Intrahepatic cholangiocarcinoma(iCCA)is a rare biliary tract cancer with high mortality rate.Complete resection of the iCCA lesion is the first choice of treatment,with good prognosis after margin-negative resection.U...Intrahepatic cholangiocarcinoma(iCCA)is a rare biliary tract cancer with high mortality rate.Complete resection of the iCCA lesion is the first choice of treatment,with good prognosis after margin-negative resection.Unfortunately,only 12%-40% of patients are eligible for resection at presentation due to cirrhosis,portal hypertension,or large tumor size.Liver transplantation(LT)offers margin-negative iCCA extirpation for patients with unresectable tumors.Initially,iCCA was a contraindication for LT until size-based selection criteria were introduced to identify patients with satisfied post-LT outcomes.Recent studies have shown that tumor biology-based selection can yield high post-LT survival in patients with locally advanced iCCA.Another selection criterion is the tumor response to neoadjuvant therapy.Patients with response to neoadjuvant therapy have better outcomes after LT compared with those without tumor response to neoadjuvant therapy.Another index that helps predict the treatment outcome is the biomarker.Improved survival outcomes have also opened the door for living donor LT for iCCA.Patients undergoing LT for iCCA now have statistically similar survival rates as patients undergoing resection.The combination of surgery and locoregional and systemic therapies improves the prognosis of iCCA patients.展开更多
The aging population is an important issue around the world especially in developed countries.Although med-ical advances have substantially extended life span,the same cannot be said for the duration of health span.We...The aging population is an important issue around the world especially in developed countries.Although med-ical advances have substantially extended life span,the same cannot be said for the duration of health span.We are seeing in-creasing numbers of elderly people who are frail and/or have multiple chronic conditions;all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare system.Aging is mechanistically related to common medical conditions such as diabetes mellitus,ischemic heart disease,cognitive decline,and frailty.A recently accepted concept termed‘Accelerated Biological Aging’can be diagnosed when a person’s biological age—as measured by biomarkers of DNA methylation—is older than their corresponding chronological age.Taurine,a conditionally essential amino acid,has received much attention in the past few years.A substantial number of animal studies have provided a strong scientific foundation sug-gesting that this amino acid can improve cellular and metabolic health,including blood glucose control,so much that it has been labelled one of the‘longevity amino acids’.In this review article,we propose the rationale that an adequately powered random-ized-controlled-trial(RCT)is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health,and biological age.This trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors,and also the community at large,to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.展开更多
文摘Intrahepatic cholangiocarcinoma(iCCA)is a rare biliary tract cancer with high mortality rate.Complete resection of the iCCA lesion is the first choice of treatment,with good prognosis after margin-negative resection.Unfortunately,only 12%-40% of patients are eligible for resection at presentation due to cirrhosis,portal hypertension,or large tumor size.Liver transplantation(LT)offers margin-negative iCCA extirpation for patients with unresectable tumors.Initially,iCCA was a contraindication for LT until size-based selection criteria were introduced to identify patients with satisfied post-LT outcomes.Recent studies have shown that tumor biology-based selection can yield high post-LT survival in patients with locally advanced iCCA.Another selection criterion is the tumor response to neoadjuvant therapy.Patients with response to neoadjuvant therapy have better outcomes after LT compared with those without tumor response to neoadjuvant therapy.Another index that helps predict the treatment outcome is the biomarker.Improved survival outcomes have also opened the door for living donor LT for iCCA.Patients undergoing LT for iCCA now have statistically similar survival rates as patients undergoing resection.The combination of surgery and locoregional and systemic therapies improves the prognosis of iCCA patients.
文摘The aging population is an important issue around the world especially in developed countries.Although med-ical advances have substantially extended life span,the same cannot be said for the duration of health span.We are seeing in-creasing numbers of elderly people who are frail and/or have multiple chronic conditions;all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare system.Aging is mechanistically related to common medical conditions such as diabetes mellitus,ischemic heart disease,cognitive decline,and frailty.A recently accepted concept termed‘Accelerated Biological Aging’can be diagnosed when a person’s biological age—as measured by biomarkers of DNA methylation—is older than their corresponding chronological age.Taurine,a conditionally essential amino acid,has received much attention in the past few years.A substantial number of animal studies have provided a strong scientific foundation sug-gesting that this amino acid can improve cellular and metabolic health,including blood glucose control,so much that it has been labelled one of the‘longevity amino acids’.In this review article,we propose the rationale that an adequately powered random-ized-controlled-trial(RCT)is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health,and biological age.This trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors,and also the community at large,to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.
