Crossover use of donated blood for autologous transfusion: report of the Council on Scientific Affairs, American Medical Association

BACKGROUND: Controversy exists concerning whether the costs and potential risks outweigh the potential benefits of "crossover" use in the general blood supply of unutilized blood that was donated for autologous transfusion. STUDY DESIGN AND METHODS: Published articles and reports were identified through systematic search of MEDLINE and review of references cited in previously identified articles, textbooks, and reports. Consultation was made with experts in blood donation and transfusion. Additional peer review was received from the American Medical Association (AMA) Council on Scientific Affairs RESULTS: Concern over infectious disease transmission has led to increased interest in and support for autologous transfusion for individuals having planned surgeries. Different requirements exist for collection, labeling, and screening of blood to be used for autologous versus allogeneic transfusions; therefore, procedures for diverting autologous blood donations to the general blood supply involve considerable expense. Several cost-effectiveness studies of autologous blood donation and transfusion conclude that currently this "crossover" appears to be an expensive procedure yielding little increased benefit from a societal perspective. CONCLUSIONS: The recommendations in this report were adopted as AMA Policy at the AMA Annual Meeting in June 1997. The AMA does not encourage blood collection programs to "cross over" units donated for autologous use to the allogeneic blood supply. Practice guidelines are needed, and should be utilized to ensure parsimony in the use of autologous blood donations and transfusions.     

Pattern reversal visual evoked potentials in children with migraine or tension-type headache

Pattern reversal visual evoked potentials were recorded in 71 children with different types of migraine (e.g. migraine with aura, migraine without aura) or tension-type headache and in 19 controls (mean age of both groups 9 years). P100 latencies were comparable in all three groups.     

Use of a Model Wellness Policy May Not Increase the Strength and Comprehensiveness of Written School Wellness Policies

BACKGROUND

Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs.

METHODS

For this cross‐sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD.

RESULTS

No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02).

CONCLUSIONS

These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.

     

胃癌中微卫星不稳定性及DNA错配修复系统

1993年Altonen[1]首次发现遗传性非息肉病性大肠癌(herediary nonpolyposis colorectal cancer,HNPCC)细胞中存在高频率微卫星不稳定性(MSI)以后,许多学者相继发现在多种肿瘤中存在着微卫星不稳定性[2-6].DNA错配修复系统的发现,使微卫星不稳定性的起源得到深入的研究.近年来胃癌中微卫星不稳定性及其可能的致癌机制成为研究的热点,东西方学者由于地域、人群及研究的方法不同,对此研究存在不少争议[7-15].     

木犀草素体外抗柯萨奇B3病毒的作用

目的：了解木犀草素体外抗柯萨奇Ｂ３病毒的作用及其机制。方法：采用组织培养法,通过ＣＰＥ观察药物对ＨｅＬａ细胞的最大无毒浓度,柯萨奇Ｂ３病毒的滴度。药物抗病毒实验,使用染料摄入法测定细胞存活情况。结果：本犀草素的最大无细胞毒浓度为９．７５ｕｌ／ｍｌ。经不同时间给药,木犀草素在０．３０～９．７５ｕｇ／ｍｌ浓度范围内,对ＣｏｘＢ３病毒均有显著的抑制细胞病变作用。结论：木犀草素具有体外抗ＣｏｘＢ３病毒作用     

Pregnancy complicated with a giant splenic cyst: a case report and review of the literature

Background Splenic cysts or masses in pregnancy are extremely rare and only five cases were described in the literature. We present the first case of splenic cyst in pregnancy treated laparoscopically with fenestration and preservation of the spleen. Case A 23-year-old primigravida at 9 weeks of gestation presented for her prenatal follow-up with a 3 weeks history of epigastric pain and early satiety. A magnetic resonance imaging of the abdomen and pelvis demonstrated a gigantic splenic cyst measuring 17 × 13 × 15 cm. Aspiration of the cyst was performed under ultrasound guidance for diagnostic purposes as well as for relief of patient’s symptoms. The patient was followed by bi-weekly sonographic scan until the second trimester. A second aspiration of the cyst was complicated with sepsis, and laparoscopic fenestration and omentopexy were performed. The patient’s remaining antepartum course was uncomplicated and she had a normal spontaneous delivery at thirty-eighth week. Conclusion The most feared complication of a splenic cyst in pregnancy is spontaneous rupture, which in the third trimester is associated with a perinatal mortality rate as high as 70%. Surgical therapy should therefore be provided in the second trimester. Laparoscopic fenestration with omentopexy is a minimally invasive, effective and safe procedure for this condition.     

葛根素对小鼠实验性微循环障碍的改善作用

本文报告了葛根素对肾上腺素(Adr)引起的小鼠肠系膜微循环障碍的影响,并与罂粟碱作比较。结果表明,预先局部滴注0.5%葛根素能够拮抗Adr所致微动脉收缩、流速减慢和流量减少;而局部先滴注Adr造成微循环障碍后,再局部滴注1%葛根素,获得与上类似结果。给小鼠ⅳ葛根素(52 mg/kg)后再局部滴注Adr,可减轻Adr引起的微动脉收缩、流速减慢和流量减少,其作用优于罂粟碱。因此葛根素可改善实验性微循环障碍。