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  • 文章类型: Journal Article
    细胞外囊泡,或电动汽车,是由肿瘤细胞产生的膜结合纳米区室。电动汽车将蛋白质和核酸从宿主细胞携带到靶细胞,在那里他们可以转移脂质,蛋白质组,和遗传物质来改变靶细胞的功能。电动汽车用作移动蜂窝信号的储存器。使用侵入性较小的流程收集电动汽车引起了许多研究人员的兴趣。外泌体携带可以抑制免疫系统的物质。如果外泌体筛查结果为阴性,免疫治疗对GC患者有益。在这项研究中,我们根据正在进行的审查文件和临床试验提供了有关EV和GC的最新信息.
    Extracellular vesicles, or EVs, are membrane-bound nanocompartments produced by tumor cells. EVs carry proteins and nucleic acids from host cells to target cells, where they can transfer lipids, proteomes, and genetic material to change the function of target cells. EVs serve as reservoirs for mobile cellular signals. The collection of EVs using less invasive processes has piqued the interest of many researchers. Exosomes carry substances that can suppress the immune system. If the results of exosome screening are negative, immunotherapy will be beneficial for GC patients. In this study, we provide an update on EVs and GC based on ongoing review papers and clinical trials.
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  • 文章类型: Journal Article
    WHO对内分泌和神经内分泌肿瘤的最新分类使这些病变的诊断和分级发生了重大变化。例如,病理学家现在能够使用各种组织学特征和复合风险评估模型对甲状腺和肾上腺肿瘤的亚群进行分层.此外,关于如何治疗内分泌肿瘤的新建议涉及额外的免疫组织化学分析,识别和实施这些关键标记对于现代化诊断能力至关重要。此外,对肿瘤起源的理解的提高导致了几个实体的重命名,导致尚未得到普遍认可的术语的出现。术语和预后的调整可能对临床团队构成挑战,护理提供者可能渴望与诊断病理学家进行对话,因为治疗指南还没有完全赶上这些最近的变化。因此,对于外科病理学家来说,了解实施WHO分类方案变化背后的知识至关重要.这篇综述文章将探讨与甲状旁腺病变相关的最重要的诊断和预后变化,甲状腺,肾上腺和胃肠胰腺神经内分泌系统。此外,作者将简要分享他对临床实施的个人思考,从这些新算法的几年经验中汲取。
    The most recent WHO classification of endocrine and neuroendocrine tumours has brought about significant changes in the diagnosis and grading of these lesions. For instance, pathologists now have the ability to stratify subsets of thyroid and adrenal neoplasms using various histological features and composite risk assessment models. Moreover, novel recommendations on how to approach endocrine neoplasia involve additional immunohistochemical analyses, and the recognition and implementation of these key markers is essential for modernising diagnostic capabilities. Additionally, an improved understanding of tumour origin has led to the renaming of several entities, resulting in the emergence of terminology not yet universally recognised. The adjustments in nomenclature and prognostication may pose a challenge for the clinical team, and care providers might be eager to engage in a dialogue with the diagnosing pathologist, as treatment guidelines have not fully caught up with these recent changes. Therefore, it is crucial for a surgical pathologist to be aware of the knowledge behind the implementation of changes in the WHO classification scheme. This review article will delve into the most significant diagnostic and prognostic changes related to lesions in the parathyroid, thyroid, adrenal glands and the gastroenteropancreatic neuroendocrine system. Additionally, the author will briefly share his personal reflections on the clinical implementation, drawing from a couple of years of experience with these new algorithms.
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  • 文章类型: Journal Article
    许多关于胃癌治疗的研究已经确定了免疫治疗益处的预测因子。本文提供了与胃癌免疫治疗预测因素相关研究的最新进展。我们使用了搜索词“预测因子”,免疫疗法,在PubMed数据库中找到与胃癌免疫治疗预测因素相关的最新出版物。程序性细胞死亡,遗传,而免疫因素是胃癌免疫治疗预测因子的主要研究课题。还发现了胃癌免疫治疗的其他预防因素,包括临床因素,肿瘤微环境因素,成像因素,和细胞外因素。由于目前尚无有效的胃癌治疗方法,我们强烈建议优先考虑这些研究。
    Many studies on gastric cancer treatment have identified predictors of immunotherapy benefits. This article provides an update on the major developments in research related to predictive factors of immunotherapy for gastric cancer. We used the search term \"predictive factors, immunotherapy, gastric cancer\" to find the most current publications in the PubMed database related to predictive factors of immunotherapy in gastric cancer. Programmed cell death, genetic, and immunological factors are the main study topics of immunotherapy\'s predictive factors in gastric cancer. Other preventive factors for immunotherapy in gastric cancer were also found, including clinical factors, tumor microenvironment factors, imaging factors, and extracellular factors. Since there is currently no effective treatment for gastric cancer, we strongly propose that these studies be prioritized.
