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A ruptured recurrent small bowel gastrointestinal stromal tumour causing hemoperitoneum

null

《医学前沿(英文)》 2015年 第9卷 第1期   页码 108-111 doi: 10.1007/s11684-014-0344-0

摘要:

Hemoperitoneum is a rare and potentially life-threatening complication of GIST. We reported a 54-year-old man who developed disseminated intra-abdominal recurrence from a previously resected gastrointestinal stromal tumour (GIST) of the small bowel, and the patient presented with hemoperitoneum. Emergent debulking surgery was performed. A high dose imatinib was prescribed. Despite the presence of residual disease, the patient was well clinically 8 months after the operation. Even though, there is no evidence to support the routine use of debulking surgery in the management of GIST. In our patient, disease progression after second line targeted therapy and the absence of alternative treatment options for spontaneous rupture and hemoperitoneum prompted us to treat the patient aggressively. Resection of the ruptured GIST was carried out for control of bleeding and to prevent recurrent bleeding in this patient with good surgical risks. During the treatment decision-making, the patient’s general condition, the risk of surgery and the extent of dissemination were taken into consideration. In this patient who presented with spontaneous rupture of a small intestinal GIST, the novel use of targeted therapy and aggressive surgical treatment produced reasonably good survival outcome.

关键词: gastrointestinal stromal tumour     hemoperitoneum     small bowel GIST     small bowel neoplasm     imatinib    

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

《医学前沿(英文)》 2012年 第6卷 第3期   页码 317-321 doi: 10.1007/s11684-012-0203-9

摘要:

In order to find out the potential indicators predicting prognosis of malignant gastrointestinal stromal tumors (GISTs) after surgical resection, we collected clinical records of 80 patients with malignant GISTs. Tumor location, size, mitotic index, necrosis were compared with the prognosis of malignant GISTs by Kaplan-Meier method and log-rank test. After a median follow-up of 844 days (52–2 145), we found that as National Institutes of Health suggested, tumors with intermediate risk had more favorable prognosis than that with high risk. Their 3-year survival rate were 65.3% and 41.3%, respectively (P<0.001). Moreover, tumor size and mitotic index were associated with free survival. The 3-year survival rate for patients with tumor size≤10 cm and>10 cm were 62.3% and 41.8%, respectively (P = 0.002), Tumors with mitotic index≤5/50 HPF had a higher 3-year survival rate than tumors with mitotic index>5/50 HPF (67.1% versus 40.7%, P = 0.005). The presence of necrosis was directly related to the malignant behavior. The 3-year survival rate for presence and absence necrosis were 50.8% and 64.8% (P = 0.008). From the present study, we can conclude that besides tumors size and mitotic index, tumor location and necrosis also influence on the long-term survival of patient with malignant GISTs after surgical resection.

关键词: gastrointestinal stromal tumors     surgery     survival    

Prognostic significance of clinicopathologic parameters in gastrointestinal stromal tumors: a study of

LIANG Yumei, LI Xianghong, LU Youyong, LV Yali, ZHONG Mei, PU Xiaolu, LI Wenmei

《医学前沿(英文)》 2008年 第2卷 第1期   页码 87-94 doi: 10.1007/s11684-008-0016-z

摘要: The biological behavior of gastrointestinal stromal tumors (GISTs) are highly variable. To investigate the biological behavior of GIST, we collected 83 cases of gastric and 62 cases of small intestinal GIST from the Department of Pathology of the Chinese PLA General Hospital. The parameters include age, primary tumor location, tumor diameter, mitotic index, tumor necrosis, risk assessment, clinical stage and the exon 11 mutation. All these were analyzed in 105 cases along with the follow-up data and tested by log rank and COX hazard proportional model. We find that the average age of gastric GIST was 55.4 years. Of the 62 cases that were followed up, 17 cases had metastasis or recurrence and the 5-year survival rate was (66.51 ± 17.06)%. For the small intestinal GIST, the average age was 50.6 years and 43 cases were followed up. Of these, 22 cases had metastasis or recurrence and the 5-year survival rate was (61.76 ± 18.30)%. Small intestinal GIST was more frequently associated with metastasis and tumor relapse than gastric GIST ( = 6.131, = 0.013). For gastric GIST, patients younger than 50 years ( = 0.046), the advanced clinical stage ( = 0.0001), the large tumor diameter ( = 0.0001), a high mitotic index ( = 0.0001), necrosis ( = 0.0001) and a high risk grade ( = 0.004) were all correlated with a lower survival rate. The COX hazard proportional model revealed that advanced clinical stage ( = 0.001), large tumor size ( = 0.001), a high mitotic index ( = 0.002) and the high risk grade ( = 0.018) indicated a poorer prognosis in gastric GIST. For small intestinal GIST, necrosis ( = 0.036) and advanced clinical stage ( = 0.010) were associated with lower survival rates and the clinical stage was shown to be an independent prognostic indicator. A total of 25 cases harbored mutations in exon 11. The frequency of mutation was 32% and 22.5% for gastric and small intestinal GIST, respectively. In gastric GIST, the mutated was predominant in patients older than 50 years of age. But in the small intestinal GIST, the mutated was predominant in the age group of 40–49 years. In conclusion, for gastric GIST, clinical stage, tumor size, mitotic index, and risk grade are the prognostic indicators. For small intestinal GIST, necrosis and clinical stage are the prognostic indicators. Small intestinal GIST are more aggressive than gastric GIST. The occurrence of mutation may correlate with the age of patients.

