Objectives: To investigate the relation between metastatic potential of salivary adenoid cystic carcinoma (SACC) and tumor cell-platelet adhesion, and the antimetastatic effect of integrin IIb/IIIa inhibitor on SACC. ...Objectives: To investigate the relation between metastatic potential of salivary adenoid cystic carcinoma (SACC) and tumor cell-platelet adhesion, and the antimetastatic effect of integrin IIb/IIIa inhibitor on SACC. Methods: Tumor cell-platelet adhesion of highly metastatic SACC-LM, non-highly metastatic SACC-83 and effect of aspirin, arginine-aspartate (RD), magnesium acetylsalicylate on adhesion were studiedin vitro. Antimetastafic effect of aspirin, RD, magnesium acetysalicylate on experimental metastasis of SACC was observedin vivo. Results: The tumor cell-platelet adhesion was stronger in SACC-LM than in SACC-83. Aspirin, RD and magnesium acetylsalicylate could inhibit the adhesion of SACC-LM at the concentration of 1, 5 and 25 μg/ml. RD can inhibit experimental metastasis of SACC. Conclusion: Metastasis of SACC is related to platelet-tumor cell adhesion, RD could inhibit metastasis of SACC.展开更多
Background Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PPCI）. Furthermore, it results in i...Background Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PPCI）. Furthermore, it results in increased infarct size and mortality rates. We performed a meta-analysis to evaluate the role of aspiration thrombectomy （AT） combined with intracoronary administration of glycoprotein IIb/IIIa inhibitors （GPI） in the improvement of myocardial reperfusion and clinical outcomes. Methods PubMed, Embase, Web of Science, and CENTRAL databases were searched for randomized controlled trials （RCTs） investigating combined AT and intracoronary GPI treatment versus AT alone. Outcomes of interest were thrombolysis in myocardial infarction myocardial perfusion grade （TMPG）, infarct size （IS） assessed by cardiac magnetic resonance imaging, left ventricular ejection fraction （LVEF）, major adverse cardiac events （MACE） at short-term （〈 1 month） and long-term （6-12 months） follow-up, and bleeding complications during the hospital stay. Results Eight trials involving 923 patients were included. Compared with AT alone, combined AT and intracoronary GPI significantly increased TMPG 3 flow （RR： 1.15, 95% CI： 1.04 to 1.26）, reduced IS [mean difference （MD）： -3.46, 95% CI： -5.18 to -1.73], and improved LVEF （MD： 1.44, 95% CI： 0.54 to 2.33）. Furthermore, GPI use decreased the risk of MACE at long-term follow-up （RR： 0.60, 95% CI： 0.37 to 0.98）. There was no significant difference between the two groups in the incidence of minor and major bleeding complications. Conclusions Our findings showed that compared with AT alone, combined AT and intracoronary GPI treatment resulted in improved myocardial reperfusion, better cardiac function, and MACE-free survival benefits at the long-term follow-up for patients with STEMI undergoing PPCI.展开更多
Context: Glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors improve myocard ial rep erfusion and clinical outcomes of patients undergoing primary percutaneous coron ary intervention (PCI), but optimal timing of administra...Context: Glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors improve myocard ial rep erfusion and clinical outcomes of patients undergoing primary percutaneous coron ary intervention (PCI), but optimal timing of administration remains unclear. No systematic reviews have comprehensively examined the effects of early vs delaye d administration of these agents. Objective: To perform a meta-analysis of ra nd omized trials of early (prior to transfer to the catheterization laboratory) vs late (at the time of PCI) intravenous administration of Gp IIb/IIIa inhibitors i n acute ST-segment elevation myocardial infarction (STEMI). Data Sources: MEDLI NE and the Cochrane Controlled Trials Register search of the literature over the past 10 years; papers presented at major cardiac conferences; consultation with national and international colleagues as well as Gp IIb/IIIa inhibitor drug man ufacturers; and text and journal article bibliographies. Study Selection and Dat a Extraction: We examined trials of randomized comparisons between early adminis tration at the point of initial contact (emergency department or ambulance) and late administration (catheterization laboratory) of Gp IIb/IIIa inhibitors in ST EMI. Outcome data had to be available on both culprit artery patency evaluated b y Thrombolysis in Myocardial Infarction (TIMI) flow grades on admission and mort ality. Two authors independently reviewed abstracts or complete articles. Six st udies met inclusion criteria. Independent data extraction was performed by 2 rev iewers and confirmed by consensus. Data Synthesis: The 6 trials enrolled 931 STEMI patients treated with abciximab (3 trials) or tirofiban (3 trials) in combination with primary P CI. TIMI grade 2 or 3 flow (41.7%<<194/465 vs 29.8%<<139/466>>) as well as TIMI g rade 3 flow (20.3%<<84/ 413>> vs 12.2%<<51/418>>) were significantly more frequent in the early group compared with the late group (odds ratio <<OR>>, 1.69; 95%con fidence interval <<CI>>, 1.28-2.22; P< .001; and OR, 1.85; 95%CI, 1.26-2.71; P< .001, respectively). The early administration of Gp IIb/IIIa inhibitors was ass ociated with a 28%reduction of mortality from 4.7%to 3.4%, which was not sign ificant but consistent with similar trends for reinfarction and the composite is chemic end point. Conclusions: In a meta-analysis of 6 randomized trials, early administration of Gp IIb/IIIa inhibitors in STEMI appeared to improve coronary patency with favorable trends for clinical outcomes. These findings are supporti ve of a strategy of facilitated PCI. Further evaluations in adequately powered l arge trials are awaited to confirm the clinical benefit of this strategy.展开更多
基金the National Natural Science Foundation of China (No. 39270723).
