BACKGROUND & AIMS: :A novel mechatronic body weight support (BWS) system has been developed to provide precise body weight unloading for patients with neurological or other impairments during treadmill training. The system is composed of a passive elastic spring element to take over the main unloading force and an active closed-loop controlled electric drive to generate the exact desired force. Both force generating units, the passive spring and the active electric drive, act on the patient via a polyester rope connected to a harness worn by the patient. The length of the rope can be adjusted with an electric winch to adapt the system to different patient sizes. The system is fully computer controlled. At unloading loads of up to 60 kg and walking speeds of up to 3.2 km/h, the mean unloading error and the maximum unloading error of the presented BWS system was less than 1 and 3 kg, respectively. The performance was compared with those of two purely passive BWS systems currently being used by most other rehabilitation groups. This comprised counterweight systems and static BWS systems with fixed rope lengths. Counterweight systems reached mean and maximum unloading errors of up to 5.34 and 16.22 kg, respectively. The values for the static BWS were 11.02 kg and 27.67 kg, respectively. The novel mechatronic BWS system presented in this study adjusts desired unloading changes of up to 20 kg within less than 100 ms. Thus, not only constant BWS, but also gait cycle dependent or time variant oscillations of the desired force can be realized with high accuracy. Precise and constant unloading force is believed to be an important prerequisite for BWS gait therapy, where it is important to generate physiologically correct segmental dynamics and ground reaction forces. Thus, the novel BWS system presented in this paper is an important contribution to maximize the therapeutic outcome of human gait rehabilitation.

背景与目标： ：已开发出新型机电一体化体重支持（BWS）系统，以在跑步机训练期间为患有神经系统疾病或其他障碍的患者提供精确的体重减轻。该系统由一个被动的弹性弹簧元件（承担主要的卸载力）和一个主动的闭环控制电驱动装置组成，以产生确切的所需力。被动发条和主动电驱动两个力产生单元均通过连接到患者佩戴的安全带上的聚酯绳作用在患者身上。绳索的长度可以用电动绞盘调节，以使系统适应不同的患者体型。该系统完全由计算机控制。在最高60 kg的卸载负荷和最高3.2 km / h的步行速度下，所提出的BWS系统的平均卸载误差和最大卸载误差分别小于1 kg和3 kg。将该性能与大多数其他康复团体目前使用的两个纯被动BWS系统的性能进行了比较。这包括配重系统和具有固定绳索长度的静态BWS系统。配重系统的平均和最大卸载误差分别高达5.34和16.22 kg。静态BWS的值分别为11.02 kg和27.67 kg。这项研究中提出的新型机电一体化BWS系统可在不到100 ms的时间内将所需的卸荷变化调整至20 kg。因此，不仅可以实现恒定的BWS，而且还可以高精度地实现与步态周期有关的或所需力的随时间变化的振荡。精确和恒定的卸载力被认为是BWS步态治疗的重要前提，在步态治疗中，产生生理上正确的节段动力学和地面反作用力很重要。因此，本文提出的新型BWS系统是最大程度地提高步态康复治疗效果的重要贡献。

BACKGROUND & AIMS: OBJECTIVE:To identify and review early complications in the operative treatment of patella fractures. DESIGN:Retrospective review. SETTING:Single tertiary care institution with multiple surgeons, including generalists and fellowship trained subspecialists. PATIENTS:A consecutive series of eighty-seven patella fractures over a five year period was reviewed. Patients treated nonoperatively or with partial or total patellectomy were excluded. Minimum follow-up to fracture healing (four months) was available in fifty-one fractures. INTERVENTION:Modified tension band wire fixation was used in forty-nine fractures, whereas two fractures were treated with tension band wires threaded through cannulated screws. OUTCOME MEASURES:Early complications such as loss of reduction or fixation, infection, or soft-tissue problems were evaluated. RESULTS:Displacement of > or = 2 mm before healing was noted in eleven fractures. The displacement could be attributed to technical errors in five cases, and to patient noncompliance with postoperative activity restrictions in another five cases. Two cases of superficial infection were documented. Nine patients with symptomatic hardware required hardware removal. CONCLUSIONS:Twenty-two percent of fractures treated with tension band wiring and early motion displaced > or = 2 mm within the early postoperative period. Technical errors or patient noncompliance were identified as factors. The incidence of early complications in operatively treated patella fractures is higher than previously reported.

