Does distillery yeast sludge ameliorate moldy feed toxic effects in White Leghorn hens?

Aflatoxin and ochratoxin are important mycotoxins formed by different species of Aspergillus and Penicillium. The purpose of this study was to check the toxic pathological effects of moldy feed in White Leghorn (WLH) hens and to estimate the amelioration by distillery yeast sludge (DYS) against mycotoxins. For this purpose, 100, 40-weeks old WLH hens were procured and kept under standard management conditions. Birds were divided in five equal groups. Birds were kept on moldy feed (ochratoxin A (OTA): 56?μg/kg and aflatoxin B1 (AFB1): 136?μg/kg) mixed with 0, 0.5, 1 and 2% DYS/kg moldy feed. Group A served as control. The birds of the control group were active, with normal feed intake and feathers as compared to moldy feed and in combination with DYS. The attraction toward feed and water, feed intake, body weight gain, egg production (%) and egg weight significantly (p?≤?0.05) decreased in the moldy group as compared to control group. The relative weight of liver, kidney, heart and spleen increased significantly in groups B (moldy feed) and C (moldy feed?+?0.5% DYS) as compared to control group. Total erythrocyte count (TEC), total leukocyte count (TLC), hemoglobin (Hb) and hematocrit lowered significantly in B and C groups. Moldy feed in liver, kidney and spleen produced pathological changes like enlargement, ecchymotic hemorrhages on the surface, vacuolar degeneration, cellular infiltration, congestion, etc. Almost all parameters studied were normal compared to control group with the addition of 2% DYS in moldy feed while 1% DYS partially ameliorated the toxic effects of mycotoxins.     

急性等容血液稀释对血液成份及凝血功能的影响

目的：了解急性等容血液稀释对血液成份及凝血功能的影响，方法：选择20例估计出血量多的大手术患者，随机分为急性等容血液稀释组（简称稀释组）和对照组，每组10例，稀释组术前进行急性等容血液稀释，预计把Hct稀释至30％，监测并比较两组血液稀释毕，术毕，术后第1天，第7天Hb,Hct,Plt,Alb,Pt,Aptt,Fg变化，结果：稀释组稀释毕，术毕，术后第1天，第7天及对照组术毕，术后第1天，第7天，Hb,Hct,Plt值均极显著低于术前值（P＜0．01），稀释组术毕，术后第1天Hb,Hct极显著低于对照组同期值（P＜0．01），但第7天两组则无差别，两组术毕，术后第1天，第7天Alb显著低于术前值（P＜0．05），但两组上述各监测值均仍在安全范围内；两组稀释毕及术毕，术后Pt,Aptt,Fg与术前相比无差别（P＞0．05），结论：急性等容血液稀释可使患者Hb,Hct,Plt较显著下降，但经控制好稀释程度仍可维持在安全范围内，而结凝血功能影响轻微。     

Effect of treatment with cadmium on kinetic properties of Na(+), K(+)-ATPase and glucose-6-phosphatase activity in rat liver microsomes a correlative study on influence of lipid/phospholipid make-up

