α-L-岩藻糖苷酶对无机磷测定的干扰及排除

目的探讨由于全自动生化分析仪试剂探针污染携带使得α-L-岩藻糖苷酶(AFU)试剂对无机磷(P3+)检测结果的影响.方法用无溶血、无乳糜的混合血清先单独地测试P3+(对照组);用同样的血清先测AFU紧接着测P3+(铡试组Ⅰ);调整项目的测定顺序后,再用同样的血清先测P3+紧接着测AFU(测试组Ⅱ).结果测试组Ⅰ的P3+含量与对照组比较有显著性差异(P<0.01);测试组Ⅱ的P3+含量与对照组比较无显著性差异(尸>0.05).结论试剂针携带污染AFU试剂对P3+测定有干扰,使结果偏高,调整测试项目顺序可以消除干扰.     

微量、快速比色法测定血清唾液酸含量

1 方法唾液酸测定试剂盒购自上海海军医学研究所。王氏常规法按试剂说明书进行测定。微量法测定方法:血清标本测定管加血清标本10μl;标准管加标准液10μl;空白管加蒸馏水10μl;各管内再分别加测定试剂400μl。将各管混匀,90℃水浴,30min(或100℃ 20min),冷水冷却3min,离心5min(3000 r/min),取上清200μl,置ELISA     

生化分析仪加样系统精密度测定结果分析

目的 :了解生化分析仪加样系统精密度和准确度。方法 :设定仪器标本加入量分别为 3μL、4μL、5 μL、8μL、10 μL,试剂加入量分别为 15 0 μL、2 0 0 μL、2 5 0 μL、30 0 μL,每半年测试仪器测定结果的精密度和准确度一次。结果 :随着标本、试剂加入量的增加 ,其测定结果的变异系数逐渐减小 ,随着标本、试剂加样注射器使用时间的延长 ,其测定结果的变异系数逐渐变大。结论 :建议生化分析仪设置标本加入量不小于 4μL,设置试剂加入量不小于 15 0 μL 为佳     

胆红素浓度对干化学法测定肌酐的影响

目的 :研究不同浓度胆红素对干化学法测定肌酐的影响。方法 :分别用干化学法和改良苦味酸法测定 12 0例不同胆红素浓度的血清肌酐含量。结果 :干化学法测定肌酐含量均值为 (12 9.8± 88.11) μmol/L ,改良苦味酸法为 (91.0 0± 37.6 8) μmol/L ,对于胆红素浓度 <81.4μmol/L时 ,血清肌酐含量两法测定结果差异无显著性意义 (P >0 .0 5 ) ,而当胆红素含量 >81.4μmol/L时 ,干化学法测定结果明显高于改良苦味酸法 (P<0 .0 0 1)。结论 :对于胆红素含量 >81.4μmol/L标本 ,干化学法测定肌酐存在正偏差 ,需用改良苦味酸法测定。     

不同温度测定血ECP水平对支气管哮喘的结果评价

目的探讨在不同温度条件下,正常健康儿童与支气管哮喘患儿血嗜酸性粒细胞阳离子蛋白(ECP)的含量。方法采用固相双位点酶放大化学发光法,分别对25例正常健康儿童与20例支气管哮喘患儿,在不同温度(25℃和37℃)下收集的血清和血浆标本(EDTA-K2做抗凝剂)进行ECP水平测定。结果不同温度的血清组血清ECP水平分别为,正常对照组10.66±5.21μg/L(x-±s)和17.61±11.60μg/L,哮喘组36.51±21.90μg/L和62.72±32.59μg/L,不同温度之间比较有显著性差异(P<0.001),37℃凝集的血清ECP阳性检出率显著高于25℃;在不同温度的血浆组血浆ECP水平分别为,正常对照组4.69±2.09μg/L(x-±s)和5.96±2.40μg/L,哮喘组为7.40±2.35μg/L和8.05±2.23μg/L,不同温度之间比较没有显著性差异(P>0.05)。在同一温度下,血清标本ECP水平显著高于用EDTA-K2做抗凝剂的血浆标本(P<0.01)。结论温度和抗凝剂对血ECP水平有显著影响,37℃凝集为ECP水平测定的最适温度,日常工作中应制定相应温度下的正常参考值。     

