Coasting疗法对于高反应者IVF／ICSI周期结局的影响

目的：研究coasting疗法对于促性腺激素释放激素激动剂（GnRHa）体外受精（IVF）周期结局的影响。设计：回顾性研究。机构：私立IVF中心。患者：进行IVF／卵母细胞单精子显微注射（ICSI）治疗的不孕夫妇[正常反应者（对照组），高反应者（coasting疗法组）]。干预：Coasting疗法可以降低高反应者卵巢过度刺激综合征（OHSS）的发生风险。主要观察指标：卵巢刺激、胚胎学参数、妊娠率（PR）。结果：coasting疗法的平均时间为2．2d。两组的年龄和基线FSH值相似。coasting疗法组有更多的卵泡数和卵子数，但受精卵数和移植胚胎数与对照组相似。对照组的胚胎种植率较高（22．4％ vs 13．9％），两组妊娠率相似（45．1％ vs 38．5％）。在coasting疗法组内，比较了妊娠与非妊娠周期的基线、卵巢刺激和胚胎学参数。比较了coasting疗法1d、2d和≥3d的妊娠率（36．3％粥38．4％13540％）；还比较了基于不同E2（〈25％，25％～50％，〉50％）的妊娠率（28．5％ vs 35．7％ vs 44．4％）。结论：对于IVF周期中高反应的患者Coasting 3d疗法是可取的。     

Effectiveness of porcelain repair systems.

The study indicates that the repair system using a bonding agent with acrylic resin is significantly stronger than the repair system using a specific composite resin. On the basis of this study, the acrylic resin repair system has the best potential for clinical success in porcelain-to-porcelain repairs.     

Retention magnets in guiding plates of distal-extension removable partial dentures

This investigation studied vertically placed magnets that act simultaneously as guiding plates and retentive devices. The retention of vertically placed magnets was less than that of horizontally or obliquely placed magnets, but comparable to that of I-bar retainers. Load-induced stresses were lower, transmitted more axially to the abutments and were generally more equitably distributed than stresses produced by magnets in other orientations to the abutment tooth. The force distribution characteristics were less stressful than those of a comparable RPD with distal guiding plates, mesial rests, and I-bar retainers. Although the investigators were initially concerned about the relative capabilities of the vertically placed magnets, in vitro and in vivo studies demonstrated that retention was as good if not better than that of conventional clasp designs.     

Preparation of BMP-2 Containing Bovine Serum Albumin (BSA) Nanoparticles Stabilized by Polymer Coating

Purpose  The purpose of this study was to investigate the preparation process of bone morphogenetic protein-2 (BMP-2) containing bovine serum albumin (BSA) nanoparticles (NPs), and to assess the bioactivity of BMP-2 encapsulated in such NPs. Methods  The NPs were prepared by a coacervation method, and the effects of process parameters on NP size and polydispersity were examined. Polymer coated NPs were characterized with respect to amount of adsorbed polymer, particle size and zeta potential. Using bone marrow stromal cells (BMSC), biocompatibility of the NPs was investigated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) Assay, and bioactivity of the encapsulated BMP-2 was investigated by alkaline phosphatase (ALP) induction and calcification. Results  The size of NPs could be controlled in the 50–400 nm range by process parameters including BSA concentration, non-solvent:solvent ratio and pH value. After coating with cationic polymers, the particle size and zeta potential were significantly increased. MTT assay indicated no toxicity of both the uncoated and coated NPs on BMSC. Based on ALP induction and calcification, full retention of BMP-2 bioactivity was retained in the polymer-coated NPs. Conclusions  This study described a preparation procedure for BSA NPs with controllable particle size, and such polymer-coated BSA NPs are promising delivery agents for local and systemic administration of BMP-2 in bone regeneration.     

