The clinical and pathological characteristics of Chinese patients with pauci-immune crescent golmerulonephritis

Objective　To investigate the clinical and pathological characteristics of pauci-immune crescent glomerulo～nephritis (PICGN) in Chinese patients. Methods　During 13 years (1985-1998), 6400 patients underwent non-transplanting renal biopsy. Twenty-four patients were diagnosed as PICGN. All clinical and laboratory data of these patients were collected from the patients’ records and used for detailed analysis. The diagnosis is based on clinico-pathologic findings. Results　Of the 24 patients, 16 were females and 8 were males, with median age of 33 years (ranged 10-76 years). Microscopic polyarteritis (MPA) (33.3%) and systemic vasculitis (8.3%) were the secondary diseases. The incidence of PICGN was 0.38% in renal biopsies and 22.9% in crescentic glomerulonephritis. Clinically, most patients (75.0%) showed rapidly progressive nephritis with enlarged kidneys. At onset, gross hematuria was noted in 58.3% of patients, hypertension in 45.8%, nephrotic syndrome in 41.7%, and oliguria in 25.0%. However, systemic symptoms were rare except for anemia. Pathologically, necrosis of glomerular capillaries (62.5%), infiltration of monocytes and neutrophil cells in glomeruli (66.7%), and vasculitis in the interstitium (53.3%) were observed. In addition, glomerulosclerosis was noted in 45.8%, severe tubular atrophy in 83.3% and interstitial fibrosis in 75.0%. Anti-neutrophil cytoplasmic antibodies (ANCAs) were positive in 52.2%. All patients except two received intensively immunosuppressive therapy. Sixteen patients were available for long-term follow up (median 29.8 months, range 8-92 months). Twelve of them had life-sustaining renal function, four had normal serum creatinine (<124?μmol/L) and only 4 patients were dialysis-dependent. Conclusion　PICGN is not rare in China. Early diagnosis and administration of immunosuppressive therapy, particularly in patients with rapidly progressive glomerulonephritis (RPGN), are important for good prognosis.     

短肠综合征的康复治疗

目的总结27例短肠综合征病人康复治疗的经验,介绍短肠康复治疗的具体方法,探讨改善短肠病人营养状况、促进肠功能代偿的措施。方法短肠康复治疗包括营养支持、应用谷氨酰胺和生长激素促进肠粘膜生长、富含膳食纤维的短肠康复饮食、减轻短肠临床症状以及预防和治疗短肠并发症等措施。1997年1月至2000年7月间共27例短肠患者接受了29次康复治疗,患者平均年龄38.5岁±19.3岁。剩余小肠长度范围15～80cm,平均46.8cm±23.4cm,15例有回盲瓣。从肠切除至接受康复治疗的平均时间为86d±105d。结果治疗后病人的营养状况明显改善,肠道吸收功能有所增强。随访超过2年者8例,4例完全脱离肠外营养,随访时间超过1年者13例,有10例完全脱离肠外营养。结论短肠康复治疗能够有效地改善短肠病人的营养状况、并能促进肠功能代偿,治疗效果与残留小肠长度、治疗开始的时间和病人年龄有关,及早进行康复治疗能够促进肠功能代偿,减少病人对肠外营养的依赖。     

IDENTIFICATION OF GLUCOSE TRANSPORTER-1 AND ITS FUNCTIONAL ASSAY IN MOUSE GLOMERULAR MESANGIAL CELLS CULTURED IN VITRO

INTRODUCTION Glomerular mesangial cells play a key role in the development of diabetic glomerular lesions. There is a close correlation between expansion of the mesangium of the glomerulus and the clinical manifestations of diabetic nephropathy(1). Although it has become evident that the accumulation of extracellular matrix (ECM) occurs in the diabetic glomerulus and that mesangial cells in culture demonstrate enhanced production of ECM in response to elevated glucose levels (2), the me…     

IgA肾病患者的扁桃体免疫组织化学观察

目的：了解ＩｇＡ肾病（ＩｇＡ－Ｎ）与扁桃体免疫异常的关系。方法：经肾穿刺活检确诊为ＩｇＡ－Ｎ３１例,以慢性扁桃体炎１６例作对照,扁桃体切除术后运用ＡＢＣ方法对扁桃体组织进行免疫组化标记。结果：两组扁桃体在ＩｇＡ、ＩｇＧ的表达上存在明显的区别,ＩｇＡ－Ｎ患者的扁桃体组织内产生ＩｇＡ的淋巴细胞数显著增加,结论：ＩｇＡ－Ｎ患者存在着扁桃体免疫异常,切除扁桃可预防抗原入浸,消除扁桃体来源的ＩｇＡ,减少循环中的ＩｇＡ免疫复合物形成,进一步使肾小球基底膜区的ＩｇＡ免疫复合物沉积减少。     

