Tenecteplase

日报精选医学文献 今日精选20篇医学文献，查看更多请点击阅读原文 本文支持继续浏览摘要内容；完整摘要、收藏文章、订阅管理等完整功能，请前往小程序「医研日新」。前往小程序查看更多与订阅收藏 1. Single-cell multi-omics dissection of RevitalAge Markers uncovers age-dependent immunotherapy resistance and druggable targets in melanoma. [Melanoma] Biology direct | 2026-06-17 | IF 5.7 AIST3GAL4可作为老年黑色素瘤患者免疫治疗耐药的预测标志物和潜在治疗靶点，联合RAF/MEK抑制剂具有应用前景。 摘要Aging-related molecular reprogramming profoundly influences melanoma progression and therapeutic sensitivity, yet underlying mechanisms remain poorly understood. We constructed a comprehensive multi-omics atlas integrating mutations, transcription, methylation, and copy number variations, utilizing the MOFA algorithm to uncover key age-driving factors. Among 20 factors, Factor6 exhibited significa...查看完整摘要 2. Breaking the mast cell-T helper 2 axis in atopic dermatitis: Insights from oral MRGPRX2 antagonist. [Dermatitis] The Journal of investigative dermatology | 2026-06-17 | IF 5.7 AIMRGPRX2拮抗剂通过双重机制（抑制肥大细胞活化+阻断Th2轴）为难治性特应性皮炎提供精准靶向治疗新选择。 3. Bintrafusp alfa for patients with recurrent or metastatic olfactory neuroblastoma. [Skin Diseases] Cancer immunology, immunotherapy : CII | 2026-06-17 | IF 5.1 AIBintrafusp alfa在R/M ONB中虽未达客观缓解终点，但展现可控安全性及部分患者的持久获益，证实了该罕见肿瘤免疫治疗临床试验的可行性。 摘要There is no established treatment for patients with recurrent/metastatic (R/M) olfactory neuroblastoma (ONB), a rare sinonasal tumor. We conducted the first immunotherapy clinical trial (NCT05012098) in patients with R/M ONB, to evaluate the activity of the bifunctional TGF-β "trap"/anti-PD-L1 fusion protein bintrafusp alfa (BA). Patients received BA (1200 mg, intravenously) every 2 weeks. Primary...查看完整摘要 4. Programmable mRNA 3'UTR engineering restores MHC-I and overcomes immune evasion in prostate cancer. [Melanoma] Nature biomedical engineering | 2026-06-16 | IF 26.8 AI该研究为克服前列腺癌免疫治疗耐药提供了新靶点，通过LNP递送的3'UTRCES平台精准恢复MHC-I表达，有望将免疫冷肿瘤转化为热肿瘤，提升ICT疗效。 摘要Immune-cold tumours such as prostate cancer often resist immune checkpoint therapies (ICT) due to impaired antigen presentation via major histocompatibility complex class I (MHC-I). While MHC-I downregulation is a common immune evasion mechanism, no approved therapies selectively restore MHC-I expression in tumours. We developed a programmable RNA engineering platform, termed the 3'UTR CRISPR/dCas...查看完整摘要 5. Clinical utility of immune biomarker staining of skin biopsies in psoriasis and eczematous dermatitis: A single-center retrospective analysis. [Psoriasis] Journal of the American Academy of Dermatology | 2026-06-16 | IF 12.8 AI免疫生物标志物染色可作为银屑病与湿疹性皮炎鉴别诊断的有效辅助工具，尤其对组织形态学重叠的疑难病例具有重要的临床参考价值。 6. AKAP1 enhances glycogen accumulation and hepatocarcinogenesis through YTHDF2-mediated G6PC mRNA decay. [Carcinoma, Hepatocellular] Signal transduction and targeted therapy | 2026-06-16 | IF 40.8 AIAP-21肽抑制剂通过靶向AKAP1线粒体定位可有效抑制糖原积累和肝癌发生，为HCC提供了一种新颖且无明显毒性的治疗策略。 