Studies on Cd hepatotoxicity have focused mainly on induction of cytochrome P(450) system and related enzymes. In the present study young adult male rats given a single intra-peritoneal injection of Cd (0.84mg Cd/kg body weight) and effects on kinetic parameters rat liver microsomal Na(+), K(+)-ATPase and G6Pase were evaluated at the end of 1 month and 1 week. The substrate and temperature kinetics parameters were examined and attempts were made to seek correlation with changes in lipid/phospholipid profiles. The Na(+), K(+) ATPase activity decreased only in 1 week Cd-treated group but recovered at the end of 1 month. The activity resolved in two distinct kinetic components in control as well as the experimental groups. In 1 week Cd-treated group the K(m) value of both the components was unchanged, whereas V(max) value decreased. In 1-month Cd-treated group V(max) value only of component I increased. The catalytic efficiency of both the components was not affected in the experimental groups. In 1-week Cd-treated group the energy of activations at high-temperature range (E(H)) and low-temperature range (E(L)) decreased, whereas for 1-month Cd-treated group the energies of activations did not change. The G6Pase activity measured at 37 degrees C was high only in 1-month Cd-treated group. The activity resolved in two kinetically distinguishable components in control as well as in the experimental groups. K(m) value of component I decreased in both the Cd-treated groups. In 1-month Cd-treated group the V(max) value of component II increased. The catalytic efficiency of G6Pase was unchanged despite changes in K(m) and V(max). In 1-week Cd-treated group the E(H) and E(L) decreased, whereas only E(L) showed decrease in 1-month Cd-treated group. Cholesterol (CHL) content increased in both the Cd-treated groups. Content of lysophospholipid (Lyso), spinghomyelin (SPM) and phosphatidic acid (PA) increased, whereas phosphatidylcholine (PC) and phosphatidylserine (PS) decreased in 1-week Cd-treated group. In 1-month Cd group the Lyso, SPM, and PC increased while PC, phosphatidylethanolamine (PE) and PA decreased. In conclusion, Cd has short-term effects on microsomal Na(+), K(+)-ATPase which are reversed by the end of 1 month and that G6Pase does not seem to be a target of Cd insult.     

左卡尼汀对促红细胞生成素治疗血液透析患者肾性贫血疗效的影响

目的 探讨左卡尼汀对促红细胞生成素治疗血液透析患者肾性贫血疗效的影响.方法 将40例进行血液透析治疗（HD）的慢性肾衰尿毒症患者,随机分为治疗组和对照组,每组20例.对照组给予促红细胞生成素9 000 u/周,于血液透析后皮下注射,同时常规口服铁剂、叶酸.治疗组在对照组基础上予左卡尼汀1.0g加入20 ml 0.9％氯化钠注射液静脉缓慢注射3～5 min,每周2次.两组均治疗3个月.治疗前和治疗4周、3个月后检测血红蛋白（Hb）、血细胞比容（Hct）、血清铁蛋白（SF）、血清全段甲状旁腺素（iPHT）并比较.结果 治疗组治疗4周后,Hb、Hct水平较治疗前上升（均P＜0.05）.3个月后两组Hb较治疗前均显著升高（均P＜0.05）,而且治疗组Hb的升高明显优于对照组（P＜0.01）.结论 左卡尼汀能提高促红细胞生成素治疗血液透析患者肾性贫血的疗效.     

Effect of ethanol on the distribution of cadmium between the cadmium metallothionein- and non-metallothionein-bound cadmium pools in cadmium-exposed rats.

In an attempt to assess the effect of ethanol on cadmium accumulation, metallothionein (MT) synthesis, Cd-binding capacity and lipid peroxidation, rats were administered either Cd, ethanol or their combination for a period of 4 weeks. A significant increase in Cd accumulation was observed in all the organs of rats under study co-exposed to Cd and ethanol as compared to only Cd-treated rats. Increased MT levels in response to Cd were associated with a marked alteration in the distribution of Cd amongst the two pools of intracellular Cd i.e. Cd bound to MT (Cd-MT) and Cd not bound to MT (non-MT-Cd). Higher levels of non-MT-Cd were observed in liver, kidney and heart of Cd+ethanol-exposed rats as compared to only Cd-exposed rats. Lesser binding of 109Cd to the protein peak was observed in Cd+ethanol-exposed rats than the Cd-treated rats when hepatic supernatants from all the groups were chromatographed on Sephadex G-75 columns, suggesting that ethanol has a redistributing effect on Cd amongst the two pools. A marked increase in lipid peroxidation was observed which was linear to the increase in non-MT-Cd levels. A positive correlation between non-MT-Cd levels and lipid peroxidation was observed in liver, kidney and heart suggesting that non-MT-Cd levels are more crucial and toxicologically more important than total Cd levels.     

