BACKGROUND & AIMS: :Operating room (OR) is a cost-intensive environment, and it should be managed efficiently. When improving efficiency, shortening case duration by parallel processing, training of the resident surgeons, the choice of anesthetic methods, effective scheduling, and monitoring of the overall OR performance are important. When redesigning the OR processes, changes should be given a clear target and the achieved results monitored and reported to everyone involved. Advanced, reliable, and easy to use information technology solutions for OR management are under development. Pre-operative clinic and functionally designed facilities support efficiency. OR personnel must be kept motivated by clear management and leadership, supported by superiors.

背景与目标： : 手术室 (或) 是一种成本密集型环境，应该对其进行高效管理。在提高效率，通过并行处理缩短病例持续时间，对住院医师进行培训时，麻醉方法的选择，有效的调度以及对整体或绩效的监控很重要。在重新设计或流程时，应为更改提供明确的目标，并对已实现的结果进行监控并报告给所有相关人员。正在开发用于或管理的先进，可靠且易于使用的信息技术解决方案。术前诊所和功能设计的设施支持效率。或者，必须在上级的支持下，通过明确的管理和领导来保持人员的动力。

BACKGROUND & AIMS: :Decorrelation and depolarization properties of multiply scattering media and tissues in the case of propagation of coherent probe beams are analyzed in terms of photon path distribution. A specific correlation time determining the relationship between correlation and polarization states of scattered optical fields is introduced. Results of correlation and polarization experiments with phantom scatterers (such as water suspensions of polystyrene spheres) and tissues with controlled optical properties (such as the human sclera) are presented. © 1999 Society of Photo-Optical Instrumentation Engineers.

背景与目标： : 根据光子路径分布分析了相干探测束传播情况下多重散射介质和组织的去相关和去极化特性。介绍了确定散射光场的相关和偏振态之间关系的特定相关时间。给出了使用幻影散射体 (例如聚苯乙烯球的水悬浮液) 和具有受控光学特性的组织 (例如人巩膜) 进行相关和偏振实验的结果。©1999光电仪器工程师学会。

BACKGROUND & AIMS: AIM:NetworkZ is a simulation-based multidisciplinary team-training programme designed to enhance patient safety by improving communication and teamwork in operating theatres (OTs). In partnership with the Accident Compensation Corporation, its implementation across New Zealand (NZ) began in 2017. Our aim was to explore the experiences of staff - including the challenges they faced - in implementing NetworkZ in NZ hospitals, so that we could improve the processes necessary for subsequent implementation. METHOD:We interviewed staff from five hospitals involved in the initial implementation of NetworkZ, using the Organising for Quality model as the framework for analysis. This model describes embedding successful quality improvement as a process of overcoming six universal challenges: structure, infrastructure, politics, culture, motivation and learning. RESULTS:Thirty-one people participated. Structural support within the hospital was considered essential to maintain staff enthusiasm, momentum and to embed the programme. The multidisciplinary, simulation-based approach to team training was deemed a fundamental infrastructure for learning, with participants especially valuing the realistic in situ simulations and educational support. Participants reported positive changes to the OT culture as a result of NetworkZ and this realisation motivated its implementation. In sites with good structural support, NetworkZ implementation proceeded quickly and participants reported rapid cultural change towards improved teamwork and communication in their OTs. CONCLUSION:Implementation challenges exist and strategies to overcome these are informing future implementation of NetworkZ. Embedding the programme as business as usual across a nation requires significant and sustained support at all levels. However, the potential gains in patient safety and workplace culture from widespread multidisciplinary team training are substantial. Trial registration number ACTRN12617000017325.

