小鼠肾血管球和肾小囊的生长曲线

目的研究小鼠肾小体发生发育过程中血管球和肾小囊体积的增长规律。方法光镜下应用体视学方法对胚胎和生后发育期小鼠肾血管球和肾小囊的绝对和体积进行测量。结果从胚龄16天到生后40天血管球体积增大约86倍，肾小囊体积增大约32倍。生后7天之前，血管球的相对体积增大迅速，而肾小囊的相对体积减小迅速，之后二者变化平缓。结论肾小体发育中血管球和。肾小囊的体积变化为肾小体的滤过功能的逐渐成熟提供了形态结构基础。     

Prenatal protein malnutrition induces a phase shift advance of the spontaneous locomotor rhythm and alters the rest/activity ratio in adult rats

Abstract

Evidence is accumulating for significant structural and functional changes within the central nervous system (CNS) following prenatal protein malnutrition. Included among the structures that are likely to be affected are the suprachiasmatic nuclei (SCN) involved in the regulation of locomotor activity, sleep-wake cycle, and drinking behavior. To determine the effects of prenatal protein malnutrition on the spontaneous activity rhythm, 24h radiotelemetric measurements were recorded over an 8-day period. Male offspring of rats provided with protein-deficient (6% casein) or adequate (25% casein) diets for 5 weeks prior to mating and throughout pregnancy were studied. Well nourished rats displayed a rise in activity level during the first hour of the 12h light phase, whereas prenatally malnourished rats displayed this increase during the 12h dark phase, approximately 50min before lights on, reflecting a significant phase advance in this group. In addition, cosinor analysis revealed that the alpha/rho relationship was affected in the previously malnourished group, the activity phase being shorter than in the well-nourished animals. These findings suggest changes in the regulatory systems controlling the locomotor activity rhythm as a consequence of prenatal protein malnutrition. Alterations in entrainment to the light–dark cycle, and/or in the coupling force of the circadian oscillators are all candidate mechanisms.     

Influence of a low protein diet on brain contents of free amino acids and histamine in the weanling guinea pig

Male weanling guinea pigs fed ad libitum a 3 per cent protein diet for 21 days demonstrated marked reduction in plasma levels of essential amino acids when compared with control animals pair-fed normal protein diet. Most prominently affected were leucine(−70%), isoleucine (−69%), valine (−67%), threonine (−63%), phenylalanine (−54%) and lysine (−52%). Similar changes were noted in the liver. Plasma and liver contents of free histidine were resistant to malnutrition. Changes in brain levels of free amino acids were less extensive than in liver and plasma. Protein malnutrition produced a two-fold increase in brain content of free histidine, and associated with this were prominent elevations in levels of homocarnosine (+91%) and histamine (+161%). Several lines of evidence suggest some neuroregulatory roles for histamine and homocarnosine, and marked alterations in their levels may be one of the mechanisms by which protein-energy malnutrition elicits changes in behaviour and neuroendocrine function.     

The value of urine screening in a young adult population

BACKGROUND: GPs in England and Wales are required to perform screening urinalysis on all newly registered patients. The value of this practice, however, is unclear. OBJECTIVE: The purpose of this study was to identify the prevalence of persistent urine abnormalities and to establish the added value of screening for both haematuria and proteinuria in a large cohort of young adults in the UK. METHODS: Urine screening was carried out in a cohort of young adults in a student health centre and a university hospital nephrology unit in a large British city. University students enrolling for health screening in a university health centre over a 2-year period were tested for haematuria and/or proteinuria by dipstick urinalysis. Subjects with persistent urine abnormalities were evaluated for the presence of significant renal tract pathology. RESULTS: Of 3808 students screened, 3570 provided an initial urine sample; 220 were abnormal. Of these, 38 (1% of original cohort) had persistent abnormalities (haematuria, 14; proteinuria, 16; both, eight). Subjects with isolated haematuria or proteinuria did not have significant pathology. In contrast, all the students with both haematuria and proteinuria had identifiable renal disease. CONCLUSIONS: Our findings do not support the value of routine screening for proteinuria or haematuria in young adults. However, the combination of haematuria and proteinuria is a powerful predictor for parenchymal renal disease. Thus, if proteinuria is detected, further testing for haematuria should be performed.     

