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As precision and intelligent medicine takeing hold, the concept of minimally invasive surgery for gastric cancer has evolved from simply pursuing the effect of surgical results to being more patient-centered, safer, less trauma, more efficient, and more in line with the spirit of the evidence-based decision-making comprehensive treatment model. The authors review the develop-ment and technical innovation of precise and intelligent surgery in recent years, and proposes the expanding direction of new paradigm of precise and intelligent minimally invasive surgery for gastric cancer based on the work and achievements of team work. It is believed that in the future, advances in artificial intelligence, fluorescence imaging, surgical navigation, optical biopsy and other technolo-gies will bring new vitality to minimally invasive surgery for gastric cancer.
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Integrated pharmacological approach was used to predict the target genes and signal pathways of Xiaoer Fupi granules in the treatment of functional dyspepsia(FD), and the possible mechanism was discussed. The disease target information was collected by the DISEASES and UniProt databases, integrated pharmacological platform of traditional Chinese medicine(TCM-IP) was used to predict chemical composition, target, protein gene ontology(GO) function and Kyoto encyclopedia of genes and genomes(KEGG) pathway, and the networks of candidate target and TCMs-chemical components-core targets-key pathways were constructed. A total of 2 882 potential targets and 96 candidate target pathways were predicted, and β-1,4-galactosyltransferase(β-1,4-GalT) subtypes(B4GALT4, B4GALT2, B4GALT1) and phosphorylated protein kinase C subtype D(PRKCD), adenylate cyclase 2(ADCY2) and other targets were predicted. Some pathways were enriched, such as nervous system, endocrine system, thyroid hormone signaling pathway, long-term depression and other pathways related to FD. It was predicted that Xiaoer Fupi granules for treating FD by regulating gastrointestinal hormones, anti-depression, and regulating nerves and endocrine system. This study provides a basis for the precise clinical application and positioning of Xiaoer Fupi granules, and helps to clarify the mechanism of this drug.
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Tumor heterogeneity is one of the characteristics of malignant tumors, which can cause differences in tumor growth rate, invasion, migration, drug sensitivity and prognosis. Discoveries and development upon on tumor-driver genes and targeted therapy paved the way on dealing with cancer diagnosis and treatment. However, the existence of tumor heterogeneity makes malignant tumor more hardly to overcome. It is generally present and far more complicated during the process of cancer recurrence, development and evolution. Thus, it has becoming key areas in precision medicine regarding to designing optimal therapeutic approaches targeting the mechanisms and phenotypes of tumor heterogeneity, based on novel detecting techniques and new concepts and theory. This review summarized the current references on tumor heterogeneity, in order to better understand the function and mechanisms, and eventually manage tumor heterogeneity through various methods. .
Subject(s)
Humans , Evolution, Molecular , Mutation , Neoplasms , Diagnosis , Genetics , Pathology , TherapeuticsABSTRACT
Because of the special anatomical position of hilar cholangiocarcinoma and its characteristics of longitudinal and vertical invasion,it is difficult to obtain satisfactory effect by surgical resection.More and more researchers have realized that the treatment of the hilar cholangiocarcinoma should take biological characteristics of the tumor.Precise medicine using of frontier technologies and omics technologies such as proteomics and genomics,can accurately diagnose diseases at molecular level and may provide a new model for the treatment of hilar cholangiocarcinoma.The gene mutation rate of the hilar cholangiocarcinoma is higher,and the most common mutation genes are KRAS and TP53,following other genes such as CDKN2A,SMAD4,ERBB2,PTEN,APIK3CA,ARID1A,MLL3,ROBO2,RNF43,and PEG3,GNAS,etc.Such frequent,important functional mutations suggest that hilar cholangiocarcinoma may have potential therapeutic targets for molecular targeted drugs.However,due to the complex pathogenesis of the bile duct cancer,the clinical trials of most targeted drugs have not been able to achieve breakthrough progress.Surgical resection should still remain the dominant treatment.The appropriate extent of hepatectomy should be determined individually,and the minor resection is enough for most hilar cholangiocarcinoma.
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American Society of Clinical Oncology has named immunotherapy 2.0 as the advance of this year recently .This se-lection is based on the recognition of the amazing progress achieved by the immunotherapy agents .Lung cancer is the leading cause of cancer death worldwide .Immunotherapy , along with traditional treatment strategies such as chemotherapy , radiation therapy and targe-ted therapy , provides patients of lung cancer with more possibilities .The new era of immunotherapy seems irresistible .
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With the efforts of several generations, modern medicine has been from experience medicine and evidence-based medicine to the precise medicine. The precision medicine has also become a common goal for global clinical workers. However, traumatic brain injury involves a wide range and various types of injuries. The extent of the brain damage caused by trauma is complex. There is still a big gap between current medicine and precise medicine in the treatment of traumatic brain injury. Therefore, to achieve accurate, punctual, sharing and individualized precision medicine of traumatic brain injury, we must follow the objective routines of traumatic brain injury, and constantly improve the monitoring and treatment means of traumatic brain injury, and constantly improve the clinical research with globalization, multi-center, large data and prospection.
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Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.
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Syncope is one of the most common emergencies in the pediatric population.Autonomic -mediated reflex syncope,including postural tachycardia syndrome and vasovagal syncope,is the main cause.Although the clinical manifestations are similar,each subtype has its optimal treatment option.With the development of translational medicine in recent years,as well as the emergence of biomarkers,precision medicine has become possible,and will be the main direction in the future researches.
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Clinic genetic testing have make rapid progress in recent years , and have been widely applicated in genetic disease diagnosis , infection disease diagnosis and personalized treatment .The aim of this article is to pay attention to the ethical issues raised by genetic testing .The important ethical problems are proposed accompany with prenatal , adolescent, and adult genetic testing respectively .We should adopt responsible best ethical practices in the provision of genetic testing , promote the widely application of gene detection in clinic orderly.
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Dormant follicular lymphoma, prostate carcinoma and breast carcinoma are frequently detected by autopsy of non-tumor patients. Dormancy of malignant cells in hematopoietic malignancies is associated with genesis, development and treatment of these diseases. Dormancy is the universally applied strategy by living organism during survival competition. As the in vivo neoplasm, tumor cells keep this property. Recently, much attention has been paid to the mechanisms of tumor dormancy. These studies not only have theoretical significance, provide new ways for the prevention and treatment of tumors, but also help the understanding of over-diagnosis, over-treatment and provide clues for precise medicine. This paper reviewed cellular mechanism of tumor cell dormancy,immunological and vascular regulation of dormant tumors. The clinical significance,application of these mechanisms and direction of further study, which will provide new clues for the treatment of hematopoietic malignancies, were also discussed.