This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretat...This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.展开更多
BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a ...BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.展开更多
In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological interve...In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.展开更多
BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MO...BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.展开更多
AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective co...AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojeju...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.展开更多
BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases an...BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases and 57000 deaths were reported worldwide in 2020.The main modalities for melanoma treatment include surgery,immunotherapy,targeted therapy,high-dose interferon,antitumor angiogenesis,chemotherapy,and radiotherapy.Due to China's special national conditions,the main pathological types and therapeutic effects are greatly different from those in Europe and the United States,so more studies are needed to determine the curative effects of such treatments in the Chinese population.AIM To explore their clinical characteristics,prognostic influencing factors and realworld data to provide a reference basis for further diagnosis and treatment.METHODS We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years.Univariate analysis was conducted using the log-rank test,while multivariate analysis was performed with the Cox proportional hazard regression model.The survival rate was calculated using the Kaplan-Meier method.RESULTS The male-to-female patient ratio was 1.04:1.Among the clinical classifications,melanoma of the limb accounted for 47.56%of cases,followed by melanoma of the skin(18.18%)and mucosal melanoma(18.05%).The 5-year survival rates for stage I-II,stage III,and stage IV patients were 54.65%,37.88%,and 28.58%,respectively.Univariate analysis revealed that age,tumor stage,treatment mode,platelet count at the first visit,and lactate dehydrogenase(LDH)level were significantly related to patient survival.Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year,3 years,and 5 years.Multivariate analysis demonstrated that tumor stage,chemotherapy,interferon therapy,and LDH level were independent risk factors affecting patient survival and prognosis.Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy,those of patients who received chemotherapy and interferon therapy were 30.0%and 44.5%lower,respectively.Additionally,patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels.CONCLUSION Melanoma is highly malignant,and its prognosis is influenced by numerous factors,resulting in an overall poor prognosis.This study identified several factors that impact patient prognosis,providing a foundation for individualized comprehensive treatment.展开更多
Ovarian cancer remains a leading cause of gynecological cancer mortality1,and patients with advanced stage ovarian cancer frequently develop malignant ascites that foster immunosuppressive microenvironments and therap...Ovarian cancer remains a leading cause of gynecological cancer mortality1,and patients with advanced stage ovarian cancer frequently develop malignant ascites that foster immunosuppressive microenvironments and therapeutic resistance2,3.Although ascites have traditionally been considered detrimental,we report a paradoxical role in which they enhance the cytotoxicity ofγδT cells—a unique T cell subset that can be allogenically transferred for cancer treatment4,5—toward ovarian cancer.展开更多
Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It ...Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.展开更多
This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obst...This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical outcomes.By comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused on.Additionally,patient selection for stenting and future advancements in stent technology are important.Overall,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery.展开更多
With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as ...With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as sarcopenia(SP).In recent years,a growing number of studies have investigated SP,revealing that many tumor diseases,especially in the digestive system,promote its occurrence due to the influence of the disease itself,diet,and other factors.Moreover,SP patients tend to have poorer postoperative recovery.At present,many diagnostic methods have been developed for SP,but no unified standard has been established.Furthermore,the cutoff values of many diagnostic methods for different populations are still in the exploratory stage,and additional clinical studies are required to explore these issues.This article comprehensively and systematically summarizes the diagnostic methods and criteria mentioned in previous research,focusing on the impact of SP on post-surgical patients with various malignant tumors.展开更多
Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between Octob...Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between October 2022 and October 2024 were selected for high-frequency ultrasound diagnosis.The diagnostic efficacy of high-frequency ultrasound was evaluated by comparing it with the results of surgical pathology.Results:High-frequency ultrasound detected 50 benign nodules,primarily breast fibroadenomas,and 35 malignant nodules,mainly breast ductal carcinoma in situ.Based on surgical pathology results,the diagnostic accuracy of high-frequency ultrasound was 96.47%,specificity was 97.96%,and sensitivity was 94.44%.In high-frequency ultrasound diagnosis,the proportion of grade III and IV blood flow in malignant nodules was higher than that in benign nodules,while the proportion of regular shape and clear margins was lower.The proportion of microcalcifications and posterior echo attenuation was higher in malignant nodules,and the resistance index(RI)and peak blood flow velocity were lower than those in benign nodules(P<0.05).Conclusion:High-frequency ultrasound can effectively differentiate benign and malignant breast micronodules,determine specific nodule types,and exhibits high diagnostic accuracy and sensitivity.Additionally,benign and malignant nodules can be differentiated based on the grading of blood flow signals,sonographic features,and blood flow velocity,providing reasonable guidance for subsequent treatment plans.展开更多
BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this...BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this tumor is categorized as a rare form.AIM To examine growth suppressive effect of GO-Y030,a diarylpentanoid curcumin analog,(1E,4E)-1,5-bis[3,5-bis(methoxymethoxy)phenyl]penta-1,4-dien-3-one against the malignant meningioma.METHODS The growth suppression of malignant meningioma cells by GO-Y022 and GOY030 were examined,using IOMM-Lee and HKBMM cell lines.Male nude mice aged eight weeks,specifically BALB/cSlc-nu/nu mice received a subcutaneous inoculation of IOMM-Lee(107 cells/site)on their back and 30μg/kg of recombinant hepatocellular growth factor(HGF)was injected into the tumor every three days.After confirmed the growth tumor mass,500μL of GO-Y030 diluted with PBS were administrated intraperitoneally daily at doses of 1 mg/kg and 2 mg/kg,respectively.RESULTS GO-Y030 exhibits a growth inhibitory effect on malignant meningioma cell lines,IOMM-Lee and HKBMM ranging from 0.8-2.0μM in vitro.Notably,GO-Y030’s inhibitory effect is about 10 to 16th times more potent than that of curcumin,which has previously demonstrated potential in combating malignant meningioma.In mouse models,the intraperitoneal administration of GO-Y030 effectively suppresses the growth of malignant meningioma tumors that have been inoculated in the back(P=0.002).High-performance liquid chromatography analysis has confirmed the distribution of GO-Y030 in the bloodstream and brain tissue.Moreover,GOY030 demonstrates the ability to significantly suppress HGF(P<0.01),nuclear factor kappa B(P<0.001),and Ncadherin(P<0.001),all of which contribute to the epithelial-mesenchymal transition.CONCLUSION GO-Y030 holds promise as a potent compound for the systemic inhibition of malignant meningioma.GO-Y030 has higher tumor growth inhibitory effect against meningiomas than curcumin,which is known to have antitumor activity through multi-molecular target control resulting in apoptosis induction.GO-Y030 controls at least three molecules of HGF,nuclear factor kappa B,and N-cadherin.展开更多
BACKGROUND Osteoporotic vertebral fracture(OVF)is one of the most common sequelae of osteoporosis.Differential diagnosis between OVF and malignant vertebral fracture(MVF)is a challenge in clinical practice.Findings on...BACKGROUND Osteoporotic vertebral fracture(OVF)is one of the most common sequelae of osteoporosis.Differential diagnosis between OVF and malignant vertebral fracture(MVF)is a challenge in clinical practice.Findings on computed tomography and magnetic resonance images(MRI)may help to differentiate between these two types of fracture.AIM To determine whether paravertebral soft tissue swelling is useful for differentiation between OVF and MVF.METHODS We retrospectively reviewed the MRI for 165 patients diagnosed with a vertebral fracture between May 2021 and July 2022.Three radiologists evaluated the vertebral segments and thickness of soft tissue swelling on sagittal MRI by consensus.The morphology of the soft tissue swelling was also evaluated.The statistical analyses were performed using theχ^(2) test and analysis of variance.RESULTS The study included 117 patients(153 vertebrae)with OVF and 48 patients(63 vertebrae)with MVF.Soft tissue swelling was observed beneath the anterior longitudinal ligament on sagittal MRI and rim-shaped in the paravertebral area on axial MRI in all 153 vertebrae with OVF(100%)and in 12(19%)of the 63 vertebra with MVF;the difference was statistically significant(P<0.001),95%CI:3.156–8.735.Soft tissue swelling beneath the anterior longitudinal ligament spanned significantly more vertebral segments in patients with OVF than in those with MVF(P<0.001),95%CI:0.932-1.546.The mean thickness of the soft tissue swelling was significantly greater for OVF than for MVF(5.62 mm±2.50 mm vs 3.88 mm±1.73 mm,P<0.05,95%CI:0.681–0.920).Post-contrast examination was performed in 13 patients;T1-weighted images confirmed OVF in 11 cases and MVF in 2 cases.Soft tissue swelling in OVF and MVF had a fusiform appearance or appeared as a thin line on sagittal MRI and was rim-shaped on axial MRI.The length and diameter of the soft tissue swelling in patients with OVF decreased during follow-up.CONCLUSION Paravertebral soft tissue swelling is helpful for differentiating between OVF and MVF.展开更多
