Treatment Strategies and Prognostic Factors in Patients with Stage T3 and T4 Laryngeal Carcinoma / 肿瘤防治研究

Objective To investigate the selection of treatment strategies and prognostic factors for patients with stage T3 and T4 laryngeal carcinoma. Methods A total of 132 patients with stage T3 and T4 laryngeal cancer admitted to our hospital from March 2010 to March 2019 were retrospectively selected as research objects. According to the different treatment strategies, the patients were divided into simple surgery group (group A, 57 cases), simple chemoradiotherapy group (group B, 32 cases), and surgery combined with chemoradiotherapy group (group C, 43 cases). The general data and clinicopathological features of the three groups were compared, and a survival curve was drawn by the Kaplan–Meier method. The 3-year survival rates of the three groups were compared. Then, the same 132 patients were divided into survival and death groups. The clinical data of the two groups were compared, and the prognostic factors were analyzed by multivariate logistic regression. A back propagation (BP) neural network model was constructed, and its differentiation and accuracy were evaluated. Results The proportions and 3 year survival rates of patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule in group C were significantly higher than those in groups A and B (P < 0.05). The 3 year survival rate of 132 patients was 68.94%(41/132). Poor differentiation, N2-N3 stage, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule were risk factors for death (P < 0.05), whereas surgery combined with radiotherapy and chemotherapy were protective factors (P < 0.05). The BP neural network model exhibited good discrimination and high accuracy. Conclusion Surgery combined with radiotherapy and chemotherapy can significantly improve survival rate in patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule. Close attention should be paid to patients with stage N2-N3 in the formulation of reasonable treatment strategies.

Recent advances in diverse nanosystems for nitric oxide delivery in cancer therapy

Gas therapy has been proven to be a promising and advantageous treatment option for cancers. Studies have shown that nitric oxide (NO) is one of the smallest structurally significant gas molecules with great potential to suppress cancer. However, there is controversy and concern about its use as it exhibits the opposite physiological effects based on its levels in the tumor. Therefore, the anti-cancer mechanism of NO is the key to cancer treatment, and rationally designed NO delivery systems are crucial to the success of NO biomedical applications. This review summarizes the endogenous production of NO, its physiological mechanisms of action, the application of NO in cancer treatment, and nano-delivery systems for delivering NO donors. Moreover, it briefly reviews challenges in delivering NO from different nanoparticles and the issues associated with its combination treatment strategies. The advantages and challenges of various NO delivery platforms are recapitulated for possible transformation into clinical applications.

Rare tumors: a blue ocean of investigation / 医学前沿

Advances in novel drugs, therapies, and genetic techniques have revolutionized the diagnosis and treatment of cancers, substantially improving cancer patients' prognosis. Although rare tumors account for a non-negligible number, the practice of precision medicine and development of novel therapies are largely hampered by many obstacles. Their low incidence and drastic regional disparities result in the difficulty of informative evidence-based diagnosis and subtyping. Sample exhaustion due to difficulty in diagnosis also leads to a lack of recommended therapeutic strategies in clinical guidelines, insufficient biomarkers for prognosis/efficacy, and inability to identify potential novel therapies in clinical trials. Herein, by reviewing the epidemiological data of Chinese solid tumors and publications defining rare tumors in other areas, we proposed a definition of rare tumor in China, including 515 tumor types with incidences of less than 2.5/100 000 per year. We also summarized the current diagnosis process, treatment recommendations, and global developmental progress of targeted drugs and immunotherapy agents on the status quo. Lastly, we pinpointed the current recommendation chance for patients with rare tumors to be involved in a clinical trial by NCCN. With this informative report, we aimed to raise awareness on the importance of rare tumor investigations and guarantee a bright future for rare tumor patients.

