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Advances in managing hepatocellular carcinoma

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《医学前沿（英文）》 2014年 第8卷 第2期   页码 175-189 doi: 10.1007/s11684-014-0332-4

摘要：

Multiple modalities for treatment of hepatocellular carcinoma are available, depending on tumor size and number. Surgical resection remains the gold standard, so long as the residual liver function reserve is sufficient. In patients with advanced cirrhosis, liver transplantation is the preferred option, as these patients may not have adequate hepatic reserve after resection. Salvage liver transplantation has also become an option for a select few patients who recur after surgical resection. Ablative techniques have been used for palliation as well as to either completely destroy the tumor, act as an adjunct to resection, or downstage the tumor to meet Milan criteria such that a patient may be a candidate for liver transplantation. Radiofrequency ablation, microwave ablation, chemoembolization, radioembolization, and irreversible electroporation have all been used in this capacity. Currently, sorafenib is the only US Food and Drug Administration-approved chemotherapeutic for hepatocellular carcinoma. The efficacy of sorafenib, in combination with other agents, transarterial chemoembolization, and surgical resection is currently being investigated. Sunitinib and brivanib, tyrosine kinase inhibitors, have failed as potential first- or second-line options for chemotherapy. Bevacizumab in combination with erlotinib is also currently being studied. Final analysis for ramucirumab and axitinib are pending. Tivantinib, a selective mesenchymal-epithelial transition factor (MET) inhibitor, is also undergoing clinical trials for efficacy in MET-high tumors. This review serves to emphasize the current and new technologies emerging in the treatment of hepatocellular carcinoma.

关键词： hepatocellular carcinoma     radiofrequency ablation     microwave ablation     chemoembolization     radioembolization     sorafenib     irreversible electroporation    

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Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

《医学前沿（英文）》 2011年 第5卷 第3期   页码 271-276 doi: 10.1007/s11684-011-0148-4

摘要： Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, closely correlated with viral hepatitis and liver cirrhosis. The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve. Tumors can involve major vessels or hilar structures, necessitating major liver resection and/or rendering liver resection unfeasible. A series of new technologies have been developed to optimise HCC management. Stem cell therapy improves impaired liver functional reserve prior to liver resection. Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy. Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia, while increasing parenchymal sparing. These benefits combined maximize the safety of liver resection.

关键词： management     hepatocellular carcinoma (HCC)     radiofrequency (RF) ablation     laparoscopic liver resection     stem cell     intravascular RF ablation     endobiliary RF ablation    

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State-of-the-art of intelligent minimally invasive surgical robots

Masakatsu G. Fujie, Bo Zhang

《医学前沿（英文）》 2020年 第14卷 第4期   页码 404-416 doi: 10.1007/s11684-020-0743-3

摘要： A number of developed countries are rapidly turning into super-aged societies. Consequently, the demand for reduced surgical invasiveness and enhanced efficiency in the medical field has increased due to the need to reduce the physical burden on older patients and shorten their recovery period. Intelligent surgical robot systems offer high precision, high safety, and reduced invasiveness. This paper presents a review of current intelligent surgical robot systems. The history of robots and three types of intelligent surgical robots are discussed. The problems with current surgical robot systems are then analyzed. Several aspects that should be considered in designing new surgical systems are discussed in detail. The paper ends with a summary of the work and a discussion of future prospects for surgical robot development.

关键词： robot history     medical robot     surgical robot     radiofrequency ablation     organ model    

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Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

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《医学前沿（英文）》 2015年 第9卷 第4期   页码 437-443 doi: 10.1007/s11684-015-0422-y

摘要：

This study aimed to investigate the outcome of treatment with Stretta radiofrequency (SRF) or laparoscopic Nissen fundoplication (LNF). A total of 137 gastroesophageal reflux disease (GERD) patients with severe asthmatic symptoms who responded inadequately to medical treatment for asthma were investigated. The patients were followed up 1 year and 5 years after SRF (n = 82) or LNF (n = 55) treatment. A questionnaire covering 29 related symptoms and medication use was employed. Digestive, respiratory, and ear-nose-throat (ENT) symptom scores significantly decreased after antireflux treatment. Symptom scores respectively changed from 17.2±10.1, 31.9±6.6, and 21.1±11.8 to 5.0±6.2, 11.5±10.2, and 6.3±6.8 at 1 year and to 5.6±6.5, 13.1±10.1, and 7.8±7.2 at 5 years (P <0.001). The outcome of LNF was significantly better than that of SRF in terms of digestive (P <0.001, P = 0.001), respiratory (P = 0.006, P = 0.001), and ENT symptoms (P = 0.006, P = 0.003) at both 1 year and 5 years. SRF and LNF were both effective against the digestive symptoms of GERD as well as GERD-related severe asthmatic and ENT symptoms, with better outcomes exhibited by the LNF group. Severe asthmatic symptoms and GERD were closely associated, and this finding warrants further study.

