Type O Renal Glucosuria

ABSTRACT. We observed a 7-year-old boy with virtual absence of renal tubular glucose reabsorption (type O renal glucosuria). Glucose titration studies in his family revealed severe type A renal glucosuria in a younger brother, a mild type A defect in the mother and normal glucose reabsorption in the father; thus a spectrum of renal glucose transport defects was observed in members of the same family.     

脑瘤手术中吸入异氟醚或异丙酚麻醉对血流动力学及应激反应的影响

目的　研究两种麻醉方法对血流动力学和应激反应的影响。方法　行脑瘤手术的 38例病人随机分为两组 ,醚组和酚组 ,醚组 (2 0例 ,咪唑安定、芬太尼、万可松诱导 ;维持麻醉为吸入异氟醚 1MAC ,30min后 1.5MAC ,30min。间断静注芬太尼、万可松 ) ;酚组 (18例 ,诱导同醚组 ,维持麻醉为全凭异丙酚静脉泵入 6mg·kg 1 ·h 1 ,30min后 12mg·kg 1 ·h 1 ,30min。间断静注芬太尼、万可松 )。快速补液。两组分别于诱导前 (T1 )、插管后即刻 (T2 )、麻醉维持 30min(T3)和 6 0min(T4 ) 4个时动脉血测定血糖浓度。同时监测血流动力学。结果　 (1)血流动力学变化　醚组 :MAP值在T3、T4 时点非常显著降低 (P <0 .0 1) ,且显著低于酚组同时点值 (P<0 .0 5 )。HR值各时点无统计学差异 (P <0 .0 5 ) ;酚组 :MAP值在T4 时点显著降低 (P <0 .0 5 )。HR值在T3、T4 时点显著降低 (P<0 .0 5 ) ,并低于醚组同时点值 (P <0 .0 5 )。 (2 )动脉血血糖浓度的变化　异丙酚组各时点血糖无变化 ;异氟醚组血糖浓度在麻醉后 30及 6 0min显著升高 (P <0 .0 5 ,P <0 .0 1)。结论　酚组的麻醉方式可适当控制应激反应 ,术中平稳 ,更利于脑瘤手术     

Human monocyte interactions with non-enzymatically glycated collagen

Summary We have previously shown that receptors for advanced glycation end products are expressed on activated human monocytes. We now report that activated human monocytes exhibit increased adhesion to non-enzymatically glycated collagen substrates (+32%±1, p<0.001), and the increased adhesion can be competitively inhibited with non-enzymatically glycated albumin. Non-activated monocytes, which do not express receptors for advanced glycation end products, exhibit decreased adhesion (-16%±1, p<0.001). Similar results were observed with substrates of fibronectin and endothelial cell matrix proteins. As the presence of glycation adducts on collagen interferes with the normal binding of monocytes/macrophages, one possible role for advanced glycation adduct receptors on activated monocytes is to counterbalance such decreased adherence. Overcompensation for long periods of time may lead to pathological changes. Additionally, such receptors may play a role in monocyte-mediated remodelling of glycated matrix proteins, as we have observed increased degradation of nonenzymatically glycated collagen substrates by activated human monocytes at 2 h (+52%±11, p=0.01), 3 h(+49% ±10, p=0.01), and 4 h (+36%±6, p<0.01) after adding activated monocytes to ¹²⁵I-labelled substrates.     

医疗器械产品召回制度探讨与典型案例分析

着重介绍了国内外医疗器械产品召回制度现状,并以强生血糖仪、佳腾除颤器两起召回事件为案例,阐明整个召回事件处理的过程,旨在为我国建立和完善医疗器械产品召回制度提供借鉴。     

Thoracic epidural analgesia in aortocoronary bypass surgery II: effects on the endocrine metabolic response

Thoracic epidural analgesia (TEA) may offer haemodynamic benefits for patients with coronary heart disease going through major surgery. This may – in part – be secondary to an effect on the endocrine and metabolic response to surgery. We therefore investigated the effect of TEA on the endocrine metabolic response to aortocoronary bypass surgery (ACBS).
Thirty male patients (age < 65 years, ejection fraction > 0.5) were randomized into 3 groups; the HF group receiving a high dose fentanyl (55 μg–kg^-1) anaesthesia, the HF + TEA group with the same fentanyl dose + TEA with 10 ml bupivacain 5 mg ml^-1, followed by 4 ml every hour, and the LF + TEA group receiving fentanyl 15 μg kg^-1 + TEA. Adrenalin, noradrenalin, systemic vascular resistance (SVR), glucose, Cortisol, lactate and free fatty acids were followed during the operation and for 20 h postoperatively.
A significant increase in adrenalin, noradrenalin and SVR was found in the HF group whereas this increase was blocked in both epidural groups. An increase in glucose and Cortisol was noticed in all groups, but the increase was delayed in the epidural groups.
Our results suggest that a more effective blockade of the stress response during ACBS is obtained when TEA is added to general anaesthesia than with high dose fentanyl anaesthesia alone.     