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  • 文章类型: Journal Article
    迄今为止,药品的非说明书使用是指未经批准使用已批准的药品,涵盖未经批准的适应症,患者群体,剂量,和/或给药途径,已经存在很多年了。目前,关于抗肿瘤药物的标签外使用的研究频率和普遍性有限,主要是由于定义和分类问题不完整。现在是时候接受抗癌药物标签外使用的新类别了。这篇综述提供了对抗癌药物标签外使用的概念和类别的最新概述,以及举例说明具体的例子,以建立关于抗癌药物在肿瘤学环境中的标签外使用程度的下一步研究。目前的抗癌药物超出以前定义的标签外使用范围不仅包括适应症方面的标签外使用,患者群体,剂量,和/或给药途径,以及药物疗程方面的标签外使用,组合,药物的顺序,临床目的,禁忌症场景,等。此外,抗癌药的标签外用法的定义应在给定时间添加到该病症中,它不同于审批机构。我们提出了一个新的和相对全面的分类,首次提供抗肿瘤药物标签外使用的广泛分析和说明性示例。这种分类有可能促进实际采用并增强抗肿瘤药物的标签外使用的管理策略。
    To date, the definition that the off-label usage of drugs refers to the unapproved use of approved drugs, which covers unapproved indications, patient populations, doses, and/or routes of administration, has been in existence for many years. Currently, there is a limited frequency and prevalence of research on the off-label use of antineoplastic drugs, mainly due to incomplete definition and classification issues. It is time to embrace new categories for the off-label usage of anticancer drugs. This review provided an insight into an updated overview of the concept and categories of the off-label use of anticancer drugs, along with illustrating specific examples to establish the next studies about the extent of the off-label usage of anticancer drugs in the oncology setting. The scope of the off-label use of current anticancer drugs beyond the previous definitions not only includes off-label uses in terms of indications, patient populations, doses, and/or routes of administration but also off-label use in terms of medication course, combination, sequence of medication, clinical purpose, contraindications scenarios, etc. In addition, the definition of the off-label usage of anticancer drugs should be added to the condition at a given time, and it varies from approval authorities. We presented a new and relatively comprehensive classification, providing extensive analysis and illustrative examples of the off-label usage of antineoplastic drugs for the first time. Such a classification has the potential to promote practical adoption and enhance management strategies for the off-label use of antitumor drugs.
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  • 文章类型: Journal Article
    由于与这种疾病和胃癌相关的高死亡率,已经对幽门螺杆菌感染进行了许多研究。本综述的目标是对近年来幽门螺杆菌和胃癌研究的最新进展进行更新。使用搜索词“幽门螺杆菌,胃癌\“,搜索了PubMed数据库。只有2024年发表的论文符合纳入标准。因为病例报告文件不是我们调查的一部分,他们满足排除标准。大多数关于幽门螺杆菌可变基因的研究都是通过遗传学指导来确定潜在的治疗方法。需要研究根除幽门螺杆菌的临床治疗方法以及有希望的治疗选择。我们发现与幽门螺杆菌感染的免疫病理学相关的研究最少,这仍然是未知的。总之,应该优先考虑这种研究。
    Numerous studies have been performed on Helicobacter pylori infection because of the high death rate linked to this illness and gastric cancer. An update on the key developments in recent years in the investigation of Helicobacter pylori and gastric cancer is the goal of this review. Using the search term \"Helicobacter pylori, gastric cancer\", the PubMed database was searched. Only papers published in 2024 fulfilled the inclusion criteria. Because case report papers were not part of our investigation, they satisfied the exclusion criteria. Most of the research on the variable genes of Helicobacter pylori is guided by genetics to determine potential treatments. Studies on clinical treatments for the eradication of H. pylori with promising therapeutic options are needed. We found the fewest studies related to the immunopathology of H. pylori infection, which is still unknown. In conclusion, priority should be given to this kind of research.
