BACKGROUND Macro-aspartate aminotransferase(AST), a macroenzyme, is a high-molecular mass complex formed by self-polymerization or association with other serum components that are difficult for the kidney to clear, le...BACKGROUND Macro-aspartate aminotransferase(AST), a macroenzyme, is a high-molecular mass complex formed by self-polymerization or association with other serum components that are difficult for the kidney to clear, leading to the isolated elevation of serum AST activity. Cases of macro-AST formation are rare, with only 3 published in the English language literature up to September 2019 in China. In this paper, we present a case in which an asymptomatic woman with persistent isolated elevated AST was confirmed as having macro-AST by the polyethylene glycol precipitation method.CASE SUMMARY A 34-year-old woman was referred to our clinic for elevated AST levels with normal levels of other liver-associated enzymes on November 12, 2018. Her AST level of liver function test had been abnormal for 7 mo before she came to the clinic. The patient was asymptomatic with a normal physical examination. There was no relevant family history and no alcohol consumption or smoking. She had a several-month history of traditional Chinese medical taking and had stopped it 1 year prior. The laboratory tests in our clinic showed only the elevation of AST(89.5 U/L) with no other significant abnormalities. We performed the precipitation technique with polyethylene glycol to confirm the presence of macro-AST. Then for almost a year, her AST level still fluctuated in the abnormal range.CONCLUSION This case highlights that clinical physicians should be familiar with this rare condition of persistent isolated AST elevation due to the presence of macro-AST to avoid unnecessary investigation and patient anxiety.展开更多
介绍并解读澳大利亚循证方法学组织(Joanna Briggs Institute,JBI)研发的基于文本和专家意见的系统综述(the systematic review of text and opinion,Sr TO)流程,分别对纳入标准、检索策略、真实性/严格性评价、文本信息提取、文本信息...介绍并解读澳大利亚循证方法学组织(Joanna Briggs Institute,JBI)研发的基于文本和专家意见的系统综述(the systematic review of text and opinion,Sr TO)流程,分别对纳入标准、检索策略、真实性/严格性评价、文本信息提取、文本信息综合5项内容观点进行概括总结,并在其中适时融入中医经验类证据。形成围绕“PICO纳入标准”“检索策略”“资料提取表”“质量评估清单”“信息综合与评级”5项流程的Sr TO,并对中医学领域中医学经验类证据(古籍、医案医话、专家经验等)的系统综述提出了意见和建议。在中医药领域推广应用Sr TO方法,具有较好的方法学研究价值,为中医药领域医案医话相关研究的证据整合提供思路与方向。对中医经验类证据评价和分析路径的标准化和规范化处理,有利于提高此类证据利用度,进而用于解答特定情境下的临床问题。展开更多
文摘BACKGROUND Macro-aspartate aminotransferase(AST), a macroenzyme, is a high-molecular mass complex formed by self-polymerization or association with other serum components that are difficult for the kidney to clear, leading to the isolated elevation of serum AST activity. Cases of macro-AST formation are rare, with only 3 published in the English language literature up to September 2019 in China. In this paper, we present a case in which an asymptomatic woman with persistent isolated elevated AST was confirmed as having macro-AST by the polyethylene glycol precipitation method.CASE SUMMARY A 34-year-old woman was referred to our clinic for elevated AST levels with normal levels of other liver-associated enzymes on November 12, 2018. Her AST level of liver function test had been abnormal for 7 mo before she came to the clinic. The patient was asymptomatic with a normal physical examination. There was no relevant family history and no alcohol consumption or smoking. She had a several-month history of traditional Chinese medical taking and had stopped it 1 year prior. The laboratory tests in our clinic showed only the elevation of AST(89.5 U/L) with no other significant abnormalities. We performed the precipitation technique with polyethylene glycol to confirm the presence of macro-AST. Then for almost a year, her AST level still fluctuated in the abnormal range.CONCLUSION This case highlights that clinical physicians should be familiar with this rare condition of persistent isolated AST elevation due to the presence of macro-AST to avoid unnecessary investigation and patient anxiety.
文摘介绍并解读澳大利亚循证方法学组织(Joanna Briggs Institute,JBI)研发的基于文本和专家意见的系统综述(the systematic review of text and opinion,Sr TO)流程,分别对纳入标准、检索策略、真实性/严格性评价、文本信息提取、文本信息综合5项内容观点进行概括总结,并在其中适时融入中医经验类证据。形成围绕“PICO纳入标准”“检索策略”“资料提取表”“质量评估清单”“信息综合与评级”5项流程的Sr TO,并对中医学领域中医学经验类证据(古籍、医案医话、专家经验等)的系统综述提出了意见和建议。在中医药领域推广应用Sr TO方法,具有较好的方法学研究价值,为中医药领域医案医话相关研究的证据整合提供思路与方向。对中医经验类证据评价和分析路径的标准化和规范化处理,有利于提高此类证据利用度,进而用于解答特定情境下的临床问题。
