Maternal attachment influences mother–infant styles of regulation and play with objects at nine months

We examined the association between the quality of maternal representations of attachment evaluated by the Adult Attachment Interview (AAI) and mother styles of regulating attention and emotion during free play with objects in 41 mother dyads when infants were nine months old. The secure mother dyads showed a greater duration of engagement matches, with more positive matches, and a greater capacity to move from non-matched to matched states. Secure mother dyads demonstrated greater involvement in play with objects than insecure mother dyads. Insecure mother dyads showed a greater duration of mismatches and spent more time in negative matches. Correlations between maternal AAI scores and the variables studied also showed that the maternal Passivity and Unresolved scales were associated with less adequate dyadic attention and emotion regulation, while the maternal Coherence scale was associated with more adequate dyadic attention and emotion regulation.     

Mothers’ attachment styles and their children’s self-reported security,as related to maternal socialization of children’s positive affect regulation

This study investigated how mothers’ attachment was related to their responses to their own and their children’s positive events and positive affect (PA). Ninety-seven mothers reported on their attachment and their responses to their own and their 7–12-year-old children’s positive events and emotions. Children reported on their mothers’ responses to the children’s positive events and their attachment security with their mothers. The results indicated that more avoidant mothers reported less intense PA in response to their own and their children’s positive events. More avoidant mothers also were less likely to encourage their children to savor positive events (through expressing PA, reflecting on PA or themselves, giving rewards, and affectionate responses). Mothers higher on anxiety reported greater likelihood of dampening (e.g., minimizing the event’s importance) their own positive events and reported being more likely to feel discomfort and to reprimand their children for expressing PA. Children’s security was predicted by mothers’ lower likelihood of encouraging children’s dampening and of reprimanding children for PA displays. This study advances the literature on how mothers’ attachment is related to the ways in which they regulate their own and their children’s PA, which may have implications for children’s attachment and developing PA regulation.     

B cell elimination in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a worldwide distribution, potentially life-threatening with considerable morbidity. The elimination of pathogenic B cells has emerged as a rational therapeutic option. Many open label studies have reported encouraging results in which clinical and serological remission have invariably been described, often enabling the reduction of steroid and immunosuppressive treatment. However, the results from randomized controlled studies have been disappointing and several questions remain to be answered. In this review we will focus on results of B cell direct depletion in the treatment of patients with systemic lupus erythematosus.     

探讨腹腔镜联合胆道镜治疗胆结石合并肝外胆管结石效果及对免疫功能的影响

目的探讨腹腔镜联合胆道镜治疗胆结石合并肝外胆管结石的效果及对免疫功能的影响。方法回顾性分析2018年8月至2020年8月长治市第三人民医院普外科收治的105例胆结石合并肝外胆管结石患者的临床资料,男55例,女50例,年龄(60.25±2.65)岁,年龄范围为53~72岁。按照不同手术方法分为传统组(n=58)与双镜组(n=47),传统组给予传统开腹结石切除术治疗,双镜组给予腹腔镜联合胆道镜结石切除术治疗,比较两组患者的围术期指标、术前与术后免疫功能指标及术后并发症发生率。结果双镜组患者术中出血量[(43.58±5.17)ml]、手术时间[(104.22±16.50)min]、术后排气时间[(26.44±8.21)h]、切口长度[(2.45±1.04)cm]、术后住院时间[(6.54±1.46)d]均少于传统组[(71.02±6.14)ml、(128.75±20.57)min、(35.10±6.58)h、(9.26±1.58)cm、(11.56±1.82)d],差异有统计学意义(P<0.05)。传统组患者术后1 d的表面抗原分化簇4(CD4⁺)为[(30.15±1.08)%]、表面抗原分化簇8(CD8⁺)为[(24.54±1.60)%]、免疫球蛋白G(IgG)为[(10.28±1.63)g/L]、免疫球蛋白A(IgA)为[(2 556.43±62.89)mg/L]、免疫球蛋白M(IgM)为[(1 510.56±114.35)mg/L]水平均低于术前1 d[(35.62±1.17)%、(25.75±1.32)%、(11.59±1.62)g/L、(2 762.58±60.85)mg/L、(1 574.25±121.58)mg/L],差异有统计学意义(P<0.05)。双镜组患者术后1 d的CD4⁺[(30.24±1.17)%]、CD8⁺[(24.47±1.57)%]、IgG[(10.35±1.59)g/L]、IgA[(2 571.02±60.55)mg/L]及IgM[(1 507.74±109.88)mg/L]水平均低于术前1 d[(35.68±1.09)%、(25.64±1.26)%、(11.63±1.54)g/L、(2 751.42±61.74)mg/L、(1 580.96±115.47)mg/L],差异有统计学意义(P<0.05)。两组患者术后1 d的CD4⁺、CD8⁺、IgG、IgA及IgM水平比较,差异无统计学意义(P>0.05)。双镜组患者术后并发症发生率与传统组比较,差异无统计学意义(P>0.05)。结论腹腔镜联合胆道镜治疗胆结石合并肝外胆管结石的围术期指标更好,不会对免疫功能指标造成较大的影响,术后未增加并发症发生率,安全性较高。     

