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@#Currently, in precision cardiac surgery, there are still some pressing issues that need to be addressed. For example, cardiopulmonary bypass remains a critical factor in precise surgical treatment, and many core aspects still rely on the experience and subjective judgment of cardiopulmonary bypass specialists and surgeons, lacking precise data feedback. With the increasing elderly population and rising surgical complexity, precise feedback during cardiopulmonary bypass becomes crucial for improving surgical success rates and facilitating high-complexity procedures. Overcoming these key challenges requires not only a solid medical background but also close collaboration among multiple interdisciplinary fields. Establishing a multidisciplinary team encompassing professionals from the medical, information, software, and related industries can provide high-quality solutions to these challenges. This article shows several patents from a collaborative medical and electronic information team, illustrating how to identify unresolved technical issues and find corresponding solutions in the field of precision cardiac surgery while sharing experiences in applying for invention patents.
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Cyclosporin A (CYPA) is an important member of the cyclophilin family, encoded by the peptidyl prolyl isomerase A gene, and has a variety of important biological functions, mainly involved in inflammation, immunity, and other pathophysiological processes. In addition, CYPA plays a regulatory role in tumor cell proliferation, invasion, apoptosis, metastasis, angiogenesis, and epithelial-mesenchymal transition through various molecular mechanisms, among which the specific binding of CYPA to CD147 has received wide attention. In this review, the mechanism of CYPA in various malignant tumors was mainly reviewed, and its regulatory mechanism and potential interventions in malignant tumors were analyzed, with the aim that CYPA will play an important role in the early diagnosis and precise treatment of tumors in the future.
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Precision medicine aims at using target therapy on specific diseases by studying the pathogenesis and finding biomarkers. Inborn errors of immunity (IEI) are caused by single gene mutations, providing the perfect human models to study immunology. The technology rapidly developes recently, so scientists have a deeper understandings of the phenotypes, genotypes, and the biological targets, so that doctors are able to use precision medicine on IEIs with many successful cases. The precision medicine have advantages in the treatment of pathogenesis of diseases. This article summarizes successful cases of using precision medicine for IEI recently.
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Metastatic colorectal cancer (mCRC) is a clinical and molecular heterogeneous disease. Currently, for mCRC, extended rat sarcoma (RAS) testing is recommended in routine clinical practice before any treatment. RAS mutational status is significantly associated with the outcome of patients and strongly predictive for anti-EGFR-targeted therapy. However, specific treatments for RAS target are not yet available. Previous studies have shown that direct inhibition of RAS proteins has limited clinical benefits. Recently, a promising drug, AMG-510, which can directly inhibit KRAS G12C has been reported; however, it needs further confirmation. In the past few years, important advances have also been made in approaches designed to indirectly target RAS by inhibiting RAS effectors, multi-target combination strategies and immunotherapy. They are expected to be effective treatments for RAS target. This article summarizes the precision treatment of RAS-mutant mCRC.
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The osteoporotic thoracolumbar fracture (OTLF) accounts for nearly half of all osteoporotic fracture. Although this kind of fracture is more likely to heal spontaneously, some patients may experience complications such as chronic lower back pain, decreased pulmonary function, kyphosis, neurological dysfunction and mobility problems. Some relevant guidelines and expert consensus on osteoporosis and OTLF have been made at home and abroad, but there still exists a great controversy regarding the choice of treatment options for OTLF. Therefore, by summarizing the treatment progress of OTLF, the authors put forward the viewpoint of stepwise treatment of OTLF from the two aspects of the choice of treatment mode and the choice of surgical plan. At the same time, the concept of precision treatment is proposed, including accurate diagnosis, accurate treatment and application of intraoperative digital assistive technology, to provide a reference for clinicians to reasonably choose treatment methods.
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Objective To design a new type of rehabilitation device to execute electrode fixation and precision positioning during transcranial electrical stimulation.Methods The device was composed of a positioning cap,a soft rubber keel scaffold, an inlaid nut,a unionbolt,an electrical stimulation shim and etc.The electrode was put into the shim at the target site,and fixation and positioning were realized by regulating the depth of the bolt into the slot to change the attachment between the electrode fixing cushion and cranial skin,and then electrical stimulation therapy could be carried out reliably and accurately. Results The device gained advantages over the traditional means in fixation time in one time, dropping-off rate, patient satisfaction and easy operation.Conclusion This device behaves well in simple structure,easy manufacture,low cost,fixation and large applicability to kinds of population and electrical stimulators,and enhances the reliability of transcranial electrical stimulation therapy to some extent.