背景与目标：

BACKGROUND & AIMS: :We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

背景与目标： : 我们以德国拥有独立麻醉科的医院为例，研究手术室的生产率。与麻醉学组文献相关，我们使用ln (总手术时间/总麻醉师工资) 作为手术室生产率的代表。我们根据87家医院的调查数据，测试了手术室生产率与不同结构，组织和管理特征之间的关联。我们的实证分析将提高手术室生产率与更大的手术室容量，适当的调度行为和重新调整利益的管理方法联系起来。从这种分析来看，强制管辖权和避免提前过度调度似乎是提高手术室生产率的可实施工具。

BACKGROUND & AIMS: :Polycystic ovary syndrome (PCOS) is a highly complex disorder influenced by genetic and environmental factors. Previous genome-wide association studies (GWAS) on Han Chinese, Korean, and European populations identified multiple PCOS-susceptible loci; however, only a few studies reported the association of susceptibility genes with disease phenotypic traits. This cross-sectional study aimed to investigate the association between PCOS susceptibility genes from GWAS and disease-related clinical features. A total of 1,810 reproductive-aged women were recruited, including 927 control women and 883 women with PCOS, diagnosed based on the European Society for Human Reproduction and Embryology criteria. Genomic DNA was extracted and genotyped, and a Bonferroni test was performed to determine the association between 12 independent SNPs and the clinical features of PCOS. In women with PCOS, rs11031006, nearest to FSHB, was significantly associated with free testosterone (P = 1.94 × 10-3) and luteinizing hormone (P = 1.96 × 10-3) levels. The menstruation number per year, ovarian follicular number, ovarian volume, and insulin sensitivity index were not associated with any SNP. In the control group, no SNPs were associated with any PCOS traits. Collectively, our results suggest that FSHB may play an important role in the development and progression of PCOS.

背景与目标： 多囊卵巢综合征 (PCOS) 是一种受遗传和环境因素影响的高度复杂的疾病。先前对汉族，韩国和欧洲人群进行的全基因组关联研究 (gwa) 确定了多个PCOS易感位点; 然而，只有少数研究报告了易感基因与疾病表型性状的关联。这项横断面研究旨在研究来自gwa的PCOS易感基因与疾病相关临床特征之间的关联。总共招募了1,810名育龄妇女，包括927名对照妇女和883名患有多囊卵巢综合征的妇女，根据欧洲人类生殖和胚胎学协会的标准进行诊断。提取基因组DNA并进行基因分型，并进行Bonferroni测试以确定12个独立snp与PCOS临床特征之间的关联。在PCOS女性中，最接近FSHB的rs11031006与游离睾酮 (p   =   1.94 × 10-3) 和黄体生成素 (p   =   1.96 × 10-3) 水平显著相关。每年的月经次数，卵巢卵泡数，卵巢体积和胰岛素敏感性指数与任何SNP无关。在对照组中，没有snp与任何PCOS性状相关。总的来说，我们的结果表明FSHB可能在PCOS的发展和发展中起重要作用。

BACKGROUND & AIMS: :The authors describe a new, digitally controlled operating table for neurosurgery. The apparatus includes a digitally controlled motor for manipulating the table and a rotary encoder with a central processing unit, which calculates and displays the table's position. The table can be operated with any type of digitalized computer system and its position is monitored by the encoder unit in real time.

背景与目标： 作者介绍了一种新型的数字控制神经外科手术台。该装置包括用于操纵工作台的数控电机和具有中央处理单元的旋转编码器，该中央处理单元计算并显示工作台的位置。该表可以使用任何类型的数字化计算机系统进行操作，并且其位置由编码器单元实时监控。

BACKGROUND & AIMS: :Recurrent aphthous stomatitis (RAS), are common inflammatory lesions of the oral mucous, usually round or ovoid, circumscribed by erythematous haloes with a yellow-grey floor and mostly painful. The RAS has reached an incidence about 20% in general population, present on any aged group, especially adolescents and young adults. Etiopathogenesis of RAS is not entirely understood. Some factors involved include immune system anomalies, infections, nutritional deficiency, mucous traumatism, food or contact allergy, autoimmunity illness and cancer; together with psychiatric, genetic and environment agents. In this article, main clinical features, etiology related factors, differential diagnosis and initial study of patients consulting for RAS are presented.

