血浆凝血酶调节蛋白检测的临床应用

目的：探讨血浆凝血酶调节蛋白（PTM）检测的临床价值。方法：用ELISA法测定979例PTM，并以60名健康人为对照。结果：对照组PTM （20.40±7.72） μg/L，无性别和年龄差异。疾病组PTM水平，原发性慢性肾小球疾病肾功能衰竭（CRF）高于无CRF，败血症高于非败血症，多脏器功能衰竭（MOF）高于无MOF，均为P<0.01；分别以>70、>50和>40 μg/L为标准，预示CRF、败血症和MOF的灵敏度为85.7%、86.6%和77.8%，特异性为82.4%、89.5%和77.3%，阳性预示值为77.8%、76.5%和73.7%。系统性红斑狼疮（SLE）尿蛋白阳性组PTM高于阴性组；糖尿病并发症高于无并发症，微血管病变高于大血管病变（均P<0.01）；以PTM高于正常上限值为标准，预示SLE尿蛋白阳性临床肾损害、糖尿病并发症和微血管病变的灵敏度为77.8%、53.4%和71.2%，特异性为92.3%、97.1%和97.1%，阳性预示值为93.3%、98.6%和97.9%。急性白血病（AL）和多发性骨髓瘤（MM）初诊时PTM升高，两病并发肾衰时极度升高（P<0.01）。动态检测多发伤、脑卒中急性期和恢复期、AL和MM化疗前后、癌症术前后PTM与病情变化相关。分析微血管病变疾病PTM高于大血管病变疾病（P<0.01），以高于正常上限值（35.54 μg/L）为标准，预示微血管病变灵敏度为77.7%、特异性71.2%，阳性预示值75.6%。结论：PTM是评估微血管病变疾病的良好指标，也是预警或评估疾病严重程度及其演变或疗效观察的有用指标。     

四川南部汉族人群血管紧张素转换酶基因多态性对血管紧张素转换酶抑制剂抗蛋白尿作用的影响

目的　探讨四川南部汉族人群血管紧张素转换酶(angiotensin- coverting enzyme,ACE)基因多态性与血管紧张素转换酶抑制剂治疗原发性慢性肾小球肾炎蛋白尿疗效的相关性。方法　用苯那普利治疗99例伴有蛋白尿的原发性慢性肾小球肾炎患者,疗程为3个月。用PCR方法检测ACE基因第16内含子的插入/缺失(insertion/ deletion,I/ D)多态性,比较血管紧张素转换酶抑制剂治疗前后各基因型患者尿蛋白定量下降程度的差异。结果　治疗前ACE基因DD型组尿蛋白显著高于II型组(P<0 .0 5 ) ;苯那普利治疗3月后,DD、ID型组的尿蛋白定量下降幅度明显高于II型组(P<0 .0 5 )。结论　苯那普利可以改善原发性慢性肾小球肾炎患者的尿蛋白,且降低尿蛋白的疗效与患者的ACE基因型有明显的相关性。     

内皮素和一氧化氮/一氧化氮酶检测对老年糖尿病与血管病变患者临床价值的研究

探讨内皮素(ET)、一氧化氮/一氧化氮酶( NO/NOS)在糖尿病与血管病变患者中的变化。ET采用放射免疫分析法,NO/NOS采用酶法。结果是:(1)糖尿病组ET水平(68.80±37.35)pg/mL)较对照组(41.70±21.50pg/mL)显著升高(P<0.001);NOS水平(2.75±1.49U/mL)明显高于对照组(1.12±0.56U/mL),P<0.01;NO水平(49.32± 16.32μmol/L)明显低于对照组(54.60 ±15.60μmol/L),P<0.05。(2)糖尿病合并血管病变组ET水(80.1140.25pg/mL)显著高于无并发症组(62.73±24.29pg/mL),P<0.001;NOS水平(4.02 ± 0.59U/mL)明显高于无并发症组(2.51±1.19U/mL),P<0.001;NO水平(42.25 ± 10.10/μmol/L)明显低于无并发症组(52.16±14.59mol/L,P<0.05;NO/NOS(11.99±7.05)明显低于无并发症组(26.9±13.15),P<0.001提示 ET、NO/NOS与糖尿病的发生和发展有关,联合检测不仅可作为糖尿病及其血管并发症的重要依据,还将有助于糖尿病合并血管病变的预防和治疗。     

