头皮发际区微针法治疗糖尿病周围神经病变的临床研究

目的观察头皮发际区微针法治疗糖尿病周围神经病变的临床疗效。方法将60例糖尿病周围神经病变患者随机分为2组。治疗组30例用头皮发际区微针法,每日1次。对照组30例用甲钴胺0.5mg,每日早晚各1次口服。2组均60d为1个疗程,1个疗程后统计疗效,并检测血浆内皮素（ET）和一氧化氮（NO）含量。结果治疗组总有效率86.67%,对照组总有效率90.00%,2组比较差异无统计学意义（P〉0.05）。2组治疗前后血浆ET和NO含量比较差异均有统计学意义（P〈0.05） 2组治疗前后血浆ET和NO含量差值比较差异无统计学意义（P〉0.05）。结论头皮发际区微针法对于糖尿病周围神经病变患者具有确切疗效,其治疗机制与调节ET和NO平衡失调,改善血液循环状态相关。     

等离子电切治疗前列腺增生症

目的探讨经尿道等离子双极电切治疗前列腺增生症(PKRP)的安全性和疗效。方法回顾分析经尿道等离子双极电切治疗前列腺增生112例,比较术前术后尿流率,前列腺症状评分,残余尿量;记录手术失血量,体重变化,切除前列腺组织重量。结果所有手术顺利完成,切除前列腺重量65±15.5g,手术时间40±7.5min,平均出血量150ml,最大尿流率(Qmax)术前7.4±2.6ml/s术后3个月为18.6±4.6ml/s;国际前列腺症状评分(IPSS)术前生活质量评分22.6分,术后3个月为6.5;残余尿量(RUV)术前>60m1,术后<20ml。结论等离子双极电切治疗前列腺增生症具有安全,有效,经济,技术易于掌握等优点,适合基层医院开展。     

POEMS综合征8例临床分析

目的探讨POEMS综合征发病机制及临床特征，提高对POEMS综合征的诊治水平。方法分析8例POEMS综舍征的一般资料、临床表现、相关的辅助检查、治疗及预后，并结舍文献进行讨论。结果本病是累及多系统的疾病，以周围神经病最具有特征性，肝、脾和（或）淋巴结肿大，内分泌的病变，皮肤改变，水肿及骨髓浆细胞增多比较常见。治疗以激素、免疫抑制剂为主，可结合抗雌激素、放疗的方法，预后差。结论POEMS综合征与浆细胞病关系密切，累及多系统的病变，临床表现复杂多样，应注意多系统的检查，提高临床的诊断水平。     

高敏受者肾移植术前行血浆置换的临床探讨

目的 :探讨高敏受者肾移植术前行血浆置换 (PE)的效果。方法 :12例高敏受者在肾移植术前进行PE治疗 ,37例高敏受者未行PE治疗 ,观察两组肾移植病人排斥反应发生率的差异。结果 :PE组置换前PRA值71.0 %± 19.1% ,置换后 34.3%± 17.9% ,两者有显著性差异 (P <0 .0 1)。术后发生超排 2例 ,急性排斥 2例 ;未行PE组发生超排 2例 ,急性排斥 8例 ,两组间超排和急性排斥的发生率均无显著性差异。结论 :PE对预防超排和降低急性排斥的发生率均无明显作用。PE治疗的主要适应症为PRA大于 80 %的受者 ,能快速降低PRA值 ,有助于HLA抗体特异性分析和HLA配型。     

Drug-protein binding kinetics in patients with Type I diabetes

Summary Sera from 17 patients with Type I diabetes and 19 healthy volunteers have been examined to evaluate whether the kinetics of the binding of drugs to Site II of serum albumin is altered in diabetes. Stopped-flow measurements showed that the association velocity and the affinity constants of the fluorescent marker dansylsarcosine were significantly lower in diabetics (160 s^–1 and 2.0 × 10⁵ l·mol^–1) than in non-diabetics (196s^–1 and 4.0 × 10⁵ l·mol^–1). The dissociation velocity was not different [20.3 s^–1 vs. 19.4 s^–1]. Although patients with a reduced albumin concentration were excluded the diabetics had significantly lower concentrations than the healthy volunteers. There was a significant correlation between decreased glycosylation of albumin and increased association velocity. The dissociation velocity constants were correlated with the molar concentration ratio of free fatty acids/human serum albumin. Thus, the extent of glycosylation and the amount of fatty acids bound per mole albumin can both affect the kinetics of drug binding to Site II. The lower affinity in patients with Type I diabetes is due to the increased in the glycoalbumin concentration.     

