BACKGROUND & AIMS: :Schwann cells (SCs) combined with acellular nerve allografts (ANAs) effectively promote the regeneration and repair of peripheral nerves, but the exact mechanism has not been fully elucidated. However, the disadvantages of SCs include their limited source and slow rate of expansion in vitro. Previous studies have found that adipose-derived stem cells have the ability to differentiate into Schwann-like cells. Therefore, we speculated that Schwann-like cells combined with ANAs could profoundly facilitate nerve regeneration and repair. The aim of the present study was to investigate the cellular and molecular mechanisms of regeneration and repair. In this study, tissue-engineered nerves were first constructed by adipose-derived Schwann-like cells and ANAs to bridge missing sciatic nerves. Then, the rats were randomly divided into five groups (n = 12 per group): a Control group; a Model group; an ADSC group; an SC-L group; and a DMEM group. Twelve weeks postsurgery, behavioral function tests and molecular biological techniques were used to evaluate the function of regenerated nerves and the relevant molecular mechanisms after sciatic nerve injury (SNI). The results showed that adipose-derived Schwann-like cells combined with ANAs markedly promoted sciatic nerve regeneration and repair. These findings also demonstrated that the expression of neurotrophic factors (NFs) was increased, and the expression of Janus activated kinase2 (JAK2)/P-JAK2, signal transducer and activator of transcription-3 (STAT3)/P-STAT3 was decreased in the spinal cord after SNI. Therefore, these results suggested that highly expressed NFs in the spinal cord could promote nerve regeneration and repair by inhibiting activation of the JAK2/STAT3 signaling pathway.

背景与目标： 雪旺细胞 (SCs) 联合脱细胞同种异体神经移植 (ANAs) 能有效促进周围神经的再生和修复，但其确切机制尚未完全阐明。然而，SCs的缺点包括来源有限和体外扩增速度慢。先前的研究发现，脂肪来源的干细胞具有分化为雪旺样细胞的能力。因此，我们推测雪旺样细胞与ANAs结合可以深度促进神经再生和修复。本研究的目的是研究再生和修复的细胞和分子机制。在这项研究中，组织工程神经首先由脂肪来源的雪旺样细胞和ANAs构建，以桥接缺失的坐骨神经。然后，将大鼠随机分为5组 (每组n   =   12): 对照组; 模型组; ADSC组; Sc-l组; DMEM组。术后12周，通过行为功能测试和分子生物学技术评估坐骨神经损伤 (SNI) 后再生神经的功能及其相关分子机制。结果表明，脂肪来源的雪旺样细胞与ANAs结合可明显促进坐骨神经的再生和修复。这些发现还表明，SNI后脊髓中神经营养因子 (NFs) 的表达增加，Janus激活激酶2 (JAK2)/P-JAK2，信号转导和转录激活因子3 (STAT3)/P-STAT3的表达减少。因此，这些结果表明，脊髓中高表达的NFs可以通过抑制JAK2/STAT3信号通路的激活来促进神经再生和修复。

