ABSTRACT
The incidence of intrahepatic cholangiocarcinoma (ICC) is increasing year by year,and the cause of its onset is still not clear.Enhanced CT or enhanced magnetic resonance imaging is a commonly used diagnostic method,and postoperative pathology inspection is the most important criterion for diagnosis.The overall therapeutic effect of ICC is not satisfactory.Surgical resection is the only curative treatment.However,the low resection rate and high recurrence rate are difficult treatments for the disease.This article reviews the etiology,diagnosis and treatment of ICC.
ABSTRACT
The incidence of intrahepatic cholangiocarcinoma (ICC) is increasing year by year, and the cause of its onset is still not clear. Enhanced CT or enhanced magnetic resonance imaging is a commonly used diagnostic method, and postoperative pathology inspection is the most important criterion for diagnosis. The overall therapeutic effect of ICC is not satisfactory. Surgical resection is the only curative treatment. However, the low resection rate and high recurrence rate are difficult treatments for the disease. This article reviews the etiology, diagnosis and treatment of ICC.
ABSTRACT
Objective To identify prognostic factors ofmotorfunctionafter surgery of metastatic spinal cord compression (MSCC).Methods The clinical data of 681 patients with spinal metastases from January 2008 to December 2017 were retrospectively analyzed.According to inclusion and exclusion criteria,a total of 206 patients with spinal metastatic were included.Postoperative neurological function was assessed using Frankel classification.The influence of age,gender,preoperative status,number of spine metastases,location of spinal metastases,visceral metastases,bone metastases,primary tumor type,interval from symptom to surgery,time of developing motor deficits,interval from primary tumor diagnosis to MSCC,preoperativethe Eastern Cooperative Oncology Group performance status (ECOG-PS),Karnofsky Performance score (KPS) and surgical procedures on postoperative function outcomes were explored.Results 140 (68.0％) patients were able to walk postoperatively compared with 88 (42.7％) patients preoperatively.Moreover,in 89.8％ of all patients,79 ambulatory patients maintained ambulation after treatment.The univariate analysis according to Ordered-logit model showed thatnumber of spine metastases,location of spinal metastases,preoperative ECOG-PS,preoperative KPS,interval from symptom to surgery and time of developing motor deficits were related with posttreatment motor functions.The multivariable analysis showed that number of spine metastases (OR=2.03;95％CI:1.12-3.33;P=0.04),preoperative ECOG-PS (OR=4.84;95％CI:2.42-8.15;P=0.038),interval from symptom to surgery (OR=3.78;95％CI:3.12-9.15;P=0.024),time of developing motor deficits(OR=2.75;95％CI:1.22-3.89;P=0.01) were independent prognostic factors for function outcomes.Conclusion 1-2 levels of metastasis,Interval from symptom to treatment ≥ 48 h,time of developing motor deficits ≥7 d,and ECOG-PS 1-2 can be considered as the most significant positive prognosticfactors for post-treatment ambulatory status.Spinal metastasis should have a higher priority,and immediate intervention should be started before the development of irreversible neurologic deficits.Increasing awareness of early symptoms and earlier screeningwith regular outpatient review might make a difference for patients with MSCC.Consequently,the identified prognostic factors can be considered as apreoperative assessment tool to predict the neurologic outcomeand guide clinical treatment for individual patients with MSCC.
ABSTRACT
Bioactive glasses (BGs) are a kind of biomaterials with osteoconductive and osteoinductive properties and are able to create a strong bond with host bone and promote osteogenesis after implantation. According to their compositions, bioactive glasses can be classified as silicate BGs, phosphate BGs, and borate BGs. Nowadays, silicate BGs are still the most common, while phosphate BGs and borate BGs have higher dissolution and degradation rates. Melt?quenching and sol?gel process are two basic methods to produce melt?derived BGs and sol?gel BGs, respectively. The latter requires lower heat treatment temperature with higher specific surface area and biological activity. Bioactive glass?ceramics can be obtained by heat treatment, which improves the mechanical strength but slightly reduces the bioactivity. Nano?bioactive glasses with the higher specific surface area can be ob?tained by changing the structure size of the materials by other treatment methods. On this basis, 3D BGs scaffolds can be made, and hybrid BGs scaffolds as well by combining with other biomaterials to obtain the 3D interconnected pores with the hierarchical or bionic structures, to enhance the mechanical strength, osteogenic activity and provide mechanical support suitable for the host bone. However, the bioactivity of BGs depends on the degradation rate, to some extent, which is contradictory to the mechanical strength. An appropriate porosity or controllable degradation rate can be selected to meet the common needs of early support and osteogenesis. In basic studies, it was found that BGs could act on cells by releasing ions or through the macropinocytosis pathway, up?regulating the expression of related genes or promoting osteogenesis. The degradation rates of BGs are related to their struc?tures and compositions, which enables the quantitative prediction of the change of mechanical strength during degradation. Prog?ress has also been made in structural mechanics and testing methods.