目的观察血小板自身抗体与同种抗体对血小板交叉配型难易程度及输注效果的影响。方法选择2021年7月—2023年9月在本实验室完成血小板抗体鉴定的106例血小板输注无效(PTR)患者,根据血小板抗体类型将患者分为两组,20例自身抗体阳性患者为...目的观察血小板自身抗体与同种抗体对血小板交叉配型难易程度及输注效果的影响。方法选择2021年7月—2023年9月在本实验室完成血小板抗体鉴定的106例血小板输注无效(PTR)患者,根据血小板抗体类型将患者分为两组,20例自身抗体阳性患者为观察组,86例同种抗体阳性患者为对照组。比较两组患者配型相合次数百分率、配型相合供者百分率、输注交叉配型相合血小板及随机血小板的24 h血小板计数增加指数(CCI)值及输注有效率的差异,并对观察组自身抗体变化情况进行追踪。结果观察组的配型相合次数百分率及配型相合供者百分率均高于对照组(P<0.05)。观察组患者输注交叉配型相合血小板与随机血小板的24 h CCI值及输注有效率均无显著性差异(P>0.05),对照组患者输注交叉配型相合血小板的24 h CCI值及输注有效率均高于输注随机血小板(P<0.001),对照组患者输注交叉配型相合血小板后24 h CCI值及输注有效率比观察组高(P<0.05),对照组和观察组输注随机血小板后24 h CCI值及输注有效率无显著性差异(P>0.05)。观察组多数患者的自身抗体强度呈下降趋势。结论血小板自身抗体对血小板交叉配型难易程度及输注效果的影响比同种抗体小。血小板自身抗体强度随时间推移呈现逐渐下降乃至消失的规律。在临床实践中,对于自身抗体患者的治疗,应当首先查找病因,并进行针对性治疗,如果需要输注血小板,可以选择输注随机血小板。展开更多
《电子商务法》实施以来,电子商务平台经营者的法律责任经历了从无到有、从线下移转至线上的模式改变,《消费者权益保护法》所规定的电子商务平台内经营者主体责任转向了《电子商务法》的电子商务平台经营者第一责任,再至目前的合规经...《电子商务法》实施以来,电子商务平台经营者的法律责任经历了从无到有、从线下移转至线上的模式改变,《消费者权益保护法》所规定的电子商务平台内经营者主体责任转向了《电子商务法》的电子商务平台经营者第一责任,再至目前的合规经营阶段,由过去责任转变至预防责任,由被动化为主动,经济法社会责任的特质在平台责任之构建上得以充分体现,电子商务平台经营者法律责任同电子商务治理模式共同处于不断进化的过程当中。《电子商务法》作为一部在互联网环境下应运而生的法律,在整体规则设计上还存在一定的不成熟之处,尤其在司法实践过程中,平台经营者责任认定与要件构成方面存在系列法律的适用问题仍待明晰。本文以《电子商务法》第38条为载体,就该条款的逻辑结构进行分析拆解,分析其适用要件与法律后果,以期进一步明晰平台经营者法律责任定位与内涵,为司法裁判提供一个稳定统一的裁判思路。Since the implementation of the E-Commerce Law, the legal responsibility of e-commerce platform operators has experienced a change in mode from none to some, from offline to online, the main responsibility of e-commerce platform operators stipulated in the Consumer Protection Law has shifted to the first responsibility of e-commerce platform operators in the E-Commerce Law, and then to the current stage of compliant operation, and has changed from the past responsibility to the preventive responsibility, and has become active instead of passive, and the quality of social responsibility in economic law has been fully reflected in the construction of platform responsibility. The legal responsibility of e-commerce platform operators and the e-commerce governance model are in the process of continuous evolution. The E-Commerce Law, as a law that came into being under the Internet environment, has certain immaturity in the overall design of rules, especially in the process of judicial practice, there are a series of legal problems in the determination of the responsibility of the platform operator and the composition of the elements that still need to be clarified. This article takes Article 38 of the E-Commerce Law as the carrier, analyzes and dismantles the logical structure of this article, analyzes its applicable elements and legal consequences, in order to further clarify the positioning and connotation of the legal responsibility of the platform operator, and provide a stable and unified adjudication idea for the judicial decision.展开更多
