cancer treatment

癌症治疗
  • 文章类型: Journal Article
    患有严重精神疾病(SMI)的个体比没有SMI的个体具有更高的癌症死亡率。本文的目的是强调SMI患者在癌症治疗中的这些差异,并提出潜在的解决方案。我们对已发表的论文进行了叙述性审查,关注死亡率,发病率,行为和提供者风险因素,筛选,诊断,治疗,以及SMI和癌症患者的姑息治疗。文献没有提供关于SMI个体与普通人群相比是否存在癌症发病率差异的明确共识。然而,很明显,SMI患者的癌症死亡率更高.癌症相关危险行为增加等因素,心理健康耻辱,和难以获得癌症治疗有助于这种死亡率差异。文献还表明筛查率较低,延误和不当的诊断和治疗,以及SMI患者的临床试验招募不足。虽然文献中关于姑息治疗的差异尚无定论,我们概述了为该人群提供最佳生命终结护理的关键概念。我们还总结了解决筛查差异的策略,诊断,和治疗水平,并描述了改善SMI患者癌症护理的一般战略方法。我们强调与病人有关的,与医生有关的,以及医疗保健/系统相关因素导致SMI患者癌症护理差异。未来的研究必须检查所提出的解决方案的有效性,以指导基于证据的实践。
    Individuals with severe mental illness (SMI) have higher mortality rates from cancer than individuals without SMI. The aim of this paper is to highlight these disparities in cancer care in individuals with SMI and suggest potential solutions. We conducted a narrative review of published papers, focusing on mortality, incidence, behavioral and provider risk factors, screening, diagnosis, treatment, and palliative care among individuals with SMI and cancer. The literature does not provide a clear consensus on whether a difference in cancer incidence exists among individuals with SMI compared to the general population. However, it is evident that individuals with SMI have higher mortality from cancer. Factors such as increased cancer related risk behavior, mental health stigma, and difficulty accessing cancer care contribute to this mortality difference. The literature also indicates lower screening rates, delayed and improper diagnosis and treatment, as well as inadequate clinical trial enrollment in individuals with SMI. While the literature is inconclusive regarding disparities in palliative care, we outline key concepts to provide the best possible end of life care to this population. We also summarize strategies to address disparities at the screening, diagnostic, and treatment levels and describe general strategic approaches to improve cancer care in individuals with SMI. We highlight patient-related, physician-related, and healthcare/systems-related factors leading to disparities in cancer care in individuals with SMI. Future research must examine the effectiveness of proposed solutions to guide evidence-based practices.
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  • 文章类型: Journal Article
    单原子纳米酶(SAzymes)代表了纳米材料的前沿进步,将天然酶的高催化效率与原子经济效益相结合。传统上,天然酶表现出很高的特异性和效率,但是它们的稳定性受到环境条件和生产成本的限制。这里我们展示了SAzymes,具有大的比表面积和高的原子利用率,取得优越的催化活性。然而,它们的高分散性带来了稳定性挑战。我们的综述集中在旨在增强SAzyes的催化特异性和稳定性的最新结构和制备进展。与以前的纳米酶相比,SAzymes在生物医学应用中表现出显着改善,特别是在肿瘤医学中。这一进展将SAzymes定位为未来癌症治疗策略的有希望的工具。将无机材料的鲁棒性与生物系统的特异性相结合。SAzymes的开发和应用将彻底改变生物催化领域,提供稳定的,具有成本效益的替代天然酶。
    Single-atom nanozymes (SAzymes) represent a cutting-edge advancement in nanomaterials, merging the high catalytic efficiency of natural enzymes with the benefits of atomic economy. Traditionally, natural enzymes exhibit high specificity and efficiency, but their stability are limited by environmental conditions and production costs. Here we show that SAzymes, with their large specific surface area and high atomic utilization, achieve superior catalytic activity. However, their high dispersibility poses stability challenges. Our review focuses on recent structural and preparative advancements aimed at enhancing the catalytic specificity and stability of SAzymes. Compared to previous nanozymes, SAzymes demonstrate significantly improved performance in biomedical applications, particularly in tumor medicine. This progress positions SAzymes as a promising tool for future cancer treatment strategies, integrating the robustness of inorganic materials with the specificity of biological systems. The development and application of SAzymes could revolutionize the field of biocatalysis, offering a stable, cost-effective alternative to natural enzymes.