背景与目标： : 复发性口疮性口炎 (RAS) 是口腔粘液常见的炎性病变，通常为圆形或卵形，周围有红斑晕，地板呈黄灰色，大部分疼痛。在一般人群中，RAS的发病率约为20%，存在于任何老年人群，尤其是青少年和年轻人中。RAS的病因尚不完全清楚。涉及的一些因素包括免疫系统异常，感染，营养不足，粘液创伤，食物或接触过敏，自身免疫性疾病和癌症; 以及精神病，遗传和环境因素。本文介绍了RAS患者的主要临床特征，病因相关因素，鉴别诊断疾病和初步研究。

BACKGROUND & AIMS: :The goal of this project was to remove iron from drinking water using a new electrocoagulation (EC) cell. In this research, a flow column has been employed in the designing of a new electrocoagulation reactor (FCER) to achieve the planned target. Where, the water being treated flows through the perforated disc electrodes, thereby effectively mixing and aerating the water being treated. As a result, the stirring and aerating devices that until now have been widely used in the electrocoagulation reactors are unnecessary. The obtained results indicated that FCER reduced the iron concentration from 20 to 0.3 mg/L within 20 min of electrolysis at initial pH of 6, inter-electrode distance (ID) of 5 mm, current density (CD) of 1.5 mA/cm2, and minimum operating cost of 0.22 US $/m3. Additionally, it was found that FCER produces H2 gas enough to generate energy of 10.14 kW/m3. Statistically, it was found that the relationship between iron removal and operating parameters could be modelled with R2 of 0.86, and the influence of operating parameters on iron removal followed the order: C0>t>CD>pH. Finally, the SEM (scanning electron microscopy) images showed a large number of irregularities on the surface of anode due to the generation of aluminium hydroxides.

背景与目标： : 该项目的目标是使用新的电凝 (EC) 细胞从饮用水中去除铁。在这项研究中，在设计新的电凝反应器 (FCER) 时采用了流动柱，以实现计划的目标。其中，被处理的水流过穿孔的圆盘电极，从而有效地混合和充气被处理的水。因此，不需要迄今为止在电凝反应器中广泛使用的搅拌和充气装置。获得的结果表明，在初始pH为6，电极间距离 (ID) 为5毫米，电流密度 (CD) 为1.5 mA/cm2，最低运行成本为0.22美元/m3的情况下，FCER在电解20分钟内将铁浓度从20 mg/L降低到0.3 mg/L。此外，发现FCER产生足以产生10.14 kW/m3能量的H2气体。统计发现，可以用0.86的R2建模除铁与操作参数之间的关系，并且操作参数对除铁的影响顺序为: C0>t>CD>pH。最后，SEM (扫描电子显微镜) 图像显示，由于氢氧化铝的产生，阳极表面出现了大量不规则性。

BACKGROUND & AIMS: :Balloon kyphoplasty (BKP) sometimes fails to improve patients' outcomes, with revision surgery, using anterior or posterior reconstruction, being required. The purpose of this study was to investigate the radiological risk factors of failure after BKP in the treatment of osteoporotic vertebral fractures (OVFs). This case-control study included 105 patients treated with single BKP and 14 patients  who required revision BKP. We evaluated radiological findings differentiating both groups, using plain radiography and computed tomography, before BKP. Angular flexion-extension motion was significantly greater in the revision than BKP group. While the frequency of pedicle fracture and posterior wall injury was not different between the groups, a split type fracture was more frequent in the revision group. Split type fracture had the highest adjusted odds ratio (OR) for revision (16.5, p = 0.018). Angular motion ≥14° increased the risk for revision surgery by 6-fold (p = 0.013), with endplate deficit having an OR of revision of 5.0 (p = 0.032). The revision rate after BKP was 3.8%, with split type fracture, greater angular motion and large endplate deficit being risk factors for revision. Treatment strategies for patients with these risk factors should be carefully evaluated, considering the inherent difficulties in performing revision surgery after BKP.

