晨尿尿蛋白/尿肌酐比值与24小时尿蛋白的临床相关性的初步评价

目的：通过研究晨尿尿蛋白/尿肌酐比值与24h尿蛋白的相关性,并与24h的AAP、NAG、GAL相比较,了解是否可以用晨尿尿蛋白/尿肌酐比值测定的检测方法代替24h尿蛋白定量测定,以便在临床上更准确快捷监测及评估CKD患者尿蛋白程度。方法：收集142例患者的同1d内的晨尿与24h尿液标本,分别测定尿蛋白与尿肌酐,同时测定24h尿AAP、NAG、GAL,并进行相关性分析。结果：晨尿尿蛋白/尿肌酐比值与24h尿蛋白定量结果相关性良好,但晨尿尿蛋白/尿肌酐比值与24h尿AAP、NAG、GAL相关性分析结果显示相关性差。结论：研究结果显示,晨尿尿蛋白经过肌酐校正后与24h尿相关性良好,建议临床用晨尿尿蛋白/尿肌酐比值代替24h尿蛋白定量检测。     

Sysmex XT-2000iv型动物血细胞分析仪的性能验证

目的：对Sysmex XT-2000iv型动物血细胞分析仪进行性能验证。方法：对该仪器的准确度、精密度、携带污染率和线性进行验证,并与其他仪器测定结果及人工白细胞分类镜检结果进行比较。结果与结论：该仪器的准确度、精密度、携带污染率和线性均在允许范围内;与JT-IR血细胞计数仪测定结果相关性良好;白细胞分类测定结果与人工显微镜分类比较,中性粒细胞、淋巴细胞和嗜酸性粒细胞相关性较好,单核细胞和嗜碱性粒细胞相关性较差。Sysmex XT-2000iv动物血细胞分析仪各方面性能良好,测定结果准确可靠,可以满足GLP安全性评价课题动物血液样本分析的需要。     

血清胶原代谢指标在评价高血压左室重构中的作用

目的 探讨高血压患者血清胶原代谢指标的变化及临床意义。方法 按WHO（1999年）高血压诊断标准选择原发性高血压患者94例，其中左室肥厚组（EH-LVH）4l例、非左室肥厚组（EH-NLVH）53例；对照组32例。用放射免疫分析法测定血清Ⅰ型前胶原羧基端肽（PICP）、Ⅲ型前胶原（PCⅢ）、透明质酸（HA）、层粘连蛋白（LN）水平，同时应用超声背向散射积分（IBS）技术测定左室图像平均强度（AⅡ2、AⅡ2）、左室质量指数（LVMI），对上述各指标进行相关性分析。结果 EH-LVH组PⅠCP、PCⅢ、LN、HA水平高于EH-NLVH组和对照组；EH-NLVH组上述指标水平亦高于对照组。3组左室IBS参数AⅡ1、AⅡ2间差异均有显著性。PⅠCP、PCⅢ、LN均与AⅡ1、AⅡ2和LVMI呈正相关。结论 PⅠCP、PCⅢ、LN和HA可反映高血压患者胶原代谢异常，并对评价左室重构有一定作用。     

高效液相色谱法测定心达康片的含量

目的应用反相高效液相色谱法测定心达康的含量。方法以甲醇-0.2％磷酸（45：55）（pH2．27）为流动相，采用C18化学键合硅胶为固定相，在368nm进行测定。结果槲皮素、山奈素、异鼠李素3种黄酮在测定范围内线性良好。结论该方法简便、可靠、准确，可用于该制剂的质量控制。     

肝素稀释对血气分析结果的影响及其校正法

已有文献报道，血气酸碱分析样本被抗凝和隔绝空气用的肝素过大稀释时，将引起血液PCO2及［HCO3－］评价的错误。作者工作中得到相似的结果，本文介绍了对这类样本测定结果的校正法，经临床19例对照，不同稀释度的血PCO2结果其校正值与原血实测值无显著差异，［HCO3－］可用PCO2（mmHg，1mmHg=0．133kPa）校正后的值按公式计算求得。方法简易实用，现报道如下。仪器和材料一、仪器美国康宁（C0rning）M－168型血气酸碱分析仪。经用质按液测试性能良好。＝、10‘U／L（1000U／ml）的肝素生理盐＊根据规程’‘’的要求用8．sg／L的N…     