Effect of traditional Chinese medicine in attenuating chronic kidney disease and its complications by regulating gut microbiota-derived metabolite trimethylamine N-oxide: a review / 中国中药杂志

Trimethylamine N-oxide(TMAO), a metabolite of gut microbiota, is closely associated with chronic kidney disease(CKD). It can aggravate the kidney injury and promote the occurrence of complications of CKD mainly by inducing renal fibroblast activation, vascular endothelial inflammation, macrophage foaming, platelet hyperreactivity, and inhibition of reverse cholesterol transport. Thus it is of great significance for clinical treatment of CKD to regulate circulating TMAO and alleviate its induced body damage. Currently, therapeutic strategies for TMAO regulation include dietary structure adjustment, lifestyle intervention, intestinal microflora regulation, and inhibition of intestinal trimethylamine synthesis and liver trimethylamine oxidation. Chinese medicinal herbs have the clinical advantage of multi-component and multi-target effects, and application of traditional Chinese medicine(TCM) to synergistically regulating TMAO and improving CKD via multiple pathways has broad prospects. This study systematically reviewed the clinical relevance and mechanism of TMAO in aggravating CKD renal function deterioration and complication progression. In addition, the effect and mechanism of TCM in improving TMAO-induced kidney injury, cardiovascular disease, hyperlipidemia, thrombosis and osteoporosis were summarized. The results provided a theoretical basis for TCM in attenuating gut microbiota-derived metabolite TMAO and improving CKD, as well as a basis and direction for in-depth clinical development and mechanism research in the future.

Initial study on a comprehensive strategy for female patients with bladder pain syndrome / 现代泌尿外科杂志

【Objective】 To explore the efficacy of a comprehensive treatment strategy of bladder hydrodistension, transurethral resection of bladder lesions and triple drug instillation in patients with painful bladder syndrome (BPS). 【Methods】 A total of 15 female BPS patients treated during Jan.2020 and Oct.2021 were enrolled. All patients received bladder hydrodistension and transurethral resection. After operation, intravesical instillation of a triple-drug mixture (2% lidocaine hydrochloride 20 mL, heparin sodium 25 000 U, and dexamethasone 10 mg) was administered once a day for 5 days, and then once per week for 4 weeks. The Visual Analogue Scale (VAS) score, quality of sexual life, health-related quality of life, and self-rating anxiety scale score were compared before treatment and 1, 4 and 12 weeks after treatment. The complications were recorded. 【Results】 All patients completed the treatment. Of 14 patients, the VAS score and self-rating anxiety scale score were lower in week 1, 4 and 12 after treatment, while the health-related quality of life score increased. One patient’s symptoms remained unchanged. The VAS score decreased from (5.47±1.81) to (1.87±1.51) (P<0.05), and the self-rating anxiety scale score decreased from (18.13±8.64) to (6.33±8.22) (P<0.05). The score of health-related quality of life increased from (24.47±5.41) to (31.53±6.49) (P<0.05). 【Conclusion】 The comprehensive strategy is effective in the treatment of bladder pain syndrome, which can relieve pain symptoms and improve patients’ quality of life.

Strategies of Traditional Chinese Medicine Standardized Treatment Based on Syndrome Differentiation of Bipolar Disorder / 中国实验方剂学杂志

