Safety,efficacy, and pharmacokinetics/pharmacodynamics of daclizumab (anti-CD25) in patients with adult T-cell leukemia/lymphoma

Interleukin-2 receptor α chain (CD25) is overexpressed in human T-cell leukemia virus 1 associated adult T-cell leukemia/lymphoma (ATL). Daclizumab a humanized monoclonal antibody blocks IL-2 binding by recognizing the interleukin-2 receptor α chain (CD25). We conducted a phase I/II trial of daclizumab in 34 patients with ATL. Saturation of surface CD25 on circulating ATL cells was achieved at all doses; however saturation on ATL cells in lymph nodes required 8 mg/kg. Up to 8 mg/kg of daclizumab administered every 3 weeks was well tolerated. No responses were observed in 18 patients with acute or lymphoma ATL; however, 6 partial responses were observed in 16 chronic and smoldering ATL patients. The pharmacokinetics/pharmacodynamics of daclizumab suggest that high-dose daclizumab would be more effective than low-dose daclizumab in treatment of lymphoid malignancies and autoimmune diseases (e.g., multiple sclerosis) since high-dose daclizumab is required to saturate IL-2R alpha in extravascular sites.     

武警特种作战队员的工作倦怠调查研究

目的了解武警特种作战队员的工作倦怠情况,探讨影响工作倦怠的某些因素。方法采用Maslach的工作倦怠问卷对264名武警特战队员进行问卷调查。结果武警作战队员总体上工作倦怠中等,男女特战队员在情绪衰竭维度上表现出显著差异。军龄越短表现出的工作倦怠程度越高,学历越高工作倦怠程度越低。结论武警特战队员有明显的工作倦怠,存在性别、军龄以及教育程度上的显著差异。     

SWAT计划和MIROR项目介绍及其对循证中医药学发展的启示

严格的随机对照试验是提供无偏倚证据的来源。由于目前国内外随机对照试验的设计、实施过程及结果报告方面存在诸多问题在很大程度上降低了临床研究价值,造成经费浪费。因此,一些研究者意识到针对临床研究中存在的问题开展高质量的方法学研究,对提高临床研究水平有重要意义。在开展方法学研究方面,国外有嵌入式研究(Study Within A Trial,SWAT)和基于研究的研究(Research On Research,ROR),并形成了相应的组织。在该项研究中,研究者首先介绍了有一定影响力的SWAT计划和探索ROR研究方法的MIROR(Methods in Research on Research)项目进行介绍,并探讨其对循证中医药学发展的启示,以期引起相关研究者的重视。     

Physician Roles in Tactical Emergency Medical Support: The First 20 Years

Background

The benefits of Tactical Emergency Medical Support (TEMS) elements are providing injury prevention, immediate care of injuries, and medical augmentation of the success of dangerous law enforcement operations. TEMS is recognized by civilian Special Weapons and Tactics (SWAT) and various other law enforcement agencies around the country as a vital addition to such SWAT teams. The integration of specially trained TEMS personnel has become a key component of law enforcement special operations.

Objective

Our aim was to review the published literature to identify if there is a role for physicians within TEMS elements with regard to its establishment and progression, and to characterize the level of physician-specific support provided in the tactical environment for civilian tactical law enforcement teams.

Discussion

Physician presence as part of TEMS elements is increasing in number and popularity as the realization of the benefits provided by such physicians has become more apparent. The inclusion of physicians as active and participating members of TEMS elements is a critical measure to be taken for tactical law enforcement units. Physicians provide an added level of medical expertise to TEMS elements in rural and urban settings compared with law enforcement personnel with medic training.

Conclusions

Physician involvement is an essential element of a successful TEMS program. There is a need for more physicians to become involved as TEMS personnel for specialized tactical teams to spread the time commitment and increase their availability to tactical units on a daily basis.     

针刺足三里对特警训练后恢复的效果

目的:探讨针刺足三里对特定负荷下特警学员疲劳恢复的效果。方法: 招募筛选出131名特警学员,随机分5组：Sham针高心理预期组（n=26）、Sham针低心理预期组(n=26)、针刺高心理预期组(n=26)、针刺低心理预期组(n=26)和空白对照组（n=27）。借助瑞典Monark839E功率车进行逐级递增负荷运动试验,增加梯度15 W/min,直到力竭。测试运动及恢复过程中的心率(heart rate, HR)、氧耗量(oxygen volume, VO2 )、呼吸频率(respiratory rate, RR)、主观感觉疲劳等级(rating of perceived exercise, RPE )、收缩压（systolic blood pressure, SBP）和舒张压(diastolic blood pressure, DBP）。运动结束后6 min内由临床经验丰富的针刺医生对其进行Sham针刺或针刺,留针20 min。针刺穴位足三里,Sham针刺激位置是离开足三里1~2 cm的非经非穴位点。对照组自然休息恢复。按照针刺真假和心理预期高低两个因素进行ABC 3种对照,分别为：4个实验组vs.空白对照组、2个真针刺组vs.2个假针刺组、2个低心理预期组vs2个高心理预期组。比较3种对照中的两大组间产生的疲劳恢复效果相关指标水平的不同。结果: 除DBP外,HR、RPE、RR、VO2在3组对照中的双因素方差分析结果为P<0.05。结论: 针刺足三里可促进特警训练后疲劳恢复过程,结合高心理预期效果更佳。