尿微量蛋白联合血浆TM检测对糖尿病早期肾损伤的诊断价值

目的探讨尿微量蛋白[微量白蛋白(MA)、α1-微球蛋白(α1-M)、β2微球蛋白(β2-M)、转铁蛋白(TRF)]联合血浆凝血酶调节蛋白(TM)检测对糖尿病早期肾损伤的诊断价值.方法用放射免疫法检测1 44例糖尿病患者及72例健康人尿微量蛋白,同时用ELISA法检测血浆TM,并对检测结果进行统计、分析.结果糖尿病组尿微量蛋白和血浆凝血酶调节蛋白测定结果明显高于健康对照组,其差异有统计学意义;糖尿病常规尿蛋白阳性组尿MA、α1-M、β2-M、TRF与常规尿蛋白阴性组比较P＜0.01,二者有显著性差异.尿MA与血浆TM联检后,阳性率则提高到93.7%.结论尿微量蛋白联合血浆TM检测对糖尿病早期肾损伤的诊断有重要价值.     

尿微量蛋白联合血浆TM检测对糖尿病早期肾损伤的诊断价值

目的探讨尿微量蛋白〔微量白蛋白(MA)、α1-微球蛋白(α1-M)、β2微球蛋白(β2-M)、转铁蛋白(TRF)〕联合血浆凝血酶调节蛋白(TM)检测对糖尿病早期肾损伤的诊断价值。方法用放射免疫法检测144例糖尿病患者及72例健康人尿微量蛋白,同时用ELISA法检测血浆TM,并对检测结果进行统计、分析。结果糖尿病组尿微量蛋白和血浆凝血酶调节蛋白测定结果明显高于健康对照组,其差异有统计学意义;糖尿病常规尿蛋白阳性组尿MA、α1-M、β2-M、TRF与常规尿蛋白阴性组比较P<0.01,二者有显著性差异。尿MA与血浆TM联检后,阳性率则提高到93.7%。结论尿微量蛋白联合血浆TM检测对糖尿病早期肾损伤的诊断有重要价值。     

尿微量蛋白联合检测对糖尿病肾损伤早期诊断的价值

目的探讨联合检测尿微量白蛋白（MA）、尿α1-微球蛋白（α1-M）对糖尿病肾损伤早期诊断的价值。方法对126例糖尿病患者组成的糖尿病组和118例健康体检者组成的对照组用速率散射比浊法分别进行尿微量白蛋白（MA）和尿α1-微球蛋白（α1-M）测定，并对结果进行统计学分析。结果糖尿病组MA和α1-M阳性率分别是52．38％和61．90％，并且两者均与糖尿病患者的年龄和病程呈正相关，年龄越大，病程越长，MA和α1-M阳性率越高。结论联合检测尿微量白蛋白（MA）及尿α1-微球蛋白（α1-M）对糖尿病肾损伤的早期诊断有非常重要的临床参考价值，可作为糖尿病肾损伤的早期诊断指标。     

糖尿病肾病患者尿微量蛋白的观察与分析

目的探讨糖尿病肾病患者尿微量蛋白在早期糖尿病肾病的临床诊断价值。方法采用免疫散射比浊法抽取89例糖尿病患者的尿液标本，分别检测尿微量白蛋白(mAlb)、转铁蛋白(TRF)、免疫球蛋白G(IgG)α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)含量。结果糖尿病尿蛋白定性阴性时，微量蛋白均高于正常对照组，尿蛋白定性阳性时，上述指标均明显高于尿蛋白阴性组。结论联合检测尿mAlb、TRF、IgG、α1-MG、β2-MG可提高早期糖尿病肾病诊断阳性率，是一种理想方法。     

尿微量蛋白联合检测对早期糖尿病肾病诊断价值分析

目的探讨尿微量蛋白联合检测对早期糖尿病肾病（DN）的诊断价值。方法采用免疫速率散射比浊法，检测80例尿蛋白定性阴性的DM患者及60例健康对照者的尿MA、TRF、IgG、α1—MG、RBP、β2-MG的含量。结果DM尿6种微量蛋白水平均显著高于对照组（P〈0．01），阳性率分别为MA（43．2％）、TRF（47.8％）、IgG（36．4％）、a1-MG（40．7％）、RBP（53．8％）、β2-MG（59．6％），联合检测阳性率为85．7％。结论尿MA、TRF、够、a1-MGRBP及降MG可作为DN早期诊断的灵敏指标，并且6项指标联合检测有助于提高阳性率。     

