Implementing newer agents for the management of castrate‐resistant prostate cancer: what is known and what is needed?

Men receiving androgen‐deprivation therapy will in time develop metastatic castrate‐resistant prostate cancer (mCRPC). Whilst effective treatment options for mCRPC have traditionally been limited, new agents are becoming available. Since 2010, the number and class of agents available to treat mCRPC has increased dramatically. As such, there is a need for clear guidance on the optimum treatment and sequence of treatments for mCRPC before and after chemotherapy. This evidence‐based statement, reflecting the views of the authors, provides suggestions on the continued relevance of conventional approaches to first‐ and second‐line treatment in mCRPC, the potential role of novel treatments, and factors that may influence the choice of hormonal agents and/or chemotherapy.     

神经肌肉阻滞剂在急性呼吸窘迫综合征中的应用

目前神经肌肉阻滞剂在ICU应用较广,其中25％ ～ 55％的急性呼吸窘迫综合征（acuterespiratory distress syndrome,ARDS）机械通气患者接受该药作为辅助治疗,但至今神经肌肉阻滞剂在ARDS机械通气患者的应用仍存在不少争议.本文对神经肌肉阻滞剂在ARDS中的应用进行系统阐述.     

An investigation of the composite resin/porcelain interface.

Failures at composite resin/porcelain interfaces under shear-like loading were examined. Porcelain surfaces were treated with hydrofluoric acid and/or one of two silane coupling agents, using two different composite resin cements. The results showed that after seven days storage, bond strengths of specimens which had undergone porcelain surface treatment were greater than the cohesive strength of the porcelain itself, resulting in brittle fracture of the porcelain. The diluted restorative composite resin performed as well as the commercial composite resin cement. Silane pretreatment of porcelain was important as the bond strength of etched/silane primed specimens was significantly higher than the etched only specimens. However, one primer appeared to be more efficient than the other in bond promotion. Some explanations for the differences in bond strengths are offered.     

Effect of composition and complexity of dentin-bonding agents on operator variability--analysis of gap formation using confocal microscopy

The variability of gap formation due to different operators and bonding agents around dentin-bonded composites in cylindrical cavities (internal diameter, 3 mm; depth, 1 mm; n = 210) was evaluated in vitro. Seven dentists evaluated two experimental bonding systems (A & B) and one commercial product (C) by each treating 10 teeth with each system. One of the investigators restored all cavities with composite (Z100, 3M ESPE) and removed excess material to expose the cavity margins. After storage in water for 1 wk, the maximum gap-width was measured using a confocal microscope and statistically analysed. The relative gap-widths (%) for the three bonding systems were not statistically different. Means +/- SD were 0.18 +/- 0.06, 0.19 +/- 0.08, and 0.20 +/- 0.06 for groups A, B, and C, respectively. The variation caused by the operator-material interaction was significant. When the operator's variability (SD) within the different materials was examined, group C displayed a significantly lower variability than the other two. It was concluded that the operator variable is a more important consideration than the material variable. The self-etching system performed better than the more complex A and B systems when variability rather than gap size was considered.     

脱敏剂对牙本质粘接剂剪切粘接强度的影响

目的 研究脱敏剂对牙本质粘接剂剪切粘接强度的影响,以期为临床操作提供参考.方法 将20个牙试件均分为实验组和对照组,每组10个;实验组牙本质表面涂布脱敏剂(极固宁TM);对照组不做任何处理.用牙本质粘接剂(Variolink Ⅱ)将铸瓷(IPS Empress)粘接于两组试件牙本质粘接面上,测试剪切粘接强度,扫描电镜(SEM)观察试件断面.结果 实验组和对照组的剪切粘接强度分别为(5.53±0.96)MPa和(7.32±1.34)MPa,差异有统计学意义(P=0.003).SEM见实验组试件发生黏附破坏,对照组试件发生内聚破坏.结论 牙本质表面涂布脱敏剂后可显著降低粘接剂的剪切粘接强度.