肾素—血管紧张素—醛固酮系统在阿霉素肾病大鼠肾钠潴留中的作用

为了解肾病时钠潴留的机制，采用配伍组设计的方法，研究了肾素－血管紧张素－醛固酮系统（ＲＡＡＳ）在阿霉素肾病在鼠肾钠潴留中的作用。结果表明，接受阿霉素的所有大鼠在尿蛋白排泄增加之前，即开始肾钠潴留，切除肾上腺不能阻止其发生；出现大量蛋白尿后，醛固酮不前进一步增加钠潴留，而血管紧张素Ⅱ肽拮抗剂也不能减少钠潴留。所有肾病大鼠肾内髓匀浆中的钠－钾－三磷酸腺苷酶的活性均增加，切除肾上腺不能阻止其增加，醛固酮     

阿霉素肾病大鼠肾钠潴留机制的初步研究

在大鼠阿霉素肾病模型，利用血小板活化因子拮抗剂对蛋白尿的保护作用，研究肾钠潴留与尿蛋白的关系；并测定肾组织匀浆中钠－钾－三磷酸腺甙酶的活性，证实了肾病时肾钠潴留与尿蛋白无关。从而提出本模型中肾钠潴留系阿霉素对小管细胞的直接作用所致，肾内因素为小管细胞钠－钾－三磷酸腺甙酶活性的增高，潴留部位在内髓集合管的假说。     

阿霉在鼠肾钠留机制的初步研究

在大鼠阿霉素肾病模型，利用血小板活化因子拮抗剂对蛋白尿的保护作用，研究肾钠潴留与尿蛋白的关系；并测定肾组织匀浆中钠－钾－三磷酸腺甙酶的活性，证实了肾病时肾钠潴留与尿蛋白无关。从而提出本模型中肾钠留系阿霉素对小管细胞的直接作用所致，肾内因素为小管细胞钠－钾－三磷酸腺甙酶活性的增高，潴留部位在内髓集合管的假说。     

病毒性心肌炎患儿血浆内分泌素的改变及其临床意义的探讨

采用放射免疫法测定４７例急性病毒性心肌炎患儿及２０例正常儿童血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＰＡⅡ）、醛固酮（ＰＡＬＤ）、心钠素（ＰＡＮＦ）的水平，以探讨病毒性心肌炎发病机制以及以上４种内分泌素在其临床中的意义。结果表明，心肌炎患儿（心功能为１和２级）与正常儿童相比，ＰＲＡ没有明显改变，ＰＡⅡ、ＰＡＬＤ及ＰＡＮＦ皆显著升高；ＰＡⅡ、ＰＡＬＤ、ＰＡＮＦ三者之间分别呈正相关关系；心肌炎组中表现为心肌缺血及心律失常的两个组间ＰＡⅡ、ＰＡＬＤ、ＰＡＮＦ没有显著差异。说明心肌炎急性期肾素－血管紧张素－醛固酮系统（ＲＡＡＳ）被激活，以维持心排血量和血压，增加血管阻力。同时，心肌细胞ＡＮＦ的合成和分泌增加，通过排钠、利尿、扩血管作用拮抗ＲＡＡＳ增加的炎症心肌的负担     

肾素-血管紧张素系统对肾纤维化的作用研究进展

肾素-血管紧张素系统(renin-angiotensinsystem,RAS)对肾纤维化的作用及形成机制已有广泛研究。RAS激活许多转录因子,通过复杂机制导致肾组织损伤。研究证实血管转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂可缓解肾纤维化的形成,但不能阻止进行性肾病肾纤维化的最终结果,阻断RAS的作用有限,因而进一步认识RAS对肾纤维化的作用,对开辟新的有效阻止肾纤维化形成的途径具有重要的临床意义。     

血管紧张素Ⅱ阻滞剂对肾小球硬化的防治作用

各种肾小球疾病发展的结果均可导致肾小球硬化。血管紧张素Ⅱ阻滞剂在降低全身血压的同时，还能调节肾血流动力学，抑制系膜细胞增生、肥大和细胞外基质增生，减轻蛋白尿等，从而防治肾小球硬化。本文对比了血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体－１拮抗剂（ＡＴＩＲＡ）在这方面的作用，并提示ＡＴ１ＲＡ可能成为在保护肾功能、防治肾小球硬化方面具有潜力的药物。     

血管紧张素Ⅱ阻滞剂对肾小球硬化的防治作用

各种肾小球疾病发展的结果均可导致肾小球硬化，血管紧张素Ⅱ阻滞剂在降低全身血压的同时，还能调节肾血流动力学，抑制系膜细胞增生，肥大和细胞外基质增生，减轻蛋白尿等，从而防治肾小球硬化。本文对比了血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体－１拮抗剂在这方面的作用，并提示ＡＴ１ＲＡ可能成为在保护肾功能，防治肾小球硬化方面具有潜力的药物。     

