静电纺丝聚乳酸复合物纳米纤维材料与小鼠神经干细胞的生物相容性

背景:聚乳酸聚乙醇酸支架材料广泛应用于组织工程学领域,但其细胞黏附性较差、缺乏活性功能基团以及疏水性较强等缺点限制了其进一步的发展和应用。目的:观察小鼠神经干细胞与静电纺丝聚乳酸聚乙醇酸/聚乙二醇共聚物纳米纤维支架材料的体外相容性。方法:自孕15 d CD-1小鼠胚胎大脑皮质分离培养小鼠神经干细胞。静电纺丝法制备聚乳酸聚乙醇酸和聚乳酸聚乙醇酸/聚乙二醇纳米纤维支架材料,扫描电镜观察材料结构;取第5代神经干细胞分别接种于聚乳酸聚乙醇酸和静电纺丝聚乳酸聚乙醇酸/聚乙二醇纳米纤维支架材料上,进行体外培养。结果与结论:扫描电镜检测显示,两种支架材料呈现相互交联的多孔网状结构。聚乳酸聚乙醇酸组和静电纺丝聚乳酸聚乙醇酸/聚乙二醇组纤维直径和孔隙率差异无显著性意义(P0.05)。CCK-8检测显示,两种材料无明显细胞毒性。神经干细胞在支架材料中生长良好,两组吸光度值均随培养时间延长而增大,两组在培养1,3,5,7,9,11 d吸光度值差异均有显著性意义(P0.05)。两组材料培养3,6,9 h,静电纺丝聚乳酸聚乙醇酸/聚乙二醇组的细胞黏附率明显高于聚乳酸聚乙醇酸组(P0.05)。Hoechst染色显示两组细胞核质均染,形态正常,静电纺丝聚乳酸聚乙醇酸/聚乙二醇组细胞数量明显多于聚乳酸聚乙醇酸组(P0.05)。扫描电镜观察显示,与聚乳酸聚乙醇酸组相比,静电纺丝聚乳酸聚乙醇酸/聚乙二醇组神经干细胞在支架上的生长情况和基质分泌更好。结果说明,静电纺丝法制备的静电纺丝聚乳酸聚乙醇酸/聚乙二醇纳米纤维支架细胞生物相容性良好,安全无毒,具备合适的孔径和孔隙率,适宜神经干细胞生长,是一种适用于组织工程优质的支架载体。     

三维支架材料与脂肪干细胞的生物相容性

背景：构建组织工程化气管需要适合的三维支架。 目的：观察脂肪干细胞与聚乳酸-乙醇酸共聚物及聚三亚甲基碳酸酯共聚物支架的生物相容性。 方法：采用组织块法原代分离培养SD大鼠脂肪干细胞,行流式细胞术及多向分化能力鉴定。将脂肪干细胞分别种植于聚乳酸-乙醇酸共聚物和聚乳酸-乙醇酸-三亚甲基碳酸酯共聚物支架中,扫描电镜观察细胞与支架的生物相容性。 结果与结论：脂肪干细胞种植于两种支架材料后生长速度快,扫描电镜观察可见脂肪干细胞呈球型,并伸展形成伪足,贴附于支架材料,细胞间相互连接成团。说明聚乳酸-乙醇酸共聚物与聚三亚甲基碳酸酯共聚物支架均具有良好的生物相容性,无细胞毒性,其多孔的三维立体状结构适合脂肪干细胞黏附生长。     

双层左旋聚乳酸静电纺织纳米纤维支架与人牙周膜细胞的生物相容性

背景：静电纺织制备的纳米纤维支架形态结构与天然细胞外基质相似,为细胞的生长、增殖提供了良好的微环境,可增强细胞的黏附、迁移、增殖及分化功能。 目的：观察双层左旋聚乳酸静电纺织纳米纤维支架与人牙周膜细胞的生物相容性。 方法：采用静电纺织技术制备双层左旋聚乳酸静电纺织纳米纤维支架。MTT法评估不同浓度(100%、75%、50%、25%)双层左旋聚乳酸静电纺织纳米纤维支架浸提液对人牙周膜细胞的毒性;将双层左旋聚乳酸静电纺织纳米纤维支架与人牙周膜细胞共培养,以MTT法检测细胞的早期黏附能力,扫描电镜观察细胞在支架上的生长情况。 结果与结论：不同浓度双层左旋聚乳酸静电纺织纳米纤维支架浸提液对人牙周膜细胞无毒性。共培养2,6,24 h,人牙周膜细胞在双层左旋聚乳酸静电纺织纳米纤维支架上的黏附能力较差。复合培养7 d,人牙周膜细胞在支架疏松面黏附良好,并保持原有的形态,伸展良好,伸出突起相互连接;在支架致密面呈复层生长,胞体呈梭形、多角形,连接成片。表明双层左旋聚乳酸静电纺织纳米支架与人牙周膜细胞具有良好的生物相容性。 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

