血清胱抑素C在糖尿病肾功能检测中的价值和准确性分析

目的 分析血清胱抑素C在糖尿病肾功能检查中的应用价值,以便为日后临床检测提供可靠参考。方法 于2019年6月～2020年6月共计84例糖尿病患者作为研究对象,,依据是否伴有肾脏疾病分为单纯糖尿病组与糖尿病肾病组,各42例,同期选择42例健康体检人员作为对照组,均给予血清胱抑素C、血肌酐及尿素氮检测,就患者检查结果进行分析。结果 糖尿病肾病组患者血清胱抑素C(1.78±0.55)mg/L、血肌酐(94.71±18.93)umol/L、(7.96±2.79)mmol/L高于单纯糖尿病组(0.73±0.34)mg/L、(78.65±12.64)umol/L、(6.04±1.26)mmol/L以及对照组(0.55±0.17)mg/L、(55.84±11.57)umol/L、(5.12±1.57)mmol/L,且单纯糖尿病组血肌酐、血清胱抑素C、尿素氮均高于对照组,差异有意义(P<0.05);血清胱抑素C对糖尿病肾病的检出率为97.62%高于血肌酐检出率71.43%、尿素氮检出率66.67%,差异有统计学意义(P<0.05)。结论 血清胱抑素C在糖尿病肾功能检查中能起到良好的诊断价值...     

肾功能与脑白质疏松症的相关性研究

目的:探讨肾功能与脑白质疏松(leukoaraiosis LA)之间的关系.方法:选取162例患者,经过磁共振证实101例患诊断为LA;其余61例为健康病例,收集每个病例的尿素、肌酐、胱抑素C、年龄等信息.结果:LA组肌酐、尿素、胱抑素C的水平分别为80(66～97)μmol/L,6.04(4.61～7.16)mmol/L,0.97(0.80～1.12)mg/L;显著高于对照组69(60～85)μmol/L,5.1(3.83～6.85)mmol/L,0.75(0.68～0.87)mg/L;其P值分别为0.0044,0.0222和0.0001;进一步的多因素回归表明胱抑素C对LA的影响有统计学意义.结论:肾功能与LA之间有明显相关性.     

血清胱抑素C测定在早期肾脏疾病中的诊断价值

目的:探讨血清胱抑素C(CysC)检测在对肾脏疾病诊断中的临床价值。方法:应用微粒子增强比浊法检测血清CysC浓度;血清尿素(Urea)测定采用尿素酶法;肌酐(Cr)测定采用碱性苦味酸法。结果:肾病患者组中血清胱抑素C(CysC)与健康对照组比较,差异有显著性(P<0.01)。结论血清CysC检测可作为诊断肾病和肾功能早期损伤的指标。     

颅内压监测指导双额脑挫裂伤高冠状开颅脑挫裂伤清除术79例

目的 通过颅内压监测提高双额脑挫裂伤患者的救治成功率和预后.方法 回顾性分析2004年10月-2012年4月收治的79例双额脑挫裂伤患者,根据治疗方法分为颅内压监测组(40例),未颅内压监测组(39例).分析高冠状切口手术的时机、手术策略、颅内压监护在诊治中的重要性及对预后的影响.结果 颅内压监测组与未颅内压监测组比较,渗透性脱水时间[(14.24 ±7.93)d:(21.61±11.97)d,P＜0.01]、ICU监护时间[(14.38±7.56)d:(24.71±17.94)d,P＜0.01]、总住院时间[(17.20±8.09)d:(33.92 ±21.70)d,P＜0.01]明显缩短;6个月时GOS评分明显好于未颅内压监测组[(4.15±1.22)分∶(3.69±1.56)分,P＜0.05].结论 高冠状开颅手术尤其去骨瓣减压术是双额脑挫裂伤,特别是中重度双额脑挫裂伤患者最重要的控制颅内压、保障脑灌注压的治疗手段之一.颅内压监护有助于手术时机的选择,合理指导渗透性治疗、颅内压控制及脑灌注压保障等综合治疗.     

谷氨酰胺颗粒对创伤患者肠黏膜屏障功能的影响

目的　观察服用谷氨酰胺 (glutamine ,GLN)颗粒对创伤、烧伤及大手术患者肠黏膜屏障功能的影响及可能发生的不良反应。　方法　采用随机、双盲对照法 ,将受试患者分为谷氨酰胺组和安慰剂 (甘氨酸 )对照组 (P组 ) ,每组 6 0例 ,两组患者采用等氮、等热卡的营养支持。谷氨酰胺组口服或管饲谷氨酰胺 0 .5g·kg-1·d-1,P组使用同等剂量的安慰剂 ,疗程为 7d。比较各组患者用药前后血浆谷氨酰胺浓度、肠黏膜屏障功能、肝、肾功能及不良反应发生率。　结果　用药前两组患者血浆谷氨酰胺浓度明显低于正常值 ,肠黏膜通透性明显增高。与P组相比 ,谷氨酰胺组患者用药 7d后血浆谷氨酰胺浓度 [(5 92 .5 0± 185 .2 3) μmol/L]明显高于P组 [(4 0 7.4 1± 190 .2 2 )μmol/L) ],增幅达4 5 .4 % (P <0 .0 1)。谷氨酰胺组患者肠黏膜通透性明显改善 ,血浆二胺氧化酶(DAO)活性 [(1.2 2± 0 .4 5 )U/ml]、内毒素含量 [(0 .2 1± 0 .0 9)U/ml]、乳果糖 /甘露醇比值 (0 .11± 0 .0 7)明显低于P组 [分别为 (2 .2 7± 1.90 )U/ml、(0 .2 7± 0 .0 9)U/ml和 0 .2 3± 0 .13],降幅分别为 4 6 .3%、2 2 .2 %和 5 2 .2 % (P <0 .0 5～ 0 .0 1)。血、尿常规及肝、肾功能两组之间差异无显著性意义 (P >0 .0 5 )。少数患者出现轻微不良     

