Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion...Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion.With regard to diagnosis,remarkable advances have been made:Chromogranin A is recommended as a general marker for pNETs.But other new biomarker modalities,like circulating tumor cells,multiple transcript analysis,microRNA profile,and cytokines,should be clarified in future investigations before clinical application.Therefore,the currently available serum biomarkers are insufficient for diagnosis,but reasonably acceptable in evaluating the prognosis of and response to treatments during follow-up of pNETs.Surgical resection is still the only curative therapeutic option for localized pNETs.However,a debulking operation has also been proven to be effective for controlling the disease.As for drug therapy,steroids and somatostatin analogues are the first-line therapy for those with positive expression of somatostatin receptor,while everolimus and sunitinib represent important progress for the treatment of patients with advanced pNETs.Great progress has been achieved in the combination of systematic therapy with local control treatments.The optimal timing of local control intervention,planning of sequential therapies,and implementation of multidisciplinary care remain pending.展开更多
Hepatic impairment in coronavirus disease 2019(COVID-19)may derive from cholangiocyte damage in the beginning,but not from direct infection of hepatocytes.Chronic liver disease patients co-infected with severe acute r...Hepatic impairment in coronavirus disease 2019(COVID-19)may derive from cholangiocyte damage in the beginning,but not from direct infection of hepatocytes.Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm.Consensus has been reached that we should encourage as many people as possible to be vaccinated in order to achieve herd immunity.SARS-CoV-2 vaccines can prevent or alleviate severe infection and cytokine storm.It is recommended that all adult patients with chronic liver diseases and liver transplant recipients should receive COVID-19 vaccines using the standard dose and schedule.Data is not yet sufficient to compare the efficacy of different types of vaccines used in chronic liver disease patients.展开更多
基金Supported by Guangzhou Health and Family Planning Technology Project,No.20191A011096the National Natural Science Foundation of China,No.81602172+1 种基金Guangdong Provincial Science and Technology Plan Projects,No.2016A030313769Guangzhou Science and Technology Plan of Scientific Research Projects,No.201707010323.
文摘Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion.With regard to diagnosis,remarkable advances have been made:Chromogranin A is recommended as a general marker for pNETs.But other new biomarker modalities,like circulating tumor cells,multiple transcript analysis,microRNA profile,and cytokines,should be clarified in future investigations before clinical application.Therefore,the currently available serum biomarkers are insufficient for diagnosis,but reasonably acceptable in evaluating the prognosis of and response to treatments during follow-up of pNETs.Surgical resection is still the only curative therapeutic option for localized pNETs.However,a debulking operation has also been proven to be effective for controlling the disease.As for drug therapy,steroids and somatostatin analogues are the first-line therapy for those with positive expression of somatostatin receptor,while everolimus and sunitinib represent important progress for the treatment of patients with advanced pNETs.Great progress has been achieved in the combination of systematic therapy with local control treatments.The optimal timing of local control intervention,planning of sequential therapies,and implementation of multidisciplinary care remain pending.
文摘Hepatic impairment in coronavirus disease 2019(COVID-19)may derive from cholangiocyte damage in the beginning,but not from direct infection of hepatocytes.Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm.Consensus has been reached that we should encourage as many people as possible to be vaccinated in order to achieve herd immunity.SARS-CoV-2 vaccines can prevent or alleviate severe infection and cytokine storm.It is recommended that all adult patients with chronic liver diseases and liver transplant recipients should receive COVID-19 vaccines using the standard dose and schedule.Data is not yet sufficient to compare the efficacy of different types of vaccines used in chronic liver disease patients.