简介：Inthecomingyearslifeexpectancyisexpectedtoincreaseandwiththisthepercentageofthepopulationaboveage65willgrow.Patientsabove65makeupmorethantwothirdsofthosecurrentlydiagnosedwithgastrointestinalmalignancies.Availableevidencebasedmedicinedoesnotfocusontheaveragepatient,abovetheage70,encounteredineverydaypractice.Mostguidelinesandclinicaltrialsarenotdesignedtotakeintoaccountthespecialconsiderationsneededwhentreatingtheelderlysuchasfunctionalstatus,comorbidities,polypharmacy,lifeexpectancy,andsocialsupport.Themajorityofavailabledataisbasedonretrospectivereviewsorsubsetanalysesoflargerstudieswheretheelderlyrepresentafractionofthestudiedpopulation.Thisreviewfocusesonthetoxicitiesandtolerabilityofcurrentstandardtherapiesfornoncolorectalgastrointestinalmalignancies,includinggastroesophageal,pancreatic,bileductandhepatocellularcancersintheelderly.Withcarefulpatientselectionandgeriatricassessmenttheelderlycansafelybenefitfromstandardtherapiesofferedtoyoungerpatients.

简介：Bell’spalsyisacommonlyseencranialnervediseaseandcanresultincompromisedfacialappearanceandfunctions.Itsetiology,prognosisandtreatmentarestillbeingdebated.Thispaperisareviewofrecentdevelopmentintheunderstandingofetiology,diagnosisandnon-surgicaltreatmentofBell’spalsy.

简介：Longnon-codingRNAs(lncRNAs)refertoagroupofRNAsthatareusuallymorethan200nucleotidesandarenotinvolvedinproteingeneration.Instead,lncRNAsareinvolvedindifferentregulatoryprocesses,suchasregulationofgeneexpression.DifferentlncRNAsexistthroughoutthegenome.LncRNAsarealsoknownfortheirrolesindifferenthumandiseasessuchascancer.HOTAIRisanlncRNAthatplaysaroleasanoncogenicmoleculeindifferentcancercells,suchasbreast,gastric,colorectal,andcervicalcancercells.Therefore,HOTAIRexpressionlevelisapotentialbiomarkerfordiagnosticandtherapeuticpurposesinseveralcancers.ThisRNAtakespartinepigeneticregulationofgenesandplaysanimportantroleindifferentcellularpathwaysbyinteractingwithPolycombRepressiveComplex2(PRC2).Inthisreview,wedescribethemolecularfunctionandregulationofHOTAIRanditsroleindifferenttypesofcancers.

简介：Themostimportantriskfactorforstrokeandneurodegenerationisaging.Infact,survivalafterstrokediminisheslargelywithaging.Infact,recoveryafterbrainarteryocclusionisdramaticallyworsenedbyaging,evennormalagingisassociatedwithneurondamageandcognitivedecline.Mechanismsinvolvedinaging-related,cognitivedeclineandsusceptibilitytoneurondamageinstrokeandneurodegenerationarelargelyunknown.Oneofthemostimportant

简介：Superficialnon-ampullaryduodenalepithelialtumor(SNADET)isdefinedasasporadictumorthatisconfinedtothemucosaorsubmucosathatdoesnotarisefromVater’spapilla,anditincludesadenomaandadenocarcinoma.Recentdevelopmentsinendoscopictechnology,suchashigh-resolutionendoscopyandimage-enhancedendoscopy,mayincreasethechancesofdetectingSNADETlesions.However,becauseSNADETisrare,littleisknownaboutitspreoperativeendoscopicdiagnosis.TheuseofendoscopicresectionforSNADET,whichhasnoriskofmetastasis,isincreasing,buttheincidenceofcomplications,suchasperforation,issignificantlyhigherthaninanyotherpartofthedigestivetract.Apreoperativediagnosisisrequiredtodistinguishbetweenlesionsthatshouldbefollowedupandthosethatrequiretreatment.Retrospectivestudieshaverevealedcertainendoscopicfindingsthatsuggestmalignancy.Inrecentyears,severalnewimagingmodalitieshavebeendevelopedandexploredforrealtimediagnosisoftheselesiontypes.EstablishinganendoscopicdiagnostictooltodifferentiatebetweenadenomaandadenocarcinomainSNADETlesionsisrequiredtoselectthemostappropriatetreatment.ThisreviewdescribesthecurrentstateofknowledgeaboutpreoperativeendoscopicdiagnosisofSNADETs,suchasduodenaladenomaandduodenaladenocarcinoma.Newerendoscopictechniques,includingmagnifyingendoscopy,mayhelptoguidethesediagnostics,buttheiradditionaladvantagesremainunclear,andfurtherstudiesarerequiredtoclarifytheseissues.

