阿仑膦酸钠改善去卵巢大鼠的骨基质结构

背景：双膦酸盐可以提高骨密度、抑制骨吸收的作用已被临床所证实,但其对于骨骼基质结构的影响研究较少。 目的：实验通过观察双膦酸盐类药物——阿仑膦酸钠对骨结构及骨基质代谢的影响,探讨阿仑膦酸钠改善骨质量、提高骨强度的骨基质调控机制。 方法：实验建立去卵巢大鼠模型,用阿仑膦酸钠进行干预,同时设置模型组和假手术组进行对照。运用骨骼影像学、骨组织病理学和骨生物力学检测技术与酶联免疫吸附法观察阿仑膦酸钠对骨丢失大鼠骨密度、骨代谢、骨生物力学性能和骨结构的影响。 结果与结论：药物干预后4,8,12周,阿仑膦酸钠组骨密度均高于模型组(P < 0.05);药物干预8周后,与模型组相比,阿仑膦酸钠组骨代谢指标尿脱氧吡啶诺啉,血清Ⅰ型胶原羧基端前肽水平均降低(P < 0.05),腰椎和股骨的最大载荷、最大压强、模量以及Ⅰ型胶原不同交联形式的尿吡啶啉/脱氧吡啶啉值均增高(P < 0.05)。结果证实,阿仑膦酸钠能够对抗因雌激素缺乏导致大鼠骨量的丢失,提高生物力学性能,改善骨基质结构,同时恢复因去卵巢所导致的Ⅰ型胶原交联组分的改变。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

伊班膦酸钠间断静脉输注治疗北京绝经后骨质疏松症的疗效

 目的 评价新一代双膦酸盐类药物伊班膦酸钠间断静脉输注对北京绝经后骨质疏松症的疗效及安全性。方法 研究纳入绝经后骨质疏松女性60例,年龄48~74岁,绝经年限3~32年,随机分为2组,治疗组每3个月静脉输注伊班膦酸钠2mg,对照组每周口服阿仑膦酸钠70mg,疗程12个月。疗效指标为腰椎及髋部骨密度（采用双能X线骨密度仪测量）、骨吸收指标血I型胶原羧基末端肽（酶联免疫吸附法测量）及骨形成指标碱性磷酸酶（自动分析仪酶法检测）。安全性指标包括血尿生化指标、心电图及不良反应。结果 59例患者完成研究。治疗12个月后,伊班膦酸钠组腰椎2-4、股骨颈及大转子骨密度增幅达6.3%,2.5%和0.1% (腰椎P <0.001,股骨颈P <0.01)。阿仑膦酸钠组腰椎、股骨颈及大转子骨密度改变率为 3.7%,4.9和-0.5% (腰椎和股骨颈P <0.001)。两组间治疗前后骨密度均无明显差别。伊班膦酸钠和阿仑膦酸钠治疗后ALP及CTX浓度均快速、显著下降,ALP降低15.8%和17.2%,CTX降低78.1%及43.2%（均P <0.001）。两组血钙磷水平、肝肾功能在正常范围内,伊班膦酸钠组常见的不良反应是首次输液后肌肉疼痛和低热,占26.7%,反酸、上腹不适是阿仑膦酸钠组主要的不良反应,占13.3%,患者可以耐受这些轻度的不良反应。结论 新一代双膦酸类药物伊班膦酸钠对于治疗绝经后骨质疏松症是安全而有效的。     