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  • 文章类型: Journal Article
    由于与胃癌相关的高死亡率,已经对这种疾病进行了大量的研究。本文的目标是对刚刚开始的那一年的2024年进行三次审查。从2024年1月1日开始的科学文献是考虑到欧洲医学肿瘤学会(ESMO)的指南而选择的。这些都是用新的发现更新的,但不是每年进行系统审查。我们使用搜索术语“胃癌”来查找PubMed数据库中与胃癌预后和治疗相关的最新出版物。如前所述,唯一符合纳入标准的文章是2024年的文章。带有病例报告的文章被删除,因为它们与我们的研究无关。从2024年开始,胃癌的治疗是大多数文章的重点。主要研究轴包括手术和免疫营养,免疫疗法和幽门螺杆菌,和治疗目标。GC患者可能会经历较少的心理,社会,如果在流通中发现的最近确定的标记物得到更好的评估和验证,以及财务困难。这可以通过在基于人工智能的诊断评分中包括标记或通过将它们与传统诊断方法结合使用来实现。由于与GC相关的死亡率上升,为诊断研究提供资金,预后,治疗,治疗目标至关重要。
    Due to the high death rate associated with gastric cancer, a great deal of research has been conducted on this disease. The goal of this paper was to start a trimestral review of 2024 for the year that had just started. The scientific literature from 1 January 2024 was chosen with consideration of the the guidelines of the European Society of Medical Oncology (ESMO), which are updated with new findings but not systematically reviewed annually. We used the search term \"gastric cancer\" to find the most current publications in the PubMed database related to the prognosis and treatment of gastric cancer. As previously said, the only articles that satisfied the inclusion criteria were those from 2024. Articles with case reports were eliminated since they had nothing to do with our research. The treatment of gastric cancer is the focus of the majority of articles from 2024. The primary research axes include surgery and immunonutrition, immunotherapy and Helicobacter pylori, and therapeutic targets. Patients with GC may experience less psychological, social, and financial hardship if the recently identified markers discovered in circulation are better assessed and validated. This could be achieved by either including the markers in an artificial intelligence-based diagnostic score or by using them in conjunction with traditional diagnostic methods. Due to the rising death rate associated with GC, funding for research into diagnosis, prognosis, therapy, and therapeutic targets is essential.
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  • 文章类型: Journal Article
    艰难梭菌感染(CDI)是全球最常见和最严重的医院感染之一。它也会影响社区中的健康个体。在过去的十年中,CDI的发病率在全球范围内一直在上升,需要采取积极主动的方法来对抗其传播;正在开发新的策略来提高诊断准确性并优化治疗结果。实施两步测试提高了诊断特异性,减少CD特异性抗生素的使用,没有伴随的手术并发症发生率的增加。2021年,由于复发率较低,美国传染病学会/美国医疗保健流行病学学会(IDSA/SHEA)将初始治疗的首选转移到了万古霉素和甲硝唑。它还优先使用非达霉素治疗复发性CDI。粪便微生物群疗法的前沿有了新的发展,RBX2660和SER-109最近被FDA批准用于预防,与其他基于微生物组的疗法在各种开发和临床试验中。这篇评论为提供商提供了CDI管理的最新实用指南。
    Clostridioides difficile infection (CDI) is one of the most common and severe nosocomial infections worldwide. It can also affect healthy individuals in the community. The incidence of CDI has been on the rise globally for the past decade, necessitating a proactive approach to combat its spread; new strategies are being developed to enhance diagnostic accuracy and optimize treatment outcomes. Implementing the 2-step testing has increased diagnostic specificity, reducing the usage of CD-specific antibiotics with no concomitant increase in surgical complication rates. In 2021, the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) shifted its preference for initial treatment to fidaxomicin over vancomycin and metronidazole due to its lower recurrence rate. It also prioritized fidaxomicin for the treatment of recurrent CDI. There are new developments on the frontiers of fecal microbiota therapies, with RBX2660 and SER-109 approved recently by the FDA for prevention, with other microbiome-based therapies in various development and clinical trials. This review offers providers an updated and practical guide for CDI management.