影响CT测量BMD精确性因素的探讨

目的：利用QCT技术进行实验性BMD测量。材料和方法：以不同深度的水（2cm，4cm，6cm，8cm，10cm，12cm，14cm，16cm，18cm，20cm，22cm，24cm，）模拟不同的软组织厚度；以不同浓度的磷酸氢二钾溶液（160mg/ml，180mg/m，1200mg／ml）模拟不同的骨矿物质含量，同一样本在不同深度的水内置于同样的位置，又不同样本在相同深度的水内置于同样的位置，均分别重复扫描10次，检测样本密度值，并行统计处理。结果：随着水深度增加，所测各样本的BMD值均降低；不同浓度样本置于相同深度时，不影响测量结果的精确性。通过对测量结果进行统计学处理，得出校正公式为：（BMD）真实值=（BMD）测量值-1.140＋0．973H－0．0158H2。结论：样本浓度对BMD测量值影响不大，软组织厚度对测量值有影响，软组织越厚，BMD测量值比实际值越低。     

2005年放疗水平二级剂量标准的TLD国际比对

目的通过参加国际原子能机构（IAEA）和世界卫生组织（WHO）组织的二级标准剂量学实验室（SSDL）TLD国际比对，检查SSDL放疗水平剂量标准和国际标准的一致性。方法SSDL对IAEA邮寄的TLD进行照射，并计算出其吸收剂量，然后将TLD及其计算结果寄往IAEA剂量学实验室，IAEA对其进行评价，给出比对的偏差。结果本次^60Co比对的偏差为-1．4％，高能X射线比对的偏差为-1．8％。结论按照IAEA要求，该项比对的最大允许偏差为±3．5％，所以这次比对结果是合格的。     

慢性肾炎患者血、尿及肾组织中ET-1变化

目的：探讨内皮素（ET）在慢性肾小球肾炎发病中所起的作用。方法：检测正常人，40例慢性肾炎患者肾组织局部ET－1、血浆ET－1和24h尿ET－1排泄量，以及血肌酐（Scr)，尿素氮（Bum),24h尿蛋白定量（Pro)和内生肌酐清除率（Ccr)，结果：40例慢性肾小球肾炎患者肾组织局部，血，尿ET－1均较正常对照组明显升高（P＜0．01），且血，尿ET－1与Bun,Scr,Pro明显呈正相关，与Ccr呈负相关。结论：内皮素可能参与慢性肾小球肾炎发病及疾病进展，血尿ET－1可作为判断肾炎性的一个临床指标。     

基于不同管电压下腰椎定量CT骨密度测量临床研究

【摘要】目的：探讨不同管电压下定量CT(QCT)测量腰椎骨密度（BMD）结果的差异及校正方法。方法：招募2021年10月至2022年1月于我院进行低剂量肺CT联合腰椎QCT健康体检人群中检出疑似肺部炎性病变，进而需进一步CT复查者为志愿者，两次扫描时间间隔1~4周，共入组122例，根据两次检查管电压的不同记为100kV组和120kV组，其余扫描参数相同，分别进行骨密度测量，采用配对t检验对两次测量结果的差异进行比较，计算组内相关系数(ICC)评价两组间相关性，应用Bland-Altman分析两次测量结果之间的一致性，运用Pearson相关性分析、线性回归分析得出相关系数及回归方程。结果：保持其他扫描条件一致，采取不同管电压扫描，定量CT所测得的腰椎骨密度不同，100kV管电压下测得的骨密度大于120kV管电压下的骨密度，差异具有统计学意义（P=0.000），两组间测量结果一致性好、相关性好（ICC=0.996，P=0.000）；不同管电压下骨密度测量结果相关性强，且二者呈正相关（r=0.9961，P=0.000），得出回归方程Y=0.9932X-2.160，R2=0.9923。结论：100kV和120kV管电压条件下，定量CT骨密度测量结果存在差异，结果呈高度正性相关。当管电压为100kV时，可通过回归方程进行校正，获得120kV条件下的真实骨密度值。     

HPLC法测定枸橼酸钾溶液中枸橼酸钾和羟苯乙酯的含量

目的用HPLC法验证原有测定枸橼酸钾溶液中枸橼酸钾和羟苯乙酯含量的方法,并与原方法进行比对。方法采用Nucleodur C18Pyramid（250 mm×4.6 mm,5μm）色谱柱。梯度洗脱,流动相A：水-磷酸（1000∶1）;流动相B：乙腈。洗脱程序：0~5 min,A100%;5.01~22 min：A70%,B30%;22.1~30 min,A100%;流速1 ml·min^-1,检测波长210 nm。结果以峰面积（Y）对进样浓度（X,μg·ml^-1）进行线性回归,枸橼酸钾回归方程为Y=2.586 X-16.49,r=0.9999,线性范围500.8~5008μg·ml^-1;羟苯乙酯回归方程为Y=0.021 44 X-0.4065,r=0.9999,线性范围2.503~25.03μg·ml^-1;枸橼酸钾回收率为100.2%,RSD为0.15%;羟苯乙酯回收率为99.6%,RSD为1.9%。结论 HPLC法测定结果准确,重复性好,操作简便,优于原方法,可更好的用于枸橼酸钾溶液中枸橼酸钾和羟苯乙酯的含量测定。     