宫内生长迟缓对大鼠肾脏血管紧张素Ⅱ受体 mRNA表达的影响

目的 探讨宫内生长迟缓（IUGR）对大鼠肾脏血管紧张素Ⅱ受体mRNA表达的影响，为研究发育程序化成年疾病的发病机制提供实验依据。方法 SD大鼠，孕期全程低蛋白（6％蛋白）营养，建立IUGR大鼠模型。选取IUGR雄鼠作为研究对象。实时定量聚合酶链反应（PCR）检测生后1d和4周龄大鼠肾组织血管紧张素Ⅱ-1型受体（AT，）亚型AT1A，小AT1B及血管紧张素Ⅱ-2型受体（AT2）mRNA含量；放免法测定4周龄大鼠血浆中肾素、血管紧张素Ⅱ和醛固酮浓度。结果 与对照组相比，IUGR新生鼠肾脏AT1A、AT2 mRNA表达明显下调（P均〈0．05）。4周龄时，IUGR大鼠肾脏AT2 mRNA表达仍明显降低（P〈0．05）；AT1A mRNA表达虽较对照组增加，但差异无统计学意义（P〉0．05）；血浆中肾素、血管紧张素Ⅱ和醛固酮浓度两组之间无统计学意义（P〉0．05）。结论 肾内血管紧张素Ⅱ受体的异常表达可能是IUGR影响肾脏发育和引起高血压的分子机制之一。     

血管紧张素转换酶抑制剂及血管紧张素受体阻断剂对残肾慢性肾衰竭幼鼠肾小球硬化的影响

进行性肾小球硬化是慢性肾脏病变的基本病理变化,细胞外基质(ＥＣＭ)的过度沉积是诱导肾小球硬化的因素之一。既往研究提示肾素血管紧张素系统可促进系膜细胞肥大,血管平滑肌细胞增殖,及ＥＣＭ过度产生和沉积而致肾硬化或纤维化。我们采用5/6肾切除大鼠模型,观察了血管紧张素转换酶抑制剂(ＡＣＥＩ)苯那普利及Ⅰ型血管紧张素Ⅱ受体(ＡＴ1)阻滞剂氯沙坦对肾小球硬化的治疗作用及其机理。材料和方法1.实验动物分组及给药方法:ＳＤ雌性幼年(4周龄)大鼠共51只,体重为130～150ｇ,随机分为4组:假手术组(1组)12只(存活10只);5/6肾切除未治疗组(2组)…     

宫内生长迟缓对大鼠肾脏血管紧张素Ⅱ受体mRNA表达的影响

目的探讨宫内生长迟缓(IUGR)对大鼠肾脏血管紧张素Ⅱ受体mRNA表达的影响,为研究发育程序化成年疾病的发病机制提供实验依据。方法SD大鼠,孕期全程低蛋白(6%蛋白)营养,建立IUGR大鼠模型。选取IUGR雄鼠作为研究对象。实时定量聚合酶链反应(PCR)检测生后1d和4周龄大鼠肾组织血管紧张素Ⅱ-1型受体(AT1)亚型AT1A、AT1B及血管紧张素Ⅱ-2型受体(AT2) mRNA含量;放免法测定4周龄大鼠血浆中肾素、血管紧张素Ⅱ和醛固酮浓度。结果与对照组相比,IUGR新生鼠肾脏AT1A、AT2 mRNA表达明显下调(P均<0.05)。4周龄时,IUGR大鼠肾脏AT2 mRNA表达仍明显降低(P<0.05);AT1A mRNA表达虽较对照组增加,但差异无统计学意义(P>0.05);血浆中肾素、血管紧张素Ⅱ和醛固酮浓度两组之间无统计学意义(P>0.05)。结论肾内血管紧张素Ⅱ受体的异常表达可能是IUGR影响肾脏发育和引起高血压的分子机制之一。     

EMPYEMA IN CHILDREN IN TROPICS

ABSTRACT. Thirty-six cases of empyema were diagnosed in children over a two year period, giving an overall incidence of 0.11 % of the total hospital admissions. Many of them had measles bronchopneumonia and most were malnourished. 16 children had penicillin resistant staphylococcal infection. 29 of them were treated with closed tube drainage. Thirteen died during the course of treatment, the majority within three days of admission. The rest were followed up over a period of up to six months and showed good recovery. Six of these patients developed pneumothorax during the course of treatment. Various combinations of Ampicillin, Cloxacillin, Gentamycin and Cotrimoxazole parenterally were used. Supportive treatment with blood transfusion was found to be beneficial.     

RENAL FUNCTIONAL ADAPTATION IN THE REMNANT KIDNEY IN PATIENTS WITH RENAL AGENESIS AND IN PATIENTS NEPHRECTOMIZED IN CHILDHOOD

ABSTRACT. The renal response to volume expansion was determined in four patients with renal hypertrophy due to unilateral renal agenesis (URA) and in four patients with renal hypertrophy due to nephrectomy (Nz). Four healthy controls were also studied. The studies were performed during water diuresis and following i.v. infusion of isotonic saline solution. Conventional clearance techniques were used. GFR and PAH clearence were increased to about the same extent in Nz and in URA. Fractional Na⁺ excretion was highest in the Nz group and lowest in the control group. It was higher in the Nz group than in the URA group. Fractional water excretion (V/GFR) and free water clearance (C h ₂ o ) were also determined and the results indicate that the high fractional excretion of Na⁺ from the hypertrophied kidney can be attributed to reduced fractional re-absorption of filtrated Na⁺ both in the proximal and the distal tubules. The fractional Na⁺ reabsorption in the distal tubule appears to be higher in URA than in Nz. It is concluded that glomerular tubular balance for Na⁺ is more similar to that found in healthy controls if the stimulus to hypertrophy occurs prenatally than if it occurs postnatally.     