摘要During recent years, a growing body of evidence has revealed that metabolic rewiring of glycogen is a hallmark of cancer that plays a significant role in tumor development and progression. Nonetheless, the molecular mechanism underlying the dysregulation of glycogen remains largely unknown. In this study, using liver-specific AKAP1 depletion and overexpression mouse models, we demonstrated that AK...查看完整摘要 7. Valorization of Sea Buckthorn (Hippophae rhamnocaides L.) Leaves: Polyphenol-Rich Extract Targeting Helicobacter pylori Virulence and Gastric Mucosal Homeostasis. [Helicobacter Infections] Journal of agricultural and food chemistry | 2026-06-05 | IF 5.7 AI沙棘叶提取物对多重耐药幽门螺杆菌具有显著抑制作用，并兼具黏膜保护功效，可作为传统抗生素疗法外的一种天然辅助治疗选择。 摘要Sea buckthorn (Hippophae rhamnoides L.) leaves are rich in polyphenols and exhibit potent activity against Helicobacter pylori. This study found that its extract demonstrates a dual mechanism of action, inhibiting bacterial virulence while protecting the gastric mucosa. For multidrug-resistant strains, the minimum inhibitory concentration (MIC) range of this extract was 0.08-0.64 mg/...查看完整摘要 8. Patient-derived organoids from metastatic colorectal cancer mirror tumor heterogeneity and predict patient survival and drug sensitivity. [Liver Neoplasms] Cell reports. Medicine | 2026-05-28 | IF 11.7 AI类器官形态学特征可快速预测转移性结直肠癌药物敏感性，囊性形态提示更高化疗敏感性，为个性化治疗决策提供实时体外药敏参考。 摘要This study reports the pharmacogenomic analysis of tumor heterogeneity in a living biobank of 213 organoids derived from liver metastases of 102 patients with metastatic colorectal cancer. Successful organoid establishment reflects poorer chemosensitivity and patient survival. Molecular fidelity is confirmed in tumor-organoid pairs, and multi-modal phenotypes are defined based on organoid morpholo...查看完整摘要 9. Leveraging longitudinal data to boost statistical power for gene-environment interaction analysis. [Mental Disorders] Nature computational science | 2026-06-16 | IF 12.0 AISAGELD方法通过高效利用纵向随访数据显著提升基因-环境交互分析的统计效能，可帮助临床识别更多疾病风险基因位点，为个体化预防策略提供遗传学依据。 摘要Gene-environment interaction (G×E) analyses play a crucial role in advancing genetic discovery, addressing missing heritability, and facilitating precision medicine. However, existing G×E methods are mostly designed for cross-sectional data, limiting the utility of longitudinal data. Here we propose SAGELD, a scalable and accurate genome-wide G×E method for longitudinal traits that controls for sa...查看完整摘要 10. Digital Tools to Support Mental Health in Later Life: Scoping Review of Systematic Reviews. [Mental Disorders] 综述 | Current psychiatry reports | 2026-06-16 | IF 6.7 AI数字工具在改善老年人抑郁症状方面具有一定潜力，但当前证据质量参差不齐，临床应用时需关注工具的可用性评估及长期有效性验证。 