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  • 文章类型: Journal Article
    目的:回顾子宫内膜癌FIGO2023分期系统新版本的变化。
    结果:新的FIGO2023子宫内膜癌分期系统为子宫内膜癌的诊断和治疗提供了关键更新。诊断的一个重要步骤是分子分类,这可以更准确地对复发进行风险分层,并确定靶向治疗。新的暂存系统,根据国际社会ESGO的建议,ESTRO和ESP,不仅包括对疾病的病理和解剖范围的描述,还有肿瘤的组织病理学特征,包括组织学类型和淋巴管间隙侵犯的存在。此外,分期系统使用分子检测将子宫内膜癌分为四个预后组:POLEmut,MMRd,NSMP和p53abn。每个群体都有其特定的特点和预后。最显著的变化发生在第一和第二阶段,其中亚分期更好地反映了肿瘤的生物学行为。这一更新提高了预后的准确性,并改善了子宫内膜癌患者的个性化治疗选择。
    结论:2023年子宫内膜癌的最新FIGO分期包括不同的组织学类型,肿瘤特征,和分子分类,以更好地反映当前对几种子宫内膜癌类型及其潜在生物学行为的复杂性的理解。新的子宫内膜癌分期系统的目的是更好地定义具有相似预后的分期。允许更精确地指示个体化辅助放射或全身治疗,包括使用免疫疗法。
    To review the changes in the new version of the FIGO 2023 staging system for endometrial cancer.
    The new FIGO 2023 endometrial cancer staging system provides key updates for the diagnosis and treatment of endometrial cancer. An important step in diagnosis is molecular classification, which allows more accurate risk stratification for recurrence and the identification of targeted therapies. The new staging system, based on the recommendations of the international societies ESGO, ESTRO and ESP, incorporates not only the description of the pathological and anatomical extent of the disease, but also the histopathological characteristics of the tumour, including the histological type and the presence of lymphovascular space invasion. In addition, the staging system uses molecular testing to classify endometrial cancers into four prognostic groups: POLEmut, MMRd, NSMP and p53abn. Each group has its own specific characteristics and prognosis. The most significant changes have occurred in stages I and II, in which the sub-staging better reflects the biological behaviour of the tumour. This update increases the accuracy of prognosis and improves individualized treatment options for patients with endometrial cancer.
    The updated FIGO staging of endometrial cancer for 2023 incorporates different histologic types, tumour features, and molecular classifications to better reflect the current improved understanding of the complex nature of several endometrial cancer types and their underlying bio logic behaviour. The aim of the new endometrial cancer staging system is to better define stages with similar prognosis, allowing for more precise indication of individualised adjuvant radiation or systemic treatment, including the use of immunotherapy.
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  • 文章类型: Journal Article
    国际生物气象学会学生和新专业人员小组新任主席和执行委员会的最新信息。
    An update from the new Chair and Executive Committee of the Students and New Professionals Group of the International Society of Biometeorology.
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  • 文章类型: Journal Article
    目的:本综述的目的是确定用于治疗患有神经认知障碍的老年人的关键药物类别。
    结果:临床因素在这些治疗痴呆症的药物种类的处方中起着至关重要的作用。处方趋势的变化取决于老年人中常见的医学和精神病学合并症的存在,并且基于对合并症和痴呆症药物治疗之间潜在相互作用的考虑。目前存在六种药物类别来解决痴呆症的神经认知方面,具有不同的药代动力学和药效学特征。我们在本报告中回顾了这六个类别,并提供了有关这些药物使用的临床见解。虽然有文献研究老年人群痴呆的个别药物治疗方案的安全性和有效性,对于这些药物在临床实践中的具体使用,需要进一步的研究提供更明确的指导.
    The purpose of this review is to identify key classes of medications that are used for the treatment of older adults with neurocognitive disorders.
    Clinical factors play a critical role in the prescribing of these medication classes for the treatment of dementia. The variation in prescribing trends is determined by the presence of medical and psychiatric comorbidities commonly occurring in older adults and is based on the consideration of potential interactions between pharmacotherapies for the comorbidities and for the dementia. Six medication classes currently exist to address the neurocognitive aspect of dementia, with varying pharmacokinetic and pharmacodynamic profiles. We review these six classes in this report and provide a provision of clinical insights regarding the use of these agents. While literature exists on the safety and efficacy of individual medication options for the treatment of dementia in the older adult population, further research is needed to provide clearer guidance regarding the specific use of these agents in clinical practice.
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