Bipolar disorder （BD） is a serious chronic emotional disorder with a high suicide rate and a common psychiatric disease. Traditional Chinese medicine （TCM） treatment based on syndrome differentiation of BD has unique advantages and good safety， which is expected to become a breakthrough in the treatment. Based on Expert Consensus on TCM Syndrome Differentiation Criteria for Bipolar Disorder by Professor Yin Dongqing and Professor Jia Hongxiao， this study collated the treatment protocols of BD with various syndrome types according to Meta-analysis of the existing literature in the database and evaluated the evidence level according to the evidence evaluation standard issued by the US Agency for Healthcare Research and Quality （AHRQ）. （1） Depression attack. ① Liver depression and spleen deficiency syndrome： Xiaoyaosan pills or Shugan Jieyu capsules， ② Phlegm dampness and spleen stagnation syndrome： Wendantang modified with Tianwang Buxindan， ③ Heart and spleen deficiency syndrome： Jiuwei Zhenxin Granules or DANG's Ganmai Dazhaotang， ④ Fire heat and internal depression syndrome： Danzhi Xiaoyaosan Granules or Chaihu Longgu Mulitang， ⑤ Liver and kidney deficiency syndrome： JIANG's Buganshen Decoction. （2） Mania episode. ① Heart and liver fire hyperactivity syndrome： Zhengan Ningshen Formula， ② Phlegm heat harassing spirit syndrome： Huatan Xiehuo Dingshen decoction， Lianzhi Tongqiao Anshen decoction， Qingshen Dingkuang decoction or Qingshen Xingnao decoction， ③ Liver and gallbladder dampness-heat syndrome： Longdan Xiegantang. （3） Other syndrome types. ① Liver qi stagnation syndrome： modified Tongqiao Huoxue decoction， Shengyang Yiwei Acupuncture， ② Deficiency of kidney yang syndrome： Jingui Shenqitang， ③ Phlegm accumulation and blood stasis syndrome： modified Tongqiao Huoxue decoction， ④ Qi and Yin deficiency， stagnation of blood stasis syndrome： Xinnaoxin pills， ⑤ Syndrome of blood deficiency generating wind and fire heat harassing spirit： Fangji Dihuangtang.

Advances in the regulation of autosomal dominant polycystic kidney disease by Hippo signaling pathway / 中华肾脏病杂志

The Hippo signaling pathway is highly conserved in evolution, and participates in the regulation of cell proliferation, differentiation, and tissular dynamic balance, and plays an important role in regulating tissue, organ size, and cell number. Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and one of the most common causes of end-stage renal disease. Emerging studies have identified the Hippo signaling pathway is closely related to the occurrence and development of ADPKD. The abnormal activity and expression of the main members of the pathway affect the cilia and cell polarity of renal tubular epithelial cells and induce the formation of renal cysts. The review summarizes the potential mechanism of the Hippo pathway in the pathogenesis of ADPKD, the crosstalk with other signaling pathways, and the variances in different species, and discusses the strategies for the treatment of ADPKD based on the Hippo signaling pathway to provide new strategies for the treatment.

Treatment of advanced non-small cell lung cancer with driver mutations: current applications and future directions / 医学前沿

With the improved understanding of driver mutations in non-small cell lung cancer (NSCLC), expanding the targeted therapeutic options improved the survival and safety. However, responses to these agents are commonly temporary and incomplete. Moreover, even patients with the same oncogenic driver gene can respond diversely to the same agent. Furthermore, the therapeutic role of immune-checkpoint inhibitors (ICIs) in oncogene-driven NSCLC remains unclear. Therefore, this review aimed to classify the management of NSCLC with driver mutations based on the gene subtype, concomitant mutation, and dynamic alternation. Then, we provide an overview of the resistant mechanism of target therapy occurring in targeted alternations ("target-dependent resistance") and in the parallel and downstream pathways ("target-independent resistance"). Thirdly, we discuss the effectiveness of ICIs for NSCLC with driver mutations and the combined therapeutic approaches that might reverse the immunosuppressive tumor immune microenvironment. Finally, we listed the emerging treatment strategies for the new oncogenic alternations, and proposed the perspective of NSCLC with driver mutations. This review will guide clinicians to design tailored treatments for NSCLC with driver mutations.

Prognostic analysis of continuous lumbar cistern external drainage after aneurysmal subarachnoid hemorrhage / 国际外科学杂志