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  • 文章类型: Journal Article
    癌症仍然是全球健康挑战,需要不断改进诊断和治疗策略。本文综述了非侵入性生物标志物在癌症诊断和治疗中的应用。它们在早期检测中的作用,疾病监测,和个性化的治疗干预措施。通过对文献的系统回顾,我们确定了45项相关研究,突出了这些生物标志物在各种癌症类型中的潜力,如乳房,前列腺,肺,和大肠癌。讨论的非侵入性生物标志物包括液体活检,表观遗传标记,非编码RNA,外泌体货物,和代谢物。值得注意的是,液体活检,特别是那些基于循环肿瘤DNA(ctDNA)的,已经成为早期最有前途的方法,非侵入性癌症检测,因为它们能够从易于获取的血液样本中提供全面的遗传和表观遗传信息。这篇综述展示了非侵入性生物标志物如何促进早期癌症检测,准确的子分型,和量身定制的治疗策略,从而改善患者的预后。它强调了非侵入性生物标志物在肿瘤学中的转化潜力,强调它们在加强早期检测方面的应用,存活率,和癌症护理中的治疗精度。
    https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD4202347474749PROSPERO,标识符CRD42023474749。
    Cancer remains a global health challenge, necessitating continuous advancements in diagnostic and treatment strategies. This review focuses on the utility of non-invasive biomarkers in cancer diagnosis and treatment, their role in early detection, disease monitoring, and personalized therapeutic interventions. Through a systematic review of the literature, we identified 45 relevant studies that highlight the potential of these biomarkers across various cancer types, such as breast, prostate, lung, and colorectal cancers. The non-invasive biomarkers discussed include liquid biopsies, epigenetic markers, non-coding RNAs, exosomal cargo, and metabolites. Notably, liquid biopsies, particularly those based on circulating tumour DNA (ctDNA), have emerged as the most promising method for early, non-invasive cancer detection due to their ability to provide comprehensive genetic and epigenetic information from easily accessible blood samples. This review demonstrates how non-invasive biomarkers can facilitate early cancer detection, accurate subtyping, and tailored treatment strategies, thereby improving patient outcomes. It underscores the transformative potential of non-invasive biomarkers in oncology, highlighting their application for enhancing early detection, survival rates, and treatment precision in cancer care.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023474749 PROSPERO, identifier CRD42023474749.
