血液透析患者血浆游离氨基酸浓度的分析

尿毒症常存在着氨基酸代谢异常［１］。血液透析虽可纠正部分尿毒症症状,但氨基酸代谢紊乱等情况继续存在甚至加重。氨基酸代谢紊乱是血透患者营养不良的一个重要因素。本研究对２４例血透患者食物中必需氨基酸的摄入和血浆游离氨基酸进行了测定和分析。１　对　象　与　方　法１．１　临床资料　　２４例血液透析患者（男１４,女１０）,平均年龄４４．６（３３～６２）岁。基础病均为慢性肾小球肾炎。另选１２例性别和年龄相配对的健康正常人作对照。１．２　膳食摄入分析　　先对患者进行膳食记录宣传教育,由患者连续记录三天（含透析…     

复合氨基酸输液对烧伤病人血浆游离氨基酸浓度的影响

复合氨基酸输液对烧伤病人血浆游离氨基酸浓度的影响黎君支，王怀宾，赵有，郭振荣，盛志勇（北京军医进修学院创伤外科中心，三○四医院，１０００２７）关键词：烧伤，复合氨基酸注射液血浆氨基酸ＥｆｆｅｃｔｏｆＣｏｍｐｏｓｉｔｅＡｍｉｎｏＡｃｉｄＴｒａｎｓｆｕｓ...     

家兔肝部分切除术围手术期血浆氨基酸含量的变化

家兔肝部分切除术围手术期血浆氨基酸含量的变化管文贤，高志清，傅由池，刘智广（第四军医大学西京医院肝胆外科，西安７１００３２）ＴｈｅＣｈａｎｇｅｓｏｆＰｌａｓｍａＡｍｉｎｏＡｃｉｄＳｐｅｃｔｒｕｍｄｕｒｉｎｇｔｈｅＰｅｒｉｏｐｅｒａｔｉｖｅｐｅｒｉｏｄ...     

糖尿病肾病患者使用血液透析机透析的时机观察

目的:探究糖尿病肾病患者使用血液透析机透析的时机。方法:回顾性分析本院2012年1月~2017年12月收治的42例行血液透析的糖尿病肾病患者的临床资料。其中,有24例患者在血肌酐达到707μmol/L时开始行长期血液透析(正常组),剩余18例患者透析前患者血肌酐在224~675uomL/L间,均因不同病情提前开始进行血液透析治疗(提前组)。结果:正常组中有13例患者死亡,剩余11例患者均已出现程度不一的血管病变情况,且均须通过血液透析机行长期透析。提前组中有2例死亡,4例须每周行2次长期透析,2例须每7~10d内行1次透析,有1例患者在出院1年后每周行1次血液透析,1例患者行肾移植,8例患者未再行透析治疗。结论:提前进行血液透析能够减缓糖尿病肾病进展至终末期肾功能衰竭的速度,并有效延长透析间隔时间,降低并发症发生率。     

Parenteral Amino Acid Intakes in Critically Ill Children

Background: Parenteral and enteral amino acid requirements for nutrition balance and function have not been defined in critically ill children or adults. In addition to playing a role in protein synthesis, amino acids trigger signaling cascades that regulate various aspects of fuel and energy metabolism and serve as precursors for important substrates. Amino acids can also be toxic. In this study, parenteral intakes of essential and nonessential amino acids (EAAs and NEAAs) supplied to critically ill children were assessed as an initial step for further studies aimed at establishing parenteral amino acid requirements. Methods: A retrospective review was conducted to assess intakes of parenteral amino acid for 116 critically ill children, and these intakes were compared with EAA intakes recommended by the Institute of Medicine. Because there are no recommended intakes for NEAA, NEAA intakes were compared with mixed muscle protein content in the older children and breast milk amino acid content in the infants. Results: Parenteral EAAs were provided in amounts that exceeded recommended intakes for healthy children, except for phenylalanine and methionine, which although excessive, were given in less generous amounts. NEAAs were supplied in lower or higher amounts than the content of mixed muscle proteins or breast milk. Parenteral amino acid formulas are limited in taurine, glutamine, and asparagine despite the fact that inflammatory/immune proteins are rich in these amino acids. Conclusions: Amino acid composition of parenteral formulas is variable and lacks scientific support. Parenteral amino acid intakes should be based on measured requirements to maintain nutrition and functional balance and on knowledge of toxicity.     