Malignant melanoma,characterized by its high metastatic potential and resistance to conventional therapies,presents a major challenge in oncology.This review explores the current status and advancements in tumor vacci...Malignant melanoma,characterized by its high metastatic potential and resistance to conventional therapies,presents a major challenge in oncology.This review explores the current status and advancements in tumor vaccines for melanoma,focusing on peptide,DNA/RNA,dendritic cell,tumor cell,and neoantigen-based vaccines.Despite promising results,significant challenges remain,including the immunosuppressive tumor microenvironment,patient heterogeneity,and the need for more effective antigen presentation.Recent strategies,such as combining vaccines with immune checkpoint inhibitors(ICIs),aim to counteract immune evasion and enhance T cell responses.Emerging approaches,including personalized neoantigen vaccines and the use of self-amplifying RNA platforms,hold promise for overcoming tumor heterogeneity and improving vaccine efficacy.Additionally,optimizing vaccine delivery systems through nanotechnology and genetic modifications is essential for increasing stability and scalability.This review highlights the potential of these innovative strategies to address current limitations,with a focus on how future research can refine and combine these approaches to improve melanoma treatment outcomes.展开更多
Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected fro...Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.展开更多
This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the au...This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.展开更多
Objective:To investigate the therapeutic effects and safety of Dioscorea Decoction combined with Coix Seed in treating cancer cachexia(spleen-kidney Yang deficiency syndrome)in malignant tumor patients.Methods:A total...Objective:To investigate the therapeutic effects and safety of Dioscorea Decoction combined with Coix Seed in treating cancer cachexia(spleen-kidney Yang deficiency syndrome)in malignant tumor patients.Methods:A total of 90 patients with cancer cachexia admitted between June 2024 and June 2025 were randomly divided into a control group and a study group(45 cases each)using a random number generator.Both groups received antitumor therapy,oral megestrol acetate capsules,and conventional nutritional intervention.The study group additionally received oral Dioscorea Decoction combined with Coix Seed.Differences in TCM syndrome scores,nutritional indicators(serum albumin,hemoglobin),and adverse reactions were compared before and after treatment.Results:Baseline TCM syndrome scores and nutritional indicators were comparable between the two groups before treatment.After treatment,both groups showed significant reductions in TCM syndrome scores and increases in serum albumin and hemoglobin levels.The study group exhibited lower TCM syndrome scores and higher serum albumin and hemoglobin levels than the control group,with statistically significant differences.No significant difference in adverse reaction rates was observed between the two groups.Conclusion:Dioscorea Decoction combined with Coix Seed can further improve nutritional status,alleviate clinical symptoms,and demonstrate good safety in treating cancer cachexia patients.展开更多
The integration of Chinese and Western medicine in the treatment of malignant tumors is becoming increasingly widespread.By combining modern medical technology with traditional Chinese medicine,this approach enhances ...The integration of Chinese and Western medicine in the treatment of malignant tumors is becoming increasingly widespread.By combining modern medical technology with traditional Chinese medicine,this approach enhances therapeutic efficacy while reducing side effects.This paper reviews the principles and mechanisms of integrated therapy and analyzes its clinical applications and advantages.Studies indicate that this approach is effective in treating common malignancies such as lung,stomach,and liver cancer,especially in slowing tumor progression,relieving symptoms,and improving patients’quality of life.Chemotherapy combined with Chinese medicine has shown positive effects on survival rates and immune function.However,limitations remain,including insufficient clinical trial data and differences in efficacy across different cancer types,necessitating further high-quality studies.Overall,integrated Chinese and Western medicine offers advantages such as reduced side effects,improved survival rates,and enhanced immune function,providing a comprehensive treatment strategy and a theoretical foundation for its clinical application.展开更多
