正常高值血压与尿微量白蛋白的关系

目的探讨尿微量白蛋白含量与血压水平的相关性。方法根据《2004年中国高血压防治指南》选择正常高值血压者（≥120／80mmHg）109例及正常血压者（〈120／80m／nHg）49例，测量血压，计算体重指数（BMI），测定空腹血糖（VBS）、血清总胆固醇（CHO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、尿微量白蛋白（EusA法）等，并做比较。结果正常高值血压组与正常血压组相比，尿微量白蛋白含量升高[（3．08±1．58）mg／L比（3．86±1．7）mg／L，P〈0．01]，CHO、TG、HDL—C和LDL—C两组差异无统计学意义（P〉0．05）。Spearman相关分析显示，尿微量白蛋白与血压、血糖呈正相关，相关系数收缩压r=0．177，P〈0．05；舒张压r=0．252，P=0．001；空腹血糖r=0．279，P〈0．01。校正年龄、性别、血脂、体重指数偏相关分析表明，尿微量白蛋白含量与血压、血糖水平仍呈正相关，相关系数收缩压r=0．156，P=0．055；舒张压r=0．233，P〈0．05；空腹血糖r=0．251，P〈0．05。结论①正常高值血压组尿微量自蛋白水平较高，血糖、体重指数有异常变化，但血脂无异常变化。②尿微量白蛋白发生与舒张压、血糖关系更密切。     

颈动脉内膜中层厚度及尿微量白蛋白与冠状动脉病变形态的关系

目的探讨冠状动脉粥样硬化性心脏病（冠心病）患者颈总动脉的内膜中层厚度（common carotid intimamedia thickness, CIMT）和尿微量白蛋白水平同冠状动脉病变程度及形态之间的关系。方法冠状动脉造影证实的冠心病患者158例,检测CIMT和晨尿白蛋白与肌酐浓度比值（urinary albumin-to-creatintine ratio, UACR）。根据冠状动脉造影将患者分为单纯狭窄组和复杂狭窄组,比较两组CIMT和UACR。以冠状动脉狭窄程度为应变量（Y）,而以患者年龄（x1）、总胆固醇（X2）、三酰甘油（X3）、高密度脂蛋白（X4）、低密度脂蛋白（X5）、UACR（X6）及CIMT（X7）作为自变量,进行多因素逐步回归分析。结果复杂狭窄组CIMT[（1．06±0．27mmvs（0．92±0．19）mm,P〈O．05]及晨UACR[0．69±O．36vs0．52±O．33,P〈O．05]明显高于单纯狭窄组,差异有统计学意义。多因素逐步回归分析显示冠状动脉病变积分与UACR之间存在线性关系（Y=8．493—3．537X4±1．036X6,F=4．851．P=0．037）。结论CIMT及尿微量白蛋白升高与冠心病患者的冠状动脉病变程度和形态有一定关系。     

2型糖尿病患者尿微量白蛋白与颈动脉内膜中层厚度的关系

目的观察糖尿病患者尿微量白蛋白与颈动脉内膜中层厚度的相关性，并探讨其临床意义。方法2型糖尿病患者98例（T2DM组），糖尿病合并颈动脉内膜中层增厚患者（T2DM＋IMT组）55例，正常对照组64例，分别测定空腹血糖、血脂、尿微量白蛋白，并统计微量白蛋白尿的阳性例数及阳性率。结果T2DM组、T2DM＋IMT组空腹血糖、血脂、尿微量白蛋白水平及阳性率高于正常对照组（P〈0．05），T2DM＋1MT组尿微量白蛋白水平及阳性率高于单纯T2DM组（P〈0．05），尿微量白蛋白水平与颈动脉内膜中层厚度呈正相关（r=0．22，P〈0．05）。结论T2DM患者尿微量白蛋白与颈动脉内膜中层厚度密切相关。     