阿仑膦酸钠可抑制骨质疏松性骨折的愈合

背景：阿仑膦酸钠作为治疗骨质疏松症的首选药物已被临床广泛应用。 目的：观察阿仑膦酸钠对骨质疏松性骨折大鼠股骨干骨折愈合的影响。 方法：将SD大鼠随机分成3组：假手术组,模型组和阿仑膦酸钠组。模型组及阿仑膦酸钠组于卵巢切除后4周进行右股骨干中段横行骨折,克氏针固定。阿仑膦酸钠组建模后皮下注射阿仑膦酸钠。 结果与结论：骨折造模后3及6周,阿仑膦酸钠组右股骨整体骨密度和远段骨密度高于模型组(P < 0.01),与模型组相比,阿仑膦酸钠组骨折端骨痂体积大、骨痂数量多,软骨性骨痂向骨性骨痂转换过程延迟,骨折愈合过程减慢,破骨细胞数量显著降低(P < 0.05)。结果证实,阿仑膦酸钠对大鼠骨质疏松性骨折愈合过程有抑制作用,其机制可能与阿仑膦酸钠抑制破骨细胞活性使骨痂钙化过程减慢有关。     

阿仑膦酸钠和阿法骨化醇联合治疗严重骨质流失和骨质疏松性骨折

背景：阿仑膦酸钠和阿法骨化醇均可抑制骨质疏松性骨折患者骨转换,增加骨矿物密度。 目的：观察阿仑膦酸钠和阿法骨化醇联合治疗患有严重骨质流失和骨质疏松性骨折患者的效果。 方法：纳入严重骨质流失和骨质疏松性骨折患者,进行阿仑膦酸钠和阿法骨化醇联合治疗2年。 结果与结论：相比治疗前,阿仑膦酸钠和阿法骨化醇联合治疗后患者腰椎骨密度增加(P < 0.05),随后尿Ⅰ型胶原N末端肽水平和血清碱性磷酸酶活性减少(P < 0.05)。证实,阿仑膦酸钠和阿法骨化醇联合治疗患有严重的骨质流失和骨质疏松性骨折患者疗效好。     

不同药物治疗原发性骨质疏松症的网状Meta分析

文题释义：阿仑膦酸钠：属于双膦酸盐类药物,可以通过多种作用机制治疗骨质疏松,通过抑制破骨过程,维持骨结构,改善骨矿化程度,有效增加骨皮质的厚度和骨密度,从而提高人体骨骼强度,减轻和预防骨质疏松。 钙剂：通常把以钙元素的生理生化功能及药理学作用为基础、以钙盐为主要成分的制剂称为钙剂。钙剂产品常见为片剂、胶囊、冲剂、粉剂、溶液、针剂等剂型。 背景：临床研究发现阿仑膦酸钠联合降钙素类、钙剂类等其他药物治疗原发性骨质疏松症能提高疗效、降低其不良反应发生率,但尚乏系统评价。 目的：系统评价不同药物治疗原发性骨质疏松症的临床疗效、骨密度、安全性的差异。 方法：计算机检索PubMed、CNKI、VIP、万方数据库、Embase、CBM、Cochrane图书馆,收集不同药物治疗原发性骨质疏松的随机对照试验(RTC)。文献筛选,数据提取,采用Cochrane系统评价及RevMan 5.3对纳入文献进行质量评价;运用马尔科夫链-蒙特卡洛方法,采用Stata 15.0进行贝叶斯网状Meta分析。结果与结论：①共纳入14项RCT,共计1 822例患者,涉及阿仑膦酸钠、唑来膦酸、钙剂、钙剂联合唑来膦酸、阿仑膦酸钠联合钙剂、阿仑膦酸钠联合骨肽注射液、钙剂联合骨肽注射液、阿仑膦酸钠联合特立帕肽注射液、鲑鱼降钙素等9种干预措施;②在提高总有效率方面,共涉及9种干预措施,网状Meta排序结果为钙剂联合骨肽注射液>阿仑膦酸钠联合骨肽注射液>阿仑膦酸钠联合唑来膦酸>唑来膦酸>唑来膦酸联合钙剂>鲑鱼降钙素>阿仑膦酸钠联合钙剂>阿仑膦酸钠>钙剂;③在提高治疗后骨密度方面,共涉及5种干预措施,网状Meta排序结果为阿仑膦酸钠联合钙剂>钙剂>钙剂联合唑来膦酸>唑来膦酸>阿仑膦酸钠;④在降低不良反应发生率方面,共涉及7种干预措施,网状Meta排序结果为钙剂>阿仑膦酸钠联合钙剂>阿仑膦酸钠联合骨肽注射液>唑来膦酸联合钙剂>唑来膦酸>阿仑膦酸钠>阿仑膦酸钠联合特立帕肽注射液;⑤结论：骨肽注射液的联合用药能显著提高治疗总有效率,其中钙剂联合骨肽注射液效果最佳;钙剂在提高治疗后骨密度的疗效确切,而联合阿仑膦酸钠具有增效作用,且不良反应的发生率较低,效果最好。ORCID: 0000-0002-4976-9599(阙敏强) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

