Prostate cancer is the most prevalent malignant tumor among men, ranking first in incidence and second in mortality globally. Novel hormone therapies (NHT) targeting the androgen receptor (AR) pathway have become the standard of care for metastatic prostate cancer. This review offers a comprehensive overview of NHT, including abiraterone, enzalutamide, apalutamide, darolutamide, and rezvilutamide, which have demonstrated efficacy in delaying disease progression and improving patient survival and quality of life. Nevertheless, resistance to NHT remains a critical challenge. The mechanisms underlying resistance are complex, involving AR gene amplification, mutations, splice variants, increased intratumoral androgens, and AR-independent pathways such as the glucocorticoid receptor, neuroendocrine differentiation, DNA repair defects, autophagy, immune evasion, and activation of alternative signaling pathways. This review discusses these resistance mechanisms and examines strategies to counteract them, including sequential treatment with novel AR-targeted drugs, chemotherapy, poly ADP-ribose polymerase inhibitors, radionuclide therapy, bipolar androgen therapy, and approaches targeting specific resistance pathways. Future research should prioritize elucidating the molecular basis of NHT resistance, optimizing existing therapeutic strategies, and developing more effective combination regimens. Additionally, advanced sequencing technologies and resistance research models should be leveraged to identify novel therapeutic targets and improve drug delivery efficiencies. These advancements hold the potential to overcome NHT resistance and significantly enhance the management and prognosis of patients with advanced prostate cancer.

Objective:To investigate the correlation between vasoactive-inotropic score and 30-day mortality after surgery in acute Stanford type A aortic dissection(ATAAD) patients.Methods:The clinical data of 242 patients with ATAAD who underwent surgical treatment was retrospectively analyzed between November 2015 and May 2024. There were 172 males and 70 females. The average age was(53.1±11.9) years, ranging from 28 to 85 years. Patients were divided into death group(18 cases) and survival group(224 cases) according to the 30-day outcomes after surgery. The VIS at different time points and perioperative indexes of two groups of patients were analyzed, and multivariate logistic regression was used to analyze the risk factors of 30-day mortality after surgery in ATAAD patients. The receiver operating characteristic curve( ROC) was drawn to evaluate the predictive value of vasoactive-inotropic score. Results:Among 242 ATAAD patients, 18 patients died within 30 days after surgery, with a mortality rate of 7.4%. The age, incidence of pericardial tamponade/cardiogenic shock, incidence of malperfusion syndrome, cardiopulmonary bypass time, red blood cell transfusion intraoperative and in 24 hours postoperatively, ventilator assisted time, and incidence of major postoperative complications of patients in the death group were significantly higher than those in the survival group( P<0.05). The VIS of the death group was significantly higher than that of the survival group at all time points( P<0.05). The area under the receiver operating characteristic curve( AUC) of VIS for predicting death at each time point was greater than 0.500( P<0.05), with the highest AUC(0.906) of the second 24 hours(VISmax48h) in ICU. The optimal cut off value was determined to be 9, with a sensitivity of 0.944 and a specificity of 0.821. Logistic regression analysis showed that the VISmax48h of the second 24 hours in ICU was an independent risk factor for 30-day mortality after surgery in ATAAD patients( OR=1.462, 95% CI: 1.230-1.737, P<0.05). Conclusion:When VISmax48h≥9, patients with ATAAD have an increased risk of mortality after surgery. VISmax48h, cardiopulmonary bypass time, and red blood cell transfusion intraoperative in 24 hours postoperatively are independent risk factors for the 30-day mortality of ATAAD patients.

Objective:To investigate the correlation between vasoactive-inotropic score and 30-day mortality after surgery in acute Stanford type A aortic dissection(ATAAD) patients.Methods:The clinical data of 242 patients with ATAAD who underwent surgical treatment was retrospectively analyzed between November 2015 and May 2024. There were 172 males and 70 females. The average age was(53.1±11.9) years, ranging from 28 to 85 years. Patients were divided into death group(18 cases) and survival group(224 cases) according to the 30-day outcomes after surgery. The VIS at different time points and perioperative indexes of two groups of patients were analyzed, and multivariate logistic regression was used to analyze the risk factors of 30-day mortality after surgery in ATAAD patients. The receiver operating characteristic curve( ROC) was drawn to evaluate the predictive value of vasoactive-inotropic score. Results:Among 242 ATAAD patients, 18 patients died within 30 days after surgery, with a mortality rate of 7.4%. The age, incidence of pericardial tamponade/cardiogenic shock, incidence of malperfusion syndrome, cardiopulmonary bypass time, red blood cell transfusion intraoperative and in 24 hours postoperatively, ventilator assisted time, and incidence of major postoperative complications of patients in the death group were significantly higher than those in the survival group( P<0.05). The VIS of the death group was significantly higher than that of the survival group at all time points( P<0.05). The area under the receiver operating characteristic curve( AUC) of VIS for predicting death at each time point was greater than 0.500( P<0.05), with the highest AUC(0.906) of the second 24 hours(VISmax48h) in ICU. The optimal cut off value was determined to be 9, with a sensitivity of 0.944 and a specificity of 0.821. Logistic regression analysis showed that the VISmax48h of the second 24 hours in ICU was an independent risk factor for 30-day mortality after surgery in ATAAD patients( OR=1.462, 95% CI: 1.230-1.737, P<0.05). Conclusion:When VISmax48h≥9, patients with ATAAD have an increased risk of mortality after surgery. VISmax48h, cardiopulmonary bypass time, and red blood cell transfusion intraoperative in 24 hours postoperatively are independent risk factors for the 30-day mortality of ATAAD patients.

