碘 131 治疗期间辐射防护方法的研究进展

〔摘 要〕 同位素治疗手段及医学显像技术在医疗科技中发挥着越来越重要的作用，在这一趋势之下，放射性治疗 药物在临床中效果更加明显，同时其应用也变得越来越广泛。但同时还需要意识到，放射性治疗药物的应用，本质上 对于患者及医护工作人员都会产生一定的影响，也就是辐射影响。碘 131 主要在一些甲状腺疾病的治疗中进行应用， 其具备明显的靶向性治疗优势和价值，并且碘 131 还可以用于标记多种化合物，在临床中的肝、胆、肾等器官疾病的 诊断过程中均有运用，为了碘 131 在治疗中的价值和作用得到全面发挥，就需要注重辐射防护方法的应用。本研究针 对碘 131 治疗期间辐射防护方法的研究进展进行了系统研究和分析，目的在于提升碘 131 治疗效果和辐射防护效果。     

The Effect of Therapeutic Horseback Riding on Gross Motor Function and Gait Speed in Children Who Are Developmentally Delayed

The purpose of this study was to measure the effects of a seven-week therapeutic horseback riding program and to determine if changes were retained after therapeutic riding was discontinued. A repeated-measures within-participants design was used to assess performance on the Gross Motor Function Measure and timed 10-meter walk in seven developmentally delayed children. A statistically significant improvement in gross motor function was found in post-intervention measures. Improvements were maintained seven weeks after therapeutic riding had ended. No considerable difference in gait speed was noted. This study indicates that therapeutic riding may lead to improvement in gross motor function in developmentally delayed children and that these improvements remain once therapeutic riding ceases.     

Antigen-presenting cells transfected with Hsp65 messenger RNA fail to treat experimental tuberculosis

In the last several years, the use of dendritic cells has been studied as a therapeutic strategy against tumors. Dendritic cells can be pulsed with peptides or full-length protein, or they can be transfected with DNA or RNA. However, comparative studies suggest that transfecting dendritic cells with messenger RNA (mRNA) is superior to other antigen-loading techniques in generating immunocompetent dendritic cells. In the present study, we evaluated a new therapeutic strategy to fight tuberculosis using dendritic cells and macrophages transfected with Hsp65 mRNA. First, we demonstrated that antigen-presenting cells transfected with Hsp65 mRNA exhibit a higher level of expression of co-stimulatory molecules, suggesting that Hsp65 mRNA has immunostimulatory properties. We also demonstrated that spleen cells obtained from animals immunized with mock and Hsp65 mRNA-transfected dendritic cells were able to generate a mixed Th1/Th2 response with production not only of IFN-γ but also of IL-5 and IL-10. In contrast, cells recovered from mice immunized with Hsp65 mRNA-transfected macrophages were able to produce only IL-5. When mice were infected with Mycobacterium tuberculosis and treated with antigen-presenting cells transfected with Hsp65 mRNA (therapeutic immunization), we did not detect any decrease in the lung bacterial load or any preservation of the lung parenchyma, indicating the inability of transfected cells to confer curative effects against tuberculosis. In spite of the lack of therapeutic efficacy, this study reports for the first time the use of antigen-presenting cells transfected with mRNA in experimental tuberculosis.     

ON SAMPLE SIZE CALCULATION BASED ON ODDS RATIO IN CLINICAL TRIALS

Sample size calculation formulas for testing equality, noninferiority, superiority, and equivalence based on odds ratio were derived under both parallel and one-arm crossover designs. An example concerning the study of odds ratio between a test compound (treatment) and a standard therapy (control) for prevention of relapse in subjects with schizophrenia and schizoaffective disorder is presented to illustrate the derived formulas for sample size calculation for various hypotheses under both a parallel design and a crossover design. Simulations were performed to assess the adequacy of the sample size calculation formulas. Simulation results were given at the end of the paper.     

(Em)placing recovery: Sites of health and wellness for individuals with serious mental illness in supported housing

This study used photo-elicitation methodology to explore how the move from supervised to supported housing affects recovery and community connections for individuals living with serious mental illness (SMI) in four Canadian cities. Qualitative interviews conducted in 2015 revealed five themes: (1) the characteristics distinguishing home from housing; (2) the importance of amenities offered by supported housing; (3) the connections between accessibility, mobility, and wellbeing; (4) the role of certain places in facilitating aspects of recovery such as offering hope or facilitating social connectedness; and (5) the concrete and metaphorical impact of changing vantage points on identity (re)construction. Utilizing therapeutic landscapes as an analytical framework, and combining insights from the health geography, and mental health (MH) housing and recovery literatures, this study deepens current understanding of how everyday places—conceptualized as therapeutic landscapes—directly and indirectly support MH recovery for individuals with SMI. Implications for research on housing, and on the spatial aspects of recovery processes are discussed.     

Role of viral RNA and lipid in the adverse events associated with the 2010 Southern Hemisphere trivalent influenza vaccine

In Australia, during the 2010 Southern Hemisphere (SH) influenza season, there was an unexpected increase in post-marketing adverse event reports of febrile seizures (FS) in children under 5 years of age shortly after vaccination with the CSL 2010 SH trivalent influenza vaccine (CSL 2010 SH TIV) compared to previous CSL TIVs and other licensed 2010 SH TIVs. In an accompanying study, we described the contribution to these adverse events of the 2010 SH influenza strains as expressed in the CSL 2010 SH TIV using in vitro cytokine/chemokine secretion from whole blood cells and induction of NF-κB activation in HEK293 reporter cells. The aim of the present study was to identify the root cause components that elicited the elevated cytokine/chemokine and NF-κB signature. Our studies demonstrated that the pyrogenic signal was associated with a heat-labile, viral-derived component(s) in the CSL 2010 SH TIV. Further, it was found that viral lipid-mediated delivery of short, fragmented viral RNA was the key trigger for the increased cytokine/chemokine secretion and NF-κB activation. It is likely that the FS reported in children <5 years were due to a combination of the new influenza strains included in the 2010 SH TIV and the CSL standard method of manufacture preserving strain-specific viral components of the new influenza strains (particularly B/Brisbane/60/2008 and to a lesser extent H1N1 A/California/07/2009). These combined to heighten immune activation of innate immune cells, which in a small proportion of children <5 years of age is associated with the occurrence of FS. The data also demonstrates that CSL TIVs formulated with increased levels of splitting agent (TDOC) for the B/Brisbane/60/2008 strain can attenuate the pro-inflammatory signals in vitro, identifying a potential path forward for generating a CSL TIV indicated for use in children <5 years.