尿微量白蛋白测定方法的探讨

目的 探讨溴酚蓝测定尿中微量白蛋白。方法 利用康宁—560自动生化分析仪采用终点法测定尿中微量白蛋白。结果 最低检出率为5mg/L。线性范围5-50gm/L，批内CV为0．5％-5．8％，批间CV0．6％-6．5％。回收率96％-102％。与免疫比浊法的相关系数r＝0．970，相关方程为y＝0．82 0．98x.尿中常见物质及临床常用药物均无明显干扰。正常参考范围5-45mg/L。可在自动生化分析仪上测定和用目视比色半定量测定尿微量白蛋白。结论 方法简易快速，灵敏度高，特异性强，重复性好。     

尿微量白蛋白测定方法的探讨

目的　探讨溴酚蓝测定尿中微量白蛋白。方法　利用康宁 - 5 6 0自动生化分析仪采用终点法测定尿中微量白蛋白。结果　最低检出率为 5mg L。线性范围 5～ 5 0 0mg L ,批内CV为 0 .5 %～ 5 .8% ,批间CV 0 .6 %～ 6 .5 %。回收率 96 %～ 10 2 %。与免疫比浊法的相关系数r=0 .970 ,相关方程为y =0 .82 0 .98x。尿中常见物质及临床常用药物均无明显干扰。正常参考范围 5～ 4 5mg L。可在自动生化分析仪上测定和用目视比色半定量测定尿微量白蛋白。结论　方法简易快速 ,灵敏度高 ,特异性强 ,重复性好。     

Biosystems A25全自动特定蛋白分析仪测定尿蛋白肌酐比的性能评价

目的:对Biosystems A25全自动特定蛋白分析仪测定尿蛋白肌酐比(albumin-creatinine ratio,ACR)项目进行性能评价.方法:参考美国临床和实验室标准协会系列文件和相关文献,结合实际工作对尿白蛋白(UAlb)、尿肌酐(UCr)项目的准确度、精密度(批内、批间)、交叉污染率、最大检测线性验证及不同系统间比对(本室原有的生化分析仪日立-7600测定的尿肌酐)进行评价.结果:准确度验证,相对偏差分别为5.08％、10.74％,小于厂家声明的偏差(尿白蛋白≤10％,肌酐≤15％);批内精密度变异系数(CV)分别为3.30％、1.09％,批间精密度变异系数(CV)分别为7.21％、3.38％,均小于厂家声明的精密度(批内CV≤7.00％、批间CV≤10.00％);交叉污染率分别为0.17％、0.00％,符合携带污染率≤10.00％的要求;以理论值为X轴,仪器测定值为Y轴,UAlb的线性回归方程为Y=1.0105X+10.140(a=0.9653,R2=0.9937),UCr的线性回归方程Y=0.9442X-0.0652(a=0.9442,R2=0.9998),二者估算线性范围分别可达1176.12mg/L和24.74mmol/L,大于要求规定的800mg/L和8.84mmol/L;不同系统间比对UCr,以日立-7600测定值为X轴,A25测定值为Y轴,进行线性回归得到Y=0.8540X+0.9304(R2=0.9909),要求R2>0.975,两者相关性良好.结论:用Biosystems A25全自动特定蛋白分析仪测定ACR项目各项性能验证指标均合格,可用于临床标本检测.     

尿酶联合尿微量白蛋白自动检测及临床应用探讨

目的　建立一种能诊断和监测早期肾病变、鉴别肾小球与肾小管损伤的联合实验。方法　在全自动生化分析仪上用带标准的两点法测定尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG) ,用免疫透射比浊法测定同一样品的尿微量白蛋白 (mAlb)。结果　尿NAG和mAlb的批内CV分别为 4 .4 %与 2 .8% ,尿mAlb的批间CV为 3.8% ,回收率为 84 %～ 90 %。其线性范围分别为30 0U/L与 2 0 0mg/L以内 ,参考值为 <2 2U/ gCr与 <30mg/gCr,且基本不受葡萄糖、尿素、尿酸和口服维C的干扰。病例组NAG和mAlb均数比正常对照组明显增高 (P <0 .0 1和P <0 .0 5 )。结论　该联合自动检测法快迅、简便、灵敏可靠、适合临床应用     

酶法检测血清总二氧化碳的实验评价及临床应用

目的：探讨应用酶法检测血清总二氧化碳及临床应用。方法：用日立7600—10全自动生化分析仪酶法测定血清总二氧化碳，通过线性实验、回收实验、干扰实验、重复性实验和对比实验进行方法评价。结果：该法线性范围为4—50mmol／L，批内CV为2．96％，批间CV为3．85％，雏生素C 300mg／L、脂血（TG）15mmol／L、胆红素600μmol／L、血红素5g/L对测定均无干扰，平均回收率为100．8％，本法与间接离子选择电极法对200份血浆标本总二氧化碳的测定结果作相关性分析，Y=0．995X＋0．456，γ=0．986。结论：酶法检测血清（浆）总二氧化碳具有较高的灵敏性和特异性。快速自动化分析，适合临床需要，是判断体内酸碱平衡的重要指标。     