关键词： asthma     gastroesophageal reflux     Stretta radiofrequency     laparoscopic Nissen fundoplication    

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Laser ablation of block copolymers with hydrogen-bonded azobenzene derivatives

Jintang Huang, Youju Huang, Si Wu

《化学科学与工程前沿（英文）》 2018年 第12卷 第3期   页码 450-456 doi: 10.1007/s11705-018-1735-6

摘要：

Supramolecular assemblies (PS-b-P4VP(AzoR)) are fabricated by hydrogen-bonding azobenzene derivatives (AzoR) to poly(4-vinyl pyridine) blocks of polystyrene-block-poly(4-vinyl pyridine) (PS-b-P4VP). PS-b-P4VP(AzoR) forms phase separated nanostructures with a period of ~75–105 nm. A second length scale structure with a period of 2 µm is fabricated on phase separated PS-b-P4VP(AzoR) by laser interference ablation. Both the concentration and the substituent of AzoR in PS-b-P4VP(AzoR) affect the laser ablation process. The laser ablation threshold of PS-b-P4VP(AzoR) decreases as the concentration of AzoR increases. In PS-b-P4VP(AzoR) with different substituents (R= CN, H, and CH3), ablation thresholds follow the trend: PS-b-P4VP(AzoCN)<PS-b-P4VP(AzoCH3)<PS-b-P4VP(AzoH). This result indicates that the electron donor group (CH3) and the electron acceptor group (CN) can lower the ablation threshold of PS-b-P4VP(AzoR).

关键词： laser ablation     block copolymers     hydrogen-bond     azobenzene derivatives     supramolecular assembly    

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High-intensity focused ultrasound tumor ablation: Review of ten years of clinical experience

Lian ZHANG, Zhi-Biao WANG

《医学前沿（英文）》 2010年 第4卷 第3期   页码 294-302 doi: 10.1007/s11684-010-0092-8

摘要： High-intensity focused ultrasound (HIFU) is a technique to destroy tissue at depth within the body, selectively and without harming overlying and adjacent structures within the path of the beam because the ultrasonic intensity at the beam focus is much higher than that outside of the focus. Diagnostic ultrasound is the first imaging modality used for guiding HIFU ablation. In 1997, a patient with osteosarcoma was first successfully treated with ultrasound imaging-guided HIFU in Chongqing, China. Over the last decade, thousands of patients with uterine fibroids, liver cancer, breast cancer, pancreatic cancer, bone tumors, and renal cancer have been treated with ultrasound imaging-guided HIFU. Based on several research groups’ reports, as well as our ten-year clinical experience, we conclude that this technique is safe and effective in treating human solid tumors. HIFU is a promising technique. Most importantly, HIFU offers patients another alternative when those patients have no other treatment available.

关键词： high-intensity focused ultrasound (HIFU)     ultrasound imaging-guided HIFU (USgHIFU)     magnetic resonance imaging-guided HIFU (MRgHIFU)    

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Immune response triggered by the ablation of hepatocellular carcinoma with nanosecond pulsed electric

Jianpeng Liu, Xinhua Chen, Shusen Zheng

《医学前沿（英文）》 2021年 第15卷 第2期   页码 170-177 doi: 10.1007/s11684-020-0747-z

摘要： Nanosecond pulsed electric field (nsPEF) is a novel, nonthermal, and minimally invasive modality that can ablate solid tumors by inducing apoptosis. Recent animal experiments show that nsPEF can induce the immunogenic cell death of hepatocellular carcinoma (HCC) and stimulate the host’s immune response to kill residual tumor cells and decrease distant metastatic tumors. nsPEF-induced immunity is of great clinical importance because the nonthermal ablation may enhance the immune memory, which can prevent HCC recurrence and metastasis. This review summarized the most advanced research on the effect of nsPEF. The possible mechanisms of how locoregional nsPEF ablation enhances the systemic anticancer immune responses were illustrated. nsPEF stimulates the host immune system to boost stimulation and prevail suppression. Also, nsPEF increases the dendritic cell loading and inhibits the regulatory responses, thereby improving immune stimulation and limiting immunosuppression in HCC-bearing hosts. Therefore, nsPEF has excellent potential for HCC treatment.