尿微量蛋白早期诊断高血压肾病的研究

目的 通过检测尿微量蛋白含量以探讨早期诊断高血压病肾脏损伤的方法。方法采用免疫速率散射比浊法检测尿免疫球蛋白G(IgG)、尿转铁蛋白(TRF)、尿微量白蛋白(mALB)、尿α1-微球蛋白(α1-MG)、尿视黄醇结合蛋白(RBP)、尿β2-微球蛋白(β2-MG)。结果 75例尿蛋白定性阴性高血压病患者尿IgG、TRF、mALB、α1-MG、β2-MG、RBP水平显著高于对照组(P<0.001);将尿IgG、TRF、mALB、α1-MG、β2-MG、RBP联合检测在尿蛋白定性阴性的高血压病中阳性率可达90.67％,大大提高了阳性检出率。结论 检测尿微量白蛋白是诊断肾脏早期损伤灵敏、可靠的实验室指标。     

尿微量蛋白联合尿酶早期诊断糖尿病肾病

目的通过联合检测尿微量蛋白及尿酶以探讨早期诊断糖尿病肾脏损伤的方法。方法采用免疫速率散射比浊法检测尿免疫球蛋白G（IgG）、尿转铁蛋白（TRF）、尿微量白蛋白（mALB）、尿α1-微球蛋白（α1—MG）、尿视黄醇结合蛋白（RBP）、尿β2-微球蛋白（β2-MG），速率法测尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）及尿肌肝。结果167例尿蛋白定性阴性糖尿病患者尿IgG、TRF、mALB、α1—MG、β2-MG、RBP及NAG水平显著高于对照组（P〈0．01）；将尿IgG、TRF、mALB、α1—MG、β2-MG、RBP及NAG联合检测在尿蛋白定性阴性的糖尿病中阳性率可达86．23％，大大提高了阳性检出率。结论检测尿微量白蛋白及尿酶是诊断肾脏旱期桶伤灵敏、可靠的实验室指标.     

尿微量蛋白和尿酶在糖尿病肾病早期诊断中的应用研究

目的 探讨联合检测尿微量蛋白及尿酶在糖尿病肾脏损伤早期诊断中的价值。方法采用免疫速率散射比浊法检测尿免疫球蛋白G(IgG)、尿转铁蛋白(TRF)、尿微量白蛋白(mALB)、尿α1-微球蛋白(α1-MG)、尿视黄醇结合蛋白(RBP)、尿β2-微球蛋白(β2-MG),速率法测尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)及尿肌肝。结果:127例尿蛋白定性阴性糖尿病患者尿IgG、TRF、mALB、α1-MG、β-MG、RBP及NAG水平显著高于对照组(P<0.01);联合检测的阳性率可提高到86.23％。结论 检测尿微量白蛋白及尿酶是诊断糖尿病肾脏早期损伤灵敏、可靠的实验室指标。     

尿液微量蛋白4项检测对糖尿病肾病的早期诊断价值

目的探讨尿微量白蛋白(MA)、尿转铁蛋白(TRF)、α_1-微球蛋白(α_1-MG)及β_2-微球蛋白(β_2-MG)的定量检测对糖尿病肾病(DN)的早期诊断价值。方法根据尿蛋白定性试验将65例2型糖尿病患者分为尿蛋白定性阳性组和阴性组,采用免疫比浊法定量检测65例2型糖尿病患者及30例健康体检人员的MA、TRF、α_1-MG及β_2-MG水平,并对结果进行统计和分析。结果尿蛋白定性阳性组和尿蛋白定性阴性组患者的MA(mg/L:28.6±4.4、11.3±1.9比6.9±1.1)、TRF(mg/L:3.5±0.9、1.3±0.4比1.1±0.3)、α_1-MG(mg/L:28.1±6.3、9.4±2.0比8.2±1.9)及β_2-MG(mg/L:4.77±0.71、1.58±0.39比0.94±0.22)均明显高于正常对照组,且尿蛋白阳性组的这4项微量蛋白水平又明显高于尿蛋白阴性组,差异均有统计学意义(均P0.05);MA、TRF、α_1-MG及β_2-MG单项检测对2型糖尿病患者诊断的阳性率分别为41.5%、44.6%、38.5%及33.8%,联合检测这4项微量蛋白的阳性率可高达90.5%。结论尿MA、TRF、α_1-MG及β_2-MG是DN的早期诊断的敏感指标,联合检测这4项指标对提高DN的早期诊断以及鉴别其病变部位有重要意义。     

尿微量蛋白检测对老年高血压早期肾损害的诊断价值

目的探讨尿微量清蛋白检测在老年高血压早期肾损害诊断中的临床作用。方法采用速瘁散射法对97例老年高血压病患者和30例老年健康对照组进行尿液α1-M微球蛋白（α1—M）、β2-微球蛋白（β2-M）、微量清蛋白（MA）、转铁蛋白（TRF）的检测。结果高血压组中I级、Ⅱ级、Ⅲ级尿中α1—M、β2-M、MA水平均显著高于对照组（P〈0．05），高血压Ⅱ级、Ⅲ级尿中TRF水平均显著高于对照组（P〈0．05）。结论尿中微量蛋白联合检测是老年高血压肾脏早期损害的指标，与老年高血压病程有相关性。     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.