体验式饮食管理在糖调节受损患者中的应用效果

目的 探讨体验式饮食管理在糖调节受损患者中的应用效果。方法 选取2018年1—6月笔者所在医院糖尿病门诊的120例患者,采用随机数字表法将所有患者分为对照组和观察组,各60例。比较2组空腹血糖、餐后2h血糖、糖化血红蛋白、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇以及患者自我管理能力。结果 干预3个月后,观察组的空腹血糖、餐后2h血糖、糖化血红蛋白,三酰甘油均低于对照组(t=5.523,P<0.001;t=4.280,P<0.001;t=2.970,P=0.004;t=3.478,P=0.001)。患者糖尿病前期自我管理量表得分明显高于对照组(t=-10.357,P<0.001)。2组总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较,差异无统计学意义(P＞0.05)。结论 体验式饮食管理能有效控制糖调节受损患者的血糖水平以及部分血脂指标水平,同时提高了患者的饮食自我管理能力,对糖调节受损患者的饮食指导具有良好的意义。     

非综合征型先天缺牙致病基因和分子机制的研究进展

先天缺牙是牙齿发育过程中常见的牙数目发育异常,对患者的颌面部发育及美观和咀嚼功能产生严重的影响。根据有无伴发全身症状,先天缺牙可分为综合征型先天缺牙与非综合征型先天缺牙。近几年发现新的相关基因和新的突变位点及分子机制已成为目前非综合征型先天缺牙基因研究的主要方向。本文通过对近年来文献的回顾,对与非综合征型先天缺牙主要相关的Wnt/β-catenin信号通路、TGF-β/BMP信号通路、PAX9基因和MSX1基因、EDA/EDAR/NF-κb信号通路的分子机制以及相互调节的紧密联系进行综述,为未来先天缺牙的防治提供了新的理论基础。非综合征型先天缺牙致病基因的分子机制的研究目前甚少,对于其机制的精准探索将成为先天缺牙未来主要的研究方向之一。     

牙源性干细胞来源外泌体的功能研究新进展

近年来关于间充质干细胞来源外泌体的研究已成为热点,但有关牙源性干细胞来源外泌体的研究相对较少。相比于其他间充质干细胞,牙源性干细胞因易获取,并具有更强的免疫调节功能和组织再生能力而成为学者们研究的新方向。文章总结了近几年牙源性干细胞来源外泌体功能研究新进展,主要就牙源性干细胞来源外泌体的炎症调节功能、促组织再生功能和神经保护功能3个方面做一阐述。     

Carbamazepine-induced immune thrombocytopenia confirmed by modified MASPAT test

A 76-year-old man suffering post-herpetic neuralgia developed severe thrombocytopenia 15 days after the administration of carbamazepine. Carbamazepine-dependent platelet antibodies were proved to be present in the patient’s serum by a modified Monoclonal Antibody Solid-phase Platelet Antibody Test (MASPAT), and the diagnosis of carbamazepine-induced immune thrombocytopenia was confirmed. For the patient, carbamazepine should be advised to be avoided permanently. The present report advocated the application of a modified MASPAT test for the detection of carbamazepine-dependent platelet antibodies.     

Personalized Immuno-Oncology

Cancer immunotherapy, which aims to control the immune system to eradicate cancer cells and prevent their spread, needs to be personalized because anticancer immune responses can be inhibited in several ways that vary from patient to patient. Cancer immunotherapy includes pharmaceuticals such as immune checkpoint inhibitors and monoclonal antibodies (MAbs) as well as cell therapy, immunogene therapy, and vaccines. Combination of programmed cell death protein 1 (PD-1)/programmed cell death protein ligand 1 (PD-L1) drugs with other immunotherapy drugs, for example, antibody-drug conjugates, as well as combination of PD-1/PD-L1 drugs with other therapies, for example, chemotherapy and radiation therapy, are being explored. Biomarkers are important for predicting the response to immunotherapy. Molecular diagnostics and sequencing are important technologies for guiding treatment in immuno-oncology. Genomic profiling of tumor mutational burden may enhance the predictive utility of PD-L1 expression and facilitate personalized combination immunotherapy. Optimization of personalized immuno-oncology requires integration of several technologies and selection of those best suited for an individual patient. Advances in immuno-oncology are also attributed to technologies for targeted delivery of anticancer therapeutics such as antigen-capturing nanoparticles for precision targeting and selective delivery. A breakthrough in cell therapy of cancer is a chimeric antigen receptors-T cell, which combines the antigen-binding site of a MAb with the signal activating machinery of a T cell, freeing antigen recognition from major histocompatibility complex restriction. Gene-editing tools such as clustered regularly interspaced short palindromic repeats have a promising application for removing alloreactivity and decreasing immunogenicity of third-party T cells. In conclusion, personalized immuno-oncology is one of the most promising approaches to management of cancer.