This study aims to evaluate the accuracy of portable hemoglobinometer (Hemocue Hb 201+ hemoglobin analyzer) in patients with maintenance hemodialysis (MHD) and its diagnostic value for anemia. The data of venous hemoglobulin (Hb) and fingertip capillary hemoglobulin (DHb) in MHD patients from Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed, and the correlation and difference between DHb and Hb and the accuracy of DHb in the diagnosis of anemia were evaluated. A total of 105 patients were included in the study. There was no significant difference between the paired DHb and Hb [(109±21) g/L vs. (108±20) g/L, t=-1.284, P=0.202]. Pearson correlation analysis showed that DHb was positively correlated with Hb ( r=0.929, P<0.001). Linear regression analysis showed that DHb and Hb met the regression equation Hb=0.88×DHb+12.23, and P<0.001. Bland-Altman analysis showed that the differences between the paired DHb and Hb was (1.0±7.8) g/L with the limit of agreement as (-14.2, 16.2) g/L. The mean percentage of the differences in Hb was 1% with limit of agreement as (-13.7%, 15.7%). A DHb of >110 g/L was 0.90 sensitive and 0.83 specific to identify patients with an Hb >110 g/L and its positive and negative predictive values were 0.84 and 0.90, respectively. It suggests that, in MHD patients, Hemocue Hb 201+ analyzer shows good accuracy, and can be used to monitor the Hb trend and serve as a screen method for those reaching target Hb.

Objective:To explore the application effect of the ternary linkage continuation care model based on cognitive balance theory in patients with rheumatoid arthritis (RA), and to provide a reference for the continuation care model of RA patients.Methods:The convenience sampling method was adopted. A total of 72 RA patients who were treated in Huainan First People's Hospital, Anhui Province from January to December 2020 were selected as the research objects, and they were divided into observation group and control group by random number table method with 36 cases in each group. The control group was given regular discharge guidance and health education, and the observation group was given ternary continuous care based on cognitive balance theory on the basis of the control group. The intervention time was 3 months. The fatigue state, pain catastrophe, exercise self-efficacy and hope index was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ), the Pain Catastrophic Scale (PCS), the Self-Efficacy for Exercise Chinese version(SEE-C), and the Herth Hope Index Scale-Chinese version (HHI-C) and the results were compared between the two groups before and after the intervention.Results:There was no significant difference in the score of BRAF-MDQ, PCS, SEE-C, HHI-C before the intervention between the two groups( P>0.05). The scores of physical fatigue, life fatigue, cognitive fatigue and emotional fatigue of BRAF-MDQ in the observation group after the intervention were (10.02 ± 0.85), (6.33 ± 0.58), (3.31 ± 0.48), (4.25 ± 0.56) points, respectively, significantly lower than those in the control group (12.97 ± 1.89), (8.94 ± 0.97), (6.55 ± 0.97), (5.92 ± 0.87) points, and the differences were statistically significant ( t values were 8.54-17.96, all P<0.05). The scores of contemplation, exaggeration, and helplessness of PCS in the observation group after the intervention were (5.66 ± 0.43), (4.12 ± 0.36), (3.31 ± 0.41) points, respectively, which were significantly lower than those in the control group (8.41 ± 0.88), (5.74 ± 0.85), (5.52 ± 0.86) points, and the differences were statistically significant ( t=16.85, 10.53, 13.92, all P<0.05). The scores of SEE-C and HHI-C were (60.22 ± 7.89), (37.48 ± 5.79) points in the observation group after the intervention, which were significantly higher than those in the control group (46.98 ± 5.84), (34.21 ± 4.93) points, and the differences were statistically significant ( t=8.09, 2.58, both P<0.05). Conclusions:The ternary linkage continuation nursing model based on the cognitive balance theory has a significant effect on alleviating the fatigue state and pain catastrophe of RA patients, and helps to improve the patients' hope level and exercise self-efficacy.