Detection of digestive malignancies and post-gastrectomy complications via gastrointestinal fluid examination

null

《医学前沿(英文)》 2017年 第11卷 第1期   页码 20-31 doi: 10.1007/s11684-016-0493-4

摘要:

To date, gastric carcinoma (GC) is one of the common and fatal digestive malignancies worldwide. The prognosis of GC is not always satisfactory because of late diagnosis. Scholars are keen on discovering novel accurate and economical biomarkers in body liquids for GC screening to detect and evaluate the lesion before the results of imaging techniques are obtained. While traditional serum assays have limited sensitivity and specificity, gastrointestinal juice may provide relevant specific biomarkers because of its close contact with the tumor. Herein, the current progress in the relationship between gastrointestinal fluid analyses and GC is systematically and comprehensively reviewed. The detection of gastric juice pH, fluorescence spectrum, cytology, Helicobacter pylori-associated markers, nitrosamines, conventional tumor markers, amino acids, proteomics, microRNAs, long noncoding RNAs, protein-coding genes, vitamin C, etc., and combination tests of different category markers could provide important diagnostic and prognostic clues for gastrointestinal diseases. Particularly, early GC may be efficiently screened using gastric juice. Gastrointestinal fluid examination could also predict the adverse effects of postgastrectomy, such as pancreatic leakage, fistula, and abscess. Gastric fluid markers should be further studied to reveal the early predicators of malignancy and complications. The methods for obtaining the samples of gastrointestinal juice with minimum incision should also be comprehensively investigated.

关键词: gastrointestinal fluid     gastric carcinoma     biomarker     diagnosis     prognosis     gastrectomy     adverse events    

Novel lysosome-targeted anticancer fluorescent agents used in zebrafish and nude mouse tumour imaging

《化学科学与工程前沿(英文)》 2022年 第16卷 第1期   页码 112-120 doi: 10.1007/s11705-021-2075-5

摘要: The design of three novel fatty nitrogen mustard-based anticancer agents with fluorophores incorporated into the alkene structure (CXL 118, CXL121, and CXL122) is described in this report. The results indicated that these compounds are selectively located in lysosomes and exhibit effective antitumour activity. Notably, these compounds can directly serve as both reporting and imaging agents in vitro and in vivo without the need to add other fluorescent tagging agents.

关键词: fluorescent drug     lysosomal     anticancer     zebrafish     nude-mouse tumour imaging    

Immunotherapy-based combination strategies for treatment of gastrointestinal cancers: current status

Chenfei Zhou, Jun Zhang

《医学前沿(英文)》 2019年 第13卷 第1期   页码 12-23 doi: 10.1007/s11684-019-0685-9

摘要:

Strategies in comprehensive therapy for gastrointestinal (GI) cancer have been optimized in the last decades to improve patients’ outcomes. However, treatment options remain limited for late-stage or refractory diseases. The efficacy of immune checkpoint inhibitors (ICIs) for treatment of refractory GI cancer has been confirmed by randomized clinical trials. In 2017, pembrolizumab was approved by the US Food and Drug Administration as the first agent for treatment of metastatic solid tumors with mismatch repair deficiency, especially for colorectal cancer. Given the different mechanisms, oncologists have focused on determining whether ICIs-based combination strategies could achieve higher efficacy than conventional therapy alone in late-stage or even front-line treatment of GI cancer. This review discusses the current status of combining immune checkpoint inhibitors with molecular targeted therapy, chemotherapy, or radiotherapy in GI cancer in terms of mechanisms, safety, and efficacy to provide basis for future research.