简介：Objective:Basedontheclinicalmanifestationsofahearinglosspatient,thePOU3F4genewastestedfordiagnosisofetiology.Methods:Acomprehensivephysicalexaminationwasperformedontheprobandtoexcludeabnormalitiesofotherorgans,anddetailedaudiologicaltestingandtemporalboneCTscanwerealsoperformed.GenomicDNAwasextractedusingtheproband’speripheralbloodleukocytes.Polymerasechainreactions(PCR)wereperformedinthecodingsequenceofthePOU3F4gene.DirectDNAsequencingwassubsequentlyappliedtoscreentheentirecodingregionofthePOU3F4gene.Results:Theprobandhadseveresensorineuralhearingloss.TemporalCTshowedbilateralcochlearincompletepartition,vestibuledysplasia,internalauditorycanalfundusexpansion,andcochlearinterlinkwiththeinternalauditorycanalfundus.Anovelmutation(c.530C>A(p.S177X))inthePOU3F4genewasfoundinthispatient,creatingannewstopcodonandwaspredictedtoresultinatruncatedproteinlackingnormalPOU3F4transcriptionfactorfunction.Conclusion:ThroughanalysisofthePOU3F4geneandclinicalmanifestationsinthepatient,weconcludethatanovelmutationmayhaveresultedinaprematurestopcodon,contributingtothemutationofPOU3F4gene.

简介：AIM：Toestablishaprognosticformulathatdistinguishesnon-hypervascularhepaticnodules（NHNs）withhigheraggressivenessfromlesshazardousone.METHODS：Seventy-threeNHNsweredetectedingadoliniumethoxybenzyldiethylene-triamine-pentaaceticacidmagneticresonanceimaging（Gd-EOB-DTPA-MRI）studyandconfirmedtochange2mmormoreinsizeand/ortogainhypervascularity.Allimageswereinterpretedindependentlybyanexperienced,board-certifiedabdominalradiologistandhepatologist;bothknewthatthepatientswereatriskforhepatocellularcarcinomadevelopmentbutwereblindedtotheclinicalinformation.AformulapredictingNHNdestinywasdevelopedusingageneralizedestimatingequationmodelwiththirteenexplanatoryvariables：age,gender,backgroundliverdiseases,Child-Pughclass,NHNdiameter,T1-weightedimaging/T2-weightedimagingdetectability,fatdeposition,lowersignalintensityinarterialphase,lowersignalintensityinequilibriumphase,α-fetoprotein,des-γ-carboxyprothrombin,α-fetoprotein-L3,andcoexistenceofclassicalhepatocellularcarcinoma.Theaccuracyoftheformulawasvalidatedinbootstrapsamplesthatwerecreatedbyresamplingof1000iterations.RESULTS：Duringamedianfollow-upperiodof504d,73NHNswithamediandiameterof9mm（interquartilerange：8-12mm）greworshrankby68.5%（fiftynodules）or20.5%（fifteennodules）,respectively,whereashypervascularitydevelopedin38.4%（twentyeightnodules）.Inthefifteenshranknodules,twelvenodulesdisappeared,while11.0%（eightnodules）werestableinsizebutacquiredvascularity.AgeneralizedestimatingequationanalysisselectedfiveexplanatoriesfromthethirteenvariablesassignificantfactorstopredictNHNprogression.Theestimatedregressioncoefficientswere0.36forage,6.51forlowersignalintensityinarterialphase,8.70or6.03forpositivityofhepatitisBvirusorhepatitisCvirus,9.37fordes-γ-carboxyprothrombin,and-4.05forfatdeposition.Aformulaincorpora

简介：Objective:Ameta-analysiswasperformedtoaugmenttheinsufficientdataontheimpactofmutativeEGFRdownstreamphosphatidylinositol-3-kinase(PI3K)andmitogen-activatedproteinkinase(MAPK)pathwaysontheclinicalefficiencyofepidermalgrowthfactorreceptortyrosinekinaseinhibitor(EGFR-TKI)treatmentofnon-smallcelllungcancer(NSCLC)patients.Methods:NetworkdatabaseswereexploredinApril,2015.PapersthatinvestigatedtheclinicaloutcomesofNSCLCpatientstreatedwithEGFR-TKIsaccordingtothestatusofK-rasand/orPIK3CAgenemutationwereincluded.Aquantitativemeta-analysiswasconductedusingstandardstatisticalmethods.Oddsratios(ORs)forobjectiveresponserate(ORR)andhazardratios(HRs)forprogression-freesurvival(PFS)andoverallsurvival(OS)werecalculated.Results:MutationinK-rassignificantlypredictedpoorORR[OR=0.22;95%confidenceinterval(CI),0.13-0.35],shorterPFS(HR=1.56;95%CI,1.27-1.92),andshorterOS(HR=1.59;95%CI,1.33-1.91)inNSCLCpatientstreatedwithEGFR-TKIs.MutantPIK3CAsignificantlypredictedshorterOS(HR=1.83;95%CI,1.05-3.20),showedpoorORR(OR=0.70;95%CI,0.22-2.18),andshorterPFS(HR=1.79;95%CI,0.91-3.53)inNSCLCpatientstreatedwithEGFR-TKIs.Conclusion:K-rasmutationadverselyaffectedtheclinicalresponseandsurvivalofNSCLCpatientstreatedwithEGFRTKIs.PIK3CAmutationshowedsimilartrends.InadditiontoEGFR,addingK-rasandPIK3CAasroutinegenebiomarkersinclinicalgeneticanalysisisvaluabletooptimizetheeffectivenessofEGFR-TKIregimensandidentifyoptimalpatientswhowillbenefitfromEGFR-TKItreatment.