BACKGROUND & AIMS: OBJECTIVE:Despite significant improvement in spinal cord function after in utero spina bifida (SB) repair compared with traditional postnatal repair, over half of the children who undergo this procedure do not benefit completely. This lack of benefit has been attributed to closure methods of the defect, with subsequent spinal cord tethering at the repair site. Hence, a regenerative patch or material with antiinflammatory and anti-scarring properties may alleviate comorbidities with improved outcomes. The authors' primary objective was therefore to compare cryopreserved human umbilical cord (HUC) versus acellular dermal matrix (ADM) patches for regenerative repair of in utero SB lesions in an animal model. METHODS:In vivo studies were conducted in retinoic acid-induced SB defects in fetuses of Sprague-Dawley rats. HUC or ADM patches were sutured over the SB defects at a gestational age of 20 days. Repaired SB defect tissues were harvested after 48-52 hours. Tissue sections were immunofluorescently stained for the presence of neutrophils, macrophages, keratinocytes, meningeal cells, and astrocytes and for any associated apoptosis. In vitro meningeal or keratinocyte cell coculture experiments with the ADM and HUC patches were performed. All experiments were scored quantitatively in a blinded manner. RESULTS:Neutrophil counts and apoptotic cells were lower in the HUC-based repair group (n = 8) than in the ADM patch repair group (n = 7). In the HUC patch repair group, keratinocytes were present on the outer surface of the patch, meningeal cells were present on the inner surface of the patch adjacent to the neural placode, and astrocytes were noted to be absent. In the ADM patch repair group, all 3 cell types were present on both surfaces of the patch. In vitro studies showed that human meningeal cells grew preferentially on the mesenchymal side of the HUC patch, whereas keratinocytes showed tropism for the epithelial side, suggesting an inherent HUC-based cell polarity. In contrast, the ADM patch studies showed no polarity and decreased cellular infiltration. CONCLUSIONS:The HUC patch demonstrated reduced acute inflammation and apoptosis together with superior organization in regenerative cellular growth when compared with the ADM patch, and is therefore likely the better patch material for in utero SB defect repair. These properties may make the HUC biomaterial useful as a "meningeal patch" during spinal cord surgeries, thereby potentially reducing tethering and improving on spinal cord function.

背景与目标：

BACKGROUND & AIMS: :Reduced-antigen, combined diphtheria, tetanus, and three-component acellular pertussis vaccine (Tdap; Boostrix(®)) is indicated for booster vaccination against diphtheria, tetanus, and pertussis. In clinical trials, a single booster dose of Tdap induced high seroprotective levels of antibodies to its three component acellular pertussis antigens in virtually all children and adolescents, and in a high proportion of adults and elderly individuals, at ≈1 month post-vaccination, irrespective of their vaccination history. Seropositivity rates for antibodies against pertussis toxin had begun to decline by 5 years after a booster dose of Tdap in adolescents/adults, with a subsequent booster dose 10 years later generally as immunogenic and as well tolerated as the initial booster. Tdap was safe and well tolerated in all age groups.

背景与目标： : 减抗原、白喉、破伤风和三组分无细胞百日咳疫苗 (Tdap; Boostrix (®)) 适用于白喉，破伤风和百日咳的加强疫苗接种。在临床试验中，单次Tdap加强剂量在几乎所有儿童和青少年中以及在成人和老年人中，在疫苗接种后约1个月时，都会对其三种成分的非细胞百日咳抗原诱导高血清保护水平的抗体，无论其疫苗接种史如何。在青少年/成人中，Tdap加强剂量后5年，针对百日咳毒素的抗体的血清阳性率开始下降，随后的加强剂量通常在10年后具有免疫原性，并且与最初的加强剂具有良好的耐受性。Tdap在所有年龄组均安全且耐受性良好。

BACKGROUND & AIMS: OBJECTIVES:To: (1) investigate the clinical efficacy of acellular dermal matrix allograft to achieve increased peri-implant keratinized mucosa around implants, and (2) evaluate the effect as to whether the increase of keratinized mucosa has a positive effect on oral hygiene. MATERIALS AND METHODS:There were 10 male patients, ranging from 43 to 53 years of age, with attached gingiva < or = 2 mm on the buccal aspect included in this study. Acellular dermal matrix allograft was used to increase the keratinized mucosa on the buccal side. RESULTS:The change of peri-implant pocket depth showed statistical differences among 3 measurements. The modified plaque index at 3 and 6 months showed statistical differences compared with the baseline measurements. The modified gingival index did not show any significant differences among all measurements. The width of peri-implant keratinized mucosa increased from a mean of 0.8 +/- 0.6 to 3.2 +/- 0.9 mm at 3 months and 2.2 +/- 0.6 mm at 6 months. CONCLUSIONS:It is concluded that the acellular dermal matrix allograft could be applied as a grafting material to increase the width of peri-implant keratinized mucosa. Its procedure appears to have some benefits for oral hygiene. Further randomized controlled trials over long periods of time are necessary to establish whether this procedure offers long-tem benefits to patients.