2型糖尿病肾病患者尿单核细胞趋化蛋白1和血细胞间黏附分子1与炎症反应的关系

目的 探讨糖尿病患者尿单核细胞趋化蛋白1（MCP-1）和血细胞间黏附分子1（ICAM-1）水平与糖尿病肾病的发生发展及炎症反应的关系。方法将90例糖尿病患者按尿白蛋白排泄率（UAER）分为正常白蛋白尿（NA）组、微量白蛋白尿（MA）组、临床白蛋白尿（CA）组,分别测定血、尿MCP-1与血sICAM-1和高敏C反应蛋白（hsC-RP）,并与30名健康对照组（NC）比较。结果NC、NA、MA、CA组间的血MCP-1水平差异无统计学意义（P〉0．05）,尿MCP-1及血sICAM-1水平逐渐升高,差异有统计学意义（P〈O．05或P〈0．01）;尿MCP-1及血sICAM-1水平与UAER均呈正相关（r=0．891,P〈0．01;r=0．583,P〈0．01）;尿MCp-1及血sICAM-1水平与血hsC-RP均呈正相关（r=0．723,P〈0．01;r=0．625,P〈0．01）。结论尿MCP-1及血slCAM-1水平与糖尿病肾病炎症反应程度有一定关系,可作为肾脏损害程度及其发生发展的判断指标。     

检测2型糖尿病患者糖化血红蛋白、超敏C反应蛋白及尿微量蛋白的临床价值

目的：探讨检测2型糖尿病（T2DM）患者糖化血红蛋白（HbAlc）、超敏c反应蛋白（hsCRP）及尿微量白蛋白（UMA）、尿β2-微球白蛋白（β2-MG）的价值。方法：入选T2DM患者224例（T2DM组）,健康体检者197例（健康对照组）,检测两组HbAle、hsCRP、UMA、尿β2-MG,并进行比较分析。结果：与健康对照组比较,T2DM组HbAlc[（5．24±0．75）％比（8．72±0．92）％]、hsCRP[（1．13±0．89）mg／L比（6．21±1．31）mg／L]、UMA[-（14．9±9．24）mg／L比（72．5±15．6）mg／L]及尿β2-MG[（0．18±0．05）mg／L比（1．24±0．28）mg／L]水平明显升高（P〈0．05或〈0．01）;Pearson相关分析显示,HbAlc与糖尿病并发症发生率呈正相关（r=0．415,P〈0．05）结论：糖化血红蛋白、超敏c反应蛋白及尿微量蛋白检测对2型糖尿病患者的诊断具有重要价值。     

老年高血压病血小板聚集率和胱抑素C关系的研究

目的：探讨老年高血压病患者血小板聚集率（PAR）和胱抑素C（cys-C）的关系,为临床早期诊断高血压所致的肾损伤提供依据。方法：老年高血压病患者70例,按照尿微量白蛋白是否正常分为A1组（高血压尿微量白蛋白正常组,35例）;A2组（高血压病尿微量白蛋白异常组,35例）,另设正常对照组35例,均于入院第3d抽血测PAR、cys—C含量,并行组间比较。结果：A1组的PAR（25．6±2．6）％、cys—C（1．25±0．40）mg／L明显高于正常对照组[（9．2±2．1）％、（0．48±0．25）mg／L],P〈0．01。A2组的PAR（48．1±10．3）％、cys—C（1,92±0．96）mg／L又较A1组明显升高。P〈0．01。高血压病患者PAR与cys—C呈正相关（r＝0．653,P〈0．01）。结论：高血压早期即有血小板聚集率、胱抑素C水平升高,发生。肾脏损害时两者升高更为明显,二者呈正相关,且能较尿微量白蛋白更早反应高血压病所致的肾损害。     

糖尿病患者尿液中期因子与糖尿病肾病的关系

目的探讨尿液中期因子（MK）与糖尿病肾病的关系。方法96例糖尿病患者,根据尿白蛋白排泄率分为正常白蛋白尿组（NUAlb组）,微量白蛋白尿组（MUAlb组）,大量白蛋白尿组（CUAlb组）,设对照组（NC组）。用酶联免疫吸附法测定尿液MK水平。结果CUAlb组尿液MK水平高于NC组、NUAlb组及MuAlb组（P〈0．01）,MUAlb组高于NC组及NUAlb组（P〈0．05）,NUAlb组与NC组差异无统计学意义（P〉O．05）。相关分析显示,尿液MK与尿白蛋白排泄率（r=0．40,P〈O．05）及病程（r=0．23,P〈0．05）呈正相关,与内生肌酐清除率（CCr）呈负相关（r=-0．20,P=〈0．05）。结论尿液MK可能参与临床糖尿病肾病的发生。     

