Efficacy and safety of once-daily aclidinium in chronic obstructive pulmonary disease

Background

The long-term efficacy and safety of aclidinium bromide, a novel, long-acting muscarinic antagonist, were investigated in patients with moderate to severe chronic obstructive pulmonary disease (COPD).

Methods

In two double-blind, 52-week studies, ACCLAIM/COPD I (n = 843) and II (n = 804), patients were randomised to inhaled aclidinium 200 μg or placebo once-daily. Patients were required to have a post-bronchodilator forced expiratory volume in 1 second (FEV₁)/forced vital capacity ratio of ≤70% and FEV₁ <80% of the predicted value. The primary endpoint was trough FEV₁ at 12 and 28 weeks. Secondary endpoints were health status measured by St George''s Respiratory Questionnaire (SGRQ) and time to first moderate or severe COPD exacerbation.

Results

At 12 and 28 weeks, aclidinium improved trough FEV₁ versus placebo in ACCLAIM/COPD I (by 61 and 67 mL; both p < 0.001) and ACCLAIM/COPD II (by 63 and 59 mL; both p < 0.001). More patients had a SGRQ improvement ≥4 units at 52 weeks with aclidinium versus placebo in ACCLAIM/COPD I (48.1% versus 39.5%; p = 0.025) and ACCLAIM/COPD II (39.0% versus 32.8%; p = 0.074). The time to first exacerbation was significantly delayed by aclidinium in ACCLAIM/COPD II (hazard ratio [HR] 0.7; 95% confidence interval [CI] 0.55 to 0.92; p = 0.01), but not ACCLAIM/COPD I (HR 1.0; 95% CI 0.72 to 1.33; p = 0.9). Adverse events were minor in both studies.

Conclusion

Aclidinium is effective and well tolerated in patients with moderate to severe COPD.

Trial registration

ClinicalTrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT00363896","term_id":"NCT00363896"}}NCT00363896 (ACCLAIM/COPD I) and {"type":"clinical-trial","attrs":{"text":"NCT00358436","term_id":"NCT00358436"}}NCT00358436 (ACCLAIM/COPD II).     

GABA_A受体在酒精依赖中作用的研究进展

酒精依赖的产生机制是由特定的GABAA受体亚单位介导的,并且能够影响其它GABAA受体亚单位,使其对一定剂量的酒精敏感。此外酒精还可以通过细胞内信号转导途径影响GABA在大脑不同区域及核团单元的表达。焦虑、抗惊厥、镇静催眠、认知功能障碍等由酒精依赖产生的现象或者机制,均与GABA受体的介导有关。这些机制包括酒精对GABAA受体的直接或间接的作用,以及GABA的合成和释放。因此对GABAA受体功能的研究,将有助于人们关注酒精依赖现象及其治疗手段,为寻找酒精依赖治疗药物和治疗酒精中毒的机制的提供新线索。     

认知负荷对色词Stroop干扰效应的影响

目的:依据负荷理论,认知负荷会导致选择性注意任务中干扰刺激干扰效应的增加.本研究目的在于检验两种类型的认知负荷对色词Stroop干扰效应的影响.方法:实验一通过比较色词Stroop任务与言语工作记忆任务同时进行的双任务区组(高负荷条件)与单任务区组(低负荷条件)来检验认知负荷对构成Stroop干扰效应的语义冲突及反应冲突产生的影响.实验二则通过比较色词Stroop任务与言语工作记忆任务相协调的双任务区组(高负荷条件)与单任务区组(低负荷条件)来操纵认知负荷.结果:实验一的结果显示工作记忆负荷变化对语义冲突及反应冲突均不产生影响.实验二发现虽然在反应时指标上认知负荷与一致性之间未产生显著交互作用,但在错误率指标上两者交互作用达到显著,说明在高认知负荷条件下反应冲突显著增加了.结论:认知负荷对选择性注意任务中干扰刺激干扰效应的影响取决于认知负荷类型及冲突所发生的水平.     

GABAA受体在酒精依赖中作用的研究进展

酒精依赖的产生机制是由特定的GABAA受体亚单位介导的,并且能够影响其它GABAA受体亚单位,使其对一定剂量的酒精敏感.此外酒精还可以通过细胞内信号转导途径影响GABA在大脑不同区域及核团单元的表达.焦虑、抗惊厥、镇静催眠、认知功能障碍等由酒精依赖产生的现象或者机制,均与GABA受体的介导有关.这些机制包括酒精对GABAA受体的直接或间接的作用,以及GABA的合成和释放.因此对GABAA受体功能的研究,将有助于人们关注酒精依赖现象及其治疗手段,为寻找酒精依赖治疗药物和治疗酒精中毒的机制的提供新线索.     