背景与目标：

BACKGROUND & AIMS: :The histamine sensitization test is a widely used method for measuring the residual toxicity of pertussis toxin in acellular pertussis vaccines. Although it has been used as a routine assay for decades, the current protocols are difficult to standardize because the test results vary considerably and are based on several factors, including mouse strain, age and sex. In this study, we observed that mice of strains CD1, ddY and C57/BL6 were sufficiently sensitive to pertussis toxin among six mice strains tested and that aged male mice were more sensitive to pertussis toxin than younger or female mice. Using this animal model, we showed pertussis toxin dose-dependent responses in the two histamine sensitization test protocols based on either lethal end-point determination or mouse rectal temperature measurement. Sensitivity to pertussis toxin was further enhanced by the addition of lipopolysaccharide in both methods. With these improvements, pertussis toxin activity can be estimated more accurately and reproducibly using a reduced number of animals.

背景与目标： : 组胺致敏试验是一种广泛用于测量百日咳毒素在无细胞百日咳疫苗中残留毒性的方法。尽管数十年来一直用作常规测定，但由于测试结果差异很大，并且基于多种因素，包括小鼠品系，年龄和性别，因此当前的方案难以标准化。在这项研究中，我们观察到CD1，ddY和C57/BL6菌株的小鼠对百日咳毒素足够敏感，并且老年雄性小鼠对百日咳毒素的敏感性高于年轻或雌性小鼠。使用该动物模型，我们基于致死终点测定或小鼠直肠温度测量，在两种组胺致敏试验方案中显示了百日咳毒素剂量依赖性反应。通过在两种方法中添加脂多糖，进一步增强了对百日咳毒素的敏感性。通过这些改进，可以使用减少数量的动物来更准确和可重复地估计百日咳毒素的活性。

BACKGROUND & AIMS: Ideal reconstructions of complex defects in the midface require the restitution not only of bone and soft tissue, but also of a thin and durable lining of the oral cavity. So far, split-thickness skin grafts, intestinal grafts, and in vitro cultured mucosal grafts have been used for the reconstruction of the oral lining. The use of skin as a substitute for oral mucosa is controversial because contraction, hair growth, maceration, and dysplastic changes can occur. This clinical and histologic study was performed to evaluate the suitability of dermis as a substitute for oral lining. Twelve complex defects of the midface were reconstructed with dermis-prelaminated scapula flaps. A bony flap from the lateral border of the scapula was prepared, and osseointegrated implants were placed. The bone flap was then prelaminated with dermis and covered with a Gore-Tex membrane to prevent adhesions. The composite flap was transferred to the midface 2 to 3 months later. The oral lining of the flap was evaluated clinically and histologically at 2, 4, and 6 weeks and at 3 to 41 months after the reconstruction. In all patients, the reconstructed bone was covered with a thin and lubricated surface without hair growth. None of the patients showed any signs of maceration. Histologically, these findings corresponded to a keratinized stratified squamous epithelium with highly developed connective-tissue papillae. These features closely resemble those of the normal mucosa of the hard palate and the gingiva. Thus, dermis prelamination is an effective method for reconstructing the mucosa of the alveolar ridge and the hard palate.

背景与目标： 中面部复杂缺陷的理想重建不仅需要修复骨骼和软组织，还需要修复口腔薄而耐用的衬里。到目前为止，已将厚度分开的皮肤移植物，肠移植物和体外培养的粘膜移植物用于重建口腔衬里。使用皮肤代替口腔粘膜是有争议的，因为会发生收缩，毛发生长，浸软和发育不良的变化。进行了这项临床和组织学研究，以评估真皮作为口服衬里替代品的适用性。用真皮预层压的肩胛骨皮瓣重建了十二个复杂的中面部缺损。从肩胛骨的外侧边界准备了一个骨瓣，并放置了骨整合植入物。然后将骨瓣与真皮预层压，并用Gore-Tex膜覆盖以防止粘连。复合皮瓣在2至3个月后转移到中面。在重建后的第2、4和6周以及3至41个月，对皮瓣的口腔衬里进行了临床和组织学评估。在所有患者中，重建的骨骼均覆盖有薄而润滑的表面，而没有毛发生长。没有患者出现任何浸渍迹象。从组织学上讲，这些发现对应于角化的复层鳞状上皮，具有高度发达的结缔组织乳头。这些特征与硬腭和牙龈的正常粘膜非常相似。因此，真皮预层压是重建牙槽嵴和硬腭粘膜的有效方法。