背景与目标： 目的：确定并回顾early骨骨折手术治疗的早期并发症。
设计：回顾性审查。
地点：拥有多名外科医生的单一三级护理机构，包括通才和经过研究金培训的专科医师。
患者：回顾了五年内连续发生的87例骨骨折。排除非手术治疗或部分或全部pa骨切除术的患者。对五十一个骨折进行了最少的骨折愈合随访（四个月）。
干预：改良的张力带钢丝固定术用于49处骨折，而两个骨折均用穿过空心螺钉的张力带钢丝治疗。
观察指标：评估早期并发症，如复位或固定丢失，感染或软组织问题。
结果：在11处骨折中发现愈合前位移>或= 2 mm。该移位可归因于五例病例中的技术错误，以及另外五例归因于患者不遵守术后活动限制的情况。记录了两例浅表感染病例。九名有症状硬件的患者需要移除硬件。
结论：在术后早期，有22％的骨折采用张力带连线治疗并且早期运动移位>或= 2 mm。技术错误或患者违规被确定为因素。经手术治疗的骨骨折早期并发症的发生率高于以前的报道。

BACKGROUND & AIMS: :In a patient with temporomandibular disorder who does not respond to conservative treatment, treatment with intra-articular injection of high molecular weight sodium hyaluronate can be suggested. In our study, 27 patients with nonreduced disc displacement were diagnosed clinically and confirmed by magnetic resonance imaging. The age range was from 21 to 63 years old, with a mean of 39.3 years. Two cycles of injection of high molecular weight sodium hyaluronate was performed on alternative weeks. Pain intensity was measured by the visual analog scale. Maximal mouth opening, clicking joint noise, and lateral movement were measured before and after injection for more than 6 months. Reduction of pain intensity and improvement in the maximum mouth opening parameter was statistically significant. In conclusion, this intra-articular injection using high molecular weight sodium hyaluronate looks very positive for patients affected by nonreduced disc displacement and is encouraged to be used as a primary treatment of temporomandibular joint dysfunction.

背景与目标： ：对于颞下颌关节疾病，对保守治疗无反应的患者，建议采用关节内注射高分子量透明质酸钠进行治疗。在我们的研究中，临床上诊断出27例椎间盘移位未减少的患者，并通过磁共振成像对其进行了确认。年龄范围是21至63岁，平均39.3岁。每隔几个星期进行两次高分子量透明质酸钠注射。通过视觉模拟量表测量疼痛强度。在注射前后超过6个月，测量了最大张口，咔嗒声和侧向运动。疼痛强度的降低和最大张口参数的改善在统计学上是显着的。总之，这种高分子量透明质酸钠的关节腔内注射对于未减少椎间盘移位的患者看起来非常积极，因此被鼓励用作颞下颌关节功能障碍的主要治疗方法。

BACKGROUND & AIMS: BACKGROUND:Second-generation antipsychotics are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been developed for monitoring metabolic and neurological complications. To assist practitioners who perform these monitoring procedures, a complementary set of treatment recommendations have been created for situations in which abnormal measurements or results are encountered. OBJECTIVE:To create evidence-based recommendations to assist in managing metabolic complications in children being treated with second-generation antipsychotics. METHODS:A systematic review of the literature on metabolic complications of second-generation antipsychotic medications in children was conducted. Members of the consensus group evaluated the information gathered from the systematic review of the literature and used a nominal group process to reach a consensus on treatment recommendations. Wherever possible, references were made to existing guidelines on the evaluation and treatment of metabolic abnormalities in children. RESULTS:Evidence-based recommendations are presented to assist in managing metabolic complications including weight gain; increased waist circumference; elevation in prolactin, cholesterol, triglyceride and glucose levels; abnormal liver function tests and abnormal thyroid studies. CONCLUSION:The use of second-generation antipsychotics requires proper monitoring procedures. The present treatment guideline provides guidance to clinicians on the clinical management of metabolic complications if they occur.

背景与目标： 背景：第二代抗精神病药通常与代谢并发症相关。这些药物被更频繁地用于治疗儿童的精神疾病，这刺激了建立监测其安全性和有效性的正式指南的需求。已经开发了用于监测代谢和神经系统并发症的先前指南。为了帮助执行这些监视程序的从业人员，针对遇到异常测量或结果的情况，创建了一组补充的治疗建议。
目的：建立基于证据的建议，以帮助管理接受第二代抗精神病药治疗的儿童的代谢并发症。
方法：对儿童第二代抗精神病药物的代谢并发症的文献进行了系统的综述。共识小组成员评估了从文献系统回顾中收集的信息，并使用名义上的小组程序就治疗建议达成共识。尽可能参考有关儿童代谢异常评估和治疗的现有指南。
结果：提出了循证医学建议，以帮助控制包括体重增加在内的代谢并发症。腰围增加；催乳激素，胆固醇，甘油三酸酯和葡萄糖水平升高；肝功能检查异常和甲状腺检查异常。
结论：使用第二代抗精神病药需要适当的监测程序。本治疗指南为临床医生就代谢并发症（如果发生）的临床管理提供了指导。

