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Identification of tumor antigens and immune subtypes of hepatocellular carcinoma for mRNA vaccine development
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作者 Tai-Liang Lu cheng-Long Li +2 位作者 Yong-Qiang Gong Fu-Tao Hou chao-wu chen 《World Journal of Gastrointestinal Oncology》 SCIE 2023年第10期1717-1738,共22页
BACKGROUND mRNA vaccines have been investigated in multiple tumors,but limited studies have been conducted on their use for hepatocellular carcinoma(HCC).AIM To identify candidate mRNA vaccine antigens for HCC and sui... BACKGROUND mRNA vaccines have been investigated in multiple tumors,but limited studies have been conducted on their use for hepatocellular carcinoma(HCC).AIM To identify candidate mRNA vaccine antigens for HCC and suitable subpopu-lations for mRNA vaccination.METHODS Gene expression profiles and clinical information of HCC datasets were obtained from International Cancer Genome Consortium and The Cancer Genome Atlas.Genes with somatic mutations and copy number variations were identified by cBioPortal analysis.The differentially expressed genes with significant prognostic value were identified by Gene Expression Profiling Interactive Analysis 2 website analysis.The Tumor Immune Estimation Resource database was used to assess the correlation between candidate antigens and the abundance of antigen-presenting cells(APCs).Tumor-associated antigens were overexpressed in tumors and associated with prognosis,genomic alterations,and APC infiltration.A consensus cluster analysis was performed with the Consensus Cluster Plus package to identify the immune subtypes.The weighted gene coexpression network analysis(WGCNA)was used to determine the candidate biomarker molecules for appropriate populations for mRNA vaccines.immune subtypes showed distinct cellular and clinical characteristics.The IS1 and IS3 immune subtypes were immunologically“cold”.The IS2 and IS4 immune subtypes were immunologically“hot”,and the immune checkpoint genes and immunogenic cell death genes were upregulated in these subtypes.IS1-related modules were identified with the WGCNA algorithm.Ultimately,five hub genes(RBP4,KNG1,METTL7A,F12,and ABAT)were identified,and they might be potential biomarkers for mRNA vaccines.CONCLUSION AURKA,CCNB1,CDC25C,CDK1,TRIP13,PES1,MCM3,PPM1G,NEK2,KIF2C,PTTG1,KPNA2,and PRC1 have been identified as candidate HCC antigens for mRNA vaccine development.The IS1 and IS3 immune subtypes are suitable populations for mRNA vaccination.RBP4,KNG1,METTL7A,F12,and ABAT are potential biomarkers for mRNA vaccines. 展开更多
关键词 mRNA vaccine Hepatocellular carcinoma Immunotype ANTIGENS Immune subtypes
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Long-term survival of patients with hepatocellular carcinoma with hepatic,pulmonary,peritoneal and rare colon metastasis:A case report
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作者 Yong-Qiang Gong Tai-Liang Lu chao-wu chen 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第8期1819-1824,共6页
