Regulatory T cells for tolerance

Regulatory T cells (Tregs) are critical mediators of immune homeostasis and hold significant promise in the quest for transplantation tolerance. Progress has now reached a critical threshold as techniques for production of clinical therapies are optimised and Phase I/II clinical trials are in full swing. Initial safety and efficacy data are being reported, with trials assessing a number of different strategies for the introduction of Treg therapy. It is now more crucial than ever to elucidate further the function and behaviour of Tregs in vivo and ensure safe delivery. This review will discuss the current state of the art and future directions in Treg therapy.     

Analysis of density and epitopes of D antigen on the surface of erythrocytes from DEL phenotypic individuals carrying the RHD1227A allele

Background

The characteristics of the D antigen are important as they influence the immunogenicity of D variant cells. Several studies on antigenic sites have been reported in normal D positive, weak D and partial D cases, including a comprehensive analysis of DEL types in Caucasians. The aim of this study was to assess D antigen density and epitopes on the erythrocyte surface of Asian type DEL phenotypic individuals carrying the RHD1227A allele in the Chinese population.

Materials and methods

A total of 154 DEL phenotypic individuals carrying the RHD1227A allele were identified through adsorption and elution tests and polymerase chain reaction analysis with sequence-specific primers in the Chinese population. D antigen density on the erythrocyte surface of these individuals was detected using a flow cytometric method. An erythrocyte sample with known D antigen density was used as a standard. Blood samples from D-negative and D-positive individuals were used as controls. In addition, D antigen epitopes on the erythrocyte surface of DEL individuals carrying the RHD1227A allele were investigated with 18 monoclonal anti-D antibodies specific for different D antigen epitopes.

Results

The means of the median fluorescence intensity of D antigen on the erythrocyte membrane surface of D-negative, D-positive and DEL individuals were 2.14±0.25, 193.61±11.43 and 2.45±0.82, respectively. The DEL samples were estimated to have approximately 22 D antigens per cell. The samples from all 154 DEL individuals reacted positively with 18 monoclonal anti-D antibodies specific for different D antigen epitopes.

Discussion

In this study, D antigen density on the erythrocyte surface of DEL individuals carrying the RHD1227A allele was extremely low, there being only very few antigenic molecules per cell, but the D antigen epitopes were grossly complete.     

Background factors of molar-incisor hypomineralization in a group of Finnish children

Objective. Molar-Incisor Hypomineralization (MIH) is a common developmental enamel defect characterized by demarcated opacities in permanent molars and incisors. Its etiology still remains unclear. The aim of this retrospective cohort study was to assess if the socioeconomic environment of the child is associated with MIH. Materials and methods. The study was located in two rural towns and three urban cities in Finland. A total of 818 children, between 7–13 years old, were examined for MIH using the evaluation criteria in line with those of the European Academy of Paediatric Dentistry, but excluding opacities smaller than 2 mm in diameter. The mothers filled in a questionnaire which included questions related to the family’s way of living (e.g. area of residency, farming, day care attendance) and socioeconomic status (family income, number of mother’s school years, level of maternal education). Results. The prevalence of MIH in the study population was 17.1%. Family income, urban residency and day care attendance were associated with MIH in the univariate analysis. In the multivariate analysis using binary logistic regression, only urban residency during a child’s first 2 years of life remained associated with MIH. The prevalence of MIH in urban areas was 21.3% and in rural areas 11.5% (OR = 2.18, CI = 1.35–3.53, p = 0.001). Conclusions. The prevalence of MIH was related to urban residency and could not be explained by any other factor included in the study.     