老年患者血清胱抑素C与肌酐清除率对肾功能评价的相关性研究

目的:探讨血清胱抑素C对老年患者肾功能评价的临床意义.方法:将91例平均年龄83岁住院患者根据病史、检验结果分成非肾病组和肾病组,采用胶乳增强免疫比浊法检测血清胱抑素C(Cys C),同时检测血清肌酐(Scr)、血清尿素氮(Bun)、尿肌酐(Ucr),推算肌酐清除率(Ccr),比较两组患者Cys C、Ccr 、Scr、Bun.结果:两组患者Cys C、Ccr、Scr有统计学差异(P＜0.01);Ccr法假阳性率为34.1%,Cys C法与之相比差异具有统计学意义(P＜0.01),Cys C法判断肾小球滤过率较Ccr法为优.结论:Cys C作为基因控制的内源性标志物,反映肾小球滤过率(GFR)更准确、客观,有检测快速、方便、可重复等特点,是比Ccr更好的评价肾功能的指标.     

血清胱抑素C在肿瘤化疗患者肾功能评价中的临床应用

目的:探讨血清胱抑素C(cystatin C,Cys C)在肿瘤化疗患者肾脏功能评价中的临床应用. 方法:随机取37例肿瘤化疗患者和30例正常对照血清,同时测定血清中的Cys C、肌酐(Scr),Cys C检测采用增强透射免疫比浊法;Scr采用苦味酸法测定,并测定患者24 h尿肌酐(Ucr),计算出内生肌酐清除率(Ccr).结果:肿瘤化疗患者Cys C水平(1.16±0.43)mg/L显著高于正常对照组(0.61±0.06)mg/L;化疗前、后(1个疗程)Cys C、Scr和Ccr水平存在显著性差异(P＜0.05);患者化疗前后Cys C的异常检出率均显著高于Scr、Ccr (P＜0.05).结论:Cys C是评价肿瘤患者化疗期间肾功能损伤的一项灵敏、可靠的指标,在反映肿瘤化疗患者肾功能早期损害中有很好的临床参考价值.     

胱抑素C在判断糖尿病早期肾损害的作用

目的：探讨糖尿病肾病患者血清胱抑素C、血肌酐和尿微量白蛋白水平的变化及意义。方法：选取糖尿病肾病患者60例,单纯糖尿病患者65例,正常对照组55例,分别检测其尿微量白蛋白、血肌酐、血清胱抑素。结果：正常对照组与单纯糖尿病组三者比较差异无显著性（P〉0.05）;糖尿病肾病组与正常对照组及单纯糖尿病组比较尿微量白蛋白及胱抑素C差异显著（P〈0.01）,血肌酐水平无明显差异（P〉0.05）;糖尿病肾病组经辛伐他汀治疗1个月后,尿微量白蛋白、血清胱抑素C明显下降,与治疗前水平比较差异有显著性（P〈0.01）。结论：在糖尿病肾病早期肾功能损害中,CysC水平与尿微量白蛋白水有很好的相关性,是糖尿病肾病的敏感指标,且可以作为肾功能好转的指标。     

出血性脑卒中术后颅内压监测及临床意义的研究

 目的 探讨持续动态颅内压(ICP)监测在出血性脑卒中术后治疗中的意义.方法 对出血性脑卒中60例术后进行回顾性分析,随机分为监护组(30例)和对照组(30例).监护组根据持续ICP的变化分为＜20 mmHg、20～30 mmHg、＞30 mmHg,并随时调整治疗.对照组根据常规经验进行术后治疗.结果 监护组ICP＞20 mmHg者占60%,＞30 mmHg者占20%.在甘露醇的应用和并发症发生率方面均低于对照组,两组差异有统计学意义(P＜0.01和P＜0.05).预后情况监护组优于对照组(P＜0.05),且不同ICP之间预后差异有统计学意义(P＜0.05).结论 对于出血性脑卒中术后患者进行ICP监护有利于指导和及时调整治疗方案,减少并发症,改善预后.     

血清胱抑素C测定在2型糖尿病肾病早期诊断中的临床应用

目的探讨血清胱抑素C（Cys-C）浓度在2型糖尿病肾病早期诊断中的临床意义,为临床提供反映肾小球滤过功能的敏感的肾小球滤过率（GFR）标志物。方法测定97例本院门诊和住院2型糖尿病患者与60名健康体检者血清胱抑素C（Cys-C）、尿素（UREA）、肌酐（CRE）水平比较分析。结果2型糖尿病无糖尿病肾病（DN）组与对照组比较无统计学意义（P〉0.05）;在DN三组中,血清Cys-C浓度升高,Ⅲ期DN组〉无DN组（P〈0.05）,Ⅳ期DN组〉Ⅲ期DN组（P〈0.01）,Ⅴ期DN组〉Ⅳ期DN组（P〈0.01）。血清尿素和血清肌酐浓度,无DN组、Ⅲ期DN组与对照组比较无统计学意义（P〉0.05）,Ⅳ、Ⅴ期DN组血清尿素、血清肌酐浓度水平显著升高,有统计学意义（P〈0.01）。结论胱抑素C是能反映肾小球滤过率的理想标志物,比尿素、肌酐敏感,是糖尿病肾病早期评价的理想指标。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.