男性2型糖尿病患者维生素D营养状况及其对骨代谢指标的影响

目的 了解男性2型糖尿病患者维生素D营养状况及其对骨代谢指标的影响.方法 采用Roche E170全自动电化学发光免疫分析仪检测258例男性2型糖尿病患者血清的25羟维生素D[25(OH)D]、总Ⅰ型前胶原氨基端肽(tPINP)和Ⅰ型胶原羧基端肽(β-CTX).根据血清25 (OH)D水平分为维生素D严重缺乏(＜25nmol/L)、缺乏(≥25nmol/L且＜ 50nmol/L)、不足(≥50nmol/L且＜75 nmol/L)和充足(≥75nmol/L).结果 男性2型糖尿病患者总体25(OH)D浓度为33.80±18.43nmol/L,为维生素D缺乏水平.根据年龄将受试者分为中年组(35 ～49岁)、老年前期组(50 ～ 59岁)、老年1组(60～69岁)、老年2组(＞70岁),发现随着年龄的增长,25(0H)D的浓度呈逐渐降低趋势,老年2组的25(OH)D显著低于中年组(P=0.044),而骨标志物在各年龄组间差异均无统计学意义(P＞0.05).258例男性2型糖尿病患者中维生素D严重缺乏、缺乏、不足、充足的比例分别为36.43％ (94/258)、48.45％(125/258)、11.63％ (30/258)和3.49％ (9/258).维生素D严重缺乏组的β-CTX明显高于其他各营养状况组(均P＜0.05),而tPINP在各营养状况组间差异均无统计学意义(P＞0.05).相关分析表明,血清25(OH)D水平与β-CTX呈负相关(r=-0.197,P=0.001),与tPINP无相关性(r=-0.046,P =0.464).结论 男性2型糖尿病患者存在严重维生素D缺乏和不足状况,维生素D严重缺乏对骨吸收可能有影响.     

胱抑素C、尿微量白蛋白/肌酐比值对早期糖尿病肾病的诊断价值

目的 探讨测定血清胱抑素C（CysC）、尿微量白蛋白/肌酐比值在早期2型糖尿病肾病（DN）中的诊断价值。方法 选取2017年1月~2018年11月北京市门头沟区医院糖尿病患者276例,其中非糖尿病肾病组122例,早期糖尿病肾病组86例,临床糖尿病肾病组68例,同时选择同期健康体检60例设为对照组,应用日立7600全自动生化分析仪测定血清CysC,尿素氮,血肌酐,尿微量白蛋白,尿肌酐数值。结果 临床糖尿病肾病组CysC、尿微量白蛋白/肌酐比值、尿素氮、肌酐比高于其他三组（P＜0.01）;早期糖尿病肾病组CysC、尿微量白蛋白/肌酐比值分别高于非糖尿病肾病组和对照组（P＜0.01）,其尿素氮、肌酐与非糖尿病肾病组和对照组比较,差异无统计学意义（P＞0.05）;非糖尿病肾病组CysC、尿微量白蛋白/肌酐比值、尿素氮、肌酐与对照组比较,差异无统计学意义（P＞0.05）。结论 CysC、尿微量白蛋白/肌酐比值的测定对早期发现糖尿病肾病有明显的临床价值,而且病情越重,高的越明显;随着病情加重,CysC、尿微量白蛋白/肌酐比值与传统的肾功能指标尿素氮、肌酐相关性明显,而且在糖尿病肾病早期价值明显优于尿素氮、肌酐。     

2型糖尿病患者血清脂联素水平与糖尿病肾病的关系

目的:研究2型糖尿病肾病患者血清脂联素水平与糖尿病肾病的关系.方法:用放射免疫分析测定163例2型糖尿病患者及50例正常人的血清脂联素水平.结果:在糖尿病各亚组中,大量蛋白尿组患者的血清脂联素水平高于微量蛋白尿组(P＜0.01)及正常蛋白尿组和对照组(P＜0.001).微量蛋白尿组患者的血清脂联素水平高于正常蛋白尿组(P＜0.05).脂联素水平与血肌酐、HbA1c、TC、SBP、DBP、TG及UAER呈正相关(P＜0.05),而与年龄、HDL-C、BMI无明显相关性(P＞0.05).女性血清脂联素水平(15.82±7.21)mg/L高于男性(13.98±7.86)mg/L,但无统计学意义(P＞0.05).结论:2型糖尿病肾病患者血清脂联素水平随着肾病进展而升高,说明肾脏参与了脂联素的代谢与排泄.脂联素在糖尿病肾病发生发展过程中可能起到重要作用.     