背景与目标： 球囊后凸成形术 (BKP) 有时无法改善患者的预后，需要使用前或后重建进行翻修手术。目的探讨BKP治疗骨质疏松性椎体骨折 (OVFs) 后失败的放射学危险因素。这项病例对照研究包括105例接受单一BKP治疗的患者和14例需要修订BKP的患者。在BKP之前，我们使用普通放射线照相和计算机断层扫描评估了区分两组的放射学发现。修订中的角度屈伸运动明显大于BKP组。虽然椎弓根骨折和后壁损伤的发生率在两组之间没有差异，但翻修组的劈裂型骨折更为常见。劈裂型骨折的修正优势比 (OR) 最高 (16.5，p   =   0.018)。角运动 ≥ 14 ° 将翻修手术的风险增加6倍 (p   =   0.013)，终板缺陷具有5.0的OR (p   =   0.032)。BKP后的翻修率为3.8%，劈裂型断裂，较大的角运动和较大的端板缺陷是翻修的危险因素。考虑到BKP后进行翻修手术的固有困难，应仔细评估具有这些危险因素的患者的治疗策略。

BACKGROUND & AIMS: OBJECTIVES:Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas encompasses a spectrum of neoplasms with both morphological and immunohistochemical variations of mucin glycoproteins. Recently, a consensus nomenclature and criteria were histologically defined for classifying these variants of IPMNs into gastric, intestinal, pancreatobiliary, and oncocytic types. The purpose of this study was to determine associations between the histological types and clinicopathological features in patients with IPMN. METHODS:Sixty-one patients with IPMN operated upon at Tohoku University Hospital between 1988 and 2006 were retrospectively analyzed. RESULTS:Our series included 27 gastric-, 29 intestinal-, 4 pancreatobiliary-, and 1 oncocytic-type IPMNs. Statistically, the types of IPMN were significantly associated with the histological diagnoses, macroscopic types, and survival of the patients. Characteristically, the gastric-type IPMNs were likely to be diagnosed as benign, to be confined to branch ducts, and to have fair prognoses. On the other hand, the intestinal-type IPMNs were likely to be diagnosed as malignant, occupy the main duct, and have poor prognoses. Because of the small number of pancreatobiliary-type IPMNs and only 1 case of oncocytic-type IPMN, we were unable to determine any of their clinicopathological characteristics in our series. CONCLUSIONS:Evaluation of the histological types of IPMN may help to predict the clinical course of patients with IPMN and to design improved clinical management for these patients.

背景与目标：

BACKGROUND & AIMS: :Of the multiple murine models of autoimmunity, the three most closely resembling human systemic lupus erythematosus (SLE) are the MRL/lpr, New Zealand Black/White F(1), and male BXSB. Although these strains share many disease characteristics, no common cellular defect has previously been found in prediseased mice from all these strains. We show in this study that macrophages from prediseased mice of all three SLE-prone strains, as well as macrophages from mice whose genomes contribute to the development of SLE (MRL/+, New Zealand White, New Zealand Black, female BXSB, and LG/J), have an identical and profound defect in cytokine expression that is triggered by apoptotic cells. Strikingly, none of 13 nonautoimmune strains tested exhibited this defect. Given that apoptotic Ags have been increasingly recognized as the target of autoantibodies, a defect in cytokine expression that is triggered by apoptotic cells has broad potential to upset the balance between tolerance and immunity.