Pharmacokinetics of prednisolone in children with the nephrotic syndrome

The aim of this study was to establish whether the criteria for the clinical effectiveness of steroids are correlated with the pharmacokinetics of prednisolone in children treated with prednisone during an attack of idiopathic nephrotic syndrome (INS). Thirteen patients with nephrosis were included. Prednisolone, prednisone and cortisol levels were measured using a specific high-performance liquid chromatography assay after an oral dose of 1 mg/kg body weight of prednisone taken at the onset of the disease. All the pharmacokinetic parameters, including the conversion of prednisone to prednisolone were similar to the data already published in children with INS. No correlation was found between the values of pharmacokinetic parameters and criteria of clinical effectiveness. Hypo-albuminaemia was significantly correlated with the area under the plasma-concentration curve but not with the elimination half-life of prednisolone. Moreover, the prednisolone elimination half-life correlated with the urinary exretion of 17-hydroxycorticosteroids achieved in the first 6h. The present study suggests that routine measurements of prednisolone kinetics do not help when assessing the treatment of children with INS.     

Amadori糖化白蛋白对牛视网膜血管二酯酰甘油--蛋白激酶C级联的影响

目的 :探讨Amadori糖化血清白蛋白对牛视网膜血管二酯酰甘油 (DAG)———蛋白激酶C(PKC)信号级联的影响及d-α-生育酚的干预作用。方法 :体外制备的Amadori糖化的牛血清白蛋白 (AGSA)分别在生理浓度葡萄糖 (5 .5mmol/L)和高浓度葡萄糖 (2 0mmol/L)培养液中作用于新鲜牛视网膜血管。采用薄层层析和放射自显影法测定DAG含量和PKC活性 ;并检测d -α-生育酚预处理后DAG、PKC改变。结果 :在生理葡萄糖浓度下 ,牛视网膜血管暴露于AGSA2 4h或 72h后细胞内DAG含量、PKC活性均较对照组显著增加 ,当AGSA和高葡萄糖同时作用于牛视网膜血管时 ,DAG -PKC级联显著激活 ,分别为正常葡萄糖组的 3.4 7倍和 4 .5 4倍 ;在正常血清培养液中 ,与 5 .5mmol/L的葡萄糖相比 ,2 0mmol/L高糖在 2 4h时并不刺激DAG含量增加 (P >0 .0 5 ) ,而 72h时则较对照组增加 4 5 % ,PKC活性较对照增加 5 6 % ,而d -α -生育酚可逆转上述生化改变。结论 :Amadori糖化血清白蛋白可在生理葡萄糖浓度下刺激DAG -PKC途径活化 ,从而影响血管一系列生理功能 ,而d -α-生育酚对血管生化改变有保护作用。     

Behavioral conditioning of endotoxin-induced plasma iron alterations

The cascade of physiologic mechanisms in response to infection, the acute-phase response, is recognized as playing a major role in host defence. One such response is the hypoferremia that is consistently reported to occur during bacterial infection. This study aimed to determine whether the alterations in plasma iron were conditionable using the conditioned taste aversion (CTA) paradigm. The regime involved the pairing of a novel-tasting saccharin solution with bacterial endotoxin. Seven days after the initial pairing of these stimuli (the test day), the saccharin solution was represented. Animals exposed to this condition displayed a significant reduction in the level of plasma iron. Animals treated with an intraperitoneal dose of 400 μg/Kg lipopolysaccharide (LPS) displayed lower conditioned iron levels than rats infused with 100 μg/Kg LPS; however, this difference was not significant. These results showed that in addition to other acute-phase responses (fever and anorexia), plasma iron alterations are able to be manipulated through behavioral manipulations.     

Infusion clearance of subcutaneous iothalamate versus standard renal clearance

 Accurate, timed urine collections for the measurement of glomerular filtration rate (GFR) may be impractical in infants or in patients with urological abnormalities. GFR may be measured without urine collection using a constant subcutaneous infusion of iothalamate. We compare the infusion clearance with conventional renal clearance in 14 children and young adults. The mean clearance ratio (infusion clearance/renal clearance ± 1 SD) was 0.99±0.1 and the mean discrepancy between the two methods was 8.5%±4.7%. The 95% limits of agreement for the ratio of the two methods are 0.83–1.23. These data indicate that subcutaneous infusion of iothalamate is a practical method for measuring GFR in children without a urine collection. Received March 18, 1996; received in revised form February 12, 1997; accepted March 26, 1997     

儿童边缘性锌缺乏症综合判断的研究

对沈阳市某幼儿园９９例３～６岁锌缺乏儿童的营养调查和生物样品（血液、尿液和毛发）的分析发现：同对照组儿童相比，锌缺乏儿童除Ｆｅ、维生素Ａ外，其他主要营养素的摄入明显不足；缺锌儿童的发锌、ＲＢＣ锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值均明显低于对照组。经补锌治疗后血浆锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值显著升高。应用临床诊断实验的评价方法分析发现结合血浆锌水平，联合使用发锌，血清ＡＬＰ和尿锌／尿肌酐比值３项指标可以准确判断儿童边缘性锌缺乏，这时并联的灵敏度为９６．１８％，串联的特异度可高达到１００％（血清ＡＬＰ活性＜１０４ＩＵ／Ｌ，同时发锌含量＜１１０ｐｐｍ．尿锌／尿肌酐比值＜０．３μｇ／ｇ）。