血脂常规检测结果正常的血清标本中脂蛋白(a)水平分析及其临床意义

目的 :统计血脂常规检测结果正常的血清标本中脂蛋白 (a) [L P(a) ]水平 ,分析其临床意义。方法 :在我院 2 0 0 3年 1月至 2 0 0 4年 3月期间检测的血脂标本中筛选 5 4 70例总胆固醇 (TG) ,甘油三酯 (TC) ,高密度脂蛋白胆固醇 (HDL- C) ,低密度脂蛋白胆固醇 (L DL- C)浓度正常的血清标本 ,分析其 L P(a)水平 ,并比较高 L P(a)组 (浓度 >30 0 mg/L )和正常 L P(a)组 TC,L DL - C浓度。结果 :在 5 14 5例 TG,TC,HDL - C,L DL - C浓度正常的血清标本中 ,高L P(a)标本占 2 2 .9% ,高 L P(a)组比正常 L P(a)组 TC,L DL- C浓度明显增高 ,差异有显著性 (P<0 .0 1)。结论 :目前L P(a)不作为临床常规监测项目 ,有可能使高 L P(a)患者漏检 ,值得注意。高 L P(a)组 ,其 TC,L DL - C水平也较对照组高 ,虽不能认为一定会患 AS,但属于 AS的高危人群 ,其个人可能得不到重视和预防。     

血清瘦素与慢性阻塞性肺病患者营养状况的关系研究

目的　探讨血清瘦素与慢性阻塞性肺病 (COPD)患者营养状况的关系。方法　测定 42例COPD患者 (营养不良组 2 0例 ,非营养不良组 2 2例 )及 18名正常人的血清瘦素、体重指数 (BMI)、理想体重百分比 (IBW % )、三头肌皮皱厚度 (TSF)、血清白蛋白 (ALB)、血糖 (G)值。分析瘦素与各项指标的相关性。结果　 3组血清瘦素浓度 2 .7± 2 .1μg/L ,与BMI ,IBW % ,TSF ,MAMC呈正相关 (P <0 .0 0 1) ,与血糖水平及ALB无相关性 ;营养不良组血清瘦素浓度 1.4± 2 .1μg/L ,显著低于非营养不良组 3 .6± 1.8μg/L ,非营养不良组血清瘦素浓度与正常组比较差异无显著性 (P >0 .0 5 )。结论　血清瘦素浓度与COPD患者的营养参数相关 ,瘦素与COPD营养不良的发生有关     

生化检测中的交叉污染及预防

全自动生化分析仪可同时对一个标本中的多个指标进行检测 ,提高了检验工作效率 ,但存在项目间交叉污染的现象〔1～ 3〕 。作者对不同检测顺序测得的血清磷结果作了对比 ,现报告如下。1　材料和方法1 .1　仪器　OLYMPUSAU 40 0全自动生化分析仪。1 .2　试剂　钙的测定采用偶氮胂Ⅲ法 ,试剂由宁波亚太公司提供 (批号H3 0 3 ;2 0 0 2 1 2 3 0 ) ,主要成分 :偶氮胂Ⅲ(1 0 0 μmol L) ;磷酸盐缓冲液 (5 0mmol L)。氯的测定采用硫氰酸汞比色法 ,试剂由山东 3V公司提供 (批号2 0 0 2 1 1 0 1 ) ,主要成分 :硫氰酸汞 (0 .3g L) ;硝酸铁适量。…     

生化分析仪总胆汁酸试剂的携带污染对总二氧化碳测定的干扰分析

目的分析COBAS 400生化分析仪总胆汁酸(TBA)试剂的携带污染对409 nm酶法总二氧化碳(TCO2)测定的干扰,并提出消除措施。方法通过将TBA试剂各组分与TCO2校准液、TCO2质控液及患者血清按不同比例混合后,检测TCO2结果并进行分析。调整测试顺序,设置附加清洗程序,观察TCO2试剂稳定性。结果调整前试验标本检测结果低于预期值(理论计算值),按要求调整后,TCO2试剂稳定性提高,校准周期从1 d延长到7 d。结论 TBA试剂对409 nm酶法TCO2的测定产生携带污染,调整分析顺序,设定清洗程序,可有效提高试剂的稳定性与准确性。     

血清透明质酸在肝脏、肾脏等疾病患者体内的改变

目的：探讨血清透明质酸（HA）在肝脏、肾脏等疾病患者体内的改变。方法：采用放射免疫分析（RIA）法测定。结果：肝硬化时血清HA水平明显升高,与对照组比较差异有非常显著性（P〈0．001）,其测定值顺序为：慢迁肝〈慢活肝〈肝硬化;糖尿病组血清HA含量为192．12±201．21μg/L,明显高于对照组（P〈0．05）,而低于肝硬化组（P〈0．001）。慢性肾炎组血清HA含量为345．6μg/L。结论：血清HA放射免疫测定结果对慢迁肝与慢活肝,肝硬化与非肝硬化都有鉴别诊断意义。血清HA含量测定,可作为判断肾功能是否受损的间接指标,同时提示当肾功能受损时,如果血清HA增高,则不要轻易作出肝受损或肝纤维化的结论。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.