Facial recognition of heroin vaccine opiates: Type 1 cross-reactivities of antibodies induced by hydrolytically stable haptenic surrogates of heroin, 6-acetylmorphine,and morphine

Novel synthetic compounds similar to heroin and its major active metabolites, 6-acetylmorphine and morphine, were examined as potential surrogate haptens for the ability to interface with the immune system for a heroin vaccine. Recent studies have suggested that heroin-like haptens must degrade hydrolytically to induce independent immune responses both to heroin and to the metabolites, resulting in antisera containing mixtures of antibodies (type 2 cross-reactivity). To test this concept, two unique hydrolytically stable haptens were created based on presumed structural facial similarities to heroin or to its active metabolites. After conjugation of a heroin-like hapten (DiAmHap) to tetanus toxoid and mixing with liposomes containing monophosphoryl lipid A, high titers of antibodies after two injections in mice had complementary binding sites that exhibited strong type 1 (“true”) specific cross-reactivity with heroin and with both of its physiologically active metabolites. Mice immunized with each surrogate hapten exhibited reduced antinociceptive effects caused by injection of heroin. This approach obviates the need to create hydrolytically unstable synthetic heroin-like compounds to induce independent immune responses to heroin and its active metabolites for vaccine development. Facial recognition of hydrolytically stable surrogate haptens by antibodies together with type 1 cross-reactivities with heroin and its metabolites can help to guide synthetic chemical strategies for efficient development of a heroin vaccine.     

Epidemiology and outcomes of adults with asthma who were hospitalized or died with 2009 pandemic influenza A (H1N1) – California, 2009

Background

Asthma was the most common chronic condition among adults hospitalized for 2009 pandemic influenza A (H1N1) (pH1N1).

Objectives

We describe the epidemiology and factors for severe outcomes among adults with asthma who were hospitalized or died from pH1N1 in California.

Methods

We reviewed California Department of Public Health pH1N1 reports from April 23, 2009 through August 11, 2009. Reports were included if the patient had pH1N1 (or non‐subtypeable influenza A) infection by polymerase chain reaction in an adult (age ≥ 18 years) with asthma who was hospitalized or died. Patients were classified as having intermittent or persistent asthma on the basis of regular medications. Risk factors associated with severe outcomes (i.e., intensive care unit admission or death) vs those with less severe outcomes were assessed by chi‐square tests and logistic regression.

Results

Among 744 identified patients, 170 (23%) had asthma (61% intermittent, 39% persistent). 132 of 142 (93%) patients had other chronic medical conditions. Severe outcomes occurred in 54 of 162 (33%), more commonly among those with renal disease (64% versus 31%; P = 0.04) and chest radiograph infiltrates (54% versus 11%; P < 0.01), less commonly among those who received antivirals within 48 hours of symptom onset (22% versus 44%; P = 0.02). In multivariable analysis, chest radiograph infiltrates were associated with severe outcomes (adjusted odds ratio 9·38, 95% confidence interval 3·05–28·90).

Conclusions

One third of adults with asthma who died or were hospitalized with pH1N1 experienced severe outcomes. Early empiric antiviral therapy should be encouraged, especially among asthma patients.     

Cardiovascular surgery in Marfan syndrome: implications of new molecular concepts in thoracic aortic disease

Acute dissection and rupture of aortic aneurysms comprise for 1-2% of all deaths in industrialized countries. Dilation of the aorta is caused by a multitude of mechanisms including inherited connective tissue disorders such as Marfan syndrome (MFS). MFS is one of the most common inherited connective tissue disorders affecting 1 in 5000 individuals. Although the phenotype of MFS can be quite variable, aneurysmal dilation of the aortic root and consecutive acute aortic dissection is the leading cause of death in this patient population. Over the past years it has been shown that a comprehensive understanding of this disorder provides greater understanding of vascular wall biology and identifies pathways relevant to aortic aneurysms and dissection in general. The current review discusses the surgical management of patients with MFS with a special emphasis on indications for surgery in this complex group of patients.     