关键词: gastrointestinal cancer     immune checkpoint inhibitor     combination therapy    

Gastrointestinal damage caused by swallowing multiple magnets

null

《医学前沿(英文)》 2012年 第6卷 第3期   页码 280-287 doi: 10.1007/s11684-012-0207-5

摘要:

Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms “magnet ingestion, ” “fistula, ” and “perforation. ” A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.

关键词: magnet     ingestion     fistula     perforation    

Detecting genetic hypermutability of gastrointestinal tumor by using a forensic STR kit

Anqi Chen, Suhua Zhang, Jixi Li, Chaoneng Ji, Jinzhong Chen, Chengtao Li

《医学前沿(英文)》 2020年 第14卷 第1期   页码 101-111 doi: 10.1007/s11684-019-0698-4

摘要: Growing evidence suggests that somatic hypermutational status and programmed cell death-1 overexpression are potential predictive biomarkers indicating treatment benefits from immunotherapy using immune checkpoint inhibitors. However, biomarker-matched trials are still limited, and many of the genomic alterations remain difficult to target. To isolate the potential somatic hypermutational tumor from microsatellite instability low/microsatellite stability (MSI-L/MSS) cases, we employed two commercial kits to determine MSI and forensic short tandem repeat (STR) alternations in 250 gastrointestinal (GI) tumors. Three types of forensic STR alternations, namely, allelic loss, Aadd, and Anew, were identified. 62.4% (156/250) of the patients with GI exhibited STR alternation, including 100% (15/15) and 60% (141/235) of the microsatellite high instability and MSI-L/MSS cases, respectively. 30% (75/250) of the patients exhibited STR instability with more than 26.32% (26.32%–84.21%) STR alternation. The cutoff with 26.32% of the STR alternations covered all 15 MSI cases and suggested that it might be a potential threshold. Given the similar mechanism of the mutations of MSI and forensic STR, the widely used forensic identifier STR kit might provide potential usage for identifying hypermutational status in GI cancers.

关键词: mismatch repair protein deficiency (MMR-D)     microsatellite instability (MSI)     short tandem repeats (STR)     gastrointestinal tumor     hypermutability    

Histone variants: critical determinants in tumour heterogeneity

Tao Wang, Florent Chuffart, Ekaterina Bourova-Flin, Jin Wang, Jianqing Mi, Sophie Rousseaux, Saadi Khochbin

《医学前沿(英文)》 2019年 第13卷 第3期   页码 289-297 doi: 10.1007/s11684-018-0667-3

摘要: Malignant cell transformation could be considered as a series of cell reprogramming events driven by oncogenic transcription factors and upstream signalling pathways. Chromatin plasticity and dynamics are critical determinants in the control of cell reprograming. An increase in chromatin dynamics could therefore constitute an essential step in driving oncogenesis and in generating tumour cell heterogeneity, which is indispensable for the selection of aggressive properties, including the ability of cells to disseminate and acquire resistance to treatments. Histone supply and dosage, as well as histone variants, are the best-known regulators of chromatin dynamics. By facilitating cell reprogramming, histone under-dosage and histone variants should also be crucial in cell transformation and tumour metastasis. Here we summarize and discuss our knowledge of the role of histone supply and histone variants in chromatin dynamics and their ability to enhance oncogenic cell reprogramming and tumour heterogeneity.

关键词: cancer-testis     TH2B     TH2A     H1T     H1.0     H1F0     linker histones    

Ingestible wireless capsules for enhanced diagnostic inspection of gastrointestinal tract

Mahdi RASOULI, Andy Prima KENCANA, Van An HUYNH, Eng Kiat TING, Joshua Chong Yue LAI, Kai Juan WONG, Su Lim TAN, Soo Jay PHEE

《机械工程前沿(英文)》 2011年 第6卷 第1期   页码 40-44 doi: 10.1007/s11465-011-0204-4

摘要:

Wireless capsule endoscopy has become a common procedure for diagnostic inspection of gastrointestinal tract. This method offers a less-invasive alternative to traditional endoscopy by eliminating uncomfortable procedures of the traditional endoscopy. Moreover, it provides the opportunity for exploring inaccessible areas of the small intestine. Current capsule endoscopes, however, move by peristalsis and are not capable of detailed and on-demand inspection of desired locations. Here, we propose and develop two wireless endoscopes with maneuverable vision systems to enhance diagnosis of gastrointestinal disorders. The vision systems in these capsules are equipped with mechanical actuators to adjust the position of the camera. This may help to cover larger areas of the digestive tract and investigate desired locations. The preliminary experimental results showed that the developed platform could successfully communicate with the external control unit via human body and adjust the position of camera to limited degrees.

