吲哚昔芬对大鼠成骨细胞增殖和Ⅰ型胶原合成的影响

目的研究吲哚昔芬对大鼠成骨细胞增殖和Ⅰ型胶原合成的影响。方法分离、培养大鼠头盖骨成骨细胞,分别采用四唑盐(MTT)比色实验和3H-Proline(3氢-脯氨酸)法测定成骨细胞增殖和Ⅰ型胶原合成的情况。结果吲哚昔芬作用大鼠成骨细胞48、72h,1×10-10 mol/L吲哚昔芬与对照组比较,MTTA490nm值显著升高(P<0.05),1×10-9、1×10-8 mol/L的吲哚昔芬使MTTA490nm值进一步升高(P<0.01)。经1×10-10 mol/L吲哚昔芬作用72、96h,3H-Proline掺入值显著升高(P<0.05),1×10-9、1×10-8 mol/L的吲哚昔芬使3H-Proline掺入值进一步升高(P<0.05)。分别用1×10-10 mol/L吲哚昔芬和雌二醇作用大鼠成骨细胞72h,二者的MTTA490nm值和3H-Proline掺入值均显著高于对照组,且吲哚昔芬MTTA490nm值和3H-Proline掺入值显著高于雌二醇(P<0.05)。结论吲哚昔芬发挥抗骨质疏松作用在短期主要促进成骨细胞增殖,中期既促进成骨细胞增殖又促进Ⅰ型胶原合成,而长期效应主要是通过促进胶原合成实现,并且其效应显著强于雌二醇,提示吲哚昔芬对骨质疏松的防治作用可能优于雌二醇。     

门静脉系统用药制备犬肝硬化模型过程中肝储备功能的变化

目的　对肝硬化门静脉高压症的术式及手术时机的选择提供依据。方法　对成年杂种犬进行脾静脉属支置管术 ,每周 3次经管内应用 0 .8ml/kg体重的 1 0 %CCl4 脂肪乳溶液 ,制备犬肝硬化模型。第 2、4、6、8、1 0周末采取小块肝组织 ,测定血清生化指标 ,进行吲哚氰绿排泄试验及口服糖耐量试验 ,并测取门静脉压力。结果　肝储备功能在用药 8～ 1 0周间下降显著 ,吲哚氰绿清除率由 0 .1 31± 0 .0 1 3降至 0 .0 52± 0 .0 0 9,吲哚氰绿 1 5min滞留率由 9.52± 1 .50升至 31 .30±8.50。口服糖耐量试验 (1 2 0min) (8.3± 0 .7)mmol/L升至 (1 4 .9± 2 .3)mmol/L。结论　肝硬化进展中 ,肝储备功能逐渐下降 ,肝功能、口服糖耐量试验及吲哚氰绿排泄试验 ,对肝硬化进展程度具有较高的评价价值     

吲哚美辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征患者疼痛的研究

我们采用吲哚美辛治疗以疼痛为主诉的慢性非细菌性前列腺炎 /骨盆疼痛综合征 (CPPS)患者 ,效果较好 ,现报告如下。材料与方法　本组 180例。年龄18～ 4 9岁 ,平均 31岁。病史 3个月～ 4年。患者均以下腹部、会阴区、腰骶部、睾丸阴囊疼痛为主诉 ,分别伴有性功能减退、尿频等症状。均根据病史、症状和Meares Stamey“四杯法”诊断为CPPS ,并系统检查除外其他可能引起上述疼痛的疾病。 180例随机分为吲哚美辛组、左氧氟沙星组、特拉唑嗪组 3组 ,每组6 0例。吲哚美辛组肛塞吲哚美辛 10 0mg ,根据疼痛程度 1～ 2次 /d。左氧氟沙星组口服左氧…     

