胆汁酸代谢

胆汁酸是胆汁中存在的一类胆烷酸的总称,以钠盐或钾盐的形式存在,是胆汁的主要有机成分.胆汁酸在肝细胞内由胆固醇转化而来,为脂类物质(包括脂溶性维生素)的消化、吸收所必需.……     

胆红素代谢

黄疸是肝脏病常见的症状,是胆红素代谢紊乱的临床表现,了解正常胆红素代谢,是揭示黄疸发生机制的关键. 　　……     

代谢肥胖对雄性大鼠骨代谢影响

[目的]探讨代谢肥胖对雄性SD大鼠青年期（17周龄）和成年期（27周龄）骨代谢的影响。[方法] 5周龄雄性SD大鼠40只，按随机数字表法随机分成普食组（normal diet, ND组）、高脂组（High-fat diet, HFD组），分别给予ND和HFD饲养至17周和27周。检测血清骨代谢标志物，行微型CT检查和三点弯曲力学测试。[结果]两组大鼠17周龄时血Ca、P、PINP、CTX的差异均无统计学意义（P>0.05）。27周龄时HFD组大鼠PINP显著小于ND组（P<0.05），而CTX显著大于ND组（P<0.05）。随周龄增加，大鼠体重及肌肉量显著增加（P<0.05）。与ND组相比，17周龄HFD组大鼠的Tb.vBMD、Tb.BV/TV、Tb.N均显著减少（PP<0.05），而Tb. Sp显著增加（P<0.05）。27周龄HFD组大鼠的Tb. vBMD、Tb. BV/TV、Tb. Th、Tb. N均显著减少（P<0.05）,Tb. Sp和SMI显著增加（P<0.05）。与17周相比，27周ND组最大负荷、最大断裂负荷、能量吸收、韧...     

代谢亢进、器官衰竭与代谢支持

20年前,营养支持应用于临床,其原则源于对健康人饥饿时的营养支持,目的在于恢复机体器官功能,并着力维持瘦体细胞群、氮平衡及内脏蛋白合成。葡萄糖是主要燃料,非蛋白热卡/氮大于150/L,蛋白质负荷为1 g/kg/d。现代外科监护室中,有一类代谢亢进病人易发生进行性器官衰竭,且有显著的营养不良。由于使用标准营养支持后有合并症,通过对代谢亢进及器官衰竭时代谢、器官间相互关系的了解,产生了着重支持器官结构及其功能,清除底物限制性代谢,推进各代谢通路,减少葡萄糖     

用于肥胖及其相关代谢代谢性疾病的主要减重代谢手术方式发展现状

减重代谢手术通过限制食物摄入和减少营养物质吸收, 可降低体重并改善2型糖尿病、高血压、睡眠呼吸暂停综合征等肥胖相关代谢性疾病。腹腔镜胃袖状切除术、Roux-en-Y胃旁路术、可调节胃束带术和胆胰分流-十二指肠转位术是目前4种主流术式。胃袖状切除联合手术、单吻合口胃旁路术、胃内球囊及内镜下减重手术等创新术式也不断涌现。目前, 减重代谢手术正迎来学科深度融合、术式优化创新、减重降糖疗效确切的发展机遇期, 必将使更多肥胖患者临床获益。     

骨代谢与铁代谢指标相关性的研究进展

研究骨代谢是研究骨代谢疾病的关键。近年来,在关于骨代谢影响因素的研究中,涉及铁代谢指标的研究报道越来越多,很多研究结论提示骨代谢与铁代谢有相关性。高铁环境中成骨细胞生物活性指标(细胞增殖、碱性磷酸酶活性、钙结节)均受到抑制,成骨细胞凋亡增加;而低铁环境使成骨细胞碱性磷酸酶活性增加,上调成骨细胞Ⅰ型胶原、骨钙素及骨保护蛋白mRAN的表达。铁调素作为一种调节体内铁稳态的肽类激素,也对成骨细胞的生物活性有着显著影响。因此本文就骨代谢与铁代谢的相关研究进展综述如下。     

皮肤色素代谢性疾病

人体皮肤颜色各不相同 ,与种族、遗传因素、年龄、性别、外界环境以及某些疾病等因素有密切关系。肤色可分为红、黄、白、棕、蓝、黑六种。正常皮肤颜色主要决定因素 :1皮肤内色素的含量 ,即皮肤内黑素胡萝卜素以及皮肤血液内氧化与还原血红蛋白的含量 ;2皮肤解剖差异 ,主要是皮肤的薄厚度 ,特别是角质层和颗粒层的薄厚 ;3某些外源性物质如重金属、文身染料。药物和疾病也可引起皮肤色素沉着 ,色素沉着或色素减退可以是遗传的 ,也可以发生在炎症改变后或由外源性物理化学刺激或金属物所致。黑素是决定皮肤颜色的主要色素 ,由黑素细胞( Mela…     

肠道菌群对代谢术后骨代谢的影响

肠道菌群的改变对宿主起着多方面的影响。代谢手术对肠道结构及生理功能的改变影响了寄居于肠道内的菌群。而这些菌群的变化参与了术后体重下降﹑糖代谢及脂代谢的改变。同时已有很多研究证实肠道菌群的变化可以通过影响宿主的代谢系统﹑神经系统﹑免疫调节系统对骨代谢造成不容忽视的影响。益生菌作为一种对宿主有益的活性微生物，其骨保护作用也越来越得到重视。本文从减重术后肠道菌群的改变﹑肠道菌群对骨代谢的影响及益生菌与骨代谢等方面进行综述，总结近年来的研究进展及热点，搭建肠道菌群与代谢术后骨代谢相关多学科之间的桥梁，为代谢术后的菌群治疗、靶点研究奠定基础。     

老年人药物代谢动力学

长期以来,临床医师一直意识到老年病人比年轻病人对药敏感。正常情况下,随着年龄增长,体内成分和功能发生一定变化,但这些变化如何影响麻醉药的吸收、分布和     

外科病人蛋白质代谢研究进展

正常成人蛋白质合成速度等于蛋白质分解速度,使体内的氮处于动态平衡状态,但在创伤、手术、感染、肿瘤及其它许多外科疾病状态下,体内的这种平衡状态受到破坏,出现蛋白质的净丢失,即负氮平衡。本文试就外科病人负氮平衡发生机理、研究手段及纠正措施等方面的进展作一综述。研究蛋白质代谢方法的进展用以了解体内蛋白质代谢状态的由来已久的方法是精细地测定氮平衡。近10多年来,随着稳定性同位素应用的进展,在蛋白质代谢研     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.