镧对大鼠大脑皮质兴奋性氨基酸和钙稳态的影响

目的 观察镧对大鼠学习记忆的影响,并从大脑皮质兴奋性氨基酸水平和钙稳态的角度探讨镧影响学习记忆的机制.方法 将40只雌性Wistar大鼠随机分为对照组和低、中、高剂量LaCl_3(0.25%,0.50%,1.0%)染毒组,每组10只.LaCl_3,染毒组仔鼠在出生至断乳后1个啁期间染镧,然后进行跳台测试,并测定大脑皮质中兴奋性氨基酸含量、细胞内钙离子浓度以及尼氏体表达水平.结果 跳台测试结果表明,LaCl_3,染毒组仔鼠的学习记忆能力明显低于对照水平,具有一定的剂量.效应关系;低、中剂量LaCl_3染毒组大脑皮质谷氨酸含量和细胞内Ca~(2+)浓度明显高于对照组,高剂量LaCl_3染毒组大脑皮质谷氨酸、天冬氨酸含量和细胞内Ca~(2+)浓度显著高于对照组和低、中剂量LaCl_3,染毒组.此外,低剂量LaCl_3染毒组大脑皮质神经细胞中尼氏体表达水平明显低于对照组,中和高剂量LaCl_3,染毒组大脑皮质神经细胞中尼氏体表达水平进一步降低.结论 本实验结果表明镧可能是通过使兴奋性氨基酸水平异常升高和钙稳态失衡的机制引起大脑皮质神经细胞损伤,造成学习记忆能力低下.     

正常和营养不良儿童血浆游离氨基酸含量

<正> 正常人体血浆游离氨基酸(简称血浆氨基酸)浓度对于氨基酸代谢缺陷性疾病,肝、肾等疾病的诊断与治疗以及对儿童营养状况的评价有参考意义。我们于1985年9月～1986年6月对251名正常儿童和39例营养不良儿童测定了15种血浆氨基酸含量。 对象与方法     

Associations between Circulating Markers of Cholesterol Homeostasis and Macrovascular Events among Patients Undergoing Hemodialysis

Current strategies targeting serum cholesterol bring limited benefits to mortality and macrovascular events prevention among hemodialysis patients. Direct measurements and analysis on circulating markers of cholesterol homeostasis could be promising solutions to this bottleneck. We prospectively enrolled 90 maintenance hemodialysis patients and 9 healthy controls in 2019 for 1 year. We measured circulating desmosterol and lathosterol as markers for cholesterol synthesis and campesterol and sitosterol for cholesterol absorption. At baseline, hemodialysis patients showed higher levels of campesterol (p = 0.023) compared to healthy controls. During follow-up, we identified 14 (15.4%) patients who experienced macrovascular events. Comparisons of cholesterol homeostasis markers between cohorts with and without macrovascular events showed no significant differences in markers of cholesterol synthesis or absorption. Using logistic regression analysis, the odds ratio was not statistically significant for the prediction of macrovascular events after full-adjusting for age, sex, diabetes, serum albumin, cholesterol, and triglyceride. We concluded that hemodialysis patients demonstrated higher level of cholesterols absorption, indicated by circulating campesterol compared to healthy subjects. Markers for cholesterol homeostasis were not significantly associated with macrovascular events during a 1-year follow-up. Our results shed light on the novel therapeutic target of modulating cholesterol absorption in HD patients.     