吲哚菁绿应用于先天性胆管扩张症腹腔镜治疗的价值初探

目的:探讨采用吲哚菁绿荧光辅助腹腔镜肝外扩张胆管切除、胆肠吻合术治疗先天性胆管扩张症的应用价值与技术要点。方法:回顾分析2021年5月至2021年12月为5例先天性胆管扩张症患者行吲哚菁绿荧光辅助腹腔镜肝外扩张胆管切除、胆肠吻合术的临床资料,观察手术前后实验室检查及手术相关指标、术后并发症发生率、术后拔管时间、术后住院时间等。其中2例患者术前8～12 h于外周静脉注入吲哚菁绿5 mg, 3例患者术前0.5～1 h于外周静脉注入吲哚菁绿5 mg。结果:5例患者均完成腹腔镜手术,无吲哚菁绿过敏反应,胆总管均被吲哚菁绿染色显影。总手术时间145(35)min,术中出血少于50 mL,均未输血。术后引流管拔除时间4(1)d,术后住院7(1.5)d,无≥Clavien-DindoⅡ级并发症发生。结论:吲哚菁绿辅助腹腔镜肝外扩张胆管切除、胆肠吻合术治疗先天性胆管扩张症安全、可行,术中胆总管显影可指导手术,具有一定的应用价值。     

测定肝功能时吲哚菁绿清除试验的影响因素分析

目的 探讨肝有效血流量、总胆红素、乙型肝炎、血浆总蛋白等因素对吲哚菁绿排泄试验的影响及可能的机制。方法 通过对127例患者进行吲哚菁绿清除试验,运用多元线性回归的统计学方法,以15 min吲哚菁绿滞留率（ICGR15）为变量,以肝有效血流量（EHBF）、血浆总蛋白（TP）、总胆红素（TBIL）、乙型肝炎（HBV）为自变量,综合分析多个独立因素对吲哚菁绿排泄试验的影响及可能的机制。结果 回归模型ICGR15=25.469-20.520 EHBF+0.044 TBIL+4.217 HBV;F=70.734,P＜0.01;修正R2=0.624,所拟合的回归方程具有统计学意义。结论 吲哚菁绿清除试验与肝有效血流量呈负相关,与总胆红素水平以及是否患有乙型肝炎呈负相关。其机制可能是总胆红素与吲哚菁绿竞争性结合载体,与乙肝导致的肝硬化及其肝血流量变化有关,而血浆总蛋白对吲哚菁绿清除试验的影响尚需进一步研究。     

吲哚美辛预防髋臼骨折术后异位骨化的临床研究

目的通过服用吲哚美辛预防髋臼骨折术后异位骨化(HO)的发生以了解非甾体类抗炎药抑制HO形成的效果。方法对2001年2月～2003年8月采用Kocher-Langenbeck(K-L)入路治疗并在术后服用吲哚美辛的50例髋臼骨折患者进行随访研究(用药组),其结果与1993年3月～1998年5月采用相同后入路治疗而在术后未服用吲哚美辛的40例髋臼骨折患者进行对照研究(对照组)。用药组患者从术后第1天开始口服吲哚美辛,25 mg/次,3次/d,应用4周。术后定期对患者进行复杏。随访术后HO的发生情况,并对所有患者进行临床功能评价。结果用药组48例患者获完整资料随访,平均随访时间为22．8个月(6～39个月)。8例患者发生HO,据Brooker分型：Ⅰ度5例,Ⅱ度3例,尤严重HO(Ⅲ、Ⅳ度)发生；HO的发生率为16．7。对照组40例患者获平均26．4个月(4～58个月)随访。14例患者发生HO,HO发生率为35．0%,其中4例为严重HO。两组患者HO和严重HO的发生率差异均有显著性意义(P＜0．05)。结论吲哚美辛对髋臼骨折术后HO形成有一定的预防作用。     