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  • 文章类型: Journal Article
    癌症是世界上死亡率的主要贡献者。作为治疗选择的常规疗法是化疗,放疗和手术。然而,这些治疗方法在大多数情况下几乎没有细胞特异性。如今,在癌症治疗之前,进行了广泛的研究和调查以开发细胞特异性方法。其中一些是光动力疗法,热疗,免疫疗法,干细胞移植和靶向治疗。本文将对肿瘤基因治疗的发展进行综述。基因治疗的目的是纠正导致癌症的细胞过度增殖的特定突变基因。在修饰基因的方法上有很多探索。这种疗法的实施在其成功中起着重要作用。如果插入的基因找不到目标,治疗被认为是失败的。因此,载体是必需的,常用的载体是病毒,非病毒或合成,基于聚合物和基于脂质的载体。基因治疗在癌症治疗中的进展将集中在世界三大癌症病例上,即乳腺癌,肺癌和结肠癌。在乳腺癌中,讨论的疗法是CRISPR/Cas9,siRNA和基因沉默,而在结肠癌miRNA和自杀基因治疗以及肺癌中,替换抑癌基因,CRISPR/Cas9和miRNA。
    Cancer is the main contributor for mortality in the world. Conventional therapy that available as the treatment options are chemotherapy, radiotherapy and surgery. However, these treatments are hardly cell-specific most of the time. Nowadays, extensive research and investigations are made to develop cell-specific approaches prior to cancer treatment. Some of them are photodynamic therapy, hyperthermia, immunotherapy, stem cell transplantation and targeted therapy. This review article will be focusing on the development of gene therapy in cancer. The objective of gene therapy is to correct specific mutant genes causing the excessive proliferation of the cell that leads to cancer. There are lots of explorations in the approach to modify the gene. The delivery of this therapy plays a big role in its success. If the inserted gene does not find its way to the target, the therapy is considered a failure. Hence, vectors are needed and the common vectors used are viral, non viral or synthetic, polymer based and lipid based vectors. The advancement of gene therapy in cancer treatment will be focussing on the top three cancer cases in the world which are breast, lung and colon cancer. In breast cancer, the discussed therapy are CRISPR/Cas9, siRNA and gene silencing whereas in colon cancer miRNA and suicide gene therapy and in lung cancer, replacement of tumor suppressor gene, CRISPR/Cas9 and miRNA.
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  • 文章类型: Journal Article
    目前,由于生活质量低,癌症患者的数量一直在增加。出于这个原因,用于治疗癌症的疗法已经得到了专家的很多考虑。许多抗癌药物已被用于治疗癌症患者。然而,立即使用抗癌药物会导致患者不愉快的副作用,并且对应用这些治疗有许多限制。许多聚合物,如纤维素,壳聚糖,聚乙烯醇(PVA),聚丙烯腈(PAN),多肽和聚羟基链烷酸酯具有良好的治疗癌症的性能,但是通过同轴静电纺丝技术生产的基于纳米纤维的靶标和受控药物递送系统具有非凡的性能,例如良好的机械特性,一个很好的释放配置文件,高表面积,和高海绵状和无害的,生物可再生,生物友好,高度可降解,并且可以非常方便地以工业规模生产。因此,通过同轴静电纺丝生产的纳米纤维可以设计为靶向特定的癌细胞或组织。通过改变纳米纤维的组成和性能,研究人员可以控制治疗剂的释放动力学,并增强其在肿瘤部位的积累,同时将全身毒性降至最低。同轴电纺纳米纤维的核-壳结构允许治疗剂随时间的受控和持续释放。这种受控释放曲线可以通过在肿瘤微环境内维持治疗药物浓度延长的时间来提高癌症治疗的功效。
    Currently, the number of patients with cancer is expanding consistently because of a low quality of life. For this reason, the therapies used to treat cancer have received a lot of consideration from specialists. Numerous anticancer medications have been utilized to treat patients with cancer. However, the immediate utilization of anticancer medicines leads to unpleasant side effects for patients and there are many restrictions to applying these treatments. A number of polymers like cellulose, chitosan, Polyvinyl Alcohol (PVA), Polyacrylonitrile (PAN), peptides and Poly (hydroxy alkanoate) have good properties for the treatment of cancer, but the nanofibers-based target and controlled drug delivery system produced by the co-axial electrospinning technique have extraordinary properties like favorable mechanical characteristics, an excellent release profile, a high surface area, and a high sponginess and are harmless, bio-renewable, biofriendly, highly degradable, and can be produced very conveniently on an industrial scale. Thus, nanofibers produced through coaxial electrospinning can be designed to target specific cancer cells or tissues. By modifying the composition and properties of the nanofibers, researchers can control the release kinetics of the therapeutic agent and enhance its accumulation at the tumor site while minimizing systemic toxicity. The core-shell structure of coaxial electrospun nanofibers allows for a controlled and sustained release of therapeutic agents over time. This controlled release profile can improve the efficacy of cancer treatment by maintaining therapeutic drug concentrations within the tumor microenvironment for an extended period.
