Objective To understand pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of metaplastic breast cancer (MBC), and to provide some new ideas for clinical diagnosis and treatment, and exploration of scientific research for it. Method The relevant literatures of the latest research on MBC were reviewed and analyzed. Results At present, the pathogenesis of the MBC was still uncertain. The incidence of the MBC was lower, and it’s clinical manifestations were not specific. Compared with the invasive breast cancer, the tumor diameter was larger, the growth was faster, the differentiation degree was lower, the risks of the local and distant metastases were higher, while the lymph node metastasis was rare. Because of the clinical manifestation, auxiliary examination, and imaging examinations were lack of specificity, the diagnosis was difficult. Although the preoperative puncture could provide a reliable diagnosis evidence, it was difficult for distinguishing and accurate diagnosis due to it’s more subtypings. Some of the specific molecular targets could provide a help for it. At present, the modified radical mastectomy was often performed, the axillary lymph node metastasis was relatively rare in the MBC, so the sentinel lymph node biopsy was more important in the treatment of the MBC. The therapeutic effect was limited by the endocrine therapy, targeted therapy, or neoadjuvant chemotherapy and was poor by the systemic chemotherapy. Although the radiotherapy and chemotherapy could improve the overall survival and prolong the disease-free survival and control the local recurrence, the difference of it’s therapeutic effect was great due to the complex MBC typing. Conclusions MBC is a highly malignant and strongly invasive tumor, and it has more subtypings. Clinical manifestation and preoperative examination are lack of specificity, hence it is easy for misdiagnosis or missed diagnosis. Unified treatment guideline is lack of, prognosis is poor. So, it needs to explore some new treatment methods and formulate standardized treatment guidelines in order to achieve a better therapeutic effect.
ObjectiveTo review the research progress on etiology and pathogenesis of spina bifida. MethodsBy consulting relevant domestic and foreign research literature on spina bifida, the classification, epidemic trend, pathogenesis, etiology, prevention and treatment of it were analyzed and summarized. ResultsSpina bifida, a common phenotype of neural tube defects, is classified based on the degree and pattern of malformation associated with neuroectodermal involvement and is due to the disturbance of neural tube closure 28 days before embryonic development. The prevalence of spina bifida varies greatly among different ethnic groups and regions, and its etiology is complex. Currently, some spina bifida patients can be prevented by folic acid supplements, and with the improvement of treatment technology, the short-term and long-term survival rate of children with spina bifida has improved. ConclusionThe research on the pathogenesis of spina bifida will be based on the refined individual information on exposure, genetics, and complex phenotype, and will provide a theoretical basis for improving prevention and treatment strategies through multidisciplinary cooperation.
Objective To discuss the treatment of retinal detachment(RD) after posterior chamber intraocular lents(PCIOL) implantation. Methods Twenty eyes with RD after PCIOL inplantation which were treated with vitrectomy combined with scleral buckling and intraocular tamponade from March 1993 to June 1997 in this institute were analysed retrospctively. Results The retinas reattached completely in 16 eyes and partly in 2 eyes after RD operation.The postoperative visual acuity improved in 17 eyes,not improved in 2 eyes,and decreasde in 1 eyes.The PCIOL was taken off during RD operative in 6 eyes.Postoperative complications including displacement of the PCIOL in 2 eyes,hyphema and vitreous hemorrhage were found in this series of RD operation in 1 eyes. Conclusion Vitrectomy combined with scleral buckling and intraocular tamponade is one of the effective methods to treat the eyes with RD with PCIOL. (Chin J Ocul Fundus Dis,1998,14:165-166)
Aortic dissection is a catastrophic emergency with a high mortality rate, and its full pathogenesis remains unknown to researchers, which brings a heavy burden to the individuals, society and family because of its poor prognosis. Improving the efficiency of its diagnosis and treatment and defining the pathogenic mechanism clearly is a research hotspot. Recently, utilizing bioinformatics to find diagnostic biomarker of aortic dissection has attracted the attention of many researchers. Besides, exploring the relationship between pathogenic mechanism and inflammatory process, extracellular matrix degradation, elastic fiber fracture and the phenotypic transformation of vascular smooth muscle cells is also a hot topic. We summarize recent progress made in the pathogenesis of aortic dissection. We hope to identify key molecules driving aortic dissection and provide reliable reference for the diagnosis, medical treatment and prevention of aortic dissection.
Objective To review the research progress on the correlation between sarcopenia and osteoarthritis (OA). Methods The basic and clinical studies at home and abroad in recent years on sarcopenia and OA were extensively reviewed. The correlation between sarcopenia and OA was analyzed and summarized from five aspects: epidemiological status, risk factors, pathogenesis, clinical treatments, and the impact on joint arthroplasty. Results Sarcopenia and OA are common diseases in the elderly with high prevalence and can increase the ill risk of each other. They share a set of risk factors, and show negative interactive and influence on pathogenesis and clinical treatments, thus participating in each other’s disease process and reducing the treatment benefits. Clinical studies show that sarcopenia can affect the rehabilitation effect and increase the risk of postoperative complications after total joint arthroplasty in many ways. ConclusionCurrent research results show that sarcopenia and OA are related and can be mutually affected in the above 5 aspects, but more studies are needed to further clarify the relationship between them, so as to provide more theoretical basis for the understanding, prevention, diagnosis, and treatments of the two diseases.
