Measurement Accuracy of Aluminium Content in Bone

Abstract

The aluminium content in bone has been related in several ways: to the weight of wet bone, to the weight of dry bone, to the weight of bone-ash and to the calcium content of bone. We determined the accuracy and precision of measurement (using an inductively coupled mass-spectrometer) in 30 bone samples taken from one patient. The coefficient of variation of the aluminium/weight-quotient was 12.4 per cent for wet bone, 4.7 for dry bone and 5.0 for bone ash; and the coefficient of variation of the aluminium/calcium-weight-quotient was 7.5 per cent. Thus, the aluminium content in bone seems to be best related to the weight of dry bone.     

A case of severe preeclampsia diagnosed as post-partum hemolytic uremic syndrome

Post-partum hemolytic uremic syndrome (PHUS) is a severe thrombotic microangiopathy clinically characterized by hemolytic anemia, renal dysfunction, and low platelets after birth with rapid progression and poor prognosis. Here, we reported a rare case of severe preeclampsia diagnosed as hemolytic uremic syndrome after birth. The patient was diagnosed with PHUS and underwent intermittent plasma exchange with supportive treatment including glucocorticoid injections and transfusion of suspended red blood cells. After these treatments, the patient experienced no apparent remission and chronic renal dysfunction occurred on her. PHUS is a severe emergency with acute onset, rapid progress, and poor prognosis. Early detection, diagnosis, and treatment can significantly improve the prognosis.

     

糖皮质激素治疗儿童非腹泻相关溶血尿毒综合征的疗效评价

目的：探讨应用糖皮质激素治疗儿童非腹泻相关溶血尿毒综合征（HUS）临床症状改善的时间,评估其疗效。方法：选择22例非腹泻相关HUS患儿作为研究对象。根据患儿急性期在使用血浆的同时是否联合使用糖皮质激素,将患儿分为单纯血浆治疗组（n=11）和血浆联合糖皮质激素治疗组（n=11）,分析2组患儿平均住院时间、尿色转清时间、血小板及血肌酐恢复正常水平的时间,并收集2组患儿出院后的临床资料,根据随访结果评估2组患儿的预后。结果：与单纯血浆治疗组比较,血浆联合糖皮质激素治疗组患儿平均住院时间、尿色转清时间和血肌酐恢复正常水平时间均缩短,但差异无统计学意义（P>0.05）。2组患儿血小板升至正常水平时间比较差异无统计学意义（P>0.05）。单纯血浆治疗组有10例患儿顺利完成随访,其中1例患儿遗留高血压后遗症,1例患儿在出院1年后病情复发;血浆联合糖皮质激素治疗组9例患儿顺利完成随访,其中1例患儿持续尿检异常,并遗留听力受损,生长发育较同龄儿缓慢,其余随访患儿达到临床治愈标准。单纯血浆治疗组临床治愈率为80.0%,血浆联合糖皮质激素治疗组临床治愈率为88.9%,组间临床治愈率比较差异无统计学意义（P>0.05）。结论：在儿童非腹泻相关HUS的急性期使用糖皮质激素并不能缩短患儿的急性期病程,也不能改善患儿的预后。     

成人不典型溶血尿毒综合征临床分析及诊治体会

目的 探讨成人不典型溶血尿毒综合征的临床特点及诊治经验.方法 回顾性分析2005～2011年我院诊断成人不典型溶血尿毒综合征患者共5例,总结分析其临床表现、辅助检查、治疗方法及疗效.结果 5例患者中,治愈2例,死亡1例,遗留肾功能不全2例,其中1例最终走向透析,1例肾功能长期保持稳定.其中,与妊娠相关者共3例.早期血浆置换可有效控制病情,改善预后,糖皮质激素的效果尚不确定.肾脏病理改变是估计预后的重要指标.以小动脉改变为主的预后差.结论 成人不典型溶血尿毒综合征病因多样、预后较差.早期诊断、早期治疗是改善预后的关键因素.     

