胱抑素C和尿微量白蛋白在早期肾损害中的应用

目的：探讨胱抑素C和尿微量白蛋白联合检测在高血压早期肾损害诊断中的临床应用价值。方法：以我院2012年12月～2014年12月收治的经病理确诊为高血压早期肾损害的患者83例作为研究对象,并以同期的健康体检者78例作为空白对照,采用免疫比浊法检测两组受检者的胱抑素C和尿微量白蛋白水平,比较单独检测和联合检测对诊断灵敏度和特异度的影响。结果：高血压早期肾损害患者的血清胱抑素C和尿微量白蛋白均明显高于正常对照组;此外,血清胱抑素C联合尿微量白蛋白检测的诊断灵敏度高达97.59%（81/83）,显著高于单独检测的80.72%（67/83）、87.95%（73/83）;而诊断特异度高达98.72%（71/78）,也显著高于单独检测的83.33%（65/78）、89.74%（70/78）;组间比较差异均具有统计学意义（P<0.05）。结论：胱抑素C和尿微量白蛋白对高血压早期肾损害均具有一定的诊断价值,但两者联合检测的灵敏度和特异度均较单独检测高,具有更高的应用价值,值得临床推广。     

胱抑素C与超敏C反应蛋白联合检测2型糖尿病早期肾损害的临床价值

目的检测2型糖尿病（T2DM）患者血清中胱抑素C（CysC）与血清尿素（Urea）、肌酐（Cr）、超敏C反应蛋白（hs-CRP）的水平,并评价胱抑素C（CysC）联合超敏C反应蛋白（hs-CRP）检测对预防糖尿病早期肾损害的价值。方法65例2型糖尿病无肾损害患者（单纯糖尿病组）、65例2型糖尿病肾损害患者（糖尿病肾损害组）和50例健康体检者（正常对照组）分别检测血清胱抑素C（CysC）、尿素（Urea）、肌酐（Cr）、超敏C反应蛋白（hs-CRP）水平。结果2型糖尿病肾损害患者CysC、Urea、Cr、hs-CRP水平均高于单纯糖尿病组与健康体检者,差异有统计学意义（P〈0.01）;2型糖尿病肾损害患者血清CysC阳性率显著高于Urea、Cr（P〈0.05）,CysC水平且与Urea、Cr水平呈正相关;2型糖尿病肾损害患者联合检测CysC、hs-CRP阳性率与各单项比较有显著差异（P〈0.05）且CysC与hs-CRP水平呈正相关。结论胱抑素C及血清超敏C反应蛋白是糖尿病早期肾损害敏感指标,联合检测对及时准确地诊断糖尿病早期肾损害有重要的临床价值。     

血清胱抑素C与尿白蛋白排泄率联合检测在高血压早期肾损害诊断中的应用

目的探讨血清胱抑素C与尿白蛋白排泄率联合检测在高血压早期肾损害诊断中的应用。方法选取2014年3月至2016年2月在我院治疗的高血压早期肾损害患者80例为实验组,并以同期的80例体检健康者为对照组,并采用全自动生化分析仪分别测定两组患者的血清胱抑素C含量和尿白蛋白排泄率,比较两组患者血清胱抑素C、与尿白蛋白排泄率水平及两项指标单独及联合检测的阳性率。结果实验组的血清胱抑素C、与尿白蛋白排泄率水平明显高于对照组,差异有统计学意义(P<0.05),且实验组中血清胱抑素C联合尿白蛋白排泄率检测的阳性率高达97.50%,明显高于血清胱抑素C与尿白蛋白排泄率单独检测的88.75%和80.00%,二者差异有统计学意义(P<0.05)。结论血清胱抑素C与尿白蛋白排泄率对高血压早期肾损害患者均有一定的诊断价值,二者联合检测灵敏度更高,有助于及早发现病情,值得在临床上应用推广。     

血清胱抑素C检测在妊娠高血压综合征肾损伤诊断中的临床意义

目的探讨血清胱抑素C检测在妊娠高血压综合征肾损伤诊断中的临床意义。方法选择2012年1月至2013年12月该院门诊和住院部确诊为妊娠高血压综合征的60例患者为观察组,根据病情程度,分为轻度组（21例）、中度组（20例）和重度组（19例）。另选择同期在该院进行健康体检的孕妇60例为对照组。所有受试人员均进行血清胱抑素C浓度检测,同时检测肾功能相关常规指标（尿素和肌酐）水平,绘制受试者工作特征曲线（ROC曲线）,并进行综合分析。结果观察组患者血清胱抑素C、尿素和肌酐水平较对照组显著提升,差异均有统计学意义（P〈0.05）。观察组患者血清胱抑素C阳性检出率在90.00%以上,轻度组患者血清胱抑素C阳性检出率为90.48%,分别与对应的尿素、肌酐阳性检出率（61.90%、66.67%）进行两两比较,差异均有统计学意义（P〈0.05）,中、重度组患者血清胱抑素C的阳性检出率分别与对应的尿素、肌酐阳性检出率进行两两比较,差异均无统计学意义（P〉0.05）。ROC曲线分析结果显示,3项指标对于妊娠高血压综合征肾损伤的诊断效率从高到低依次为血清胱抑素C、肌酐、尿素。结论血清胱抑素C对于诊断妊娠高血压综合征患者的早期肾损伤具有较高的灵敏度和临床价值,值得在临床推广应用。     

