Understanding endometriosis from an immunomicroenvironmental perspective / 中华医学杂志(英文版)

Endometriosis, a heterogeneous, inflammatory, and estrogen-dependent gynecological disease defined by the presence and growth of endometrial tissues outside the lining of the uterus, affects approximately 5-10% of reproductive-age women, causing chronic pelvic pain and reduced fertility. Although the etiology of endometriosis is still elusive, emerging evidence supports the idea that immune dysregulation can promote the survival and growth of retrograde endometrial debris. Peritoneal macrophages and natural killer (NK) cells exhibit deficient cytotoxicity in the endometriotic microenvironment, leading to inefficient eradication of refluxed endometrial fragments. In addition, the imbalance of T-cell subtypes results in aberrant cytokine production and chronic inflammation, which contribute to endometriosis development. Although it remains uncertain whether immune dysregulation represents an initial cause or merely a secondary enhancer of endometriosis, therapies targeting altered immune pathways exhibit satisfactory effects in preventing disease onset and progression. Here, we summarize the phenotypic and functional alterations of immune cells in the endometriotic microenvironment, focusing on their interactions with microbiota and endocrine and nervous systems, and how these interactions contribute to the etiology and symptomology of endometriosis.

Treatment status and meditation of benign gallbladder diseases / 中华消化外科杂志

Benign gallbladder diseases are common diseases in general surgery, including gallstones, polypoid lesions, cholecystitis, etc. In China, the treatment of benign gallbladder diseases is still not standardized, which mainly shows in following aspects: (1)the tendency of cholecystectomy to all gallbladder diseases may result in the incidence of abdominal pain, distension, diarrhea and bile duct injury after surgery; (2)the attitude of "no-surgery" in which the standard cholecystectomy fails to implement in time for the benign gallbladder diseases with potential high-risk factors for gallbladder cancer, as a result, patients develop occurrence of gallbladder cancer. Especially, gallbladder sparing surgery is an unscientific surgery for benign gallbladder diseases, the gallbladder may become a high-risk factor for cancer after the operation. Implementation of standard cholecystectomy in time for benign gallbladder diseases with potential high risk gallbladder cancer can not only significantly reduce the incidence of gallbladder cancer, but also significantly improve the early diagnosis and the prognosis. Based on current literatures, the authors analyze the treatment status of benign gallbladder diseases, and investigate the disputes and problems in surgical indications, operation time and the selection of treatments of benign gallbladder diseases.