ObjectiveTo summarize the treatment strategies and clinical experiences of 5 cases of giant plexiform neurofibromas (PNF) involving the head, face, and neck. MethodsBetween April 2021 and May 2023, 5 patients with giant PNFs involving the head, face, and neck were treated, including 1 male and 4 females, aged 6-54 years (mean, 22.4 years). All tumors showed progressive enlargement, involving multiple regions such as the maxillofacial area, ear, and neck, significantly impacting facial appearance. Among them, 3 cases involved tumor infiltration into deep tissues, affecting development, while 4 cases were accompanied by hearing loss. Imaging studies revealed that all 5 tumors predominantly exhibited an invasive growth pattern, in which 2 and 1 also presenting superficial and displacing pattern, respectively. The surgical procedure followed a step-by-step precision treatment strategy based on aesthetic units, rather than simply aiming for maximal tumor resection in a single operation. Routine preoperative embolization of the tumor-feeding vessels was performed to reduce bleeding risk, followed by tumor resection combined with reconstructive surgery. Results All 5 patients underwent 1-3 preoperative embolization procedures, with no intraoperative hemorrhagic complications reported. Four patients required intraoperative blood transfusion. A total of 10 surgical procedures were performed across the 5 patients. One patient experienced early postoperative flap margin necrosis due to ligation for hemostasis; however, the incisions in the remaining patients healed without complications. All patients were followed up for a period ranging from 6 to 36 months, with a mean follow-up duration of 21.6 months. No significant tumor recurrence was observed during the follow-up period. Conclusion For patients with giant PNF involving the head, face, and neck, precision treatment strategy can effectively control surgical risks and improve the standard of aesthetic reconstruction. This approach enhances overall treatment outcomes by minimizing complications and optimizing functional and cosmetic results.
目的 為避免選擇和發表偏倚,系統評價者應采用多種查詢技術,并盡力獲得未發表的研究.本文試圖探討,英特網檢索對鑒定未發表和正在進行的臨床試驗是否有用.研究設計 利用七個Cochrane系統評價的查詢策略回顧性地在英特網上檢索未納入的隨機對照試驗.方法 檢索策略 以普通檢索式"研究方法學 NEAR干預措施NERA 條件"、用AltaVista在英特網上搜索.測量指標包括搜索時間、英特網搜索已發表研究的回溯率、精確度(已發表和未發表的隨機臨床試驗鏈接的網頁比例)、英特網檢索到的未納入的未發表和正在進行的研究數.結果 用21小時查詢了429個網頁,找到14個鏈接到未發表的、正在進行的或最近完成的試驗,至少有9個與4篇系統評價相關.英特網檢索已發表研究文獻的回溯率在0～43.6%,其鏈接已發表和未發表研究的精確度在0～20.2%.結論 未發表尤其是正在進行的試驗的信息可在英特網上找到.潛在的問題是如何評價未經同行評審的電子出版物的質量.急需更強的搜索工具.建議用"Open Trial Initiative"定義英特網發表試驗的語法,以加強試驗登記的共同操作性.因此,專門的搜索引擎可找到更多有關正在進行和已完成的臨床試驗信息.
Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of early-stage lung cancers are detected. Radical lobectomy with systematic nodal dissection (SND) remains the standard-of-care for operable lung cancer patients. However, whether SND should be performed on non-metastatic lymph nodes remains controversy. Unnecessary lymph node dissection can increase the difficulty of surgery while also causing additional surgical damage. In addition, non-metastatic lymph nodes have been recently reported to play a key role in immunotherapy. How to reduce the surgical damage of mediastinal lymph node dissection for early-stage lung cancer patients is pivotal for modern concept of "minimally invasive surgery for lung cancer 3.0". The selective mediastinal lymph node dissection strategy aims to dissect lymph nodes with tumor metastasis while preserving normal mediastinal lymph nodes. Previous studies have shown that combination of specific tumor segment site, radiology and intraoperative frozen pathology characteristics can accurately predict the pattern of mediastinal lymph node metastasis. The personalized selective mediastinal lymph node dissection strategy formed from this has been successfully validated in a recent prospective clinical trial, providing an important basis for early-stage lung cancer patients to receive more personalized selective lymph node dissection with "precision surgery" strategies.
In recent years, deep learning has provided a new method for cancer prognosis analysis. The literatures related to the application of deep learning in the prognosis of cancer are summarized and their advantages and disadvantages are analyzed, which can be provided for in-depth research. Based on this, this paper systematically reviewed the latest research progress of deep learning in the construction of cancer prognosis model, and made an analysis on the strengths and weaknesses of relevant methods. Firstly, the construction idea and performance evaluation index of deep learning cancer prognosis model were clarified. Secondly, the basic network structure was introduced, and the data type, data amount, and specific network structures and their merits and demerits were discussed. Then, the mainstream method of establishing deep learning cancer prognosis model was verified and the experimental results were analyzed. Finally, the challenges and future research directions in this field were summarized and expected. Compared with the previous models, the deep learning cancer prognosis model can better improve the prognosis prediction ability of cancer patients. In the future, we should continue to explore the research of deep learning in cancer recurrence rate, cancer treatment program and drug efficacy evaluation, and fully explore the application value and potential of deep learning in cancer prognosis model, so as to establish an efficient and accurate cancer prognosis model and realize the goal of precision medicine.
