SCR氧化法测定血清胆红素的质量评价

目的 :评价 SCR氧化法测定血清中总胆红素和直接胆红素。方法 :测定精密性、准确性、抗干扰性及与改良 J- G法的相关性。结果 :总、直接胆红素的精密度分别为批内 CV 0 .76 %与 0 .86 % ,日间 CV为 1.0 0 %和 1.2 6 % ;平均回收率为总胆红素 10 0 .4 % ,直接胆红素 98.6 % ;与改良 J- G法的相关性为 :总胆红素 Y(SCR) =0 .96 3X(改良 J- G) +0 .16 6 ,r=0 .998,直接胆红素 :Y(SCR) =1.0 0 3X(改良 J- G) - 0 .0 90 ,r=0 .998;血红蛋白浓度和甘油三酯在 5g/ L和 8.0 0 m mol/ L以下无干扰。结论 :该法准确、稳定、简单、快速 ,完全可以满足临床应用。     

水溶性新显色剂5-Br-PADCAP直接光度法测定血清铁试剂盒的研制与评价

目的 :研制 5 Br PADCAP直接光度法测定血清铁试剂盒 ,并评价其应用价值 ,以用于血清中微量铁的测定。方法 :在表面活性剂存在下 ,以 2 (5 溴 2 吡啶偶氮 ) 5 [(N ,N 二羧基甲基 )氨基 ]苯酚 (5 Br PAD CAP)作显色剂用手工分析法和自动分析法测定血清铁。结果 :该法线性范围为 0～ 140 μmol/L ,手工分析法和自动分析法平均回收率为 10 0 .0 %和 10 0 .2 % ,批内变异系数 (CV)和批间变异系数分别为 0 .0 19～ 0 .0 2 1、0 .0 10～ 0 .0 14和 0 .0 2 2～ 0 .0 2 9、0 .0 15～ 0 .0 2 1,与原子吸收分光光度法比较具有良好的相关性 ,线性回归方程和相关系数分别为Y =0 .992 8X +0 .2 3 3 9,r=0 .992 7和Y =0 .993 3X +0 .2 5 62 ,r=0 .9819,5 8例健康男性和 47例健康女性血清铁含量分别为 8.19～ 2 7.71μmol/L、10 .10～ 3 1.0 2 μmol/L和 8.0 4～ 2 7.68μmol/L、10 .2 2～ 3 0 .82μmol/L( x± 2s)。 结论 :用 5 Br PADCAP直接光度法试剂盒测定血清铁方法简便、灵敏可靠 ,适合临床应用     

免疫抑制法直接测定血清高密度脂蛋白胆固醇试剂盒的评价

目的 :评价免疫抑制法直接测定血清高密度脂蛋白胆固醇 (HDL -C)试剂盒是否符合临床应用要求。方法 :将免疫抑制法与磷钨酸———镁法 (PTA)和选择性抑制法进行比较 ,并分析其线性范围、精密度、准确度和干扰因素。结果 :免疫抑制法 (Y)与PTA法 (X1)的回归方程为Y =0 .993X1 0 .2 1 3,r =0 .981 ;与选择性抑制法 (X2 )的回归方程为Y =1 .0 1X2 0 .1 77) ,r =0 .971 ;Y与X1、X2 所测得的均值无显著差异 (P >0 .0 5 ) ;HDL -C浓度在 0 5 1～ 2 .5 5mmol/L范围内线性良好。对高、中、低血清标本进行精密度测定 ,批内CV值分别为 1 35 %、1 6 7%和 2 0 1 % ,日间CV值分别为 2 78%、3 1 4%和 3 43%。回收率为 97 8%～ 1 0 0 .9% ,平均回收率为 99 2 %。胆红素 ( <2 5 0 μmol/L)、血红蛋白 ( <5 g/L) ,抗坏血酸 ( <2 0 0 μmol/L)、TG( <1 0mmol/L)不干扰测定。 结论 :日本和光公司生产的免疫抑制法直接测定血清HDL -C试剂盒符合临床应用要求 ,可用于自动化分析     

LDL-C直接测定法在生化分析仪上的应用

用日本第一化学药品株式会社LDL—C试剂盒在BeckmanCX4型自动生化分析仪上直接测定血清LDL—C含量。方法批内CV 0 37%～ 1 11% ,批间CV为 2 11%～ 3 0 2 % (n =2 0 )。平均回收率为 98 9% ,在 8 10mmol/L浓度范围内呈良好线性关系。TG <5 0 0mmol/L时与聚乙烯硫酸沉淀法 (X1)及Friedewald(X2 )公式计算结果相关良好 ,回归方程分别为Y =0 988X1+0 0 47,r=0 95 1,Y =0 96 1X2 +0 0 5 2 ,r=0 930。LDL—C直接测定法简单、快速 ,用血量少 ,勿需沉淀分离 ,适宜于自动化分析。     

壳聚糖作为敏感膜材料的研究

以壳聚糖为膜材料制成薄膜 ,运用生物素 -亲和素系统将辣根过氧化物酶 (HRP)固定在膜上 ,固定化过程对 HRP的活性无影响 ,而其稳定性提高 ,运用 L uminol- H2 O2 - HRP化学发光体系 ,对水样中微量 H2 O2 进行检测 ,在 10 - 6～ 10 - 9m ol/ L 范围内线性关系良好 ,回归方程 :Y=2 0 .6 48X- 2 15 .2 39(X:nm ol/ L) ,检测灵敏度为 0 .5 nmol/ L。实验研制的壳聚糖膜可制成生物传感器多功能敏感膜     

