每搏量变异度在围手术期容量治疗监测中的应用

每搏量变异度是动态的容量监测指标.机械通气患者心肺的相互作用是每搏量变异度的产生基础,通过动脉压力波形分析技术可以进行连续监测.每搏量变异度能够准确预测容量治疗反应,与静态的血流动力学参数相比,对于优化心输出量和组织氧供更有优势,但也存在一定的局限性.每搏量变异度受多种因素影响且不能用于自主呼吸和心律失常的患者.临床应用时应该综合考虑其影响因素,结合其他的指标和方法指导容量治疗.     

Evaluation of candidate reference genes in Clostridium difficile for gene expression normalization

Quantitative real-time polymerase chain reaction (qPCR) is a sensitive, efficient and reproducible technique for studying gene expression. Identification of stably expressed reference genes is required to avoid bias in these studies yet mostly unvalidated reference genes are used in studying gene expression in Clostridium difficile. Here, we sought to identify a set of stable reference genes used to normalize C. difficile expression data comparing exponential versus stationary phases of growth. Eight candidate reference genes (rpoA, rrs, gyrA, gluD, adk, rpsJ, tpi, and rho) were assessed in 3 C. difficile genotypes (ribotypes 027, 078, and 001). The primers were analyzed for efficiency and the 8 genes were ranked according to their stability. Overall, the genes rrs, adk, and rpsJ ranked among the most stable. Identification of the most stable genes was, however, strain dependent and suggests that selection of reference genes in a heterogeneous species, such as C. difficile, requires multiple genes to be assessed to confirm their stability within the strains being studied.     

Programmed anuclear cell death delimits platelet life span

Platelets are anuclear cytoplasmic fragments essential for blood clotting and wound healing. Despite much speculation, the factors determining their life span in the circulation are unknown. We show here that an intrinsic program for apoptosis controls platelet survival and dictates their life span. Pro-survival Bcl-x(L) constrains the pro-apoptotic activity of Bak to maintain platelet survival, but as Bcl-x(L) degrades, aged platelets are primed for cell death. Genetic ablation or pharmacological inactivation of Bcl-x(L) reduces platelet half-life and causes thrombocytopenia in a dose-dependent manner. Deletion of Bak corrects these defects, and platelets from Bak-deficient mice live longer than normal. Thus, platelets are, by default, genetically programmed to die by apoptosis. The antagonistic balance between Bcl-x(L) and Bak constitutes a molecular clock that determines platelet life span: this represents an important paradigm for cellular homeostasis, and has profound implications for the diagnosis and treatment of disorders that affect platelet number and function.     

Why evolutionary biologists should be demographers

Evolution is driven by the propagation of genes, traits and individuals within and between populations. This propagation depends on the survival, fertility and dispersal of individuals at each age or stage during their life history, as well as on population growth and (st)age structure. Demography is therefore central to understanding evolution. Recent demographic research provides new perspectives on fitness, the spread of mutations within populations and the establishment of life histories in a phylogenetic context. New challenges resulting from individual heterogeneity, and instances where survival and reproduction are linked across generations are being recognized. Evolutionary demography is a field of exciting developments through both methodological and empirical advances. Here, we review these developments and outline two emergent research questions.     

5'-halogenated analogs of oxymorphindole

The presence of a 6,7-fused indole group in the indolomorphinans was considered to be responsible for the delta opioid selectivity for this class of ligands. Herein is shown that 5'-halogenated analogs of oxymorphindole are opioids with little selectivity for delta receptors over mu opioid receptors.     

Across the great divide: genetic forensics reveals misidentification of endangered cutthroat trout populations

Accurate assessment of species identity is fundamental for conservation biology. Using molecular markers from the mitochondrial and nuclear genomes, we discovered that many putatively native populations of greenback cutthroat trout (Oncorhynchus clarkii stomias) comprised another subspecies of cutthroat trout, Colorado River cutthroat trout (Oncorhynchus clarkii pleuriticus). The error can be explained by the introduction of Colorado River cutthroat trout throughout the native range of greenback cutthroat trout in the late 19th and early 20th centuries by fish stocking activities. Our results suggest greenback cutthroat trout within its native range is at a higher risk of extinction than ever before despite conservation activities spanning more than two decades.     

The role of trust in restoration success: public engagement and temporal and spatial scale in a complex social‐ecological system

The social dimensions of river restoration are not well understood especially in the context of large‐scale restoration projects embedded in a complex social‐ecological system. This study used in‐depth interviews with diverse stakeholders to examine perceptions of restoration success on the Clark Fork River Superfund project in Western Montana. Trust emerged as critical to restoration success and was influenced by public engagement, and by spatial and temporal scale. At this large scale, multiple relationships between agencies, NGOs, businesses, landowners, and other stakeholders meant that building trust was a complicated endeavor. The large spatial scale and long time frame made public engagement challenging, and landowners in particular were critical of the project, expressing mistrust in both agencies and the project as a whole. However, projects focused on smaller spatial scales, such as particular stream reaches, appeared to inspire more effective collaboration. Relationships between organizations were important at this large scale, but inter‐organizational conflict affected trust across the project. Further, because trust requires accepting vulnerability, recognizing the differential vulnerability that particular groups and communities experience, based on the risks and benefits they accrue relative to the project, is important.     

Discovery of 5-(arenethynyl) hetero-monocyclic derivatives as potent inhibitors of BCR-ABL including the T315I gatekeeper mutant

Ponatinib (AP24534) was previously identified as a pan-BCR-ABL inhibitor that potently inhibits the T315I gatekeeper mutant, and has advanced into clinical development for the treatment of refractory or resistant CML. In this study, we explored a novel series of five and six membered monocycles as alternate hinge-binding templates to replace the 6,5-fused imidazopyridazine core of ponatinib. Like ponatinib, these monocycles are tethered to pendant toluanilides via an ethynyl linker. Several compounds in this series displayed excellent in vitro potency against both native BCR-ABL and the T315I mutant. Notably, a subset of inhibitors exhibited desirable PK and were orally active in a mouse model of T315I-driven CML.     

Discovery of INCB10820/PF-4178903, a potent, selective, and orally bioavailable dual CCR2 and CCR5 antagonist

We report the discovery of a potent, selective, and orally bioavailable dual CCR2 and CCR5 antagonist (3S,4S)-N-[(1R,3S)-3-isopropyl-3-({4-[4-(trifluoromethyl)pyridin-2-yl]piperazin-1-yl}carbonyl)cyclopentyl]-3-methoxytetrahydro-2H-pyran-4-amine (19). After evaluation in 28-day toxicology studies, compound 19 (INCB10820/PF-4178903) was selected as a clinical candidate.