活化血小板葡萄糖摄取及血小板膜整合素对其的影响

目的 :了解活化血小板葡萄糖摄取过程及血小板膜整合素对其影响 ,探讨整合素与血小板能量代谢的关系 ,旨在研究血小板能量代谢涉及的信号传导 ,并为目前临床应用血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)单抗抗血小板活化提供新的理论依据。方法 :用液态闪烁计数方法检测在血小板膜糖蛋白Ⅱb/Ⅲa单抗 10E5及血小板整合素αυβ3 单抗 6 0 9干预与否情况下凝血酶激活后血小板摄取氚标 2 脱氧葡萄糖 ([3 H]2 DG)率。结果 :在生理浓度范围内活化血小板 [3 H]2 DG摄取率较静息时明显升高 ,单抗 10E5可充分阻断活化血小板葡萄糖摄取 ,单抗 6 0 9可部分阻断。结论 :整合素家族单抗可抑制血小板激活后葡萄糖摄取 ,提示其可能参与血小板能量代谢信号传导过程 ,并可能以GPⅡb/Ⅲa为主     

高糖等因素对系膜细胞细胞周期调节负控蛋白P27的影响

目的探讨高糖不同浓度刺激或抑制剂对肾小球系膜细胞表达细胞周期负控蛋白P27的影响.方法不同浓度高糖(5.5 mmol/L和25mmol/L、内皮素-1(10-7mol/L)、白介素-13(10 ng/ml和100 ng/ml)作用于培养的系膜细胞.流式细胞仪检测系膜细胞P27表达水平.结果5.5mol/L浓度组在不同时间P27表达为5.10±0.94和3.84±0.81,较对照级明显降低(P＜0.001),而25 mmol/L浓度组在不同时间P27表达为26.82±3.15和30.88±3.68,较对照组明显升高.内皮素-1刺激14 h和18 h后P27的表达分别为14.76±1.49和12.18±1.30,与对照组比较有明显差异(P＜0.05,P＜0.05).IL-13 10 ng/ml浓度组和100 ng/ml浓度组P27表达为46.74±3.52和23.8±2.56,对对照组比较有明显差异(P＜0.001,P＜0.05),不同浓度组之间有显著差异(P＜0.01).结论细胞周期调节负控蛋白P27在调节系膜细胞增殖过程中起重要作用.     

早期营养对IUGR大鼠糖耐量和胰岛素敏感性的远期影响

【目的】了解宫内发育迟缓(IUGR)和生后早期蛋白质营养不良对IUGR大鼠糖耐量和胰岛素敏感指数(ISI)及胰岛素抵抗指数(IRI)的远期影响。【方法】采用被动吸烟法制作IUGR大鼠动物模型,新生正常鼠仔102只和IUGR鼠仔105只随机分为4组:①正常对照组;②IUGR模型组;③正常大鼠低蛋白饮食组(CLP组);④IUGR大鼠低蛋白饮食组(SLP组)。观察各组大鼠在生后4周(幼年期)、12周(成年期)和48周龄(老年期)时糖耐量和胰岛素释放试验变化。【结果】①SLP组大鼠宫内发育迟缓和生后早期蛋白质营养不良其远期葡萄糖-胰岛素代谢功能受损明显,至48周时空腹血糖(5.2±1.4)mmol/L已升高,胰岛素(31. 2±3.4)mU/L水平明显升高,ISI(1.7±0.4)明显下降,IRI(8.7±1.8)明显升高,与正常对照组[(4.5±1.1)mmol/L,(12.9±1.0)mU/L和2.8±0.2,2.3±0.41比较均有显著性差异(P<0.05或P<0.01)。②CLP组大鼠生后早期单纯蛋白质营养不良的远期影响主要表现为糖负荷后胰岛素对血糖升高的应答分泌反应延迟和糖耐量减低。③IUGR模型组大鼠生后即给予正常营养供给,其葡萄糖-胰岛素代谢紊乱的程度减轻,但仍有糖耐量减低。【结论】在宫内和/或生后早期机体发育的关键时期,蛋白质营养不良将对葡萄糖-胰岛素代谢功能产生长期的不良影响,主要表现为糖耐量减     

轻中度哮喘及吸入二丙酸倍氯米松对血糖及相关激素的影响

目的：探讨哮喘吸入二丙酸倍氯米松治疗哮喘时血糖和相关激素的改变及其，方法：将研究对象分成四组：正常对照组、哮喘组、短期吸入（二丙酸倍氯米松）、组和长期吸入（二丙酸倍氯米松）组，应用放射免疫法分别测定上述四组儿童的胰岛不，胰高血糖素水平，氧化法测定血糖水平并做糖耐量实验。结果：四组儿童的胰岛素、胰高血糖素和血糖之间差异无显性意义；糖耐量试验也证明，在哮喘和吸入二丙酸倍氯米松治疗的情况下血糖水平差异无显性。结论：轻中度哮喘患糖代谢基本正常，吸入小剂量糖皮质素不会引起机体糖代谢紊乱。