SUICIDE IN CHILDREN IN ENGLAND AND WALES

Reported suicide rates for children aged 10-14 yrs in England and Wales remain at low levels. There has been a decrease in rate for males in this age group between the 1940's and the 1980's and an increase for females, so that both sexes now have similar suicide rates. The increase in suicide by poisoning with solids and liquids (including "overdosing") which occurred up until the 1970's has not continued into the 1980's.     

RECENT TRENDS IN BREAST-FEEDING IN SOUTHERN FINLAND

Abstract. Verkasalo, M. (Children's Hospital, University of Helsinki, Finland). Recent trends in breast-feeding in southern Finland. Acta Paediatr Scand, 69:89, 1980.—A retrospective study on breast-feeding (BF) during 1962–77 has been carried out for the province of Uusimaa. The study was based on 35815 child health records kept by community health centres. Information was entered in 76% of the records, the percentage improving from 52 to 94 during the study period. The average duration of BF was observed to decline steadily from 2.3 months in 1962 to 1.7 in 1971, increasing thereafter to 3.6 months by the end of the study. A similar pattern of slow decline turning to a sharp rise by 1971 can be seen in the percentage of mothers beginning BF, and various time categories of nursing. The observed increase in BF is attributed to changing general attitudes, which are influenced by international trends and campaining by health authorities. Social benefits also play a role, as the increase in BF coincides with extensions of maternity leave from 2 to 7 months in the seventies. The results indicate a favourable response to efforts to promote BF and suggest that these efforts should be continued and intensified     

CHANGES IN DISC ELECTROPHORETIC PATTERNS IN GLOBULINS IN SERUM OF CHILDREN WITH ASTHMA

The aim of this investigation was to study types of protein in asthmatic sera in relation to allergy. There are differences in the serum of some patients with asthma when compared with normal controls. There is an increase in the slow alpha globulin fraction, demonstrable by acrylamide gel electrophoresis. Similar changes have been reported in sera from patients with tuberculosis, pneumonia and bronchiectasis. Sera from patients with chronic infections also show intense gamma globulin bands.     

PHENOBARBITAL METABOLISM IN ADULTS AND IN NEWBORN INFANTS

ABSTRACT. Two adult volunteers and four newborn infants were given a single dose of phenobarbital. The output in the urine of unchanged phenobarbital and of the two main metabolites p -hydroxy phenobarbital and conjugated p -hydroxy phenobarbital was followed during 8 days in the newborns and during 2 or 4 weeks in the adults. The plasma levels were also determined and some pharmacokinetic constants calculated. It was found that the newborn patients excreted unchanged phenobarbital and p -hydroxy phenobarbital in the same proportions relative to dose as did the adult volunteers, i.e. 16–17 % unchanged drug and 9–10 % of the metabolite during the first 8 days after administration. On the other hand, there was a clear-cut age difference in output of conjugated metabolite where the newborns excreted only 5% of the given dose during the 8-day observation period. The corresponding value for the adults was 15%. It is concluded that a poor conjugating capacity in the newborn may not have any serious consequences with a drug like phenobarbital where major alternative routes of excretion exist (unchanged drug and unconjugated metabolite). The clinical significance of immature drug metabolism in the newborn cannot be determined unless the excretion of all major metabolites and of unchanged drug is taken into consideration.     

INFECTIONS IN PRESCHOOL CHILDREN IN GROUP DAY CARE

Abstract. Viral and bacterial infections in 20 children under 3 years of age were studied in a day centre for 12 weeks. Febrile illnesses were found on one occasion in each of 11 children but no serious infection occurred. Pneumococci types 6, 9, or 19 were isolated from all children but more often from those with rhinitis or cough. The individual child had an average of 2 viral infections. Adenovirus types 1, 2, 5, coxsackievirus type B5, herpes simplex virus or respiratory syncytial virus was isolated from 12% of the oropharynx swabs and 40% of the fecal specimens. When a virus was first isolated from the oropharynx, the children were asymptomatic or had only rhinitis in 73% of the cases which might indicate that the dismissing of symptomatic children is of limited value in controlling the spread of infections in a day care centre. Cytomegalovirus was recovered from 22% of the urine specimens. Carrier frequency of cytomegalovirus was 23% in 40 other children attending one of 13 different day care centres. Because asymptomatic cytomegalovirus infections apparently occur frequently among small children in Sweden, it seems reasonable not to take pronounced measures of isolating the children in the relatively few recognized cases of cytomegalovirus infections.