小儿重型溶血尿毒综合征诊治研究

目的探讨影响重型溶血尿毒综合征(HUS)的预后因素,并评价治疗方法。方法分析10例重型HUS患儿临床资料,采用血浆置换加连续血液净化等综合治疗措施。结果本组病例急性期均存活,溶血控制,肾及其他各脏器功能大多恢复正常。随访时间3个月至10年,血压、尿素氮(BUN)、肌酐(CRE)恢复正常8例,尿常规正常7例,尿常规轻度异常3例;反复发生溶血并急性肾功能衰竭3例,经积极治疗溶血控制,BUN、CRE均恢复正常;尿液检查正常1例,轻度蛋白尿、血尿1例,发展为慢性肾功能不全1例。结论影响预后的主要因素为急性期病情轻重及是否早期采用以血浆置换加血液净化为主等综合治疗措施。     

血栓性血小板减少性紫癜和溶血性尿毒症综合征肾脏病理特点分析

目的探讨血栓性血小板减少性紫癜和溶血性尿毒症(TTP/HUS)综合征的临床与肾脏病理特点.方法回顾性分析7例TTP/HUS综合征患者的临床特点并总结其中3例的肾脏病理特征.结果临床表现包括血小板减少6例、微血管病性溶血性贫血7例、发热6例、神经系统损害6例和急性肾功能衰竭7例.肾损害表现包括无尿3例,肉眼血尿4例,镜下血尿3例,蛋白尿7例,为(2.5±1.9)g/L.肾脏组织学检查3例,主要表现为肾内动脉血栓栓塞、肾小动脉内膜增厚、肾小球毛细血管微血栓形成、肾小球弥漫性内皮细胞增生和系膜细胞增生.死亡1例,发展为尿毒症3例,遗留慢性肾损害3例.发病年龄小、肾病理损害轻、给予血浆置换治疗患者,短期预后相对较好.结论TTP/HUS综合征是临床急症,预后较差.肾组织学检查有助于预后评价和指导治疗.     

艾滋病合并恶性肿瘤10例临床病理分析

目的:分析艾滋病(AIDS)合并恶性肿瘤的临床与病理特点。方法:对会诊和复查的48例AIDS患者的病理活检与尸检材料进行临床、影像、解剖与病理对照研究。结果:48例AIDS患者中合并恶性肿瘤10例;其中儿童2例系母婴传播;成年人8例中经输血传播4例。合并非霍奇金淋巴瘤4例,乳腺癌2例,卡波西肉瘤1例,肝母细胞瘤1例,食管癌1例,肾癌1例。结论:AIDS患者易合并恶性肿瘤,疾病谱广泛,以淋巴瘤多见,确诊需依赖病理检查。     

普通变异型免疫球蛋白缺乏症5例并文献复习

目的旨在提高对临床表现各异的普通变异型免疫球蛋白缺乏症(common variable im-munodeficiency,CVID)的认识,以减少临床漏诊和误诊率。方法回顾我院5例CVID患者的诊治经过,并对该病的发病机制、免疫学改变和临床诊治等研究进展进行文献复习。结果5例患者分别以伴或不伴有发热、消化道、呼吸道症状就诊,最终检测免疫球蛋白明显降低而确诊,予丙种球蛋白及相应抗感染治疗后好转出院。结论CVID为原发性免疫缺陷病的一种,成年人发病多见,临床以反复感染为主要特征,尤以消化系统、呼吸系统为突出表现,可伴有自身免疫病和恶性肿瘤,血清免疫球蛋白明显减低有助于确诊。治疗上采取丙种球蛋白替代治疗。     

血浆置换联合连续血液净化救治重型溶血尿毒综合征的研究

目的 观察血浆置换(PE)联合连续血液净化(CBP)对重型溶血尿毒综合征(HUS)的作用.方法 9例重型HUS患儿在内科综合治疗同时,采用序贯血浆置换(PE)加连续性静-静脉血液滤过或序贯PE加连续性血液透析治疗.结果 经PE+CBP后患儿全身状况迅速改善,溶血控制,尿量增加,肾及其他各脏器功能检测指标逐步恢复正常,部分患儿尿常规轻度异常.结论 PE+CBP救治重型溶血尿毒综合征能增强疗效,尽早治疗可改善惠儿预后.     

Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

Background  Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.

Methods  It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4⁺ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 µg) were performed in 4 eyes (2 patients).

Results  Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque. Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4⁺ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×10⁶/L (range, (0–85) ×10⁶/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.

Conclusions  CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.

     

获得性免疫缺陷综合征患者的肺部感染

目的: 提高对获得性免疫缺陷综合征(AIDS)肺部机会性感染的认识。方法: 对18例AIDS患者进行临床分析。结果: 18例患者肺部感染临床症状有发热、消瘦、乏力、咳嗽、咳痰等。卡氏肺囊虫肺炎(PCP)9例;细菌性肺炎7例;霉菌性肺炎6例;肺结核5例;伴有其他多系统感染8例。结论: 肺部感染是AIDS患者晚期的主要机会性感染,其中PCP和细菌性肺炎最多,其次为霉菌性肺炎和肺结核,同时常伴有多系统损害。     