BACKGROUND & AIMS: INTRODUCTION:The role of the volume of radicular and dentigerous cysts on clinical symptoms is unclear and potentially may predict development of pre- and postoperative complications, especially after cystectomies with large bony defects. Therefore the aim of this study was to assess pre- and postoperative symptoms associated to the volume of jaw cysts. MATERIAL AND METHODS:Retrospective chart review of 111 patients with follicular or dentigerous cysts from 2008-2012. Anterior iliac crest grafts were used to fill defects after cystectomy. χ2-test was performed to analyze associations between two qualitative variables. Binary logistic regression analysis was used as multivariate analysis. P-values p < 0.05 were considered as significant. Volume measurement was performed in a semiautomatic segmentation method with the software "ITK-Snap". RESULTS:Postoperative hypaesthesia correlated significantly with histology (p = 0.025) and localization (p = 0.006). Volume was associated significantly with preoperative hypaesthesia (p = 0.052), postoperative hypaesthesia (p < 0.001), wound healing complications (p < 0.001) and length of wound healing complications (p = 0.001). Multivariate analysis identified volume as independent risk factor for postoperative hypaesthesia (p = 0.015). CONCLUSIONS:Volume analysis appears to be a method that allows risk stratification after surgery of jaw cysts. Therefore we recommend a precise treatment planning with the means of volume analysis to improve therapy outcome of patients with jaw cysts.

背景与目标： 引言：根管性和牙状囊肿的体积在临床症状上的作用尚不清楚，可能潜在地预测术前和术后并发症的发生，特别是在具有大骨缺损的膀胱切除术之后。因此，本研究的目的是评估与颌骨囊肿体积相关的术前和术后症状。
材料与方法：回顾性分析2008年至2012年间111例滤泡性或齿状囊肿患者的病历。膀胱切除术后，使用前terior骨移植物填补缺损。进行χ2检验以分析两个定性变量之间的关联。二元逻辑回归分析用作多元分析。 P值p <0.05被认为是显着的。使用软件“ ITK-Snap”以半自动分割方法进行体积测量。
结果：术后感觉低下与组织学（p = 0.025）和局限性（p = 0.006）显着相关。容量与术前感觉不足（p = 0.052），术后感觉不足（p <0.001），伤口愈合并发症（p <0.001）和伤口愈合并发症的时间（p = 0.001）显着相关。多变量分析确定了体积为术后感觉不足的独立危险因素（p = 0.015）。
结论：体积分析似乎是一种允许对颌骨囊肿手术进行风险分层的方法。因此，我们建议采用体积分析的方法制定精确的治疗计划，以改善颌骨囊肿患者的治疗效果。

BACKGROUND & AIMS: OBJECTIVE:The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. STUDY DESIGN:In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265). The study population was followed until 2013. A total of 364 553 mother-firstborn-offspring pairs were analyzed. Sixty-one women with Marfan syndrome became mothers. Women with Marfan syndrome were also compared to 543 healthy controls. RESULTS:Women with Marfan syndrome were more often born preterm (p<0.001), small-for-gestational age (p<0.001), and delivered by cesarean section (p=0.001). Women with Marfan syndrome had no increased risk of giving birth by cesarean section (p=0.079). No increased neonatal risks in their children were found. Women with Marfan syndrome were less likely to give birth than those without (p<0.001). There were no maternal deaths. CONCLUSIONS:Women with Marfan syndrome were more likely to be born preterm, SGA and by cesarean section. These increased risks of preterm birth and SGA babies were not found in connection with their own first childbirth. Pregnancies with known fetal Marfan syndrome have to be carefully monitored. The results are important for obstetricians giving preconception counseling and treating women with Marfan syndrome. Further studies are needed to evaluate risks during pregnancy and long-term effects of pregnancy on the cardiovascular status of women with Marfan syndrome.

