Résumé
With the arrival of an aging society, the number of orthopedic geriatric patient who require surgical treatment is also rapidly increasing. Elderly patients have decreased hematopoietic function, and perioperative blood management is difficult and challenging. This article aims to elaborate on the perioperative blood management strategies for orthopedic geriatric patients, including the diagnosis and treatment of preoperative anemia, specific measures to reduce perioperative blood loss, and blood transfusion strategies.
Résumé
Development of ovarian cancer involves the co-evolution of neoplastic cells together with the adjacent microenvironment. Steps of malignant progression including primary tumor outgrowth, therapeutic resistance, and distant metastasis are not determined solely by genetic alterations in ovarian cancer cells, but considerably shaped by the fitness advantage conferred by benign components in the ovarian stroma. As the dynamic cancer topography varies drastically during disease progression, heterologous cell types within the tumor microenvironment (TME) can actively determine the pathological track of ovarian cancer. Resembling many other solid tumor types, ovarian malignancy is nurtured by a TME whose dark side may have been overlooked, rather than overestimated. Further, harnessing breakthrough and targeting cures in human ovarian cancer requires insightful understanding of the merits and drawbacks of current treatment modalities, which mainly target transformed cells. Thus, designing novel and precise strategies that both eliminate cancer cells and manipulate the TME is increasingly recognized as a rational avenue to improve therapeutic outcome and prevent disease deterioration of ovarian cancer patients.