关键词: wireless capsule endoscopy     ingestible medical device     in-body medical device     miniature actuator     medical robot     medical imaging    

Artificial intelligence in gastroenterology: where are we heading?

Joseph JY Sung, Nicholas CH Poon

《医学前沿(英文)》 2020年 第14卷 第4期   页码 511-517 doi: 10.1007/s11684-020-0742-4

摘要: Artificial intelligence (AI) is coming to medicine in a big wave. From making diagnosis in various medical conditions, following the latest advancements in scientific literature, suggesting appropriate therapies, to predicting prognosis and outcome of diseases and conditions, AI is offering unprecedented possibilities to improve care for patients. Gastroenterology is a field that AI can make a significant impact. This is partly because the diagnosis of gastrointestinal conditions relies a lot on image-based investigations and procedures (endoscopy and radiology). AI-assisted image analysis can make accurate assessment and provide more information than conventional analysis. AI integration of genomic, epigenetic, and metagenomic data may offer new classifications of gastrointestinal cancers and suggest optimal personalized treatments. In managing relapsing and remitting diseases such as inflammatory bowel disease, irritable bowel syndrome, and peptic ulcer bleeding, convoluted neural network may formulate models to predict disease outcome, enhancing treatment efficacy. AI and surgical robots can also assist surgeons in conducting gastrointestinal operations. While the advancement and new opportunities are exciting, the responsibility and liability issues of AI-assisted diagnosis and management need much deliberations.

关键词: artificial intelligence     endoscopy     robotics     gastrointestinal diseases    

血清免疫球蛋白G N-糖基的高通量分析——一种消化道癌症的非侵入性生物标志物 Article

刘鹏程, 王小兵, 顿爱社, 李昱潼, 李厚强, 王璐, 张怡春, 李灿灿, 张金霞, 张晓雨, 马立兴, 侯海峰

《工程(英文)》 2023年 第26卷 第7期   页码 44-53 doi: 10.1016/j.eng.2023.02.008

摘要:

免疫球蛋白G (Immunoglobulin G, IgG) 的 N-糖基化在炎症性疾病的发展中起着重要作用。本研究旨在评价IgG N-糖基在消化道癌症亚型中的诊断效能。从中国医学科学院肿瘤医院招募749名消化道癌症患者,包括食管癌 (esophageal cancer, EC)、胃癌 (gastric cancer, GC)、结直肠癌 (colorectal cancer, CRC) 和胰腺癌 (pancreatic cancer, PC) 患者。采用亲水交互高效液相色谱-超高效液相色谱(hydrophilic interaction liquid chromatography using ultra-performance liquid chromatography, HILIC-UPLC)分析血浆中IgG的 N-糖基构成。采用Bio-Plex悬液芯片系统检测方法(Bio-Rad)进行炎症因子检测。采用典型相关分析(canonical correlation analysis, CCA)探索糖基和炎症因子之间的相关性。 采用LASSO回归和logistic回归模型,基于检测到的糖基谱建立可用于区分胃肠癌症患者和健康人群诊断模型。与健康对照组相比,EC、GC、CRC和PC患者的唾液酸化和半乳糖基化水平降低,而二等分乙酰葡萄糖胺基化水平在消化道癌症患者中升高。 此外,只有胰腺癌患者具有低水平的岩藻糖基化。消化道癌症组的IL-1β、IL-31和sCD40L水平均高于对照组。IgG N-糖基的组成与炎症因子相关 (r = 0.556)。基于糖基的模型表现出良好的诊断效能,EC、GC、CRC和PC的受试者工作特征曲线下面积(AUC)分别为0.972、0.871、0.867和0.907。这些研究结果表明,IgG N-糖基在调节消化道肿瘤的发病机制中发挥了重要作用。血清IgG N-糖基可以作为潜在的非侵入性辅助消化道癌症临床诊断的方法。

关键词: 消化道癌症     糖基化     免疫球蛋白 G     诊断生物标志物    

Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

《医学前沿(英文)》 2008年 第2卷 第4期   页码 414-418 doi: 10.1007/s11684-008-0080-4

摘要: Brunner’s gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastrointestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any complications. Histological examination revealed a Brunner’s gland adenoma.