P-选择素与糖尿病肾病的相关性

目的观察不同阶段糖尿病肾病患者血清中P-选择素的水平变化,探讨其与糖尿病肾病的相关性。方法健康对照组为50名健康体检者,2型糖尿病患者150例分为正常蛋白尿组、微量白蛋白尿组及临床蛋白尿组,每组各50例。用酶联免疫吸附法检测血清P-选择素。结果所有糖尿病患者血清中P-选择素含量（17．36±6．19）ng／ml,均明显高于正常对照组[（7．25±1．69）ng／ml]（P〈0．01）;微量白蛋白尿组[（16．59±3．36）ng／ml]及临床白蛋白尿组[（23．84±5．96）ng／ml]P-选择素又高于正常白蛋白尿组[（12．34±2．31）ng／ml]（P〈0．01）;临床白蛋白尿组又高于微量白蛋白尿组（P〈0．01）;P选择素水平与空腹血糖、糖化血红蛋白、高敏C反应蛋白、尿白蛋白均呈正相关（r=0．54,0．68,0．97,0．71,P均〈0．01）。结论糖尿病肾病患者血清P-选择素的水平升高,可作为糖尿病肾病的检测指标之一。     

糖代谢异常对原发性高血压患者血管内皮损伤的影响

目的：探讨糖代谢异常对原发性高血压（EH）患者血管内皮损伤的影响。方法：对46例单纯EH患者（EH组）与33例EH合并2型糖尿病（T2DM）患者（EH＋T2DM组）的血糖、血脂、体质指数（BMI）及血清同型半胱氨酸（Hcy）、尿微量白蛋白浓度进行测定、比较,同时分析血清Hcy及尿微量白蛋白浓度与血糖、血脂及BMI之间的相关性。结果：与EH组相比,EH＋T2DM组的BMI、血糖[空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbAlc）,血脂[甘油三酯（TG）、低密度脂蛋白胆固醇（LDL．C）及载脂蛋白B（ApoB）]水平均显著升高（P〈0．05或〈0．01）,而且血清Hcy[（12．78±2．51）μmol／L比（16．26±2．91）μmol／L]及尿微量白蛋白水平[（19．45±5．24）mg／L比（33．65±10．70）mg／L]升高更加显著（P〈0．01）;Pearson相关分析显示,在EH＋T2DM组患者,血清Hcy水平分别与BMI、FBG、HbAlc、LDL．C、ApoB及尿微量白蛋白水平显著正相关（r=0．667～0．906,P均〈0．01）,而尿微量白蛋白水平则分别与BMI、HbAlc、LDL-C、ApoB及血清Hcy水平显著正相关（r=0．566～0．685,P均〈0．01）。结论：糖代谢异常可加重原发性高血压患者的血管内皮及肾微血管损伤,而且这与血糖代谢异常程度密切相关;控制血糖水平可减轻血管损伤,进而延缓心血管疾病及肾脏并发症的病理进展。     

2型糖尿病患者微量白蛋白尿与胰岛素抵抗关系

伴微量白蛋白尿的2型糖尿病患者（DM-MA）36例，不伴微量白蛋白尿的（DM-NA）29例，正常对照组（NC）20例。3组患者均行空腹血糖、胰岛索、血脂等测定，并计算HOMA-IR评估组织胰岛索抵抗．根据结果进行比较分析，将所有患者的尿白蛋白排泄率（UAER）与有关因素进行多元回归分析。结果：DM-MA组与DM-NA组HOMA-IR均高于NC组，差异非常显著（P〈0．01），DM-MA组HOMA-IR示明显高于DM-NA组（P〈0．05），而且HOMA-IR与UAER呈独立相关（r=0．4875，P〈0．01）。结论：与DM-NA相比，DM-MA有更严重的IR，IR是MA尿的独立危险因索。     

Concordance of iron indices in homozygote and heterozygote sibling pairs in hemochromatosis families: implications for family screening