背景与目标： : 在自身免疫的多种鼠模型中，最类似于人类系统性红斑狼疮 (SLE) 的三种是MRL/lpr，新西兰黑/白F(1) 和雄性BXSB。尽管这些菌株具有许多疾病特征，但以前在所有这些菌株的患病小鼠中未发现常见的细胞缺陷。我们在这项研究中表明，来自所有三种SLE易患菌株的患病小鼠的巨噬细胞，以及来自其基因组有助于SLE发展的小鼠的巨噬细胞 (MRL/，新西兰白人，新西兰黑人，雌性BXSB和LG/J)，凋亡细胞触发的细胞因子表达具有相同且深刻的缺陷。令人惊讶的是，测试的13种非自身免疫菌株均未显示出这种缺陷。鉴于凋亡Ags已被越来越多地视为自身抗体的靶标，凋亡细胞触发的细胞因子表达缺陷具有破坏耐受性和免疫力之间平衡的广泛潜力。

BACKGROUND & AIMS: :The lives of recipients of peripheral blood progenitor cells (PBPC) depend upon the availability of PBPC. Rupture of stem cell bags does occur and can have devastating consequences. Each transplant center should agree on a rescue procedure and train its personnel to use it. We provide an example of such a procedure, and its update after the procedure was used for the first time.

背景与目标： : 外周血祖细胞 (PBPC) 接受者的生命取决于PBPC的可用性。干细胞袋确实会破裂，并可能造成毁灭性的后果。每个移植中心应就抢救程序达成一致，并培训其人员使用该程序。我们提供了这样一个过程的示例，以及该过程首次使用后的更新。

BACKGROUND & AIMS: :Early tracheal extubation in the operating room after atrial septal defect (ASD) surgery was recommended as part of a clinical practice guideline (CPG) established in the Cardiovascular Program at the Children's Hospital, Boston, MA. This retrospective review was undertaken to determine whether this practice was efficient without compromising patient care. The charts and hospital charges for 102 patients undergoing secundum ASD or sinus venosus defect surgery between March 1992 and July 1994 were reviewed; 36 patients (Group I) had surgery prior to introduction of the CPG, and 66 patients were managed according to the CPG. Of the latter, 25 patients (Group II) were tracheally extubated in the operating room (OR) and 41 patients (Group III) were extubated in the cardiac intensive care unit (CICU). Patients in all three groups were similar with respect to height, weight, and surgical conditions including cardiopulmonary bypass time, lowest esophageal temperature, hematocrit, total OR time, and the time from completion of bypass to leaving the OR. Patients in Group II received significantly less fentanyl during anesthesia, were more likely to have a respiratory acidosis on admission to the CICU, and had an increased frequency of vomiting in the CICU. There was no difference in duration of CICU stay among groups. The length of hospital stay was reduced in Groups II and III after introduction of the CPGs, but was not influenced by tracheal extubation in the OR. There was no difference among groups in the hospital charges for OR, anesthesia and CICU time. However, when the combined hospital charges for services provided both in the OR and CICU were included, patients in Group II were charged significantly less, and this primarily reflects the absence of postoperative mechanical ventilation charges. Tracheal extubation in the OR after ASD surgery in children can result in lower patient charges without significantly compromising patient care.

背景与目标： : 建议将房间隔缺损 (ASD) 手术后在手术室进行早期气管拔管，作为马萨诸塞州波士顿儿童医院心血管计划中建立的临床实践指南 (CPG) 的一部分。进行这项回顾性审查是为了确定这种做法在不影响患者护理的情况下是否有效。回顾了1992年3月至1994年7月之间接受secundum ASD或鼻窦静脉缺损手术的102例患者的图表和住院费用; 36例患者 (I组) 在引入CPG之前进行了手术，66例患者根据CPG进行了治疗。在后者中，25例患者 (II组) 在手术室 (OR) 气管拔管，41例患者 (III组) 在心脏重症监护病房 (CICU) 拔管。三组患者的身高，体重和手术条件相似，包括体外循环时间，最低食管温度，血细胞比容，总或时间以及从旁路完成到离开OR的时间。第二组患者在麻醉期间接受的芬太尼明显减少，入院时更容易出现呼吸性酸中毒，并且在CICU中呕吐的频率增加。各组间CICU停留时间无差异。引入CPGs后，II组和III组的住院时间减少了，但不受OR中气管拔管的影响。两组之间的医院费用，麻醉和CICU时间没有差异。但是，如果将OR和CICU中提供的服务的合并医院费用包括在内，则II组患者的费用明显减少，这主要反映了术后没有机械通气费用。儿童ASD手术中或之后的气管拔管可降低患者费用，而不会显着影响患者的护理。