BACKGROUND & AIMS: OBJECTIVE:To assess the economic benefits associated with hospital-based postpartum Tdap (combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination. METHODS:A decision tree model was constructed to calculate the potential cost-benefit of this strategy from both a health care system and a societal perspective. Probabilities and costs were derived from published literature, data reported to Centers for Disease Control and Prevention, and recommendations from expert panels. The maternal vaccination protection period for infants was defined as 7 months, and 10 years of waning immunity following Tdap for birth mothers was estimated in the model. All cost estimates were inflated to year 2012 US dollars and discounted at a 3% annual discount rate. RESULTS:In the base case from a societal perspective, the expected costs per vaccinated and unvaccinated mother were estimated at $129.27 and $187.97, respectively, suggesting an expected net benefit of $58.70 per vaccinated mother. The overall societal benefits in the cohort of 3.6 million U.S. birth mothers ranged from $52.8-126.8 million, depending on the vaccination coverage level. If including direct medical costs only, the strategy would not generate net savings from a health care system perspective. Annual incidence of pertussis in birth mothers and Tdap efficacy exhibited substantial impact on the model as shown in one-way and two-way sensitivity analyses. CONCLUSIONS:Although postpartum Tdap vaccination is not cost-beneficial from a health care system perspective in the base case, this strategy is likely to generate net benefits from a societal perspective.

背景与目标：

BACKGROUND & AIMS: It has been known since 1851 that atmospheric oxygen is taken up by the human epidermis. The contribution to total respiration is negligible. Until now the significance for the local oxygen supply of the skin has remained unknown. With a newly developed sensor, the oxygen fluxoptode, it has become possible to make local measurements of the transcutaneous oxygen flux (tcJ(O2)). In this study the sensor was calibrated so that absolute values of tcJ(O2) could be reported. At rest, tcJ(O2) was determined on normal, humidified skin on the volar forearm of 20 volunteers of different age groups. In order to evaluate the contribution of the blood flow to the oxygen supply of the skin, tcJ(O2) was recorded at the end of a 5 min suprasystolic occlusion of the forearm. At normal skin surface partial oxygen pressure (163 +/- 9 Torr), tcJ(O2) was 0.53 +/- 0.27 ml O2 min(-1) x m(-2). A 5 min interruption of blood flow resulted in an increase of 9.5 +/- 6.3 % in tcJ(O2). The value of tcJ(O2) was unaffected by the age of the subject. Published data on the oxygen diffusion properties of skin and simulations of intracutaneous profiles of oxygen partial pressure indicated that under these conditions, the upper skin layers to a depth of of 0.25-0.40 mm are almost exclusively supplied by external oxygen, whereas the oxygen transport of the blood has a minor influence. As a consequence, a malfunction in capillary oxygen transport cannot be the initiator of the development of superficial skin defects such as those observed in chronic venous incompetence and peripheral arterial occlusive disease.