血清胱抑素C和尿微量白蛋白联合检测对高血压早期肾损害的诊断价值

目的：探讨血清胱抑素C（Cys-C）和尿微量白蛋白（UmAlb）联合检测对高血压早期肾损害的诊断价值。方法选择151例高血压患者,其中,高血压1级62例,高血压2级48例,高血压3级41例。另选取同期在本院作健康体检者60例作为对照组。分别采血及24 h尿液检测Cys-C和UmAlb水平并进行比较分析。结果高血压1级、2级、3级三组患者血清Cys-C及UmAlb水平均显著高于对照组（P均〈0.01）;高血压1级、2级、3级三组间Cys-C和UmAlb水平比较,差异均有显著统计学意义（高血压1级组〈2级组〈3级组, P均〈0.01）。结论血清Cys-C和UmAlb均为反映高血压早期肾功能损害的敏感指标,两者联合检测对高血压早期肾损害的诊断有重要价值。     

血清胱抑素C在肝硬化患者肾功能评价中的意义

目的探讨血清胱氨酸蛋白酶抑制剂C（胱抑素C）在诊断肝硬化患者肾功能损害中的应用价值。方法检测36例肝硬化患者和30例健康体检者的血清胱抑素C（CysC）水平,尿微量白蛋白排泄率（UAER）和血清肌酐（Cr）。结果肝硬化患者UAER正常组,微量组及大量组间CysC水平差异有统计学意义,随病情加重Cysc水平升高。结论肝硬化患者早期肾损害时,Cysc已有变化,检测Cysc可以有效的判断肝硬化患者是否存在肾功能异常。     

妊高征患者血清CYSC与UMA检测的临床意义

目的探讨妊高征患者尿微量白蛋白（Microalbuminuria,MA）、血清胱抑素C（CysC）与血清尿素（Urea）、肌酐（Cr）、尿酸（UA）联合检测的临床意义。方法对50例正常妊娠晚期妇女及65例妊高征患者测定血清中胱抑素C与其他肾功能指标;同时检测尿MA并进行分析比较。结果妊高征患者各指标血清值较对照组增高有统计学意义（P〈0．05）。其中重度妊高征患者的各指标血清值较轻度、中度妊高征明显增高（P〈0．01）,胱抑素C与微量白蛋白检测值对重度妊高征肾损害有很好的阳性预测率。结论尿MA和血清CysC具有较好的早期肾损伤诊断价值,在重度的妊高征中有明显变化,与其他肾功能指标联合能灵敏反映重度妊高征患者早期肾损害。     

尿微量白蛋白与血清胱抑素C联合检测对高血压早期肾损害诊断的应用价值

目的：研究联合检测尿微量白蛋白（UmAlb）和血清胱抑素 C（SCys-C）对高血压早期肾损害的诊断价值。方法选取高血压早期肾病患者80例为观察组,选取同期来院行健康体检者80例为对照组,统计分析2组患者SCys-C、肌酐和晨 UmAlb 的水平。结果观察组 SCys-C、UmAlb 均显著高于对照组（P ＜0.05）,2组血肌酐水平比较差异无统计学意义（P ＞0.05）。相关性分析提示 SCys-C 与 UmAlb 呈现高度相关性（r =0.512,P ＜0.05）,提示 SCys-C的水平将随着 UmAlb 升高而升高。结论高血压早期肾损害患者损害程度较轻,血清肌酐水平尚未发生显著变化时,联合检测 SCys-C 及 UmAlb 对于诊断高血压早期肾病具有重要诊断价值。     

血清胱抑素C在妊娠期高血压早期肾损害中的诊断意义

目的：研究血清胱抑素C（cystatin,Cys-C）检测在妊娠期高血压患者早期肾损害的诊断意义。方法：选取60例妊娠期高血压患者作为观察组,另选取同期60例正常健康孕妇作为对照组,检测两组对象血清胱抑素C（Cys-C）水平、尿酸（UA）含量以及尿液24h尿微量清蛋白定量水平。Cys-C测定采用胶乳增强免疫透射比浊法,UA含量采用过氧化物酶-尿酸酶偶联法,24h尿微量清蛋白定量采用散射比浊法。结果：观察两组研究对象血清胱抑素C、尿酸以及24h尿微量清蛋白定量水平发现,观察组明显较高,对比有差异,P＜0.05;而妊娠结果可见,早产、胎盘剥离、产后出血以及胎儿窘迫的发生率,观察组明显很高,对照组较低,对比有显著差异,P＜0.05。结论：血清胱抑素C的水平对妊娠期高血压早期肾损害有重要诊断价值,值得临床应用及推广。     

血清胱抑素C检测在妊娠期早期肾损害中的临床意义

目的：探讨血清胱抑素C检测在妊娠期早期肾损害中的临床意义。方法选择本院门诊或者住院的妊娠高血压综合征患者共30例,作为观察组;同时选择到本院接受孕期检查的正常晚期妊娠者共30例,作为对照组;同时选择到本院体检的健康非妊娠妇女共30例,作为正常组。检测血清胱抑素C、血尿素氮、肌酐、血尿酸、尿微量白蛋白水平。结果观察组血清胱抑素C水平高于对照组,对照组血清胱抑素C水平高于正常组,差异有统计学意义（P〈0.05）;观察组血尿素氮水平和正常组比较,差异无统计学意义（P〉0.05）;观察组肌酐水平高于对照组和正常组,差异有统计学意义（P〈0.05）;对照组血尿酸水平高于正常组,差异有统计学意义（P〈0.05）;观察组尿微量蛋白水平高于正常组和对照组,差异有统计学意义（P〈0.05）。结论血清胱抑素C检测有助于了解妊娠期早期肾损害,具有重要临床检测意义。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.