| 2 | 口服直接Xa因子抑制剂阿哌沙班对症状性深静脉血栓形成的疗效和安全性:Botticelli DVT剂量范围研究的结果显示文摘目的阿哌沙班是一类强效的可逆性活化X因子直接抑制剂,经口服给药,已在骨科大手术后静脉血栓栓塞的预防中显示出可靠作用。本小组在深静脉血栓形成(deepveinthrombosis,DVT)患者中开展了一项剂量范围研究。方法连续招募症状性DVT患者,随机分别接受阿哌沙班5mg/次(2次/d)、10mg/次(2次/d)、20mg/次(1次/d)或先低分子量肝素(low molecularweighthepafin,LMWH)后维生素K拈抗剂(vitamin K antagonist,VKA)联合治疗,疗程为84~91d。主要有效性终点为症状性静脉血栓栓塞症(venous thromboembolism,VTE)复发和双侧加压超声或肺灌注扫描显示无症状性恶化的复合终点,主要安全性终点为严重出血和临床相关非严重出血的复合终点。结果520例入组患者的平均年龄为59岁,其中62%为男性。在所有可评估的患者中,阿哌沙班组358例中有17例[4.7%,95%可信区间(confidence interval,CI)为2.8%-7.5%]以及LMWH/VKA组118例中有5例(4.2%,95%CI为1.4%~9.6%)发生主要终点事件。3个阿哌沙班治疗组的终点事件发生率均较低且相当,且无证据显示存在剂量-效应关系。阿哌沙班组中28例患者(28/385,7.3%)和LMWH/VKA组中10例患者(10/126,7.9%)发生主要安全性终点事件,未观察到阿哌沙班的剂量-效应关系。结论上述观察结果为进一步开展阿哌沙班的Ⅲ期临床评估研究提供了坚实的基础。该药出色的固定剂量用药方案将满足VTE确诊患者简化抗凝治疗方案的需求。 | H.BULLER D.DEITCHMAN M.PRINS A.SEGERS | 2013 | 中华关节外科杂志(电子版)2013，7，5： | 0 |
| 3 | Chronic inflammation drives glioma growth:cellular and molecular factors responsible for an immunosuppressive microenvironment显示文摘This review examines glioma disease initiation,promotion,and progression with a focus on the cell types present within the tumor mass and the molecules responsible for the immunosuppressive microenvironment that are present at each step of the disease.The cell types and molecules present also correlate with the grade of malignancy.An overall“type 2”chronic inflammatory microenvironment develops that facilitates glioma promotion and contributes to the neo-vascularization characteristic of gliomas.An immunosuppressive microenvironment shields the tumor mass from clearance by the patient’s own immune system.Here,we provide suggestions to deal with a chronically-inflamed tumor microenvironment and provide recommendations to help optimize adjuvant immune-and gene therapies currently offered to glioma patients. | Edward T.Ha Joseph P.Antonios Horacio Soto Robert M.Prins Isaac Yang Noriyuki Kasahara Linda M.Liau Carol A.Kruse | 2014 | Neuroimmunology and Neuroinflammation2014，1，1： | 0 |
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