尿白蛋白肌酐比与UAER相关性分析

2型糖尿病253人,IGT22人,正常人43人.收集过夜计时尿及次日随机尿样,放免法测定过夜尿白蛋白排泄率(UAER),与DCA2000+测定的ACR及RALB进行相关性分析.结果318例过夜尿UAER与ACR及RALB的相关系数分别为0.753,0.712(P=0).UAER与ACR的诊断符合率为92.5%.结论DCA2000+测定的随机尿ACR及RALB在临床筛查微量白蛋白尿以及大规模人群调查中较测定UAER更具优势.     

尿白蛋白肌酐比与UAER相关性分析

2型糖尿病253人,IGT22人,正常2 43人。收集过夜计时尿及次日随机尿样,放免法测定过夜尿白蛋白排泄率（UAER）,与DCA2000＋测定的ACR及RALB进行相关性分析。结果：318例过夜尿UAER与ACR及RALB的相关系数分别为0．753,0．712（P＝0）。UAER与ACR的诊断符合率为92．5％。结论：DCA2000＋测定的随机尿ACR及RALB在临床筛查微量白蛋白尿以及大规模人群调查中较测定UAER更具优势。     

胶体金法检测尿微量白蛋白的结果比较

目的探讨尿微量白蛋白检测在肾损伤早期诊断及治疗中的应用。方法收集糖尿病及体检健康人群的随机尿,使用自动生化分析仪和胶体金检测尿微量白蛋白水平。结果糖尿病组尿微量白蛋白显著高于对照组(P<0.05)。胶体金法与自动生化仪器法对健康人群的检测基本一致。结论胶体金法测定尿微量白蛋白结果准确、稳定,能较早地反映肾损伤情况,适合家庭的动态监测。     

尿微量白蛋白试纸对早期糖尿病肾病诊断的意义

糖尿病肾病 (DN)为糖尿病主要微血管并发症和死亡原因之一 ,对其早期诊治是十分重要的 ,现公认的早期 DN(微量白蛋白尿期 )的临床诊断标准为持续性微量白蛋白尿 ,尿白蛋白排泄率 (UAER)在 2 0～ 2 0 0 μg/min之间[1 ] 。本研究用 Micral-Test 试条测定晨尿微量白蛋白 ,并与放免法 (RIA )测定U AER进行比较 ,现报告如下 :一、对象与方法1.对象 :本院住院的糖尿病患者 12 0例 ,诊断符合 1999年WHO糖尿病诊断标准。均除外酮症、肾炎、泌尿系感染、发热、心力衰竭 ,血糖控制较稳定 ,尿 (常规 )蛋白阴性 ,血 BU N、Cr在正常范围内。2…     

血、尿微量蛋白联合检测对高血压病肾损害早期诊断的意义

血、尿微量蛋白联合检测早期诊断高血压病肾损害已较广泛用于临床。近年来,我们采用放射免疫法(RIA)对94例尿常规阴性的高血压病患者进行了血、尿β_2-微球蛋白(β_2-MG)、尿微量白蛋白(Alb)联合检测,以评价其对高血压病肾损害早期诊断的临床价值。     

血浆肾素活性及醛固酮水平与2型糖尿病患者微量白蛋白尿的关系

目的 观察2型糖尿病(T2DM)患者血浆肾素(PRA)活性及醛固酮(PAC)水平变化,探讨二者与微量白蛋白尿的关系。方法 选择283例T2DM患者,采用干化学微粒免疫比浊法检测尿白蛋白水平,按24 h尿白蛋白排泄率(AER)分为正常白蛋白尿(NA)组135例、微量白蛋白尿(MAU)组81例、大量白蛋白尿(CAU)组67例,用放射免疫法检测患者血浆PRA活性、PAC水平,计算PAC与PRA比值(ARR)。结果CAU组PAC水平低于MAU组、NA组(P均<0.05),3组PRA、ARR比较差异无统计学意义(P均>0.05)。经Spearman秩相关及偏相关分析,AER与PAC呈负相关(rs=-0.296,P<0.05),与PRA、ARR无相关性(r分别为-0.053、-0.090,P均>0.05)。结论 T2DM患者血浆PRA活性与微量白蛋白尿无相关性,PAC水平随微量白蛋白尿的增多而下降。     