糖尿病微血管病变

<正>微血管病变是糖尿病的特异性病变,糖尿病微血管并发症包括肾脏病变、视网膜病变、神经病变和心肌病变。糖尿病肾病是导致西方国家终末期肾病的首要原因,其肾组织早期病理改变为肾小球肥大、细胞外基质聚集、基底膜增厚,晚期出现弥漫性肾小球硬化,导致肾功能衰竭[1]。糖尿病视网膜病变已成为四大致盲原因之一,其主要病理变化是视网膜微血管结构和功能的改变,结构改     

老年人肾脏疾病血液流变性变化的临床研究

本文研究了35例经临床确诊为老年人肾脏疾病病人的血液流变性变化,结果表明:老年人急性肾炎组全血比粘度、红细胞压积较对照组低(P<0.01)。慢性肾小球肾炎组唯有血沉高于对照组(P>0.05),老年人肾病综合症组处于高凝状态,老年人肾功能衰竭组红细胞压积明显低于对照组(P<0.01),尿毒症期血小板粘附率降低,血浆纤维蛋白原明显升高,说明肾衰时,老年人处于低凝状态。提示进行血液流变性检查对老年人肾病是必要的。     

糖尿病微血管病变与外周血中性粒细胞计数

背景：糖尿病病程和高血压是糖尿病微血管并发症发生的独立危险因素,而空腹C肽水平是其保护因素。糖化血红蛋白、C-反应蛋白、白细胞计数与糖尿病微血管并发症的相关研究报道较多,但关于中性粒细胞的报道较少。目的：分析外周血中性粒细胞计数与糖尿病微血管并发症的关系。方法：112例2型糖尿病患者根据是否合并微血管并发症将其分为2组：2型糖尿病合并微血管并发症组和2型糖尿病。收集2组患者性别、年龄、民族、既往史、实验室检查指标等各项临床资料,通过单因素及多因素分析进行统计学比较。结果与结论：①单因素分析结果显示：合并微血管病变组患者年龄、糖尿病病程、球蛋白、肌酐、中性粒细胞百分比、中性粒细胞绝对值、合并高血压的比率明显高于2型糖尿病组(P < 0.05),然而合并微血管病变组淋巴细胞百分比、肾小球滤过率、三酰甘油水平明显低于2型糖尿病组(P < 0.05)。②多因素Logistic回归分析结果示：患者的年龄、糖尿病病程、中性粒细胞绝对值是2型糖尿病患者发生微血管并发症的独立危险因素(OR=1.155、2.145、2.275,均P < 0.01)。控制年龄因素后,对所有对象偏相关分析结果显示：中性粒细胞计数与肌酐、低密度脂蛋白胆固醇、球蛋白、血红蛋白呈正相关,与血胆汁酸、肾小球滤过率呈负相关。结果提示,慢性亚临床炎症反应与2型糖尿病患者微血管并发症的发生密切相关,中性粒细胞计数可作为预测2型糖尿病患者微血管并发症的一个指标。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

糖尿病肾病相关实验室检测指标的临床意义

糖尿病肾病(DN)是糖尿病(DM)最常见的慢性并发症,其病理基础是微血管病变,且最终发展为肾脏功能衰竭,因此DN的早期诊断和治疗尤为重要.DM引起的肾脏慢性微血管改变,主要是肾动脉、肾小球动脉以及肾微小血管病变所致的肾小球硬化.在DN早期患者尿常规虽无明显异常,但用放射免疫分析(RIA)则可发现多种指标异常(如目前临床常做的血、尿β2-m、尿Alb等),说明肾脏功能已经出现病理改变.本文仅就DN发病机理和近年来与DN相关一些新的检测指标作一个简要概述.     