BACKGROUND & AIMS: :A cost-minimization analysis was performed to compare the direct costs of various neuromuscular blocking agents (NMBAs) in procedures of specific durations. Secondary objectives were to review the role of the NMBAs studied with respect to their place on our hospital formulary, and to develop a pharmacoeconomic methodology to be applied to other formulary decisions. Patients were stratified according to estimated length of surgical procedure; group 1 (55 patients) included surgeries estimated to take less than 2 hours, and group 2 (55 patients) included those estimated to be 2-4 hours long. Patients were then randomized to one of three intermediate-acting NMBAs: atracurium, vecuronium, or rocuronium. Anesthesia records were used to obtain all anesthetic agents administered in the operating room, and drug costs were calculated from hospital drug acquisition costs as of December 1994. Postanesthesia care unit (PACU) costs were estimated from patient charges and converted to costs using our hospital's cost-to-charge ratio. Costs that were common to all study treatments or unrelated to the use of NMBAs were excluded from the analysis. Two time-adjusted costs were calculated to determine the cost of neuromuscular blockade/hour and the total anesthesia drug costs/hour. In group 1 there were no statistical differences in NMBA cost/hour, anesthesia cost/hour, or PACU times or costs. In group 2, a significant difference was found in NMBA cost/case between atracurium ($54.23 +/- 41.26, mean +/- SD) and vecuronium ($31.95 +/- 15.33, p = 0.046). Atracurium was also significantly more costly than either vecuronium or recuronium/hour ($21.95 +/- 7.42 vs $14.39 +/- 7.02 and $16.07 +/- 8.15, respectively, p = 0.011) and anesthesia cost/hour ($28.77 +/- 7.43 vs $ 22.82 +/- 7.46 and $23.32 +/- 6.54, respectively, p = 0.03). There were no differences in PACU times or costs. Based on these results, vecuronium or rocuronium is preferred over atracurium in procedures with an estimated duration of 2-4 hours. In the patient population evaluated, there were no significant cost differences among the three NMBAs in surgeries with an estimated duration of less than 2 hours.

背景与目标： : 进行了成本最小化分析，以比较在特定持续时间内各种神经肌肉阻滞剂 (nmba) 的直接成本。次要目标是审查研究的nmba在我们医院处方集中的位置方面的作用，并开发可应用于其他处方集决策的药物经济学方法。根据估计的手术时间对患者进行分层; 第1组 (55例患者) 包括估计时间少于2小时的手术，第2组 (55例患者) 包括估计时间为2-4小时的手术。然后将患者随机分配到三种中效NMBAs之一: 阿曲库铵，维库溴铵或罗库溴铵。麻醉记录用于获取手术室中使用的所有麻醉剂，并根据1994年12月的医院药物获取成本计算药物成本。麻醉后护理单元 (PACU) 的费用是根据患者费用估算的，并使用我们医院的费用与费用比率转换为费用。所有研究治疗的共同费用或与使用NMBAs无关的费用被排除在分析之外.计算两个时间调整后的成本，以确定神经肌肉阻滞/小时的成本和总麻醉药物成本/小时。在第1组中，NMBA成本/小时，麻醉成本/小时或PACU时间或成本没有统计学差异。在第2组中，阿曲库铵 ($54.23/- 41.26，平均值/- SD) 和维库溴铵 ($31.95/- 15.33，p = 0.046) 之间的NMBA成本/案例存在显着差异。阿曲库铵的成本也明显高于维库溴铵或复发性/小时 (分别为 $21.95/- 7.42与 $14.39/- 7.02和 $16.07/- 8.15，p = 0.011) 和麻醉费用/小时 (分别为 $28.77/- 7.43 vs $22.82/- 7.46和 $23.32/- 6.54，p = 0.03)。PACU时间或费用没有差异。基于这些结果，在估计持续时间为2-4小时的程序中，维库溴铵或罗库溴铵比阿曲库铵更受欢迎。在评估的患者人群中，在估计持续时间少于2小时的手术中，三个nmba之间的成本没有显着差异。