背景与目标： 1851年已经知道，大气中的氧气被人的表皮吸收。对总呼吸的贡献可以忽略不计。到目前为止，皮肤局部氧气供应的重要性仍然未知。借助新开发的传感器氧气通量，可以对经皮氧气通量 (tcJ(O2)) 进行局部测量。在这项研究中，对传感器进行了校准，以便可以报告tcJ(O2) 的绝对值。休息时，在20个不同年龄组的志愿者的前臂掌侧正常湿润皮肤上测定tcJ(O2)。为了评估血流对皮肤氧气供应的贡献，在前臂5分钟的上动脉闭塞结束时记录了tcJ(O2)。在正常皮肤表面氧分压 (163 +/- 9 Torr) 下，tcJ(O2) 为0.53 +/-0.27毫升O2 min(-1) × m(-2)。血流中断5分钟导致tcJ(O2) 的9.5 +/- 6.3% 增加。tcJ(O2) 的值不受受试者年龄的影响。关于皮肤的氧气扩散特性的公开数据和氧分压的皮内分布的模拟表明，在这些条件下，上层皮肤层至0.25-0.40毫米的深度几乎完全由外部氧气供应，而氧气的输送血液的影响很小。结果，毛细血管氧运输的故障不能成为浅表皮肤缺损发展的始作俑者，例如在慢性静脉功能不全和外周动脉闭塞性疾病中观察到的那些。

BACKGROUND & AIMS: OBJECTIVE:The aim of this study is to investigate the use of a porcine-derived acellular dermal matrix (MD) in root coverage procedures combined with extended coronally positioned flap (eCAF), in comparison to the subepithelial connective tissue graft (SCTG) associated with the eCAF. MATERIAL AND METHODS:Eighteen adult patients presenting bilateral type 1 gingival recession were randomly assigned to SCTG or MD groups. Clinical and patient-based outcomes were recorded at 3 and 6 months after the surgical procedure. RESULTS:Both groups showed a significant reduction in the mean recession height of 3.33 ± 0.89 mm to 1.24 ± 1.10 mm (MD) and 3.21 ± 0.8 mm to 0.83 ± 0.86 mm (SCTG) without difference between groups. Six patients in the test group and eight in the control group obtained complete root coverage. The keratinized tissue height and thickness (KTT) showed a significant increase after 3 and 6 months in both groups. The average KTT gains were 0.39 ± 0.4 mm (MD) and 0.51 ± 0.5 mm (SCTG) (p < 0.05). Performing multivariate analysis suggests that MD addition to coronally advanced flaps may be similar to SCTG. CONCLUSION:The MD had similar results in comparison to SCTG and in the context of reducing patient morbidity it can be used as an alternative for the treatment of gingival recessions. CLINICAL RELEVANCE:The SCTG is the gold standard therapy for root coverage. The MD has been widely used in mucogingival surgery as a substitute for SCTG and proposed similar results. A substitute is very important for clinicians and patients. It will give a better postoperative and possibilities to treat multiples recession. (Clinicaltrials.gov Identifier: NCT03675334).

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The acellular dermal matrix (ADM) used in correcting the tear trough deformity has been reported, but there were only a few cases. The long-term effectiveness of ADM was not clear. We aim to discuss the technique and the effect of using ADM to correct the tear trough deformity through more cases. METHODS:A retrospective study was conducted from January 2012 to January 2017. Twenty-six patients who showed obvious tear trough deformity with moderate or severe orbital fat bulging and excess of lower eyelid skin were treated with ADM to improve the appearance of the midface. Follow-up was performed for 2-12 months in 26 cases. The level of postoperative satisfaction was assessed by interview during the follow-up and rated as very satisfied, satisfied, acceptable, or unacceptable. RESULT:Twenty patients were very satisfied for having achieved complete correction. Three patients were satisfied for having achieved obvious improvement. Three patients felt the results were just acceptable and were refilled because of the insufficiency of the filler. No one was unacceptable. There were no complications such as rapid resorption, rejection, or inflammation. CONCLUSION:The method of using ADM for the correction of tear trough deformity has the advantages of low absorption rate, good appearance, and high security. It provides a new choice for the treatment of tear trough deformity. LEVEL OF EVIDENCE IV:This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Acellular dermal matrix (ADM) is a common filler used widely in clinical practice to increase penile girth for cosmetic reasons, but there are few studies on its complications. AIM:The aim of this study was to investigate and analyze the complications of penile girth enhancement (PGE) with ADM. METHODS:The medical records of 78 patients who underwent PGE with ADM between June 2016 and January 2019 were retrospectively reviewed. MAIN OUTCOME MEASURE:Related complications and their subsequent management were summarized and analyzed. RESULTS:78 patients (mean age 31.14 years [21-66 years]) received PGE with ADM. At the 3-month follow-up, the penile circumference was increased by 1.1 (0.5-2.1) cm on average. There were 47 patients with erectile discomfort, 12 with delayed healing, 10 with unobvious augmentation effect, 8 with wound hematoma, 7 with prepuce edema, 4 with wound infection, and 3 patients with skin necrosis of the dorsal side. 7 patients eventually underwent ADM removal. CLINICAL IMPLICATIONS:These adverse complications indicate that ADM should be used with caution for PGE. STRENGTH & LIMITATIONS:This study adds important data, as there are few published reports on the complications of PGE with ADM. However, this study did not compare postoperative complications with ADM to those seen with other filler material. CONCLUSION:Even with standardized surgical methods and rigorous postoperative care, complications of PGE using ADM are severe, which indicates that it is not an ideal or safe method for PGE. Xu T, Zhang G, Bai W, et al. Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix. J Sex Med 2019;16:2011-2017.