2型糖尿病血管病变时血浆ANP、BNP及CNP的变化及临床意义

目的：探讨血浆心钠素(ANP)、脑利钠肽(BNP)、C型利钠肽(CNP)在2型糖尿病血管病变时的变化及其临床意义。方法:应用酶联免疫吸附法(ELISA)测定正常对照组(9例)、2型糖尿病无血管病变组(34例)及2型糖尿病血管病变组(23例)血浆proANP、BNP fragment及NT-proCNP浓度，分析各组间血浆利钠肽水平的变化及相关因素。结果:2型糖尿病血管病变组血浆ANP、BNP明显高于另外2组（P<0.01），而血浆CNP明显降低（P<0.01），2型糖尿病血管病变组各亚组(微血管病变组、大血管病变组及微血管合并大血管病变组)间血浆利钠肽水平无明显差异（P>0.05）。2型糖尿病血管病变组血浆ANP与BNP间存在显著正相关（r=0.309, P<0.05），ANP与CNP（r=-0.374, P<0.05）以及BNP与CNP（r=-0.653, P<0.01）间存在显著负相关。结论:血浆ANP、BNP及CNP的联合检测可以作为简便、价廉、可靠的糖尿病血管病变的筛选指标。     

血清HGF、VEGF、sP-selectin和LTB4水平的波动与DM2大血管病变

目的:探讨2型糖尿病(DM2)大血管病变发生及病程进展过程中相关多肽生长因子水平测定的临床意义。方法:本文将40例DM2患者按不同的病情分为大血管病变组和非血管病变组进行研究。同时设置体检健康人40名作为正常对照组。血清血管内皮生长因子(vascular endothelial growth factor,VEGF)采用RIA测定;血清肝细胞生长因子(hepatocyte growth factor,HGF)、血清可溶性P-选择素(soluable P-selectin,sP-selectin)、白三烯B4(leukotrieneB4,LTB4)水平均采用ELISA测定。并将测定结果进行统计学分析。结果:两组DM2患者血清VEGF水平均显著地高于正常对照组(P<0.05,P<0.01),大血管病变组则显著高于非血管病变组(P<0.01)。HGF水平显示大血管病变组显著高于非血管病变组及正常对照组(P均<0.01),大血管病变组与非血管病变组比较差异不显著(P>0.05)。sP-selectin含量大血管病变组显著地高于非血管病变组及正常对照组(P均<0.01),大血管病变组则显著地高于非血管病变组(P<0.01)。LTB4水平的变化为两组DM2患者血清VEGF水平均显著地高于正常对照组(P<0.05,P<0.01),大血管病变组则显著高于非血管病变组(P<0.01)。结论:四项指标的变化与患者的病情关系密切,其测定对DM2大血管病变的早期诊断具潜在的临床价值。     

血管紧张素Ⅱ 1型受体自身抗体在原发性肾小球疾病患者血清中的表达及意义

 目的：探讨原发性肾小球疾病患者血清中血管紧张素Ⅱ 1型受体自身抗体（AT1-AA）的表达及其临床意义。方法：采用ELISA,对326例原发性肾小球疾病患者与同期收集的197例健康对照者进行血清AT1-AA的检测。将原发性肾小球疾病患者分为AT1-AA阴性组和AT1-AA阳性组,比较两组的临床和病理指标。结果：(1)原发性肾小球疾病患者血清中AT1-AA阳性率为35.58%（116/326）,明显高于正常对照组的9.64％（19/197）（P<0.01）;(2)原发性肾小球疾病患者中有免疫抑制剂用药史的患者AT1-AA阳性率明显低于无用药史的患者（P<0.05）;(3)原发性肾小球疾病患者中无高血压组和有高血压组的AT1-AA阳性率均显著高于正常对照组（P<0.01）,但无高血压组和有高血压组之间AT1-AA阳性率的差异并无统计学意义（P>0.05）;(4)AT1-AA阳性组中女性患者所占比例和血清球蛋白水平高于AT1-AA阴性组（P<0.05）。结论: AT1-AA在原发性肾小球疾病患者血清中明显增高,提示与其它经典的自身免疫抗体相似,AT1-AA可能也是肾小球疾病的重要致病因素,抑制AT1-AA的表达可能成为预防和治疗原发性肾小球疾病的新手段。     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.     