低温快速成型亲水改性复合人工骨支架的性能测定

背景：低温快速成型技术具有支架成型可控性、保持材料生物学活性和易于实现支架材料的三维多孔立体结构等优势,被迅速用于骨组织工程支架的制备。 目的：采用低温快速成型制备聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石复合支架,并检测其性能。 方法：采用低温快速成型设备分别制备聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石与聚乳酸-乙醇酸/纳米羟基磷灰石复合支架,通过电镜观察支架超微结构,以介质(乙醇)浸泡法测定支架孔隙率,采用电子试验机检测支架力学性能;将两种支架材料分别与大鼠成骨细胞共培养,培养12 h采用沉淀法检测细胞黏附率,培养1,3,5,7,9,12 d采用CCK-8法检测细胞增殖。 结果与结论：两组支架孔径均在理想范围内并具有较高孔隙率,但聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石支架的孔径波动范围大,孔径均值较聚乳酸-乙醇酸/纳米羟基磷灰石支架小且部分有闭塞现象。聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石支架的细胞黏附率及表面细胞增殖活性高于聚乳酸-乙醇酸/纳米羟基磷灰石支架(P < 0.05),力学性能低于聚乳酸-乙醇酸/纳米羟基磷灰石支架(P < 0.05)。表明聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石复合支架具有良好的细胞相容性。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架修复喉软骨缺损

背景：喉软骨缺损传统的修复方法受到供体来源、排斥反应等限制,因而难以推广。 目的：观察聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架修复喉软骨缺损的效果。 方法：将20只Wistar 大鼠随机分为聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架组和聚乳酸-乙醇酸共聚物支架组,建立喉软骨缺损模型后分别采用聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架和聚乳酸-乙醇酸共聚物支架修复。 结果与结论：聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架组大鼠造模后3,5,7 d时喉骨缺损直径显著小于聚乳酸-乙醇酸共聚物支架组;聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架组大鼠喉软骨缺损部位基本修复,表面平整,且与周围其他组织之间没有明显界限;而聚乳酸-乙醇酸共聚物支架组大鼠喉软骨缺损部位存在凹陷,表面粗糙,和周围组织存在明显界限。说明聚乳酸-乙醇酸共聚物/羟基磷灰石复合支架能够促进喉软骨缺损部位修复,修复喉软骨缺损的效果更理想。  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

静电纺丝纳米纤维膜作为骨骼肌组织工程支架材料的细胞相容性

背景：有报道以生物可降解的胶原盘或聚L-乳酸、聚羟基乙酸、聚L-乳酸/聚羟基乙酸共聚物等作为骨骼肌组织工程的支架材料,各有优缺点,不能完全满足骨骼肌组织工程的需要。 目的：探讨静电纺丝纳米纤维膜作为骨骼肌组织工程支架材料的可行性。 方法：制备7种不同组分的静电纺丝纳米纤维膜,以其浸提液为培养基培养第3代SD乳鼠成肌细胞,以含体积分数20%新生小牛血清的F12培养基培养的为对照。采用MTT法和扫描电镜检测成肌细胞在各组材料的黏附及生长情况。 结果与结论：各组分静电纺丝纳米纤维膜吸光度值与对照组间差异无显著性意义(P > 0.05)。各组分静电纺丝纳米纤维膜组成肌细胞黏附率差异有显著性意义(P < 0.05)。扫描电镜与上述结果一致。含70%聚乳酸+20%蚕丝蛋白+10%胶原组成电纺丝纳米纤维膜组可见大量成肌细胞黏附,呈梭形,两极伸展,排列规律,效果最好。其他各组细胞少,形态不规则,似衰退期成肌细胞。提示静电纺丝纳米纤维膜无细胞毒性,对成肌细胞的增殖无影响,成肌细胞能良好地黏附;以70%聚乳酸+ 20%蚕丝蛋白+10%胶原组分效果最佳。     