BACKGROUND Perivascular epithelioid cell tumor(PEComa)of the colorectum is exceedingly rare,with only a few published reports.It presents with a wide spectrum of biological behavior,ranging from benign to malignant.Th...BACKGROUND Perivascular epithelioid cell tumor(PEComa)of the colorectum is exceedingly rare,with only a few published reports.It presents with a wide spectrum of biological behavior,ranging from benign to malignant.The prognosis for malignant PEComa is poor and there is little consensus on its treatment.AIM To fully characterize PEComa and standardize its diagnosis and treatment.METHODS Patients with colorectal malignant PEComa were identified from the First Affiliated Hospital,Zhejiang University School of Medicine and People's Hospital of Anji.Cases with controversial pathology and cases lost to follow-up were excluded,leaving seven remaining cases that formed the basis of the study.We collected relevant clinicopathological,therapeutic and followup details.Disease stage and progression were assessed by contrast-enhanced computed tomography at baseline and at 3-month intervals.RESULTS The mean age was 43 years,with a range of 5 years to 73 years.The average body mass index was 21.8±3.0 kg/m^(2),and 71.4%of cases occurred in the colon.The main symptoms of colorectal PEComas were abdominal mass and hematochezia.The most common microscopic finding of malignant behavior was infiltrative growth.Immunohistochemical analysis found that 6/7 cases were positive for HMB45,5/7 were positive for melan-A,and 3/5 were positive for MiTF.The watch-and-wait approach to treatment was a risky option.Radical resection was preferable to systemic treatment.The median progression-free survival exceeded 38 months,longer than previously reported.CONCLUSION Radical or extended resection is the key to prolonged survival of malignant PEComa.More meaningful studies are urgently needed to establish the standardized diagnosis and treatment.展开更多
文摘This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.
文摘BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.
基金Supported by the National Natural Science Foundation of China(71774049).
文摘In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.
文摘BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.
基金Supported by Natural Science Foundation of Hubei Province(No.2023BCB147,No.2023AFB1026).
文摘AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.
基金Supported by Natural Science Foundation of Chongqing,No.CSTB2023NSCQ-MSX0829.
文摘BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases and 57000 deaths were reported worldwide in 2020.The main modalities for melanoma treatment include surgery,immunotherapy,targeted therapy,high-dose interferon,antitumor angiogenesis,chemotherapy,and radiotherapy.Due to China's special national conditions,the main pathological types and therapeutic effects are greatly different from those in Europe and the United States,so more studies are needed to determine the curative effects of such treatments in the Chinese population.AIM To explore their clinical characteristics,prognostic influencing factors and realworld data to provide a reference basis for further diagnosis and treatment.METHODS We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years.Univariate analysis was conducted using the log-rank test,while multivariate analysis was performed with the Cox proportional hazard regression model.The survival rate was calculated using the Kaplan-Meier method.RESULTS The male-to-female patient ratio was 1.04:1.Among the clinical classifications,melanoma of the limb accounted for 47.56%of cases,followed by melanoma of the skin(18.18%)and mucosal melanoma(18.05%).The 5-year survival rates for stage I-II,stage III,and stage IV patients were 54.65%,37.88%,and 28.58%,respectively.Univariate analysis revealed that age,tumor stage,treatment mode,platelet count at the first visit,and lactate dehydrogenase(LDH)level were significantly related to patient survival.Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year,3 years,and 5 years.Multivariate analysis demonstrated that tumor stage,chemotherapy,interferon therapy,and LDH level were independent risk factors affecting patient survival and prognosis.Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy,those of patients who received chemotherapy and interferon therapy were 30.0%and 44.5%lower,respectively.Additionally,patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels.CONCLUSION Melanoma is highly malignant,and its prognosis is influenced by numerous factors,resulting in an overall poor prognosis.This study identified several factors that impact patient prognosis,providing a foundation for individualized comprehensive treatment.
