《應用英文》Foot the Bill

liver411

《應用英文》Foot the Bill

數年前我來美國住在紐約市Bronx區的某公寓裡，與同一層樓的美國朋友John及其家人相處很好，他們有深厚的中國情結，尤其對中國菜餚情有獨鍾。一次他們興致勃勃地想去中國餐館品嚐廣東菜，請我同去，以便作點菜指導。我欣然奉陪。

席間海闊天空閒聊，也談到中國飲食文化、舉世文明 。快到結束時，服務員小姐送來一份帳單，John隨手拿下，並說I foot the bill。我聽了一頭霧水，心想他的腳 (foot)與帳單 (bill)有何關係？

其夫人見我疑視之狀，忙說He pays! He pays! 我才明白，I foot the bill是「我付帳」的意思。

（紐約‧周祖道）

2005-09-18

gdxz05

Hi, I am new here. I said hello to everyone, but no one answers me. I hope I can get more help in learning English and make new friends here. Will you accept me? Thanks![em08]

liver411

Obviously, your English is pretty good. I am surprised that no one replied to the topic you posted. They are either very busy with life or striving to make the ends meet. [em02]

gdxz05

Thank you very much.

From your other articles in Chinese, I think you may be a doctor. Can I ask you a very basic question? I am not a hbv patient or carrier. I even don't know how to spell hbv in full, but I've got a problem--- no matter how many times I have received the vaccine , I still haven't got the resistent body ( 乙肝抗体). What can I do? I never discriminate any hbv patients, for I have some friends and accquaintances with hbv, and I think I know how people get hbv. Still I want to know if I am in danger of getting hbv in my present case?

Please tell me what I can do.

Thanks again.

[em02]

liver411

After the recommended three-dose intramuscular series, about 1% people will not develop protective levels of antibody to hepatitis B virus. Those people may be nonresponders to hepatitis B vaccine.

Current recommended follow-up of those people who are nonresponders to the hepatitis B vaccine after the three-dose series is to give a fourth dose of hepatitis B vaccine followed by a blood test for HBsAb in one to two months. If HBsAb result is <10mIU/ml, people should be counseled about being a nonresponder. Another option is to repeat the series, three vaccine doses and a blood test (HBsAb) one to two months after the sixth dose of vaccine. However, this strategy is unsuccessful in at least 50% of people. Sometimes, using a high-dose intradermal method, or switching a different brand of vaccine can achieve a higher degree of success.

liver411

If booster, higher dose and intradermal method don't work, you should check if you are co-infected with other virus, such as hepatitis C or if you are immunocompetent , such as a lower cytokine response to the vaccine. Actually, the study indicates the mechanisms causing nonresponsiveness to hepatitis B surface Ag (HBsAg) vaccines in humans remain largely unknown. The increased incidence of nonresponsiveness in subjects with HLA-DR3 or -DR7 haplotype suggests that immune response mechanisms governed by genes of the MHC are involved. It is conceivable that APC of nonresponders are defective in the presentation of HBsAg because they are unable to adequately take up, process, or present this Ag.

Thus, should you be considered a nonresponder to vaccination and susceptible to HBV infection. Monthly HBsAg testing should then be continued, and anti-HBs testing should be done every 6 months if you are among high risky group.

There is another method for nonresponders. That is to revaccinate with regular i.m. (intramuscular) injections that may be appropriate for immunocompetent subjects, in particular high risky people. Accordingly, in a post-marketing surveillance all complying nonresponders achieved satisfactory anti-HB_s levels after receiving bimonthly 20 mg i.m. until a satisfactory response had been achieved

gdxz05

Thank you very much. I have had your letter printed off, for there many medical terms which I don't understand. I will look them up in the dictionary and think over what I can do. I hope I am not infected with hipatitis C.

Thank you again to give me a chance to learn some medical terms.

[em02]