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Angiogenesis inhibitors can make tumor cells in a harsh environment by inhibiting tumor angiogenesis and effectively blocking the tumor progression.However,anti-angiogenic drugs have shown lots of limitations,such as short-term duration,numerous adverse reactions,benefiting only a minority of tumor types and so on.These limitations restrain the development of new drugs and limit the cancer therapies.Many studies have revealed that tumor cells can escape from anti-angiogenic treatments through a variety of ways and mechanisms.In this review,we focus on the reasons behind the failure in treatments,so as to propose solving strategies to improve the current anti-angiogenic drug efficacy and provide reference for new angiogenesis inhibitors and clinical medication.
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Precision medicine has shown a new hope for cancer treatment because it can provide clear individual disease causes, precision therapeutic targets and accurate classification based on the genome sequencing, bioinformatics, and large database. However, the effective precision therapy should also include how to deliver and release drugs with controlled dosage at the precision therapeutic targets. A challenge in clinical anti-tumor precision therapy is how to achieve precision delivery and regulate the dosage of screened drugs, including how to overcome the biological barrier, how to safely deliver the drugs to nidus, how to enhance intratumoral accumulation of drugs, how to promote endocytosis of target cells, and how to accurately deliver drugs to intracellular therapeutic targets. Nanomedicine can effectively solve the problems as mentioned above. Through fine design and nanocarrier tailoring, nano-products will accurately and efficiently deliver the screened drug molecules to target organs, target tissues, target cells or intracellular target organelles, and precisely release the drug to a desirable dosage under the stimulation of lesions. The combination of precision medicine and nanomedicine can efficiently achieve precision therapy: from the tumor molecular classification, drug screening, drug precision delivery, controlled drug release to the treatment. Consequently, precision medicine mainly refers to accurate diagnosis and accurate screening of drug targets, which is the so called “advance troops and scouts” of precision treatment of cancer. Nanomedicine mainly focuss on the accurate delivery and controlled release of drugs to the therapeutic target, which can be called “accurate strategic bombing”. Both precision medicine and nanomedicine are essential and interdependent elements in precision therapy.
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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have become the preferred treatment option for advanced non-small-cell lung cancer (NSCLC) patients with activating mutations in epidermal growth factor receptor (EGFR) according to major practice guidelines. Gefitinib, elortinib and icotinib formed the cornerstone of first-line EGFR-TKIs in the clinical practice in our country. Now, with the continuously emerging of new types of EGFR-TKIs and ever-increasing publication of clinical trial results on afatinib, AZD9291 and other TKIs, we have more first-line choices for patients with EGFR mutations. Meanwhile, the development of gene detection technology is facilitating investigators to get insights on the molecular biological behavior of NSCLC and to elucidate the mechanism of drug resistance. This review will focus on precision first-line therapy for advanced NSCLC patients harboring EGFR mutation.
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Recently, with the research progress in molecular classification, the treatment of advanced non-small cell lung cancer (NSCLC) has been established as a model of anti-tumor treatment of precision medicine. The discovery of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) has transformed the treatment of NSCLC from platinum based doublet chemotherapy into era of target therapy. EGFR-TKI, such as erlotinib and gefitinib, have been recommended as standard first-line treatment of patients with EGFR mutation. However, acquired resistance, defined as tumor progression after initial response, seems to be an inevitable consequence of this treatment approach. Clinical modes of EGFR-TKI failure are classified into three types: dramatic progression, gradual progression and local progression. A threonine-to-methionine substitution (T790M) in exon 20 of the EGFR gene is the most common mechanism of resistance. Other mechanisms of resistance include MET amplification, epithelial to mesenchymal transition, small cell transformation, and PIK3CA mutation. This brief comment will provide an overview of the complex and heterogeneous problem of acquired resistance to EGFR-TKI therapy in NSCLC, and the clinical treatment options and new targeted drugs overcoming EGFR-TKI acquired resistance.
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Inflammatory bowel disease (IBD) is a bowel disease with uncontrolled inflammation and unknown etiology.With the recent expert consensus,multidisciplinary collaborative groups focusing on IBD have been gradually built in China,and IBD is not only an internal medical disease anymore.Furthermore,the therapeutic effect of IBD has also been greatly improved,but it is still not satisfactory.Precision therapy is the future direction of treatment for IBD,meanwhile,stem cell therapy and fecal transplantation also provide the new choices for refractory IBD.