背景与目标： 目的：由于仅对马凡氏综合征妇女的妊娠相关结局进行了稀疏调查，因此目的是通过瑞典国家登记簿调查马凡氏综合征妇女的首次生育的​​出生特征，产科和新生儿结局。
研究设计：在这项基于全国人群的队列研究和匹配的病例对照研究中，对1973年至1993年出生的瑞典妇女进行了比较，将患有马凡氏综合症（n = 273）的妇女与未患此病的妇女（n = 1 017 265）进行了比较。研究人群一直追踪到2013年。共分析了364 553对母亲-第一胎-后代。六十一名患有马凡氏综合症的妇女成为母亲。还比较了患有马凡氏综合症的女性和543名健康对照者。
结果：马凡氏综合征的妇女更早产（p <0.001），小胎龄（p <0.001），并通过剖宫产分娩（p = 0.001）。患有马凡氏综合症的妇女通过剖宫产术分娩的风险没有增加（p = 0.079）。没有发现孩子的新生儿患病风险增加。患有马凡氏综合症的妇女比没有马芬综合症的妇女分娩的可能性更低（p <0.001）。没有孕产妇死亡。
结论：马凡氏综合征的女性更可能早产，SGA和剖宫产。未发现早产和SGA婴儿的这些增加的风险与他们的初生有关。患有已知胎儿马凡氏综合征的孕妇必须进行仔细监测。这些结果对于产科医生进行孕前咨询和治疗患有马凡氏综合症的妇女非常重要。需要进一步的研究来评估妊娠期间的风险以及妊娠对马凡氏综合症女性心血管状况的长期影响。

BACKGROUND & AIMS: BACKGROUND:Inconsistent evidence of a higher risk of adverse perinatal outcomes during off-hours compared to office hours necessitated a search for clear evidence of an association between time of birth and adverse perinatal outcomes. METHODS:A cross-sectional study conducted at a tertiary referral hospital compared perinatal outcomes across three working shifts over 24 h. A checklist and a questionnaire were used to record parturients' socio-demographic and obstetric characteristics, mode of delivery and perinatal outcomes, including 5th minute Apgar score, and early neonatal mortality. Risks of adverse outcomes included maternal age, parity, referral status and mode of delivery, and were assessed for their association with time of delivery and prevalence of fresh stillbirth as a proxy for poor perinatal outcome at a significance level of p = 0.05. RESULTS:Off-hour deliveries were nearly twice as likely to occur during the night shift (odds ratio (OR), 1.62; 95% confidence interval (CI), 1.50-1.72), but were unlikely during the evening shift (OR, 0.58; 95% CI, 0.45-0.71) (all p < 0.001). Neonatal distress (O.R, 1.48, 95% CI; 1.07-2.04, p = 0.02), early neonatal deaths (OR, 1.70; 95% CI, 1.07-2.72, p = 0.03) and fresh stillbirths (OR, 1.95; 95% CI, 1.31-2.90, p = 0.001) were more significantly associated with deliveries occurring during night shifts compared to evening and morning shifts. However, fresh stillbirths occurring during the night shift were independently associated with antenatal admission from clinics or wards, referral from another hospital, and abnormal breech delivery (OR 1.9; 95% CI, 1.3-2.9, p = 0.001, for fresh stillbirths; OR, 5.0; 95% CI 1.7-8.3, p < 0.001, for antenatal admission; OR, 95% CI, 1.1-2.9, p < 0.001, for referral form another hospital; and OR 1.6; 95% CI 1.02-2.6, p = 0.004, for abnormal breech deliveries). CONCLUSION:Off-hours deliveries, particularly during the night shift, were significantly associated with higher proportions of adverse perinatal outcomes, including low Apgar score, early neonatal death and fresh stillbirth, compared to morning and evening shifts. Labour room admissions from antenatal wards, referrals from another hospital and abnormal breech delivery were independent risk factors for poor perinatal outcome, particularly fresh stillbirths.

背景与目标： 背景：与办公时间相比，非工作时间不利于围产期结局的风险的证据不一致，因此有必要寻找明确的证据来证明出生时间与不良围产期结局之间的关联。
方法：在一家三级转诊医院进行的横断面研究比较了24小时内三个工作班次的围产期结局。使用检查表和调查表记录产妇的社会人口统计学和产科特征，分娩方式和围产期结局，包括第5分钟的Apgar评分和新生儿早期死亡率。不良结局的风险包括产妇年龄，胎次，转诊状况和分娩方式，并评估了它们与分娩时间和新鲜死产的发生率之间的关联，以作为围产期预后不良的指标，其显着性水平为p = 0.05。
结果：夜班期间的下班时间交付几率几乎翻倍（几率（OR）为1.62; 95％置信区间（CI）为1.50-1.72），但在晚班期间则不太可能出现（OR为0.58） ; 95％CI，0.45-0.71）（所有p <0.001）。新生儿窘迫（OR，1.48，95％CI; 1.07-2.04，p = 0.02），早期新生儿死亡（OR，1.70; 95％CI，1.07-2.72，p = 0.03）和新鲜死产（OR，1.95; 95％ CI，1.31-2.90，p = 0.001）与夜班和早班相比，与夜班期间的分娩更显着相关。但是，夜班期间发生的新鲜死产与从诊所或病房的产前入院，从另一家医院转诊以及异常的臀位分娩独立相关（OR 1.9;新鲜死产的95％CI，1.3-2.9，p = 0.001;或者； 5.0； 95％CI 1.7-8.3，p <0.001（对于产前入院）；或95％CI，1.1-2.9，p <0.001，对于从另一家医院转诊；或OR 1.6； 95％CI 1.02-2.6，p = 0.004，用于异常臀位）。
结论：与早班和晚班相比，非工作时间的分娩，特别是在夜班期间，与较高的围产期不良后果显着相关，包括低的Apgar评分，早期的新生儿死亡和新鲜的死产。从产前病房分娩，从另一家医院转诊以及异常的臀位分娩是围产期预后不良（尤其是新鲜死产）的独立危险因素。