摘要This scoping review synthesises existing evidence from systematic reviews on the effectiveness and implementation of digital mental health interventions among community-dwelling older adults. Twenty-one systematic reviews were included. Results showed that a range of digital tools demonstrate potential to improve common mental health and psychosocial symptoms among older adults, with most evidence...查看完整摘要 11. The Joy and the Pain of Being Alone: Managing the Solitude-Loneliness (SOLO) Paradox in People High on the Autism Spectrum. [Autism Spectrum Disorder] 综述 | Clinical child and family psychology review | 2026-06-16 | IF 6.1 AI自闭症患者的孤独感与独处偏好可同时存在且相互矛盾，临床干预需平衡其社交需求与独处偏好，而非简单鼓励社交接触。 摘要This narrative review examines the complex relationship between autism and two fundamental social needs: the need to belong and the need to be alone, which underpin the conceptually distinct experiences of loneliness and solitude. After outlining core features of autism spectrum disorder-focusing on characteristic patterns of social functioning across the spectrum-we synthesize evidence showing th...查看完整摘要 12. Distinct contributions of schizophrenia and neurotransmitter pathway genetic liability to neurocognition and antipsychotic efficacy in drug-naïve first-episode schizophrenia. [Schizophrenia] Molecular psychiatry | 2026-06-15 | IF 9.6 AIGABA和5-HT通路多基因风险评分可预测抗精神病药疗效，有望成为指导个体化用药的潜在生物标志物。 摘要The genetic mechanisms underlying heterogeneity in symptom presentation and antipsychotic response in schizophrenia remain unclear, limiting the development of personalized treatment. We integrated genome-wide schizophrenia polygenic risk scores (SZ-PRS) and pathway-specific PRSs (pPRSs) for four major neurotransmitter systems to examine their associations with clinical phenotypes across the cours...查看完整摘要 13. A novel composite model of PTSD induced by social bullying: validation via multidimensional behavioral and molecular biomarkers. [Mental Disorders] Molecular psychiatry | 2026-06-15 | IF 9.6 AI新型社会欺凌模型填补了社会创伤相关PTSD动物模型的空白，社交回避表型可指导临床识别高危个体，氟西汀的疗效验证为此类患者提供治疗参考。 摘要Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition characterized by persistent fear memory, hyperarousal, and social impairment. Mounting evidence highlights the critical role of social stress, such as bullying, in triggering PTSD. However, progress in elucidating the underlying mechanisms and developing effective treatments has been hindered by the lack of animal models...查看完整摘要 14. Alterations in Cardiac and Systemic Metabolism in Heart Failure. [Heart Failure] 综述 | Circulation. Heart failure | 2026-06-17 | IF 7.8 AIHFrEF与HFpEF存在截然不同的代谢异常模式，针对代谢通路的新疗法（SGLT-2i、GLP-1RA）可能通过纠正代谢紊乱改善患者预后。 