增殖及非增殖腺病毒载体介导的RNA干扰对肾癌细胞杀伤作用

目的比较荷载Ki67基因小干扰RNA（Ki67-siRNA）的增殖腺病毒ZD55-Ki67及非增殖腺病毒Ad-Ki67对肾癌细胞的杀伤作用。方法MOI=10的ZD55-Ki67、Ad-Ki67感染肾癌786-0细胞，2d后收集细胞，蛋白印迹法检测E1A表达；逆转录-聚合酶链反应（RT-PCR）、蛋白印迹法、免疫细胞化学法检测Ki67表达；原位末端标记法（TUNEL）检测凋亡。4d后噻唑蓝（MTT）法检测细胞存活率，7d后结晶紫染色法检测细胞毒性作用。结果感染ZD55-Ki67的786-0细胞表达E1A，感染Ad-Ki67的细胞不表达E1A。ZD55-Ki67、Ad-Ki67感染的786-0细胞Ki67mRNA表达率分别为（37．9±2．3）％、（64．1±1．9）％；Ki67蛋白表达率分别为（42．5±2．4）％、（60．1±2．2）％；Ki67染色阳性率分别为（20．8±2．8）％、（32．3±2．5）％；786-0细胞存活率分别为（22．2±3．0）％、（60．4±3．4）％；凋亡率分别为（53．0±3．7）％、（35．3±2．5）％，两种病毒处理之间差异均有统计学意义（P〈0．01）。结论ZD55．Ki67抑制786-0细胞Ki67表达及增殖、诱导凋亡及细胞毒性作用均显著优于Ad-Ki67。增殖腺病毒介导的RNA干扰杀伤肾癌细胞作用优于非增殖腺病毒。     

肝移植术后期主要死亡原因分析

目的 研究肝移植术后期的死亡率和主要死亡原因，探讨肝移植术后期导致死亡的主要并发症的风险因素、预防和治疗。方法回顾性地研究1981年2月至1998年4月进行的生存期大于1年的2940例肝移植长期随访结果，着重分析其主要死亡原因与相关因素。结果肝移植术后第1～10年死亡率依次为20．4％，6．7％，4．5％，3．8％，3．7％、4．6％，3．5％，3．3％，2．9％，1．9％。后期死亡817例，主要原因依次为恶性肿瘤(复发 新生；20．69％)、心血管并发症(11．38％)、各种感染(11．26％)和呼吸系统并发症(9．42％)。结论肝移植术后期主要死亡原因为复发或新生恶性肿瘤、心血管并发症、各种感染和呼吸系统并发症。尽早预防和及时治疗这些并发症，成为进一步提高肝移植长期生存率的关键。     

吲哚菁绿荧光成像技术在四例腹腔镜脾部分切除术中的应用

目的:探讨吲哚菁绿荧光成像技术在腹腔镜脾部分切除术(LPS)中的临床应用价值。方法:回顾分析首都医科大学附属北京潞河医院2017年5月至2020年5月利用吲哚菁绿荧光成像技术辅助完成的4例LPS患者资料,女性3例,男性1例,年龄分别为46、41、27、12岁。分析手术情况,术中通过吲哚菁绿荧光成像与普通白光对比确定保脾...     

气腹对肝硬化大鼠肝脏血流的影响

目的：探讨气腹压力下正常机体及肝硬化机体肝脏吲哚青绿排泄的变化及气腹对肝脏血流的影响。方法：雄性Wistar大鼠30只,随机分成5组,其中2组用60％四氯化碳皮下注射加5％乙醇口服的方法建立肝硬化模型。同期对5组进行吲哚青绿15min排泄试验：正常麻醉组、正常开腹组、正常气腹组、肝硬化麻醉组、肝硬化气腹组。结果：5组分别测得血清吲哚青绿含量,正常开腹组（0．662μg/ml）虽高于正常麻醉组（0．645μg/ml）,但差异无显著意义（P＞0．05）;正常气腹组（0．967μg/ml）显著高于麻醉组及开腹组（P＜0．05）;而肝硬化麻醉组（1．198μg/ml）和肝硬化气腹组（1．348μg/ml）均显著高于正常3组（P＜0．05）;肝硬化气腹组又显著高于肝硬化麻醉组（P＜0．05）。结论：气腹使吲哚青绿排泄降低的结果,证实了腹腔镜手术中的气腹压力可减少肝脏血流量,对于肝硬化机体更有临床意义。     