BACKGROUND & AIMS: INTRODUCTION:Chronic lymphocytic leukemia (CLL) is a disorder of mature but dysfunctional monoclonal B cells. Microenvironment, antigenic stimulation and genetical mutations are demonstrated in etiopathogenesis. We aimed to evaluate the expression of CD11c in patients with CLL and its possible clinical significance. METHODS:Data of 259 patients with CLL between 2010 and 2016 in Trakya University Faculty of Medicine, including age at diagnosis, sex, whole blood count, stage, percentage of CLL cells in bone marrow, line of treatments, development of Richter's transformation and secondary tumors, autoimmune complications, IgG level, prognostic cytogenetic analysis, and length of survival were recorded from files. RESULTS:151 patients were male (58.3%) and 108 were male (41.7%). Mean age was 70 (21-92) years. CD11c was observed to be positive (>%20) in 103 patients (39.8%). Development of Richter's transformation, secondary tumors and ITP was significantly frequent in patients with CD11c positivity (P values .000, .003, .000 respectively). Also, IgG levels were significantly lower in this group (P = .000). Hemoglobin level, RAI stage and bone marrow CLL infiltration percentage were statistically related with CD11c (P values .036, .037, .000 respectively). Finally, CD11c was statistically related (in positive group 70 months, negative group 79 months, P = .001). CONCLUSION:CD11c, expressed not only in Hairy cell leukemia but also in dendritic cells, macrophages and monocytes is a differentiation marker for inflammation. Prolonged inflammation in the microenvironment of CLL cells may cause a susceptibility to autoimmune disorders and secondary tumors in CLL, in this way, an increase in mortality.

背景与目标： 简介：慢性淋巴细胞性白血病（CLL）是一种成熟但功能失调的单克隆B细胞疾病。微环境，抗原刺激和遗传突变已在病因学中得到证实。我们旨在评估CD11c在CLL患者中的表达及其可能的临床意义。
方法：特拉基亚大学医学院2010年至2016年间259例CLL患者的数据，包括诊断年龄，性别，全血细胞计数，分期，骨髓CLL细胞百分比，治疗方法，里氏转化的发展和继发性从文件中记录肿瘤，自身免疫并发症，IgG水平，预后细胞遗传学分析和生存期。
结果：男性151例，占58.3％；男性108例，占41.7％。平均年龄为70（21-92）岁。在103例患者中（39.8％）观察到CD11c阳性（>）。 CD11c阳性患者中Richter转化，继发性肿瘤和ITP的发生非常频繁（分别为P值.000，.003，.000）。此外，该组的IgG水平显着降低（P = .000）。血红蛋白水平，RAI分期和骨髓CLL浸润百分比与CD11c具有统计学相关性（P值分别为.036，.037和.000）。最后，CD11c具有统计学相关性（阳性组70个月，阴性组79个月，P = .001）。
结论：CD11c不仅在毛细胞白血病中表达，而且在树突状细胞，巨噬细胞和单核细胞中表达，是炎症的分化标志。 CLL细胞微环境中的长时间炎症可能会导致自身免疫性疾病和CLL中继发性肿瘤的易感性，从而增加死亡率。

