超声微泡介导靶向治疗研究进展

载药超声微泡的靶向治疗是当前医药领域中的研究热点。超声微泡破坏技术介导的靶向药物和基因治疗是一种最新的靶向治疗方法。超声微泡不仅可以作为一种超声造影剂增强成像对比度,更可以通过各种物理、化学修饰携带各种药物或基因在超声场强破坏作用下进行靶向治疗。超声微泡造影剂靶向治疗包括超声介导载药微泡的治疗及超声介导靶向载药微泡的治疗。本文就超声微泡特性、超声靶向微泡破坏(UTMD)技术机制、超声微泡介导靶向治疗三方面进行综述。     

非小细胞肺癌靶向药物治疗争论热点

非小细胞肺癌作为全球和我国发病率最高、死亡人数最多的恶性肿瘤,其药物治疗始终是临床肿瘤学界高度关注的焦点之一。肿瘤的药物治疗模式从单纯以细胞毒药物杀伤肿瘤逐步向调节信号传导通路转变,分子靶向药物日益成为治疗肿瘤的重要武器。回顾肺癌靶向治疗的进展,诸多问题需要解决。     

非小细胞肺癌靶向药物治疗争论热点

非小细胞肺癌作为全球和我国发病率最高、死亡人数最多的恶性肿瘤,其药物治疗始终是临床肿瘤学界高度关注的焦点之一.肿瘤的药物治疗模式从单纯以细胞毒药物杀伤肿瘤逐步向调节信号传导通路转变,分子靶向药物日益成为治疗肿瘤的重要武器.回顾肺癌靶向治疗的进展,诸多问题需要解决.     

晚期结直肠癌的分子靶向治疗

对于晚期结直肠癌(mCRC)的靶向治疗,目前正在研究和临床应用的主要有:(1)针对肿瘤细胞表面的表皮生长因子受体(EGFR)的药物;(2)针对血管内皮生长因子(VEGF)信号传导通路的药物;(3)针对受体酪氨酸激酶及其下游级联反应的药物;(4)免疫靶向治疗药物,例如PD-1/PD-L1抑制剂。但在我国经CFDA批准应用于临床的仅有抗EGFR的西妥昔单抗和抗VEGFR的贝伐单抗。怎么用好这两个靶向药物,让mCRC患者得到最合理、最有效的治疗,让患者生存时间尽可能延长且生活质量高。2016年ESMO共识指南,将患者的治疗按治疗目标来考虑,比较具有可操作性。肿瘤部位因为分子水平的差异,对靶向药物可能有选择倾向。免疫靶向药物的出现,它的作用特点,也许对我们的mCRC的治疗会是另外一种策略。     

应用分子靶向治疗的时机选择

分子靶向药物的出现显示出肿瘤治疗传统模式的重要进展。与传统放疗、化疗相比,分子靶向治疗因其特异性高、不良反应轻微,在恶性肿瘤个体化治疗中扮演重要角色。十五年来,分子靶向药物的出现,给肿瘤的治疗模式带来重大改变,也给临床医生带来新的挑战。准确把握分子靶向药物应用时机,获得最大临床效果,已成为肿瘤治疗领域关注热点。本文就非小细胞肺癌、消化系统肿瘤、乳腺癌、肾癌治疗中分子靶向药物如何选择应用时机进行阐述。     

胃肠道肿瘤的分子靶向治疗:未来的方向?

分子靶向治疗是这几年来消化道肿瘤治疗领域的热门话题.这类新一代的分子靶向生物治疗模式,将在临床治疗肿瘤实践中具有广阔的应用前景.从事肿瘤研究的临床医务人员需要综合归纳这些信息,融汇入自己的认知将之合理应用于患者.我们将真正进入传统的细胞毒性药物攻击与非细胞毒性靶向性药物相结合使用的时代,真正实现延长患者的生命,改善其生活质量的目标.     