摘要Altered cardiac and systemic metabolism is a hallmark of heart failure (HF). In the failing heart, cardiomyocytes develop alterations in substrate preference, mitochondrial oxidative metabolism, and the shuttling of high-energy phosphates from mitochondria to the cytosol that compromise energetic efficiency and contribute to disease progression. At the systemic level, neurohormonal activation play...查看完整摘要 15. The microbiome in reptile health, disease, and ecology. [Zoonoses] 综述 | Microbiology and molecular biology reviews : MMBR | 2026-06-17 | IF 7.8 AI爬行动物微生物组研究揭示了外热性动物独特的宿主-微生物互作模式，为理解脊椎动物微生物组多样性及珍稀物种保护提供重要参考。 摘要SUMMARYReptiles are a diverse and speciose class of animals that are broadly threatened by habitat loss, climate change, and other factors. From a microbiological perspective, reptiles have historically been examined as a source of disease, particularly salmonellosis, with most studies being culture-based investigations into causative agents of disease and potential for zoonoses. More recent work ...查看完整摘要 16. Application of hydrogel technologies in the treatment of musculoskeletal disorders. [Osteoarthritis] Chinese medical journal | 2026-06-17 | IF 7.5 AI水凝胶技术为骨关节炎、软骨损伤等常见MSDs提供了有前景的非手术再生治疗策略，但临床转化仍需解决机械耐久性、生物活性可控释放及规模化生产等关键挑战。 摘要Musculoskeletal disorders (MSDs) represent a diverse group of conditions affecting bones, cartilage, intervertebral discs, tendons, muscles, and related structures, and continue to be a leading cause of global disability. Despite advancements in surgery and pharmacotherapy, issues such as incomplete regeneration, limited longevity, and procedure-related complications remain unresolved. As a result...查看完整摘要 17. Tenecteplase Beyond the 4.5-h Window for Patients with Acute Ischemic Stroke: An Updated Meta-Analysis of Randomized Controlled Trials. [Hemorrhage] 系统综述 | CNS drugs | 2026-06-17 | IF 7.4 AI对于发病超过4.5小时的急性缺血性卒中患者，替奈普酶可显著改善功能预后，虽症状性颅内出血风险略增，但绝对值低，可作为经筛选患者的有效溶栓选择。 摘要Intravenous thrombolysis (IVT) is the established treatment for acute ischemic stroke (AIS) when administered within 4.5 h of the last known well (LKW) status. However, this narrow therapeutic window limits the number of patients eligible for treatment. In this context, tenecteplase (TNK) is being investigated as an alternative thrombolytic agent in the extended time window. The objective of this ...查看完整摘要 18. An injectable SFMA/HA-E hydrogel for sustained delivery of hucMSC-derived exosomes promotes myocardial repair after infarction. [Heart Failure] Stem cell research & therapy | 2026-06-17 | IF 7.1 AI可注射水凝胶缓释人脐带间充质干细胞外泌体可实现单次给药显著改善心功能，为心肌梗死患者提供一种微创、高效的细胞衍生生物疗法新选择。 摘要Myocardial infarction (MI) causes permanent loss of cardiomyocytes and heart failure. Human umbilical cord mesenchymal stem cell-derived exosomes (hucMSCs-Exos) have shown therapeutic potential. Still, their clinical utility is limited by rapid systemic clearance, highlighting the need for a delivery system to achieve sustained release and effect. We fabricated an injectable, photopolymerizable hy...