脲酶电导电极法测定血清尿素方法学探讨

目的评价和证实脲酶电导电极法测定尿素的性能。方法采用电极法测定血清尿素 ,对其精密度、准确度和特异性进行了评价 ,并与脲酶 -谷氨酸脱氢酶偶联的酶速率法进行了比较。结果脲酶电极法 (Y)与酶法 (X)测定血清尿素有良好的相关性 :Y =1.0 2 5X - 0 .32 ,r =0 .994。尿素高、中、低值血清标本的批内和批间CV值分别为 1 2 2 %、1 5 5 %、1 78%和 2 36 %、2 6 8%、2 99% ,平均回收率为 10 1 3% ,线性范围达 5 3 3mmol/L。血红蛋白 <5g/L ,胆红素 <36 3umol/L ,TG <8.3mmol/L不干扰测定。结论脲酶电极法测定血清尿素简便、快速、准确 ,适合临床常规应用     

免疫比浊法测定血清C-反应蛋白(CRP)的评价

目的 :评价C -反应蛋白 (CRP)免疫比浊法试剂盒。方法 :利用日立 70 60全自动生化分析仪对CRP试剂进行一系列方法学评价试验。结果 :批内CV <3 % ,批间CV <5 % ;线性范围可达 0 4～ 2 0 0mg/L ;当样品中血红蛋白达5 0 0 0mg/L ,胆红素达 10 0 0umol/L ,甘油三酯达 5mmol/L ,以及常用抗凝剂均不干扰测定结果 ;与进口试剂比较 ,其中与德国德塞公司原装试剂比较 ,回归方程为 :y =0 9946x -2 490 6,r =0 9881,与日本klkk公司原装试剂比较 ,y =1 2 0 5 3x +0 8892 ,r =0 993 2。结论 :该试剂使用方便、快速、准确 ,适用于自动化分析     

偶氮氯膦I显色EDTA褪色法测定血清钙

目的　建立灵敏度高、选择性好、试剂稳定的血清钙偶氮氯膦Ⅰ显色EDTA褪色测定法。方法　在 2 氨基 2 甲基 1,3 丙二醇 (AMP)缓冲介质中 ,偶氮氯膦Ⅰ与钙络合显色 ,加入EDTA使钙解离 ,测定吸光度的下降来分析血清钙。对反应条件和方法性能进行系统研究。结果　线性范围 0 - 5 .0mmol/L ,回收率为 97.5 - 99.2 % ,平均 98.4 %。批内变异系数 (CV)和批间变异系数 (CV)分别为 0 .98%和 1.93%。与邻甲酚酞络合酮 (OCPC) (X1)比较 :Y =1.0 0 5X1- 0 .0 32 ,r=0 .994 ;与偶氮胂Ⅲ(X2 )比较 :Y =1.0 0 2X2 - 0 .0 2 5 ,r=0 .996 :血清胆红素高达 5 0 0umol/L ,血红蛋白 10g/L ,镁 2 .5 0mmol/L及intralipid高达 15mmolL时均对本法无显著干扰。结论　该法具有简便、快速、试剂稳定和灵敏可靠的优点 ,适合血清钙的手工测定和自动分析。     

两种清除法测定低密度脂蛋白胆固醇的临床评价

目的对表面活性剂清除法 (SUR法 )和过氧化氢酶清除法 (CAT法 )两种低密度脂蛋白胆固醇 (LDL C)均相测定法进行临床评价。方法将上述两种方法与聚乙烯硫酸沉淀法 (PVS法 )进行比较 ,分析各自方法的精密度、准确性、特异性和干扰因素。结果两种清除法与PVS法 (X)具有良好的相关性 ,SUR法 (Y1) :Y1=0 .9311X +0 .10 2 2 ,r =0 .980 1;CAT法 (Y2 ) :Y2 =0 .94 0 1X +0 .0 991,r=0 .9832。高、中、低三种LDL C浓度混合血清所测定结果表明两种方法均具有良好的精密度 ,总CV值SUR法 3.4 5 - 3.89% ,CAT法 3.5 1- 3.99% ,均达到临床满意的程度。两法线性范围均较宽 (线性均至 8.2 2mmol/L) ,最低检测浓度均为 0 .12mmol/L ,平均回收率SUR法为 98.0 % ,CAT法为 97.6 %。TG <14 .2mmol/L ,Hb <5g/L ,HDL C <3.88mmol/L ,胆红素 <4 5 0 μmol/L对两法基本无影响。 结论两种LDL C清除法测定结果的准确度和精密度均符合临床要求 ,适宜自动分析 ,值得在临床推广应用。     

HPLC法间接测定肿瘤患者外周血DPD的活性

目的 建立高效液相色谱法(HPLC)间接测定肿瘤患者外周血二氢尿嘧啶脱氢酶(DPD)活性的方法.方法 采用HPLC法测定肿瘤患者血浆中内源性物质二氢尿嘧啶(H2U)和尿嘧啶(U)的比值,间接估算DPD的活性.色谱柱:Xterra RPC18 (250 mm×4.6 mm,5μm);流动相:甲醇-0.02 mol/L磷酸二氢钠(pH4.0),比例为5∶95;流速为1.0 mL/min,H2U和U检测波长分别为204 nm、260 nm.结果 H2U线性范围为62.5 ～2 000μg/L,线性方程为:Y=7.48×10 -4X+ 1.24×10-1,r=0.999 7(n=6),批内RSD小于7.7％,批间RSD小于13.8％,方法学回收率为99.63％ ～ 103.02％;U线性范围为15.625 - 500 μg/L,线性方程为:Y=3.42×10-3X+2.58×10-2,r=0.999 3(n=6),批内RSD小于8.3％,批间RSD小于13.4％,方法学回收率为98.38％～109.08％.结论 本方法可用于肿瘤患者外周血DPD活性的常规监测.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.