肝炎病毒感染对维持性血液透析患者贫血的影响

目的 回顾性分析乙型和(或)丙型病毒性肝炎感染对于慢性血液透析患者贫血状况的影响.方法 52例终末期肾脏病(ESRD)接受血液透析患者,根据肝炎病毒检测分为两组,HBV阳性及(或)HCV阳性22例为A组,HBV阴性并HCV阴性30例为B组.比较两组间人重组促红细胞生成素的使用剂量,以及两组间血红蛋白和红细胞压积的差异.结果 两组病人人重组促红细胞生成素的用量差异无显著性(P＞0.05),而A组病人血红蛋白和红细胞压积均较B组高,差异存在显著性(P＜0.05).结论 HBV及(或)HCV的感染可能启动了肝脏产生EPO途径,在一定程度上改善了ESRD患者的贫血状态.     

Amelioration of immunosuppressive effects of aflatoxin and ochratoxin A in White Leghorn layers with distillery yeast sludge

The present study was carried out with the objectives to thrash immunotoxic effects of moldy feed in commercial White Leghorn layers and to know either addition of distillery yeast sludge (DYS) in moldy feed ameliorates the immunotoxic effects or not. For this purpose, moldy feed was prepared containing OTA and AFB1 56 and 136?μg/kg, respectively. For this purpose, 100, 40-week-old White Leghorn hens were procured and kept under standard management conditions. Birds were divided into five equal groups. Birds were kept on moldy feed (ochratoxin A: 56?μg/kg and aflatoxin B1: 136?μg/kg) mixed with 0%, 0.5%, 1% and 2% DYS/kg moldy feed. Group A served as control. Blood was collected without anticoagulant to separate serum. Serum ALT, creatinine and blood urea levels significantly increased in moldy-fed group as compared to control group, while nonsignificantly different readings of serum ALT, creatinine and blood urea were recorded in moldy feed?+?2% DYS and control group. Immune parameters, that is, lymphoproliferative response to PHA-P, phagocytic potential and total protein and IgG titers against sheep RBCs were significantly decreased in birds receiving moldy feed as compared to control group. Almost all parameters studied were normal compared to control group with the addition of 2% DYS in moldy feed, while 1% DYS partially ameliorated the immunotoxic effects of mycotoxins.     

老年慢性心力衰竭患者贫血相关指标分析

目的分析老年慢性心力衰竭患者贫血相关指标变化情况。方法对比分析48例老年慢性心力衰竭患者（观察组）和48例健康人（对照组）的外周血红细胞计数（RBC）、血红蛋白（Hb）、红细胞比容（Hct）等贫血相关指标。结果观察组RBC、Hb、Hct分别为（3．37±0．49）×10^12／L、（103．64±14．33）g／L、（0．31±0．08）,对照组分别为（4．64±0．51）×10^12／L、（121．33±17．69）g／L、（0．37±0．07）,两组差异均有统计学意义（t=4．46、3．06、4．18,P=0．02、0．04、0．04）;治疗后,观察组心力衰竭症状缓解,RBC为（3．76±0．58）×10^12／L,与对照组差异有统计学意义（t=0．48,P=0．03）;观察组Hb、Hct分别为（123．77±17．26）g／L、（0．37土0．05）,与对照组差异均无统计学意义（P=0．06、0．11）。结论老年心力衰竭患者贫血相关指标均低于健康人,心力衰竭与贫血之间存在明显的相关性。     

不同容量治疗方案对硬膜外麻醉下急诊骨科手术患者效果比较

目的：探讨不同容量治疗方案对硬膜外麻醉下急诊骨科手术患者治疗效果的影响。方法：收集急诊骨科手术患者100例,随机分为两组。两组患者一般情况比较,差异无统计学意义,具有可比性。所有患者进行硬膜外麻醉,高容量血液稀释组快速输入6%羟乙基淀粉;对照组常规输液。比较两组MAP、HR、CVP、Hct及Hb的变化情况。结果：Ⅰ组患者MAP、HR变化与术前比较,差异无统计学意义;CVP略有增高,但在正常范围内。Ⅱ组患者术后与术前比较MAP、CVP降低,HR增快。Ⅰ组患者术后与术前比较,Hb、Hct略有降低;Ⅱ组患者术后Hb、Hct明显降低,与术前比较,差异有统计学意义。结论：急性高容量血液稀释,可提高急诊骨科手术患者对失血的耐受性,对维持手术患者机体内环境稳态有积极意义,操作简便、安全有效。     