213例健康人血清α1-酸性糖蛋白浓度及其与年龄的相关关系分析

目的　研究健康男性成人血清α1 酸性糖蛋白 (α1 AGP)的浓度范围及其与年龄的关系。方法　采用免疫比浊法 ,测定经临床实验室检查证实的 2 13例男性健康成人血清α1 AGP浓度 ,并观察其与年龄的相互关系。结果　青年组 (18～ 2 3岁 ,n =172 )和非青年组 (2 4～ 5 9岁 ,n=41)男性血清α1 AGP浓度分别为 (5 6 3.9± 2 9.5 )mg/L(范围 44 4.5～ 6 18.0mg/L)和 (5 6 4.5± 32 .7)mg/L(范围 46 0 .9～ 6 47.5mg/L) ,两组健康人的血清α1 AGP含量无显著差异 (P >0 .0 5 )。α1 AGP浓度的 95 %参考值范围为 :下限 5 0 5 .0mg/L ,上限 6 2 3.0mg/L。回归分析表明 ,2 13例健康男性的血清α1 AGP浓度与年龄无相关性 (r=0 .0 35 3,P>0 .0 5 )。结论　健康男性成人血清α1 AGP浓度水平较低 ;95 %以上的个体 ,浓度为 5 0 5 .0～ 6 2 3.0mg/L。健康男性成人的年龄不影响其血清α1 AGP浓度。     

非洛地平缓释胶囊药物动力学与相对生物利用度

建立气相色谱-电子捕获法测定非洛地平血药浓度,比较国产非洛地平缓释胶囊和阿斯特拉公司缓释片的人体生物利用度,14名健康志愿者随机交叉口服两种制剂后,单剂量血浆中非洛地平浓度分别于3．07±0．92h和3．14±1．03h达到峰值4．75±1．38ng／ml和4．55±1．71ng／ml,药-时曲线下面积(AUC     

心肌细胞培养方法和活细胞噻唑兰法测定

目的:介绍心肌细胞培养方法和研究比色分析法测定活心肌细胞.方法:接种不同数量细胞培养后行噻唑兰(MTT)比色分析;正常培养、含不同浓度维拉帕米培养的细胞行MTT代谢比色分析,并测乳酸脱氢酶(LDH)活性.结果:比色值与接种细胞数量、细胞释放的LDH活性呈高度相关(r=0.996、-0.986,P<0.01).结论:MTT比色分析法可用于测定活心肌细胞.     

脂肪酸、二磷酸果糖和谷氨酰胺对大鼠移植小肠粘膜细胞增殖和凋亡的作用

目的探讨ｎ３脂肪酸、１,６二磷酸果糖和谷氨酰胺对移植小肠粘膜细胞增殖和凋亡的作用。方法１９６只近交系Ｗｉｓｔａｒ大鼠分别作为供、受体行全小肠异位移植,术前和术后分别用ｎ３脂肪酸灌胃、１,６二磷酸果糖及谷氨酰胺静脉输注１０天,应用流式细胞术和细胞凋亡原位检测的方法分析小肠粘膜细胞增殖和凋亡的变化。结果移植小肠粘膜细胞增殖低下,凋亡增加。补充外源性ｎ３脂肪酸、１,６二磷酸果糖和谷氨酰胺后,移植小肠粘膜细胞的增殖加速,凋亡减少。结论ｎ３脂肪酸、１,６二磷酸果糖和谷氨酰胺特殊营养支持可显著地增加移植小肠粘膜细胞的增殖活性,同时也不同程度地抑制细胞凋亡发生,这种调控作用有助于改善移植小肠的结构和吸收功能。     

中药指纹图谱研究的有关技术要点探讨

简要介绍了中药指纹图谱的原理，提出了在进行中药指纹图谱研究时，选择中药材来源、样品处理方法、检测技术及参照物的原则和注意事项。探讨了用高效液相色谱技术制备中药指纹图谱的有关技术要点问题，样品洗脱应尽可能选用等度或线性梯度洗脱，检测器的选择应尽可能采用二极管阵列检测器，以方便地选定适合于指纹图谱检测的最佳检测波长。指纹图谱相似度评价软件的引入，不仅可大大降低人工计算指纹图谱相似度的工作强度，而且减少了人为判断的随意性和主观性，提高了中药指纹图谱量化评判的客观标准。     

难治性癫痫的原因及药物治疗策略

本文阐述了难治性癫痫的病因及预告因素 ,提出针对真性难治的药物治疗策略。新诊断癫痫的患者应首选单药治疗 ;当单药或 2种药治疗无效时应重新评估诊断 ,排除非痫性事件 ,权衡手术的利弊 ,并选择合理的多药治疗。