BACKGROUND Hepatocellular carcinoma(HCC)is a highly malignant cancer that often metastasizes and has a poor prognosis.Gastrointestinal tract metastases are rare,and colon metastases are even rarer.The long-term surviv... BACKGROUND Hepatocellular carcinoma(HCC)is a highly malignant cancer that often metastasizes and has a poor prognosis.Gastrointestinal tract metastases are rare,and colon metastases are even rarer.The long-term survival of patients with multiple intrahepatic and extrahepatic metastases,especially to the colon,has not been previously reported.CASE SUMMARY We present an atypical clinical case of a patient with liver,right lung,peritoneal,and colon metastases diagnosed successively following hepatic resection for primary HCC.Comprehensive treatment,including partial liver,lung and colon resection,palliative management such as systemic chemotherapy,trans-arterial chemoembolization,targeted therapy with sorafenib,and cryotherapy were attempted.Despite his early metastases,the patient remained relatively healthy for 8 years after diagnosis.CONCLUSION This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC.Clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors. 展开更多
关键词 Hepatocellular carcinoma Multiple metastasis Rare colon metastasis Comprehensive treatments Long-term survival Case report
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经内镜腔内射频消融联合胆管支架置入治疗晚期胰腺癌并梗阻性黄疸的临床研究 被引量:2
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作者 陈娟 潘长宝 +5 位作者 徐庆成 陈炜炜 陈超伍 刘军 向晓星 邓登豪 《中国内镜杂志》 2021年第6期19-25,共7页
目的探讨经内镜腔内射频消融(RFA)联合胆管支架置入治疗晚期胰腺癌并梗阻性黄疸的安全性和疗效。方法回顾性分析46例失去手术机会的晚期胰腺癌合并梗阻性黄疸患者的临床资料,比较射频组(n=16,腔内RFA联合支架置入)和对照组(n=30,单纯支... 目的探讨经内镜腔内射频消融(RFA)联合胆管支架置入治疗晚期胰腺癌并梗阻性黄疸的安全性和疗效。方法回顾性分析46例失去手术机会的晚期胰腺癌合并梗阻性黄疸患者的临床资料,比较射频组(n=16,腔内RFA联合支架置入)和对照组(n=30,单纯支架置入)术后并发症发生情况、黄疸消退程度、腹痛缓解情况、支架中位通畅时间和中位生存时间。结果两组患者术后均未出现穿孔、出血、胆漏和胰漏等严重并发症,术后胆管炎和一过性胰腺炎发生率比较,差异均无统计学意义(P>0.05)。术后1周射频组血清总胆红素(TBIL)和直接胆红素(DBIL)分别为(62.99±42.31)和(50.89±37.78)μmol/L,较术前的(181.51±114.14)和(156.90±105.79)μmol/L明显降低,对照组分别为(112.21±84.27)和(84.23±70.01)μmol/L,较术前的(184.06±130.00)和(160.65±119.93)μmol/L明显降低,射频组黄疸消退程度较对照组更明显(P<0.05)。两组患者术后1个月视觉模拟评分(VAS)均较术前降低,射频组腹痛缓解有效率为87.5%,明显高于对照组的26.7%(P<0.05)。射频组患者中位生存时间和支架中位通畅时间分别为296和241 d,均长于对照组的240和188 d(P<0.05)。结论对于晚期胰腺癌合并梗阻性黄疸的患者,腔内RFA联合胆管支架较单纯胆管支架置入能够更有效地减黄、缓解癌性疼痛、延长支架通畅期、延长患者生存时间、提高患者生活质量,疗效确切,值得临床进一步推广应用。 展开更多
关键词 晚期胰腺癌 梗阻性黄疸 腔内射频消融 胆管支架
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经内镜逆行胰胆管造影术在治疗合并消化道狭窄的胆胰疾病患者中的应用价值 被引量:1
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作者 王维钊 向晓星 +13 位作者 刘军 邓登豪 王璐 陈娟 陈炜炜 柴海娜 孙超 吴莹莹 徐庆成 陈功 韩维维 陈超伍 倪修凡 任天棋 《世界华人消化杂志》 CAS 2021年第15期866-872,共7页
背景随着目前医学诊疗技术的飞速发展,手术微创化,已成为疾病诊疗新趋势,而经过数十年的发展,经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)已成为微创治疗胆胰疾病的首选手段之一,但是,当胆胰疾病合... 背景随着目前医学诊疗技术的飞速发展,手术微创化,已成为疾病诊疗新趋势,而经过数十年的发展,经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)已成为微创治疗胆胰疾病的首选手段之一,但是,当胆胰疾病合并消化道狭窄时,行ERCP难度往往较大,目前在该领域的研究较少,因此我们以此为中心展开研究.目的分析ERCP在治疗合并消化道狭窄的胆胰疾病患者中的应用价值.方法收集2014-01/2019-01我院ERCP治疗合并消化道狭窄的胆胰疾病患者临床资料,分析患者病例特点、狭窄处理方式、ERCP并发症情况,评估手术成功率及预后.结果4216例接受ERCP患者中,共有消化道狭窄(食管、胃、十二指肠狭窄)患者134例,其中食管胃吻合口狭窄13例(食管癌术后)、胃窦部狭窄1例(胃窦部巨大脂肪瘤)、十二指肠狭窄120例(恶性狭窄113例,良性狭窄7例).