Objective To report 9 HIV-negative patients with talaromycosis marueffei (TSM)complicated by Sweet syndrome,and to analyze the relationship of the anti-interferon-γ (anti-IFN-γ)autoantibody with TSM complicated by Sweet syndrome.Methods HIV-negative patients with TSM complicated by Sweet syndrome were collected from the First Affiliated Hospital of Guangxi Medical University between 2013 and 2018.Their clinical and laboratory data were analyzed retrospectively.Meanwhile,19 HIV-positive patients with TSM and 107 health checkup examinees served as controls.Anti-IFN-γ autoantibody was detected in peripheral blood samples of the patients and controls.Results A total of 9 HIV-negative patients with TSM (5 males and 4 females) were included in this study,and the age of onset ranged from 38 to 60 years.The 9 patients all presented with disseminated infections,manifesting as long-term irregular fever,multiple lymph node enlargement,cough,emaciation and anemia.All of the 9 patients met the diagnostic criteria for classical Sweet syndrome,and microbiological examination of Sweet syndrome lesions was negative.Besides Talaromyces marneffei,6 patients also were infected with nontuberculous mycobacteria,4 with varicella-zoster virus,and 2 with Salmonella.All the 9 HIV-negative patients with TSM were positive for anti-IFN-γ autoantibody,while the 107 healthy controls and 19 HIV-positive patients with TSM were negative for anti-IFN-γ autoantibody.Conclusion Anti-IFN-γ autoantibody may be associated with HIV-negative TSM complicated by Sweet syndrome.

ObjectiveTo explore the relationship among clinical nursing students＇ humanistic care ability, locus of control and meaning in life, and to provide scientific theoretical basis for improving their humanistic care ability. MethodsFrom November to December 2018, a questionnaire survey was conducted on 358 school nursing students selected by convenience sampling from a college in Liaoning Province using the Caring Ability Inventory(CAI), Internality, Powerful Others,and Chance Scale(IPC), and Chinese version of Meaning in Life Questionnaire(C-MLQ). ResultsThe 358 nursing students achieved the total score of (177.84±23.56)in CAI ; in IPC, the total score of "Internity" was (30.80±6.03), the total score of "Powerful Others" was (21.61±9.81)and the total score of "Chance" was (21.88±8.73); the total score of C-MLQ was (44.48±8.06). The "meaning in life", "powerful others" and "internity" could explain 51.5% of variations of the humanistic care ability. ConclusionsThe humanistic care ability of school nursing students is low and closely related to their locus of control and meaning in life. Intervention research on locus of control and meaning in life based on this theory should be strengthened so as to improve the clinical nursing students＇ humanistic care ability.

An on-line solid phase extraction ( SPE ) coupled with HPLC-MS/MS method was developed to determine S-ammuxetine and R-ammuxetine in rat plasma. The sample preparation consisted of the following steps:A protein precipitation extraction used methanol and acetonitrile ( 50:50 , V/V ); an on-line SPE treatment to remove most matrixes in plasma;an enrichment and separation step used a C18 analytical column. S-and R-ammuxetine were determined by tandem mass spectrometry. The SPE column was a Retain PEP Javelin (10 mm × 2. 1 mm × 5 μm), while the chromatographic separation was achieved using a ZORBAX SB-C18 (50 mm × 2. 1 mm × 3. 5 μm) analytical column with an isocratic mobile phase composed of acetonitrile-water-formic acid (40:60:0. 1, V/V/V, 0. 3 mL/min). The selected reaction monitoring mode of the positive ion was performed and the precursor to the product ion transitions of m/z 292 . 1/154 . 0 and m/z 260. 4/116. 2 were used to measure S-ammuxetine, R-ammuxetine and internal standard (propranolol). The method was linear over a concentration range from 0 . 2 to 1000 μg/L with the correlation coefficients of 0 . 9903 and 0 . 9951 . The average intra-day precision values were 1 . 2% -12 . 0% for S-ammuxetine and 0. 4%-11. 2% for R-ammuxetine, respectively. The average recoveries were 94. 2%-101. 6% for S-ammuxetine and 94. 3% -109. 4% for R-ammuxetine. Compared to the literature, the sensitivity of this method increased dramatically. The present method has been successfully applied to the preclinical rat research of ammuxetine isomers following intragastric administration.

Objective To investigate prognostic factors in patients receiving mechanical ventilation. Methods 91 patients receiving mechanical ventilation from Jan 2002 to May 2004 were divided into two groups: death group and survival group. The patients' clinical data were retrospectively analyzed by Logistic regression method. Results Of the 98 patients, 48 cases (52.7%) died in the ICU, and 43 cases (47.3%)were survival. By means of single factor analysis, differences in total hospitalized time, time stayed in ICU,active partial thromboplastin time, red cell count, the level of haemoglobin and blood glucose, and Acute Physiology and Chronic Health Evaluation (APACHE) II scores between the two groups were significant (P