2型糖尿病患者运动生活习惯监控疗法的实验研究

目的探讨运动生活习惯监控疗法对2型糖尿病患者糖脂肪代谢的影响效果。方法随机选择50名2型糖尿病患者采用运动生活习惯测定仪,对BMI(体重kg/身高(m2)、标准体重、运动目标达成度、总能量消耗(kcal)、运动量(kcal)、运动步数、运动强度等级(0-9级)等进行了8周的全天候监控疗法,观察监控前后BMI、FBG(mmoi/L)、PBG(mmoi/L)、HbA1c(%)、TC(mmol/L)、TG(mmol/L)评价指标的变化。结果监控实验前后比较除BMI以外,FBG(mmoi/L)、PBG(mmoi/L)具有非常显著性差异(P<0.01),HbA1c(%)、TC(mmol/L)、TG(mmol/L)也差异显著(P<0.05)。结论对2型糖尿病患者实施严格的运动生活习惯监控疗法可有效地改善糖、脂肪的代谢水平。     

神经反馈调节健康个体注意力的研究进展

神经反馈是指通过脑机交互方式,将大脑活动转换成声音、图像、游戏等形式反馈给个体,以实现自主调节脑功能的目的。注意力是认知功能的重要方面,不仅是儿童发展成长的影响因素,也是成人日常生活中不可替代的重要心理品质。越来越多的实证研究已经发现神经反馈对健康个体的注意力具有调节作用,但缺乏对相关研究进展的总结和综述。综述基于大脑节律活动的神经反馈对于健康个体注意力调节作用的研究进展,分析注意力测量范式、学习者和非学习者的划分以及实验设计类型对神经反馈训练效果的影响,指出了追踪实验对研究的必要性。同时提及可用于健康个体注意力调节的其他几种神经反馈技术。期望为神经反馈提高注意能力的研究和实践提供参考。     

镇江市个别正常（牙合）学生EPQ常模的性别影响研究

目的：根据流行病学调查的方法,对艾森克个性问卷（EPQ）进行信效度检验,并建立该问卷镇江市个别正常（牙合）学生性别常模,对临床工作指导更具针对性.方法：根据学校综合实力的不同,采用随机分层整群抽样的方法,随机抽取镇江市9所学校不同年级38个班的1430学生,根据纳入和排除标准筛选出符合标准的个别正常（牙合）学生,并根据年龄分为幼年（12～15岁）组和成人（16岁以上）组,然后在相同的环境条件和相同的指导语指导下进行艾森克个性问卷测量,根据测量结果建立镇江市个别正常（牙合）学生艾森克个性问卷性别常模.结果：男性个别正常（牙合）学生在P分量表和E分量表上的评分高于女生的评分,但男女学生在E分量表上的差异没有统计学意义;男性个别正常（牙合）学生在N分量表和L分量表上的评分低于女生的评分,但幼年男女生在N分量表上的差异没有统计学意义.结论：可采用艾森克个性问卷建立镇江市个别正常（牙合）学生EPQ的性别常模,女性对错牙（牙合）畸形所致的容貌影响更为关注.     

Upper limb function and activity in people with facioscapulohumeral muscular dystrophy: a web-based survey

Purpose To investigate the upper extremity (UE) at the level of impairments and related activity limitations and participation restrictions in people with facioscapulohumeral muscular dystrophy (FSHD). Methods The study was conducted using web-based questionnaires that were distributed amongst people with FSHD in the Netherlands. Eighty-eight respondents started the survey, and 71 completed it. The questionnaires covered the following dimensions: Function, Activity and Participation of the International Classification of Functioning Disability and Health. Results More than 40% of the respondents experienced pain in one arm or both the arms. Increased pain and stiffness scores and longer disease duration were associated with increased limitation scores. For basic activities, lifting the arm above shoulder-level was most frequently reported as most limited, coherent with the clinical picture of FSHD. Among the respondents, 50% indicated restrictions at school, 78% indicated restrictions at work and more than 80% indicated restrictions whilst participating in sports, hobbies, household activities and romantic relationships. Conclusions This study has shown that alongside the well-known problem of lifting the arms above shoulder-level, UE activities below shoulder height during vocational and occupational activities are also problematic in patients with FSHD. Alongside disease duration, pain and stiffness are associated with UE activity limitations.

• Implications for Rehabilitation

• Attention is needed for pain and experienced stiffness in the upper extremity as it is frequently present in patients with FSHD.

• Rehabilitation professionals need to be aware that patients with FSHD not only experience problems with activities above shoulder height, but also with activities below shoulder height.

• At least 50% of the patients with FSHD experience restrictions in participation as a result of limitations in their UE.