背景与目标：

BACKGROUND & AIMS: :Combination vaccines decrease the number of injections and improve parental satisfaction and vaccination schedule compliance. In a phase 1, randomized, partially-blinded, single-dose booster study, we evaluated two formulations of an investigational liquid hexavalent vaccine containing diphtheria, tetanus, acellular pertussis (5-component), inactivated poliovirus, Haemophilus influenzae b conjugate and hepatitis B surface antigen (DTaP-IPV-Hib-HBV) in 60 healthy toddlers, 15 to 18 months of age, who had been primed with three doses of a licensed pentavalent diphtheria, tetanus, acellular pertussis (5-component), inactivated poliovirus, Haemophilus influenzae b conjugate (DTaP-IPV//PRP-T) vaccine. The DTaP-IPV//PRP-T vaccine was used as a control in 30 subjects. The investigational formulations, which contained the same DTaP-IPV components, differed only in Hib (content and conjugate) and HBV (content) (PRP-T/HBV10 = 12 mug Hib tetanus toxoid conjugate with 10 microg HBsAg; PRP-OMPC/HBV15 = 6 microg Hib Neisseria meningitidis outer membrane protein complex with 15 microg HBsAg). Injection-site pain, redness and swelling were reported by 46.7%, 46.7%, and 20.0% of the licensed vaccine recipients, 43.3%, 43.3%, and 26.7% of PRP-T/HBV10 recipients and 70.0%, 46.7%, and 46.7% of PRP-OMPC/HBV15 recipients, respectively. Fever > or = 37.8 degrees C and irritability were reported by 0% and 16.7% of licensed vaccine recipients, 10.3% and 23.3% of PRP-T/HBV10 recipients and 30.0% and 16.7% of PRP-OMPC/HBV15 recipients, respectively. There were no apparent differences between the groups in the proportion of participants achieving predefined, threshold or seroprotective immune responses. Geometric mean antibody levels for all antigens were similar except for anti-PRP levels, which were 19.0 microg/mL in recipients of the licensed vaccine, 40.8 microg/mL in PRP-T/HBV10 recipients and 9.4 microg/mL in PRP-OMPC/HBV15 recipients. We conclude that the hexavalent formulations appear generally well tolerated and immunogenic as a booster dose in these toddlers.

