Technologies for localization and diagnosis of prostate cancer

The gold standard for detecting prostate cancer (PCa), systematic biopsy, lacks sensitivity as well as grading accuracy. PSA screening leads to over-treatment of many men, and it is unclear whether screening reduces PCa mortality. This review provides an understanding of the difficulties of localizing and diagnosing PCa. It summarizes recent developments of ultrasound (including elastography) and MRI, and discusses some alternative experimental techniques, such as resonance sensor technology and vibrational spectroscopy. A comparison between the different methods is presented. It is concluded that new ultrasound techniques are promising for targeted biopsy procedures, in order to detect more clinically significant cancers while reducing the number of cores. MRI advances are very promising, but MRI remains expensive and MR-guided biopsy is complex. Resonance sensor technology and vibrational spectroscopy have shown promising results in?vitro. There is a need for large prospective multicentre trials that unambiguously prove the clinical benefits of these new techniques.     

针对性护理模式对冠心病心绞痛患者心率血压及心理状态的影响分析

目的 探讨针对性护理模式在冠心病心绞痛患者临床治疗中的应用效果,结合患者的心率血压及心理状态变化情况进行评价。方法 选取解放军东部战区总医院心血管内科2019年2月至2020年2月期间收治的74例冠心病心绞痛患者作为研究对象,应用随机数字表法,分为观察组37例,进行针对性护理模式,对照组37例,进行常规护理,对比两组患者的护理效果。结果 与对照组相比,观察组患者在护理后的心率(HR)水平[(76.17±4.82)次/min vs.(80.62±3.94)次/min]、收缩压(SBP)水平[(134.42±10.25)mmHg vs.(143.57±11.94)mmHg]、舒张压(DBP)水平[(88.92±7.63)mmHg vs.(44.73±5.05)mmHg]、心绞痛发作频次[(0.52±0.13)次/周vs.(1.47±0.31)次/周]以及焦虑自评量表(SAS)评分[(38.14±4.37)分vs.(93.71±5.09)分]相对更低(P0.05),与对照比,观察组患者的护理满意度相对更高(P0.05)。结论 冠心病心绞痛患者的治疗恢复期间,针对性护理模式的应用,可以有效纠正患者的心率、血压异常,同时改善其心理状态,减少症状的发作,改善患者的预后。     

Pore Narrowing of Mesoporous Silica Materials

To use mesoporous silicas as low-k materials, the pore entrances must be really small to avoid diffusion of metals that can increase the dielectric constant of the low-k dielectric. In this paper we present a new method to narrow the pores of mesoporous materials through grafting of a cyclic-bridged organosilane precursor. As mesoporous material, the well-studied MCM-41 powder was selected to allow an easy characterization of the grafting reactions. Firstly, the successful grafting of the cyclic-bridged organosilane precursor on MCM-41 is presented. Secondly, it is demonstrated that pore narrowing can be obtained without losing porosity by removing the porogen template after grafting. The remaining silanols in the pores can then be end-capped with hexamethyl disilazane (HMDS) to make the material completely hydrophobic. Finally, we applied the pore narrowing method on organosilica films to prove that this method is also successful on existing low-k materials.     

Photodynamic therapy: A next alternative treatment strategy for hepatocellular carcinoma?

Liver cancer is one of the most common cancers in the world. Of all types of liver cancer, hepatocellular carcinoma (HCC) is known to be the most frequent primary liver malignancy and has seriously compromised the health status of the general population. Locoregional thermal ablation techniques such as radiofrequency and microwave ablation, have attracted attention in clinical practice as an alternative strategy for HCC treatment. However, their aggressive thermal effect may cause undesirable complications such as hepatic decompensation, hemorrhage, bile duct injury, extrahepatic organ injuries, and skin burn. In recent years, photodynamic therapy (PDT), a gentle locoregional treatment, has attracted attention in ablation therapy for patients with superficial or luminal tumors as an alternative treatment strategy. However, some inherent defects and extrinsic factors of PDT have limited its use in clinical practice for deep-seated HCC. In this contribution, the aim is to summarize the current status and challenges of PDT in HCC treatment and provide potential strategies to overcome these deficiencies in further clinical translational practice.     

The Emerging Molecular Landscape of Urothelial Carcinoma

Although there have been many recent discoveries in the molecular alterations associated with urothelial carcinoma, current understanding of this disease lags behind many other malignancies. Historically, a two-pathway model had been applied to distinguish low- and high-grade urothelial carcinoma, although significant overlap and increasing complexity of molecular alterations has been recently described. In many cases, mutations in HRAS and FGFR3 that affect the MAPK and PI3K pathways seem to be associated with noninvasive low-grade papillary tumors, whereas mutations in TP53 and RB that affect the G1-S transition of the cell cycle are associated with high-grade in situ and invasive carcinoma. However, recent large-scale analyses have identified overlap in these pathways relative to morphology, and in addition, many other variants in a wide variety of oncogenes and tumor-suppressor genes have been identified. New technologies including next-generation sequencing have enabled more detailed analysis of urothelial carcinoma, and several groups have proposed molecular classification systems based on these data, although consensus is elusive. This article reviews the current understanding of alterations affecting oncogenes and tumor-suppressor genes associated with urothelial carcinoma, and their application in the context of morphology and classification schema.     

Improving outcomes in primary CNS lymphoma

Primary central nervous system lymphoma (PCNSL) is an aggressive disease with previously poor prognosis. The advent of high-dose methotrexate-based induction regimens as well as use of consolidation therapy has greatly improved this prognosis in recent decades, but durable remission still eludes half of patients. In this review, we summarize the progress made in the treatment of PCNSL as well as the challenges that remain, with a focus on defining optimal induction and consolidation regimens, including the promise of developing biotherapies. Future studies will help delineate the best combination of existing and novel treatment strategies, with the goal of expanding the cohort of patients achieving a cure.     

自制气管切开封管帽在长期气管切开病人中的应用

目的：探讨自制气管切开导管封管帽用于长期气管切开病人的封管效果。方法选择气管切开需长期封管的病人80例，随机分成观察组和对照组各40例。观察组使用自制封管帽封管，对照组使用自制消毒棉签封管，对比两组病人封管期间封管物因呛咳被喷出掉落的人均次数和呼吸道感染发生次数。选择其中30例病人清醒时分别使用棉签和封管帽封管进行自身对照，比较其舒适度。选择30名操作人员分别使用封管帽和棉签进行封管操作，操作后让其对两种封管方法进行使用评价和选择封管方法。结果两组病人封管期间封管物因呛咳被喷出掉落的人均次数和呼吸道感染发生次数比较差异有显著意义，P＜0．05；30例病人用棉签和封管帽封管的舒适满意度分别是90．3％和70％，χ2＝5．45， P＜0．05。30例病人和30名操作人员均选择使用封管帽长期封管。结论自制封管帽体积小，与气管切开导管衔接较好，装卸方便，不易丢失或掉落；既方便吸痰，又不易污染，增加了护理人员的可操作性；可提高患者封管的舒适度和安全系数；容易规范气管切开的护理操作流程，有效降低因气管切开所致的医院感染率，值得长期气管切开病人推广应用。