主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

肠内免疫营养对多发伤患者免疫功能的影响

Objective To study the effects of enteral immunonutrition on immune function in patients with multiple trauma. Method A total of 32 patients with multiple trauma admitted to general ICU in ChangZheng hospital, Shanghai from March 2007 to May 2008 were randomly (random number) divided into two groups,enteral immunonutrition group (EIN group, n = 16)and the general formula enteral nutrition group (EN group, n = 16).Two groups of patients on the third day after injury began to accept the EIN and the general formula EN which respectively support at least 14 days. The patients peripheral blood lymphocyte count (TLC), immunoglobulin (IgG,IgM, IgA) ,and T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were detected on the day of the group formation, the seventh and the fortteenth day of the nutritional support. Results TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in EIN Group on the 7th and 14th day than that on the first day ( P ＜0.05), and extended with the EIN and sustained increase. All immunization indicators of EN group on the 7th day were no significant changes compared with the day of the group formation, and on the 14 th day TLC, IgG, IgM,IgA, CD4 and CD4/CD8 ratio were significantly higher than that on the day of the group formation ( P ＜ 0.05),but were significantly lower than that in the EIN group on the 14th day ( P ＜ 0.05). Conclusions Compared with the general formula EN, EIN is more helpful to restore and increase the humoral and cellular immune function in early post-multitraumatic phase.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.