背景与目标： : 联合疫苗减少了注射次数，提高了父母的满意度和疫苗接种计划的依从性。在一项1期，随机，部分盲，单剂量加强研究中，我们评估了两种含白喉，破伤风，无细胞百日咳 (5组分)，灭活脊髓灰质炎病毒，乙型流感嗜血杆菌结合物和乙型肝炎表面抗原 (DTaP-IPV-Hib-HBV) 在60名15至18个月大的健康幼儿中使用了三剂经许可的五价白喉，破伤风，无细胞百日咳 (5-组分)，灭活脊髓灰质炎病毒，流感嗜血杆菌b偶联物 (DTaP-IPV // prp-t) 疫苗。DTaP-IPV // prp-t疫苗被用作30名受试者的对照。包含相同DTaP-IPV成分的研究性制剂仅在Hib (含量和结合物) 和HBV (含量) 方面有所不同 (prp-t/HBV10 = 12杯Hib破伤风类毒素结合物与10 microg HBsAg; prp-ompc/HBV15 = 6 microg Hib脑膜炎奈瑟氏菌外膜蛋白复合物与15 microg HBsAg)。46.7%，46.7% 和20.0% 的许可疫苗接受者，prp-t/HBV10接受者的43.3%，43.3% 和26.7% 以及prp-ompc/HBV15接受者的70.0%，46.7% 和46.7% 报告了注射部位疼痛，红肿。分别。经许可的疫苗接受者的0% 和16.7%，prp-t/HBV10接受者的10.3% 和23.3% 以及prp-ompc/HBV15接受者的30.0% 和16.7% 分别报告了发烧> 或 = 37.8摄氏度和烦躁不安。两组之间在达到预定义，阈值或血清保护性免疫反应的参与者比例方面没有明显差异。除抗-PRP水平外，所有抗原的几何平均抗体水平相似，抗-PRP水平在许可疫苗的接受者中是19.0微克/毫升，在prp-t/HBV10接受者中是40.8微克/毫升，在prp-ompc/HBV15接受者中是9.4微克/毫升。我们得出的结论是，在这些幼儿中，六价制剂通常表现出良好的耐受性和免疫原性，作为加强剂量。

BACKGROUND & AIMS: OBJECTIVES:To identify parental perceptions regarding vaccine safety and assess their relationship with the immunization status of children. DESIGN, SETTING, AND PARTICIPANTS:Case-control study based on a survey of a sample of households participating in the 2000-2001 National Immunization Survey, a quarterly random-digit-dialing sample of US children aged 19 to 35 months. Three groups of case children not up-to-date for 3 vaccines were compared with control children who were up-to-date for each respective vaccine. Main Outcome Measure Measles-containing or measles-mumps-rubella, diphtheria and tetanus toxoids and pertussis or diphtheria and tetanus toxoids with acellular pertussis, and hepatitis B vaccination coverage. RESULTS:Among those sampled from the 2000-2001 National Immunization Survey, the household response rate was 2315 (52.1%) of 4440. Most respondents (>90%) in all groups believed vaccinations are important. In each case-control group, there was no significant difference between the percentage of case and control parents expressing general vaccine safety (range, 53.5%-64.1%). However, case parents were more likely to have asked that their child not be vaccinated for reasons other than illness (range, 10.2%-13.7% vs range, 2.9%-5.3%, respectively) and to believe their children received too many vaccinations (range, 3.4%-7.6% vs range, 0.8%-1.0%, respectively). Among the case-control group receiving a measles-containing or measles-mumps-rubella vaccination, only a small percentage of parents knew about the alleged association between autism and measles-mumps-rubella vaccinations (8.2%), and case parents were more likely to believe it than control parents (4.4% vs 1.5%, respectively; chi(2) P =.04). CONCLUSIONS:Despite belief in the importance of immunization by a vast majority of parents, the majority of parents had concerns regarding vaccine safety. Strategies to address important misperceptions about vaccine safety as well as additional research assessing vaccine safety are needed to ensure public confidence.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:The aim of this study was to develop a novel decellularization method in order to obtain an ideal scaffold with good biocompatibility. METHODS:The porcine corneas were treated with human serum for 5 days or serum-electrophoresis respectively. The electrophoresis (100 V/cm) was performed in sterilized buffer containing 40-mM tris base, 18-mM glacial acetic acid, and antibiotics for 1 h at 4°C. The properties of artificial corneal scaffolds were characterized by morphological and histological examinations. The biocompatibility and biological safety were examined by subcutaneous implant test and lamellar keratoplasty. RESULTS AND CONCLUSIONS:The transparency and appearance of serum-electrophoresis acellular porcine corneal matrix were better than serum acellular porcine corneal matrix. DNA and α-gal in serum-electrophoresis acellular porcine corneal matrix were more efficiently removed than those in serum acellular porcine corneal matrix (p < 0.05). The subcutaneous and corneal implantation experiments showed serum-electrophoresis acellular porcine corneal matrix had better biocompatibility compared to serum acellular porcine corneal matrix (p < 0.01). This novel serum-electrophoresis decellularization method may be valuable for preparation of xenogenic corneal tissue for clinical application.

