全自动生化仪免疫比浊法检测血清白蛋白的方法学评价

目的使用免疫比浊法对血清白蛋白（ALB）测定的方法学进行评价。方法根据美国临床实验室标准化委员会（NCCLS）的标准,对免疫比浊法测定血清白蛋白的精密度、线性范围、回收率及准确性等指标进行测试．同时与溴甲酚绿法进行相关性的比较。结果精密度批内CV〈4．0,批间CV〈5．0。ALB线性范围可达5-89g／L,平均回收率为102.3％;抗干扰性强,当Hb≤50g／L,胆红素≤400μmol／L,TG≤23．0mmol／L时对测定无影响：与溴甲酚绿法对比,直线回归方程Y=1．05X＋5．56（Y：免疫比浊法：X：溴甲酚绿法）,相关系数r=0．926,提示两种方法有良好的相关性。结论免疫比浊法检测血清白蛋白是较为理想的新方法,完全能满足临床需要。     

钙和锌及镁等微量元素与维吾尔族孕妇发生妊娠期高血压疾病的关系

目的探讨维吾尔族妊娠期高血压疾病（HDCP）患者及其新生儿血清微量元素钙、锌、镁等微量元素的变化。方法分别测定维吾尔族和汉族轻度子痫前期（各30例）、维吾尔族和汉族重度子痫前期（各36例）患者及其新生儿血清中钙、镁、锌、铁、铜含量并进行比较。结果①汉族患者轻度子痫前期组血清铜、锌含量低于维吾尔族[分别为（35±6）μmol／L比（37±4）μmol／L;（7.7±0．5）μmol／L比（8．0±2．8）μmol／L],差异有统计学意义（P＜0．01）;汉族新生儿脐血清锌含量低于维吾尔族[（11．2±1．2）μmol／L比（13．94±4．1）μmol／L],差异有统计学意义（P＜0．01）。②汉族患者重度子痫前期组血清钙、镁含量高于维吾尔族[分别为（1．71±0．22）mmol／L比（1．59±0．07）mmol／L;（0．60±0．19）mmol／L比（0．49．4±0．05）mmol／L],差异有统计学意义（P＜0．01）;汉族新生儿脐血清铁、镁、锌含量与维吾尔族比较[分别为（53±1）μmol／L比（54±3）μmol／L;（0．72±0．05）mmol／L比（0．604±0．03）mmol／L;（8．8±0．3）μmol／L比（9．3±1．8）μmo]／L],差异有统计学意义（P＜0．05或P＜0．01）。结论维吾尔族与汉族患者微量元素锌、铜、钙、镁的含量有差异且与HDCP的发生及病情发展有一定的关系,无论患者在正常状态下还是在病理状态下,都首先保证胎儿对锌、铜、钙、镁的需要。     

应用循环酶法对血液同型半胱氨酸的测定及临床应用分析

目的对循环酶法测定血液同型半胱氨酸（HCY）的方法学进行初步评价并探讨其临床应用。方法通过循环酶法测定HCY的精密度及重复性，同时对71例健康体检者和20例脑梗死、20例高血压、20例冠心病患者血液中HCY进行测定。结果循环酶法测定HCY的批内平均变异系数为2．23％，批间平均变异系数为1．59％。71例正常人中，39例男性HCY为8．22～20．78μmol／L，32例女性HCY为4．74～14．8μmol／L。21例高血压患者中，男性14例，HCY为（23．76±11．58）μmol／L；女性7例，HCY为1（9．76±9．16）μmol／L。20例冠心病患者中，男性17例，HCY为（28．24±7．03）μmol／L；女性3例，HCY为（33．43±5．09）μmol／L。20例脑梗死患者中，男性10例，HCY为（19．32±10．11）μmol／L；女性10例，HCY为（18．00±3．16）μmol／L。结论循环酶法测定血液HCY具有较高的精密度，重复性好，试剂稳定，结果准确可靠，适合临床推广使用。HCY是心血管疾病特别是脑梗死、冠心病、高血压的危险指标，其浓度升高程度与疾病的危险性成正比。     