泌尿系统疾病

994150 尿微量白蛋白胶乳凝集抑制试验药盒的研制及其肾脏损害早期诊断价值的评估/徐新女…//中国危重病急救医学.-1999,11(4).-206～209 用自行研制胶乳法、国产ELISA法和进口Micral-TestⅡ法对健康组41例尿白蛋白检测阳性率分别为4.88%、7.32%和7.32%,对糖尿病组73例为24.66%、26.03%和27.40%,对脑血管病组57例为     

正常高值血压人群微量白蛋白尿和小动脉顺应性的变化

目的研究正常高值血压和理想血压人群中微量白蛋白尿和小动脉顺应性(C2)的变化及其影响因素。方法入选正常血压受试者153例,分成两组:理想血压组(n=53)和正常高值血压组(n=100)。检测腰围、身高、体重、坐位血压,晨起静脉空腹血糖、血脂、肝肾功能,尿液肌酐等指标;放射免疫法检测尿液微量白蛋白,计算尿液微量白蛋白与肌酐比(ACR);用HDI CVprofilorDO-2020检测大小动脉顺应性。结果理想血压组和正常高值血压组收缩压、舒张压、脉压和C2、ACR均有明显差异(P<0.05);相关分析显示,收缩压与log C2呈负相关(r=-0.439,P<0.001),与log ACR正相关(r=0.460,P<0.001);log ACR与log C2之间也有明显负相关性(r=-0.461,P<0.001);多元回归分析发现,收缩压是独立影响微量白蛋白尿和C2的指标。结论随血压水平的上升,C2逐渐降低,微量白蛋白尿水平逐渐提高,其水平的提高能一定程度上反映C2的减退;收缩压是影响正常高值血压人群微量白蛋白尿和C2的独立因素。     

探析血同型半胱氨酸、糖化血红蛋白、尿微量白蛋白及β2-微球蛋白联合检验在2型糖尿病早期肾损害诊断中的临床价值

目的探讨血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)联合检测在2型糖尿病(T2DM)肾病早期诊断中的价值。方法抽取该院2013年6月—2014年12月来该院就诊92例2型糖尿病患者,其中糖尿病肾病40例(观察1组)、2型糖尿病非肾病52例(观察2组),正常健康体检者54例(对照组)为研究对象,检测血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)指标参数的含量,并对其检测结果进行比对。结果观察1组和2组的血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)明显高于对照组,差异有统计学意义(P0.01);糖尿病的病程的长短与血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)指标有密切关系,糖尿病的病程与血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(Um Alb)、尿β2-微球蛋白(尿β2-MG)成正比,糖尿病的病程越长血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)指标越高。结论对2型糖尿病(T2DM)患者进行定期联合检测血同型半胱氨酸(HCY)、糖化血红蛋白(Hb A1c)、尿微量白蛋白(U-m Alb)、尿β2-微球蛋白(尿β2-MG)指标参数,通过这些指标参数值能准确掌握糖尿病是否侵蚀肾功,为糖尿病早期肾损害诊断、治疗提供可靠依据。     

血清胱抑素C在2型糖尿病肾病诊断中的应用

目的探讨血清胱抑素C(Cys-C)在2型糖尿病肾病诊断中的应用价值。方法选取昆明医科大学第一附属医院肾内科住院部2016年9月—2017年12月收治的2型糖尿病患者355例,其中按照尿白蛋白肌酐比值(ACR)不同,分为正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组,分别检测3组患者血清胱抑素C(Cys-C)、尿素(Urea)、血肌酐(Scr)及肾小球滤过率(eGFR,以MDRD公式计算)。结果微量白蛋白尿组及大量白蛋白尿组Cys-C水平均明显高于正常白蛋白尿组(P<0.05)。糖尿病肾病组中Cys-C、Urea、Scr、eGFR阳性率分别为95%、71%、86%、96%,且Cys-C和eGFR检测阳性率结果明显高于Urea和Scr(P<0.05)。结论Cys-C更为准确地反映肾小球滤过功能,尤其在诊断糖尿病患者早期肾损伤中具有重要临床意义。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.     