     

首发精神分裂症患者的心理障碍特点及其影响因素——附483例分析

目的:探讨首发精神分裂症患者的心理障碍特点及其影响因素.方法:对483例首发精神分裂症患者(病例组)及100名健康对照者(对照组)进行症状自评量表-90(symptom check list-90,SCL-90)及EPQ评定,比较2组的差异,并以病例组SCL-90的总分以及因子分作为因变量,EPQ各因子分、年龄、性别、文化程度、病程等作为自变量,进行逐步多元回归分析.结果:病例组SCL-90总分及各因子分均高于对照组(均为P＜0.01).病例组EPQ的情绪稳定性、精神质和掩饰性因子分均显著高于对照组(P＜0.05～P＜0.01),内外向分值则低于对照组(P＜0.05).EPQ的各因子以及年龄、性别、文化程度分别与SCL-90总分或部分因子分相关(均为P＜0.05).结论:首发精神分裂症患者心理障碍较明显;个性特征、年龄、性别、文化程度等多种因素对患者心理状况有影响.     

影响脑卒中患者日常生活活动能力社区康复效果的相关因素

目的探讨影响脑卒中患者日常生活活动能力（ADL）社区康复效果的相关因素。方法202例脑卒中患者随机分为社区康复组103例和对照组99例，社区康复组进行康复治疗和随访，包括对高危因素的药物控制、康复治疗、卫生宣教、心理疏导等，对照组只进行随访。于入组时和治疗5个月后，应用巴氏指数（BI）、神经功能缺损量表及综合功能评定（FCA）中的认知项，对两组患者进行评定。将所有患者最后一次ADL评分作为因变量，分组情况、病程、高血压、高血脂、糖尿病、吸烟、发病部位、文化程度、性别、年龄、饮酒、睡眠质量、FCA认知功能（入组时）、FCA运动功能（入组时）、BI（入组时）、神经功能缺损程度评分（入组时）做为自变量，进行多元回归分析。结果分组情况、发病前是否饮酒、病程（入组时间早晚）、神经功能缺损评分及综合功能评分（运动功能和认知功能）与患者日后的ADL恢复存在相关性。结论早期社区康复治疗对提高脑卒中患者的ADL作用显著；认知障碍对患者的ADL有显著影响。     

Predictors of basic and instrumental activities of daily living performance in persons receiving rehabilitation services

OBJECTIVE: To examine the relations among cognitive and emotional function and other patient impairment and demographic variables and the performance of daily activities. DESIGN: Cohort. SETTING: Acute inpatient rehabilitation, skilled nursing facilities, home care, and outpatient clinics. PARTICIPANTS: Adults (N=534) receiving services for neurologic (32.3%), lower-extremity orthopedic (42.7%), or complex medical (24.9%) conditions. Mean age was 63.8 years; 55% were women; 88.6% were white; and the time since condition onset ranged from 0.2 to 3.9 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Activity Measure for Post-Acute Care: applied cognitive, personal care and instrumental, and physical and movement scales; Mental Health Inventory-5 (MHI-5); and patient-identified problems (vision, grasp). RESULTS: Path analyses resulted in good model fit both for the total sample and 3 patient subgroups (chi(2) test, P>.05; comparative fit index >.95). There was a significant (P<.05) direct relation between the applied cognitive, grasp, and personal care and instrumental variables in all patient groups. There were also significant indirect relations between the MHI-5, visual impairment, and grasp problems with the personal care and instrumental scale through an association with the applied cognitive scale. Strength and significance of associations between age, sex, and physical and movement and personal care and instrumental scales varied more across patient groups. The model R(2) for the personal care and instrumental scale for the total sample was .60, with R(2) values of .10, .72, and .62 for the lower-extremity orthopedic, neurologic, and complex medical groups, respectively. CONCLUSIONS: Results suggest that variations in cognitive function, along with visual impairment and lower perceived well-being are associated with a patient's ability to complete daily activities. Rehabilitation professionals should consider cognitive and emotional factors as well as physical performance when planning treatment programs to restore daily activity function.