双联抗血小板治疗急性冠脉综合征临床疗效观察

目的:探讨双联抗血小板治疗急性冠脉综合征(ACS)的临床疗效和安全性。方法:60例ACS患者随机分为治疗组和对照组。对照组给予阿司匹林单抗血小板治疗,治疗组采用阿司匹林+氯吡格雷双联抗血小板治疗,治疗3个月后评价临床疗效。结果:治疗组临床疗效总有效率为93.3%,显著高于对照组(76.7%),相比较有显著性差异(P<0.05);治疗后,两组LVEF、CO、E/A显著上升,与治疗前比较均有显著性差异(P<0.05);且治疗组与对照组比较有显著性差异(P<0.05)。结论:阿司匹林和氯吡格雷双联抗血小板药物治疗ACS,可以强化对血小板聚集的抑制,并增强抗栓效果,值得临床应用。     

Smad3 mediates TGF-beta1 induction of VEGF production in lung fibroblasts

Transforming growth factor-beta1 (TGF-beta1) is a key factor in a variety of physiological and pathological processes. Vascular endothelial growth factor (VEGF) is a key angiogenic factor, and vascular change is one of the features of airway remodeling. We examined the effect of TGF-beta1 on VEGF production by fibroblasts from mice lacking expression of Smad2 or Smad3 as well as human lung fibroblasts treated with or without Smad2 or Smad3 siRNA. TGF-beta1 stimulated VEGF production by fibroblasts from Smad2 deficient animals and wildtype animals. In contrast, TGF-beta1 did not affect VEGF production by fibroblasts from Samd3 deficient mice. Similarly, TGF-beta1 failed to stimulate VEGF production by HFL-1 cells treated with Samd3 siRNA but significantly increased VEGF production by the cells treated with Smad2 siRNA. These result suggest that TGF-beta1 stimulation of VEGF production by fibroblasts is regulated by Smad3 but not by Smad2 signaling.     

中国斑翅跳小蜂属一新种(膜翅目,跳小蜂科)

记述了育自上海桃树上1种盾蚧中的斑翅跳小蜂属1新种:上海斑翅跳小蜂Epitetracnemus shanghaiensis sp.nov..文中给出了新种的形态特征图和该属分种检索表.研究标本保存于中国科学院上海生命科学研究院植物生理生态研究所.     

优化萝卜基因组DNA RAPD-PCR反应体系的正交设计法

以CTAB微量提取方法提取10个红萝卜雄性不育系A单株的基因组DNA,等浓度混合成基因池。以其为模板,用正交设计方法论定RAPD-PCR反应体系的各影响因子,用随机引物S42（5’GGACCCAACC3’）优化萝卜雄性不育系A基因组DNARAPD,PCR反应体系,16次试验即可获得最佳的RAPD-PCR反应体系。     

强光照和全黑暗条件下荒漠沙蜥视网膜内GAP-43表达的免疫组织化学

采用免疫组织化学技术研究了在强光照和全黑暗条件下荒漠沙蜥(Phrynocephalus prezewalskic)视网膜内生长相关蛋白GAP-43的表达变化。结果表明,在正常光照条件下,视网膜内GAP-43阳性表达部位主要存在于内网层;强光照条件下,GAP-43免疫染色部位主要出现在内网层、节细胞层和内核层的部分细胞核。在全黑暗条件下,在视纤维层和内网层呈阳性染色;提示视网膜在不同环境条件下GAP-43的不同定位,可能与其在相应的环境下参与不同的视觉功能有关。     

Smad3 mediates TGF-beta1-induced collagen gel contraction by human lung fibroblasts

Transforming growth factor-beta1 (TGF-beta1) is a key mediator in tissue repair and fibrosis. Using small interference RNA (siRNA), the role of Smad2 and Smad3 in TGF-beta stimulation of human lung fibroblast contraction of collagenous matrix and induction of alpha-SMA and the role of alpha-SMA in contraction were assessed. HFL-1 cells were transfected with Smad2, Smad3 or control-siRNA, and cultured in floating Type I collagen gels +/- -TGF-beta1. TGF-beta1 augmented gel contraction in Smad2-siRNA- and control-siRNA-treated cells, but had no effect in Smad3-siRNA-treated cells. Similarly, TGF-beta1 upregulated alpha-SMA in Smad2-siRNA- and control-siRNA-treated cells, but had no effect on Smad3-siRNA-treated cells. Alpha-SMA-siRNA-treated cells did not contact the collagen gels with or without TGF-beta1, suggesting alpha-SMA is required for gel contraction. Thus, Smad3 mediates TGF-beta1-induced contraction and alpha-SMA induction in human lung fibroblasts. Smad3, therefore, could be a target for blocking contraction of human fibrotic tissue induced by TGF-beta1.