ObjectiveTo review and evaluate the research progress of the robot-assisted joint arthroplasty.MethodsThe domestic and foreign related research literature on robot-assisted joint arthroplasty was extensively consulted. The advantages, disadvantages, effectiveness, and future prospects were mainly reviewed and summarized.ResultsThe widely recognized advantages of robot-assisted joint arthroplasty are digital and intelligent preoperative planning, accurate intraoperative prosthesis implantation, and quantitative soft tissue balance, as well as good postoperative imaging prosthesis position and alignment. However, the advantages of effectiveness are still controversial. The main disadvantages of robot-assisted joint arthroplasty are the high price of the robot system, the prolonged operation time, and the increased radioactive damage of the imaging-dependent system.ConclusionCompared to traditional arthroplasty, robot-assisted joint arthroplasty can improve the accuracy of the prosthesis position and assist in the quantitative assessment of soft tissue tension, and the repeatability rate is high. In the future, further research is needed to evaluate the clinical function and survival rate of the prosthesis, as well as to optimize the robot system.
Cancer presents a significant global public health challenge, impacting human health on a broad scale. In recent years, the rapid advancement of big data-based bioinformatics has unveiled crucial potential in precision oncology through various omics research methods. The advent of radiomics has notably expanded the application scope of medical imaging in the field. However, due to the multi-level and multifactorial nature of tumor initiation and progression, a single omics information remains insufficient to meet the demands for advancing precision oncology strategies. Multi-omics research has become an emerging trend. The research paradigm integrating radiomics with other omics offers a novel perspective for personalized decision-making in oncology. Nevertheless, there persists a need to introduce more integrated new technologies and theories to expedite the progress of this field.
ObjectiveTo review the progress of radiomics in the field of colorectal cancer in recent years and summarize its value in the imaging diagnosis of colorectal cancer.MethodsEighty English and seven Chinese articles were retrieved through PUBMED, OVID, CNKI, Weipu and Wanfang. The structure and content of these literatures were classified and analyzed.ResultsIn five studies predicting the preoperative stages of colorectal cancer based on CT radiomics, the area under curve (AUC) ranged from 0.736 to 0.817; in two studies predicting the preoperative stages of colorectal cancer based on MRI radiomics, the AUC were 0.87 and 0.827 respectively. In two studies about radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy based on CT, the AUC were 0.79 and 0.72 respectively; in four studies about radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy based on MRI, the AUC ranged from 0.84 to 0.979. In one study evaluating the sensitivity of neoadjuvant chemotherapy based on MRI radiomics, the AUC was 0.79. In one study predicting the postoperative survival rate based on MRI radiomics, the AUC value of the final model was 0.827. In one study, the accuracy of the model based on PET/CT radiomics in 4-year disease-free survival (DSS), progression-free survival (DFS) and overall survival (OS) were 0.87, 0.79 and 0.79 respectively.ConclusionAt present, radiomics has a valuable impact on preoperative staging, neoadjuvant therapy evaluation, and survival analysis of colorectal cancer.
ObjectiveTo summarize the application of radiomics in colorectal cancer.MethodsRelevant literatures about the therapeutic decision-making, therapeutic, and prognostic evaluation of colorectal cancer using radiomics were collected to make an review.ResultsRadiomics is of great value in preoperative stages, therapeutic, and prognostic evaluation in colorectal cancer.ConclusionRadiomics is an important part of precision medical imaging for colorectal cancer.
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease caused by the mutations in the NF1 gene, with an incidence of approximately 1/3 000. Affecting multiple organs and systems throughout the body, NF1 caused a wide variety of clinical symptoms. A comprehensive multidisciplinary diagnostic and treatment model is needed to meet the diverse needs of NF1 patients and improve their quality of life. In recent years, the emergence of targeted therapies has further benefited NF1 patients, and the number of clinical consultations has increased dramatically. However, due to the rarity of the disease itself and insufficient attention previously, the standardized, systematic, and precise diagnosis and treatment model of NF1 still needs to be further improved. In this paper, we reviewed the current status of comprehensive diagnosis and treatment of NF1 in China, combine with our long-term experiences in diagnosis and treatment of this disease. Meanwhile, we propose future directions and several suggestions for the comprehensive diagnosis and treatment model for Chinese NF1 patients.
Liddle syndrome and Gordon syndrome are two rare single-gene inherited hypertension diseases. In patients≤40 years, the prevalence of Liddle syndrome is about 1% and Gordon syndrome is uncertain all over the word, for which is often misdiagnosed and mistreated. The therapies of those diseases are targeted at gene mutation sites, as well as combined with modified lifestyle, and can achieve satisfactory diseases control. This paper reports a patient who is diagnosed with Liddle syndrome and Gordon syndrome at the same time. We aimed to consolidate and improve the diagnosis and accurate treatment of those two diseases by sharing, studying and discussing together with clinical doctors.