Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading caus...Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however,about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features,diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.展开更多
目的探讨年龄及瞳孔直径对成人正视眼调制传递函数（modulation transfer function，MTF）的影响。方法前瞻性临床研究。将102例正视眼按年龄分为3组：A组40眼（20～30岁）、B组30眼（31-40岁）、C组32眼（41～50岁），使用iTrace视觉...目的探讨年龄及瞳孔直径对成人正视眼调制传递函数（modulation transfer function，MTF）的影响。方法前瞻性临床研究。将102例正视眼按年龄分为3组：A组40眼（20～30岁）、B组30眼（31-40岁）、C组32眼（41～50岁），使用iTrace视觉功能分析仪测量所有正视眼在3．0、4．0,5．0mm瞳孔直径，5、10、15、20、25、30周／度（cpd）六个空间频率状态下的全眼总MTF曲线以及去除低阶像差的MTF曲线。对年龄与两种MTF作相关性分析，用单因素方差分析对不同年龄组、不同瞳孔的两种MTF分别进行比较。结果在不同瞳孔直径所有空间频率下，年龄与总MTF及去除低阶像差的MTF均呈负相关，空间频率5c／d下3组5．0mm瞳孔直径时的总MTF值分别为0．629±0．147、0．440±0．160、0．415±0．184，差异有统计学意义（F=18．773，P=0．000）。其他空间频率及瞳孔直径下，3组的总MTF及去除低阶像差的MTF值差异也均有统计学意义。在所有空间频率下两种MTF均随瞳孔直径的增大而降低。结论成人正视眼的总MTF及去除低阶像差的MTF均随年龄的增长、瞳孔的增大而下降，因此用它们来评价人眼视觉质量时，应当对不同年龄、不同瞳孔大小的人眼采用不同的评价标准。展开更多
目的探讨宫颈绒毛腺管状腺癌的临床病理特征、诊断标准及预后。方法分析北京协和医院10例宫颈绒毛腺管状腺癌的临床病理表现,临床资料包括年龄、症状、术前检查、国际妇产科联盟(International Federation of Gynecology Obstetrics,FI...目的探讨宫颈绒毛腺管状腺癌的临床病理特征、诊断标准及预后。方法分析北京协和医院10例宫颈绒毛腺管状腺癌的临床病理表现,临床资料包括年龄、症状、术前检查、国际妇产科联盟(International Federation of Gynecology Obstetrics,FIGO)分期、治疗方式及随访结果,病理表现包括大体表现、颈管浸润程度、有无淋巴结转移及淋巴脉管内瘤栓、组织学分型、核异型性、核分裂及伴随病变。结果 10例患者平均发病年龄为39岁;8例FIGO分期Ib1,1例IIa,1例Ia1;手术方式为全子宫切除+盆腔淋巴结清扫术+双附件切除术/卵巢活检术;术后平均随访29个月,8例健康生存,1例复发,1例失访。大体观察,5例呈息肉样或菜花状外生性肿物,直径5～25mm;4例呈乳头状或细绒毛样粗糙区,面积25mm×14mm至35mm×20mm;1例术后转移病例表现为溃疡型肿物,直径25mm。镜下肿瘤浸润深度2～12mm,浸润宽度5～26mm,1例累及阴道后穹窿;9例有轻-中度核异型性,术后转移1例病例呈中-重度核异型性;核分裂平均48个/10高倍视野(HPF);9例伴有宫颈上皮内瘤变III级(cervical intraepithelial neoplasiaIII,CINIII)和/或原位腺癌(adenocarcinoma in situ,ACIS),2例同时伴有高分化黏液腺癌;1例观察到宫颈壁内个别淋巴脉管内瘤栓。10例均未发现子宫体受累、盆腔淋巴结或卵巢转移。结论宫颈绒毛腺管状腺癌的预后整体较好。提示预后不良的病理指标除了宫颈管壁深层浸润、累及宫体、血管浸润、淋巴结转移外,还包括肿瘤细胞重度异型性和/或合并其他恶性程度更高的肿瘤成分。展开更多
Coronary artery calcification （CAC） is highly prevalent in patients with coronary heart disease （CHD） and is associated with major adverse cardiovascular events. There are two recognized type of CAC--intimal and m...Coronary artery calcification （CAC） is highly prevalent in patients with coronary heart disease （CHD） and is associated with major adverse cardiovascular events. There are two recognized type of CAC--intimal and medial calcification, and each of them have specific risk factors. Several theories about the mechanism of vascular calcification have been put forward, and we currently believe that vascular calcification is an active, regulated process. CAC can usually be found in patients with severe CHD, and this asymptomatic phenomenon make early diagnosis of CAC important. Coronary computed tomographic angiography is the main noninvasive tool to detect calcified lesions. Measurement of coronary artery calcification by scoring is a reasonable metric for cardiovascular risk assessment in asymptomatic adults at intermediate risk. To date, effective medical treatment of CAC has not been identified. Several strategies of percutaneous coronary interven- tion have been applied to CHD patients with CAC, but with unsatisfactory results. Prognosis of CAC is still a major problem of CHD pa- tients. Thus, more details about the mechanisms of CAC need to be elucidated in order to improve the understanding and treatment of CAC.展开更多
文摘Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however,about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features,diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.