Masthead,Volume 65, Issue 2

T₂ was used in this study to assess tendon microstructure. Two unloaded digital extensor tendons were bent such that their long axes were imaged throughout 180° with respect to B₀. T₂‐weighted images reveal periodic banding (～200 μm) when tendons were oriented at ±55° with respect to B₀. Five pairs of tendons were used to study the influence of load on T2W MRI: one tendon of each pair was loaded with a 7.8‐N mass, and both tendons were fixed in formalin then imaged at 55° to B₀. MRI banding was present in the unloaded, but not loaded, tendons. In unloaded tendons, polarized‐light microscopy revealed collagen crimp with a periodicity similar to MRI. In loaded tendons, there was a strain‐induced extinction of periodicity on both MRI and polarized‐light microscopy. These studies confirm that crimp is detectable by high‐field MRI and could serve as an in vivo index of physiological strains in collagenous tissues. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Inflammatory dendritic cells migrate in and out of transplanted chronic mycobacterial granulomas in mice

An estimated one-third of the world's population is infected with Mycobacterium tuberculosis, although most affected individuals maintain a latent infection. This control is attributed to the formation of granulomas, cell masses largely comprising infected macrophages with T cells aggregated around them. Inflammatory DCs, characterized as CD11c+CD11b+Ly6C+, are also found in granulomas and are an essential component of the acute immune response to mycobacteria. However, their function during chronic infection is less well understood. Here, we report that CD11c+ cells dynamically traffic in and out of both acute and chronic granulomas induced by Mycobacterium bovis strain bacillus Calmette-Guérin (BCG) in mice. By transplanting Mycobacterium-induced granulomas containing fluorescently labeled CD11c+ cells and bacteria into unlabeled mice, we were able to follow CD11c+ cell trafficking and T cell activation. We found that half of the CD11c+ cells in chronic granulomas were exchanged within 1 week. Compared with tissue-resident DC populations, CD11c+ cells migrating out of granuloma-containing tissue had an unexpected systemic dissemination pattern. Despite low antigen availability, systemic CD4+ T cell priming still occurred during chronic infection. These data demonstrate that surveillance of granulomatous tissue by CD11c+ cells is continuous and that these cells are distinct from tissue-resident DC populations and support T cell priming during both stages of Mycobacterium infection. This intense DC surveillance may also be a feature of Mycobacterium tuberculosis infection and other granuloma-associated diseases.     

CC chemokine receptor 4 contributes to innate NK and chronic stage T helper cell recall responses during Mycobacterium bovis infection

Cysteine-cysteinyl chemokine receptor 4 (CCR4) is expressed by a variety of T-cell subsets and leukocytes. This study examined the participation of CCR4 in response to pulmonary infection with Mycobacterium bovis Bacille-Calmette-Guerin (BCG). Constitutive and induced CCR4 agonist expression was detected among large mononuclear cells. The course of infection and mobilization of effector cell populations were then analyzed in CCR4 knockout (CCR4(-/-)) mice. Compared with controls, CCR4(-/-) mice displayed delayed innate stage (<2 weeks) bacterial clearance and reduced late stage inflammation. Innate impairment was associated with reduced natural killer cell activation. In the adaptive phase, CCR4(-/-) mice generated effector T cells in draining lymph nodes and accumulated effector T cells in lungs, which resulted in normal adaptive stage bacterial elimination at 2 to 4 weeks. However, during the late stage, CCR4(-/-) mice had reduced interferonγ+CD4(+)α/β+ (Th1) and interleukin (IL)-17+CD4(+)α/β+ (Th17) T helper cells in lungs. In contrast, IL-17+ γ/δ T cells in lungs were unaffected. When challenged with mycobacterial antigen- (Ag-) Ag-coated beads to elicit a recall granulomatous response, CCR4(-/-) mice displayed abrogated recall granuloma formation and reduced interferon γ+ Th1 cells. These findings indicate that CCR4 supports innate natural killer cell activation and sustains later CD4(+) Th effector/memory antimycobacterial responses in the lung but is redundant in the early adaptive elimination phase.