A single injection of adrenergic agonists enhances pineal melatonin production in Turkish hamsters

Abstract: The purpose of this study was to determine whether the pineal gland of Turkish hamsters (Mesocricetus brandti) responds to adrenergic agonists with an increase in melatonin production, and, if it does, whether the sensitivity of the pineal gland to agonists would differ throughout the dark phase. Adult Turkish hamsters weighing 110–210 g received a subcutaneous injection of isoproterenol (ISO, 1 mg/kg B.W.) or norepinephrine (NE, 1 mg/kg B.W.) at different times of night. Animals exposed to LD 16:8 responded to ISO or NE with increased pineal melatonin content only when injected at dawn, when endogenous melatonin is at basal or near-basal levels. When the 8 hr scotophase was entirely replaced with light, the responsiveness to ISO injections at dawn disappeared. In animals exposed to light from 30 min prior to injection to the time of sacrifice, ISO injections increased pineal melatonin content (P < 0.005, three-way ANOVA), which varied, depending on the specific time of injection (effect of time of night, P < 0.05, three-way ANOVA). These results demonstrate that (1) adrenergic agonists enhance the production of pineal melatonin in Turkish hamsters, (2) this stimulatory effect takes place late, but not early in the 8 hr scotophase, and (3) the adrenergic induction of pineal melatonin production in Turkish hamsters requires priming by darkness during the appropriate circadian phase.     

Immune effector mechanisms in malaria: An update focusing on human immunity

The past decade has witnessed dramatic decreases in malaria‐associated mortality and morbidity around the world. This progress has largely been due to intensified malaria control measures, implementation of rapid diagnostics and establishing a network to anticipate and mitigate antimalarial drug resistance. However, the ultimate tool for malaria prevention is the development and implementation of an effective vaccine. To date, malaria vaccine efforts have focused on determining which of the thousands of antigens expressed by Plasmodium falciparum are instrumental targets of protective immunity. The antigenic variation and antigenic polymorphisms arising in parasite genes under immune selection present a daunting challenge for target antigen selection and prioritization, and is a given caveat when interpreting immune recall responses or results from monovalent vaccine trials. Other immune evasion strategies executed by the parasite highlight the myriad of ways in which it can become a recurrent infection. This review provides an update on immune effector mechanisms in malaria and focuses on our improved ability to interrogate the complexity of human immune system, accelerated by recent methodological advances. Appreciating how the human immune landscape influences the effectiveness and longevity of antimalarial immunity will help explain which conditions are necessary for immune effector mechanisms to prevail.     

Secondary aortoduodenal fistula

Aorto-duodenal fistulae （ADF） are the most frequent aorto-enteric fistulae （80%）, presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication （0.3%-2%） of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Married to M. tuberculosis: risk of infection and disease in spouses of smear-positive tuberculosis patients

Objectives To quantify the risk of infection and disease in spouses of tuberculosis patients and the extent to which intervention could reduce the risk in this highly exposed group. Methods We compared HIV prevalence, TB prevalence and incidence and tuberculin skin test (TST) results in spouses of TB patients and community controls. HIV‐positive spouses were offered isoniazid preventive therapy (IPT), and TST was repeated at 6, 12 and 24 months. Results We recruited 148 spouses of smear‐positive patients ascertained prospectively and 3% had active TB. We identified 203 spouses of previously diagnosed smear‐positive patients, 11 had already had TB, and the rate of TB was 2.4 per 100 person years(py) over 2 years (95% CI 1.15–5.09). 116 were found alive and recruited. HIV prevalence was 37% and 39% in the prospective and retrospective spouse groups and 17% in controls. TST was ≥10 mm in 80% of HIV negative and in 57% of HIV‐positive spouses ascertained retrospectively; 74% HIV negative and 62% HIV‐positive spouses ascertained prospectively, and 48% HIV negative and 26% HIV‐positive community controls. Of 54 HIV‐positive spouses, 18 completed 6‐month IPT. At 2 year follow‐up, 87% of surviving spouses had TST ≥10 mm and the rate of TB was 1.1 per 100 py (95% CI 0.34–3.29). Conclusions Spouses are a high‐risk group who should be screened for HIV and active TB. TST prevalence was already high by the time the spouses were approached but further infections were seen to occur. Uptake and adherence to IPT was disappointing, lessening the impact of short‐duration therapy.