统性红斑狼疮合并产后溶血性尿毒症综合征1例报告

产后溶血性尿毒症综合征(postpartum hemolytic uremic syndrome,PHUS)是产科临床上少见的危急重症,起病急,进展快,病死率高,我院收治1例系统性红斑狼疮(systemic lupus erythematosus,SLE)合并PHUS的患者,经抢救无效死亡,现将诊治经过及体会报道如下:     

系统性红斑狼疮合并产后溶血性尿毒症综合征1例报告

产后溶血性尿毒症综合征(postpartum hemolytic uremic syndrome,PHUS)是产科临床上少见的危急重症,起病急,进展快,病死率高.我院收治1例系统性红斑狼疮(systemic lupus erythematosus,SLE)合并PHUS的患者,经抢救无效死亡,现将诊治经过及体会报告如下.     

Multiple malignancies in a female patient with common variable immunodeficiency syndrome

We herein present the case of a 55-year-old woman with a previous history of malignancies – uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.     

普通变异型免疫缺陷病合并肝硬化1例并文献复习

目的:讨论普通变异型免疫缺陷病(common variable immunodeficiency disease,CVID)的发病机制、临床表现及治疗方法。方法:报道1例普通变异型免疫缺陷病合并肝硬化患者并复习相关文献。结果:普通变异型免疫缺陷病是临床少见病,易误诊,病因不清,临床表现复杂,部分患者病程中可出现肝功能异常,甚至并发肝硬化。结论:临床反复感染的患者应考虑CVID的可能,须进一步作血浆免疫球蛋白的检测确诊。对已经确诊患者定期补充静脉丙种球蛋白,同时还应定期检查肝功能。     

Fighting against acquired immunodeficiency syndrome with Chinese medicine: A perspective from China

Continuing expansion of the human immunodeficiency virus(HIV)/ acquired immunodeficiency syndrome(AIDS) pandemic has been recognized as an exceptional challenge to global health.Taking highly active antiretroviral treatment (HAART),a confirmed effective treatment,has its limitations.While a much cheaper and potential treatment—the Chinese medicine(CM) has not been paid enough attention from the worldwide.We explained the CM viewpoints about pathology and etiology to answer some questions about whether and how CM can treat AIDS. Some herbal formulae and their targeted patterns and common symptoms were also introduced.Chinese government has realized the important role of CM as an independent therapy for early management,bolstering immune-system functions depressed by HIV,and has funded large randomized double-blind controlled clinical trials to more accurately assess the benefits,and valued the fundamental research to establish a quantitative standardization of pattern diagnosis.Researchers of CM are looking for cooperation with all the world’s top experts in the areas of AIDS and immunity to strive for victories in the fight against AIDS.     

猴免疫缺陷病毒感染猕猴快速进展型死亡特征

观察猴免疫缺陷病毒（ｓｉｍｉａｎｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｖｉｒｕｓ,ＳＩＶ）ＳＩＶｍａｃ和ＳＩＶｍａｃ２５１毒株感染猕猴快速进展型死亡的感染特征。方法用ＳＩＶｍａｃ和ＳＩＶｍａｃ２５１静脉接种,实验性感染８０只恒河猴和４只食蟹猴,定期采集静脉血浆进行病毒分离测定血浆病毒水平,间接免疫荧光法测定血浆病毒抗体水平,并取淋巴组织进行常规理组织学检查。结果８４只猕猴感染ＳＩＶｍａｃ和ＳＩＶｍａｃ２     

白介素6与肾脏病的关系

白介素6(interleukin-6，IL-6)是目前认为参与肾脏疾病发病最为密切的细胞因子之一。国内外已有一些研究，但结果不尽一致。现就IL-6与各种肾脏病之间的关系作一探讨。     

流行性出血热并发溶血性尿毒症综合征1例

1　病例报告　男,19岁,因发热、咯血6d,无尿4d,于1998-05-14入院.缘于1998-05-09突然畏寒、发热达39.7℃,2d后热退.次日咯血约50mL.第3病日突然无尿,伴黑便及一过性晕厥.既往身体健康.查体:T36.5℃,P108次/min,R20次/min,BP12/8kPa.重度贫血貌,颜面部明显浮肿.心界略扩大,心率108次/min,律齐,无杂音,双肺底可闻及湿性罗音.腹水征(+).右侧肾区叩痛(+).实验室检查:血WBC14.5×109·L-1,中性0.88;Hb48g·L-1,RBC1.6×1012·L-1,网织红细胞3%,血小板35×109·L-1;尿蛋白(),BLD(),Uro(±),WBC1～2个/HP,RBC5～6个/HP;粪常规正常;大…