载荷角质细胞生长因子聚乳酸-羟基乙酸共聚物纳米缓释微球在组织工程皮肤构建中的应用

背景：聚乳酸-羟基乙酸共聚物具有良好的生物相容性和可降解性性。 目的：制备载荷角质细胞生长因子聚乳酸-羟基乙酸共聚物控释载药系统用于组织工程皮肤。 方法：采用乳化-溶剂挥发法、冷冻干燥法制备载有角质细胞生长因子的聚乳酸-羟基乙酸共聚物纳米微球,并构建组织工程皮肤。扫描电镜、倒置显微镜、纳米粒度分析仪、紫外分光及ELISA法对微球评价其特性。 结果与结论：纳米微球载药量为(14.05±0.56)%,包封率为(59.86±2.38)%,角质细胞生长因子活性保留率(78.26±5.63)%,体外释放30 d的累积释药率达75%以上,微球形态规则圆润。微球形态规整,在脱细胞真皮表面分布均匀,与其联接良好。毛囊干细胞群在荷载聚乳酸-羟基乙酸共聚物纳米微囊脱细胞真皮上生长活跃,细胞形态良好,并呈克隆团生长。说明实验用组织工程材料制备工艺合理,材料相容性好,可用于构建新型组织工程皮肤。     

静电纺丝构建胶原-透明质酸钠-硫酸软骨素组织工程关节软骨支架的工艺探索

目的探索以胶原、透明质酸钠和硫酸软骨素三种细胞外基质为原料,利用静电纺丝技术构建组织工程关节软骨支架的工艺。方法固定静电纺丝的参数,通过改变溶剂的种类,浓度和三种原料之间的比例,探索胶原-透明质酸钠-硫酸软骨素复合支架的纺丝条件。结果胶原-透明质酸钠-硫酸软骨素复合支架纺丝的最佳溶剂是3-氟乙醇和水的混合溶剂(v:v,1:1),最佳纺丝浓度范围为80~120mg/m L,三种原料支架的最佳比例范围为6~8:1:1~2。支架纤维的直径和孔隙率则由原料的浓度和比例共同决定;支架降解性能良好,降解速度主要由胶原含量决定。结论研究者成功的利用静电纺丝技术构建了胶原-透明质酸钠-硫酸软骨素复合组织工程软骨支架。这种支架在成分和形态上都可以较好的模拟关节软骨细胞外环境,是一种具有良好应用前景的组织工程关节软骨支架。     

聚乳酸乙醇酸与猕猴骨髓基质细胞的生物相容性

背景：聚乳酸乙醇酸与不同细胞的生物相容性的报道较多,但探讨其与猕猴骨髓基质细胞生物相容性的研究极少。 目的：观察猕猴骨髓基质细胞的生物学特性以及其与支架材料聚乳酸乙醇酸在体外的生物相容性。 方法：将经流式细胞检测证实的第2代猕猴骨髓基质细胞与聚乳酸乙醇酸支架材料联合培养,以单独培养的骨髓基质细胞作为对照。 结果与结论：猕猴骨髓基质细胞与聚乳酸乙醇酸共培养4 d后,激光共聚焦显微镜下可见CD29阳性的骨髓基质细胞黏附包绕在聚乳酸乙醇酸纤维表面,形成长的细胞链。扫描电镜下可见骨髓基质细胞于聚乳酸乙醇酸上贴附良好,且有较多细长的突起从骨髓基质细胞伸出,沿材料伸展。骨髓基质细胞在聚乳酸乙醇酸浸出液中培养72 h,骨髓基质细胞神经营养因子表达量与对照组比较差异无显著性意义(P > 0.05);培养7 d,其形态、细胞活力、细胞增殖指数与对照组亦无明显差异。提示猕猴骨髓基质细胞与聚乳酸乙醇酸支架材料有良好的生物相容性。     

电纺纳米纤维可降解输尿管支架肌肉埋植的降解性能*

背景：作者前期研究了电纺纳米纤维聚乳酸-羟基乙酸共聚物可降解输尿管支架材料的体外降解性能,发现80/20聚乳酸-羟基乙酸共聚物电纺纳米纤维材料在尿液中的降解时间可以满足临床需要。目的：观察80/20聚乳酸-羟基乙酸共聚物电纺纳米纤维输尿管支架的肌肉埋植降解性能。方法：采用静电纺丝法制备80/20聚乳酸-羟基乙酸共聚物纳米纤维输尿管支架,观察其在家兔脊柱旁肌肉中的降解情况。结果与结论：成功制备了电纺纳米纤维输尿管支架,扫描电镜见微观形貌良好。80/20的聚乳酸-羟基乙酸共聚物纳米纤维输尿管支架在体内降解至10周时,支架管降解至初始质量的60%左右,支架出现断裂和崩解,虽降解速度较体外降解稍慢,但其降解性能仍能够满足临床对可降解输尿管支架的需要。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.