查看完整摘要 19. Long-term metabolically unhealthy aging, its underlying molecular underpinnings, and association with cognitive impairment: a 12.4-year longitudinal cohort study. [Hypertension] BMC medicine | 2026-06-17 | IF 7.0 AI代谢不健康衰老与认知功能下降和脑结构萎缩密切相关，通过监测代谢指标和特定生物标志物可早期识别高危人群，为延缓认知衰退提供干预窗口。 摘要Individuals experience heterogeneous aging processes closely associated with metabolism. However, it remains unclear whether older adults undergo different metabolic health-related aging patterns over time. We aimed to investigate the long-term metabolic health-related aging trajectories, their associations with cognitive function, and underlying molecular underpinnings among older adults. This st...查看完整摘要 20. Retinal Vascular Caliber: 6 to 12 Months and 15 to 25 Years Following Hypertensive Pregnancy. [Hypertension] Hypertension (Dallas, Tex. : 1979) | 2026-06-17 | IF 6.9 AI子痫前期女性产后存在持续的视网膜血管异常，这一发现提示临床医生应对此类患者进行长期心血管风险监测。 摘要Women display retinal vessel caliber abnormalities after hypertensive pregnancy, but whether these predate or reflect vascular aging is unknown. Retinal imaging was performed in 2 cohorts: 196 women at 6 to 12 months postpartum (167 hypertensive, 29 normotensive), and 105 women at 15 to 25 years postpartum (64 hypertensive, 41 normotensive), using identical imaging/analysis protocols (Imedos Healt...查看完整摘要 在小程序获取完整功能 收藏文章、管理订阅、查看本期完整摘要与个性化内容，请前往小程序「医研日新」。 前往小程序查看更多内容 免责声明：仅供学术交流参考，不构成任何医学建议或诊疗指导

近期 陆军军医大学陆军特色医学中心 关于Bowen病的研究成果 正式在《The BMJ》发表 2020年以来大学实现 全球四大医学顶刊全覆盖 2020年以来 大学科技创新工作 深入贯彻习主席视察大学重要讲话精神 锚定世界一流军医大学发展目标 大力推进特色医学科研创新 巩固传统优势，抢占发展前沿 勇攀军事医学高峰 取得了突出成绩 连续在全球四大医学顶刊 以第一作者（共同第一作者） 或通讯作者单位发表论文11篇 彰显了大学的创新实力和活力 为建设世界一流军医大学注入强劲动能 2020年以来大学在 全球四大医学顶刊论文发表清单 01 《A CRISPR Path to Cutting-Edge Materials》 （《NEJM》陈鸣团队） 该研究介绍了CRISPR在精确药物递送和生物传感器等方面的应用。科学家们利用CRISPR-Cas12a系统，创制了多种水凝胶新材料，并用于药物递送和生物传感。该系统的最大优点是易于定制，能够将诸如聚丙烯酰胺和聚乙二醇这种传统材料制成可编程的凝胶。目前科学家们已经发现了几十种天然Cas蛋白，通过突变等蛋白质工程手段，可以轻而易举地对这些蛋白进行改造。同时还有成百上千种DNA酶，能够用于DNA的编辑和修饰。未来科学家将能够设计并制造出大量性能各异的新型材料，以满足多样的临床需求。 02 《Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn》 （《JAMA》刘晨团队） 该研究在新冠肺炎疫情早期报道了感染母亲所生新生儿出生后即出现 SARS-CoV-2 IgM 抗体升高等证据，在世界上首次报道新冠病毒可能存在母婴宫内垂直传播，目前被引用次数超1800次，研究成果写入包括WHO、美国胸科协会/欧洲呼吸学会、国际围产儿协会、土耳其、印度等多国新冠指南，为疫情期间孕产妇和新生儿的精准防控与临床管理提供了重要参考。 03 《Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients with Acute Ischemic Stroke：The DEVT Randomized Clinical Trial》 （《JAMA》杨清武团队） 该研究针对发病4.5小时内的前循环大血管闭塞导致的急性缺血性卒中患者，探讨直接动脉取栓治疗比静脉阿替普酶溶栓后联合取栓治疗的非劣效果。该研究结果有力支持跨过静脉溶栓，直接进行动脉取栓治疗，为急性卒中救治提供新策略，为卒中管理指南更新提供新证据，为减轻个人、家庭和社会经济负担提供新方法。 04 《Effect of Intravenous Tirofiban vs Placebo Before Endovascular Thrombectomy on Functional Outcomes in Large Vessel Occlusion Stroke The RESCUE BT Randomized Clinical Trial》 （《JAMA》杨清武团队） 该研究针对发病24小时内前循环大血管闭塞性患者，探讨血管内治疗前联用替罗非班治疗的疗效。