ABSTRACT
Tetanus consists of neonatal tetanus and non-neonatal tetanus.Non-neonatal tetanus remains a serious public health problem,although neonatal tetanus has been eliminated in China since 2012.Non-neonatal tetanus is a potential fatal disease.In the absence of medical intervention,the mortality rate of severe cases is almost 100％.Even with vigorous treatment,the mortality rate remains 30％-50％ globally.These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China,in order to improve medical quality and safety.These specifications introduce the etiology,epidemiology,pathogenesis,clinical manifestations and laboratory tests,diagnosis,differential diagnosis,grading and treatment of non-neonatal tetanus.
ABSTRACT
Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.
ABSTRACT
Memory reconsolidation interference has been shown to be an effective way to neutralize conditioned fear memory and prevent relapse. The critical factor to utilize this paradigm is inducing a labile state of the long-term memory. Novel information is viewed as a driving factor to update memory; however, it is unknown whether different forms of novelty play the same role. In addition, although pharmacological intervention studies have confirmed that prediction error (PE) during reactivation is a necessary condition in memory destabilization, the role of PE in retrieval extinction has remained under debate; furthermore, the neural mechanisms underlying the process are largely unknown. In this study, we isolated two forms of novelty: PE and stimulus novelty without PE during reactivation to compare their role in memory lability. Skin conductance responses (SCR) and functional magnetic resonance imaging (fMRI) were used to clarify their role at the behavioural and neural mechanism levels. A total of 54 healthy adults were tested in a three-day retrieval extinction protocol. The results showed that PE, the novelty of CS-US combinations, was a critical condition to destabilize memory. The novelty of the stimulus itself with the absence of PE was insufficient for retrieving the memory. The neural mechanisms that distinguished standard extinction from retrieval extinction were that the latter was associated with a diminished recruitment of the inferior temporal cortex (IT) and dorsolateral prefrontal cortex (dlPFC) and decreased functional connectivity of the dlPFC-anterior cingulate cortex (ACC) and IT-dlPFC. Possible interpretations were discussed.
Subject(s)
Conditioning, Classical/physiology , Extinction, Psychological/physiology , Fear/physiology , Memory/physiology , Adolescent , Adult , Female , Galvanic Skin Response/physiology , Humans , Magnetic Resonance Imaging/methods , Male , Prefrontal Cortex/physiology , Young AdultABSTRACT
Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.
ABSTRACT
Objective To probe the immunological traits of mesenchymal stem cells derived from umbilical cord Wharton's jelly (WJMSCs). Methods The diced Wharton's jelly which was from healthy fullterm birth human umbilical cord was cultured. The mesenchymal stem cells were identified with mesenchymal stem cells markers expression by flow cytometry and multiple differentiation ability. The expression of MHC- Ⅰ / Ⅱ, costimulatory molecules (CD40, CD80 and CD86) was detected with flow cytomctry, immunocytochemistry, and RT-PCR. The expression of immune inhibitors like HLA-G, IDO, and PGE2 was detected by immunocytochemistry and RT-PCR. The expression of immune-related molecules as IL-10, TGF-β, FGF and VEGF was detected with antibody microarray and western blot. Further more, to clarify the in vivo immune reaction of hWJMSCs, we fabricated the hWJMSC-scaffold constructs and implanted them into the rabbit backs. The lymphocyte infiltration and implanted cell survival observed with immunofluorescence. Results After culturinge of diced Wharton's jelly tissue, we obtained spindle-shaped cells. With differentiation medium, the cells can differentiate into osteoblasts, chongdrocytes, adipose cells and schwann cells. Expression of MHC, costimulatory molecules, and a series of immune suppressive-related molecules was found. Immune inhibitors as HLA-G, 1DO, PGE2, and immune suppressive related molecules as HGF, VEGF, TGFand IL-10 were positively expressed. But the cells did not express MHC-Ⅱ. No immune rejection was observed in vivo after implantation of hWJMSC-scaffold constructs. Conclusion It can be concluded that hWJMSCs have very low immunogenicity, which means the cells have potential to induce immune tolerance.The hWJMSCs do not provoke immune rejection in vivo.
