A comparison of antrafenine and aspirin on platelet aggregation and frusemide-induced diuresis.

The effects of antrafenine were compared with aspirin and placebo on platelet aggregation and on the diuretic action of frusemide in normal volunteers. Aspirin significantly reduced platelet aggregation at 3 and 6 hr after administration, but antrafenine only at 3 hr. Only aspirin significantly reduced the increase in urine sodium and potassium produced by frusemide.     

Inappropriate secretion of antidiuretic hormone treated with frusemide

Seven out of nine patients with chronic inappropriate secretion of antidiuretic hormone were successfully treated with 40 mg frusemide daily. One patient needed 80 mg, and the remaining patient achieved only a small increase in diuresis after 40 mg frusemide; this was probably related to his low creatinine clearance. In order to maintain a salt intake high enough to compensate for the loss of urine electrolytes 3 to 6 g sodium chloride was added as tablets to the sodium-free diet in six patients. Hypokalaemia occurred in five patients but was easily corrected with either supplements of potassium chloride or a potassium-sparing diuretic. These findings add further weight to evidence that Frusemide is a good alternative for the treatment of patients with inappropriate secretion of antidiuretic hormone who cannot tolerate water restriction.     

Hypokalemic metabolic alkalosis caused by surreptitious vomiting: report of four cases.

Four women, aged 22 to 40 years, presented with severe hypokalemia and metabolic alkalosis. Three had related neuromuscular symptoms. All four patients denied vomiting or diuretic ingestion, and a diagnosis of Bartter's syndrome was entertained. A diagnosis of surreptitious vomiting was suspected from the characteristic urine electrolyte pattern: high values for sodium and potassium, and a chloride concentration of less than 5 mmol/l. Three patients excreted sodium and potassium primarily with bicarbonate and had an alkaline urine; the fourth patient excreted these cations primarily with an organic anion and had an acid urine (pH 5.5). Since self-induced vomiting may be a common method of weight reduction in young women, recognition of this characteristic urine electrolyte pattern will assist in the rapid diagnosis of hypokalemia and metabolic alkalosis of obscure cause.     

Bumetanide��acute and long term studies of a new high potency diuretic

The properties of a new diuretic, bumetanide, were investigated in ten normal volunteers, and sixty-eight patients with fluid retention. It had a rapid action virtually complete in 4 hr with an effect on water and electrolyte excretion similar to that of frusemide. It was highly potent, 1 mg producing an effect comparable to 48 mg frusemide in normal subjects, and about 40 mg in oedematous subjects in controlled short-term experiments. In long-term studies in forty-eight patients extending over periods up to 51 weeks it was found to be effective in controlling oedema. There was a low incidence of electrolyte complications and no other biochemical abnormalities or haematological complications were attributed to the drug. Bumetanide was well tolerated by patients. A drug rash was observed in two cases.     

The urinary sodium: potassium ratio and response to diuretics in resistant oedema.

Nineteen patients with severe oedema due to either cirrhosis of the liver or to congestive cardiac failure, who had failed to respond to previous diuretic therapy, were treated with either increasing doses of frusemide (Group A), or with frusemide in a fixed dose of 80 mg daily and increasing doses of spironolactone (Group B). In Group A there was an inverse correlation between the baseline 24-hr urinary sodium: potassium (Na : K) ratio and the 24-hr urinary potassium excretion during diuresis, and a direct correlation between the urinary Na : K ratio before and after diuresis. Thus, in patients of this group during diuresis, there was a significantly higher urinary potassium excretion in those with a baseline urinary Na : K ratio of less than 1, as compared with those with a ratio of greater than 1. In Group B a satisfactory diuresis was achieved without marked urinary potassium loss in those patients with a baseline urinary Na : K ratio of less than 1, whereas no diuresis was obtained in the two patients with a baseline urinary Na : K ratio of greater than 1. These results suggest that the measurement of the baseline urinary Na : K ratio is of help in determining the potential value of spironolactone in patients with resistant oedema.     