糖尿病微血管病变患者血清CysC、RBP及尿NAG的变化与糖尿病肾病发展的关系

目的 探讨糖尿病肾微血管病变患者血清胱抑素C(cystatin C,CysC)、视黄醇结合蛋白(retinol binding protein,RBP)及尿N-乙酰-β-D氨基葡萄糖苷酶(N-acetyl beta-D Glucosaminidase,NAG)的水平变化与糖尿病肾病病变程度的关系.方法 本研究选取30例2型糖尿病肾病患者(尿微量白蛋白＜ 14.29mg/L)作为A组、选取30例2型糖尿病肾病患者(尿微量白蛋白≥14.29mg/L)作为B组、30例2型糖尿病肾病引发尿毒症患者作为C组、30例体检正常研究对象作为D组,比较四组患者血清中CysC、RBP、NAG的差异.结果 A、B、C、D四组研究对象的CysC、RBP及尿NAG水平差异均具有统计学意义(P＜0.01);组间比较,A、B、C组CysC、RBP及尿NAG与D组比较均显著的高于D组,差异均具有统计学意义(P＜0.05);A、B组患者的CysC、RBP及尿NAG与C组比较显著低于C组,差异具有统计学意义(P＜0.05);A组患者的CysC、RBP及尿NAG与B组比较显著低于B组,差异具有统计学意义(P＜0.05).结论 糖尿病肾病患者随着病变程度不断加重,CysC、RBP及尿NAG水平呈明显的上升趋势.     

尿转铁蛋白、β_2-微球蛋白和尿微量白蛋白在糖尿病肾病检测中的意义

目的探讨尿转铁蛋白（UTRF）与β2-微球蛋白（β2-MG）及尿微量白蛋白（mALB）在糖尿病肾病检测中的意义。方法采用电化学发光法检测78例2型糖尿病患者和43名健康者尿UTRF、β2-MG和mALB。结果糖尿病肾病患者UTRF、β2-MG和mALB与对照组之间差别均有统计学意义（P〈0.01）,UTRF和mALB在糖尿病正常蛋白尿组与对照组之间差别具有统计学意义（P〈0.01）。结论联合检测尿UTRF、β2-MG和mALB对早期诊断糖尿病肾病有良好的诊断价值;UTRF和β2-MG较mALB更敏感。     

血清CysC检测在早期诊断2型糖尿病肾病中的意义

目的 探讨血清胱抑素C（CysC）在早期糖尿病肾病（DN）患者血液中的变化及其诊断价值.方法 对120例2型糖尿病（T2DM）患者根据尿微量白蛋白排泄率（UAER）分为两组：T2DM无蛋白尿组（UAER＜ 30mg/24h）,60例;T2DM微量蛋白尿组（UAER30 ～ 300mg/24h）,60例;用免疫比浊法检测2型糖尿病肾病患者和健康体检人群的血清CysC,速率法测定尿素氮（BUN）,酶法测定血肌酐（Scr）,并对检测结果进行统计分析.结果 60例T2DM尿微量白蛋白患者CysC、BUN、Scr的异常结果检出率分别为80.0％、10.0％、18.3％,CysC的异常结果检出率明显高于BUN、Scr.结论 血清中CysC的浓度可作为2型糖尿病肾病早期诊断指标,且对了解肾脏损伤程度也有较大的临床意义.     

血清同型半胱氨酸等指标联合评价高血压患者肾损伤的临床价值

目的 探讨血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)、β2微球蛋白(β2-MG)及尿液清蛋白/肌酐比值(Alb/Cr)、尿β2-MG等指标联合评价高血压患者肾损伤的临床价值.方法 选择2013年6月到2014年6月来院诊治的226例高血压患者(根据其尿液Alb/Cr比值分为三组:正常清蛋白尿组127例,尿液Alb/Cr＜3;微量清蛋白尿组50例,尿液Alb/Cr在3 ～8.75之间;大量清蛋白尿组49例,尿液Alb/Cr＞ 8.75)和50名健康体检者,采集清晨空腹静脉血和晨尿,分别测定血清Hcy、Cys-C、β2-MG及尿液Alb、Cr、尿β2-MG,并进行统计学分析.结果 血清Hcy、Cys-C、β2-MG及尿液Alb/Cr、尿β2-MG五个指标之间均具有相关性(r:0.343～0.800,P值均＜0.01).对照组、正常清蛋白尿高血压组、微量清蛋白尿高血压组、大量清蛋白尿高血压组四组各指标总体比较,差异均有统计学意义(H:99.302～ 208.213,P值均＜0.01).四组间两两比较,正常清蛋白尿组、微量清蛋白尿组、大量清蛋白尿组血清Hcy、Cys-C、β2-MG及尿液Alb/Cr、β2-MG水平均高于对照组,差异有统计学意义(u:39.672～191.530,P值均＜0.05);正常清蛋白尿组、微量清蛋白尿组、大量清蛋白尿组血清Cys-C及尿液Alb/Cr、尿β2-MG三个指标组间差异均有统计学意义(u:37.155～191.530,P值均＜0.05),且随病情进展有增加的趋势,但血清Hcy、β2-MG组间差异无统计学意义(u:3.152～20.141,P值均＞0.05).结论 血清Hcy、Cys-C、β2-MG及尿液Alb/Cr、β2-MG五个指标均能反映高血压早期肾损伤,且血清Cys-C及尿液Alb/Cr、β2-MG三个指标能反映高血压肾损害病情发展阶段.     