NSAID use increases the risk of developing hyponatremia during an Ironman triathlon

PURPOSE: Exertional hyponatremia ((Na) < 135 mmol x L(-1)) is a potentially serious condition associated with endurance sports. It has been postulated that nonsteroidal antiinflammatory drug (NSAID) use may be a risk factor. This observational cohort study aimed to determine whether NSAID use is a risk factor for exertional hyponatremia and altered renal function during endurance exercise. METHODS: A total of 330 athletes in the 2004 New Zealand Ironman triathlon (3.8-km swim, 180-km cycle, and 42.2-km run) were weighed before and after the race. A blood sample was drawn for measurement of plasma sodium (Na), potassium (K), urea (urea), and creatinine (creatinine) concentrations postrace. RESULTS: The incidence of NSAID use was 30%, whereas the overall incidence of hyponatremia was 1.8%. NSAID use was related to the incidence of hyponatremia (P = 0.0002). The NSAID group had lower plasma Na (P = 0.02) and higher plasma K (P = 0.002), urea (P = 0.05), and creatinine (P = 0.01). Lower Na was also significantly related to female gender, lower prerace body weight, younger age and a smaller weight loss during the race. Race times were not associated with plasma Na; however, faster triathletes lost more weight. Estimated fluid intake was not different in the NSAID group, but heavier triathletes reported greater fluid intakes. CONCLUSIONS: NSAIDs are commonly used by athletes competing in endurance events and are a risk factor for hyponatremia and altered renal function. Notwithstanding high rates of NSAID use, the incidence of hyponatremia was low. We attribute this to changes in fluid replacement guidelines and drink station availability that reduce the risk of overdrinking, the principal cause of this condition.     

Comparison of glomerular filtration rate measurements with the two plasma sample and single plasma sample, gamma camera Gates, creatinine clearance, and prediction equation methods in potential kidney donors with normal renal function

OBJECTIVE: To compare measured glomerular filtration rate (GFR) by single plasma sample methods (SPSMs), gamma camera Gates, 24-h endogenous creatinine clearance, and prediction equations (Cockcroft-Gault and modification of renal disease (MDRD)) with the two plasma sample method (TPSM) considered as the reference in potential kidney donors with normal renal function. METHODS: One hundred and fifteen subjects (50 male, 65 female; mean age 41.9+/-12.2 years) with normal renal function were prospectively included in this study. GFR was calculated by TPSM (120-min and 240-min samples) and SPSM (180-min sample). RESULTS: While there was strong statistically significant correlation between the TPSM and all SPSMs, low correlation was found in Gates, creatinine clearance, Cockcroft-Gault and MDRD. In all SPSMs, 95% limits of agreements were consistent with each other and within clinically acceptable limits. The lowest bias, median absolute difference, mean percentage error, and the best precision were found for Christensen and Groth's method as modified by Watson (CGmW). CONCLUSIONS: Among the SPSMs, CGmW can reflect GFR more accurately than the other methods. Neither the gamma camera Gates method nor the creatinine clearance method nor the prediction equations (Cockcroft-Gault and MDRD) could calculate GFR accurately. All these techniques could result in mistakes in the management of potential kidney donors.     

Comparison of methods for determination of glomerular filtration rate: Tc-99m-DTPA renography,predicted creatinine clearance method and plasma sample method

