不规则抗体筛查对临床输血的意义

目的:探讨不规则抗体的筛查在临床输血中的意义。方法:对2009年5月至10月间本院6300例输血患者做不规则抗体筛查,抗体筛检阳性者做进一步鉴定,分析抗体特异性,总结各抗体出现频率。结果:半年来检测病例6300例,检测出不规则抗体阳性9例,阳性率0.14%,其中抗-D抗体2例,抗-DC抗体1例、抗-E抗体2例,抗-e抗体1例,抗-M抗体3例。还检测出自身抗体3例及高度冷凝集1例。结论:不规则抗体筛选应作为输血前检查之常规,对保障临床用血、预防溶血性输血反应具有极其重要的意义。     

The Clinical Significance of PPAR Gamma Agonism

Insulin resistance is a principal underlying defect in type 2 DM along with beta-cell dysfunction, and this insulin resistance underpins many of the abnormalities associated with the metabolic syndrome. Peroxisome-proliferator-activated receptor gamma agonists (PPARgamma agonists), also known as glitazones or thiazolidinediones (TZDs) are powerful insulin sensitisers with recent evidence suggesting that they also have a potential to improve pancreatic beta-cell function. TZDs cause a major redistribution of body fat with a decrease in visceral and hepatic fat content with a resultant increase in insulin sensitivity. The glucose lowering effects of TZDs are similar to those seen with the well-established sulphonylureas and metformin. TZDs have a small reducing effect on blood pressure and have been shown to reduce microalbuminuria independent of their blood glucose lowering effect. Both TZDs in clinical practice, pioglitazone and rosiglitazone, reduce small dense LDL-cholesterol and increase HDL-cholesterol levels but pioglitazone would appear to have a more pronounced benefit on these two parameters with a greater reduction in plasma triglycerides. TZDs improved the pro-coagulant state and show benefits in improving endothelial dysfunction and reducing 'non-traditional' inflammatory cytokines and increasing adiponectin levels. The greatest benefit for the TZDs is to directly influence atherogenesis itself and the potential that these so-called pleiotrophic effects of TZDs to reduce cardiovascular events in type 2 DM will be tested when the results of outcome trials are published in the next few years. If the results are positive for the reduction in vascular end-points, then TZDs will represent a major advance in improving the prognosis of type 2 DM subjects with the metabolic syndrome.     

不规则抗体筛查对临床输血的意义

目的:探讨不规则抗体的筛查在临床输血中的意义。方法:对2009年5月至10月间本院6300例输血患者做不规则抗体筛查,抗体筛检阳性者做进一步鉴定,分析抗体特异性,总结各抗体出现频率。结果:半年来检测病例6300例,检测出不规则抗体阳性9例,阳性率0.14%,其中抗-D抗体2例,抗-DC抗体1例、抗-E抗体2例,抗-e抗体1例,抗-M抗体3例。还检测出自身抗体3例及高度冷凝集1例。结论:不规则抗体筛选应作为输血前检查之常规,对保障临床用血、预防溶血性输血反应具有极其重要的意义。     

The Clinical Significance of Elevated Blood Lactate

Three patients with elevated blood lactate values are described. The first, despite moderate hyperlactatemia of 5.3 mEq./1. and severe acidosis with an arterial blood pH of 6.98, had no “excess lactate”. In a second patient, moderate acidosis with a pH of 7.27 and blood lactate of 7.5 mEq./1., of which 33% was excess lactate, was found to be secondary to tissue hypoxia on an ischemic basis and preceded the onset of clinical shock by four hours. A third patient, diabetic and under treatment with phenformin hydrochloride, presented with many features suggestive of pulmonary embolism, including marked pulmonary hypertension. A diagnosis of idiopathic lactic acidosis was established when the arterial blood pH was found to be 6.77 and a blood lactate value of 14.2 mEq./1., 60% as excess lactate, was discovered in the absence of a demonstrable cause of tissue hypoxia. Exploration of the pulmonary vascular bed showed no sign of mechanical blockage. The diagnostic, therapeutic and prognostic value of measuring blood lactic acid, and of quantitating the proportion circulating as “excess lactate”, is emphasized.     

水体污染经济损失估算模型及其应用

运用湖泊水污染经济损失与湖泊水质之间的关系模型,分析了某一湖泊B不同年段各种主要使用功能的经济损害效果。研究结果表明,无论水体中哪一种污染物的升高,都必然造成各种使用功能经济损害的增加;该湖仅在1990年其各种主要使用功能的污染损害较为显著,并以旅游和生活饮水两项功能损害突出,因污染所蒙受的经济损失也较大。总体上,各种使用功能在整个监测期间（1990－1999）经济损害率呈减轻趋势,但经济损失量有所增加。     

人巨细胞病毒的定量检验和临床意义

人巨细胞病毒(HCMV)是一种普遍存在的DNA病毒,在免疫系统不成熟或受损的患者中会导致严重的疾病.最近几年,HCMV的定量检测已成为临床上帮助确定抗病毒治疗方案、评估治疗方案疗效和找出耐药性案例的主要方法.这篇综述对HCMV的不同定量方法进行了比较并对如何改善临床诊断做了一些探讨.