Combined nephrotoxicity of methylmercury, lead, and cadmium in Pekin ducks: metallothionein, metal interactions, and histopathology

This report describes the metallothionein (MT) levels and accumulation of mercury, lead, and cadmium, as well as their interaction with tissue zinc, copper, and iron, and the histopathological changes in kidneys of ducks exposed to methylmercury chloride (MeHgCl), lead acetate (PbAc), and cadmium chloride (CdCl2), singly or in combination for 13 wk. Forty-eight female Pekin ducks, divided into 8 groups of 6 birds each, were fed diets containing no added metals (control), 8 mg MeHgCl/kg feed, 80 mg PbAc/kg feed, 80 mg CdCl2/kg feed, 8 mg MeHgCl + 80 mg PbAc/kg feed, 8 mg MeHgCl + 80 mg CdCL2/kg feed, 80 mg PbAc + 80 mg CdCl2/kg feed, and 8 mg MeHgCl + 80 mg PbAc + 80 mg CdCL2/kg feed. Cadmium (Cd) when administered alone or in combination caused a 60-fold increase in kidney MT levels, while methylmercury (MeHg) or lead (Pb) administration caused a threefold increase in kidney MT levels. No significant changes in kidney MT levels were observed when metals were administered concurrently when compared with single-treatment groups. Residue analysis revealed accumulation of administered metals in kidney tissue. However, lead administration resulted in accumulation of small amounts of this element in kidney tissue. Simultaneous administration of MeHgCl and PbAc significantly increased the accumulation of lead in kidney when compared with PbAc-treated group. Cadmium when administered alone or in combination caused an increase in the levels of zinc and copper in kidney. Administration of MeHgCl or PbAc either alone or in combination caused increased iron levels in kidney, while cadmium administration either alone or in combination caused decreased iron levels. Administration of cadmium either alone or in combination caused degenerative changes in kidney proximal tubules. The severity of degenerative lesions increased when cadmium was simultaneously administered with other metals. These results indicate that combined administration of MeHg, Pb, and Cd has no significant effect on kidney MT levels or on essential elements in kidney tissue when compared with single metal groups. However, there appears to be an increase in the severity of histopathologic changes.     

高渗氯化钠羟乙基淀粉40注射液预防经尿道前列腺电切综合征的临床观察

目的 观察高渗氯化钠羟乙基淀粉40注射液用于经尿道前列腺切除术(TURP)的可行性及其预防经尿道前列腺电切综合征的效果.方法 选择90例择期行TURP患者,完全随机分为乳酸林格液组(R)、6％羟乙基淀粉组(H)和高渗氯化钠羟乙基淀粉40组(S).3组均用L3～４腰-硬联合麻醉,麻醉平面控制在T10以下.手术开始后每隔15 min记录各时点(T0、T15、T30、T45、T60、T75、T90/Tend)的心率(HR)、平均动脉压(MAP)、中心静脉压(CVP).每隔30 min抽取动脉血检测Na+、K+、Hct、Hb,记录手术时间及术中冲洗液用量.结果 3组术前HR、MAP、CVP差异无统计学意义(均P＞0.05).T30之后R组HR、MAP明显下降(P＜0.05),CVP明显升高.T60之后H组HR、MAP明显下降(P＜0.05),CVP明显升高(P＜0.05).各时点S组HR、MAP、CVP差异无统计学意义(P＞0.05).3组术前Na+、K+、Hct、Hb差异无统计学意义(P＞0.05).3组各时点K+差异无统计学意义(P＞0.05).T30之后R组Na+、Hct、Hb明显下降(P＜0.05).T60之后H组Na+、Hct、Hb明显下降(P＜0.05),S组Hct、Hb明显下降(P＜0.05).R组有6例患者发生经尿道前列腺电切综合征,经输入高渗盐水及呋塞米后得到纠正.H组和S组均无一例发生.R组有12例、H组有7例患者发生低血压需要注射麻黄碱纠正,S组无一例发生严重低血压.全部病例均未发生低血钾、过敏反应等不良反应.结论 TURP术中应用高渗溶液安全可行,预防经尿道电切综合征的效果较6％羟乙基淀粉优越.     