Approaches to the reversal of malnutrition,inflammation, and atherosclerosis in end-stage renal disease

Uremic malnutrition and chronic inflammation are important comorbid conditions that predict poor clinical outcome in end-stage renal disease (ESRD) patients. These conditions are also closely associated with cardiovascular disease, the major cause of death in ESRD patients. A pathophysiologic link between malnutrition, inflammation, and atherosclerosis has been proposed in this patient population. Indeed, multiple lines of evidence suggest that chronic inflammation can predispose ESRD patients to a catabolic and atherogenic state. Malnutrition can also result from chronic inflammation and can accelerate the progression of cardiovascular disease. Whereas a single common etiology has not been identified in this complex process, nutritional and anti-inflammatory interventions provide potential treatment options to counter the high mortality and morbidity in ESRD patients.     

慢性肾脏病患者Hcy水平与IMT及左室结构关系的临床研究

目的观察不同同型半胱氨酸（Hcy）水平的慢性肾脏病患者颈动脉内膜中层厚度（IMT）及反映心脏结构的各项指标间的差异,了解慢性肾脏病患者Hcy与反映大动脉粥样硬化指标IMT及反映心脏结构的各项参数间关系。方法测定66例慢性肾脏病患者和32例对照组血Hcy、SCr水平,同时进行颈动脉和心脏彩色多普勒超声检查,并进行收缩压、舒张压测定。结果与对照组相比,肾病组（无论Hcy正常与否）,IMT、LVEDd、LVMI均增加,Hcy增高肾病组较对照组LVPWT、IVST亦增高（P值分别为0.042、0.017）,具统计学差异。与Hcy正常肾病组相比,Hcy增高肾病组IMT及反映左室结构的各项指标（LVEDd、LVPWT、LVMI、IVST）均明显增高,有统计学差异。线性相关分析显示血浆Hcy与IMT、LVEDd、LVMI相关。结论高Hcy血症慢性肾病患者,存在动脉粥样硬化程度及左室结构异常加剧情况,预示着心血管事件的发生率增高。     

Magnitude,Temporal Trends,and Inequalities in the DALYs and YLDs of Nutritional Deficiency among Older Adults in the Western Pacific Region: Findings from the Global Burden of Disease Study 1990–2019

The population in the Western Pacific region is aging rapidly. Nutritional deficiency is prevalent in older adults; however, information regarding nutritional deficiency in this population is scarce. Using the 2019 Global Burden of Disease (GBD) results, the age-standardized disability-adjusted life years (DALYs) and years of healthy life lost due to disability (YLDs) from nutritional deficiency were estimated between 1990 and 2019 for this population. Average annual percentage change (AAPC) was used to assess temporal trends, and linear mixed-effects models were used to examine socioeconomic and sex inequalities. From 1990 to 2019, the age-standardized DALYs of nutritional deficiency in this population decreased from 697.95 to 290.95 per 100,000, and their age-standardized YLDs decreased from 459.03 to 195.65 per 100,000, with the greatest declines seen in South Korea (AAPCs < −5.0). Tonga had the least decline in DALYs (AAPC = −0.8), whereas Fiji experienced an increase in YLDs (AAPC = 0.1). Being female and having a lower sociodemographic index score was significantly associated with higher age-standardized DALYs and YLDs. The magnitude and temporal trends of the nutritional deficiency burden among older adults varied across countries and sex in the region, indicating that health policies on nutritional deficiency among older adults must be crafted to local conditions.     