血清胱抑素检测对糖尿病早期肾功能损害的诊断意义

目的探讨血清半胱氨酸蛋白酶抑制剂C（Cys C）检测对糖尿病早期肾功能损害的诊断意义。方法将76例1型或2型糖尿病患者按尿白蛋白排泄率（UAER）分为3组（B、C、D组）,20例无糖尿病的正常人为A组。其中,B组为正常蛋白尿患者31例（UAER〈20μg/min）,C组为微量蛋白尿患者28例（UAER 20～200μg/min）,D组为大量蛋白尿患者17例（UAER〉200μg/min）。同时测定各组血肌酐（Scr）及Cys C,并计算肌酐清除率（CCr）。结果 2型糖尿病各组血清Cys C水平与对照组相比明显升高,而且其水平随蛋白排泄率的升高而升高（P〈0.05）,而Scr在B组、C组间的差异无统计学意义（P〉0.05）。结论 Cys C与糖尿病肾病的病情呈正相关,Cys C可作为2型糖尿病肾病患者早期监测的新指标。     

血清及尿液特定蛋白检测在糖尿病肾病早期诊断中的意义

目的探讨尿微量白蛋白(MA)、尿α1-微球蛋白(α1-MG)、尿β2-微球蛋白(β2-MG)及血清β2-微球蛋白(β2-MG)在糖尿病肾病早期诊断中的意义。方法收集67例2型糖尿病患者和82名正常健康人的血清及尿液,分别利用化学发光法检测血清β2-MG、放射免疫法测定尿β2-MG及散射速率比浊法测定尿MA和尿α1-MG水平。结果与正常对照组相比,糖尿病组4组特定蛋白水平明显升高,结果有显著性差异(P均<0.05);此4组蛋白在正常对照组测得的结果无一例阳性,但在糖尿病组的阳性率分别为32.8%、47.8%、35.8%、34.3%;实验还发现随着病程的延长,糖尿病组4组蛋白的阳性率也相应升高(P<0.05)。结论测定尿液中MA、α1-MG、β2-MG及血清β2-MG水平对糖尿病肾病的早期诊断具有一定意义,能够帮助患者及早发现病情,减少疾病迁延。     

皮肤AGEs荧光检测对糖尿病肾病的临床意义

目的 探讨皮肤AGEs荧光检测对糖尿病肾病的早期诊断价值及与糖尿病肾病分期相关性的临床意义。方法 将我院住院的122例糖尿病患者按尿白蛋白/肌酐比值,眼底检查及CKD分期分为单纯糖尿病组（DM0组）42例、糖尿病肾病eGFR≥45 ml/（min·1.73 m2）组（DKD1组）49例和糖尿病肾病eGFR＜45 ml/（min/1.73·m2）组（DKD2组）31例,选取同期行肾穿刺肾功能正常的非糖尿病患者51例为对照组（NC组）,分别检测各组皮肤AGEs、血白蛋白、尿微量白蛋白等指标。结果 ①糖尿病患者的皮肤AGEs、SBP、SCr、TG、TC均高于对照组,ALB、HB低于对照组,差异均有统计学意义（P＜0.05）;②与DMO组比较,DKD1组和DKD2组的SBP、肌酐、UA、24hUP、尿微量白蛋白、皮肤AGEs水平均升高,且DKD2组高于DKD1组,差异有统计学意义（P＜0.05);而TP、ALB、HB水平均降低,且DKD2组低于DKD1组,差异有统计学意义（P＜0.05）;③糖尿病患者皮肤AGEs水平与尿微量白蛋白水平呈正相关（r=0.484,P＜0.05）。④皮肤AGEs是糖尿病肾病相关的危险因素[OR=1.113,95%CI（1.055,1.174）]。⑤ROC曲线分析显示皮肤AGEs检测糖尿病肾病的敏感性为68.75%,特异性为71.43%。结论 AGEs可能参与糖尿病肾病发生发展,荧光检测皮肤AGEs可用于早期筛查DKD并且评估其病变程度。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.