基金supported by the National Natural Science Foundation of China(Grant No.82274034)the Peking University Medicine plus X Pilot Program-Platform Construction Project(Grant No.2024YXXLHPT004).
文摘Ovarian cancer remains a leading cause of gynecological cancer mortality1,and patients with advanced stage ovarian cancer frequently develop malignant ascites that foster immunosuppressive microenvironments and therapeutic resistance2,3.Although ascites have traditionally been considered detrimental,we report a paradoxical role in which they enhance the cytotoxicity ofγδT cells—a unique T cell subset that can be allogenically transferred for cancer treatment4,5—toward ovarian cancer.
文摘Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.
文摘This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical outcomes.By comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused on.Additionally,patient selection for stenting and future advancements in stent technology are important.Overall,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery.
文摘With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as sarcopenia(SP).In recent years,a growing number of studies have investigated SP,revealing that many tumor diseases,especially in the digestive system,promote its occurrence due to the influence of the disease itself,diet,and other factors.Moreover,SP patients tend to have poorer postoperative recovery.At present,many diagnostic methods have been developed for SP,but no unified standard has been established.Furthermore,the cutoff values of many diagnostic methods for different populations are still in the exploratory stage,and additional clinical studies are required to explore these issues.This article comprehensively and systematically summarizes the diagnostic methods and criteria mentioned in previous research,focusing on the impact of SP on post-surgical patients with various malignant tumors.
文摘Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between October 2022 and October 2024 were selected for high-frequency ultrasound diagnosis.The diagnostic efficacy of high-frequency ultrasound was evaluated by comparing it with the results of surgical pathology.Results:High-frequency ultrasound detected 50 benign nodules,primarily breast fibroadenomas,and 35 malignant nodules,mainly breast ductal carcinoma in situ.Based on surgical pathology results,the diagnostic accuracy of high-frequency ultrasound was 96.47%,specificity was 97.96%,and sensitivity was 94.44%.In high-frequency ultrasound diagnosis,the proportion of grade III and IV blood flow in malignant nodules was higher than that in benign nodules,while the proportion of regular shape and clear margins was lower.The proportion of microcalcifications and posterior echo attenuation was higher in malignant nodules,and the resistance index(RI)and peak blood flow velocity were lower than those in benign nodules(P<0.05).Conclusion:High-frequency ultrasound can effectively differentiate benign and malignant breast micronodules,determine specific nodule types,and exhibits high diagnostic accuracy and sensitivity.Additionally,benign and malignant nodules can be differentiated based on the grading of blood flow signals,sonographic features,and blood flow velocity,providing reasonable guidance for subsequent treatment plans.
基金Supported by TAIHO Pharmaceutical,No.AS2023A000122715Nippon Kayaku,No.NKCS20230416001.