BACKGROUND & AIMS: Perforin is a 68 kD protein found in the granules of cytotoxic lymphocytes and is used by lymphocytes to form lethal pores in the membranes of the cells they kill. We and others have found that when perforin is purified, its lytic activity is markedly reduced. ELISAs indicated that our final recovery of perforin protein was excellent. We decided to determine if depletion of other granule proteins contributed to the loss of lytic activity. We isolated perforin to the point where lytic activity was diminished and added back granule proteins that had no lytic activity or detectable (antigenic) perforin. Perforin was isolated by Cu2+-immobilized metal affinity chromatography (IMAC) followed by phenyl-Superose hydrophobic interaction chromatography (HIC). Its lytic activity was enhanced by a low molecular weight (<15 kD) protein, perforin enhancing protein (PEPr). We have isolated PEPr by two methods, HIC and MonoQ. Nonlytic PEPr restored perforin to close to its original lytic activity. A protein similar if not identical to PEPr was also detectable as an 125I-labeled protein associated with lytic perforin. We propose that PEPr acts in conjunction with perforin to form lethal pores and suggest that PEPr may be the rat equivalent of the human cytotoxic lymphocyte protein, granulysin.

背景与目标： 穿孔素是一种68 kD蛋白，存在于细胞毒性淋巴细胞的颗粒中，被淋巴细胞用来在其杀死的细胞膜上形成致死孔。我们和其他人已经发现，当穿孔素被纯化时，其裂解活性显着降低。 ELISA法表明，我们穿孔蛋白的最终回收率极高。我们决定确定其他颗粒蛋白的消耗是否导致裂解活性降低。我们将穿孔素分离到溶解活性降低的位置，并添加没有溶解活性或可检测（抗原性）穿孔素的颗粒蛋白。通过铜固定化金属亲和色谱法（IMAC），然后进行苯基-Superose疏水相互作用色谱法（HIC）分离穿孔素。低分子量（<15 kD）蛋白，穿孔素增强蛋白（PEPr）增强了其裂解活性。我们通过两种方法HIC和MonoQ分离了PEPr。非溶解性PEPr使穿孔素恢复至接近其原始溶解活性。与PEPr相似但不相同的蛋白质也可以作为与裂解穿孔素相关的125 I标记蛋白质检测出来。我们建议PEPr与穿孔素一起形成致死性毛孔，并建议PEPr可能与人细胞毒性淋巴细胞蛋白颗粒溶素相当。

BACKGROUND & AIMS: Hormonal fluctuations associated with the menstrual cycle influence appetite control and eating behaviour. Energy intake varies during the reproductive cycle in humans and animals, with a periovulatory nadir and a luteal phase peak. Patterns of macronutrient selection show less consistency but a number of studies report carbohydrate cravings in the premenstrual phase, particularly in women with premenstrual syndrome. The cyclical nature of food cravings are frequently, but not invariably, associated with depression. Fluctuations in appetite, cravings and energy intake during the menstrual cycle may occur in parallel with cyclical rhythms in serotonin, which can be accompanied by affective symptoms. The premenstrual phase can be considered as a time when women are especially vulnerable to overconsumption, food craving and depression; this is often associated with low serotonin activity.

背景与目标： 与月经周期有关的荷尔蒙波动会影响食欲控制和饮食行为。在人类和动物的生殖周期中，能量的摄入量会有所不同，排卵期的最低点和黄体期相峰值。大量营养素选择的模式显示出较低的一致性，但是许多研究报告说在经前期对碳水化合物的渴望，特别是在经前期综合症的女性中。渴望食物的周期性通常与抑郁症有关，但并非总是如此。月经周期中食欲，食欲和能量摄入的波动可能与5-羟色胺的周期性节律同时发生，并伴有情感症状。经期可以被认为是妇女特别容易遭受过度消费，食物渴望和沮丧的时期。这通常与5-羟色胺活性低有关。

BACKGROUND & AIMS: :Postnatal developmental stages of lung parenchyma in rhesus monkeys is about one-third that of humans. Alveoli in humans are reported to be formed up to 8 yr of age. We used design-based stereological methods to estimate the number of alveoli (N(alv)) in male and female rhesus monkeys over the first 7 yr of life. Twenty-six rhesus monkeys (13 males ranging in age from 4 to 1,920 days and lung volumes from 41.7 to 602 cm(3), 13 females ranging in age from 22 to 2,675 days and lung volumes from 43.5 to 380 cm(3)) were necropsied and lungs fixed, isotropically oriented, fractionated, sampled, embedded, and sectioned for alveolar counting. Parenchymal, alveolar, alveolar duct core air, and interalveolar septal tissue volumes increased rapidly during the first 2 yr with slowed growth from 2 to 7 yr. The rate of change was greater in males than females. N(alv) also showed consistent growth throughout the study, with increases in N(alv) best predicted by increases in lung volume. However, mean alveolar volume showed little relationship with age, lung volume, or body weight but was larger in females and showed a greater size distribution than in males. Alveoli increase in number but not volume throughout postnatal development in rhesus monkeys.