共有106例患者ERCP成功,整体成功率79.10%,包括11例食管吻合口狭窄,1例胃窦狭窄,94例十二指肠狭窄(良性7例,恶性87例).其中42例狭窄较轻患者经变换体位及上腹部压迫后通过狭窄段完成ERCP;31例通过更换JF十二指肠镜或胃镜进镜及导丝引导下完成手术;33例通过柱状气囊扩张后完成ERCP,其中9例在术后同时留置肠道支架;共有28例狭窄较重患者未能完成ERCP,2例为食管胃吻合口狭窄,26例为十二指肠球降部恶性狭窄.术中一例食管吻合口狭窄扩张后出血较多停止手术;术后6例患者在3-6 mo内因肿瘤浸润并十二指肠梗阻行肠道支架置入,2例因术后同时留置的肠道支架阻塞行肠道支架内清理扩张;无穿孔、重症胰腺炎等重大并发症.结论胆胰疾病合并消化道狭窄时,选取合适方法通过狭窄段后行ERCP仍是安全可行的:(1)对于食管癌术后狭窄,经食管扩张通过狭窄后常可完成ERCP,但需警惕食管狭窄扩张出血;(2)十二指肠球、降部狭窄较重患者ERCP难度大,尤以降部狭窄难于球部,球囊扩张可作为通过狭窄段的有效手段,经扩张后短期内易再发侵犯并狭窄,此类患者术后应选择性留置肠道支架;(3)对于扩张后内镜不能通过狭窄段以及浸润严重者,需考虑直接置入肠道支架或选取非ERCP方式解决患者胆道梗阻问题. 展开更多
关键词 经内镜逆行胰胆管造影 消化道狭窄 胆胰疾病
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乳头括约肌不同大小切开联合大气囊扩张术对胆总管大结石患者远期结石复发的影响 被引量:1
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作者 周盟 何家俊 +4 位作者 费诗茵 王婷婷 陈炜炜 陈超伍 刘军 《世界华人消化杂志》 CAS 2020年第22期1145-1149,共5页
背景内镜下括约肌切开术(endoscopic sphincterotomy,EST)联合内镜下乳头大气囊扩张术(endoscopic papilla large balloon dilatation,EPLBD)常用于治疗胆总管大结石,但括约肌切开大小对远期胆管结石复发的影响缺乏评价.本研究分析不同... 背景内镜下括约肌切开术(endoscopic sphincterotomy,EST)联合内镜下乳头大气囊扩张术(endoscopic papilla large balloon dilatation,EPLBD)常用于治疗胆总管大结石,但括约肌切开大小对远期胆管结石复发的影响缺乏评价.本研究分析不同大小EST联合EPLBD的疗效差异及对远期胆管结石复发的影响.目的通过观察不同切开大小的内镜下乳头括约肌切开取石术联合EPLBD治疗胆总管大结石的疗效,比较分析该术式的疗效差异及对患者远期胆管结石复发的影响.方法本研究共纳入168例胆总管大结石患者,根据不同大小的乳头括约肌切开程度分为三组,即:小切开组(≤5 mm),中切开组(6-9 mm)及大切开组(≥10 mm),三组均联合EPLBD,各组主要观察比较的指标为:术后胰腺炎、出血、穿孔、胆管炎等并发症,以及取石成功率、结石残留率、远期结石复发率等.结果三组患者取石成功率差异无统计学意义(P>0.05).术后并发症胰腺炎、穿孔、出血、胆管炎,三组差异无统计学意义(P>0.05),大切开组结石残留率较其余两组低,但差异无统计学意义(P>0.05).小切开组远期结石复发率显著低于其余两组,差异有统计学意义(P>0.05).结论在应用内镜治疗胆总管大结石患者时,在达到相同取石效果的情况下,较小的乳头括约肌切开联合EPLBD,有助于保护乳头功能,减少远期结石复发. 展开更多
关键词 不同大小括约肌切开 大气囊扩张 括约肌切开术 术后并发症 胆管结石复发
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Meta-analysis on the epidemiology of gastroesophageal reflux disease in China 被引量:8
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作者 Tai-Liang Lu Shao-Rong Li +1 位作者 Jia-Min Zhang chao-wu chen 《World Journal of Gastroenterology》 SCIE CAS 2022年第45期6410-6420,共11页
BACKGROUND No large-scale epidemiological survey on the prevalence of gastroesophageal reflux disease(GERD)in China has been conducted.China has a large population and a complex geographical environment.It is importan... BACKGROUND No large-scale epidemiological survey on the prevalence of gastroesophageal reflux disease(GERD)in China has been conducted.China has a large population and a complex geographical environment.It is important to understand the prevalence and spatial distribution of GERD in China.AIM To explore the prevalence and the spatial,temporal,and population distributions of GERD in the natural Chinese population.METHODS We searched Chinese and English databases for literature on the prevalence of GERD in the natural Chinese population.The prevalence of GERD was pooled using a random-effects meta-analysis model.Subgroup analysis was performed according to time,region,and population.We used ArcGIS software to draw statistical maps and trend analysis charts.Spatial autocorrelation analysis was carried out using Geoda software.Spearman correlation analysis was used to assess the spatial distribution relationship between GERD and upper digestive tract tumours.RESULTS