Alternative Treatment to Lymphocyte Immunization for Treatment of Recurrent Spontaneous Abortion: Immunotherapy With Intravenous Immunoglobulin for Prevention of Recurrent Pregnancy Loss: European Experience

PROBLEM: Due to its strong “immunomodulating” effect in several well established disorders, high-dose intravenous immunoglobulins (IVIG) has been proposed as an alternative for immunotherapy with allogeneic leucocytes in patients with unexplained recurrent spontaneous abortion. This paper is intended to provide an overview on the European experience in this field. METHOD: Five European pilot studies with a total of 172 patients as well as one controlled double-blind multicenter study including 64 patients were considered. In the latter, 5% human albumin was used as placebo. RESULTS: Success rates of the pilot studies varied from 68 to 87%. In the German controlled study, a significant specific effect of IVIG could not be verified. However, success rates for both IVIG and albumin were in the same range as for allogeneic leucocytes. CONCLUSION: At present, it is not sufficiently proven that IVIG is an appropriate tool for immunotherapy of recurrent spontaneous abortions. It is suggested that success rates of both IVIG and albumin are due to a placebo effect. However, we cannot exclude that albumin itself provides immunomodulating capacity.     

复发性抑郁患者的强迫症状及个性因素

目的探讨强迫症状对复发性抑郁障碍患者的影响以及复发性抑郁障碍患者个性因素分析。方法采用症状自评量表(SCL-90),结合临床,对56例复发性抑郁障碍患者进行评定;采用艾森克人格问卷(EPQ)对伴有强迫症状的复发性抑郁障碍患者42例与不伴强迫症状的复发性抑郁障碍患者14例进行对照研究。结果75%的患者伴有强迫症状,伴有强迫与无强迫患者相比EPQ的E分较低和N分较高,差异有显著性(P<0.01)。结论强迫症状是复发性抑郁障碍的一个重要的危险因素,人格因素中内向和神经质与强迫症状有关。     

免疫增强剂对反复呼吸道感染患儿免疫指标的影响

目的　观察免疫增强剂对反复呼吸道感染 (RRTI)患儿免疫指标的影响。方法 :用琼脂单向扩散法和荧光法 ,检测了 10 0例RRTI患儿分别用乌体林斯注射液和转移因子口服液治疗前后免疫球蛋白含量和T细胞亚群百分数 ,并与正常对照组比较。结果 :RRTI组患儿免疫指标均非常显著低于正常对照组 (P <0 .0 0 1) ,乌体林斯注射液含服治疗后IgG .IgM含量和CD3、CD4 、CD8百分数均有显著升高 (P <0 .0 5 ) ;转移因子口服液口服治疗后IgA .IgM含量和CD3、CD4 百分数均有显著升高 (P <0 .0 5 )。结论　免疫功能降低是RRTI发病的重要因素 ,免疫增强剂对RRTI疗效佳。     

Open Classic Latarjet Procedure Performed Using Freehand Technique—Surgical Technique and Outcome

IntroductionLatarjet procedure is commonly performed for recurrent anterior shoulder instability with glenoid side bone loss. Classic Latarjet procedure can be performed using specially designed drill guides, jigs, or by freehand technique. Here we have described a technical note on classic Latarjet procedure performed with freehand technique utilizing simple rulers and caliper. The functional and radiological outcomes of our patients have also been analysed.Material and Methods149 open classic Latarjet procedures were performed using our technique between March 2015 and July 2018. The mean age of the patients was 32.95 years (Range 22–59 years). The functional outcome of the patients was measured using Western Ontario Shoulder Instability (WOSI) and Oxford Shoulder Instability Score (OSIS) at 2 years of follow-up. Screw and graft positioning were studied in 24 consecutive patients with a postoperative computed tomography (CT) scan.ResultsThere was no incidence of recurrent subluxation or dislocation post-surgery. Mean OSIS score increased from 15.63 ± 3.20 preoperatively to 42.44 ± 3.88 postoperatively (p value < 0.05). WOSI score decreased significantly from 62.54% ± 8.24 to 10.26 ± 6.33 postoperatively at 2-year follow-up (p value < 0.05). Postoperative CT scan also showed satisfactory screw placement in all patients.ConclusionOpen Latarjet procedure performed using freehand technique provides good functional and radiological outcomes in patients with recurrent anterior shoulder instability with glenoid side bone loss.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43465-021-00385-7.     

