Objective To further comprehend the definition， molecular mechanism， and clinical significance of perineural invasion （PNI） so as to explore new therapy for the tumors. Methods The literatures about the definition， molecular mechanism， and clinical study of PNI were reviewed and analyzed. Results At present， widely accepted definition of PNI was that at least 33% of the circumference of the nerve should be surrounded by tumor cells or tumor cells within any of three layers of the nerve sheath. The newest theory on molecular mechanism of PNI was that PNI was more like infiltration， invasion， not just diffusion. “Path of low-resistance” and “Reciprocal signaling interactions” were the main theories. More recently， the studies had demonstrated that “Reciprocal signaling interactions” could more clearly explain the mechanism of PNI. Stromal elements， including fibroblasts， seemed to play a key role in the complex signaling interactions driving PNI. Neurotrophins and axonal guidance molecules had been implicated in promoting the progress of PNI. PNI was a prognosis index in the cancers of the head and neck， stomach， pancreas， colon and rectum， and prostate， which was positive indicated that the patients would have a poor prognosis and a low 5-year survival rate. Conclusions The mechanism of PNI is very complex， and its clear mechanism is still undefined. Keeping on researching the mechanism of PNI could provide theoretical foundation to disclose the mechanism and the therapy of PNI.
The significant increase in mortality after tuberculosis (TB) progression to severe disease is a major obstacle to achieving the goal of ending the TB epidemic by 2035. Up to now, there is no clear definition and diagnostic criteria for adult severe tuberculosis at home or abroad, which has a significant adverse impact on the early diagnosis and timely treatment of patients with severe tuberculosis. In order to improve the treatment level of patients with severe pulmonary tuberculosis, reduce mortality and improve prognosis. The Professional Committee of Tuberculosis Science of the Chinese Society of Research Hospitals and Shenzhen Third People's Hospital/National Clinical Medical Research Center of Infectious Diseases/Shenzhen Tuberculosis Clinical Medical Research Center led the formulation of "Guidelines for definition and diagnosis of severe pulmonary tuberculosis in adults in China (2023)", aiming to guide and standardize the definition and diagnosis of severe tuberculosis. So as to improve the level of diagnosis and treatment of severe pulmonary tuberculosis in our country, to maximize the benefit of patients.
Through summarizing the definition, concept, and development of patient registry, and also retrieving ClinicalTrials.gov, we introduce its application areas, application range, disease, research number. Based on the application situation, we present the challenges faced now and future development of direction.
ObjectivesTo summarize the latest advances about definition, classification, and TNM stage of adenocarcinoma of esophagogastric junction (AEG).MethodThe available guidelines, consensuses, international conference proceedings, and clinical studies were reviewed and summarized.ResultsThe AEG trended to be an independent entity of malignant tumor at the special location. The previous misunderstanding of AEG definitions from the WHO needed to be corrected and unified in China. The Siewert classification was still a practical clinical approach to guiding treatment strategy, while the new draft of JGCA classification needed to be evaluated and verified in the clinical practice. By contrast, the 8th edition AJCC/UICC classification was relatively controversial in the guiding treatment strategies, mainly due to the staging system, surgical approach, and extent of lymphadenectomy of Siewert Ⅱ type AEG. Based on the available research results, the TNM staging system of the 8th edition of gastric cancer tended to be more reasonable for the Siewert Ⅱ and Ⅲ types AEG.ConclusionWith increasing incidence of AEG, more experimental and clinical studies on AEG are ongoing, and it is expected to have more optimized classification and exclusive staging system for AEG in future.
Bias in clinical trials or systematic reviews may result in overestimation or underestimation of the benefits or harms of the interventions, and conclusions may be false. Meta-epidemiological study is an important tool to identify and quantify the impact of potential bias characteristics, and it can provide empirical evidence for controlling the bias. This paper summarized the origin, development and definition of the meta-epidemiology study, and discussed the challenges and development trends, so as to provide references for carrying out the meta-epidemiological studies.
ObjectiveTo summarize the terms and definitions related to neurofibromatosis type 1 (NF1) with a view to standardizing and unifying the existing terminology system. Methods To review the research literature related to NF1 at home and abroad, and to summarize the expressions of the disease and related terms. Results There are still some limitations in the current knowledge of NF1, especially in the expression of the terminology, and there are discrepancies in the description and naming of NF1-related features in different medical literatures and clinical guides. There are differences in the description and naming of NF1-related features in different medical literature and clinical guidelines. Through a systematic review of the literature, this paper provides a detailed compendium and summary of the terms and definitions of NF1-related clinical manifestations, pathological features, and genetic types, and further standardizes and unifies existing diagnostic criteria and terminology systems. ConclusionThe terms and definitions of NF1-related clinical manifestations are summarized to enhance the knowledge of clinicians and researchers related to NF1.