碘克沙醇致造影剂肾病

1例85岁女性患者为明确疾病诊断行下肢动脉及冠状动脉造影术,术中使用造影剂碘克沙醇150ml。造影术前患者血尿素5．8mmol／L,肌酐105μmol／L,钾4．2mmol／L,钠134mmol／L,氯97mmol／L;造影术后第2天出现反酸、恶心、无尿,血尿素10．9mmol／L,肌酐125μmol／L,尿蛋白（＋＋）;第3天仍旧少尿,血尿素13．0mmol／L,肌酐170μmol／L,钾3．5mmol／L,钠128mmol／L,氯98mmol／L。考虑为碘克沙醇所致急性肾损伤。给予利尿、血液滤过、纠正电解质紊乱等治疗,患者血肌酐水平逐渐下降,造影术后第16天患者好转出院。     

两种化学氧化法测定血清胆红素的比较

目的：比较钒酸盐氧化法和化学氧化法测定血清胆红素的性能。方法：用钒酸盐氧化法、化学氧化法分别测定血清中总胆红素（TBil）和直接胆红素（DBil）。比较两种方法的精密度、线性范围、回收率和抗干扰能力，并计算两种方法测定结果的相关性。结果：两种方法重复性实验批内变异和批间变异分别小于3．0％和5．0％；两种方法测定TBil的平均回收率分别为100．2％、101．1％；测定DBil的平均回收率分别为99．4％、98．4％。钒酸盐法测定TBil的线性范围为0-570 μmol/L，化学氧化法测定TBil的线性范围为0-650μmol/L，钒酸盐法测定DBil的线性范围为0-312μmol/L．化学氧化法测定DBil的线性范围为0-213μmol/L。以钒酸盐方法为对比法（Y），对化学氧化法（X）进行评估，两种方法测定TBil回归方程为Y=0．995X＋1．954，相关系数r^2=0．999，（P〉0．05），测定DBil的回归方程为Y=0．940X＋0．731，r^2=0．996，（P〉0．05）。化学法抗溶血干扰能力较钒酸盐法强，而抗维生素C的干扰较钒酸盐法差，两种方法对TG的抗干扰能力相当。结论：钒酸盐氧化法和化学氧化法测定血清胆红素性能相当，两种方法的线性检测范围、精密度、回收率和抗干扰能力均符合临床常规使用要求。     

静脉滴注丙氨酰谷氨酰胺致血清尿素升高

1例93岁女性患者因反复呕吐、进食困难入院,肾功能检查示血清肌酐90μmol／L,尿素10mmol／L。给予复方氨基酸注射液500ml和丙氨酰谷氨酰胺注射液100ml静脉滴注,1次／d。入院第5天患者血清肌酐122μmol／L,尿素51mmol／L,未予特殊处理。第12天血清肌酐120μmol／L,尿素62mmol／L,K＋6．0mmol／L,Na＋157mmol／L,C1-134mmol／L。患者出现神志模糊。停用复方氨基酸和丙氨酰谷氨酰胺注射液,同时控制钾、钠和补液量。4d后因患者病情再次给予肠外营养液,但仪静脉滴注复方氨基酸注射液500ml／d,共1周。复查血清肌酐126μmol／L,尿素29．7mmol／L。此后患者尿素水平未再升高。     

尿微量蛋白联合尿酶诊断早期肾损害

目的 探讨早期诊断肾脏损害的方法。方法采用酶联免疫吸附法检测尿微量白蛋白（Alb）、尿蛋白1（UPI）、尿视黄醇结合蛋白（RBP）,比色法测定N-乙酰-β-D-葡萄苷酶（NAG）,酶法测定尿肌酐（Cr）。结果对照组尿Alb／Cr（1．93±0．42）mg／mmol、UP1／Cr（47．61±5．86）μg／mmol、RBP／Cr（24．4±13．55）μg／mmol,NAG／Cr（0．96±0．58）u／mmol,尿蛋白定性阴性的糖尿病、高血压、系统性红斑狼疮及尿路感染患者尿Alb／Cr、UP1／Cr、RBP／Cr及NAG／Cr较对照组显著增高（P〈0．01）,单项或双项检测Alb、UPI、RBP或NAG这四项指标阳性率偏低,将这四项指标联合检测在糖尿病、高血压、系统性红斑狼疮及尿路感染中阳性率分别达92％、80％、85％、76％,明显提高了阳性检出率。结论联合检测尿Alb、UPI、RBP及NAG是诊断早期肾脏损害的灵敏、可靠的实验室指标。     