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  • 文章类型: Journal Article
    癌症是一个全球性的健康问题,需要持续的治疗进展。这篇综述概述了最近的治疗策略,重点是癌症治疗中的新途径。新兴研究揭示了超越传统模式的有希望的目标,为精准医疗提供新的途径,并改善患者的预后。创新的一个关键领域在于针对与癌症进展有关的特定分子途径的靶向治疗。新型生物标志物的识别为开发针对个体患者特征的精准药物铺平了道路。免疫疗法还通过使用免疫系统来识别和去除癌细胞,彻底改变了癌症治疗。此外,表观遗传疗法和基于RNA的干预措施的进展表明,在调节基因表达和破坏癌症特异性信号通路方面具有前所未有的潜力.我们讨论了癌症的病理生理学,不同的免疫检查点抑制剂,和信号疗法中的靶向疗法。表观遗传调节剂,如组蛋白脱乙酰酶(HDAC)抑制剂和DNA甲基转移酶(DNMT)抑制剂,被研究过。癌症免疫治疗(CAR-T)细胞疗法的最新突破展示了增强针对各种癌症的免疫反应的潜力;因此,相关信息被纳入。Further,基于RNA的疗法,如RNA干扰和基于mRNA的疫苗和疗法,联合疗法,本文讨论了新的治疗方法。
    Cancer is a global health issue that requires ongoing therapeutic advances. This review provides an overview of recent treatment strategies focusing on novel pathways in cancer therapy. Emerging research has unveiled promising targets that go beyond traditional modalities, offering new avenues for precision medicine and improved patient outcomes. One key area of innovation lies in targeted therapies directed at specific molecular pathways implicated in cancer progression. The identification of novel biomarkers has paved the way for the development of precision medicines tailored to individual patient profiles. Immunotherapy has also revolutionised cancer treatment by using the immune system to identify and remove cancer cells. Moreover, advancements in epigenetic therapies and RNA-based interventions demonstrate unprecedented potential in modulating gene expression and disrupting cancer-specific signalling pathways. We have discussed the pathophysiology of cancer, different immune checkpoint inhibitors, and targeted therapies in signalling therapies. The epigenetic modulators, such as Histone deacetylase (HDACs) inhibitors and DNA methyltransferase (DNMT) inhibitors, were studied. Recent breakthroughs in cancer immunotherapy treatment (CAR-T) cell therapy showcase the potential to enhance the immune response against various cancers; thus, related information was incorporated. Further, RNA-based therapies like RNA interference and mRNA-based vaccines and therapies, combination therapies, and novel therapies were discussed in the present article.
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  • 文章类型: Journal Article
    丝绸是由不同节肢动物天然产生的一类蛋白质,包括蚕,蜘蛛,蝎子,螨虫,黄蜂,和蜜蜂。这篇综述讨论了家蚕制造的丝素蛋白和丝胶蛋白作为多功能纤维。它主要由疏水性丝素蛋白和亲水性丝胶蛋白组成。丝素蛋白被定义为赋予丝强度的结构蛋白,虽然丝胶的特征是树胶状蛋白质,将两种纤维蛋白绑在一起,赋予丝蛋白弹性。由于其多功能结构,生物相容性,和生物降解性,它们可以被定制为复杂的结构,以保证特定的需求。两种蛋白质的固有官能团使得它们的官能化和与各种生物材料的交联能够赋予基质良好的抗氧化和抗菌性能。根据目标应用,它们可以与其他材料结合以配制纳米纤维,水凝胶,电影,和微纳米粒子。鉴于丝心蛋白和丝胶蛋白具有突出的生物学和可控的物理化学特征,它们可以用于涉及组织工程的药物应用,伤口修复,药物输送,和癌症治疗。这篇综述全面讨论了丝素蛋白和丝胶蛋白在伤口愈合和药物递送系统中不同配方的实施进展,特别是癌症治疗。
    Silks are a class of proteins generated naturally by different arthropods, including silkworms, spiders, scorpions, mites, wasps, and bees. This review discusses the silk fibroin and silk sericin fabricated by Bombyx mori silkworm as versatile fibers. This silk fiber is predominantly composed of hydrophobic silk fibroin and hydrophilic silk sericin. Fibroin is defined as a structural protein that bestows silk with strength, while sericin is characterized as a gum-like protein, tying the two fibrous proteins together and endowing silk proteins with elasticity. Due to their versatile structures, biocompatibility, and biodegradability, they could be tailored into intricate structures to warrant particular demands. The intrinsic functional groups of both proteins enable their functionalization and cross-linking with various biomaterials to endow the matrix with favorable antioxidant and antibacterial properties. Depending on the target applications, they can be integrated with other materials to formulate nanofibrous, hydrogels, films, and micro-nanoparticles. Given the outstanding biological and controllable physicochemical features of fibroin and sericin, they could be exploited in pharmaceutical applications involving tissue engineering, wound repair, drug delivery, and cancer therapy. This review comprehensively discusses the advancements in the implementation of different formulations of silk fibroin and sericin in wound healing and drug delivery systems, particularly for cancer treatment.