Objective:To analyze the influencing factors, prevention and treatment strategy of short-term poor prognosis of continuous lumbar cistern external drainage after aneurysms subarachnoid hemorrhage (aSAH).Methods:Used retrospective research method, the clinical data of 300 patients with aSAH combined with continuous lumbar cistern external drainage treated in Sanya Central Hospital (Hainan Third People′s Hospital) from March 2019 to March 2021 were selected as the training set. In addition, the clinical data of 144 patients with aSAH with continuous lumbar cistern external drainage treated in Sanya Central Hospital (Hainan Third People′s Hospital) from March 2017 to May 2019 were selected as the verification set. According to the results of postoperative follow-up, the patients in the training set were divided into two groups: good prognosis group ( n=208) and poor prognosis group ( n=92). The demographic characteristics, past history, Hunt-Hess grade, modified Fisher grade, location of responsible aneurysm, postoperative complications, bone flap decompression and lumbar cistern drainage were compared between the two groups. The independent risk factors for prognosis of aSAH patients undergoing continuous lumbar cistern external drainage were screened by Cox proportional hazard regression model, and these factors were included and XGboost model was established. The prediction model was validated internally and externally in the training set and verification set: AUROC(C-index) was used to verify the model differentiation; GiViTI calibration band and Hosmer-Lemeshow test were used to verify the model calibration; DCA curve was used to verify the clinical validity of the model. Results:Hunt-Hess grade, modified Fisher grade, drainage duration, average daily drainage volume, shunt-dependent hydrocephalus, aneurysm rebleeding, cerebral vasospasm and delayed cerebral ischemia were independent risk factors for poor prognosis in patients with aSAH who underwent continuous lumbar cistern external drainage( P<0.05). The XGboost model was successfully established by incorporating the above independent risk factors, and the internal and external verification of the XGboost model was carried out in the training set and verification set, respectively, the area under the curve of receiver operating characteristic was 0.882(95% CI: 0.820-0.955) and 0.878(95% CI: 0.774-0.928) respectively, and the model differentiation was good; the 80%-90% confidence interval of the GiViTI calibration curve did not cross the 45° angle bisector ( P>0.05). In the Hosmer-Lemeshow goodness-of-fit test, the P value were 0.581 and 0.716, respectively. The threshold probability value in the DCA curve was 30.4%. The clinical net benefit rate of the training set and verification set were 31% and 34%, respectively, indicating that the prediction model was clinically effective. Conclusions:The independent risk factors for poor prognosis of aSAH patients undergoing continuous lumbar cistern drainage are Hunt-Hess grade, modified Fisher grade, cerebral vasospasm, delayed cerebral ischemia and shunt-dependent hydrocephalus. The XGboost model constructed in this study can effectively predict the prognosis of patients with aSAH undergoing continuous lumbar cistern drainage, and provide reference for the formulation of follow-up treatment plans.

Research progress on drug resistance mechanism and treatment of Stenotrophomonas maltophilia / 中华临床感染病杂志

Stenotrophomonas maltophilia is a gram-negative bacillus which widely exists in natural and hospital environment, and it is also one of the common opportunistic pathogens in clinical settings. The virulence and pathogenicity of Stenotrophomonas maltophilia are weak, however, due to resistance to a variety of antibacterial drugs, it can cause bloodstream infections or pneumonia in immunocompromised or critically ill patients, leading to poor prognosis. Moreover, the inherent drug resistance and increasing acquired drug resistance may make the treatment of the first line antibiotics, like trimethoprim-sulfamethoxazole or quinolone ineffective. Therefore, it is important to understand the drug resistance mechanism and the main countermeasures for it. In this article, the research progress on drug resistance mechanism and treatment for Stenotrophomonas maltophilia are reviewed.

Perioperative diagnosis and treatment strategies of liver transplantation for liver cancer in precision medicine era / 中华消化外科杂志

Tumor recurrence and metastasis after liver transplantation (LT) remains one of the most important factors that affect the outcome of LT for hepatocellular carcinoma (HCC). The diagnosis and treatment strategies in the era of precision medicine, including utilizing multi-omics, high-throughput gene sequencing analysis, big data and artificial intelligence to select the biomarkers which can accurately predict the prognosis after LT, evaluating the immune status comprehensively, inducing immune tolerance, providing effective prevention for patients at a high risk of recurrence with sensitive antitumor drugs and attaching importance to individualized treatment for recurrence and metastasis, may further improve the outcome of LT. Combined with experience and review of relevant research articles, the authors elaborate perioperative diagnosis and treatment strategies of LT for HCC, aiming to promote the application of precision medicine in the field of LT.