文摘BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this tumor is categorized as a rare form.AIM To examine growth suppressive effect of GO-Y030,a diarylpentanoid curcumin analog,(1E,4E)-1,5-bis[3,5-bis(methoxymethoxy)phenyl]penta-1,4-dien-3-one against the malignant meningioma.METHODS The growth suppression of malignant meningioma cells by GO-Y022 and GOY030 were examined,using IOMM-Lee and HKBMM cell lines.Male nude mice aged eight weeks,specifically BALB/cSlc-nu/nu mice received a subcutaneous inoculation of IOMM-Lee(107 cells/site)on their back and 30μg/kg of recombinant hepatocellular growth factor(HGF)was injected into the tumor every three days.After confirmed the growth tumor mass,500μL of GO-Y030 diluted with PBS were administrated intraperitoneally daily at doses of 1 mg/kg and 2 mg/kg,respectively.RESULTS GO-Y030 exhibits a growth inhibitory effect on malignant meningioma cell lines,IOMM-Lee and HKBMM ranging from 0.8-2.0μM in vitro.Notably,GO-Y030’s inhibitory effect is about 10 to 16th times more potent than that of curcumin,which has previously demonstrated potential in combating malignant meningioma.In mouse models,the intraperitoneal administration of GO-Y030 effectively suppresses the growth of malignant meningioma tumors that have been inoculated in the back(P=0.002).High-performance liquid chromatography analysis has confirmed the distribution of GO-Y030 in the bloodstream and brain tissue.Moreover,GOY030 demonstrates the ability to significantly suppress HGF(P<0.01),nuclear factor kappa B(P<0.001),and Ncadherin(P<0.001),all of which contribute to the epithelial-mesenchymal transition.CONCLUSION GO-Y030 holds promise as a potent compound for the systemic inhibition of malignant meningioma.GO-Y030 has higher tumor growth inhibitory effect against meningiomas than curcumin,which is known to have antitumor activity through multi-molecular target control resulting in apoptosis induction.GO-Y030 controls at least three molecules of HGF,nuclear factor kappa B,and N-cadherin.
基金approved by the Institutional Review Board of the Affiliated hospital of Qingdao University(No.QYFYWZLL29413/dated 5rd September 2023),and all patient requirements for informed consent were waived.
文摘BACKGROUND Osteoporotic vertebral fracture(OVF)is one of the most common sequelae of osteoporosis.Differential diagnosis between OVF and malignant vertebral fracture(MVF)is a challenge in clinical practice.Findings on computed tomography and magnetic resonance images(MRI)may help to differentiate between these two types of fracture.AIM To determine whether paravertebral soft tissue swelling is useful for differentiation between OVF and MVF.METHODS We retrospectively reviewed the MRI for 165 patients diagnosed with a vertebral fracture between May 2021 and July 2022.Three radiologists evaluated the vertebral segments and thickness of soft tissue swelling on sagittal MRI by consensus.The morphology of the soft tissue swelling was also evaluated.The statistical analyses were performed using theχ^(2) test and analysis of variance.RESULTS The study included 117 patients(153 vertebrae)with OVF and 48 patients(63 vertebrae)with MVF.Soft tissue swelling was observed beneath the anterior longitudinal ligament on sagittal MRI and rim-shaped in the paravertebral area on axial MRI in all 153 vertebrae with OVF(100%)and in 12(19%)of the 63 vertebra with MVF;the difference was statistically significant(P<0.001),95%CI:3.156–8.735.Soft tissue swelling beneath the anterior longitudinal ligament spanned significantly more vertebral segments in patients with OVF than in those with MVF(P<0.001),95%CI:0.932-1.546.The mean thickness of the soft tissue swelling was significantly greater for OVF than for MVF(5.62 mm±2.50 mm vs 3.88 mm±1.73 mm,P<0.05,95%CI:0.681–0.920).Post-contrast examination was performed in 13 patients;T1-weighted images confirmed OVF in 11 cases and MVF in 2 cases.Soft tissue swelling in OVF and MVF had a fusiform appearance or appeared as a thin line on sagittal MRI and was rim-shaped on axial MRI.The length and diameter of the soft tissue swelling in patients with OVF decreased during follow-up.CONCLUSION Paravertebral soft tissue swelling is helpful for differentiating between OVF and MVF.
文摘Malignant melanoma,characterized by its high metastatic potential and resistance to conventional therapies,presents a major challenge in oncology.This review explores the current status and advancements in tumor vaccines for melanoma,focusing on peptide,DNA/RNA,dendritic cell,tumor cell,and neoantigen-based vaccines.Despite promising results,significant challenges remain,including the immunosuppressive tumor microenvironment,patient heterogeneity,and the need for more effective antigen presentation.Recent strategies,such as combining vaccines with immune checkpoint inhibitors(ICIs),aim to counteract immune evasion and enhance T cell responses.Emerging approaches,including personalized neoantigen vaccines and the use of self-amplifying RNA platforms,hold promise for overcoming tumor heterogeneity and improving vaccine efficacy.Additionally,optimizing vaccine delivery systems through nanotechnology and genetic modifications is essential for increasing stability and scalability.This review highlights the potential of these innovative strategies to address current limitations,with a focus on how future research can refine and combine these approaches to improve melanoma treatment outcomes.
