保存12周的红细胞

现代液体红细胞保存体系运行良好,使一个国家供应的异体红细胞安全、廉价,并且有效率达到95％。现代红细胞保存系统在临床上用途广泛,如可为自身输血提供血液,可为战场上的手术输送血液,避免献血者接触新生儿,显然如果延长红细胞的保存期将会有更大的益处。然而,由于衰老的红细胞具有使血流不畅,细胞破裂后一些有毒性的脱出物可能使外伤病人的死亡率增加和导致输血相关急性肺损伤(TRALI),进一步研究建立更好的红细胞保存体系仍然很重要。     

Ectopic pregnancy with postcoital contraception – a case report

The incidence of ectopic pregnancies is increasing. Common risk factors are tubal pathology, previous tubal surgery, previous ectopic pregnancy, intrauterine device use and embryo transfer. Levonelle-2^®, a progesterone-only postcoital contraceptive works by a combination of mechanisms including ovulation inhibition, prevention of fertilization, and inhibition of implantation. It is 85% effective and there have been 12 reported cases of ectopic pregnancy in the UK with its use. It is believed that progesterone slows the intratubal migration of the fertilized ovum. In the case reported here, a woman presented with an ectopic pregnancy after use of Levonelle-2 as postcoital contraception; there were no clinical predisposing risk factors. In the absence of any histological evidence of tubal damage, we suspect that the levonorgestrel from Levonelle-2 could have been responsible for delayed embryo transfer which resulted in the ectopic pregnancy.     

实证医学与中医药研究和开发

临床疗效是衡量一切防治措施价值的最高准则,也是决定一个医疗卫生体系效益的最基本因素。实证医学的核心就是任何有关疾病防治的整体策略和具体措施的制定都应基于现有最严谨的关于其临床疗效的科学证据之一。使用无效甚至有害的防治措施在伦理上是不能接受的,更是对人类宝贵医疗资源的浪费。因此,中医药研究和开发应从临床疗效的验证开始。机理的研究、有效成份的探索和剂型的改进是重要的,但应以证实临床有效为前提。本文从 ４个方面进行了论证： １、一个防治措施若没有防治作用,就没有其相关的作用机理可被发现,也没有其相关的有效成份可被探索,更没有改进剂型的必要。２、中医药临床疗效评价,为从中医药中开发新药提供一个经济的、快捷的途径。因为它节省了用于无临床疗效的药物的临床前研究所需要的大量资源。同时也大大缩短了一个新药从开发到临床使用的时间。３、中医药临床疗效评价具有巨大的经济效益。临床上无效的防治措施被淘汰,而有效的被进一步推广。从而一个医疗体系会因减少使用无效的防治措施而提高效益。４、对中医药临床疗效的评价也是对其理论体系在实践上的检验。     

转换曲线分光光度法与其改良法的比较

目的：比较转换曲线分光光度法与6波长计算分光光度法的实用性。方法：分别用转换曲线分光光度法及 其改良法计算文献实例。结果：转换曲线分光光度法及其改良法对实例处理结果基本一致。结论：6波长计算分光 光度法在一定条件下比转换曲线分光光度法操作更简单,实用。     

Focal fatty infiltration of the liver simulating metastatic disease

Two cases are reported in which multiple, well-defined lesions of the liver, as seen on computed tomographic (CT) scans and sonograms, were thought to represent metastatic malignancy. Results from radionuclide scans and biopsies (and surgery in one case) indicated the correct diagnosis was fatty infiltration of the liver. Focal fatty infiltration should be considered in cases of multiple discrete hepatic lesions, especially in patients with a predisposing condition. Radionuclide studies and biopsies may be needed to confirm the diagnosis by CT.     

Coping flexibility in college students with depressive symptoms

Background  

The current study explored the prevalence of depressed mood among Chinese undergraduate students and examined the coping patterns and degree of flexibility of flexibility of such patterns associated with such mood.     

Functional consequences of an arginine180 to glutamine mutation in factor IX Hilo

Factor IX Hilo is a variant factor IX molecule that has no detectable coagulant activity. The defect in factor IX Hilo arises from a point mutation in the gene such that in the protein Arg180 is converted to a Gln. Activation of factor IX Hilo by factor Xla was monitored using the fluorescent active site probe p-aminobenzamidine. Normal factor IX showed complete activation in one hour as determined by measuring the increase in fluorescence when p-aminobenzamidine bound to activated factor IX. Factor IX Hilo showed no increase in fluorescence even after 24 hours, indicating that the active site was not exposed. Polyacrylamide gel electrophoresis showed that factor IX Hilo was cleaved to a light chain plus a larger peptide with a molecular weight equivalent to a heavy chain covalently linked to an activation peptide. Amino terminal amino acid sequencing of factor IX Hilo cleaved by factor Xla showed cleavage only at Arg145-Ala146, indicating that the Gln180-Val181 bond was not cleaved and that the active site was thus not exposed. The presence of factor IX Hilo in patient plasma was responsible for the patient having a very long ox brain prothrombin time characteristic of severe hemophilia Bm. Patient plasma had an ox brain prothrombin time of 100 seconds using a Thrombotest kit, significantly prolonged over the normal control value of 45 seconds. When factor IX Hilo was depleted from patient plasma using an immunoaffinity column, the ox brain prothrombin time decreased to 41 seconds. When factor IX Hilo was added back to depleted patient plasma, to normal plasma depleted of factor IX by the same affinity column, or to plasma from a CRM- hemophilia B patient, the ox brain prothrombin time was significantly prolonged. We conclude that the Arg180 to Gln mutation in factor IX Hilo results in a molecule that cannot be activated by factor Xla. Further, our data suggest that the mutation results in a molecule that interacts with components of the extrinsic pathway to give a prolonged ox brain prothrombin time.     

Effect of prothrombin complex concentrates on factor VIII inhibitor levels

Factor VIII inhibitor levels were measured on 261 occasions in 76 hemophilia-A inhibitor patients before and after prothrombin complex concentrate infusion at 13 treatment centers. A rise in inhibitor level to at least twice the pretreatment value occurred in 35 treatment episodes (13.5%), in 27 patients (36%). In 16 patients (21%), such an anamnestic immune response occurred with the first treatment. Factors predisposing to anamnestic responses may include patient idiosyncrasy, low pretreatment inhibitor levels, and exposure to concentrate over several days.