背景与目标：

BACKGROUND & AIMS: :Pertussis is an infectious disease of the respiratory tract that is caused by the gram-negative bacterium Bordetella pertussis. Although acellular pertussis (aP) vaccines are safe, they are not fully effective and thus require improvement. In contrast to whole-cell pertussis (wP) vaccines, aP vaccines do not contain lipopolysaccharide (LPS). Monophosphoryl lipid A (MPL) and Neisseria meningitidis LpxL2 LPS have been shown to display immune-stimulating activity while exerting little endotoxin activity. Therefore, we evaluated whether these LPS analogs could increase the efficacy of the aP vaccine. Mice were vaccinated with diphtheria-tetanus-aP vaccine with aluminum, MPL, or LpxL2 LPS adjuvant before intranasal challenge with B. pertussis. Compared to vaccination with the aluminum adjuvant, vaccination with either LPS analog resulted in lower colonization and a higher pertussis toxin-specific serum immunoglobulin G level, indicating increased efficacy. Vaccination with either LPS analog resulted in reduced lung eosinophilia, reduced eosinophil numbers in the bronchoalveolar lavage fluid, and the ex vivo production of interleukin-4 (IL-4) by bronchial lymph node cells and IL-5 by spleen cells, suggesting reduced type I hypersensitivity. Vaccination with either LPS analog increased serum IL-6 levels, although these levels remained well below the level induced by wP, suggesting that supplementation with LPS analogs may induce some reactogenicity but reactogenicity considerably less than that induced by the wP vaccine. In conclusion, these results indicate that supplementation with LPS analogs forms a promising strategy that can be used to improve aP vaccines.

背景与目标： 百日咳是由革兰氏阴性细菌百日咳杆菌引起的呼吸道传染病。尽管无细胞百日咳 (aP) 疫苗是安全的，但它们并不完全有效，因此需要改进。与全细胞百日咳 (wP) 疫苗相反，aP疫苗不含脂多糖 (LPS)。单磷酰脂质A (MPL) 和脑膜炎奈瑟氏菌LpxL2 LPS已显示出免疫刺激活性，而几乎没有内毒素活性。因此，我们评估了这些LPS类似物是否可以提高aP疫苗的效力。在对百日咳杆菌进行鼻内攻击之前，用铝，MPL或LpxL2 LPS佐剂对小鼠进行白喉-破伤风-aP疫苗接种。与铝佐剂疫苗接种相比，用LPS类似物接种可导致较低的定植和较高的百日咳毒素特异性血清免疫球蛋白G水平，表明功效增强。用LPS类似物接种疫苗会导致肺嗜酸性粒细胞减少，支气管肺泡灌洗液中嗜酸性粒细胞数量减少，支气管淋巴结细胞和脾细胞IL-5体内产生interleukin-4 (IL-4)，表明I型超敏反应降低。用任何一种LPS类似物接种疫苗都会增加血清IL-6水平，尽管这些水平仍远低于wP诱导的水平，这表明补充LPS类似物可能会诱导一些反应原性，但反应原性明显低于wP疫苗诱导的反应原性。总之，这些结果表明，补充LPS类似物形成了一种有前途的策略，可用于改善aP疫苗。