尿微量白蛋白ELISA结果在正常人群中的分布及临床意义

目的 应用建立的ELISA抗原竞争法测定不同年龄段正常人及糖尿病患者尿微量白蛋白水平.方法 建立EUSA抗原竞争法.用同类进口试剂盒对本方法进行质虽评价;检测682例正常人及60例糖尿病患者随意尿中微量白蛋白含量.结果 尿微量白蛋白标准曲线线性良好,本法测得正常人尿微量白蛋白参考值范围为0～27.9mg/L,平均值为9.68mg/L,男女人群间无显著性差异.正常人14～20岁年龄段尿微量白蛋白为35.2mg/L,60岁和70岁以上两个老年组分别为34.4mrCL和36.9mg/L;60岁以上糖尿病患者的尿微量自蛋白含量显著高于同龄对照组.结论 正常人尿微量白蛋白参考值范围为0～27.9mg/L.青春期及60岁以上正常人尿微量白蛋白浓度可达34.4～36.9mg/L:60岁以上糖尿病患者的尿微量白蛋白高于同龄正常人群.     

血清高密度脂蛋白胆固醇直接测定法在奥斯龙160上的应用

目的：探讨高密度脂蛋白胆固醇(HDL-C)直接测定法在法国产奥斯龙160生化分析仪上的应用。方法：观察分析直接测定法批内、批间CV值，线性范围、干扰因素，并与磷钨酸镁(PT—Mg)法对比。结果：HDL-C浓度分别为0．77、1．37、2．05mmol／L低、中、高值血清标本的批内CV值分别为2．7％、1．5％、2．20％；HDL-C浓度分别为0．71、1．54、2．04mmol／L的血清标本批间CV值分别为3．6％、2．3％、2．6％，线性关系良好，直线范围达2．736mmol／L。经与PT-Mg法对照相关良好，r=0．982,，干扰试验，血红蛋白浓度10g／L，胆红素浓度184μmol/L TG浓度11．6mmol／L对测定结果影响不明显。结论：HDL-C直接法在奥斯龙160分析仪上应用结果准确可靠，适宜常规使用。     

考马斯亮蓝法检测胆石、胆汁蛋白含量

本文报告一种新的胆石、胆汁蛋白定量方法。测定的线性范围可达1000mg/L。棕色胆石蛋白批内X±SD;14.22±0.35mg％,CV％ 2.46％;批间X±SD:14.20±0.37mg％,CV2.6％;平均回收率100.88％(97.22～106.98％)。胆固醇石蛋白批内X±SD:2.99±0.10％,CV％3.34％;批间X±SD 2.95±0.15mg,CV％ 5.08％。黑色胆石蛋白批内X±SD 14.70±0.50mg％,CV％ 3.40％;批间X±SD: 14.86±0.76mg％,CV％ 5.11％。胆汁蛋白批内1854.8±35.4mg/L,CV％:2.86％;批间1860.9±90.1mg/L,CV％:4.88％。显色反应在几分钟内完成,且1.5小时内显色稳定。干扰因素少。本法具有简便快速、稳定可靠、灵敏、干扰少等优点,适用于科研及临床的胆石、胆汁蛋白质定量。     

微量荧光法在苯丙酮尿症诊治中的应用

目的 :探讨微量荧光法定量苯丙氨酸在苯丙酮尿症 (PKU)诊治中的应用。方法 :对芬兰 L absystem s公司生产的新生儿苯丙氨酸定量试剂盒及设备进行方法学鉴定 ,并测定 194 7例新生儿和 2 8例经典苯丙酮尿症患儿及 8例持续性高苯丙氨酸血症患儿末梢血中苯丙氨酸 (Phe)水平观察其实用性。结果 :经实验方法学鉴定 ,本法高、中、低各浓度批内平均变异系数 (CV)为0 .0 36 ,0 .0 6 9,0 .0 6 8,批间平均变异系数 (CV)为 0 .12 4 ;最低检测极限为 31μmol/ L ;平均重现率为 98.4 %。新生儿血苯丙氨酸水平正常参考范围 :31～ 12 0 μmol/ L。 2 8例经典苯丙酮尿症和 8例持续性高苯丙氨酸血症患儿血苯丙氨酸平均含量分别为 186 7μmol/ L(s=4 0 9.8)和 76 9μmol/ L(s=2 2 6 .2 ) ,三者间有显著性差异 P<0 .0 0 1。患儿治疗前后苯丙氨酸平均含量有明显差异 P<0 .0 0 1。结论 :微量荧光法定量准确操作简便适于 PKU诊治观察     

胶乳增强免疫比浊法测定HbAlc

目的 对胶乳增强免疫比浊法测定糖化血红蛋白(HbAlc)进行方法学评价。方法 按照要求，进行精密度、准确度和可报告范围的评估实验。结果 该方法的线性范围为2％．16％，批内CV为1．02％．2．50％．批间CV为1.47％。结论 胶乳增强免疫比浊法测定HbAlc的结果符合临床对糖尿病病人的治疗监测要求。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.