常用肾功能指标对老年人肾小球滤过率判断的应用价值

目的了解常用肾功能指标判断肾小球滤过率（GFR）的价值。方法老年患者105例,分为肾病组、非肾病1组（年龄〈80岁）、非肾病2组（年龄≥80岁）,测血清尿素氮（BUN）、血清肌酐（SCr）、血清半胱氨酸蛋白酶抑制剂C（Cys—C）,计算MDRD方程,各指标作相关分析与回归分析,组内异常率比较。结果非肾病组BUN、SCr异常率（18．57％、12．86％）与Cys—C异常率（1．43％）比较,差异有统计学意义（P〈0．001,P〈0．01）;肾病组BUN、SCr异常率（60．00％、65．71％）与Cys—C异常率（54．29％）比较,差异无统计学意义（P〉0．05）。全部患者Cys—C与年龄、简化MDRD方程（eGFRa）、中国改良MDRD方程7（C—eGFR7）、中国改良简化MDRD方程（C—eGFRa）相关,相关系数（r）分别为0．414、-0．677、-0．736、-0．677,有统计学意义（P〈0．001）;与改良MDRD方程7（eGFR7）r=-0．258,有统计学意义（P〈0．05）;3个组间Cys—C与eGFR7、C—eGFR7、C—eGFRa的直线回归方程有统计学意义。结论Cys—C特异性高于BUN、SCr,能够更准确反映老年患者GFR;C—eGFR7、C—eGFRa准确性高于eGFR7、eGFRa。     

Effects of early protein malnutrition and environmental stimulation on behavioral and biochemical parameters in rats submitted to the elevated plus-maze test

Abstract

The objective of this study was to compare the effects of the tactile/handling stimulation (H) and environmental enrichment (EE) in well-nourished (C – 16% of protein) and malnourished (M – 6% of protein) rats tested in the elevated plus-maze (EPM) at 36 and 37 days of age. The results showed higher exploration of the open arms in the EPM in M as compared with C animals, as well as lower index of risk assessment behaviors, and EE, but not H, reversed the alterations produced by malnutrition in the EPM. Biochemical analysis showed higher levels of corticosterone in M when compared with C rats. The non-stimulated animals presented higher levels of polyamines in the hippocampus when compared with the stimulated ones in both diet conditions. It is suggested that both the lower anxiety levels and the lower risk-assessment behaviors in the EPM, as well as the higher levels of corticosterone, can be due to alterations in the activity of the hypothalamic-pituitary-adrenal axis as the result of early protein malnutrition.     

Gestational Iron Supplementation Improves Fetal Outcomes in a Rat Model of Prenatal Alcohol Exposure

Prenatal alcohol exposure causes neurodevelopmental disability and is associated with a functional iron deficiency in the fetus and neonate, even when the mother consumes an apparently iron-adequate diet. Here, we test whether gestational administration of the clinically relevant iron supplement Fer-In-Sol mitigates alcohol’s adverse impacts upon the fetus. Pregnant Long-Evans rats consumed an iron-adequate diet and received 5 g/kg alcohol by gavage for 7 days in late pregnancy. Concurrently, some mothers received 6 mg/kg oral iron. We measured maternal and fetal weights, hematology, tissue iron content, and oxidative damage on gestational day 20.5. Alcohol caused fetal anemia, decreased fetal body and brain weight, increased hepatic iron content, and modestly elevated hepatic malondialdehyde (p’s < 0.05). Supplemental iron normalized this brain weight reduction in alcohol-exposed males (p = 0.154) but not female littermates (p = 0.031). Iron also reversed the alcohol-induced fetal anemia and normalized both red blood cell numbers and hematocrit (p’s < 0.05). Iron had minimal adverse effects on the mother or fetus. These data show that gestational iron supplementation improves select fetal outcomes in prenatal alcohol exposure (PAE) including brain weight and hematology, suggesting that this may be a clinically feasible approach to improve prenatal iron status and fetal outcomes in alcohol-exposed pregnancies.     

孕期高同型半胱氨酸、缺锌与先天性心脏病

先天性心脏病是指胎儿在出生以前由于心血管发育障碍所导致的心血管系统的形态结构、功能及代谢异常.该病发病率较高,临床后果严重.研究其发病因素及机制具有重要意义.孕期环境因素的改变对其有重要影响.近期孕妇高同型半胱氨酸血症与缺锌已被确定均能干扰胚胎心脏正常发育,导致先天性心脏病的发生.该文就两者引起胚心异常发育的表现及作用机制进行综述.     