BACKGROUND/AIMS: Concordance of iron indices between same-sex siblings homozygous for the cysteine-to-tyrosine substitution at amino acid 282 (C282Y) mutation suggests that the variable phenotype in hereditary hemochromatosis is caused by genetic factors. Concordance of iron indices between same-sex heterozygous sibling pairs would provide further evidence of genetic modifiers of disease expression, and guidance for family screening strategies of subjects heterozygous for the C282Y mutation. METHODS: We compared the iron indices of 35 C282Y homozygous and 35 C282Y heterozygous same-sex sibling pairs. To clarify whether concordance between siblings was due to environmental or genetic factors we compared the iron indices of 164 C282Y homozygous-normal, same-sex dizygotic twins. RESULTS: Serum ferritin (r=0.50, P=0.003), hepatic iron concentration (r=0.61, P=0.025) and hepatic iron index (r=0.67, P=0.01) were highly concordant in C282Y homozygotes. Heterozygote siblings were concordant for serum ferritin (r=0.76, P=0.0001) and transferrin saturation (r=0.79, P=0.0001). Homozygote-normal same-sex dizygotic twins were concordant for serum ferritin (r=0.62, P=0.0001) but not for transferrin saturation. CONCLUSIONS: Concordance of iron indices exists in C282Y homozygote and heterozygote sibling pairs. Siblings of expressing C282Y heterozygotes require phenotypic assessment. These data provide evidence for modifying genes influencing disease expression in hemochromatosis.     

Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states

Direct measurement of the reticulocyte hemoglobin content provides useful information for the diagnosis and treatment of iron-deficient states. We have examined direct measurements of reticulocyte and red cell hemoglobin content on the Sysmex XE 2100 (Ret He and RBC He respectively) and the Bayer ADVIA 2120 (CHr and CH respectively) analyzers. Good agreement was found between Ret He and CHr (Y = 1.04X - 1.06; r2= 0.88) and between the RBC He and CH parameters (Y = 0.93X + 1; r2= 0.84 n = 200) in pediatric patients and in normal adults (Ret He and CHr; Y = 1.06X - 0.43; r2= 0.83; n = 126; RBC He and CH; Y = 0.94X + 1; r2= 0.87; n = 126). In 1500 blood samples from patients on chronic dialysis, Ret He was compared with traditional parameters for iron deficiency (serum iron <40 microg/dl, Tsat <20%, ferritin <100 ng/ml, hemoglobin <11 g/dl) for identifying iron-deficient states. Receiver operator characteristic (ROC) curve analysis revealed values of the area under the curve for Ret He of 0.913 (P < 0.0001). With a Ret He cutoff level of 27.2 pg, iron deficiency could be diagnosed with a sensitivity of 93.3%, and a specificity of 83.2%. Ret He is a reliable marker of cellular hemoglobin content and can be used to identify the presence of iron-deficient states.     

Role of nocturnal blood pressure in the onset of diabetic nephropathy

The aim of this study was to assess the responsibility of night-time blood pressure in the onset of nephropathy in diabetic patients. PATIENTS AND METHODS: This study included 98 diabetic patients (mean age: 54 +/- 15 years, diabetes duration: 15 +/- 10 years). An evaluation of diabetes and a 24-h ambulatory blood pressure were performed at the initial evaluation (Y0) and about five years later (Y5). At Y0, all patients had normal urinary albumin excretion (UAE) (<30 mg/24h). They were separated into two groups according to urinary albumin excretion at Y5: group (N +): UAE>30 mg/24h and group (N-): UAE<30 mg/24h. Twenty four hours ambulatory blood pressure, clinical and biological parameters recorded at Y0 were compared in both. RESULTS: At Y5, there was 18 patients in group (N +) and 78 in group (N-). Patients of group (N +) were older than those of group (N-): 62.9 +/- 9.5 vs. 52.6 +/- 15.7 years, p<0.01, and their BMI was higher (28 +/- 5 vs. 25 +/- 4 kg/m2, p<0.03). Diabetes duration and Hb A1c levels did not differ from significant manner in both. At Y0, UAE was significantly higher in group (N +) than in group (N-): 13 +/- 7 vs. 8 +/- 6 mg/24h, p<0.01. At the initial evaluation, daytime systolic and diastolic blood pressures did not differ from significant manner in both. Systolic and diastolic BP night-time were higher in diabetic patients who developed microalbuminuria (SBP: 122 +/- 19 vs. 113 +/- 13 mmHg, p<0.05 and DBP: 70 +/- 6 vs. 65 +/- 10 mmHg, p<0.03). UAE collected at Y5 was correlated to night-time BP recorded at Y0 (SBP: r=0.381, p=0.001 and PAD: r=0.294, p=0.004) and night-time systolic BP explained 12.3% of the UAE variance. Progression of UAE between the two evaluations was found to be correlated to the night-time systolic BP recorded at Y0 (r=0.335, p=0.0008) and night-time systolic BP explained 11.7% of the progression variance. There was a negative correlation between UAE at A5 and the difference between daytime and night-time BP recorded during the same evaluation (r=- 0.230, p=0.024 with SBP and r=- 0.243, p=0.017 with DBP). CONCLUSION: The results underlign the resposability of night-time blood pressure, and more especially of nighttime systolic blood pressure, for the onset of nephropathy in diabetic patients.     