Five Views on Differentiation and Treatment-Building New System of Traditional Chinese Medicine Treatment of Tumors / 中国实验方剂学杂志

As one of the diseases with high incidence in China， cancer seriously endangers human health. The scientific research and clinical practice of traditional Chinese medicine （TCM） in the prevention and treatment of tumors during the Sixth Five-Year Plan period and the 13th Five-Year Plan period show that TCM has certain advantages in preventing and treating postoperative metastasis and recurrence， prolonging survival period， alleviating adverse reactions， and improving the quality of life of patients with advanced tumors. However， innovation of the TCM theoretical thinking and realization of the TCM full-cycle management are needed urgently， which limits the improvement of clinical efficacy. Malignant tumor is a truly representative of major difficult diseases. The simple mode of syndrome differentiation and treatment cannot meet the clinical needs， and thus the triple mode of disease， syndrome and symptom differentiation and treatment emerged， and has received widespread attention. However， since malignant tumors have their own characteristics of occurrence， development and evolvement， it is urgent to establish a new system of TCM differentiation and treatment for special diseases to adapt to the law of modern disease development. Therefore， on the basis of the triple mode， this paper innovatively proposed a new system of cancer prevention and treatment based on five views on differentiation and treatment in TCM， forming a new paradigm of whole-cycle， whole-chain and all-directional integrated Chinese and western medicine prevention and treatment of tumors. Specifically， time-space view： On the basis of the holistic concept and combined with the complex characteristics of different pathological types， lesion location， disease course and treatment stages of malignant tumors， the dynamic and systematic participation of TCM in the whole process of tumor treatment was brought into play from the time and space dimensions. Core view： The core pathogenesis was summarized based on the combination of disease and syndrome， and its key role in guiding differentiation and treatment of malignant tumors was emphasized. Additionally， the pathogenesis characteristics and evolvement rules of various cancer types in different stages were paid attention. Symptom view： The symptoms were ameliorated and the quality of life was improved. The current obvious contradictions of patients were solved to enhance the humanistic nature of treatment. Precision view： In combination of modern medical concepts， TCM constitutions and laboratory indicators， TCM advantages were enriched and emphasized for precise clinical positioning. Disease-before-onset view： As prevention is more important than treatment， precaution was focused on in each stage of tumors. The five views had different emphases and were interrelated， covering new understandings of the existing TCM prevention and treatment system of malignant tumors. In addition， new ideas and concepts have been introduced on the basis of the original TCM theory， which provided new strategies for the comprehensive prevention and treatment of tumors.

Impact of Coronavirus Disease 2019 on Prognosis and Treatment Strategies in Patients with Hematological Malignancy--Review / 中国实验血液学杂志

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since outbreak in December 2019, and become a global public health crisis. Patients with hematological malignancy concurrently infected with COVID-19 are often associated with severe even fatal complications, due to low basic immune function, high intensity of chemotherapy and radiotherapy, and slow immune reconstruction post hematopoietic stem cell transplantation, and their treatment strategies, such as anti-infective therapy, blood transfusion, and the use of granulocyte colony stimulating factor need to be adjusted. The characteristics of patients, chemotherapy, hematopoietic stem cell transplantation, and other clinical factors may affect the prognosis of patients with hematological malignancy concurrently infected with COVID-19. Herein, the latest research progress is reviewed.

Prevention and treatment strategy for deviation of costal cartilage dorsal onlay graft in rhinoplasty / 中华医学美学美容杂志

Objective:To investigate the prevention and treatment for deviation of costal cartilage dorsal onlay grafts in rhinoplasty.Methods:From January 2010 to October 2020, a total of 588 patients (83 male cases, 505 female cases, age range from 25 years to 55 years, 32±4 years in average) accepted costal cartilage rhinoplasty in Shenzhen Mylike Medical Plastic Aesthetic Hospital. During the operation, various methods were used in the process of catilage selection, water bath, sculpture, treatment of nasal dorsal, graft fixation and fascial modification to prevent and treat the deformation and displacement of the costal cartilage dorsal onlay grafts.Results:The immediate postoperative photograph of 588 cases showed that costal cartilage dorsal onlay graft was put on the middle of dorsum. After a follow-up period of 396 cases from 6 to 60 months, the average follow-up period was 12.1 months, there were 44 cases happened with the deviation of dorsal onlay grafts, and deviation was managed after the second rhinoplasty surgery. There was no prolonged function sequela such as ventilation dysfunction, abnormal sensation, or hyposmia occured. 362 cases were satisfied with the aesthetic effect.Conclusions:It is particularly important to grasp the principles of managing costal cartilage in rhinoplasty and to learn how to prevent and treat postoperative complications of costal cartilage dorsal onlay graft.