背景与目标： ：恒河猴的肺实质的产后发育阶段约为人类的三分之一。据报道，人类肺泡的形成年龄高达8岁。我们使用基于设计的立体方法来估计生命的前7年中雄性和雌性恒河猴的肺泡（N（alv））数量。 26只猕猴（13只雄性，年龄从4到1,920天不等，肺活量从41.7到602 cm（3），13只雌性，年龄从22到2,675天不等，肺活量从43.5到380 cm（3））进行尸检并固定肺，各向同性，分馏，取样，包埋和切片，以进行肺泡计数。在最初的2年中，实质，肺泡，肺泡导管核心空气和肺泡间隔组织的体积迅速增加，而从2到7年的生长缓慢。男性的变化率大于女性。在整个研究过程中，N（alv）也显示出一致的增长，其中N（alv）的增加最好通过肺体积的增加来预测。但是，平均肺泡容量与年龄，肺活量或体重关系不大，但女性比男性更大，并且大小分布比男性更大。在猕猴的整个产后发育过程中，肺泡的数量增加，但体积没有增加。

BACKGROUND & AIMS: :This paper reports the proceedings of a consensus meeting on the incidence and complications of multiple gestation in Canada. In addition to background presentations about current and possible future practice in Canada, the expert panel also developed a set of consensus points. The need for infertility to be understood, and funded, as a healthcare problem was emphasized, along with recognition of the emotional impact of infertility. It was agreed that the goal of assisted reproduction treatment is the delivery of a single healthy infant and that even though many positive outcomes have resulted from twin or even triplet pregnancies, the potential risks associated with multiple pregnancy require that every effort be made to achieve this goal. The evidence shows that treatments other than IVF (such as superovulation and clomiphene citrate) contribute significantly to the incidence of multiple pregnancy. There is an urgent need for studies to understand better the usage and application of these other fertility technologies within Canada, as well as the non-financial barriers to treatment. The final consensus of the expert panel was that with adequate funding and good access to treatment, it will be possible to achieve the goal of reducing IVF-related multiple pregnancy rates in Canada by 50%.

背景与目标： ：本文报道了关于加拿大多胎妊娠的发生率和并发症的共识会议的会议记录。除了关于加拿大目前和将来可能的做法的背景介绍之外，专家小组还制定了一系列共识点。作为医疗保健问题，人们需要理解和资助不育症，并认识到不育症的情感影响。一致认为，辅助生殖治疗的目标是分娩一个健康的婴儿，即使双胞胎或什至三胞胎妊娠产生了许多积极的结果，但与多次妊娠相关的潜在风险仍需要尽一切努力来实现。目标。证据表明，除IVF之外的其他治疗（例如超排卵和柠檬酸克罗米芬）对多胎妊娠的发生率有显着影响。迫切需要进行研究以更好地了解加拿大其他这些生育技术的使用和应用，以及治疗的非财务障碍。专家小组的最终共识是，只要有足够的资金和良好的治疗机会，就有可能实现将加拿大IVF相关的多胎妊娠率降低50％的目标。

BACKGROUND & AIMS: :The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss-comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose-response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed.

背景与目标： ：大多数随机，对照试验（RCT）仅通过运动干预仅显示适度的体重减轻，而将运动干预与饮食限制相结合时，体重减轻则略有增加。在大多数随机对照试验中，通过处方运动产生的能量缺乏症远小于通常通过饮食限制产生的能量缺乏症。在规定进行高水平运动的前瞻性研究中，与通过热量限制产生类似能量不足所导致的体重减轻相比，已入组个体的体重减轻显着更大。但是，对于超重或肥胖的成年人来说，高强度的运动可能难以实现和维持。研究运动及其对减肥维持的影响的随机对照试验结果不一。然而，维持体重的干预措施通常持续时间有限，长期坚持锻炼存在问题。流行病学，横断面和前瞻性相关研究表明，体育锻炼对维持体重减轻至关重要，而对前瞻性试验的事后分析表明，体育锻炼与维持体重之间存在明显的剂量反应关系。本文回顾了体育锻炼在产生和维持体重减轻中的作用。我们专注于持续至少4个月的预期RCT；但是，还包括其他前瞻性试验，荟萃分析和大型系统评价。讨论了当前文献的局限性。