关键词: superior     Histological examination     endoscopy     gastro-intestinal     gastrointestinal haemorrhage    

迈入新世纪的硼中子俘获疗法(BNCT)

周永茂

《中国工程科学》 2012年 第14卷 第8期   页码 4-13

摘要:

扼要叙述进入21世纪之际,硼中子俘获疗法(boron neutorn capture therapy,BNCT)在国际范围内的一些显著进展,包括BNCT的临床定位、肿瘤复发的探索、硼浓度的定量探测、靶向掺硼药物的开发以及我国医院中子照射器的问世。这些BNCT长期开发中的瓶颈趋于缓解,预示了BNCT个性化与例行化的前景更为清晰。

关键词: 中子俘获疗法     临床试治     肿瘤复发     硼浓度探测     靶向药物     医院中子照射器    

人体胃肠道–菌群相互作用的工程学研究模型

Marc Mac Giolla Eain, Joanna Baginska, Kacy Greenhalgh, Joëlle V. Fritz, Frederic Zenhausern, Paul Wilmes

《工程(英文)》 2017年 第3卷 第1期   页码 60-65 doi: 10.1016/J.ENG.2017.01.011

摘要:

研究宿主–胃肠道微生物的相互作用已经成为管理人类健康和疾病的关键组成部分。微生理系统的发展正在为研究人员提供前所未有的对于这种复杂关系的获取和理解。这些系统结合了微型工程、微流体和细胞培养的优点,来创建人类肠道中普遍存在的环境条件。在这里我们提出的HuMiX(人类微生物交联对话) 平台,是一个利用这种多学科方法提供具有代表性的人体胃肠道的体外模型系统,用于研究宿主–微生物分子的相互作用。我们总结了使用该平台获得的概念验证结果,强调其对于大大增强我们对宿主–微生物相互作用了解的潜力,且其可能对药物、食品和营养以及医疗保健行业产生的巨大影响。同时讨论了这些技术面临的一些关键问题和挑战。

关键词: 微生物     微流体     肠道芯片     HuMiX    

标题 作者 时间 类型 操作

A ruptured recurrent small bowel gastrointestinal stromal tumour causing hemoperitoneum

null

期刊论文

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

期刊论文

Prognostic significance of clinicopathologic parameters in gastrointestinal stromal tumors: a study of

LIANG Yumei, LI Xianghong, LU Youyong, LV Yali, ZHONG Mei, PU Xiaolu, LI Wenmei

期刊论文

Detection of digestive malignancies and post-gastrectomy complications via gastrointestinal fluid examination

null

期刊论文

Novel lysosome-targeted anticancer fluorescent agents used in zebrafish and nude mouse tumour imaging

期刊论文

Immunotherapy-based combination strategies for treatment of gastrointestinal cancers: current status

Chenfei Zhou, Jun Zhang

期刊论文

Gastrointestinal damage caused by swallowing multiple magnets

null

期刊论文

Detecting genetic hypermutability of gastrointestinal tumor by using a forensic STR kit

Anqi Chen, Suhua Zhang, Jixi Li, Chaoneng Ji, Jinzhong Chen, Chengtao Li

期刊论文

Histone variants: critical determinants in tumour heterogeneity

Tao Wang, Florent Chuffart, Ekaterina Bourova-Flin, Jin Wang, Jianqing Mi, Sophie Rousseaux, Saadi Khochbin

期刊论文

Ingestible wireless capsules for enhanced diagnostic inspection of gastrointestinal tract

Mahdi RASOULI, Andy Prima KENCANA, Van An HUYNH, Eng Kiat TING, Joshua Chong Yue LAI, Kai Juan WONG, Su Lim TAN, Soo Jay PHEE

期刊论文

Artificial intelligence in gastroenterology: where are we heading?

Joseph JY Sung, Nicholas CH Poon

期刊论文

血清免疫球蛋白G N-糖基的高通量分析——一种消化道癌症的非侵入性生物标志物

刘鹏程, 王小兵, 顿爱社, 李昱潼, 李厚强, 王璐, 张怡春, 李灿灿, 张金霞, 张晓雨, 马立兴, 侯海峰

期刊论文

Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

期刊论文

迈入新世纪的硼中子俘获疗法(BNCT)

周永茂

期刊论文

人体胃肠道–菌群相互作用的工程学研究模型

Marc Mac Giolla Eain, Joanna Baginska, Kacy Greenhalgh, Joëlle V. Fritz, Frederic Zenhausern, Paul Wilmes

期刊论文