痛风患者肾结石发病情况及其影响因素的分析

目的分析和研究痛风患者肾结石发病情况及其影响因素。方法检测痛风患者和非痛风患者的血尿酸、尿尿酸、血肌酐、尿肌酐,对影响肾结石发病的因素进行分析。结果在70例痛风患者中出现肾结石25例（35．7％）。70例非痛风患者中出现肾结石11例（15．7％）;〈420μmol／L肾结石发病3例（25．0％）;420-500μmol／L肾结石发病6例（31．6％）;501-600μmol／L肾结石发病8例（38．1）;〉600μmol／L肾结石发病9例（90．0％）。结论痛风患者较容易发生肾结石,且肾结石的发生与患者的尿酸水平、尿量等有关系,对血糖还有血尿酸严格控制,可提高自身生活质量。     

同型半胱氨酸和总胆红素及高敏C反应蛋白水平与冠心病临床分型相关性研究

目的探讨冠心病患者血清抗氧化因子总胆红素（TBIL）、促氧化因子同型半胱氨酸（Hey）和炎症因子高敏c反应蛋白（hs—CRP）水平变化及其临床意义。方法采用全自动生化分析仪检测20例急性心肌梗死（AMI）组、37例不稳定型心绞痛（UAP）组、85例稳定型心绞痛（SAP）组以及80例健康对照组血清TBIL、Hey以及hs—CRP含量,建立Logistic回归分析冠心病发生的危险因素。结果冠心病患者中AMI组、UAP组和SAP组TBIL含量分别为（12．1±3．0）p,mol／L,（11．5±2．2）μmol／L,（9．0±1．9）μmol／L,均低于正常对照组[（13．8±3．6）μmol／L]（P〈0．05）;此3组Hcy含量分别为（21．3±4．6）μmol／L,（19．4±4．1）μmol／L,（14．8±3．9）μmol／L,均高于正常对照组[（9．7±3．5）μmol／L]（P〈0．05）;且冠心病各组间TBIL和Hey含量变化密切正相关。但是hs—CRP含量AMI和UAP组分别为（4．82±1．07）mg／L和（1．33±0．33）mg／L,高于SAP组和对照组[（0．94±0．23）mg／L和（0．89±0．24）mg／L],而SAP组和对照组间hs—CRP水平没有差别。结论冠心病患者血清TBIL和Hey水平呈现出一定相关性,对评估冠心病各临床分型鉴别有一定临床价值;hs—CRP在AMI和UAP患者血清中明显升高,可作为它们风险的独立评价指标。     

硫氰酸汞法测定氯化物单点与两点定标的对比研究

目的：评价两点定标对硫氰酸汞比色法测定氯化物的重要性。方法：应用ROCHE定值血清和系列氯化物标准液比较单点与两点定标测定结果的回归方程、线性范围与偏差率。结果：所用试剂盒在使用100mmol/L或160mmol/L氯化物标准液单点定标测定时，测定定值血清的偏差率分别为19．77％，2．95％和－7．63％（前者），线性范围仅分别为90－110mmol/L和150－170mmol/L,回归方程Y100＝0.533X 40.243,r=0.965;Y160=0.707X 52.644,r=0.967;使用70／140mmol/L和100／160mmol/L氯化物标准液两点定标测定时，测定定值血清的偏差率分别为1．30％，1．02％和－0．26％（前者），线性范围分别为60－150mmol/L和90－180mmol/L,回归方程Y70/140=0.905X 9.164,r=0.998;Y100/160=0.891X 15.206,r=0.997.结论：硫氰酸汞比色法测定氯化物的反应过程为一正弧线曲线，为卤族元素氯的呈色特生决定，只能采用多点定标方式实现测定的准确性，70／140mmol/L两点定标的准确测定范围为60－150mmol/L，完全可满足临床测试需要。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.