静脉注射与口服铁剂治疗肾性贫血的疗效比较

目的：比较静脉注射铁剂与口服铁剂治疗慢性肾衰竭患者肾性贫血的临床效果。方法：对入选的60例肾性贫血患者以随机抽样法分为2组,每组各30例,在皮下注射基因重组人红细胞生成素（EPO）的基础上,分别采用静脉注射铁剂（静脉组）和口服铁剂（口服组）治疗。静脉组患者给予蔗糖铁静脉滴注,完成总量后,根据患者铁蛋白和血红蛋白（Hb）水平,定期给予100mg维持量。口服组患者口服琥珀酸亚铁200mg,1日3次。以铁剂治疗前后患者Hb和红细胞比容（Hct）的变化等衡量治疗效果。结果：治疗12周后,2组患者Hh、Hct、血清铁（SI）,血清铁蛋白（SF）、转铁蛋白饱和度（TSAT）水平均较治疗前显著升高（P〈0．01）;患者Hb、Hct改变方面,2组比较,差异无统计学意义（P〉0．05）;静脉组患者SF、TSAT上升幅度显著高于口服组（P〈0．01）。结论：静脉组比口服组疗效更好,对于慢性肾衰竭内生肌酐清除率为10～30ml／min的患者,在皮下注射EPO的基础上,联合静脉注射铁剂治疗肾性贫血比口服铁剂更具效果,值得临床推荐。     

右旋糖酐氢氧化铁在治疗血液透析患者肾性贫血中的应用

目的:评价右旋糖酐氢氧化铁注射液治疗维持性血液透析患者肾性贫血的有效性与安全性.方法:120例维持性血透病人,随机分为静脉组与口服组,分别采用静脉注射右旋糖酐氢氧化铁及口服琥珀酸亚铁进行补铁治疗,总疗程8周.检测治疗前后血清铁及红细胞相关指标并对不良反应进行监测.结果:治疗8周时,静脉组RBC、Hb、Hct、血清铁蛋白(SF)与转铁蛋白饱和度(TSAT)显著升高,幅度明显高于口服组(P＜0.01).静脉组3例有不良反应,1例出现药物相关皮疹,停药后消失,2例轻度胃肠道反应.口服组19例出现明显胃肠道症状.静脉组总不良反应发生率(3/60,5.0%)明显低于口服组(19/60,31.6%),P＜0.01.结论:静脉注射右旋糖酐氢氧化铁可有效纠正维持性血透病人的铁缺乏、提高铁利用率及rHuEPO的治疗效果.且不良反应发生率低、安全性良好.     

Effects of subcutaneous and oral cadmium on iron metabolism: Role of ceruloplasmin and metallothionein

Male ICR mice were either given water containing Cd at a level of 192–200 ppm for 45 days (ingestion group), or were injected subcutaneously once a week with Cd (1 mg/kg) as CdCl₂ for 7 weeks (injection group). The control group was given Cd-free water. In both Cd groups, the hematocrit and hemoglobin values did not change markedly. In the ingestion group, the Fe concentration decreased greatly in the liver, kidney, spleen, and duodenum. These decreases may be due to depression of Fe absorption from the intestine. In the injection group, Fe increased in the liver, spleen, and duodenum, although it decreased in the kidney. By Sephadex G-200 gel filtration, Fe-proteins in the hepatic supernatants were located in the void volume region of this gel column in both Cd groups. Apparently, Fe was not a component of metallothionein (MT) protein. The hepatic MT induction by Cd resulted in an increase in hepatic supernatant Cu. Serum Cu and ceruloplasmin (Cp) activity were stimulated only in the injection group. The enhancement of Cp activity may possibly be due to the increase in hepatic Cu which was accompanied by an increase in hepatic Fe, rather than a decrease. Our observations suggest that Fe metabolism is influenced differentially by the administration route of Cd.     