Effects of Diets Supplemented with Branched-Chain Amino Acids on the Performance and Fatigue Mechanisms of Rats Submitted to Prolonged Physical Exercise

This study aimed to determine the effects of diets chronically supplemented with branched-chain amino acids (BCAA) on the fatigue mechanisms of trained rats. Thirty-six adult Wistar rats were trained for six weeks. The training protocol consisted of bouts of swimming exercise (one hour a day, five times a week, for six weeks). The animals received a control diet (C) (n = 12), a diet supplemented with 3.57% BCAA (S1) (n = 12), or a diet supplemented with 4.76% BCAA (S2) (n = 12). On the last day of the training protocol, half the animals in each group were sacrificed after one hour of swimming (1H), and the other half after a swimming exhaustion test (EX). Swimming time until exhaustion was increased by 37% in group S1 and reduced by 43% in group S2 compared to group C. Results indicate that the S1 diet had a beneficial effect on performance by sparing glycogen in the soleus muscle (p < 0.05) and by inducing a lower concentration of plasma ammonia, whereas the S2 diet had a negative effect on performance due to hyperammonemia (p < 0.05). The hypothalamic concentration of serotonin was not significantly different between the 1H and EX conditions. In conclusion, chronic BCAA supplementation led to increased performance in rats subjected to a swimming test to exhaustion. However, this is a dose-dependent effect, since chronic ingestion of elevated quantities of BCAA led to a reduction in performance.     

Determination of Fatty Acid Levels in Erythrocyte Membranes of Patients with Chronic Fatigue Syndrome

Abstract

Chronic fatigue syndrome (CFS) is an illness characterized by persistent and relapsing fatigue, often accompanied by numerous symptoms involving various systems of whole body. The etiology of CFS remains unclear. Literature reported whether the concentrations of the essential fatty acids in red cell membranes of CFS patients were decreased is controversial. In our study, Forty-two patients who fulfilled the diagnostic criteria defined by Centers for Disease Control and Prevention (CDC). Thirty-seven age- and sex-matched controls were selected from healthy medical staffs and volunteers. After lipid analysis, we found that the levels of the arachidonic acid (ARA) and docosahexanoic acid (DHA) were decreased in patients suffered from CFS. However, the levels of the palmitic acid and oleic acid were increased. We speculated that there are two possible mechanisms--one of which is that oxidative stress has led to an excessive oxidation and resulting in the above fatty acids. Alternatively, insufficiency of ingestion of fatty acids might not be the major cause.     

医院血液透析机的一般维护保养

简要介绍了血液透析的概念(以贝朗血液透析机为例),强调工程师日常维护保养的必要性,及温度定标举例。     

高通量血液透析用于慢性肾病患者治疗中的效果分析

目的:探究高通量血液透析用于慢性肾病患者治疗中的临床疗效.方法:选择2017年10月~2018年12月在本院进行常规维持性血液透析治疗3个月的60例慢性肾病患者作为此次研究对象,对本组患者给予高通量血液透析,连续治疗6个月,观察本组患者治疗前后P、PTH、Alb、Hb、TC以及血压指标,对比临床治疗效果.结果:患者治疗后P、PTH、Alb、Hb、TC以及血压指标显著优于治疗前,且差异具有统计学意义(P<0.05).结论:针对慢性肾病患者,临床给予高通量血液透析治疗效果显著,可在一定程度上改善患者临床症状,减少出现并发症的危险.     

The Role of Microbial Amino Acid Metabolism in Host Metabolism

Disruptions in gut microbiota composition and function are increasingly implicated in the pathogenesis of obesity, insulin resistance, and type 2 diabetes mellitus. The functional output of the gut microbiota, including short-chain fatty acids and amino acids, are thought to be important modulators underlying the development of these disorders. Gut bacteria can alter the bioavailability of amino acids by utilization of several amino acids originating from both alimentary and endogenous proteins. In turn, gut bacteria also provide amino acids to the host. This could have significant implications in the context of insulin resistance and type 2 diabetes mellitus, conditions associated with elevated systemic concentrations of certain amino acids, in particular the aromatic and branched-chain amino acids. Moreover, several amino acids released by gut bacteria can serve as precursors for the synthesis of short-chain fatty acids, which also play a role in the development of obesity. In this review, we aim to compile the available evidence on the contribution of microbial amino acids to host amino acid homeostasis, and to assess the role of the gut microbiota as a determinant of amino acid and short-chain fatty acid perturbations in human obesity and type 2 diabetes mellitus.     

