Glioblastoma multiforme(GBM), the literal apogee on the hierarchy of malignant brain tumors, remains one of the greatest therapeutic challenges in oncology andmedicine. Historically this may be contextualized in the f...Glioblastoma multiforme(GBM), the literal apogee on the hierarchy of malignant brain tumors, remains one of the greatest therapeutic challenges in oncology andmedicine. Historically this may be contextualized in the fact that the medical and scientific communities have had a very elementary understanding of its intricate and complex pathophysiology. The last 10-15 years have yielded a number of studies that have elucidated much of the molecular and genetic complexities of GBM that underlie its pathogenesis. Excitingly, some of these discovered genetic mutations and molecular profiles in GBM have demonstrated value in prognostication and utility in predicting response to treatment. Despite this, however, treatment options for patients have remained somewhat limited. These treatment options are expected to expand with the availability of new data and with the transition of novel treatment modalities from animal to human studies. This paper will have a threefold objective: provide an overview of the traditional paradigm in understanding and treating GBM, describe recent discoveries in the molecular pathogenesis of GBM against this historical backdrop, and acquaint the reader with new treatment modalities that hold significant therapeutic potential for patients.展开更多
目的探讨原发性大隐静脉曲张传统开放性手术与激光治疗联合泡沫硬化术对机体免疫系统的影响。方法按照手术方式将104例择期行大隐静脉曲张手术的患者分为激光治疗联合泡沫硬术组(MIS组,53例)和传统开放性手术组(OS组,51例)。分别于术前...目的探讨原发性大隐静脉曲张传统开放性手术与激光治疗联合泡沫硬化术对机体免疫系统的影响。方法按照手术方式将104例择期行大隐静脉曲张手术的患者分为激光治疗联合泡沫硬术组(MIS组,53例)和传统开放性手术组(OS组,51例)。分别于术前和术后24 h采集2组静脉血测定超氧化物岐化酶(SOD)、IL-1β、IL-6、IL-8、IL-10、TNF-α、干扰素-γ(IFN-γ)水平。采用流式细胞术检测T淋巴细胞亚群及自然杀伤细胞(NK)的比例变化。采用单细胞测序(scRNA-seq)技术检测外周血免疫细胞差异基因表达。结果MIS组术后IL-1β、IL-8水平较术前高(P均<0.05),术前与术后的SOD、IL-6、IL-10、TNF-α、IFN-γ水平比较差异无统计学意义(P均>0.05);OS组上述指标术前与术后比较差异均有统计学意义(P均<0.05)。MIS组术前与术后T淋巴细胞亚群及NK比例比较差异均无统计学意义(P均>0.05);OS组术后24 h CD8^(+)T细胞比例升高,NK比例降低(P均<0.05)。术后24 h外周血免疫细胞表达差异基因功能富集分析提示OS组术后缺氧应答、IFN应答及NF-κB等炎症通路较MIS组上调。结论大隐静脉曲张激光治疗联合泡沫硬化术对机体系统免疫炎症及缺氧反应影响较小,能够更好地维持机体的免疫平衡,较大程度保留机体原有免疫系统抵御微生物入侵的能力。展开更多
文摘Glioblastoma multiforme(GBM), the literal apogee on the hierarchy of malignant brain tumors, remains one of the greatest therapeutic challenges in oncology andmedicine. Historically this may be contextualized in the fact that the medical and scientific communities have had a very elementary understanding of its intricate and complex pathophysiology. The last 10-15 years have yielded a number of studies that have elucidated much of the molecular and genetic complexities of GBM that underlie its pathogenesis. Excitingly, some of these discovered genetic mutations and molecular profiles in GBM have demonstrated value in prognostication and utility in predicting response to treatment. Despite this, however, treatment options for patients have remained somewhat limited. These treatment options are expected to expand with the availability of new data and with the transition of novel treatment modalities from animal to human studies. This paper will have a threefold objective: provide an overview of the traditional paradigm in understanding and treating GBM, describe recent discoveries in the molecular pathogenesis of GBM against this historical backdrop, and acquaint the reader with new treatment modalities that hold significant therapeutic potential for patients.
文摘目的探讨原发性大隐静脉曲张传统开放性手术与激光治疗联合泡沫硬化术对机体免疫系统的影响。方法按照手术方式将104例择期行大隐静脉曲张手术的患者分为激光治疗联合泡沫硬术组(MIS组,53例)和传统开放性手术组(OS组,51例)。分别于术前和术后24 h采集2组静脉血测定超氧化物岐化酶(SOD)、IL-1β、IL-6、IL-8、IL-10、TNF-α、干扰素-γ(IFN-γ)水平。采用流式细胞术检测T淋巴细胞亚群及自然杀伤细胞(NK)的比例变化。采用单细胞测序(scRNA-seq)技术检测外周血免疫细胞差异基因表达。结果MIS组术后IL-1β、IL-8水平较术前高(P均<0.05),术前与术后的SOD、IL-6、IL-10、TNF-α、IFN-γ水平比较差异无统计学意义(P均>0.05);OS组上述指标术前与术后比较差异均有统计学意义(P均<0.05)。MIS组术前与术后T淋巴细胞亚群及NK比例比较差异均无统计学意义(P均>0.05);OS组术后24 h CD8^(+)T细胞比例升高,NK比例降低(P均<0.05)。术后24 h外周血免疫细胞表达差异基因功能富集分析提示OS组术后缺氧应答、IFN应答及NF-κB等炎症通路较MIS组上调。结论大隐静脉曲张激光治疗联合泡沫硬化术对机体系统免疫炎症及缺氧反应影响较小,能够更好地维持机体的免疫平衡,较大程度保留机体原有免疫系统抵御微生物入侵的能力。