Mitochondrial dysfunction: maternal protein restriction as a trigger of reactive species overproduction and brainstem energy failure in male offspring brainstem

Mitochondria are important organelles in eukaryotic organisms, wherein their capacity to produce energy vary among the tissues depending upon the amounts of oxygen consumed. Part of the oxygen consumed during ATP generation produces reactive oxygen species, which if not efficiently removed can trigger a systemic damage to molecular compounds characterized as oxidative stress. Several studies have demonstrated that mitochondrial dysfunction and oxidative stress in the central nervous system (CNS) are related to a plethora of neural disorders. Herein, we hypothesize that a late autonomic imbalance-induced hypertension might be related to long-lasting effects of protein restriction during the critical period of the CNS development on the mitochondrial function and oxidative stress in the brainstem of adult (i.e. 150 days of age) male Wistar rats. Maternal protein restriction was induced by offering a diet based on 8% of casein from first day of pregnancy until weaning, when the male pups started to receive laboratory chow up to 150 days of life. The protein restriction induced an extended detrimental modulation in mitochondria function, decreasing the phosphorylation capacity with concomitant decrease in the mitochondrial membrane potential, wherein the reactive species overproduction triggered a disruption in proton conductance, which may gradually compromise mitochondria energy conservation. Interestingly, the elevated activity of glutathione-S-transferase and the augmented expression of uncoupling protein 2 are likely protective mechanisms induced by lipid peroxidation products, being feasible molecular changes attempting to deal with oxidative stress-induced ageing.     

不同血糖控制目标对危重颅脑疾病病人蛋白质代谢的影响

目的:研究胰岛素治疗中三种不同血糖控制目标对危重颅脑疾病病人蛋白质代谢的影响。方法:将122例危重颅脑疾病病人随机分为三组,分别给予胰岛素控制血糖于不同的目标,即A组41例,血糖控制在4.4~6.1 mmol/L);B组42例,血糖控制在6.1~8.3 mmol/L,C组39例,血糖控制在10~11.1 mmol/L。对三组病人的蛋白质代谢情况和低血糖发生率进行比较。结果:A组与B组氮平衡、PA和TF指标优于C组,差异有显著性意义(P0.05);但低血糖发生率A组高于B组和C组(P0.05)。结论:病人血糖控制在≤8.3 mmol/L,有利于减轻严重颅脑疾病病人的高分解代谢,促进蛋白合成,改善营养状况。     

高龄男性慢性肾病患者血清C-反应蛋白的临床意义

目的探讨慢性肾病(CKD)高龄男性患者血清C-反应蛋白(CRP)与营养指标及CKD进展之间的关系。方法回顾性分析曾在某院住院并门诊随访且尚未透析的72例高龄男性CKD 5期患者,分为高GRP组28例,低GRP组44例,观察血清CRP、营养评估及肾功能指标等,探讨微炎性状态与营养状况及CKD进展之间的关系。结果排除感染、创伤等因素后,所纳入对象的平均血清CRP水平为0.64mg/dl(四分位间距0.32,1.05 mg/dl)。以0.8mg/dl为分割点,将其分为高CRP组(CRP≥0.8mg/dl)和低CRP组(CRP<0.8mg/dl)。高CRP组患者占38.9%,较之低CRP组,高CRP组多伴随心血管及外周动脉粥样硬化等疾病(P<0.05),主观综合营养评估(SGA)评分明显降低(P<0.01),促红细胞生成素(EPO)用量显著增加(P<0.01)。随访18个月后,高CRP组估算肾小球滤过率下降幅度明显(P<0.01),转入透析治疗的例数较多(P<0.05),发生心血管事件的例数也显著增多(P<0.05)。结论进入CKD 5期的高龄CKD患者存在血清CRP值轻度升高的微炎性状态,高CRP患者伴随心血管病及外周动脉粥样硬化的比例显著高于低CRP患者;持续的高CRP水平多伴随营养状况的下降,且易导致EPO效力的降低;CKD的进展与血清高CRP水平具有相关性。     

Markers of Renal Function in Older Adults Completing a Higher Protein Obesity Intervention and One Year Later: Findings from the MEASUR-UP Trial

