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3709. A neurogenic mechanism for symmetrical arthritis.
作者: B L Kidd.;P I Mapp.;S J Gibson.;J M Polak.;F O'Higgins.;J C Buckland-Wright.;D R Blake.
来源: Lancet. 1989年2卷8672期1128-30页
Human synovium is richly innervated by autonomic and sensory nerve fibres, many of which contain neuropeptides. The hypothesis is that, in addition to a sensory role, some of these fibres modulate the response of the synovial membrane to a variety of noxious stimuli by releasing these peptides. Synovial damage results in acute inflammation in the damaged joint and a neurogenically mediated infiltrate of inflammatory cells in the contralateral joint. These cells might protect the contralateral synovium from injury similar to that in the damaged joint. An increased response would lead to synovitis and symmetrical disease.
3712. Are in-vitro fertilisation and embryo transfer of benefit to all?
The efficacy, safety, costs, and benefits of in-vitro fertilisation and embryo transfer (IVF/ET) have been reviewed. IVF/ET benefits only a small proportion of infertile women, it is expensive, and has serious health risks. Therefore policies for the management of infertility in which most financial and manpower resources are applied to prevention of infertility must be developed. Health authorities should also require accreditation of IVF/ET programmes, certification of providers, and ongoing monitoring of clinics. Full and accurate information on IVF/ET must also be disseminated, so that individuals seeking treatment for infertility can make the best informed choice about their care and health authorities can decide the place of IVF/ET in their infertility services.
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