非小细胞肺癌靶向治疗的前途与困惑

靶向治疗是运用抗肿瘤药物靶向性与肿瘤的不同特异性住点结合发生作用从而抑制肿瘤细胞生长的一种治疗手段。针对恶性肿瘤中的非小细胞肺癌,其在临床中取得了一定成效。然而,其中仍存在很多问题。本文针对吉非替尼在非小细胞肺癌中的运用,及其优点和所面临的问题,阐述如何应对完善靶向治疗的挑战。     

从系统论看肿瘤的生物靶向性治疗

肿瘤的生物靶向性治疗是恶性肿瘤治疗的新方法,其试图通过在基因水平上调节与肿瘤发生、发展有密切联系的生命物质来达到治愈肿瘤的目的。但临床运用中,生物靶向性治疗的疗效与我们的想象相去甚远。本文运用系统论的观点,分析目前生物靶向性治疗中存在的问题及寻求可能解决的方法。     

非小细胞肺癌靶向治疗的前途与困惑

靶向治疗是运用抗肿瘤药物靶向性与肿瘤的不同特异性住点结合发生作用从而抑制肿瘤细胞生长的一种治疗手段.针对恶性肿瘤中的非小细胞肺癌,其在临床中取得了一定成效.然而,其中仍存在很多问题.本文针对吉非替尼在非小细胞肺癌中的运用,及其优点和所面临的问题,阐述如何应对完善靶向治疗的挑战.     

靶向药物不良反应的认识与思考

新的靶向药物出现提高了抗癌疗效,降低了毒性,使转移性恶性肿瘤患者从治疗中获益。靶向药物耐受性好,通常出现轻微或中度的毒副反应。尽管大多数不良反应是可以得到迅速处理的,但是严重的甚至危及生命的不良反应仍能够发生。因此,为更好地指导临床实践工作,该文综述了实体瘤治疗中常用靶向药物的主要不良反应和安全数据,并按照药物的作用靶...     

经直肠超声在直肠癌诊疗中的应用进展

经直肠超声以其准确、价廉、无创、无辐射等优点被广泛推荐用于直肠癌术前分期和术后随访中。术前传统经直肠超声T分期准确度可达84％,术后使用经直肠超声介导活检可显著提高准确性并具有诊断早期无症状复发的独特优势。未来的研究将重．最关注直肠癌多模式术前评估,以及新型超声技术的实际应用。     

大肠癌常见诊疗误区解析

大肠癌是最常见的恶性肿瘤之一。尽管近年诊疗水平不断提高,但在临床诊疗工作中,仍存在一些误区。本文主要针对肠镜检查的必要性、肝转移是否能手术治疗、术后辅助化疗的适应证、靶向药物的适应证以及K-RAS基因检测的必要性等5方面进行分析。逐步规范大肠癌的诊断和治疗,提高大肠癌综合治疗水平。     

微创医学中的介入性超声

超声检查具有实时、动态、灵活、方便等优点,在临床上有重要作用。介入性超声是在超声显像的基础上,为进一步满足临床诊断和治疗的需要而发展起来的一门新技术,在微创医学体系中占有非常重要的地位,但只有与其它微创技术联合应用才更有活力和生机。     

Beating lady luck: Effects of competitive gambling on opponent likeability and targeted physical aggression

This study aimed to examine the effects of gambling motives and competitive gambling outcomes on opponent likeability and targeted physical aggression. We hypothesized that (a) losers would perceive their opponents to be less likeable and (b) would be physically more aggressive toward their opponents. Opponent likeability was proposed to mediate the lose–aggression relationship while social gambling motives were proposed to moderate the lose–aggression relationship. Specifically, we expected that losers of competitive gambling situations would engage in greater physical aggression only if they perceived their opponents to be less likeable. In addition, lower perceived opponent likeability would translate into greater targeted physical aggression only if the loser possessed low social motives for gambling. Ninety‐eight undergraduates who self‐identified mostly as recreational gamblers participated in a competitive gambling game. The Hot Sauce Paradigm was adapted as a measure of targeted physical aggression. Results obtained supported our hypotheses. Potential implications and limitations are discussed.     