Seasonal variations in acute toxoplasmosis in pregnant women in Slovenia

Between December 1999 and December 2004, 40 081 pregnant women were examined for toxoplasmosis with Toxo-IgG, Toxo-IgM enzyme immunoassay. Women with positive results were then retested with the Toxo-IgG avidity assay for recent toxoplasmosis. Recent acute toxoplasmosis in pregnant women was found to be significantly more frequent (p < 0.01) during winter than summer. The incidence of acute toxoplasmosis during winter-spring was also significantly more frequent (p < 0.025) than summer-autumn. This phenomenon should be taken into account when formulating preventive measures for toxoplasmosis, especially for pregnant women.     

Age-related changes in polyamines in memory-associated brain structures in rats

Polyamines putrescine, spermidine and spermine are positively charged aliphatic amines and have important roles in maintaining normal cellular function, regulating neurotransmitter receptors and modulating learning and memory. Recent evidence suggests a role of putrescine in hippocampal neurogenesis, that is significantly impaired during aging. The present study measured the polyamine levels in memory-related brain structures in 24- (aged), 12- (middle-aged) and 4- (young) month-old rats using liquid chromatography/mass spectrometry and high performance liquid chromatography. In the hippocampus, the putrescine levels were significantly decreased in the CA1 and dentate gyrus, and increased in the CA2/3 with age. Significant age-related increases in the spermidine levels were found in the CA1 and CA2/3. There was no difference between groups in spermine in any sub-regions examined. In the parahippocampal region, increased putrescine level with age was observed in the entorhinal cortex, and age did not alter the spermidine levels. The spermine level was significantly decreased in the perirhinal cortex and increased in the postrhinal cortex with age. In the prefrontal cortex, there was age-related decrease in putrescine, and the spermidine and spermine levels were significantly increased with age. This study, for the first time, demonstrates age-related region-specific changes in polyamines in memory-associated structures, suggesting that polyamine system dysfunction may potentially contribute to aged-related impairments in hippocampal neurogenesis and learning and memory.     

休克过程中肾上腺髓质素变化的研究进展

Adrenomedullin (AM) is a new peptidergic regulator of vascular function. AM serves as a hormone, which has many biological properties, plays an important role in the many pathophysiological processes, especially shock. This review will highlight the structure, biological properties of AM and the relationship between AM and shock.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Pitfalls in TRAP assay in routine detection of malignancy in effusions

Telomerase has been found to be reactivated in a majority of cancers but is inactive in most somatic cells. Our principal goal was to determine the potential use of the telomeric repeat amplification protocol (TRAP) assay as marker for malignancy in cytological effusions. The simple selection criterion was the cytological diagnosis, and routine samples were classified into malignant (58 samples) and nonmalignant (233 samples). Of the malignant samples, 44/58 (76%) were positive by TRAP assay. Of the 14 telomerase-negative cytology-positive samples, RNA integrity was poor in 9, indicating suboptimal sample conservation for molecular analysis. In 3 of the remaining 5 samples with a negative TRAP assay, a high number of malignant cells was observed, and these cells might have been telomerase-negative. Thus, the sensitivity of TRAP assay for the presence of malignant cells was about 76%. In the cytologically nonmalignant effusions, the presence of telomerase activity was observed in 24% (55/233). Of these, 6% were highly suspicious for malignancy, 9% were doubtful, and 9% were cytologically nonmalignant effusions confirmed by a follow-up of 12 mo or more. According to these data, the specificity of the TRAP assay to detect tumor cells in effusions ranged only between 82-91%. Our results indicate that, although the TRAP assay is positive in 6-15% of putative malignant effusions, the relatively high number of TRAP false-negative and false-positive cases renders this test unsuitable for routine diagnostic purposes.