脉冲电磁场治疗绝经后骨质疏松症的疗效观察

探讨脉冲电磁场(PEMFs)治疗绝经后骨质疏松症(PMO)的疗效及最佳治疗频次。比较PMO患者每周一次服用阿仑膦酸钠(共72周,阿仑膦酸钠组)和接受一个疗程PEMFs治疗(共5周,PEMFs组)在不同随访时间骨密度(BMD)、疼痛及平衡功能的改善情况。两组腰椎及全髋骨密度疗效统计量在分组后24周内无统计学差异(P≥0.05),在48周、72周PEMFs组低于阿仑膦酸钠组,差异有统计学意义(P0.05)。两组视觉模拟评分、时间限制的站起和行走测验以及Berg平衡量表评分的疗效统计量无统计学差异(P0.05)。与持续服用阿仑膦酸钠相比,一个疗程PEMFs的疗效至少能在24周内维持与阿仑膦酸钠相近,故PEMFs治疗PMO的适宜频次可能为半年一个疗程。     

甲状旁腺素和二膦酸盐对骨密度和骨生物力学的影响

目的:研究应用甲状旁腺素和阿仑膦酸钠对激素性骨质疏松兔骨密度和生物力学的影响。方法:采用成年新西兰大白兔,随机分为对照组、激素模型组、甲状旁腺素和阿仑膦酸钠治疗组,9周后取股骨和腰椎行超声骨密度测量,再行股骨扭转、三点弯曲和腰椎压缩试验。结果:激素模型组的宽频超声衰减(BUA)、超声传导速度(SOS)值和骨生物力学参数较对照组有非常明显减少,甲状旁腺素和阿仑膦酸钠治疗组的BUA、SOS值和骨生物力学参数较激素模型组明显增加。结论:序贯应用甲状旁腺素和阿仑膦酸钠可以减少激素性兔骨量的丢失,预防骨质疏松的发生。     

补肾壮骨方干预去卵巢骨质疏松模型大鼠骨代谢及骨密度的变化

背景：中医药以其良好的治疗效果及安全性越来越多的应用于骨质疏松症的治疗中,补肾壮骨方目前作为山东中医药大学附属医院协定方被广泛应用于临床中,获得了极好的治疗效果。目的：评价补肾壮骨方对去卵巢骨质疏松大鼠骨代谢及骨密度的影响。方法：60只SD大鼠随机分为6组,分别为假手术组、模型组、阿仑膦酸钠组、补肾壮骨方高、中、低剂量组,每组10只,后5组制备去卵巢骨质疏松症模型,假手术组只切除卵巢周围脂肪组织。造模8周后,补肾壮骨方高、中、低剂量组分别予以2.34,1.17,0.58 g/(kg·d)补肾壮骨方,阿仑膦酸钠组予阿仑膦酸钠1 mg/(kg·d),假手术组及模型组给予等体积的生理盐水,1次/d灌胃。连续灌胃12周后检测各组大鼠血清碱性磷酸酶、Runt相关转录因子2及核因子κB受体活化因子配体水平;取右侧股骨观察骨密度及骨微结构;苏木精-伊红染色观察组织病理改变;免疫组化法检测骨组织Wnt1、骨形态发生蛋白2蛋白表达。结果与结论：(1)造模8周后,与假手术组对比,模型组大鼠骨密度、骨小梁数明显降低(P <0.05),提示造模成功;(2)与模型组大鼠对比,补肾壮骨方低、中、高剂量组及阿...     