关键词： nanosecond pulsed electric fields (nsPEF)     hepatocellular carcinoma (HCC)     immune response     recurrence     metastasis    

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Ablation of steroid receptor coactivator-3 in mice impairs adipogenesis and enhances energy expenditure

Ling-Yan XU PhD, Xin-Ran MA PhD, Xiao-Ying LI PhD, MD, Shu WANG PhD, Guang NING PhD, MD, Jie-Li LI PhD, Jian-Ming XU PhD,

《医学前沿（英文）》 2010年 第4卷 第2期   页码 229-234 doi: 10.1007/s11684-010-0028-3

摘要： Obesity is a medical condition in which excess body fat has accumulated to an extent and may have an adverse effect on health, leading to reduced life expectancy, impaired energy homeostasis and increased health problems. The p160 steroid receptor coactivator (SRC) gene family members have been suggested to be involved in energy homeostasis, but the impact of SRC-3 ablation on white and brown adipose tissue needs to be elucidated. In the current study, we collected data and carried out morphological studies on the effect of SRC-3 deficiency on white adipose tissue (WAT) and brown adipose tissue (BAT). Primary cells were cultured to investigate the differentiation ability of both adipocytes. Western blot was applied to detect the expression of master genes governing adipogenesis and thermogenesis. We observed that SRC-3 mice were lean, with reduced WAT and decreased serum leptin levels, mainly due to the smaller white adipocyte size caused by impaired adipogenesis, presented by decreased peroxisome proliferator activated receptor (PPAR) expression. In the BAT, the lipid droplets decreased significantly in SRC-3 mice as demonstrated by histological analysis and electron microscopic observation, which could be explained by enhanced thermogenesis. The expression of thermogenic marker gene PPAR coactivator 1α and uncoupling protein-1 increased in BAT of SRC-3 mice, which proved our observations. Collectively, these results demonstrate that SRC-3 plays a key role in adipogenesis and energy expenditure.

关键词： steroid receptor coactivator-3     white adipose tissue     brown adipose tissue     obesity     adipocytes     energy expenditure    

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用高光谱发光法研究Cu(Inx,Ga1–x)Se2 (CIGS)模块中由P1引起的功率损耗的成因 Article

César Omar Ramírez Quiroz, Laura-Isabelle Dion-Bertrand, Christoph J. Brabec, Joachim Müller, Kay Orgassa

《工程（英文）》 2020年 第6卷 第12期   页码 1395-1402 doi: 10.1016/j.eng.2019.12.019

摘要：

在本文中，我们利用了高光谱高分辨率光致发光映射技术，这是一个强大的工具，可用于选择和优化在Cu(Inx,Ga1-x)Se2（CIGS）模块上对子电池进行图案化互连的激光烧蚀工艺。通过这种方式，我们可以完成对消融区域附近材料降解的深度监测以及对潜在机制的识别。具体而言，通过分析在CIGS沉积之前烧蚀的标准P1图案线，我们发现了沿着下部的钼槽边缘的异常发射猝灭效应。通过扫描电子显微镜（SEM）比较了P1边缘的横截面的形貌，我们进一步合理化产生这种效应的起因，但无法用厚度变化解释光发射的减少。我们还研究了激光诱导对CIGS沉积后的P1图案线带来的损伤。然后，我们首次记录了短距离损坏区域，该区域与在激光路径上应用的光学孔径无关。我们的发现能更好地理解P1引起的功率损耗，并为改进与行业相关的模块互连方案提供了新的见解。

关键词： Cu(Inx     Ga1–x)Se2     电池到模块的效率差距     由P1引起的功率损耗     高光谱光致发光     激光烧蚀短程热效应    

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标题 作者 时间 类型 操作

Advances in managing hepatocellular carcinoma

null

期刊论文

Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

期刊论文

State-of-the-art of intelligent minimally invasive surgical robots

Masakatsu G. Fujie, Bo Zhang

期刊论文

Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

null

期刊论文

Laser ablation of block copolymers with hydrogen-bonded azobenzene derivatives

Jintang Huang, Youju Huang, Si Wu

期刊论文

High-intensity focused ultrasound tumor ablation: Review of ten years of clinical experience

Lian ZHANG, Zhi-Biao WANG

期刊论文

Immune response triggered by the ablation of hepatocellular carcinoma with nanosecond pulsed electric

Jianpeng Liu, Xinhua Chen, Shusen Zheng

期刊论文

Ablation of steroid receptor coactivator-3 in mice impairs adipogenesis and enhances energy expenditure

Ling-Yan XU PhD, Xin-Ran MA PhD, Xiao-Ying LI PhD, MD, Shu WANG PhD, Guang NING PhD, MD, Jie-Li LI PhD, Jian-Ming XU PhD,

期刊论文

用高光谱发光法研究Cu(Inx,Ga1–x)Se2 (CIGS)模块中由P1引起的功率损耗的成因

César Omar Ramírez Quiroz, Laura-Isabelle Dion-Bertrand, Christoph J. Brabec, Joachim Müller, Kay Orgassa

期刊论文