BACKGROUND & AIMS: :Periacetabular osteotomy (PAO) is a well established method to treat hip dysplasia in the adult. There is, however, a lack of information on the subjective outcome of patients with complications after PAO. The purpose of this study was therefore to assess the influence of complications on the patients' post-operative wellbeing and function: 60 PAOs on 50 patients were investigated retrospectively after a mean follow-up of 7.4 years. The patients' self-reported assessment of health and function was evaluated by the Medical Outcomes Short Form-36 (SF-36) and the Western Ontario and McMaster Universities (WOMAC) questionnaires at last follow-up. Forty healthy persons served as a control group. Of the 60 interventions 13 had no complications. Minor complications occurred in 25 (41%) and in 22 (37%) at least one major complication occurred. SF-36 summary measure was 76.4 for PAO patients and 90.3 for the control group. Mean WOMAC score was 25.1. Patients with major complications had a similar subjective outcome as patients with minor or without complications, but persistent dysaesthesia due to lateral femoral cutaneous nerve dysfunction led to a worse subjective function. Lesions of the lateral femoral cutaneous nerve have much greater influence on patients' self-assessed functional outcome after PAO than previously reported and greater attention has to be given to this supposedly minor complication.

背景与目标： 小前截骨术（PAO）是一种成熟的治疗成人髋关节发育不良的方法。但是，缺乏有关PAO术后并发症患者的主观结果的信息。因此，本研究的目的是评估并发症对患者术后健康和功能的影响：平均随访7.4年后，对50例患者的60个PAO进行了回顾性研究。在最后一次随访时，通过医学成果简表36（SF-36）和西安大略和麦克马斯特大学（WOMAC）的问卷对患者的健康和功能自我评估进行了评估。 40名健康人作为对照组。在60项干预措施中，有13项没有并发症。轻微并发症发生在25（41％）和22（37％）中，至少发生了一次重大并发症。 SF-36总结指标为PAO患者为76.4，对照组为90.3。 WOMAC平均得分为25.1。具有严重并发症的患者的主观结局与具有轻微并发症或无并发症的患者相似，但由于股外侧皮神经功能障碍导致的持续感觉异常导致主观功能变差。股外侧皮神经病变对PAO后患者自我评估的功能结局的影响要比以前报道的要大得多，因此必须对这种所谓的轻微并发症给予更大的关注。

BACKGROUND & AIMS: BACKGROUND:Airway anastomosis complications continue to be a source of morbidity for lung transplant recipients. METHODS:This study analyzes incidence, treatment, and follow-up of airway anastomotic complications occurring in 127 consecutive lung transplant airway anastomoses (77 single lung and 25 bilateral sequential lung). Complications were categorized as stenosis (11), granulation tissue (8), infection (7), bronchomalacia (5), or dehiscence (3). Follow-up after treatment ranged from 6 months to 4 years. RESULTS:Nineteen airway anastomosis complications (15.0%) occurred in 18 patients. Telescoping the airway anastomosis reduced the complication rate to 12 of 97 (12.4%), compared with 7 of 30 (23.3%) for omental wrapping, (p = 0.15). Complications developed in 13 of 77 single-lung airway anastomoses (16.9%) versus 6 of 50 bilateral sequential lung recipients (12.0%). Treatment consisted of stenting (9 airway anastomoses), bronchodilation (8), laser debridement (4), rigid bronchoscopic debridement (2), operative revision (2), and growth factor application (2). There was no difference in actuarial survival between patients with or without airway anastomosis complications (p = 1.0). CONCLUSIONS:Airway anastomosis complications can be successfully managed in the immediate or late postoperative period with good outcome up to 4 years after intervention.

背景与目标： 背景：气管吻合并发症仍然是肺移植接受者发病的来源。
方法：本研究分析了127例连续的肺移植气道吻合术（77例单肺和25例双侧序贯肺）发生的气道吻合并发症的发生率，治疗和随访情况。并发症分为狭窄（11），肉芽组织（8），感染（7），支气管软化（5）或裂开（3）。治疗后的随访时间为6个月至4年。
结果：18例患者发生了19例气道吻合并发症（15.0％）。伸缩气道吻合术使并发症发生率降低至97例中的12例（12.4％），而网膜包裹术的并发症发生率为30例中的7例（23.3％）（p = 0.15）。 77例单肺气道吻合中有13例发生了并发症（占16.9％），而50例双侧连续肺接受者中有6例发生了并发症（占12.0％）。治疗包括支架置入术（9例气道吻合术），支气管扩张术（8），激光清创术（4），硬支气管镜清创术（2），手术翻修（2）和生长因子应用（2）。有或没有气道吻合并发症的患者之间的精算生存率无差异（p = 1.0）。
结论：气道吻合并发症可在术后即刻或晚期成功治疗，干预后长达4年的效果良好。