Subchronic cadmium treatment affects the abundance and arrangement of cytoskeletal proteins in rat renal proximal tubule cells

Disfunction of proximal tubules (PT) in cadmium (Cd) nephrotoxicity in mammals results from the diminished functional capacity of brush-border membrane (BBM) caused by (a) direct inhibition of BBM transporters by Cd, (b) shortening and loss of microvilli, and (c) loss of specific BBM transporters. The loss of transporters may partially result from impaired intracellular vesicle recycling due to loss or/and inhibition of vacuolar H+-ATPase in the PT cell organelles. Cytoskeleton plays an important role in vesicle-mediated recycling and processing of BBM transporters in PT cells. Experiments in vitro have indicated that Cd may affect the state of polymerization of some cytoskeletal proteins. In this work we studied the in vivo effect of CdCl2-treatment in rats (2 mg Cd/kg b. m., s.c., daily for 14 days) upon abundance and arrangement of actin filaments, actin-bundling protein villin, and microtubules (MT) in PT cells. Cd-treatment elicited a dramatic accumulation of Cd in the kidney cortex (200 microg/g tissue wet mass after 14 days) and a strongly increased abundance of metallothionein in PT cells. As revealed by immunocytochemistry in tissue cryosections, the staining intensity of actin and villin in PT cells of Cd-treated rats was generally decreased, without a marked change in their intracellular distribution, whereas MT became largely irregular, diminished in most cells, and lost in many cells. However, the immunoblots revealed an increased content of villin and alpha-tubulin in cortical tissue homogenates from Cd-treated rats, thus indicating an impaired bundling of actin and greatly depolymerized MT in cells intoxicated with Cd. The partial loss of apical actin and villin in PT cells of Cd-treated rats may reflect (or cause) shortening and loss of microvilli, whereas derangement and depolymerization of MT may contribute to the impairment of intracellular recycling of BBM proteins, and lead to the loss of BBM transporters.     

当归多糖对幼年大鼠染铅所致贫血的治疗作用

目的探讨当归多糖(APS)对染铅大鼠的驱铅作用和对染铅所致贫血的治疗作用。方法 4周龄SD幼鼠ip给予醋酸铅30 mg.kg-1,隔天1次,连续7次,建立铅性贫血模型。建模第2天,ip给予APS15,30,60和120 mg.kg-1,每天1次,共14 d。以给药当天为第1天,分别于给药前第7和14天剪尾取血,检测血铅(BPb)、血红蛋白(Hb)和红细胞(RBC)。第14天处死大鼠,股动脉取血,测定BPb、Hb、RBC、血细胞比容(Hct)、δ-氨基乙酰丙酸脱水酶(ALAD)活性和锌原卟啉(ZPP)浓度。采用石墨炉原子吸收光谱法测定全血血铅含量;采用氰化高铁法测定Hb含量;采用显微镜计数法计数RBC;采用血球分析仪测定Hct;采用二甲氨基苯甲醛法比色法测定全血ALAD活性;采用锌原卟啉血液荧光测定仪测定ZPP。结果与正常对照组比较,给药前第7天和第14天模型组BPb含量显著升高,Hb和RBC明显降低(P<0.01);与给药前相比模型组第7和14天BPb含量均明显降低(P<0.01)。与模型组相比,给APS 15～120 mg.kg-1第7天和第14天,BPb明显降低,并且第14天明显低于第7天,但均显著高于对应的正常对照组(P<0.01);Hb和RBC明显升高,并且第14天明显高于第7天,Hb分别增加了33.4%,34.1%,21.0%和34.6%,RBC分别增加了28.5%,17.9%,18.3%和19.2%(P<0.01),基本恢复至正常对照组水平。与模型组相比,给予APS 15～120 mg.kg-1第14天,Hct明显升高,并且恢复至正常对照组水平;ALAD明显升高(P<0.01),但仍显著低于正常对照组水平(P<0.01);ZPP明显降低,但仍显著高于正常对照组水平(P<0.01)。二巯基丁二酸120 mg.kg-1作用与APS一致、效果相当。结论 APS具有明显的驱铅作用,对染铅所致贫血具有治疗作用。     

