Recombinant platelet factor 4 for heparin neutralization

Protamine sulfate has been used for many years to reverse the effects of unfractionated heparin, but it can cause hemodynamic changes and other serious side effects. Platelet factor 4 (PF4) is a naturally occurring protein synthesized in megakaryocytes and eventually stored in the alpha granules of platelets for later release. Although the complete physiologic role of PF4 is unknown, it is highly effective for the neutralization of heparin anticoagulation. Several preliminary animal studies and trials using blood obtained from cardiopulmonary bypass circuits suggested recombinant PF4 (rPF4) would be an effective alternative to protamine. In the first open-label, phase 1 human study, patients received rPF4 in doses of 0.5, 1.0, 2.5, or 5.0 mg/kg over 3 minutes to reverse heparin anticoagulation after diagnostic cardiac catheterization. There were no important hemodynamic changes and the rPF4 was highly effective in neutralizing heparin. Serial measurements of rPF4 levels showed a monophasic elimination pattern with a serum half-life of 25.5 +/- 13.5 minutes that was independent of dose administered. A randomized and blinded trial comparing rPF4 to protamine confirmed the safety and effectiveness of rPF4. Although rPF4 was initially being evaluated as a clinical alternative to protamine, it is not currently being developed for general clinical use.     

Ad Hoc percutaneous coronary intervention: A consensus statement from the society for cardiovascular angiography and interventions

Percutaneous coronary interventions (PCI) may be performed during the same session as diagnostic catheterization (ad hoc PCI) or at a later session (delayed PCI). Randomized trials comparing these strategies have not been performed; cohort studies have not identified consistent differences in safety or efficacy between the two strategies. Ad hoc PCI has increased in prevalence over the past decade and is the default strategy for treating acute coronary syndromes. However, questions about its appropriateness for some patients with stable symptoms have been raised by the results of recent large trials comparing PCI to medical therapy or bypass surgery. Ad hoc PCI for stable ischemic heart disease requires preprocedural planning, and reassessment after diagnostic angiography must be performed to ensure its appropriateness. Patients may prefer ad hoc PCI because it is convenient. Payers may prefer ad hoc PCI because it is cost‐efficient. The majority of data confirm equivalent outcomes in ad hoc versus delayed PCI. However, there are some situations in which delayed PCI may be safer or yield better outcomes. This document reviews patient subsets and clinical situations in which one strategy is preferable over the other. © 2012 Wiley Periodicals, Inc.     

下一代测序技术在癌症诊疗中的应用及研究进展

下一代测序（NGS）在癌症诊疗中扮演着日益重要的角色,继在临床中广泛普及的伴随诊断应用之后,基于循环肿瘤DNA（ctDNA）的液体活检技术近年来发展迅速,并有望在高危人群癌症早筛和患者术后微小残留病灶（MRD）检测方面发挥重要作用。综述NGS与癌症临床相关的最新应用和研究进展,并探讨其现有临床价值和发展前景。     

人参皂甙抗小鼠手术应激的细胞免疫调节效应

人参皂甙对小鼠三种形式的手术应激(截肢术、胸壁手术和剖腹术)介导的细胞免疫功能抑制,具有显著的调整和促进恢复作用,可部分拮抗应激小鼠天然杀伤细胞和抗体依赖细胞介导细胞毒活性的抑制,完全拮抗腹腔巨噬细胞吞噬功能的受抑状态,使其在应激期间维持正常或稍高于正常水平。上述结果表明,人参皂甙有希望成为一种治疗应激介导的免疫抑制药物。     