BACKGROUND & AIMS: :All adult BALB/c mice immunized with hen egg white lysozyme (HEL) or its dominant determinant, peptide (p)106-116, mount a T cell response using a "public" Vbeta8.2Jbeta1.5 T cell clone. Neonatal exposure to tolerance-inducing doses of antigen can drastically diminish responsiveness in the draining lymph nodes but not in the spleens of animals challenged as adults with the cognate antigen. To determine the role of T cell deletion or anergy within the mechanisms of observed neonatal "tolerance," we treated neonatal BALB/c mice with HEL and directly followed the characteristic public clone using complementarity determining region 3 length T cell repertoire analysis. Our results confirm that despite intraperitoneal injection of neonates with a high dose of HEL emulsified in incomplete Freund's adjuvant, a strong splenic proliferative response to HEL was observed upon recall. However, the adult splenic T cell response of these neonatally treated mice lacked the usual Vbeta8.2Jbeta1.5 public clone characteristic of HEL-primed BALB/c mice. After challenge with HEL-complete Freund's adjuvant as adults, immunoglobulin (Ig)G2a isotype antibody was drastically reduced, and IgG1 was found to be the predominant anti-HEL IgG isotype expressed, indicating a deviation of cytokine response toward T helper type 2. 5-wk-old mice, nasally instilled with tolerogenic doses of HEL p106-116, also showed significant inhibition of this public T cell expansion. These results demonstrate that during neonatal and adult nasal tolerance induction, deletion/anergy removes the public clone, exposing a response of similar specificity but that is characterized by the T helper type 2 phenotype and a splenic residence.

背景与目标： : 所有用鸡蛋清溶菌酶 (HEL) 或其主要决定簇肽 (p)106-116免疫的成年BALB/c小鼠，均使用 “公共” Vbeta8.2Jbeta1.5 T细胞克隆进行T细胞反应。新生儿暴露于诱导耐受剂量的抗原会大大降低引流淋巴结的反应性，但不会降低成年受到同源抗原攻击的动物脾脏的反应性。为了确定T细胞缺失或无反应性在观察到的新生儿 “耐受性” 机制中的作用，我们用HEL处理了新生BALB/c小鼠，并使用互补决定区域3长度的T细胞库分析直接跟踪了特征性的公共克隆。我们的结果证实，尽管在不完全弗氏佐剂中腹膜内注射了高剂量的HEL乳化新生儿，但在回忆时仍观察到对HEL的强烈脾脏增殖反应。然而，这些新生儿治疗的小鼠的成年脾T细胞反应缺乏HEL引发的BALB/c小鼠通常的Vbeta8.2Jbeta1.5公共克隆特征。成年后，用HEL-complete弗氏佐剂攻击后，免疫球蛋白 (Ig)G2a同种型抗体急剧减少，发现IgG1是表达的主要抗HEL IgG同种型，表明细胞因子对T辅助性2的反应存在偏差。5周龄小鼠，鼻腔滴注耐受剂量的HEL p106-116，也显示出显著抑制这种公共T细胞的扩增。这些结果表明，在新生儿和成人鼻耐受诱导期间，缺失/无反应性去除了公共克隆，暴露出类似特异性的反应，但其特征是T辅助2型表型和脾脏停留。