BACKGROUND: The gamma camera uptake method with Tc-99m-DTPA is simple and less time consuming for the determination of the glomerular filtration rate (GFR). However, its diagnostic accuracy is debated. Gates' method and predicted creatinine clearance method were compared with plasma clearance method with Tc-99m-DTPA for the measurement of GFR. MATERIALS AND METHODS: Tc-99m-DTPA renography was performed on 133 patients (69 males and 64 females; age range being 24 to 84 years) with a wide range of renal function. The GFR was determined simultaneously by 3 methods; (1) gamma camera uptake method (modified Gates, Gates); (2) predicted creatinine clearance method (Cockcroft-Gault, CG); (3) single- or two-plasma clearance method (plasma sample clearance method, PSC). The PSC was chosen as a reference. RESULTS: The regression equation of the Gates and the CG against the PSC was Y = 11.89 + 1.041X (r = 0.790, p < 0.001, RMSE = 23.55 ml/min/1.73 m2) and Y = 8.845 + 0.7899X (r = 0.8270, p < 0.001, RMSE = 16.27 ml/min/1.73 m2), respectively. In comparison with the GFR by PSC, the Gates tended to overestimate the GFR, and contrarily the CG tended to underestimate the GFR. CONCLUSION: The Gates correlates well with the PSC. However, the Gates is even less precise than the CG. The Gates' method in Tc-99m-DTPA renography is not suitable for the estimation of GFR in routine practice.     

Estimation of total-body skeletal muscle mass in children and adolescents

PURPOSE: The estimation of total-body skeletal muscle mass (SMM) has been predicted in healthy adults using anthropometric measurements and urine creatinine excretion. SMM measurement is compulsory to evaluate exercise performance and the influence of physical training on muscle mass. However, there is a lack of information on children and adolescents when quantifying appendicular skeletal muscle mass. METHODS: Thirty-nine Caucasian children and adolescents (male and female, 7-16 yr old) and 20 adults (men and women, 20-24 yr old) were tested for total-body SMM using dual-energy x-ray absorptiometry measurement (DEXA), anthropometric measurements (ANTHR), and urine creatinine (UCrn) determination. Skinfold thickness and circumference were measured at mid-arm (CAG), mid-thigh (CTG), and mid-calf (CCG) and the skin-corrected circumferences (cm), together with height (Ht; m), age (yr), and sex (0 for female, 1 for male). The UCrn excretion (g.24 h(-1)) was also determined in all subjects. The ANTHR and UCrn measurements were then compared with DEXA as reference value. RESULTS: The multiple linear regression from anthropometric measurements gave the following equation to evaluate the total-body skeletal muscle mass (SMM) in children and adolescents: SMM (kg) = Ht x [(0.0064 x CAG) + (0.0032 x CTG) + (0.0015 x CCG)(2)] + (2.56 x sex) + (0.136 x age). The prediction of SMM from a 24-h urine collection was obtained with the following equation: SMM (kg) = (10.62 x Crn) + 6.63. The correlation coefficient (r(2)) was 0.966 and 0.710 for the anthropometric and creatinine methods, respectively (P < 0.001). CONCLUSION: Besides DEXA technique, the determination of total-body skeletal muscle mass in children and adolescents can be highly validated with satisfactory confidence by simple anthropometric measurements or 24-h urine creatinine excretion.     

前列地尔治疗糖尿病肾病的临床观察

目的:观察前列地尔(prostaglandin E1)治疗糖尿病肾病的临床疗效。方法:随机选取糖尿病肾病病人78例,其中46例糖尿病病人(治疗组),采用前列地尔(商品名:凯时)注射液静点,同时应用胰岛素皮下注射治疗。32例糖尿病肾病病人(对照组)单用胰岛素治疗,治疗前后的尿微量白蛋白、血肌酐、尿蛋白检测结果的变化情况。结果:凯时治疗后,尿微量白蛋白、血肌酐、尿蛋白均明显下降(P<0.01)。结论:凯时注射液同时应用胰岛素治疗糖尿病肾病有很好疗效。     

Preparation of in-house reference soil sample containing high levels of naturally occurring radioactive materials from the oil industry

An in-house reference soil sample containing high levels of naturally occurring radioactive materials collected from contaminated areas in the Syrian oilfields has been prepared as a part of the quality assurance program in AECS. Homogeneity of the sample has been examined using three methods, viz. particle size distribution of the sample matrix, total alpha/beta counting and gamma spectrometry. In conjunction with Dixon and Grubb tests as statistical tools, ten random samples from the original sample were used for this investigation. Reference values for the three radium isotopes (²²⁴Ra, ²²⁶Ra, ²²⁸Ra) were determined using gamma spectrometry equipped with HPGe detectors having high relative efficiencies of 80%, while the reference value of ²¹⁰Pb in the sample was determined using radiochemical separation and counting of its daughter ²¹⁰Po by alpha spectrometry. ANOVA analysis was used to estimate the uncertainties due to measurement and inhomogeneity of the sample; uncertainty due to inhomogeneity was found to be around 2.6 times the measurement uncertainty.     

Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?