Relationship between accelerometer-based measures of physical activity and the Yale Physical Activity Survey in adults with arthritis

Objective

To evaluate the correlation between the Yale Physical Activity Survey (YPAS) scores and objective accelerometer measures of time spent in light intensity physical activities, moderate to vigorous intensity physical activities, and moderate to vigorous activities in bouts lasting at least 10 minutes.

Methods

This study analyzed baseline data from 171 persons with rheumatoid arthritis (RA) and 139 persons with osteoarthritis (OA) in a randomized clinical trial (Increasing Motivation for Physical Activity in Arthritis Clinical Trial). Persons fulfilling the 1987 American College of Rheumatology criteria for RA and persons with symptomatic radiologic knee OA (Kellgren/Lawrence class ≥2) wore an accelerometer for 7 days, then responded to the YPAS questionnaire and questions regarding demographics (age, sex, and race) and health factors (body mass index, disease status [Health Assessment Questionnaire/Western Ontario and McMaster Universities Osteoarthritis Index], comorbidities, pain, and function). Spearman's correlation coefficients were estimated between each YPAS summary measure and accelerometer measures.

Results

In the RA participants, the strongest correlation was between the YPAS activity dimensions summary index (Y‐ADSI) and average daily minutes of bouted moderate/vigorous activity (r = 0.51). Additionally, the Y‐ADSI correlated significantly with both objectively measured average daily accelerometer counts (r = 0.45) and average daily minutes of moderate/vigorous activity (r = 0.43). For OA participants, a similar pattern emerged: the Y‐ADSI had significant correlations with average daily minutes of bouted moderate/vigorous activity (r = 0.36), average daily minutes of moderate/vigorous activity (r = 0.31), and average daily counts (r = 0.24).

Conclusion

For both the RA and OA groups, the Y‐ADSI had the strongest significant correlations with objectively measured physical activity, which supports Y‐ADSI use as a tool for clinical applications and in rheumatology research.     

Reproducibility of left ventricular myocardial volume and mass measurements by ultrafast computed tomography.

Ultrafast computed tomography has been reported to be an accurate method of measuring left ventricular mass in dogs. To assess the interstudy, intraobserver and interobserver variability of left ventricular myocardial mass measurements in humans, left ventricular myocardial volume was measured three times within 24 h in 16 patients with ischemic heart disease. The mean percent difference of the mean of the three studies performed was -0.01 +/- 1.4% (range -2.9% to 3.6%). The regression analysis for the intraobserver variability at baseline was: Y = -4.33 + 1.03X; r = 0.99, SEE = 3.5 ml. The mean percent difference of the mean of the two sets of measurements performed by two independent observers was 0.28 +/- 2.1% (range -4.35% to 4.35%). The interobserver variability excluding papillary muscles at baseline study was: Y = -4.34 + 1.06X; r = 0.99, SEE = 1.5 ml. The regression analysis with versus without papillary muscles showed: Y = -8.72 + 0.97X; r = 0.96, SEE = 2.6 ml. Regression analysis to assess the variability of 24-h studies at end-systole versus end-diastole revealed: Y = 3.07 + 0.94X; r = 0.97, SEE = 1.8 ml. In conclusion, ultrafast computed tomography is a minimally invasive technique, with very low interstudy, intraobserver and interobserver variability for left ventricular myocardial volume and mass determinations in serial studies.     