腹膜外入路腹腔镜下膀胱颈悬吊术治疗压力性尿失禁TVT-O术后失败或复发患者的初步经验

目的报道6例经腹膜外途径腹腔镜下膀胱颈Cooper韧带悬吊术(Burch手术)治疗女性压力性尿失禁行经阴道经闭孔尿道中段无张力悬吊术(TVT-O)术后失败或复发患者的初步经验。方法回顾分析2015年6月至2019年9月我们采用经腹腔镜下腹膜外途径Burch手术治疗的6例女性压力性尿失禁TVT-O术后失败或复发患者。自脐下2 cm处切开皮肤并制造腹膜外空间,用2#0薇荞线将尿道旁侧的阴道壁肌层“8字”缝合后再缝合到同侧Cooper韧带上。观察患者手术时间、出血量、住院时间等。结果所有手术均成功,手术时间(37±6)min,术中出血量(17±7)ml,术后住院时间(4.5±0.5)d。6例随访时间3~45个月,所有病例尿失禁症状均消失,均无感染、膀胱损伤、排尿困难、复发等并发症。结论女性压力性尿失禁患者行TVT-O术失败或复发后,选择腹腔镜下经腹膜外途径Burch术安全、有效,可以获得完全尿控,为临床可选方案。     

时间序列模型应用于新型冠状病毒肺炎疫情预测效果比较研究

目的比较常见时间序列模型应用于新型冠状病毒肺炎(COVID-19)疫情预测的效果。方法收集2020年4月1日至9月30日美国、印度和巴西3个国家COVID-19每日确诊病例数,分别建立差分自回归移动平均(ARIMA)模型和循环神经网络(RNN)模型,使用平均绝对百分比误差(MAPE)和均方根误差(RMSE)等指标,比较不同模型预测9月21-30日确诊病例的表现。结果应用ARIMA模型预测美国、印度和巴西疫情的MAPE分别为13.18%、9.18%和17.30%,RMSE分别为6542.32、8069.50和3954.59;应用RNN模型预测美国、印度和巴西疫情的MAPE分别为15.27%、7.23%和26.02%,RMSE分别为6877.71、6457.07和5950.88。结论ARIMA和RNN模型的COVID-19预测效果存在地区差异,ARIMA模型的预测效果在美国和巴西较优,而RNN模型的预测效果在印度较优。     

反复自然流产患者血清中封闭抗体的检测

本文根据病史将反复自然流产(RSA)分类为原发性RSA 及继发性RSA,分别以单向混合淋巴细胞反应封闭试验及补体依赖微量细胞毒试验评价封闭抗体与两类流产的关系。结果发现,原发性RSA主要因封闭抗体缺乏所致;而继发性RSA 无封闭抗体缺乏迹象。因此,尽管原发性RSA 与继发性RSA 临床表现类似,但其免疫学病因及发病机理可能不同。     

甲状腺切除病例喉返神经损伤的分析

目的：研究甲状腺切除术的主要并发症－－喉返神经（ＲＬＮ）麻痹的相关因素。方法：回顾性研究１５６３例甲状腺手术患者的临床资料,重点分析ＲＬＮ损伤与术式、ＲＬＮ在术中是否被分离保护以及与甲状腺疾病的病理关系。结果：ＲＬＮ损伤率是７．８％,与组织病理恶性程度明显相关（Ｐ〈０．０１）,但术中如明确找到ＲＬＮ并加以保护,术后则无ＲＬＮ永外性损害,暂时麻痹仅１．６％。结论：术中对ＲＬＮ的保护应该强调避免医源性     

经皮腰椎间盘切除术治疗复发性腰椎间盘突出症

目的：总结经皮腰椎间盘切除术治疗传统后路术后复发性腰椎间盘突出症的经验。方法：分析１９９５年１月至１９９８年１２月采用经皮腰间盘切除术治疗１９例复发性腰椎间盘突出症的临床资料。结果：穿刺成功率１００％,术后随访１０～３２月,平,平均２１月,优１１例、良５例,可２例,差１例,优良率８４．２％。结论：在具有再次开放手术适应症的复发性腰椎间盘突出症中,初次手术行单节段半椎板、全椎板切除和开窗术者中一侧单