文摘Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.
文摘This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.
文摘Objective:To investigate the therapeutic effects and safety of Dioscorea Decoction combined with Coix Seed in treating cancer cachexia(spleen-kidney Yang deficiency syndrome)in malignant tumor patients.Methods:A total of 90 patients with cancer cachexia admitted between June 2024 and June 2025 were randomly divided into a control group and a study group(45 cases each)using a random number generator.Both groups received antitumor therapy,oral megestrol acetate capsules,and conventional nutritional intervention.The study group additionally received oral Dioscorea Decoction combined with Coix Seed.Differences in TCM syndrome scores,nutritional indicators(serum albumin,hemoglobin),and adverse reactions were compared before and after treatment.Results:Baseline TCM syndrome scores and nutritional indicators were comparable between the two groups before treatment.After treatment,both groups showed significant reductions in TCM syndrome scores and increases in serum albumin and hemoglobin levels.The study group exhibited lower TCM syndrome scores and higher serum albumin and hemoglobin levels than the control group,with statistically significant differences.No significant difference in adverse reaction rates was observed between the two groups.Conclusion:Dioscorea Decoction combined with Coix Seed can further improve nutritional status,alleviate clinical symptoms,and demonstrate good safety in treating cancer cachexia patients.
文摘The integration of Chinese and Western medicine in the treatment of malignant tumors is becoming increasingly widespread.By combining modern medical technology with traditional Chinese medicine,this approach enhances therapeutic efficacy while reducing side effects.This paper reviews the principles and mechanisms of integrated therapy and analyzes its clinical applications and advantages.Studies indicate that this approach is effective in treating common malignancies such as lung,stomach,and liver cancer,especially in slowing tumor progression,relieving symptoms,and improving patients’quality of life.Chemotherapy combined with Chinese medicine has shown positive effects on survival rates and immune function.However,limitations remain,including insufficient clinical trial data and differences in efficacy across different cancer types,necessitating further high-quality studies.Overall,integrated Chinese and Western medicine offers advantages such as reduced side effects,improved survival rates,and enhanced immune function,providing a comprehensive treatment strategy and a theoretical foundation for its clinical application.
文摘BACKGROUND Perivascular epithelioid cell tumor(PEComa)of the colorectum is exceedingly rare,with only a few published reports.It presents with a wide spectrum of biological behavior,ranging from benign to malignant.The prognosis for malignant PEComa is poor and there is little consensus on its treatment.AIM To fully characterize PEComa and standardize its diagnosis and treatment.METHODS Patients with colorectal malignant PEComa were identified from the First Affiliated Hospital,Zhejiang University School of Medicine and People's Hospital of Anji.Cases with controversial pathology and cases lost to follow-up were excluded,leaving seven remaining cases that formed the basis of the study.We collected relevant clinicopathological,therapeutic and followup details.Disease stage and progression were assessed by contrast-enhanced computed tomography at baseline and at 3-month intervals.RESULTS The mean age was 43 years,with a range of 5 years to 73 years.The average body mass index was 21.8±3.0 kg/m^(2),and 71.4%of cases occurred in the colon.The main symptoms of colorectal PEComas were abdominal mass and hematochezia.The most common microscopic finding of malignant behavior was infiltrative growth.Immunohistochemical analysis found that 6/7 cases were positive for HMB45,5/7 were positive for melan-A,and 3/5 were positive for MiTF.The watch-and-wait approach to treatment was a risky option.Radical resection was preferable to systemic treatment.The median progression-free survival exceeded 38 months,longer than previously reported.CONCLUSION Radical or extended resection is the key to prolonged survival of malignant PEComa.More meaningful studies are urgently needed to establish the standardized diagnosis and treatment.
