The bone marrow mononuclear cell(BMMNC) subset comprises mesenchymal stem cells, hematopoietic stem cells, endothelial progenitor cells. These cells can differentiate into cardiomyocytes, vascular endothelial cells and smooth muscle cells, and they can also release a wide array of cytokines that exert their effects on surrounding cells, including inducing neovascularization, preventing apoptosis of home cells and homing of endogenous systemic repairing cells. Many trials have been developed to evaluate the effect of bone marrow mononuclear cell transplantation in treating ischemia heart diseases in this country and others. Several routes have been used to deliver these cells to human myocardium or to the coronary circulation in these trials, such as intracoronary injection, intravenous infusion, direct injection into the ventricular wall, or transepicardial/transendocardial infusions,and the cells are constructed into fragmented cell sheets to improve cell retention, or some cytokines are used to enhance therapeutic effect. Although the results of the recent clinical trials in this area are rather conflicting, these therapeutic approaches seem to be promising forthe treatment of ischemic heart disease. In this review, many aspects of bone marrow mononuclear cell transplantation in myocardial infarction are summarized such as the mechanism, delivery routes, retaining of cells, homing, survival and future development, etc.
Esophageal cancer is a common gastrointestinal cancer,and the incidence in China is the highest in the world. Esophagectomy represents the gold standard for patients with resectable esophageal cancer,but postoperative morbidity and mortality rates remain high. In recent years,there have been many reports on the pathogenesis of morbidity and mortality after esophagectomy without reaching any concrete conclusion. This review focuses on the pathogenesis,prophylaxis and therapeuticsof pulmonary infection after esophageal cancer resection.
目的探讨继发性阴茎癌的临床特点及诊治方法。方法 回顾性分析成都军区总医院全军普外中心收治的1例直肠癌术后36个月发生阴茎转移患者的临床资料,并结合国内、外46例文献报道的资料(1988~2010年),对其发病情况、临床表现、转移途径、诊断、治疗和预后进行总结。 结果阴茎转移癌以泌尿系来源最多见(51.05%),其次为消化系统来源(36.17%); 多发生在原发肿瘤术后5~18个月,部分表现为首发症状; 转移灶多位于阴茎体部或根部(87.23%),多表现于单发结节(48.94%),部分为多发结节(29.97%); 25.53%伴有异常阴茎勃起; 常伴有其他部位转移(55.32%)。对单纯继发性阴茎癌不伴其他脏器转移者行部分或全部阴茎切除,术后辅以放疗、化疗和内分泌治疗能够提高治疗效果,延长生存期; 非手术治疗的患者,多因其他部位转移不能手术,绝大多数生存期在1年内。结论对阴茎出现单个或多个结节或伴有异常勃起的肿瘤患者,要考虑阴茎继发性转移的可能; 活检可明确诊断; 手术切除、辅以放化疗及内分泌治疗可延长患者的生存期。
Objective To understand status of technical realization, present development, faced problems, and application prospects of reduced-port laparoscopic surgery for rectal cancer, and to analyze safety and feasibility so as to provide theoretical and practical basis for clinical application and promotion. Method By searching the databases such as Medline, Embase, and Wanfang, etc., the relevant literatures about reduced-port laparoscopic surgery for rectal cancer were collected and reviewed. Results At present, the most common reduced-port laparoscopic surgery was the 1-port laparoscopic surgery, 2-port laparoscopic surgery, and 3-port laparoscopic surgery. The 1-port laparoscopic surgery had the effects of minimal invasiveness and cosmesis, but it was difficult to perform. The 2-port laparoscopic surgery for rectal cancer preserved as far as possible the effect of minimal invasiveness, the difficulty of procedure was reduced greatly, which was easy to be learnt and promoted. The experience of the 3-port laparoscopic surgery for rectal cancer contributed to the technical development of the 1-port laparoscopic surgery, with no need for the assisted incision for intraoperative specimen. The reduced-port laparoscopic surgery for rectal cancer was technically feasible and safe, which possessed the equal or better short-term outcomes as compared with the conventional 5-port laparoscopic or open surgery beside the radical resection for rectal cancer. However, the stringent technique for the laparoscopic surgery was necessary and it needed to overcome the learning curve. Conclusions Reduced-port laparoscopic surgery has some obvious advantages in minimal invasiveness, cosmesis, and enhanced recovery. More large-sample, multi-center, randomized controlled trials are eager to further confirm safety, effectiveness, and feasibility of reduced-port laparoscopic surgery for rectal cancer.