Differential Effects of Military Training on Fat-Free Mass and Plasma Amino Acid Adaptations in Men and Women

Fat-free mass (FFM) adaptations to physical training may differ between sexes based on disparities in fitness level, dietary intake, and levels of plasma amino acids (AA). This investigation aimed to determine FFM and plasma AA responses to military training, examine whether adaptations differ between male and female recruits, and explore potential associations between FFM and AA responses to training. Body composition and plasma AA levels were assessed in US Army recruits (n = 209, 118 males, 91 females) before (baseline) and every three weeks during basic combat training (BCT), a 10-week military training course. Body weight decreased in men but remained stable in women during BCT (sex-by-time interaction, P < 0.05). Fifty-eight percent of recruits gained FFM during BCT, with more (P < 0.05) females (88%) gaining FFM than males (36%). Total plasma AA increased (P < 0.05) during BCT, with greater (P < 0.05) increases observed in females (17%) then in males (4%). Essential amino acids (EAA) and branched-chain amino acids (BCAA) were increased (P < 0.05) in females but did not change in males (sex-by-time interaction, P < 0.05). Independent of sex, changes in EAA (r = 0.34) and BCAA (r = 0.27) from baseline were associated with changes in FFM (P < 0.05); greater (P < 0.05) increases in AA concentrations were observed for those who gained FFM. Increases in FFM and plasma AA suggest that BCT elicits a more pronounced anabolic response in women compared to men, which may reflect sex-specific differences in the relative intensity of the combined training and physiological stimulus associated with BCT.     

Supplementation with Guanidinoacetic Acid in Women with Chronic Fatigue Syndrome

A variety of dietary interventions has been used in the management of chronic fatigue syndrome (CFS), yet no therapeutic modality has demonstrated conclusive positive results in terms of effectiveness. The main aim of this study was to evaluate the effects of orally administered guanidinoacetic acid (GAA) on multidimensional fatigue inventory (MFI), musculoskeletal soreness, health-related quality of life, exercise performance, screening laboratory studies, and the occurrence of adverse events in women with CFS. Twenty-one women (age 39.3 ± 8.8 years, weight 62.8 ± 8.5 kg, height 169.5 ± 5.8 cm) who fulfilled the 1994 Centers for Disease Control and Prevention criteria for CFS were randomized in a double-blind, cross-over design, from 1 September 2014 through 31 May 2015, to receive either GAA (2.4 grams per day) or placebo (cellulose) by oral administration for three months, with a two-month wash-out period. No effects of intervention were found for the primary efficacy outcome (MFI score for general fatigue), and musculoskeletal pain at rest and during activity. After three months of intervention, participants receiving GAA significantly increased muscular creatine levels compared with the placebo group (36.3% vs. 2.4%; p < 0.01). Furthermore, changes from baseline in muscular strength and aerobic power were significantly greater in the GAA group compared with placebo (p < 0.05). Results from this study indicated that supplemental GAA can positively affect creatine metabolism and work capacity in women with CFS, yet GAA had no effect on main clinical outcomes, such as general fatigue and musculoskeletal soreness.     

透析机及一种最佳透析方法

叙述肾功能衰竭的治疗方法,透析机的基本原理及其发展;介绍一种实时监护血细胞比容和氧饱和度以进行最佳透析的方法。     

持续低效缓慢血液透析与普通血液透析在终末期糖尿病肾病患者中的对照研究

目的:比较终末期糖尿病肾病持续低效缓慢血液透析与普通血液透析的效果.方法:2017年1月～2020年2月选取160例终末期糖尿病肾病患者展开探究分析,选择随机数字表法分为两组,即对照组(n=80)和观察组(n=80),对照组行普通血液透析,观察组持续低效缓慢血液透析.结果:PO4、BUN、β2-MG以及ALB等指标血清...