A modification of the estimation of urinary oxalate using a Sigma kit

The Sigma kit for estimating urinary oxalate is an enzymatic procedure. However, some errors were encountered using the standard assay system of the kit. Firstly, an overestimate of oxalate may arise from the oxidation of ascorbate during the alkaline wash stage of the extraction of oxalate from urine. Secondly, an underestimate of oxalate may occur because of incomplete extraction of oxalate. A modified assay system for measurement of urinary oxalate using the kit is reported. The following points were modified: urine was diluted two-fold with 0.2 M EDTA and and 0.2 M citrate buffer (pH 3.0), oxalate from urine was extracted with 0.06 N sodium hydroxide to prevent the overestimation by the oxidation of ascorbate, and a plate mixer and addition of a small magnet to the vial were used in the steps of both absorption and extraction of oxalate to keep the accuracy of the estimation. The linearity of standard curve, reproducibility and recovery rates of the modified method were studied, and good results were obtained (linearity; r = 0.999, CV of reproducibility; 5.3%, recovery rate; 101% (300 microM) and 103% (600 microM). A good correlation was seen between the modified Sigma method and high performance liquid chromatography (r = 0.991).     

Evaluation of the enzymatic method using oxalate oxidase for urinary oxalate assay

The principle of this kit method is that urinary oxalate is extracted and subsequently assayed by measuring the amount of hydrogen peroxide produced in an oxidation reaction catalyzed by oxalate oxidase. The reproducibility and accuracy of the method were tested: the within-run and day-to-day coefficients of variation were 5.4-20.0% and 16.1-18.0%, respectively, and the overall recovery rate of the added oxalate (5-25 mg/l) was 40-50%. These abnormally low recovery rates may be related to the presence of sulfate and phosphate in the extracted fluid. Therefore, the above method was modified by performing a recovery test by adding 25 mg/l oxalate to all urine samples. By the modified method, the correlation coefficient obtained between this method and the ion-chromatographic method was 0.851 (p less than 0.01). Urinary pretreatment with either acid ferric chloride or EDTA yields a higher recovery than with HCl. However, a good correlation of oxalate values is consistently observed for HCl-processed urine as measured by the above two methods. If the interference of ascorbic acid is negligible, no special urinary treatment except for HCl is necessary. The 24-hour urinary oxalate excretions were 24.4 +/- 9.1 mg (mean +/- SD) in 8 healthy males and 19.9 +/- 10.3 mg in 24 calcium-stone formers (21 males and 3 females).     

Clinical significance of tumor markers in prostatic carcinoma--comparative study of prostatic acid phosphatase, prostate specific antigen and gamma-seminoprotein

We measured the prostatic acid phosphatase (PAP), gamma-Seminoprotein (gamma-Sm) and prostate specific antigen (PA) in the serum of 862 patients with various urologic diseases including 89 patients with prostatic cancer. We used a PAP radioimmunoassay kit, gamma-Sm enzyme immunoassay kit, Markit-F-PA enzyme immunoassay kit and PA test Wako enzyme immunoassay kit. Serum PA level in advanced prostatic carcinoma (stage C, D) tended to be higher than that in early stage cancer (stage A, B). The Wako kit gave a higher PA than the Markit-F in each stage. The sensitivity rate of Wako PA test was the highest (81%) of all kits. The specificity rate of PAP was the highest (83%), and the accuracy rate of Markit-F PA was the highest (79%). The positive rate in the combined assay of PAP, gamma-Sm and PA in prostatic cancer was higher than that in the single assay of each tumor marker. We regarded PAP, gamma-Sm and PA as clinically different tumor markers, because their serum level did not correlate definitely. No apparent correlation was found between histopathological grade and the level of each tumor marker. The level of PAP, gamma-Sm and PA in the reactivated patients was significantly higher than that of the well-controlled patients. In the reactivated patients, the positive rate of Markit-F PA was the highest (89%) of all the kits.     

