学科分类
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2 个结果
  • 简介:Theperitonealstromaltissuewhichprovidesarichsourceofgrowthfactorsandchemokinesisafavorableenvironmentfortumorproliferation.Thepathophysiologicalmechanismofperitonealcarcinomatosisisanindividualsequenceconsistingofgeneticandenvironmentalfactorsandremainscontroversial.Thenaturalhistoryofthediseaserevealsapoormedianprognosisofapproximately6mo;howeveraggressivesurgeryandmultimodaltreatmentoptionscanimproveoncologicoutcomes.Consideringperitonealcarcinomatosisasthoughitisalocoregionaldiseasebutnotametastaticprocess,cytoreductivesurgeryandandintraperitonealchemotherapyhasbeenacurativeoptionduringrecentyears.Cytoreductivesurgeryimpliesaseriesofvisceralresectionsandperitonectomyprocedures.Althoughtheaimofcytoreductivesurgeryistoeliminateallmacroscopicdisease,viabletumorcellsmayremainintheperitonealcavity.Atthatpoint,intraperitonealchemotherapycanextendthemacroscopicdiseaseeliminationtomicroscopicdiseaseelimination.Thesuccessfultreatmentofperitonealcarcinomatosisrequiresacomprehensivemanagementplanincludingproperpatientselection,completeresectionofallvisibledisease,perioperativeintraperitonealchemotherapyandpostoperativesystemicchemotherapy.Surgicalandoncologicoutcomesarestrictlyassociatedwithextentofthetumor,completenessofcytoreductionandpatientrelatedfactorsaswellasmultidisciplinarymanagementandexperienceofthesurgicalteam.Inthisreview,pathophysiologyandcurrentmanagementofperitonealcarcinomatosisoriginatingfromgastrointestinaltumorsarediscussedaccordingtothelatestliterature.

  • 标签: PERITONEAL CARCINOMATOSIS GASTROINTESTINAL TUMORS
  • 简介:HepatitisB(HB)virus(HBV)infection,whichcauseslivercirrhosisandhepatocellularcarcinoma,isendemicworldwide.HepatitisBvaccinesbecamecommerciallyavailableinthe1980s.TheWorldHealthOrganizationrecommendedtheintegrationoftheHBvaccineintothenationalimmunisationprogramsinallcountries.HBVpreventionstrategiesareclassifiedintothreegroups:(1)universalvaccinationalone;(2)universalvaccinationwithscreeningofpregnantwomenplusHBimmuneglobulin(HBIG)atbirth;and(3)selectivevaccinationwithscreeningofpregnantwomenplusHBIGatbirth.Mostlow-incomecountrieshaveadopteduniversalvaccineprogramswithoutscreeningofpregnantwomen.However,HBvaccinesarenotwidelyusedinlow-incomecountries.TheGlobalAllianceforVaccineandImmunizationwaslaunchedin2000,andby2012,theglobalcoverageofathree-doseHBvaccinehadincreasedto79%.Thenextchallengesaretofurtherincreasethecoveragerate,closethegapbetweenrecommendationsandroutinepractices,approachhighriskindividuals,screenandtreatchronicallyinfectedindividuals,andpreventbreakthroughinfections.ToeradicateHBVinfections,strenuouseffortsarerequiredtoovercomesocioeconomicbarrierstotheHBvaccine;thistaskisexpectedtotakeseveraldecadestocomplete.

  • 标签: Cancer Global ALLIANCE for VACCINE and