文摘目的观察血小板自身抗体与同种抗体对血小板交叉配型难易程度及输注效果的影响。方法选择2021年7月—2023年9月在本实验室完成血小板抗体鉴定的106例血小板输注无效(PTR)患者,根据血小板抗体类型将患者分为两组,20例自身抗体阳性患者为观察组,86例同种抗体阳性患者为对照组。比较两组患者配型相合次数百分率、配型相合供者百分率、输注交叉配型相合血小板及随机血小板的24 h血小板计数增加指数(CCI)值及输注有效率的差异,并对观察组自身抗体变化情况进行追踪。结果观察组的配型相合次数百分率及配型相合供者百分率均高于对照组(P<0.05)。观察组患者输注交叉配型相合血小板与随机血小板的24 h CCI值及输注有效率均无显著性差异(P>0.05),对照组患者输注交叉配型相合血小板的24 h CCI值及输注有效率均高于输注随机血小板(P<0.001),对照组患者输注交叉配型相合血小板后24 h CCI值及输注有效率比观察组高(P<0.05),对照组和观察组输注随机血小板后24 h CCI值及输注有效率无显著性差异(P>0.05)。观察组多数患者的自身抗体强度呈下降趋势。结论血小板自身抗体对血小板交叉配型难易程度及输注效果的影响比同种抗体小。血小板自身抗体强度随时间推移呈现逐渐下降乃至消失的规律。在临床实践中,对于自身抗体患者的治疗,应当首先查找病因,并进行针对性治疗,如果需要输注血小板,可以选择输注随机血小板。
文摘目的 探讨免疫性血小板输注无效(PTR)患者HLA/HPA抗体特异性分布特征及其对血小板输注效果的影响。方法 本研究以86例免疫性PTR患者为研究对象,收集其性别、年龄、身高、体重、配血次数、疾病类型、输注前后血小板计数等临床资料,通过微珠法进行HLA特异性抗体的检测,并分析抗体特性对血小板输注效果的影响。结果 86例PTR患者中,单独HLA抗体、单独HPA抗体、HLA+HPA抗体阳性的患者分别为72例(83.72%)、8例(9.30%)、6例(6.98%)。HLA抗体在各位点中检出频率最高的抗体对应等位基因分别为A*25:01、B*15:12、C*02:02(和C*17:01),检出率分别为81.48%、87.04%、48.15%;而对应抗原表位出现频率最高的前三位为163LG、97V、71ATD,检出率分别为87.04%、77.78%、74.07%。仅存在HLA抗体的患者,输注交叉配型相合血小板的24 h血小板计数纠正增加指数(CCI)及输注有效情况均明显优于随机血小板(P<0.01)。在血小板交叉配型阴性结果的患者中,HLA抗体强度与交叉配型相合血小板的24 h CCI值及输注有效情况呈负相关关系,强度越高,输注效果越差(P<0.01)。HLA抗体强度为中、低等水平的患者,输注交叉配型相合血小板的24 h CCI值及输注有效情况均优于输注随机血小板(P<0.05)。结论 本研究所得到的PTR患者HLA/HPA抗体特性及其对血小板输注效果影响的结果,可为血小板库建立时供者的选择提供指导,同时对临床PTR患者的治疗方式选择有一定的参考价值。
文摘《电子商务法》实施以来,电子商务平台经营者的法律责任经历了从无到有、从线下移转至线上的模式改变,《消费者权益保护法》所规定的电子商务平台内经营者主体责任转向了《电子商务法》的电子商务平台经营者第一责任,再至目前的合规经营阶段,由过去责任转变至预防责任,由被动化为主动,经济法社会责任的特质在平台责任之构建上得以充分体现,电子商务平台经营者法律责任同电子商务治理模式共同处于不断进化的过程当中。《电子商务法》作为一部在互联网环境下应运而生的法律,在整体规则设计上还存在一定的不成熟之处,尤其在司法实践过程中,平台经营者责任认定与要件构成方面存在系列法律的适用问题仍待明晰。本文以《电子商务法》第38条为载体,就该条款的逻辑结构进行分析拆解,分析其适用要件与法律后果,以期进一步明晰平台经营者法律责任定位与内涵,为司法裁判提供一个稳定统一的裁判思路。Since the implementation of the E-Commerce Law, the legal responsibility of e-commerce platform operators has experienced a change in mode from none to some, from offline to online, the main responsibility of e-commerce platform operators stipulated in the Consumer Protection Law has shifted to the first responsibility of e-commerce platform operators in the E-Commerce Law, and then to the current stage of compliant operation, and has changed from the past responsibility to the preventive responsibility, and has become active instead of passive, and the quality of social responsibility in economic law has been fully reflected in the construction of platform responsibility. The legal responsibility of e-commerce platform operators and the e-commerce governance model are in the process of continuous evolution. The E-Commerce Law, as a law that came into being under the Internet environment, has certain immaturity in the overall design of rules, especially in the process of judicial practice, there are a series of legal problems in the determination of the responsibility of the platform operator and the composition of the elements that still need to be clarified. This article takes Article 38 of the E-Commerce Law as the carrier, analyzes and dismantles the logical structure of this article, analyzes its applicable elements and legal consequences, in order to further clarify the positioning and connotation of the legal responsibility of the platform operator, and provide a stable and unified adjudication idea for the judicial decision.
