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.     

More than a decade after live donor nephrectomy: a prospective cohort study

Previously reported short‐term results after live kidney donation show no negative consequences for the donor. The incidence of new‐onset morbidity takes years to emerge, making it highly likely that this will be missed during short‐term follow‐up. Therefore, evidence on long‐term outcome is essential. A 10‐year follow‐up on renal function, hypertension, quality of life (QOL), fatigue, and survival was performed of a prospective cohort of 100 donors. After a median follow‐up time of 10 years, clinical data were available for 97 donors and QOL data for 74 donors. Nine donors died during follow‐up of unrelated causes to donation, and one donor was lost to follow‐up. There was a significant decrease in kidney function of 12.9 ml/min (P < 0.001) at follow‐up. QOL showed significant clinically relevant decreases of 10‐year follow‐up scores in SF‐36 dimensions of physical function (P < 0.001), bodily pain (P = 0.001), and general health (P < 0.001). MFI‐20 scores were significantly higher for general fatigue (P < 0.001), physical fatigue (P < 0.001), reduced activity (P = 0.019), and reduced motivation (P = 0.030). New‐onset hypertension was present in 25.6% of the donors. Donor outcomes are excellent 10 years post‐donation. Kidney function appears stable, and hypertension does not seem to occur more frequently compared to the general population.     

新护士工作准备度与情绪劳动的相关性分析

目的 了解新护士工作准备度及情绪劳动水平,并分析两者之间的关系,为新护士顺利进入工作角色提供参考。 方法 采用一般资料调查表、中文版毕业护士工作准备度量表及情绪劳动量表,对新疆维吾尔自治区8所三甲医院工作1年内911名护士进行调查。 结果 新护士工作准备度总分（269.54±48.70）分,情绪劳动总分（46.85±11.91）分,两者呈负相关（r=-0.235,P＜0.05）;控制一般资料后,情绪劳动量表的表层扮演、深层扮演维度可解释新护士工作准备度35.5%的变异（均P＜0.05）。 结论 新护士工作准备度及情绪劳动均处于中等水平,表层扮演负向预测工作准备度,深层扮演正向预测工作准备度。管理者需重视新护士情绪劳动评估,重点关注倾向于表层扮演的新护士,以提高其工作准备度。     

Numerical modeling and simulations of type B aortic dissection treated by stent-grafts with different oversizing ratios

Retrograde type A dissection after thoracic endovascular aortic repair has been a major drawback of endovascular treatment. This study investigated the biomechanical mechanism of stent-graft-induced new lesions after implantation and analyzed the relationship between radial force and spring-back force of the stent-graft when it was implanted virtually under different oversizing ratios. Based on the computed tomography angiography images, a three-dimensional geometric model of a patient-specific aortic dissection was established. The stent was designed in CAD software and the stent-graft implantation procedure under different oversizing ratios was simulated in the finite element analysis software. Implantation simulations were performed six times for each stent-graft model under 0%, 3%, 6%, 9%, 12%, and 15% oversizing ratios and the peak stress of the aorta was compared among groups. It was observed that the peak stress of the aorta was located where the proximal bare stent interacted with aortic wall and its value was increased by 62.2% from 0% to 15% oversizing ratio. The conclusions are reached that the long-term higher stress in the aortic wall may lead to the emergence of new lesions in these areas, and the radial force plays a key role in the formation of a new entry in the real aorta model.     

姜黄素抗肿瘤新剂型研究进展

姜黄素是从姜科植物根茎中提取的相对分子量较小的多酚类物质,具有抗肿瘤抗炎、抗病毒、抗氧化等多种药理作用,随着现代医学发展,姜黄素抗肿瘤方面药理作用的分子机制被不断认识。肿瘤的形成和发展是一个多阶段的过程,药物干预可作用于其中的任何阶段,人类希望能找到安全、高效的肿瘤预防与治疗药物。食物来源的天然药物姜黄素因其具备较低的毒副作用、较高的安全性和较高的依从性,可被各类人群尤其是中低风险人群长期服用,而倍受关注。然而姜黄素的一些理化性质决定了其应用不尽理想,如何改善这些缺陷逐渐成为当今研究姜黄素的热点。该文将从天然食物来源的预防肿瘤药物姜黄素应用新剂型进行综述。     

P2X7受体和肾脏疾病

P2X7受体是三磷酸腺苷(ATP)门控阳离子通道受体,是嘌呤受体P2X家族受体亚型之一。P2X7受体信号通路与IL-1β、IL-6、COX-2等多种炎症因子的生成和释放相关,在多种疾病的发病过程中起到了至关重要的作用。目前以此受体为治疗靶点的P2X7受体拮抗剂已进入临床试验阶段,表现出良好的安全性和疗效。最新研究表明P2X7受体与多种肾脏疾病有关,P2X7受体拮抗剂具有潜在的肾脏疾病治疗作用。本文综述P2X7受体在肾脏疾病中的作用及其可能的作用机制,以期为肾脏疾病治疗的新靶点和新策略提供理论依据。     

小分子AMPK直接激动剂的最新研究进展

2型糖尿病是一种慢性代谢性疾病,其主要表现为高血糖和微血管并发症,是影响人类生活的重大疾病之一,目前尚无理想的治疗药物。腺苷酸活化蛋白激酶(AMP-activated protein kinase,AMPK)是一种高度保守的丝氨酸/苏氨酸蛋白激酶,在细胞和机体能量代谢与平衡等方面发挥重要作用;小分子AMPK直接激动剂因在降低血糖方面的作用而有望成为新一代治疗2型糖尿病的药物。本文按结构分类,对近几年报道的小分子AMPK直接激动剂进行综述。