A1和A2亚型的新概念

Ａ_１和Ａ_２亚型的新概念陈忠（苏州医学院附一院，江苏２１５００６）关键词ＡＢＯ血型，Ａ亚型，血型抗原ＡＢＯ血型系统中的Ａ抗原，常见的有Ａ１、Ａ２、Ａ３、Ａｘ及Ａｍ五种亚型，其中以Ａ１和Ａ２最为重要。目前已清楚地了解Ａ１和Ａ２亚型有质与量的不同，其主要...     

A new model of pharmacovigilance? A pilot study

This multicenter study tested the actuation of a new model of pharmacovigilance, focused on three pharmacological wide-used categories (non-steroidal anti-inflammatory drugs, NSAID, oral anticoagulants, and antihypertensive drugs). Besides the traditional way of pharmacovigilance, an active investigation was performed, using a phone-structured interview. Patients discharged from the participating hospitals were included into the study, if their prescribed therapy included some of the above drugs and after informed consent. Three hundred subjects were interviewed, 100 for each pharmacological category. For a period of six months after patient's discharge from the hospital, a traditional pharmacovigilance survey was carried out. About 30 days after discharge from the hospital, patients were interviewed by the medical staff and data recorded. NSAID group stratification evidenced a significant percentage of severe haemorrhage among the patients who were using acetylsalicylic acid (ASA) as antiaggregant (6.8%) compared to the patients who were using non-ASA NSAID, at therapeutic dosage (1.8%). From this data, it seems that the active pharmacovigilance model was able to better highlight a real problem for the NSAID category, in particular it evidenced a pharmacological subclass (ASA) more prone to cause ADR than expected from literature data related to whole pharmacological class. Given the required economical effort, this pharmacovigilance method could take place as a selected tool when pharmacovigilance signals from the international databases become consistent or for new wide-used drugs, to screen potentially dangerous pharmacological subclasses, normally “hidden” because of a “camouflage” among ADRs of the entire pharmacological class.     

A2B亚型含抗A11例

1病例报告 男,40岁.第1次献血,无既往输血史,献血地点为街头固定采血点,经体检医生健康检查合格后献血,血型正定型为AB型,后经复检发现反定型为B型,常规血型鉴定正反定型不符.ABO血型鉴定正反定型参照第2版<输血技术学>[1],在室温、4C、37C 3种不同温度下正反定型检查确定为A2B型,含不规则抗A1.结果见表1.     

A.A疗法对缺血性脑血管病的疗效观察

颈内动脉系统的缺血性脑血管病是神经科常见病，多发病，且致残率高，近年来，由于CT的应用，在诊断方面巳获得突破性进展，然而，寻求新的有效的治疗方法仍是临床亟待解决的重要课题。二年多来，笔者采用自体动脉加压灌注于病灶侧颈内动脉，因为是用动脉血流灌注于动     

A simple appendicitis? An anatomical pitfall: A case report

Rationale: We present a case of appendicitis with an uncommon course due to rare anatomical location of the appendix in the right retroperitoneal space below the diaphragm and above the liver.Patient's concern: A 32-year-old, previously healthy male with a history of congenital diaphragmatic hernia repair in childhood, presented with 3 days of mild, colicky, central abdominal pain associated with fever, nausea and vomiting. At presentation, pain was localized to the right lower quadrant. Diagnosis: Even though diagnosis of appendicitis was clear, we decided to confirm it with computer tomography (CT). CT revealed elevation of the right dome of the diaphragm and perforated appendix located above the liver. Intervention: Appendectomy was performed via right subcostal approach instead of usual incision in the right lower quadrant. Outcome: Patient recovered well and was discharged on the 5th day after operation. Lessons: Previous congenital diaphragmatic hermia repair may change the location of the appendix. The appendix at rare locations could lead to an uncommon course of appendicitis. On this very note, surgeons should have a high index of suspicion, and CT may help avoid inadvertent complications.     

ⅡA分泌型磷脂酶A2与冠心病的关系

目的 测定冠心病患者及非冠心病患者体内ⅡA分泌型磷脂酶A2（ⅡA-sPLA2）的浓度；分析它与高敏C-反应蛋白（hs-CRP）之间的相关性。方法 40例确诊冠心病患者及46例非冠心病患者对照，采用酶免法测定EDTA抗凝血浆中的ⅡA-sPLA2浓度；采用免疫比浊法测定血清中hs-CRP含量；同时，应用酶法测定血糖、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白的浓度。结果 冠心病患者ⅡA-sPLA2浓度的中位数（242．5ng／d1）显著高于非冠心病组的浓度中位数（198．7ng／d1）（P〈0．05）；ⅡA-sPLA2与hs-CRP呈显著正相关（P〈0．05），与传统的危险因子（年龄、吸烟、糖尿病、高血压、高胆固醇血症、低HDL-C）无相关性。多变量Logistic回归分析显示：高浓度ⅡA-sPLA2（333．9ng／d1，非冠心病组90％分布）、吸烟、糖尿病是区分冠心病与非冠心病显著的变量。结论 体内高浓度的ⅡA-sPLA2是冠心病重要的危险因子，它可能与发生动脉粥样硬化时炎症的活化有关。     

A small earthquake?