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  • 文章类型: Case Reports
    玫瑰糠疹是一种急性,通常发生在青春期和成年期的自我限制的放生,典型表现为躯干和近端有卵圆形红斑和鳞状病变。虽然其原因尚不明确,玫瑰糠疹的经典形式可能是由于潜伏的人类疱疹病毒(HHV)感染(HHV-6和HHV-7)的重新激活所致。有趣的是,临床和/或组织病理学上类似玫瑰糠疹的药疹也有报道。这些玫瑰糠疹样药疹往往发生在年龄较大,持续时间比经典类型短。由于有不同的管理范式,典型的玫瑰糠疹和模仿药疹之间的区别很重要。在这里,我们报告一例玫瑰糠疹样药疹,该药疹与甲磺酸伊马替尼治疗慢性髓性白血病相关.我们还回顾了报告的玫瑰糠疹样药疹病例的临床病理特征,包括伊马替尼。虽然皮肤药物相关性皮疹的临床形态模拟了典型玫瑰糠疹中的病变,存在独特的组织病理学发现,包括坏死的角质形成细胞,界面皮炎,和嗜酸性粒细胞,可以帮助区分。
    Pityriasis rosea is an acute, self-limited exanthem that typically occurs in adolescence and young adulthood, classically featuring ovoid erythematous and scaly lesions on the trunk and proximal extremities. While its cause is not definitively known, the classic form of pityriasis rosea may result from the reactivation of latent human herpesvirus (HHV) infections (HHV-6 and HHV-7). Interestingly, drug eruptions that clinically and/or histopathologically resemble pityriasis rosea have also been reported. These pityriasis rosea-like drug eruptions tend to occur at an older age and have a shorter duration than the classic type. As there are different management paradigms, the distinction between classic pityriasis rosea and the mimicking drug eruption is important to recognize. Herein, we report a case of a pityriasis rosea-like drug eruption that occurred in association with imatinib mesylate treatment for chronic myeloid leukemia. We also review the clinicopathologic features of reported cases of pityriasis rosea-like drug eruption, including those due to imatinib. While the clinical morphology of the cutaneous drug-related eruption mimics the lesions seen in classic pityriasis rosea, the presence of unique histopathologic findings, including necrotic keratinocytes, interface dermatitis, and eosinophils, may aid in distinction.