Comparison of 3 assay kits of prostate specific antigen in serum of prostatic cancer

The serum prostate specific antigen (PA) of the patients with prostatic cancer were determined with 3 assay kits, the Diagnostic Products Cooperation (DPC) kit, the Eiken kit and the Dainippon Pharmaceutical Co. (MARKIT F) kit. The first 2 assay kits involve radioimmunoassay and the latter EIA. For comparison, prostatic acid phosphatase (PAP) and gamma-seminoprotein (gamma-Sm) were determined using an Eiken kit and Chugai kit. Efficiency of the DPC kit, Eiken kit and the MARKIT F kit for untreated prostatic cancer was 26, 25 and 36%, respectively. The PA level measured using the Eiken kit and the MARKIT F kit both well correlated to the PAP level, but with the DPC kit correlation was slightly low. The PA level measured using the 3 different kits correlated poorly with the gamma-Sm level. The PA values obtained with 3 different assays from patients with prostatic cancer were highly correlated, but showed great differences in the values measured. When the standards used in the DPC kit were analyzed by the Eiken kit, the DPC standards as measured by the Eiken kit had only about half of their assigned values. The same standards were analyzed by the MARKIT F kit, the standards yielded measured values about one third of their assigned values. When the standards used in the MARKIT F kit were analyzed by the Eiken kit, the MARKIT F standards yielded measured values about 2.5 fold of their assigned values. The differences between the values obtained with the 3 assay kits presented a serious problem in clinical use of PA. Standardization of these assay kits will be awaited.     

两种市售试剂盒检测无症状男性不育症门诊患者支原体感染及药敏状况

目的了解无症状男性不育症门诊患者支原体感染情况,比较两种试剂盒检测结果的判定符合率和药敏结果。方法使用两种市售试剂盒对303例男性不育症门诊患者的尿道棉拭子进行支原体培养、测定和药敏试验。结果两种试剂盒解脲脲原体（UU）培养阳性率分别为14．85％、15．84％,人型支原体（MH）培养阳性率均为2．97％;UU培养阳性和阴性结果判定总符合率达97．03％,MH总符合率高达100％;两种试剂盒敏感率最高的3种药物分别为交沙霉素（JOS）、强力霉素（DOx）、美满霉素（MIN）和阿奇霉素（AZI）、克拉霉素（CLA）、JOS,耐药率最高的药物均为环丙沙星（CIP）。结论无症状男性不育人群中确实有一定水平的支原体感染率或者携带率,市售两种试剂盒的支原体培养和药敏试验性能比较稳定、结果相对可靠。     

两种精浆酸性磷酸酶检测方法的比较与评价

目的:对检测精浆酸性磷酸酶(ACP)活性的常规方法(磷酸苯二钠法)和试剂盒方法进行比较,并探讨试剂盒方法取代常规方法用于常规检测的可能性。方法:79份不育男性的精浆,分别用常规方法和试剂盒方法检测其ACP活性。取1份精浆标本用于两种方法的批内检测,另取2份标本用于两种方法的批间检测。随机留取10份精浆标本,稀释后立即或放置30 m in后检测ACP活性。另随机留取10份精浆标本,同时由2位技术人员分别用常规方法检测ACP活性。结果:试剂盒方法所测ACP活性与常规方法显著相关(r=0.745,P=0.000)。试剂盒方法与常规方法相比,两者批内CV(13.72%;10.66%)比较接近,而批间CV(13.8%和15.49%;24.43%和21.04%)明显较低。精浆稀释后放置30 m in,无论是常规方法还是试剂盒方法,所测结果都显著降低(P<0.05)。而2位技术人员用常规方法所测精浆ACP活性无显著区别(P=0.165)。结论:试剂盒方法检测精浆ACP活性优于常规方法,可以取代常规方法。     

Evaluation of commercial immunoperoxidase kits in diagnosis of prostate carcinoma

Comparison of one commercial immunoperoxidase kit for prostate specific acid phosphatase (PSAP) and two for prostate specific antigen (PA) with an unlabelled antibody peroxidase-antiperoxidase (PAP) technique using rabbit antihuman PSAP revealed generally good reproducibility of results on formalin fixed, paraffin-embedded sections of primary and metastatic prostatic carcinoma. Frequency of positivity was 92 per cent with both our noncommercial PAP and the kit method for PSAP, and 82 per cent and 89 per cent with kits for PA. Thus, sensitivity, with the PA kits was less than with our noncommercial PAP and the kit PSAP, with less intense immunostain and occasional false negatives. Specificity was good with all three kits, and no false positive results were obtained. Commercial immunoperoxidase kits provide a relatively easy and inexpensive means for practicing pathologists in a service-oriented setting to make more precise diagnoses in cases of poorly differentiated or metastatic carcinoma of prostatic origin.     