文摘Objectives: To investigate the relation between metastatic potential of salivary adenoid cystic carcinoma (SACC) and tumor cell-platelet adhesion, and the antimetastatic effect of integrin IIb/IIIa inhibitor on SACC. Methods: Tumor cell-platelet adhesion of highly metastatic SACC-LM, non-highly metastatic SACC-83 and effect of aspirin, arginine-aspartate (RD), magnesium acetylsalicylate on adhesion were studiedin vitro. Antimetastafic effect of aspirin, RD, magnesium acetysalicylate on experimental metastasis of SACC was observedin vivo. Results: The tumor cell-platelet adhesion was stronger in SACC-LM than in SACC-83. Aspirin, RD and magnesium acetylsalicylate could inhibit the adhesion of SACC-LM at the concentration of 1, 5 and 25 μg/ml. RD can inhibit experimental metastasis of SACC. Conclusion: Metastasis of SACC is related to platelet-tumor cell adhesion, RD could inhibit metastasis of SACC.
文摘Background Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PPCI）. Furthermore, it results in increased infarct size and mortality rates. We performed a meta-analysis to evaluate the role of aspiration thrombectomy （AT） combined with intracoronary administration of glycoprotein IIb/IIIa inhibitors （GPI） in the improvement of myocardial reperfusion and clinical outcomes. Methods PubMed, Embase, Web of Science, and CENTRAL databases were searched for randomized controlled trials （RCTs） investigating combined AT and intracoronary GPI treatment versus AT alone. Outcomes of interest were thrombolysis in myocardial infarction myocardial perfusion grade （TMPG）, infarct size （IS） assessed by cardiac magnetic resonance imaging, left ventricular ejection fraction （LVEF）, major adverse cardiac events （MACE） at short-term （〈 1 month） and long-term （6-12 months） follow-up, and bleeding complications during the hospital stay. Results Eight trials involving 923 patients were included. Compared with AT alone, combined AT and intracoronary GPI significantly increased TMPG 3 flow （RR： 1.15, 95% CI： 1.04 to 1.26）, reduced IS [mean difference （MD）： -3.46, 95% CI： -5.18 to -1.73], and improved LVEF （MD： 1.44, 95% CI： 0.54 to 2.33）. Furthermore, GPI use decreased the risk of MACE at long-term follow-up （RR： 0.60, 95% CI： 0.37 to 0.98）. There was no significant difference between the two groups in the incidence of minor and major bleeding complications. Conclusions Our findings showed that compared with AT alone, combined AT and intracoronary GPI treatment resulted in improved myocardial reperfusion, better cardiac function, and MACE-free survival benefits at the long-term follow-up for patients with STEMI undergoing PPCI.
文摘Context: Glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors improve myocard ial rep erfusion and clinical outcomes of patients undergoing primary percutaneous coron ary intervention (PCI), but optimal timing of administration remains unclear. No systematic reviews have comprehensively examined the effects of early vs delaye d administration of these agents. Objective: To perform a meta-analysis of ra nd omized trials of early (prior to transfer to the catheterization laboratory) vs late (at the time of PCI) intravenous administration of Gp IIb/IIIa inhibitors i n acute ST-segment elevation myocardial infarction (STEMI). Data Sources: MEDLI NE and the Cochrane Controlled Trials Register search of the literature over the past 10 years; papers presented at major cardiac conferences; consultation with national and international colleagues as well as Gp IIb/IIIa inhibitor drug man ufacturers; and text and journal article bibliographies. Study Selection and Dat a Extraction: We examined trials of randomized comparisons between early adminis tration at the point of initial contact (emergency department or ambulance) and late administration (catheterization laboratory) of Gp IIb/IIIa inhibitors in ST EMI. Outcome data had to be available on both culprit artery patency evaluated b y Thrombolysis in Myocardial Infarction (TIMI) flow grades on admission and mort ality. Two authors independently reviewed abstracts or complete articles. Six st udies met inclusion criteria. Independent data extraction was performed by 2 rev iewers and confirmed by consensus. Data Synthesis: The 6 trials enrolled 931 STEMI patients treated with abciximab (3 trials) or tirofiban (3 trials) in combination with primary P CI. TIMI grade 2 or 3 flow (41.7%<<194/465 vs 29.8%<<139/466>>) as well as TIMI g rade 3 flow (20.3%<<84/ 413>> vs 12.2%<<51/418>>) were significantly more frequent in the early group compared with the late group (odds ratio <<OR>>, 1.69; 95%con fidence interval <<CI>>, 1.28-2.22; P< .001; and OR, 1.85; 95%CI, 1.26-2.71; P< .001, respectively). The early administration of Gp IIb/IIIa inhibitors was ass ociated with a 28%reduction of mortality from 4.7%to 3.4%, which was not sign ificant but consistent with similar trends for reinfarction and the composite is chemic end point. Conclusions: In a meta-analysis of 6 randomized trials, early administration of Gp IIb/IIIa inhibitors in STEMI appeared to improve coronary patency with favorable trends for clinical outcomes. These findings are supporti ve of a strategy of facilitated PCI. Further evaluations in adequately powered l arge trials are awaited to confirm the clinical benefit of this strategy.