灰色链霉菌RX-17溶菌酶防治龋病的实验研究

目的:研究灰色链霉菌RX-17溶菌酶在动物口腔内对致龋菌变形链球菌的溶解作用及对龋病发生、发展的抑制作用,为将该溶菌酶用于人类龋病防治提供依据。方法:给大鼠口腔接种变形链球菌,并饲以致龋饲料2000#,分别喂以蒸馏水、氟化钠水溶液、RX-17溶菌酶液,测定牙菌斑pH值,菌斑取样、细菌培养计数,取上下颌骨进行Keyes龋齿计分。结果:RX-17溶菌酶组大鼠牙菌斑pH值高于蒸馏水组(P<0.05),低于氟化钠组(P<0.05)。变形链球菌计数在RX-17溶菌酶组少于蒸馏水组(P<0.01)和氟化钠组(P<0.05)。Keyes计分结果显示,RX-17溶菌酶组E级龋损和Ds级龋损均低于蒸馏水组(P<0.01),但与氟化钠组无差异(P>0.05)。结论:RX-17溶菌酶可以抑制大鼠口腔内变形链球菌的生长和龋病的发生、发展,其防龋效果与氟化钠相当,有可能成为一种新的防龋药物。     

Cosinor-rhythmometry for 24-h urinary sodium,potassium, creatinine excretion in the Chinese adult population

Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.Methods:Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.Results:The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.Conclusion:It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.     

Plasma arginine vasopressin in hyponatraemic patients receiving diuretics

Random estimations of plasma arginine vasopressin concentration were undertaken in 6 non-oedematous patients receiving diuretic therapy for hypertension, who were admitted to hospital with severe hyponatraemia. Hyponatraemia resolved within 2 weeks of discontinuing the diuretic. Measurable amounts of plasma arginine vasopressin were detected in all 6 patients. Sequential biochemical measurements in one patient, performed when plasma sodium concentration and osmolality were returning to the normal range, disclosed that urine osmolality remained higher than plasma osmolality during the first 5 days, when urine volume and sodium excretion were low. Thus the rise in plasma sodium was not initially related to water diuresis. The ability to excrete a water load was severely limited on the fifth day, but improved progressively by the tenth and seventeenth days. Diuretic-induced hyponatraemia is associated with incomplete suppression of anti-diuretic hormone secretion arising from non-osmotic stimulation, in conjunction with transient impairment of renal diluting ability which could be due to net sodium deficit.     

尿炎灵煎剂清热利湿作用的实验研究

目的:通过观察尿炎灵煎剂的有关药理作用,证实其清热利湿功效。方法:以小鼠耳肿胀法、大鼠代谢笼法等观察其抗炎及利尿等作用。结果:该方各剂量组均能缓解实验性小鼠耳炎症反应,增加水负荷下大鼠的尿量,增加尿中钠、钾、氯离子的排泄,与对照组相比P<0.05,其中以高剂量组作用最强(P<0.01)。结论:该方具有较强的利尿、抗炎效果,且对人体无毒副作用。     

维生素C、E对氟中毒大鼠尿氟排泄的影响

目的：观察氟中毒大鼠尿氟排泄情况,探讨维生素C、E不同剂量以及单独和/或联合使用对氟中毒大鼠尿氟排泄的影响.方法：将90只Wistar大鼠随机分为9组,每组10只,经饮水投氟建立氟中毒动物模型,并通过灌胃补充维生素C、E,分别于实验第5周、第10周和第15周收集24 h尿液,采用氟离子选择性电极法测定尿氟含量.定期称体重,观察大鼠体重的变化.结果： 随着染毒时间的延长大鼠尿氟的排出量逐渐增加,尿氟含量在染毒第15周＞第10周＞第5周（P＜0.05）.补充维生素C和/或维生素E均可使大鼠尿氟含量显著增加.维生素C、E不同剂量组之间尿氟含量也有所不同,随着干预剂量的增加尿氟含量减少.结论：给予维生素C、E对氟中毒大鼠氟代谢有显著作用,可促进尿氟的排泄,阻断氟的吸收.维生素C、E在一定剂量范围内可拮抗氟的毒性作用,减轻氟中毒病情.     

Urinary sodium, potassium and creatinine excretion in hypertensive and normotensive Australians.

Studies were made in urine obtained from people attending for routine measurement of blood pressure in a screening programme. Subjects with diastolic blood pressure between 95 and 109 mm Hg excreted significantly more sodium than the group with diastolic blood pressure below 90 mm Hg. Urine volumes, potassium excretion and creatinine excretion did not differ significantly between the groups.     