ObjectiveTo determine whether the intravenous administration of iodinated contrast material for computed tomography (CT) is associated with an increase in creatinine levels and acute kidney injury.Material and methodsThis retrospective cohort study included all patients who presented at the emergency department between 2010 and 2015 with baseline creatinine measurement (C1) and follow-up creatinine measurement (C2) between 24 and 72 hours later. The clinical research ethics committee approved the study. The exclusion criteria were age < 18 years, creatinine ≤ 0.4 mg/dl or ≥4.0 mg/dl, and the administration of contrast media within the previous 6 months. The mean number of patients presenting at the emergency department was 105,435.6 per year. Patients who met the inclusion criteria were classified into three groups: those who underwent contrast-enhanced CT (n = 6,642), those who underwent noncontrast CT (n = 6,193), and those who did not undergo CT (n = 33,802). We used the Acute Kidney Injury Network's (AKIN) and the Contrast-induced Nephropathy Consensus Working Panel's (CIN) criteria. Statistical analyses included bivariate statistics and logistic regression. Stata 15 was used for all statistical analyses.ResultsWe analyzed 52,411 patients; after data cleansing: 46,637; mean age: 67.95 years; C1: mean 1.16 mg/dl (SD: 0.61); C2: 1.14 mg/dl (SD: 0.66). With AKIN and CIN criteria: contrast-enhanced CT was not associated with a greater probability of developing nephropathy (odds ratio [OR: 0.90; 95% CI: 0.83–0.99] and [OR 0.89, 95% CI: 0.81–0.98], respectively). The propensity score matching study using both sets of criteria (AKIN + CIN) yielded OR 0.80 [95% CI: 0.77–0.84]. Glomerular filtration rates less than 30 ml/min were not associated with increased kidney damage [OR: 0.66, 95% CI: 0.47–0.91].ConclusionThe administration of intravenous contrast material in the patients studied is not associated with increased acute kidney injury.     

Measurement of glomerular filtration rate using 99mTc-DTPA and the gamma camera: a comparison of methods

A variety of methods have been proposed to estimate the glomerular filtration rate (GFR) from the renal uptake of technetium Tc 99m-DTPA using a gamma camera. To compare alternative methods, we calculated the GFR in several different ways from measurements in 33 patients and compared the results with an independent GFR measurement based on eight-point plasma clearance of ytterbium Yb 169-DTPA. The best agreement was obtained using an algorithm that has not been described previously, in which correction was made for overlap of the kidneys by the liver and spleen. The correlation coefficient was 0.958, and the residual standard deviation was 12.1 ml/min. This method required a single 20-min blood sample as well as the camera data. The best method not requiring a blood sample was significantly less accurate, with a correlation coefficient of 0.837 and a residual standard deviation of 23.1 ml/min. The accuracy of these methods was comparable to that reported for creatinine clearance, the most commonly used estimate of the GFR in current clinical practice.     

Renal tolerance of gadolinium-DTPA/dimeglumine in patients with chronic renal failure.

Safety data for renal tolerance of gadolinium-DTPA(Gd-DTPA)/dimeglumine were evaluated in 21 patients (age: mean +/- standard deviation [SD], 58 +/- 12 years) with impaired renal function. The mean +/- SD serum creatinine level at baseline was 213 +/- 101 mumol/L (range, 89.2-551 mumol/L). Creatinine clearance at baseline averaged 34.5 +/- 19.2 mL/minute (range, 7.2-70 mL/minute). Gd-DTPA was injected at a dose of 0.1 mmol/kg body weight. Serum parameters (creatinine, sodium, and potassium) were determined before and 6, 24, 48, and 120 hours after administration of Gd-DTPA. Urinary parameters (N-acetyl-beta-D-glucosaminidase [beta-NAG], protein, and albumin) were determined before (spot urine sample) and after treatment for collection periods 0 to 3, 3 to 6, 6 to 12, 12 to 24, and 24 to 48 hours. A final spot urine sample was taken at 120 hours. There was no significant statistical change of serum creatinine level within the observation period, and there was no single patient matching the criteria of acute renal failure (increase of serum creatinine level of 88.4 mumol/L [1 mg/dL] or more within 48 hours after injection). Serum values of sodium and potassium levels remained unchanged. Beta-NAG was slightly increased 0 to 3 hours after injection, but returned to baseline values during the collection periods up to 120 hours. There was no increase of protein or albumin excretion. These preliminary results suggest Gd-DTPA has good renal tolerance in patients with pre-existing chronic renal failure.