Rapid testing of red blood cells,white blood cells and platelets in intensive care patients using the HemoScreen™ point-of-care analyzer

Acute major bleeding is a condition that can be encountered in critically ill patients and may require rapid transfusions. To evaluate the need for packed red blood cells (RBCs) and platelets (PLTs), it is important to have rapid test results for RBC/hemoglobin and PLTs. Recently, PixCell Medical (Yokneam Ilit, Israel) introduced the HemoScreen?, an automated hematology analyzer. It is a point-of-care device that uses single sample cuvettes and image analysis of RBCs, PLTs and white blood cells (WBCs), performing a five-part differential count. The HemoScreen? is the first portable differential count instrument that uses image analysis. We compared the RBC, PLT, and WBC test results of the HemoScreen? with the Sysmex XN device. In the study we analyzed 104 samples from the cardiothoracic, neuro and general intensive care units.

The HemoScreen? technique showed good precision, with total coefficient of variation of 1–2% for RBCs and 3–5% for PLTs. Deming correlations between the HemoScreen and the Sysmex XN instrument analyzer: (WBC_HemoScreen? = 1.061* WBC_Sysmex - 0.644; r = 0.995), RBC (RBC_HemoScreen? = 0.998* RBC_Sysmex + 0.049; r = 0.993) for WBC and (Platelets_HemoScreen? = 1.087* Platelets_Sysmex – 14.80; r = 0.994) for PLT. The HemoScreen? device provided rapid and accurate test results to evaluate the need for RBC and PLT transfusion. This new technology is promising given that it allows the analysis of WBCs, RBCs, and PLTs further out in the healthcare organization compared with laboratory infrastructure based on traditional cell counters.     

Elevated insulin, norepinephrine, and neuropeptide Y in hypertension

To investigate the relationship between insulin and sympathetic activity, plasma norepinephrine, neuropeptide Y, serum glucose and insulin concentrations were measured in ten age-, weight-, and sex-matched normotensive and untreated hypertensive subjects at fasting and 2 h following ingestion of a 75 g oral glucose dose. Hypertensives had higher fasting serum insulin (27 +/- 6 v 12 +/- 2 microU/mL; P = .02) and plasma norepinephrine (356 +/- 38 v 235 +/- 35 pg/mL; P = .03) concentrations than normotensives. Glucose load increased serum insulin (P less than .001) and plasma norepinephrine concentrations (P = .001) in both groups and hypertensives had still higher postglucose insulin (P = .003) and norepinephrine levels (P = .003) than normotensives. Fasting neuropeptide Y was higher in hypertensives than in normotensives (P = .03) and correlated with age in both groups (r = 0.7; r = 0.77). Postglucose serum insulin correlated positively with plasma norepinephrine (r = 0.75; P = .013) in normotensives, but these parameters correlated negatively in hypertensives (r = -0.7; P = .036). We hypothesize that elevated plasma norepinephrine and neuropeptide Y levels reflect an increased level of sympathetic nervous activity in hypertensives, which in turn may be responsible for the abnormal relationship between plasma NE and insulin levels.     

Growth hormone therapy in children after cranial/craniospinal radiation therapy: sexually dimorphic outcomes