氨基酸保护肾小管细胞溶酶体功能的研究

目的 :研究肾小管细胞溶酶体损伤在顺铂所致实验性 ARF发病中的作用 ,探讨 8种 L-氨基酸合剂的肾功能保护作用及机理。方法 :雄性 Sprague- Dawley鼠静脉注射 2 ml氨基酸合剂或0 .9% Na Cl溶液后接受 10 mg/ kg顺铂 ,随后氨基酸或 Na Cl溶液以 2 ml/ h维持 3h,测定尿 NAG活性 ,尿钠、钾浓度 ,GFR及作形态学观察。结果 :顺铂注射后 30 min,尿 NAG活性增加 7.8倍 ,尿钠、钾浓度分别增加 56%及 2 .6倍。应用该氨基酸合剂使增高的尿 NAG活性减少 76% ,改善肾小管钠、钾排泄异常 ,增加 GFR 85%。结论 :溶酶体损伤可能在顺铂所致实验性 ARF发生极早期阶段起重要作用 ,氨基酸合剂有明显的肾功能保护作用 ,其机理可能通过改善受损的溶酶体功能所致。     

一种新型环孢素A慢性肾毒性大鼠模型的建立

目的 建立新型环孢素A慢性肾毒性大鼠模型并探讨其特点.方法 雄性SD大鼠(正常盐饮食)分为假手术组(sham-ADX组)、肾上腺切除组(ADX组)及肾上腺切除及注射环孢素A组(CsA组).后两组先行双侧肾上腺切除术,2周后分别注射安慰剂或环孢素A.6周后检测尿蛋白定量、肌酐清除率、血和尿醛固酮及钠钾水平、肾组织醛固酮及其合成酶CYP11B2表达和肾组织病理改变.结果 ADX和CsA组术后2d血和尿未检测到醛固酮,尿钠增多、血钠减低,尿钾减少、血钾升高.6周实验结束时,CsA组大鼠尿蛋白增加、肌酐清除率下降,肾组织病理检查呈现明显肾间质纤维化;ADX和CsA组大鼠肾组织CYP11B2 mRNA表达和醛固酮均显著上调,再次出现血和尿醛固酮,钠钾代谢紊乱改善.结论 用肾上腺切除和正常盐饮食制作环孢素A慢性肾毒性大鼠模型成功.消除循环醛固酮后,肾组织醛固酮表达上调并释放入血,维持钠钾平衡.     

ACEI ARB联合多巴胺及速尿持续泵入治疗慢性心力衰竭患者利尿剂抵抗50例临床观察

目的:观察ACEI、ARB与多巴胺、速尿联合治疗慢性心力衰竭伴利尿剂抵抗的临床疗效.方法:随机将慢性心力衰竭伴利尿剂抵抗患者102例分为治疗组50例、对照组52例.治疗组采用ACEI、ARB与多巴胺、速尿联合治疗,对照组仅进行常规抗心衰治疗.结果:治疗组总有效率84.0％,对照组总有效率46.2％,治疗组总有效率高于对照组(X2=15.99,P＜0.01).治疗后治疗组LVEF、LVEDD改善较对照组更为明显(P＜0.05),治疗组尿量也较对照组有显著增加(P＜0.01).结论:ACEI、ARB与多巴胺、速尿联合治疗慢性心力衰竭伴利尿剂抵抗,患者心功能改善明显,利尿剂抵抗消失,值得临床应用.     

Diuretic treatment in decompensated cirrhosis and congestive heart failure: effect of posture

The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. After fasting overnight in bed the patients received bumetanide 1 mg intravenously and were then immediately randomly assigned to either bed rest in the supine position or normal daily activity in the upright position for the next six hours. Two days later the procedure was repeated, the patients being assigned to the other posture. The diuretic response was similar in patients with heart failure and cirrhosis, and was significantly greater in the supine than in the upright position: mean 1133 v 626 ml/6 h (p less than 0.01). The natriuresis was similarly larger during recumbency: mean sodium 96 v 45 mmol(mEq)/6h (p less than 0.01), and the excreted potassium in six hours was similar in both postures. The glomerular filtration rate was 100 and 66 ml/min (p less than 0.01) and heart rate 76 and 83 beats/min (p less than 0.01) in the supine and upright positions respectively. Plasma concentrations of noradrenaline, renin, and aldosterone were all raised even when the patient adopted the supine position, and a further significant rise was observed during the upright position. The results suggest that the attenuated response to intravenous bumetanide in the upright position and during normal daily activity may be due to the activation of several homeostatic mechanisms that may reduce the excretion of water and salt.     

A rational approach to the treatment of ascites

A rational approach to the diuretic therapy of ascites is proposed. Fifty-five patients were classified according to their ability to excrete sodium and free water. Patients with a high urinary sodium excretion can be treated by low sodium intake alone. In most patients with a low sodium excretion but high free water clearance, distal diuretics (spironolactone or triamterene) with a low sodium diet will relieve ascites. Patients with low values for sodium excretion and free water clearance also have poor glomerular filtration rate and only a few of these will respond to diuretic therapy.     