脾虚证胃粘膜形态DNA cAMP微量元素改变的临床与实验研究

目的研究脾虚证实质、脾虚证与胃癌发生的关系。方法采用 IBAS2000型图象分析系统、501B 型扫描电镜附有9100/60型能量色散 X 分析仪,以及组织化学与放射免疫方法,检测脾虚证患者胃粘膜超微结构、肠化生亚型、DNA、cAMP、微量元素及其氧化物。结果脾虚色滞证患者中胃癌发生率、不完全性结肠型肠化生发生率和"背景病变"发生率均显著高于脾气虚证患者;胃粘膜 cAMP、Zn、Cu、ZnO 和 Cuo 含量,随着肠化生完全性至不完全性、小肠型至结肠型的顺序递减;而 DNA 含量则随以上顺序递增,P<0.05～0.001。胃粘膜不完全性结肠型肠化生组织内 DNA、cAMP、Zn、Cu、ZnO 和 CuO 含量则与胃癌组织同元显著性差异。结论脾虚气滞证胃病有癌变倾向;不完全性结肠型肠化生与胃癌的发生有密切关系。@何雪芬$目的!研究脾虚证实质、脾虚证与胃癌发生的关系。方法采用 IBAS2000型图象分析系统、501B 型扫描电镜附有9100/60型能量色散 X 分析仪,以及组织化学与放射免疫方法,检测脾虚证患者胃粘膜超微结构、肠化生亚型、DNA、cAMP、微量元素及其氧化物。结果脾虚色滞证患者中胃癌发生率、不完全性结肠型肠化生发生率和"背景病变"发生率均显著高于脾气虚证患者;胃粘膜 cAMP、Zn、Cu、ZnO 和 Cuo 含量,随着肠化生完全性至不完全性、小肠型至结肠型的顺序递减;而 DNA 含量则随以上顺序递增,P<0.05～0.001。胃粘膜不完全性结肠型肠化生组织内 DNA、cAMP、Zn、Cu、ZnO 和 CuO 含量则与胃癌组织同元显著性差异。结论脾虚气滞证胃病有癌变倾向;不完全性结肠型肠化生与胃癌的发生有密切关系。@尹玉芬$目的!研究脾虚证实质、脾虚证与胃癌发生的关系。方法采用 IBAS2000型图象分析系统、501B 型扫描电镜附有9100/60型能量色散 X 分析仪,以及组织化学与放射免疫方法,检测脾虚证患者胃粘膜超微结构、肠化生亚型、DNA、cAMP、微量元素及其氧化物。结果脾虚色滞证患者中胃癌发生率、不完全性结肠型肠化生发生率和"背景病变"发生率均显著高于脾气虚证患者;胃粘膜 cAMP、Zn、Cu、ZnO 和 Cuo 含量,随着肠化生完全性至不完全性、小肠型至结肠型的顺序递减;而 DNA 含量则随以上顺序递增,P<0.05～0.001。胃粘膜不完全性结肠型肠化生组织内 DNA、cAMP、Zn、Cu、ZnO 和 CuO 含量则与胃癌组织同元显著性差异。结论脾虚气滞证胃病有癌变倾向;不完全性结肠型肠化生与胃癌的发生有密切关系。     

Effects of corticosterone on submissiveness in mice: Some temporal and theoretical considerations

Two experiments were conducted to examine directly the effects of corticosterone on submissiveness in mice. A repeated testing paradigm was used in both of these studies, in order to begin to identify whether corticosterone's effects on submissiveness are of the “baseline” or the “feedback” variety. Experiment 1 examined the dose-response relationship between levels of corticosterone administered over a three week period and levels of submissiveness. This study showed that only a very high dosage (350 μg/day) increased submissiveness during an initial test, but that lower dosages increased submissiveness during a second submission test. Thus, the combination of corticosterone treatment and a prior experience of defeat is a more powerful facilitator of submissiveness than is either a prior defeat alone or corticosterone treatment alone. Experiment 2 examined the effects on submissiveness of a single treatment with corticosterone either before an initial test, before a second submission test, before both tests, or before neither test. This study showed that corticosterone did not affect submissiveness during the test which followed its application, but corticosterone treatment before the first test did increase submissiveness as measured during the second test. Thus, again, coupling corticosterone treatment with an initial experience of defeat increased future submissiveness. The findings of these two experiments show, first, that the duration of corticosterone treatment is not important to its effects on submissiveness. Second, these findings suggest that corticosterone affects submissiveness in what has been called a feedback way and may not operate at all on submissiveness in a baseline way.