肿瘤诊治相关肾损伤的防治决策

肿瘤患者在诊治过程中可能会引起肾脏损伤,如造影剂、化疗和靶向药物的使用等等。如何平衡肿瘤患者在诊治过程中的疗效及安全性,使患者能够接受并完成治疗,延长患者无进展生存和总生存,是肿瘤学界所面临的挑战。     

Changes in implicit and explicit exercise-related attitudes after reading targeted exercise-related information

The purpose of this research was to examine if reading exercise information targeted at pretest explicit attitudes were related to changes in corresponding implicit or explicit attitudes. The associative-propositional evaluation (APE) model guided the research. Participants (N = 154) completed pretest measures of implicit and explicit attitudes; one week later they read information that targeted pretest explicit affective or instrumental attitudes and again completed the attitude measures. Results showed changes in implicit attitudes in both instrumental message conditions that supported the hypotheses that counter-attitudinal information would result in implicit attitude change in the opposite direction to the reading whereas information that targeted congruent attitudes would show changes in keeping with the information. This study demonstrates the importance of considering how implicit cognitions may change as a result of reading exercise-related information, and the relationship between implicit and explicit attitudes.     

肺癌早期综合诊疗思考

通过分析目前肺癌患者5年生存率徘徊在10%,这一现实问题,可以得到一些重要启示和思考。今后肺癌治疗发展方向将是完善个体化、多学科早期综合治疗模式;利用基因芯片技术开展肺癌早期诊断,对肺癌高危人群开展大规模普查;开展靶向性、高效低毒、抗耐药性的肺癌治疗药物研究,进行肺癌逆转的分子干预治疗和分子阻断治疗,要用早期综合地手段诊疗肺癌。     

The Evolution of Cancer Risk Assessment in the Era of Next Generation Sequencing

Cancer genetics professionals face a new opportunity and challenge in adapting to the availability of cancer genetic testing panels, now available as a result of Next Generation Sequencing (NGS) technology. While cancer panels have been available for over a year, we believe that there is not yet enough data to create practice guidelines. Despite this, a year of experience allows us to provide our opinion on points to consider as cancer genetic counselors incorporate this testing technology into genetic counseling practice models. NGS technology offers the ability to potentially diagnose hereditary cancer syndromes more efficiently by testing many genes at once for a fraction of what it would cost to test each gene individually. However, there are limitations and additional risks to consider with these tests. Obtaining informed consent for concurrent testing of multiple genes requires that genetics professionals modify their discussions with patients regarding the potential cancer risks and the associated implications to medical management. We propose dividing the genes on each panel into categories that vary by degree of cancer risk (e.g. penetrance of the syndrome) and availability of management guidelines, with the aim to improve patient understanding of the range of information that can come from this testing. The increased risk for identifying variants of uncertain significance (VUS) when testing many genes at once must be discussed with patients. Pretest genetic counseling must also include the possibility to receive unexpected results as well as the potential to receive a result in the absence of related medical management guidelines. It is also important to consider whether a single gene test remains the best testing option for some patients. As panels expand, it is important that documentation reflects exactly which genes have been analyzed for each patient. While this technology holds the promise of more efficient diagnosis for many of our patients, it also comes with new challenges that we must recognize and address.     

原发性肝癌分子靶向治疗的进展

不能手术和已转移的原发性肝细胞癌（hepatocellular carcinoma,HCC）预后很差,放化疗难以使患者受益。近年来,分子靶向治疗对一些肿瘤已取得突破性进展,肝癌的分子靶向治疗也在临床试验中取得了令人鼓舞的结果。目前的肝癌临床研究主要针对EGFR、VEGF／VEGFR、HGF、MMP、乙肝表面抗原等靶点。本文针对肝癌的分子靶向治疗的研究进展进行了综述。