INTRAVENOUS a-HUMAN ATRIAL NA''TRIURETIC POLYPEPTIDE IN NORMAL VOLUNTEERS: EFFECTS ON RENAL, CARDIOVASCULAR AND ENDOCRINE FUNCTIONS

Intravenous synthetic a-human atrial na- triuretic polypeptide (a-hANP) 300 pLg was given to three normal volunteers resulting in a significant increase of urine volume and sodium, potassium and chloride excretion. This peptide also caused a fall in blood pressure, cardiac out- put and stroke volume, accompanied by an in- crease in heart rate. The plasma aldosterone level elevated and renin activity incrcascd at 0.5 t0 2 hours after injection. a-hANP is a 28-amino acidpolypeptideisolated from human atrial tissue.lWe haveshown by intravenous injection ofsynthetica-hANP that it is a potent diuretic,natriureticand induces depressor responses in rats.2 Thepresent study examines the pharmacological ef fects of a-hANP on healthy subjects.     

Comparison of chlortenoxicam and indomethacin on frusemide-induced diuresis

A single oral dose of chlortenoxicam 4 mg, a new non-steroidal anti-inflammatory drug, significantly antagonized the diuretic and natriuretic actions of frusemide when compared with placebo in normal human volunteers. Indomethacin 50 mg significantly reduced the natriuretic, but not diuretic action of frusemide.     

高盐诱导的高血压大鼠模型肾组织可溶性表氧化物酶高表达及其作用初步探讨

目的：观察高盐诱导的高血压大鼠肾组织中可溶性表氧化物水解酶(sEH)的表达并探讨其作用。方法：8周龄Wistar大鼠12只,随机分为正常饮食组(WC组)和高盐饮食组(WH组),分别给予正常饮水和高盐饮水［2%（质量分数）NaCl］喂养21 d,测定大鼠血压、血浆血管紧张素Ⅱ、血钠、血尿素氮、血肌酐水平和24 h尿量、尿钠、尿蛋白,应用免疫组化和Western印迹的方法检测肾组织sEH表达。结果：与WC组相比,WH组大鼠高盐饮食3 d后收缩压显著升高且一直持续到实验结束(P<0.05),24 h尿量、尿钠均显著增加,血钠、血尿素氮水平显著升高(P均<0.01),血肌酐、24 h尿蛋白的差异无统计学意义(P均>0.05),血管紧张素Ⅱ显著下降(P<0.05)。肾组织免疫组化结果显示WH组皮质肾小管sEH表达显著上调,Western blot测定sEH表达量(sEH/β-actin)WH组(1.24±0.13)较WC组(0.38± 0.03)显著增加(P<0.01)。结论：高盐饮食后大鼠血压升高、钠水潴留、肾组织sEH表达上调,提示sEH可能在高盐诱导的大鼠高血压发生和发展中发挥重要作用。     

肠源性高草酸尿大鼠模型的建立

目的：建立肠源性高草酸尿的大鼠模型。方法随机选取30只雌性SD大鼠置于大鼠代谢笼中适应性喂养7 d之后收集24 h尿,记录尿量,采用离子色谱仪测定其草酸浓度,计算正常大鼠在该条件下24 h尿草酸排泄量。菠菜汁灌胃处理大鼠,再测定灌胃后24 h尿草酸排泄量。对比灌胃菠菜汁前后,大鼠24 h尿草酸排泄量的差别;分组对照实验,随机选取20只雌性SD大鼠,随机分成A组和B组,B组灌胃菠菜汁,A组灌胃等量纯净水,其他条件相同,比较两组24 h尿草酸排泄量。结果反复测定,正常大鼠灌胃菠菜汁前24 h尿草酸排泄量为（0.53±0.18） mg,灌胃菠菜汁后第1天为（1.93±0.36） mg,第3天为（1.85±0.38） mg,第7天为（2.03±0.39） mg;A组（0.44±0.12） mg,B组（1.68±0.38） mg。结论大鼠在灌胃菠菜汁之后其尿液24 h草酸排泄量明显增加,大概增加3~4倍,说明每天对大鼠进行定量定浓度的菠菜汁灌胃,可以使其保持长期的高草酸尿状态,该方法建立的肠源性高草酸尿大鼠模型简便可行,可广泛用于其他方面的研究。