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  • 文章类型: Journal Article
    目的:肿瘤治疗期间的运动和身体活动(PA)有很多好处。然而,PA水平和依从性通常较低。对定性文献的系统回顾旨在探讨治疗期间锻炼和体育锻炼的经验和感知障碍和促进因素。
    方法:在Embase和Medline数据库中对已发表的文献进行了系统搜索;方案的全部细节可以在Prospero数据库(CRD42022371206)中找到。符合纳入条件的研究是定性的,包括目前正在接受肿瘤治疗或在过去6个月内完成治疗的参与者。每一项研究的结果都被制成表格,并综合成分析主题。
    结果:来自309项研究的18篇全文符合纳入标准,共有420名参与者,包括治愈性和姑息性治疗意向。产生了四个总体主题:(1)主持人;(2)障碍;(3)PA/锻炼的经验和(4)转变态度。在治疗期间显示对PA或运动的感知的子主题是积极的,看到个人的积极变化是非常有动力的,尤其是在一个组类设置。障碍包括缺乏医疗保健专业人员(HCP)的支持或指导,环境挑战和疾病负担/恐惧或症状恶化。
    结论:尽管在肿瘤治疗期间对运动和PA有积极的看法,影响参与的障碍很大。缺乏HCP的支持和对症状恶化的恐惧是重要的障碍。未来的研究应该集中在影响这些障碍,以最终改善接受肿瘤治疗的患者的PA和运动水平。
    OBJECTIVE: Exercise and physical activity (PA) during oncological treatment have many benefits. However, PA levels and adherence are often low. This systematic review of qualitative literature aims to explore the experience and the perceived barriers and facilitators to exercise and physical activity during treatment.
    METHODS: A systematic search of the published literature was carried out in the Embase and Medline databases; full details for the protocol can be found in the Prospero database (CRD42022371206). Studies eligible for inclusion were qualitative and included participants that were either currently undergoing oncological treatment or had finished treatment within the last 6 months. The findings from each study were tabulated and synthesised into analytical themes.
    RESULTS: Eighteen full texts from 309 studies met inclusion criteria with a total of 420 participants including both curative and palliative treatment intents. Four overarching themes were generated: (1) Facilitators; (2) Barriers; (3) Experience of PA/exercise and (4) Transforming attitudes. Sub-themes that showed perceptions of PA or exercise during treatment were positive, and seeing personal positive change was highly motivating, especially in a group class setting. Barriers included lack of support or guidance from healthcare professionals (HCPs), environmental challenges and disease burden/fear or worsening symptoms.
    CONCLUSIONS: Despite having positive perceptions of exercise and PA during oncological treatment, there are significant barriers impacting participation. Lack of support from HCPs and fear of worsening symptoms were significant barriers. Future research should focus on impacting these barriers to ultimately improve PA and exercise levels in those undergoing oncological treatment.
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  • 文章类型: Journal Article
    免疫检查点抑制剂(ICI)被认为是某些癌症的新型治疗方式。由于其显著的功效和对生存率的影响,它们可能很快被广泛使用,甚至作为癌症治疗的一线选择。特别是在晚期转移性癌症的病例中。值得注意的是,这些药物可能揭示新的自身免疫性疾病,并导致先前存在的自身免疫性疾病的爆发。近年来,该领域的数据已经积累。早期检测和协作方法是,因此,对于患有任何这些疾病的患者的管理至关重要。在这里,我们报道了1例诊断为转移性肾细胞癌的患者,其在nivolumab治疗期间表现为主动脉血管炎.在这种情况下,我们的目的是根据文献提高风湿病学家对ICI相关血管炎的认识。
    Immune-checkpoint inhibitors (ICIs) are considered as the novel treatment modality in certain cancers. They may soon be used widely even as the first-line option for cancer treatment due to their remarkable efficacies and impacts on survival rates, particularly in cases of advanced metastatic cancer. Of note, these agents might unveil new autoimmune diseases as well as causing flare-ups of a pre-existing autoimmune disease. Data in this field have been accumulated during recent years. Early detection and a collaborative approach are, therefore, crucial in the management of a patient who presents with any of these conditions. Herein, we report a patient with a diagnosis of metastatic renal cell cancer presented with vasculitis involvement in the aorta during nivolumab treatment. Our aim with this case is to increase the awareness of ICI-related vasculitis involvement among rheumatologists in the light of literature.
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