Altogether,70 studies involving 276014 individuals from 24 provinces of China were included.The overall pooled prevalence of GERD was 8.7%(95%CI:7.5%-9.9%)in China's Mainland.Over the past two decades,the prevalence of GERD in China has increased from 6.0%to 10.6%.GERD was more common in people aged 40-60,with body mass index≥24,and of Uygur ethnicity.The prevalence was higher in the west and east than in the centre,and there may be a local spatial autocorrelation between the Qinghai-Tibet Plateau and the southeast.GERD was correlated with gastric(r=0.421,P=0.041)and oesophageal tumours(r=0.511,P=0.011)in spatial distribution.CONCLUSION GERD is becoming common in China.The prevalence differs by region and population.The development of appropriate strategies for the prevention and treatment of GERD is needed. 展开更多
关键词 China META-ANALYSIS Gastroesophageal reflux disease PREVALENCE EPIDEMIOLOGY Spatiotemporal trends
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结肠黑变病的临床特点分析 被引量:7
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作者 柴海娜 刘军 +6 位作者 吴莹莹 陈功 孙超 王璐 陈超伍 朱海杭 赵仁淹 《中国内镜杂志》 2021年第10期24-29,共6页
目的分析结肠黑变病(MC)的检出率及其与性别、伴发肠道疾病的相关性。方法回顾性分析2013年1月-2020年10月该院378例行电子结肠镜检查并诊断为MC的患者的内镜资料及相关临床资料。采用SPSS 20.0统计软件分析MC的检出率及其与年龄、性别... 目的分析结肠黑变病(MC)的检出率及其与性别、伴发肠道疾病的相关性。方法回顾性分析2013年1月-2020年10月该院378例行电子结肠镜检查并诊断为MC的患者的内镜资料及相关临床资料。采用SPSS 20.0统计软件分析MC的检出率及其与年龄、性别、伴发肠道疾病的相关性。结果MC的检出率呈逐年升高趋势。年龄≤60岁的患者中,女性检出率高于男性;大于60岁且小于80岁的患者中,男性检出率及上升幅度大于女性。息肉是MC最常见的伴发疾病,约占28.31%。息肉大小和性别差异无统计学意义。结论MC呈逐年上升趋势。80岁前,其检出率随着年龄的增长而增加。MC与结肠息肉、结肠癌关系密切,可合并炎症性肠病、结肠憩室、结直肠炎和脂肪瘤等。 展开更多
关键词 结肠黑变病 结肠镜 回顾性分析 检出率 结肠息肉 结肠癌
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Acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy: A case report 被引量:2
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作者 Ting-Ting Wang Jia-Jun He +2 位作者 Jun Liu Wei-Wei chen chao-wu chen 《World Journal of Clinical Cases》 SCIE 2021年第13期3114-3119,共6页
BACKGROUND Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract.Gastric ulcer,gastrointestinal perforation,and intestinal obstruction are the main complications.Ac... BACKGROUND Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract.Gastric ulcer,gastrointestinal perforation,and intestinal obstruction are the main complications.Acute pancreatitis secondary to bezoar is rare.Here,we present a rare case of a migratory gastric bezoar complicated by acute pancreatitis and small bowel obstruction after dissolution therapy.CASE SUMMARY A-65-year-old woman underwent gastroscopy because of epigastric pain,which revealed a huge bezoar and a gastric ulcer 10 d prior.The patient was discharged with a prescription of drinking 1 L Coca-Cola daily for 6 d,without repeat gastroscopy.However,she suddenly developed epigastric pain,nausea and vomiting for 3 d.Abdominal computed tomography(CT)revealed mild inflammation of the pancreas.Magnetic resonance cholangiopancreatography showed no abnormalities in the pancreatic duct or common bile duct.The nasogastric tube still showed drainage of more than 1.6 L of dark fluid each day after symptomatic treatment.Abdominal CT re-examination suggested intestinal obstruction.Esophagogastroduodenoscopy revealed a huge yellowish hard mass in the jejunal lumen,and we used the basket and net to fragment the bezoar.She was discharged with a good outcome.CONCLUSION Endoscopic therapy is the first choice for gastric bezoars.When mechanical disintegration cannot be achieved,timing of repeat endoscopy is important during Coca-Cola dissolution therapy. 展开更多