Mechanisms of recurrence and coping strategies of CD19 chimeric antigen receptor T-cell in treatment of B-cell hematologic neoplasms / 白血病·淋巴瘤

Chimeric antigen receptor T-cell (CAR-T) immunotherapy is an effective treatment method in hematologic neoplasms, especially in B-cell hematologic neoplasms. Although a high remission rate is observed clinically, a large number of patients still relapse after CAR-T trerapy. With the wide applications of CAR-T therapy in B-cell tumors and other hematologic malignancies, further clinical research on its mechanisms of recurrence and treatment strategies is needed, in order to improve the clinical efficacy and promote the prognosis of patients.

A comparative study of the effects of different treatment strategies on postoperative anal function and quality of life in patients with complete obstructive left hemicolon cancer / 中华胃肠外科杂志

Objective: To compare the effects of 3 treatment strategies (emergent surgery, self-expanding metallic stents, self-expanding metallic stents plus neoadjuvant chemotherapy) on postoperative anal function and quality of life in patients with complete obstructive left hemicolon cancer. Methods: A retrospective cohort study was conducted. Clinical data of patients with complete obstructive left hemicolon cancer admitted to General Surgery Department of Beijing Chaoyang Hospital between January 2017 and October 2019 were retrospectively collected. Patient inclusion criteria: (1) complete obstructive left hemicolon cancer was confirmed through clinical manifestation and abdominal computed tomography; (2) adenocarcinoma was confirmed by postoperative pathology; (3) emergent radical resection of primary tumor was performed with temporary stoma, or radical resection of primary tumor and primary anastomosis was performed without stoma, 7 to 14 days after completion of insertion of self-expanding metallic stents. Patients who did not receive stoma reversion after emergent operation were excluded. According to different therapies, patients were divided into three groups: emergent surgery (ES) group, self-expanding metallic stents (SEMS) group and self-expanding metallic stents plus neoadjuvant chemotherapy (SEMS+NAC) group. Wexner score for incotinence (higher score indicates the worse anal function), Vaizey score (>10 indicates fecal incontinence) and low anterior resection syndrome (LARS) scale (higher score indicates the worse anal function) were applied to evaluate anal function of patients among groups at postoperative 1-, 6- and 12-month. EORTC QLQ-C30 questionnaire was used to assess the quality of life. Risk factors of decreased anal function were identified by logistic regression analysis. Results: A total of 72 patients were enrolled, including 27 (37.5%) patients in ES group, 23 (31.9%) in SEMS group and 22 (30.6%) in SEME+NAC group. The baseline characteristics including age, gender, tumor location, comorbidities, total blood loss, operation time and postoperative complications, were comparable among groups, except that the proportion of laparoscopic surgery was significantly lower in ES group (4/27, 14.9%) than that in SEMS (15/23, 65.2%) and SEMS+NAC group (16/22, 72.7%) with significant difference (P<0.001). The follow-up ended up to October 2020, and the overall follow-up rate was 79.2% (57/72). No significant differences existed in the Wexner score of patients among groups at postoperative 1-, 6- and 12-month (all P>0.05). The Vaizey scores at postoperative 1-month in ES, SEMS and SEMS+NAC group were 7 (0-17), 3 (0-7) and 4 (0-8) respectively with significant difference (H=18.415, P=0.001), and the scores in SEMS and SEMS+NAC groups were significantly lower than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC group (P>0.05). Vaizey scores at postoperative 6- and 12-month among 3 groups were not significantly different (both P>0.05). The LARS scores at postoperative 1-month in ES, SEMS and SEMS+NAC groups were 20 (0-37), 15 (0-24) and 16 (0-28) respectively with significant difference (H=3.660, P=0.036), and the scores in SEMS and SEMS+NAC groups were significantly lower than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC groups (P>0.05). LARS scores at postoperative 6- and 12-month among 3 groups were not significantly different (both P>0.05). The QLQ-C30 score revealed that the social function of patients in SEMS group and SEMS+NAC group was significantly better than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC group (P>0.05). The logistic regression analysis revealed that only ES was an independent risk factor of decreased anal function (OR=2.264, 95% CI: 1.098-4.667, P=0.027). Conclusion: Compared to ES, SEMS may improve quality of life and short-term anal function of patients with complete obstructive left hemicolon cancer.