Increases in rates of obesity in the older population are hastening the development of chronic illnesses, including chronic kidney disease (CKD). However, obesity reduction in older adults is besought with concerns about the long-term benefit/risk, especially regarding loss of muscle mass and its impact on function. Higher protein intakes have been advocated to help offset the tendency for loss of muscle during weight reduction but this raises concerns about possible negative effects on older kidneys. We assessed markers of renal function in venous blood samples collected during a six-month randomized controlled weight loss trial of higher protein intake in obese (n?=?67; BMI?≥?30?kg/m²) older (≥60?years) adults with physical frailty and age-normal renal status (glomerular filtration rate [GFR]?≥?45); the Control diet (0.8?g protein/kg body weight/day; n?=?21) was compared to a protein-enhanced (1.2?g/g protein/kg body weight/day with 30?g protein/meal; n?=?41; Protein) diet. Results showed no group effect of the Protein treatment on markers of renal function (estimated GFR, blood urea nitrogen, and creatinine), either upon intervention completion or one year later. Our findings align with literature support for the benefits of higher protein in the diets of older individuals during obesity reduction and help to confirm the safety of moderate increases in protein intake during weight loss in this population.     

某医院门诊住院人次变化的周期性分析

目的 分析评价某医院门诊住院人次变化的原因,为医院管理提供决策建议.方法 以某医院近5年门诊住院人次统计报表提供的数据为依据,采用时间序列直接平均季节指数法进行数据分析.结果 医院门诊人次旺季依次为12月、1月及5月,淡季依次为9月、2月及8月;周内比率显示门诊人次周一最高,周二开始下降,周四降至最低点,周五缓慢爬升,...     

Aflatoxin B1 reduces non-enzymatic antioxidant defenses and increases protein kinase C activation in the cerebral cortex of young rats

Objectives: Aflatoxin B1 (AFB1) is the most widespread mycotoxin, and it is a feed contaminant and is highly toxic, causing carcinogenic, mutagenic, and teratogenic effects. Many researches clarified the peripheral effects of the exposition to AFB1; however, there are few studies explaining their effects on central nervous system. The aim of the present study was to evaluate the effects caused by acute oral administration of AFB1 on behavioral tests and selected biochemical parameters.

Methods: Young male Wistar rats received a single administration of AFB1 (250?µg/kg/i.g.) and 48 hours thereafter they were subjected to behavioral analysis. After the tests, biochemical parameters were measured in the cerebral cortex.

Results: Acute treatment with AFB1 caused neurotoxic effects, evidenced by a significant reduction in the levels of non-enzymatic antioxidant defenses, ascorbic acid, and non-protein sulfhydryl groups. In addition, AFB1 increased protein kinase C (PKC) activation, evidenced by an increase in phosphorylation of Ser⁹⁵⁷ of PKCα.

Discussion: In this acute protocol, a single oral administration of AFB1 was able to cause changes in important neurochemical parameters, without concomitant, detectable behavioral alterations. These results reinforce that monitoring mycotoxin levels in food is essential to guarantee food security.     

Malnutrition in rats during different periods of pregnancy a study on body and brain weights and levels of DNA, RNA, protein and lipid in the cerebral region of their offspring

The objective of this study was to determine the time in which protein calorie malnutrition imposed on rats during pregnancy caused alterations in the brain composition of offspring. Results were obtained by organ weights and levels of lipids, DNA, RNA and protein in different areas of the central nervous system. Virgin rats were used and after the coitus confirmation were fed normal or deficient diet throughout or half of pregnancy and grouped accordingly. The offspring of malnourished rats were nursed by eutrophic mothers and the offspring of controls remained with their respective mothers during the 28-day lactation period. Some of the animals were killed at age 4 weeks and others kept up to adulthood. The most significant results were obtained from offspring of rats fed deficient diets throughout pregnancy. Up to the 28th day of life, offspring of rats malnourished during the first 11 days of pregnancy presented an accelerated growth reflected by the higher weights and DNA, RNA and protein content and normal lipid levels. This situation was not maintained in adulthood. Offspring of animals malnourished during the second half of pregnancy presented deficits in organ weights and DNA content up to adulthood, high RNA and protein contents in the three regions of the brain up to the 28th day of life. We conclude that depending on when it occurs, malnutrition during pregnancy alters the composition of different regions of the brain in different ways.