文摘目的探讨年龄及瞳孔直径对成人正视眼调制传递函数（modulation transfer function，MTF）的影响。方法前瞻性临床研究。将102例正视眼按年龄分为3组：A组40眼（20～30岁）、B组30眼（31-40岁）、C组32眼（41～50岁），使用iTrace视觉功能分析仪测量所有正视眼在3．0、4．0,5．0mm瞳孔直径，5、10、15、20、25、30周／度（cpd）六个空间频率状态下的全眼总MTF曲线以及去除低阶像差的MTF曲线。对年龄与两种MTF作相关性分析，用单因素方差分析对不同年龄组、不同瞳孔的两种MTF分别进行比较。结果在不同瞳孔直径所有空间频率下，年龄与总MTF及去除低阶像差的MTF均呈负相关，空间频率5c／d下3组5．0mm瞳孔直径时的总MTF值分别为0．629±0．147、0．440±0．160、0．415±0．184，差异有统计学意义（F=18．773，P=0．000）。其他空间频率及瞳孔直径下，3组的总MTF及去除低阶像差的MTF值差异也均有统计学意义。在所有空间频率下两种MTF均随瞳孔直径的增大而降低。结论成人正视眼的总MTF及去除低阶像差的MTF均随年龄的增长、瞳孔的增大而下降，因此用它们来评价人眼视觉质量时，应当对不同年龄、不同瞳孔大小的人眼采用不同的评价标准。
文摘目的探讨宫颈绒毛腺管状腺癌的临床病理特征、诊断标准及预后。方法分析北京协和医院10例宫颈绒毛腺管状腺癌的临床病理表现,临床资料包括年龄、症状、术前检查、国际妇产科联盟(International Federation of Gynecology Obstetrics,FIGO)分期、治疗方式及随访结果,病理表现包括大体表现、颈管浸润程度、有无淋巴结转移及淋巴脉管内瘤栓、组织学分型、核异型性、核分裂及伴随病变。结果 10例患者平均发病年龄为39岁;8例FIGO分期Ib1,1例IIa,1例Ia1;手术方式为全子宫切除+盆腔淋巴结清扫术+双附件切除术/卵巢活检术;术后平均随访29个月,8例健康生存,1例复发,1例失访。大体观察,5例呈息肉样或菜花状外生性肿物,直径5～25mm;4例呈乳头状或细绒毛样粗糙区,面积25mm×14mm至35mm×20mm;1例术后转移病例表现为溃疡型肿物,直径25mm。镜下肿瘤浸润深度2～12mm,浸润宽度5～26mm,1例累及阴道后穹窿;9例有轻-中度核异型性,术后转移1例病例呈中-重度核异型性;核分裂平均48个/10高倍视野(HPF);9例伴有宫颈上皮内瘤变III级(cervical intraepithelial neoplasiaIII,CINIII)和/或原位腺癌(adenocarcinoma in situ,ACIS),2例同时伴有高分化黏液腺癌;1例观察到宫颈壁内个别淋巴脉管内瘤栓。10例均未发现子宫体受累、盆腔淋巴结或卵巢转移。结论宫颈绒毛腺管状腺癌的预后整体较好。提示预后不良的病理指标除了宫颈管壁深层浸润、累及宫体、血管浸润、淋巴结转移外,还包括肿瘤细胞重度异型性和/或合并其他恶性程度更高的肿瘤成分。
基金This work were supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support （No. ZYLX201303）, the National Natural Science Foundation of China （No. 81470429, No.81270285）, and The capital health research and development of special （No 2011-2006-14）.
文摘Coronary artery calcification （CAC） is highly prevalent in patients with coronary heart disease （CHD） and is associated with major adverse cardiovascular events. There are two recognized type of CAC--intimal and medial calcification, and each of them have specific risk factors. Several theories about the mechanism of vascular calcification have been put forward, and we currently believe that vascular calcification is an active, regulated process. CAC can usually be found in patients with severe CHD, and this asymptomatic phenomenon make early diagnosis of CAC important. Coronary computed tomographic angiography is the main noninvasive tool to detect calcified lesions. Measurement of coronary artery calcification by scoring is a reasonable metric for cardiovascular risk assessment in asymptomatic adults at intermediate risk. To date, effective medical treatment of CAC has not been identified. Several strategies of percutaneous coronary interven- tion have been applied to CHD patients with CAC, but with unsatisfactory results. Prognosis of CAC is still a major problem of CHD pa- tients. Thus, more details about the mechanisms of CAC need to be elucidated in order to improve the understanding and treatment of CAC.