Clinical value of gene detection in metastatic prostate cancer / 中华泌尿外科杂志

The incidence of prostate cancer has increased over the past several years and it has become a major disease that seriously harms male health. Advanced prostate cancer is a heterogeneous disease with poor outcomes, the median overall survival of advanced prostate cancer usually less than two years. Clinical challenges include determining the optimal sequencing of systemic therapies and implementing biomarker-driven treatment approaches. The emergence of precision treatment has brought about a diagnosis and treatment strategy based on molecular testing, which provides the possibility for the formulation of individualized treatment plans.

Treatment strategy of gastrointestinal stromal tumors in the background of COVID-19 / 中华胃肠外科杂志

COVID-19, caused by SARS-COV-2, has the characteristics of world epidemic, highly infectious and large base of death. In China, transmission route of SARS-COV-2 has been contained so effectively that COVID-19 has been well controlled due to the proactive national prevention and control strategy. However, not only does it bring a huge impact on the existing medical structure model, but also an objective impact on the treatment of patients with chronic diseases such as malignant tumors. Based on the progress reported in the domestic and international literatures and the actual management experience of our team, this paper reflects on the treatment strategies for patients with gastrointestinal stromal tumor (GIST) during the epidemic period of COVID-19. We focus on risk stratification for primary GIST and forming treatment strategies accordingly. Major considerations include the impact of delayed operation, the burden of medical resources, the waiting time for elective operation, and the principle of emergency operation. In addition, we focus on the level of evidence for non-surgical approaches with a view to developing a holistic strategy of "priority management principles" to guide clinical treatment in the context of limited resources and different GIST priorities.

Changes of diagnosis and treatment strategies of retinal vein occlusion according to EURETINA updated guidelines / 中华实验眼科杂志

Retinal vein occlusion (RVO) is one of the most common diseases severely threatening visual acuity.There is not a complete consensus on the clinical treatment strategies and schemes,and no guideline or consensus has been published in China.The publication of the latest international guidelines has provided more comprehensive and clear suggestions and advices for treatment and management strategies for RVO.Reading and understanding those guidelines could provide references for clinical practice,and offer help for standard diagnosis and treatment.

Advances in the research of anti-organ fibrosis drugs / 药学学报

Fibrosis is a pathological process characterized by tissue scars and can occur in many organs of the human body. Organ fibrosis is manifested by increased fibrous connective tissue and reduced parenchymal cells in organ tissues, which can lead to destruction of organ structures and reduced function, which seriously endangers human health. Current strategies for treating organ fibrosis include: blocking the transforming growth factor-β1 (TGF-β1)/Smad signaling pathway, anti-inflammatory, regulating the sphingosine kinase 1/sphingosine-1-phosphate (SK1/S1P) signaling pathway, antagonizing vasoactive peptide receptors, enzyme inhibitors, kinase inhibitors, inhibitors of cellular signaling pathway, regulation of metabolic pathways, and mesenchymal stem cell therapy. In the review, the treatment strategies for organ fibrosis and the latest developments in the research of anti-organ fibrosis drugs are summarized to provide a reference for the development of anti-organ fibrosis drugs.