一种高效同时提取微量组织中总RNA、DNA和蛋白的技术方法的改进

目的 改进传统Trizol法,以至能从微量组织样品中提取高质量RNA并同时提取基因组DNA和总蛋白.方法 用改良后的Trizol法提取小鼠肝脏组织总RNA、基因组DNA以及总蛋白,并与传统Trizol法提取总RNA、商业化试剂盒提取基因组DNA和RIPA裂解Buffer提取总蛋白的方法进行比较.结果 改良Trizol法提取小鼠肝组织RNA的得率为3.64μg/mg,传统Trizol法为1.95μg/mg,平均D260/280比值为2.1和2.01;改良Trizol法能够得到比传统Trizol法更完整的RNA,琼脂糖电泳图谱中28S/18S的比值更接近2∶1.改良Trizol法与商业试剂盒相比,提取所得的基因组DNA尽管在得率上有较明显差距,分别为0.49μg/mg和1.78μg/mg,但仍保持较好的纯度.改良Trizol法提取所得蛋白的平均得率为RIPA Buffer裂解法的50％~60％,经过SDS-PAGE电泳和考马斯亮蓝染色法验证,并无明显蛋白丢失.结论 改良Trizol法可以同时提取组织的总DNA、RNA与总蛋白,相比传统Trizol法提取总RNA更高效、质量更优;相比商业化试剂盒提取基因组DNA更快捷、更经济;相比RIPA Buffer裂解法提取总蛋白在小分子蛋白的保留中更好.     

优化后的线粒体抗体检测试剂盒与两种同类进口试剂盒的比较

目的　将组建的原发性胆汁肝硬化 (primarybiliarycirrhosis,PBC)自身抗体检测试剂盒进行条件优化 ,与欧蒙公司 (EuroimmuneMedicalLaboratoryDiagnostics)和ORGENTEC公司的同类试剂盒比较检测效果。方法　将本室组建的PBC自身抗体ELISA检测试剂盒的标本稀释液和底物显色液进行条件优化 ,在同样条件下同时用该试剂盒和欧蒙试剂盒共同检测 559份血清标本 ,同样和ORGENTEC试剂盒共同检测 90份血清标本。结果　确定了以菌液Buffer作为标本稀释液 ,筛选出底物A、B液以确保标准血清的准确性 ;试剂盒与欧蒙和ORGENTEC试剂盒检测结果比较无明显差异。结论　优化后试剂盒能够准确地检测原发性胆汁肝硬变患者血清中的自身抗体 ,检测效果不亚于两种进口试剂盒     

Simple narcotic kits for controlled-substance dispensing and accountability

Operating rooms require a storage, dispensing and accounting system for restricted drugs which satisfies narcotics control authorities and is compatible with efficient care of patients. We describe narcotic kits containing fentanyl-morphine-midazolam, alfentanil-midazolam and sufentanil-midazolam, for general operating rooms, and two kits with larger quantities of fentanyl and sufentanil for cardiac operating rooms. The container for each kit is a video cassette holder which has a foam-rubber liner with sculpted depressions for each ampoule. Sealed kits are delivered each morning from pharmacy to the locked narcotics cupboard in the recovery room. On request, the recovery room nurse unlocks the cupboard and the anaesthetist signs out the required kit(s) for the day. A drug utilization form is enclosed with each kit, on which the anaesthetist records the amount of drug administered to each patient, and before returning the kit to the locked narcotics cupboard, the total amount of each drug used, discarded, and returned. Used kits are collected the following morning by a pharmacy technician who reconciles the contents and drug form of each kit. More than 40 staff anaesthetists and a similar number of residents have used the system for seven years, during which time 130,000 patients have passed through the operating rooms. Detection of one case of drug diversion by a staff anaesthetist was made partly by the control system, but mainly by behavioural changes. The system is simple, inexpensive, and effective and has been well received by the departments of pharmacy, anaesthesia, and nursing.