Rheumatoid arthritis (RA) is a common systemic autoimmune disease with complicated pathogenesis. Symmetric pain and swelling in multiple joints are the primary clinical symptoms. The early diagnosis and treatment significantly contribute to the better prognosis of RA patients. However, there are still a lot of obstacles in the way of diagnosing and treating RA, and innovative models are urgently needed. As an innovative cross-research model, the applications of the combination of medicine and engineering in the biomedical field present a good prospect, which is expected to improve the demands and defects of traditional RA diagnosis and treatment. Herein, this article reviewed the research progress of the new technologies’ applications in RA diagnosis and treatment in recent years, in order to broaden the new strategies of RA precision diagnosis and treatment.
Objective To summarize the progress on diagnosis and treatment of gastric stump cancer. Methods Related literatures in recent 5 years were collected, and the progress on diagnosis and treatment of gastric stump cancer were reviewed. Results The diagnosis of gastric stump cancer mainly depends on endoscopy, mucosal biopsy and other imaging examinations. At present, the main treatment of gastric stump cancer is the total gastrectomy, combined with laparoscopic therapy and endoscopic therapy. On the basis of No.1-No.4 and No.7-No.13 lymph node dissection, the extent of lymph node dissection is enlarged according to the different surgical procedures. Conclusions The main treatment of gastric stump cancer is total gastrectomy, and there are many factors affecting the prognosis, which should be early diagnosis and early treatment. Laparoscopic radical gastrectomy for gastric stump caner provides a more convenient and accurate method for the treatment of gastric stump caner.
ObjectiveTo understand the pathogenesis and the research progress of comprehensive treatment of primary retroperitoneal liposarcoma (PRLPS) and to provide evidence for clinical diagnosis and treatment.MethodThe recent literatures on the pathological classification, pathogenesis of PRLPS, and comprehensive treatment including the surgery, radiotherapy, chemotherapy, and molecular targeted therapy were reviewed.ResultsThe pathological types of PRLPS were highly differentiated, dedifferentiated, mucoid/round cell, polymorphic, and mixed. The main molecular pathogenesis was the synergistic effect of MDM2 with related genes, abnormal expressions of c-myc gene and microRNAs, Prune-nm23-H1 mechanism, and abnormal protein products of FUS-CHOP fusion gene which regulated the growth of tumor. The treatment of PRLRS included the radical resection, extended resection, and palliative resection combined with radiotherapy, chemotherapy, and molecular targeted therapy.ConclusionsPRLPS is a rare malignant tumor with high recurrence rate, but early diagnosis and treatment are difficult. With the further study of the molecular mechanism of PRLPS, the treatment of PRLPS has been transformed into a comprehensive treatment based on surgery, adjuvant radiotherapy and chemotherapy, and molecular targeted therapy.
ObjectiveTo understand the progress of molecular biology research on the pathogenesis of hemorrhoids. MethodThe literatures relevant to reseaches on the molecular biology of hemorrhoid pathogenesis in recent years had been reviewed. ResultsThe generally accepted theories of hemorrhoids included anal cushion downward movement theory, varicose vein theory, and vascular proliferation theory. The molecular biological studies related to the theory of anal cushion downward movement found that the increased expression of matrix metalloproteinase-9 and the abnormal expression of smooth muscle actin could damage the supporting tissue of anal cushion, causing the downward movement and prolapse of anal cushion, and then formed hemorrhoids; The molecular biology researches related to varicose vein theory found that the increase of nitric oxide synthase and transient receptor potential vanilloid 1 could promote the production of nitric oxide, causing varicose veins, and then leaded to the pathogenesis of hemorrhoids; The molecular biology researches related to vascular proliferation theory found that the low expressions of miR-412-5p and miR-4729, and the overexpressions of vascular endothelial growth factor and fibroblast growth factor were related to the vascular proliferation of hemorrhoids. In addition, the secondary inflammatory reaction after the onset of hemorrhoids also played an important role in the occurrence and development of hemorrhoids. ConclusionsThe occurrence and development of hemorrhoids is the result of the intersection and interaction of various mechanisms such as anal cushion downward movement, varicose veins, vascular proliferation, and secondary inflammatory reaction. The molecular biology research on the pathogenesis of hemorrhoids is helpful to better explain the occurrence of hemorrhoids from a microcosmic perspective, and lay a foundation for further exploring the etiology of hemorrhoids.
Objective To understand research progress on peritoneal metastasis from gastric cancer at present stage briefly. Methods The literatures about mechanism, diagnosis, prevention and treatment of the peritoneal metastasis from gastric cancer at home and aboard were collected to make a review. Results The peritoneal metastasis is the common site of the distant metastasis in the advanced gastric cancer. It’s occurrence mechanism is complex, the diagnostic measure is varied, the prevention way is difficulty, and it give priority to with the comprehensive treatment and the transformed therapy. Conclusion It has a certain necessity to study occurrence mechanism, prevention methods and treatment measures so that improve survival rate and prognosis for patients with peritoneal metastasis from advanced gastric cancer.