Radiation therapy (RT) to the craniospinal region in childhood affects final height. The use of GH treatment (GHRx) in children after cranial or craniospinal RT results in variable improvement in final height. Nineteen children (12 males and 7 females) with tumors of the head, treated with cranial or craniospinal RT and subsequently with GHRx, were assessed for final height. Two outcome measures of efficacy of GHRx were used: Y1 = final height SD score (SDS) corrected for genetic potential, using midparental sex-adjusted target height (SATH) SDS, and Y2 = change in height SDS from predicted final height SDS pre-GHRx to actual final height SDS post-GHRx. The median age at diagnosis was 5.4 yr, the median RT to the hypothalamic-pituitary axis was 40 Gy, the median spinal RT dose in 13 of 19 of the subjects treated was 36 Gy, and the median years post-RT to GHRx was 4.8 yr. Adjuvant chemotherapy was used in 12 of 19 patients. All but one (optic glioma) had a lesion anatomically distant from the suprasellar region. The effects of age at diagnosis, sex, L-T4 or GnRH agonist use, conventional vs. hyperfractionated RT, spinal RT, dose of spinal or cranial RT, chemotherapy, peak stimulated GH, dose and duration of GHRx, age at GHRx, time interval between RT and GHRx initiation, bone age, and height SDS at the start of GHRx were also assessed. Y1girls best correlated with younger age at diagnosis and im vs. sc GHRx. Y2girls best correlated with delayed bone age and younger age at diagnosis [Y1girls = -9.95 + 0.38 (age in years at diagnosis) + 3.11[GH method (1 = i.m.; 2 = s.c.)]; r2 = 0.898; P = 0.02; Y2girls = -3.54 + 1.8 (bone age - age in years) + 0.334 (age at diagnosis in years); r2= 0.956; P = 0.02]. Both Y1boys and Y2boys were strongly associated with spinal RT and younger age at diagnosis or treatment [Y1boys = -11.22 + 4.65 [spinal RT (1 = yes; 2 = no)] + 0.396 (age in years at diagnosis); r2= 0.64, P = 0.01; Y2boys = -6.32 + 0.23 (age in years at GH start) + 1.75 [spinal RT (1 = yes; 2 = no)]; r2= 0.646; P < 0.01]. This small historical cohort underscores that final stature is significantly reduced when immature bones are exposed to ionizing radiation. Intramuscular vs. sc use of GHRx is likely to be simply a surrogate marker for earlier methods of treatment. Of note, spinal RT did not significantly impact girls' final heights, whereas in boys, spinal RT strongly predicted ultimate short stature and a reduced response to GHRx. This sexually dichotomous response may be due in part to the greater percentage of spinal growth remaining for boys vs. girls throughout childhood.     

全自动蛋白分析仪BN-100缓冲液、稀释液国产化研究

目的 实现全自动特种蛋白分析仪试剂国产化。方法 对原装试剂进行理化分析,择最佳配方,采用进口和自行研制的缓冲液、稀释液（自研试剂）,在同样条件下按仪器操作规程于BN-100全自动免疫分析仪上对正常人标本、患者标本、原装质控物进行对比测定。结果 自研试剂的理化指标（pH、电导率及渗透压）与进口试剂相近;对德灵原装高、中、低值质控物,分别用进口试剂和自研试剂进行测定,其相关系数r均〉0．98;患者标本的相关性：IgG的相关方程y=1．0374x-0．28,r=0．998,IgA为Y=1．0111x-0．0594,r=0．989,IgM为Y=0．987x-0．0404,r=0．987;复性测定结果IgG、IgA、IgM结果自由度（v）均〈3％。结论 自研试剂可代替原机进口试剂在全自动蛋白分析仪上进行IgG、IgA、IgM检测。     

Correlations between redistribution areas observed on exercise thallium-201 myocardial SPECT images and the coronary collateral circulations in patients with myocardial infarction]

The significance of coronary collateral circulation for redistribution in the infarcted zone was evaluated in 16 patients with history of myocardial infarction and severe stenosis (> or = 90%) of the coronary artery. Redistribution areas were quantitatively measured using the redistribution ratios and redistribution indices on the infarction-redistribution map obtained by thallium-201 scintigraphy with single photon emission computed tomography. Coronary collateral findings were categorized in 4 classes according to the Rentrop's grading. There was good, positive linear correlation between the redistribution ratio (Y) and collateral grading (X) (Y = 0.21X + 0.10, r = 0.92, p < 0.01). The redistribution index (X) also correlated well with the collateral grading (Y) using a good, positive quadratic equation (Y = 0.32X2 + 0.24X + 0.04, r = 0.89, p < 0.01). These results suggest that the measurements of the redistribution areas in the ischemic zone in myocardial infarction correlated well with collateral perfusion. Collateral perfusion severer than Rentrop's grade 2 markedly reduces the severity of ischemia and increases redistribution areas.