Objective To investigate the expression of Human leucocyte antigen(HLA)-DP, -DQ, -DR and CD40 in human retinal pigment epithelial (RPE) cells, to determine their molecule expression in immune response process, and their abilities to stimulate T lymphocyte activation. Methods Human RPE cells were cultured with or without (IFN respectively. Expression of HLA-DP, -DQ, -DR and CD40 was measured by immunohistochemical staining. Meanwhile, peripheral blood mononuclear cells (PBMC) were cocultured with RPE cells in vitro, and then the expression of activated lymphocytes CD69 was measured by fluorescence activated cell sorter(FACS). Results Expression of HLA-DP, -DQ, -DR and CD40 antigen were enhanced by gamma;-interferon inducement. Increasing amount of CD69 positive lymphocytes were found in the co-culture system of RPE cells and PBMC. Conclusion T-lymphocytes in the peripheral blood were activated by human RPE cells which is antigen presenting cells with immunological characteristics potential.
ObjectivesTo systematically review the efficacy and safety of doxazosin for ureterolithiasis.MethodsPubMed, EMbase, Web of Science, The Cochrane Library and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of comparing doxazosin with conservative treatment or tamsulosin for ureterolithiasis from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 15 RCTs involving 1 062 patients were included. The results of meta-analysis showed that: compared with conservative treatment, doxazosin significantly facilitated ureteral stone expulsion (RR=1.62, 95%CI 1.45 to 1.81, P<0.000 01). No statistical significant difference was found in stone-free rate (RR=0.96, 95%CI 0.83 to 1.11, P=0.57), stone expulsion time (SMD=−0.17, 95%CI −0.52 to 0.19, P=0.35) or pain episode frequency (SMD=0.21, 95%CI −0.15 to 0.56, P=0.25) between doxazosin and tamsulosin. Treatment-associated serious side effects were rarely reported.ConclusionCurrent evidence shows that doxazosin is an efficient and safe medical expulsion agent for ureterolithiasis management. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
目的总结胆囊切除术致医源性胆管损伤的原因、诊断、治疗及预防的经验。方法回顾性分析昆明市第一人民医院2006年5月至2011年5月期间经治的17例胆囊切除术致医源性胆管损伤患者的临床资料。结果损伤部位包括隆突2例，肝总管3例，胆囊管汇入胆总管部7例，胆总管4例，副肝管1例。1例一期术中端端吻合，2例一期吻合并留置T管支撑，1例行胆囊管结扎，2例内镜下留置鼻胆管引流，4例术后内镜下留置胆管支架，6例术后行胆肠Roux-en-Y吻合，1例行脱细胞基质材料修补。随访0.3～5年，平均2.3年，效果良好16例，1例反复发生胆管炎。结论医源性胆管损伤重在预防，精细解剖胆囊三角、严格遵循“确认-剪断-确认”三步骤是防止医源性胆管损伤的关键; 及时发现和正确的处理方法是降低其死亡率及改善预后的关键。
Implantable brain-computer interfaces (BCIs) have potentially important clinical applications due to the high spatial resolution and signal-to-noise ratio of electrodes that are closer to or implanted in the cerebral cortex. However, the surgery and electrodes of implantable BCIs carry safety risks of brain tissue damage, and their medical applications face ethical challenges, with little literature to date systematically considering ethical norms for the medical applications of implantable BCIs. In order to promote the clinical translation of this type of BCI, we considered the ethics of practice for the medical application of implantable BCIs, including: reducing the risk of brain tissue damage from implantable BCI surgery and electrodes, providing patients with customized and personalized implantable BCI treatments, ensuring multidisciplinary collaboration in the clinical application of implantable BCIs, and the responsible use of implantable BCIs, among others. It is expected that this article will provide thoughts and references for the research and development of ethics of the medical application of implantable BCI.
With the development of brain-computer interface (BCI) technology and its translational application in clinical medicine, BCI medicine has emerged, ushering in profound changes to the practice of medicine, while also bringing forth a series of ethical issues related to BCI medicine. BCI medicine is progressively emerging as a new disciplinary focus, yet to date, there has been limited literature discussing it. Therefore, this paper focuses on BCI medicine, firstly providing an overview of the main potential medical applications of BCI technology. It then defines the discipline, outlines its objectives, methodologies, potential efficacy, and associated translational medical research. Additionally, it discusses the ethics associated with BCI medicine, and introduces the standardized operational procedures for BCI medical applications and the methods for evaluating the efficacy of BCI medical applications. Finally, it anticipates the challenges and future directions of BCI medicine. In the future, BCI medicine may become a new academic discipline or major in higher education. In summary, this article is hoped to provide thoughts and references for the development of the discipline of BCI medicine.
Motor imagery (MI) is an important paradigm of driving brain computer interface (BCI). However, MI is not easy to control or acquire, and the performance of MI-BCI depends heavily on the performance of the subjects’ MI. Therefore, the correct execution of MI mental activities, ability evaluation and improvement methods play important and even critical roles in the improvement and application of MI-BCI system’s performance. However, in the research and development of MI-BCI, the existing researches mainly focus on the decoding algorithm of MI, but do not pay enough attention to the above three aspects of MI mental activities. In this paper, these problems of MI-BCI are discussed in detail, and it is pointed out that the subjects tend to use visual motor imagery as kinesthetic motor imagery. In the future, we need to develop some objective, quantitatively visualized MI ability evaluation methods, and develop some effective and less time-consumption training methods to improve MI ability. It is also necessary to solve the differences and commonness of MI problems between and within individuals and MI-BCI illiteracy to a certain extent.