关键词 BEZOAR Intestinal obstruction Acute pancreatitis Dissolution therapy ENDOSCOPY Case report
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Endoscopic diagnosis and treatment of an appendiceal mucocele:A case report 被引量:1
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作者 Ting-Ting Wang Jia-Jun He +3 位作者 Ping-Hong Zhou Wei-Wei chen chao-wu chen Jun Liu 《World Journal of Clinical Cases》 SCIE 2021年第16期3936-3942,共7页
BACKGROUND Appendiceal mucocele is a rare disease that causes obstructive dilatation of the appendix due to the intraluminal accumulation of mucin.We report a case of endoscopic diagnosis and treatment of an appendice... BACKGROUND Appendiceal mucocele is a rare disease that causes obstructive dilatation of the appendix due to the intraluminal accumulation of mucin.We report a case of endoscopic diagnosis and treatment of an appendiceal mucocele.CASE SUMMARY A 47-year-old man presented with a protrusion around the orifice of the appendix discovered by colonoscopy incidentally.He was admitted to our hospital for a routine checkup without any symptoms.Abdominal computed tomography showed a cystic mass approximately 3 cm in diameter with fat stranding.The preoperative diagnosis was non-neoplastic appendiceal mucocele,and endoscopic treatment was performed.The endoscopic findings and pathological results supported our preoperative diagnosis.The endoscopic treatment of appendiceal mucocele was feasible and effective,which was confirmed by repeated endoscopy and post-operative computed tomography after 7 mo.CONCLUSION Endoscopic therapy provides a new method for the treatment of appendiceal mucocele. 展开更多
关键词 Appendiceal mucocele ENDOSCOPY COLONOSCOPY Diagnosis Treatment Case report
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胆道留置导丝取石法在胆管大结石治疗中的应用
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作者 陈超伍 刘军 +8 位作者 陈炜炜 邓登豪 王璐 柴海娜 孙超 吴莹莹 陈功 王维钊 陈娟 《中国内镜杂志》 2022年第10期61-65,共5页
目的探讨胆道留置导丝取石在胆管大结石治疗中的安全性及应用价值。方法回顾性分析2017年1月-2019年12月该院收治的308例胆管大结石(1.2~1.5 cm)患者的临床资料。其中,网篮组152例,气囊组42例,联合组38例,导丝组76例,分析不同取石方法... 目的探讨胆道留置导丝取石在胆管大结石治疗中的安全性及应用价值。方法回顾性分析2017年1月-2019年12月该院收治的308例胆管大结石(1.2~1.5 cm)患者的临床资料。其中,网篮组152例,气囊组42例,联合组38例,导丝组76例,分析不同取石方法的效果。结果308例患者均成功取石或置入胆道塑料支架。导丝组取石成功率高于其他组,但差异无统计学意义(P>0.05);导丝组结石嵌顿率较其他组低,差异有统计学意义(P<0.05);导丝组内镜逆行胰胆管造影术(ERCP)后并发症总发生率为10.5%(8/76),低于其他组,但差异无统计学意义(P>0.05)。其中,术后胰腺炎和高淀粉酶血症低于其他组,但差异无统计学意义(P>0.05),4组患者术后胆管炎比较,差异无统计学意义(P>0.05),网篮组和联合组各有1例术后迟发性出血,经内镜止血后好转,4组患者均未发生穿孔或死亡等严重并发症。导丝组手术时间明显短于其他组,差异有统计学意义(P<0.05),住院时间较其他组短,但差异无统计学意义(P>0.05)。结论应用胆道导丝留置法联合网篮或者气囊取石,对于1.2~1.5 cm的大结石,能够提高一次性取石成功率,减少结石乳头嵌顿率,缩短ERCP操作时间,是一种安全、有效的操作方法。 展开更多
关键词 内镜逆行胰胆管造影术(ERCP) 导丝留置法 胆管大结石 取石
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