该研究结果表明大动脉粥样硬化型脑卒中患者可能从替罗非班治疗中获益，为急性缺血性脑卒中的治疗提供了最高级别的研究证据，有望改写中国和世界脑卒中诊治指南，优化脑卒中治疗策略，减轻脑卒中后遗症，减少脑卒中救治费用。 05 《Tirofiban for Stroke without Large or Medium-Sized Vessel Occlusion》 （《NEJM》杨清武团队） 该研究联合全国117家卒中中心协同开展，结果显示，替罗非班组临床疗效显著，虽然脑出血的发生有轻微增加，但使用替罗非班在安全性方面与现有治疗方式比较无明显差异。 06 《Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large - Vessel Occlusion Stroke》 （《JAMA》杨清武团队） 该研究采用前瞻性、多中心、双盲、随机、安慰剂对照设计，最终证实，急性大血管闭塞血管内治疗早期联用低剂量甲泼尼龙琥珀酸钠（2mg/kg/d,持续3天）能显著降低死亡率、重残率及症状性颅内出血风险。 07 《Drug-coated balloon angioplasty with rescue stenting versus intended stenting for the treatment of patients with de novo coronary artery lesions (REC-CAGEFREE I): an open label, randomised, non-inferiority trial》 （《The Lancet》张志辉团队） 该研究是全球首个针对新发冠心病患者（涵盖所有血管直径）验证药物球囊中长期疗效的临床试验。张志辉团队作为主要参研中心及共同第一作者单位，作出了重要贡献。该研究在国内43个中心开展，共纳入2272例新发非复杂冠状动脉病变患者。结果显示，“药物涂层球囊+补救性支架”策略在2年主要终点上未能证实非劣效于直接植入药物洗脱支架。亚组分析提示，对于小血管病变，药物球囊可能是更优选择；而对于大血管病变，药物洗脱支架仍具有优势，是该人群的首选治疗方案。 08 《Intral-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke:The POST-TNK Randomized Clinical Trial》 （《JAMA》资文杰团队） 该研究在国内34家医院开展了一项多中心、开放标签、盲终点、随机对照试验（POST-TNK），研究结果显示，动脉内替奈普酶组和对照组之间90天无残疾的比例无显著差异。 09 《Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke：The POST-UK Randomized Clinical Trial》 （《JAMA》杨清武团队） 该研究在国内35家医院进行，共招募了535名符合条件的年龄≥18岁、近端颅内大血管闭塞的患者。研究表明，在大血管闭塞引起的急性缺血性卒中患者中，通过血管内取栓术在接近完全到完全再灌注后动脉内辅助尿激酶治疗并没有显著提高90天无残疾生存的可能性。 10 《Intravenous Tenecteplase Before Thrombectomy in Stroke》 （《NEJM》杨清武团队） 该研究采用新一代溶栓药“替奈普酶”的BRIDGE-TNK试验，证明替奈普酶桥接取栓可显著提升患者良好预后率（功能独立率52.9% vs 44.1%），且未显著增加出血风险！BRIDGE-TNK研究成果为解决大血管闭塞血管再通流程的争议提供了可靠的证据，将推动国际指南的更新。 11 《Dark Brown Plaques Between The Toes》 （《The BMJ》雷霞团队） 该研究报道1例Bowen病的罕见病例，患者经液氮冷冻治疗或手术切除后皮损全部消退，随访半年无复发。该病例因患者年纪轻、病程进展快、皮损累及趾缝、甲缘及甲下等特点而罕见，被世界顶级医学期刊《The BMJ》收录。 背景知识 四大医学顶刊包括 《新英格兰医学杂志》（NEJM） 《柳叶刀》（The Lancet） 《美国医学会杂志》（JAMA） 《英国医学期刊》（The BMJ） 这四本期刊凭借悠久的历史 高影响因子及学术影响力 成为医学领域公认的权威刊物 覆盖临床实践、科研创新 及公共卫生等领域 《新英格兰医学杂志》（The New England Journal of Medicine，NEJM），由美国麻州医学协会创办并出版发行 所属国家：美国 创刊年份：1812年 影响因子：2024年最新影响因子为78.5 特点：NEJM以发表高质量临床研究著称，尤其注重随机对照试验和突破性医学进展。其内容涵盖疾病诊疗新方法、药物研发成果及公共卫生政策，被医学界视为“金标准”。例如，COVID-19大流行期间，NEJM率先发布了多项疫苗临床试验数据。 《柳叶刀》(The Lancet)，由英国外科医生托马斯·威克利创办，爱思唯尔公司出版发行 所属国家：英国 创刊年份：1823年 影响因子：2024年最新影响因子88.5 特点：以“推动医学变革”为宗旨，发表原创研究、荟萃分析和全球健康议题。外科领域研究尤为突出，同时关注发展中国家医疗问题。其子刊系列（如《柳叶刀·肿瘤学》）进一步扩展了细分学科的影响力。 《美国医学会杂志》（The Journal of the American Medical Association，JAMA）,由美国医学会创办并出版发行 所属国家：美国 创刊年份：1883年 影响因子：2024年最新影响因子55.0 特点：JAMA以“读者覆盖面广”闻名，内容强调临床实用性和医学教育。除原创研究外，还刊发专家述评、病例报告和患者护理指南。其特色专栏如“JAMA临床证据摘要”为医生提供快速参考工具。 《英国医学杂志》(The British Medical Journal，The BMJ），于1840年由英国医学会创办并出版发行, 所属国家：英国 创刊年份：1840年 影响因子：2024年最新影响因子43.0 特点：BMJ以开放获取和“在线优先出版”模式领先，内容兼具学术性与政策性。除传统医学研究外，还关注医疗体系改革、医患关系及社会健康公平问题。其临床决策支持工具（如BMJ Best Practice）被全球医生广泛使用。 （供稿：科研学术处） 往期精选 向右滑动查看更多 主办：陆军军医大学政治工作处 来源：陆军军医大学官微（ID：ljjydxgw） 刊期：第1798期 监制：王   雷、韩治中 编审：刘小薇、李   鑫 责编：熊灵峰、左胜男 校对：郭方洁、杨　超、熊灵峰