a further understanding about structure and function of the thoracic duct. And we used this to remould and ligate it to cure some intractable disease. Now we summarize the research progress as follows.
目的:探討鼻(面)罩無創雙水平氣道正壓通氣(BiPAP)在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的治療作用。方法:入選病例60例,分為常規治療組28例,采用常規治療;呼吸機治療組32例,在常規資料基礎上加用BiPAP無創呼吸機治療,兩組患者心率,呼吸頻率,血氣分析比較。結果:呼吸機治療組患者心率,呼吸頻率,血氣分析的改善優于常規治療組,差異有統計學意義(Plt; 0.05)。結論:無創雙水平氣道正壓機械通氣輔助治療COPD合并Ⅱ型呼吸衰竭具有肯定的療效,能更快地緩解患者的臨床癥狀;提高PaO2,SaO2和降低PaCO2;能更好地促進病情的恢復,減少住院時間。