氯丙嗪和维拉帕米对大鼠镉肾毒性的影响(英文)

目的研究氯丙嗪(CPZ)和维拉帕米(Ver)对由镉引起的大鼠肾毒性是否有预防作用。方法32只大鼠随机分成4组,分别为对照组、单纯染镉组、CPZ和Ver预处理组。单纯染镉组大鼠sc7μmol·kg-1氯化镉;CPZ和Ver预处理组分别ipCPZ5mg·kg-1和Ver4mg·kg-1,1h后sc7μmol·kg-1氯化镉;对照组在相应时间内给予生理盐水,注射容量均为2mL·kg-1。最后一次注射24h后,收集24h尿样,测定尿乳酸脱氢酶(LDH)活性、尿蛋白、尿镉、肾镉和肾皮质中的Na+K+ATP酶,Ca2+ATP酶和蛋白激酶C(PKC)的活性。结果单纯染镉组与对照组比较,尿镉和肾镉含量明显升高。CPZ和Ver预处理组尿镉明显低于单纯染镉组,但肾镉无明显变化。与对照组比较,单纯染镉组尿LDH活性、尿蛋白和肾皮质中的Na+K+ATP酶,Ca2+ATP酶和PKC活性明显升高。CPZ和Ver预处理组大鼠尿LDH活性、尿蛋白和肾皮质中的Na+K+ATP酶,Ca2+ATP酶和PKC活性明显低于单纯染镉组。结论镉能激活Na+K+ATP酶,Ca2+ATP酶和PKC的活性,而且,CPZ和Ver均可不同程度地减轻肾毒性。     

右旋糖酐氢氧化铁治疗肾性贫血的临床研究

目的比较静脉注射右旋糖酐氢氧化铁(科莫非)与口服多糖铁复合物(力蜚能)治疗维持性血液透析患者肾性贫血的疗效与安全性。方法 40例病情稳定的血液透析患者,规律透析2～3次/周。所有患者血红蛋白(Hb)60～100 g/L或红细胞压积(Hct)<30%,血清铁蛋白(SF)<200μg/L,转铁蛋白饱和度(TSAT)<30%,接受皮下注射重组人促红细胞生成素(rHuEPO)每周100～150 U/kg。将上述患者随机分为口服治疗组和静脉治疗组,每组20例,观察期为24周。口服组予多糖铁复合物150 mg/d。静脉组每次透析时静脉滴注右旋糖酐氢氧化铁100 mg,累计1 000 mg后每2周给予维持量100 mg。若患者的Hb达到110 g/L或Hct达到33%以上,则将rHuEPO减量以维持Hb及Hct水平。检测补铁前及补铁4、8、12、24周时患者Hb、Hct、SF以及TSAT水平。结果治疗后两组Hb、Hct、SF、TSAT均较治疗前有明显升高(P<0.05),静脉组Hb、Hct、SF、TSAT上升幅度均高于口服组(P<0.05)。治疗后24周静脉组rHuEPO用量较治疗前及口服组明显减少(P<0.05)。两组治疗前后肝功能差异无统计学意义。治疗后静脉组血清C反应蛋白高于治疗前及口服组,但仍在正常范围内。静脉组不良反应1例,口服组不良反应4例。结论静脉用右旋糖酐氢氧化铁治疗肾性贫血安全有效,不良反应少,且可减少rHuEPO用量。