In recent years, concerns about health and healthcare have been expressed by the public, the profession, patients and politicians. These are neither new nor confined to the UK. Doctors were not always held in high public esteem; that had been earned over the last 150 years through scientific discoveries such as anaesthesia which revolutionised patient care. The turbulence of the last few years has a number of causes, including increasing patient expectations. Perhaps inevitably it has again called into question the relationship between government, the public and the profession. The resulting debate has been more widespread and better informed than previous episodes of dissent, perhaps indicating a greater willingness on the part of all three parties to assess their relationship anew. Any such assessment would no doubt have to accept the current workforce difficulties experienced by many doctors and other healthcare professionals practising in unsatisfactory circumstances.     

类维生素A研究进展

类维生素A在临床上有广泛的应用。它在调节和控制多种正常组织和上皮细胞的增殖分化、生长发育、形态发生、代谢、内环境的稳定平衡、暗视觉和生殖等方面具有广泛的生物学活性。本文主要介绍类维生素A的结构、代谢及其与各种疾病的关系。     

维生素A临床新用

<正> 维生素A(维生素甲、抗干眼醇、VitaminA、Alphalin、Arovit、Axerophtol、Retinol)系脂溶性维生素。其生理作用为促进生长、维持上皮细胞正常功能和结构的完整性,参与视紫红质的合成,增进视网膜的感光性能、还参与体内许多氧化过程,尤其是不饱和脂肪酸的氧化。成人每日需要量约3000～5000单位。口服维生素A在肠道易吸收,但必须依赖肠内脂肪及胆汁的存在,吸收后贮存于肝脏,在肝贮存量可供1年甚至数年之用。近年来发现维生素A对于多种疾病又有防治作用。     

A型和AB型红细胞表面A抗原类型调查

目的调查ABO血型正反定型相符的A和AB型患者红细胞表面A抗原类型,探讨用分子生物学方法检测A_2抗原的必要性。方法 2020年1月至8月天津市第一中心医院正反定型相符A型和AB型的患者3 024例,用血清学试管法与抗A_1试剂反应,用序列特异引物聚合酶链反应(PCR-SSP)、1～7外显子直接测序法确定与抗A_1试剂反应阴性标本的血型基因型。结果 ABO血型正反定型相符的3 024例A和AB型中,血清学检出A_2和A_2B 48例(1.59%);基因型检出A_2和A_2B 16例(0.53%),PCR-SSP与基因测序结果相符,A_2B发生率高于A_2(P0.01)。11例A_2和A_2B输血患者作为观察组,输血当日同病种输血患者23例作为对照组,输血不良反应发生率差异有统计学意义(P0.01)。结论正反定型相符A和AB型患者红细胞表面A抗原具有多态性,运用分子生物学方法检测A_2和A_2B血型有利于提高输血安全。     

A champion idea?

The Scottish government aims to have 300 dementia champions in place by 2013. The champions--to be drawn from health and social, care staff--undergo training to enable them to lead improvements in care. The scheme has its critics, but supporters insist that champions are making a big difference to patient care.     

A quick fix?

Recommendations from the National Institute for Health and Clinical Excellence say more people with high cholesterol levels should be prescribed statins. But some professionals have reservations. Currently 2 million people in England and Wales take statins. This figure will rise to 3.3 million with the change in threshold for statin treatment. The threshold for considering statin use has changed from a 30 per cent ten-year risk of developing cardiovascular disease to a 20 per cent or more risk. Statins in low dosage are available over the counter.     

Strategies For Being A Successful Physician Administrator Of A Rehabilitation Program

INTRODUCTION Purpose:The purpose of this paper is to provide rehabili-tation physicians with suggestions that will assist themin becoming successful program leaders/managers/     

在A型个体中发现ABO~* A213等位基因

目的鉴定A抗原弱阳性个体的血型血清学特点及基因特征。方法对1名A抗原弱阳性个体采用正反定型鉴定其ABO血型,并用PCR技术对ABO基因的7个外显子和启动子分别扩增后测序。结果血型血清学鉴定该个体表达弱A抗原,测序结果显示ABO合子型为A/O型,其中ABO*A等位基因第7外显子742位为T碱基。结论在A型个体中发现A213等位基因。     

Viral hepatitis: A narrative review of hepatitis A–E

Viral hepatitis continues to be a major health concern leading to hepatic decompensation ranging from acute hepatitis to cirrhosis and hepatocellular carcinoma. The hepatic and extrahepatic manifestations are not only debilitating but also associated with a significant economic burden. Over the last two decades, the field of virology has made significant breakthroughs leading to a better understanding of the pathophysiology of viral hepatitis, which in turn has led to new therapeutic options. The advent of direct-acting antiviral agents changed the landscape of hepatitis C virus (HCV) therapy, and new drugs are in the pipeline for chronic hepatitis B virus (HBV) treatment. There has also been a significant emphasis on screening and surveillance programs, widespread availability of vaccines, and linkage of care. Despite these efforts, significant gaps persist in care, and there is a pressing need for increased collaboration and teamwork across the globe to achieve a reduction of disease burden and elimination of HBV and HCV.