抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

https://caltcm.memberclicks.net/assets/documents/acc_aha_chf_2013_guidelines.pdf

2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.

/pdf/healthcare-resource-utilization-in-patients-with-newly-11hwsyg9.pdf

Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Sleep apnea syndrome is characterized by recurrent cessations or substantial reductions of airflow in nose and mouth during sleep. In some patients the cessations (apneas) or reductions (hypopneas) occur because the upper airway is repeatedly sucked closed with inspiratory effort during sleep. In others, airflow may be reduced because of decreased ventilatory effort. Apneas and hypopneas with decreased or absent ventilatory effort are called non-obstructive or central, those with ongoing substantial effort obstructive. Sometimes, during an apnea there is initially no ventilatory effort, but then as the apnea continues ventilatory effort occurs before airflow resumes. This third type of apnea is called mixed. Often, patients with sleep apnea syndrome have more than one type of apnea. Commonly, both apneas and hypopneas occur in the same patient during a typical sleep period. Hypoxia, hypercarbia, or increased ventilatory effort alone trigger arousals and associated resumptions of air flow. These arousals, even when they last only a few seconds, disrupt sleep architecture, contributing to the nonrestorative quality of sleep in patients with sleep apnea syndrome.

Sleep Apnea Syndrome and Other Ventilatory Disturbances

Acute monocular blindness is usually caused by vascular disease or trauma. Less common causes include space-occupying lesions, vascular malformations, or inflammatory processes. These can be differentiated mainly by the different time course of the visual loss (Fig. 1).

Acute Visual Loss — Monocular Blindness

/pdf/a-look-back-at-3-years-of-neurological-research-and-practice-sivv1e6u.pdf

Werner Hacke

Papers

Healthcare Resource Utilization in Patients with Newly Diagnosed Atrial Fibrillation: A Global Analysis from the GARFIELD-AF Registry

Sleep Apnea Syndrome and Other Ventilatory Disturbances

Acute Visual Loss — Monocular Blindness

A look back at 3 years of neurological research and practice (NRP)

Thrombolysis in stroke: which agent, when and how