叶酸联合阿仑膦酸钠对绝经后骨质疏松患者骨密度、骨代谢指标和纤维细胞生长因子水平的影响

目的:探讨绝经后骨质疏松患者采用叶酸与阿仑膦酸钠联合治疗对其纤维细胞生长因子、骨代谢及骨密度指标的影响.方法:采用抽签法将 2020 年4 月至 2022 年6 月我科收治的绝经后骨质疏松患者 106 例随机分为两组(n=53),对照组口服阿仑膦酸钠 10 mg、硫辛酸 0.6 g,1 次·d-1,观察组口服阿仑膦酸钠 10 mg、叶酸 2 片,1次·d-1,治疗6 m后采用骨密度测定器测定股骨大转子、股骨颈、股骨干及第二腰椎-第四腰椎(L2-L4)骨密度,采用酶联免疫吸附法测定保护素(Osteoprotegerin,OPG)、核因子 кB受体激活因子配体(Receptor activator of NF-KB ligand,RANKL)、I型胶原交联C-末端肽(type Ⅰ C-tenninal cross linked peptide,CTX-1)和纤维细胞生长因子(Fibroblast growth facto,FGF)水平,采用电化学发光免疫分析法检测骨钙素(Bone glaprotein,BGP)水平,采用随访法观察各患者不良反应.结果:与治疗前相比,各治疗组的股骨大转子、股骨颈、股骨干及L2-L4 骨密度、OPG及BGP明显升高(P<0.05),其中观察组升高更显著(P<0.05);与治疗前比,各治疗组RANKL、CTX-1、FGF-23和FGF-21 明显降低(P<0.05),其中观察组降低更明显(P<0.05),两组各不良反应无统计学差异(P>0.05).结论:绝经后骨质疏松患者口服阿仑膦酸钠联合叶酸治疗,可有效调节其FGF水平,改善其骨代谢和骨密度情况,不良反应较少.     

不同质量浓度阿仑膦酸钠干预牙槽骨吸收模型兔牙周组织破骨细胞分化因子和骨保护素的表达

背景：有研究表明阿仑膦酸钠能够防治骨质疏松症,但其应用到口腔牙周组织干预牙槽骨吸收较为罕见。 目的：建立兔牙槽骨吸收模型,观察不同质量浓度阿仑膦酸钠干预下炎症牙周组织破骨细胞分化因子和骨保护素的表达。 方法：将大耳白兔建立牙槽骨吸收模型,建模成功后随机分成5组,胶原+0.5 g/L阿仑膦酸钠组、胶原+1 g/L阿仑膦酸钠组、胶原+2 g/L阿仑膦酸钠组、胶原组、对照组。各组分别于用药后2和4周用免疫组织化学方法检测破骨细胞分化因子和骨保护素表达情况,并进行药效评价。 结果与结论：破骨细胞分化因子和骨保护素阳性细胞在5组成骨细胞、破骨细胞、成纤维细胞中均有表达,胞浆呈棕色或棕褐色颗粒状着色。对照组和胶原组牙槽嵴吸收区破骨细胞分化因子和骨保护素比率明显大于其他3组(P < 0.05),胶原+1 g/L阿仑膦酸钠组在用药后2和4周均高于胶原+0.5 g/L阿仑膦酸钠组(P < 0.05)。结果证实,阿仑膦酸钠能够降低牙槽骨破骨细胞分化因子和骨保护素的比率,应用含1 g/L 阿仑膦酸钠胶原海绵载体更适合抑制牙槽骨吸收。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.