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《Nutrition, metabolism, and cardiovascular diseases : NMCD》2022,32(1):21-31
AimThis review aims to summarize and discuss some of the most relevant clinical trials in epidemiology, diagnostics, and treatment of hypertension published in 2020 and 2021.Data synthesisThe trials included in this review are related to hypertension onset age and risk for future cardiovascular disease, reliability of different blood pressure monitoring methods, role of exercise-induced hypertension, treatment of hypertension in patients with SARS-CoV-2 infection, management of hypertension high-risk patient groups, e.g., in the elderly (≥80 years) and patients with atrial fibrillation, and the interplay between nutrition and hypertension, as well as recent insights into renal denervation for treatment of hypertension.ConclusionsHypertension onset age, nighttime blood pressure levels and a riser pattern are relevant for the prognosis of future cardiovascular diseases. The risk of coronary heart disease appears to increase linearly with increasing exercise systolic blood pressure. Renin-angiotensin system blockers are not associated with an increased risk for a severe course of COVID-19. In elderly patients, a risk-benefit assessment of intensified blood pressure control should be individually evaluated. A J-shaped association between cardiovascular disease and achieved blood pressure could also be demonstrated in patients with atrial fibrillation on anticoagulation. Salt restriction and lifestyle modification remain effective options in treating hypertensive patients at low cardiovascular risk. Sodium glucose co-transporter 2 inhibitors and Glucagon-like peptide-1 receptor agonists show BP-lowering effects. Renal denervation should be considered as an additional or alternative treatment option in selected patients with uncontrolled hypertension. 相似文献
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Canagliflozin,an inhibitor of sodium-glucose co-transporter 2, advances in the treatment of type 2 diabetes 下载免费PDF全文
Canagliflozin (CANA) is a sodium-glucose co-transporter 2 inhibitor. One of the important mechanisms of CANA is the inhibitory effect on the glucose uptake in the proximal tubule of the nephron, and the other mechanism can be the reduction of inflammatory cytokine expression monocytes and macrophages. It is proved by FDA for the management of type 2 diabetes. In the present work, we summarized the publication and clinical evidence of the CANA on healthy individuals and those with related metabolic diseases, such as type 1 and 2 diabetes, obesity, or cardiovascular and kidney diseases. This drug has been reported to offer potential advantages in regulating body weight and reducing heart failure, hypoglycemia, and stroke risk in patients with type 2 diabetes. Some in vitro and animal experiments also show that this drug has good effects on cancer treatment. However, some case reports and experiments also show the side effect of CANA, such as amputation, fracture, and pancreatitis, while the mechanism is still unknown. Overall, CANA has a good effect on the management of type 2 diabetes by reducing the risk of kidney failure, cardiovascular diseases, and stroke. However, as a new drug, more clinical trials and experiments of CANA should be carried out in the future. 相似文献
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子宫浆液性癌(uterine serous carcinoma,USC)是一种特殊类型的子宫内膜癌。有别于常见的子宫内膜样腺癌,USC较为少见,且恶性程度高,侵袭转移风险高,临床上预后较差。随着子宫内膜癌分子学研究的不断深入,分子学特征被应用于子宫内膜癌的病理分型诊断、治疗和预后评价中。研究发现USC中存在多种基因的突变,这些相关基因的突变对该病的诊断和预后具有重要的指导意义。同时,特异性的分子学改变为USC的靶向治疗提供了潜在的治疗靶点。目前,多种靶向治疗手段包括人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)抑制剂、免疫检查点抑制剂、抗血管生成治疗、磷脂酰肌醇3激酶(phosphoinositide 3-kinases,PI3K)通路抑制剂和多腺苷二磷酸核糖聚合酶[poly(ADP-ribose) polymerase,PARP]抑制剂等被应用于USC的临床治疗研究中,针对性的靶向治疗有望成为USC治疗的新突破。 相似文献
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Shaked Lev-Ari MD Michael Serzan MD Tianmin Wu MS Andrew Ip MD Lauren Pascual HSD Brittany Sinclaire MS Shari Adams HSD Michael Marafelias BS Lakshmi Ayyagari MD Sarvarinder K. Gill MD Barbara Ma MD Jacob P. Zaemes MD Alexandra Della Pia PharmD Adil Alaoui MS Subha Madhavan PhD Anas Belouali MS Andrew Pecora MD Jaeil Ahn PhD Michael B. Atkins MD Neil J. Shah MD 《Cancer》2023,129(12):1885-1894
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Maja Popovic Gorana Matovina-Brko Masa Jovic Lazar S Popovic 《World journal of clinical oncology》2022,13(1):28-38
Renal cell cancer (RCC) represents 2%-3% of all adulthood cancers and is the most common malignant neoplasm of the kidney (90%). In the mid-nineties of the last century, the standard of treatment for patients with metastatic RCC was cytokines. Sunititib and pazopanib were registered in 2007 and 2009, respectively, and have since been the standard first-line treatment for metastatic clear cell RCC (mccRCC). Renal cell cancer is a highly immunogenic tumor with tumor infiltrating cells, including CD8+ T lymphocytes, dendritic cells, natural killer cells (NK) and macrophages. This observation led to the design of new clinical trials in which patients were treated with immunotherapy. With the growing evidence that proangiogenic factors can have immunomodulatory effects on the host’s immune system, the idea of combining angiogenic drugs with immunotherapy has emerged, and new clinical trials have been designed. In the last few years, several therapeutic options have been approved [immunotherapy and immunotherapy/tyrosine kinase inhibitors (TKI)] for the first-line treatment of mccRCC. Nivolumab/ipilimumab is approved for the treatment of patients with inter mediate and poor prognoses. Several checkpoint inhibitors (pembrolizumab, nivolumab, avelumab) in combination with TKI (axitinib, lenvatinib, cabozan tinib) are approved for the treatment of patients regardless of their International mRCC Database Consortium prognostic group and PD-L1 expression. There is no specific and ideal biomarker that could help in selecting the ideal patient for the appropriate first-line treatment. 相似文献
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