糖尿病心血管并发症患者AGEs与NO的变化特点及其临床意义

目的 探讨糖尿病（DM）时AGEs与NO的关系，以及AGEs与NO在糖尿病心血管并发症中的意义。方法 用EIISA法检测研究对象血清中AGEs的水平，用硝酸还原酶法检测研究对象血清中NO含量。结果 ①糖尿病患者清AGEs水平高于健康对照组，且糖尿病有心血管并发症组AGEs明显高于无心血管并发症组。②糖尿病患者血清NO水平低于健康对照组，且糖尿病有心血管并发症组NO明显低于无心血管并发症组。③AGEs与NO呈负相关。结论 血中高浓度的AGEs可能通过灭活NO等机制与NO共同参与DM心血管并发症的发生发展。     

尿毒症患者血清瘦素水平的临床研究

目的研究慢性肾功能不全患者血液透析前、后的血清瘦素水平与健康人群血清瘦素的关系,并初步探讨血清瘦素水平与营养不良的关系.方法选择尿毒症患者(血液透析前、连续血液透析三次后)及正常对照组各30例,于空腹取血,应用放射免疫分析法测定血清中瘦素水平,同时检测肾功能、血浆白蛋白水平等.结果正常人的血清瘦素水平与尿毒症患者血液透析前的血清瘦素水平无显著性差异(P>0.05),两组血清瘦素水平与体重指数(BMI)呈明显正相关(P<0.05),且女性血清瘦素水平均分别高于男性(P<0.05);尿毒症患者血液透析后的血清瘦素水平与正常对照组差异有显著性(P<0.05),血液透析组的血清瘦素水平与血尿素氮、肌酐、白蛋白等无相关性,血液透析组的肌酐、尿素氮高于对照组(P<0.01);血液透析前与血液透析后的血清瘦素水平无显著性差异(P>0.05).结论尿毒症患者血液透析前的血清瘦素水平与对照组差异无显著性,而血液透析后的血清瘦素与对照组差异有显著性;尿毒症患者和正常对照组女性血清瘦素水平均明显高于男性;尿毒症患者血液透析后血清瘦素水平与患者营养不良无明显相关关系;血液透析无法对瘦素起到清除作用.     

2型糖尿病周围神经病变一氧化氮及内皮素水平的测定

目的:探讨血清一氧化氮(NO)及血浆内皮素(ET)水平在2型糖尿病周围神经病变患者中的变化。方法:选取2型糖尿病住院患者60例,其中糖尿病合并周围神经病变患者30例,无周围神经病变患者30例,另选健康对照组24例,采用放射免疫法分别测定其血浆ET水平和酶法测定血清NO水平。结果:糖尿病周围神经病变组NO水平显著低于糖尿病无并发症组(P<0.001),后者NO水平显著低于健康对照组(P<0.001);糖尿病周围神经病变组ET水平显著高于无并发症组(P<0.001),后者ET水平显著高于健康对照组(P<0.001);相关分析显示NO与ET呈负相关,r=-0.795,P<0.001。结论:正常人以及糖尿病无并发症组相比,一氧化氮及血浆内皮素的水平在2型糖尿病周围神经病患者中有明显变化。     

慢性肾衰竭血清晚期糖基化终产物水平的变化及意义

目的探讨慢性肾功能衰竭患者血清晚期糖基化终产物(AGEs)水平的变化、意义及高通量血透对AGEs的清除效果. 方法应用竞争性ELISA法检测慢性肾功能衰竭(CRF)患者(非血液透析组及血液透析组)血清AGEs 水平,同时测血浆脂质过氧化物丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性. 结果 CRF患者无论血液透析与否,血清AGEs均明显高于健康组(P均<0.001),非血液透析与血液透析组AGEs水平无显著性差异(P<0.05),AGEs水平与CRE呈明显正相关(r=0.5974,P<0.01),与血糖无相关性;CRF患者血浆MDA含量明显高于健康组(P均<0.001),SOD活性明显低于健康组(P<0.05).AGEs与MDA、SOD间无相关性;常规血液透析(CHD)组,透析前后血清AGEs水平无显著性差异 (P < 0.05),而高通量血液透析(HFHD)组透析后血清AGEs水平明显降低(P<0.001),两组血浆SOD活性均明显升高(P<0.01),MDA含量明显降低(P<0.01).结论 CRF时,因肾功能受损致AGEs清除障碍,是血清AGEs水平升高的主要原因,同时CRF时氧化应激增强可能也促进了AGEs生成.高通量血液透析可以有效清除血清AGEs,并改善自由基代谢紊乱.     

尿毒症透析患者血清晚期糖基化终末产物水平及影响因素分析

目的对尿毒症透析患者血清中晚期糖基化终末产物(AGEs)进行测定并对其影响因素进行分析,指导临床治疗。方法20例尿毒症患者,接受血液透析滤过联合高通量透析(HDF HFHD)组10例,接受常规血液透析(CHD)组10例,用荧光分光光度计法对透析患者血清AGEs水平进行测定(治疗6个月前后以及单次HDF、HFHD、CHD治疗前后),并对影响因素进行分析。结果尿毒症透析患者AGEs水平与年龄、透析时间、有无残余尿量等无显著相关(P>0.05),与透析方式显著相关(P<0.05);单次HDF、HFHD治疗血清AGEs水平较透析前均明显下降(P<0.05),但两组间差异无统计学意义(P>0.05),单次CHD治疗血清AGEs水平差异无统计学意义(P>0.05);HDF HFHD组、CHD组内6个月治疗后透前AGEs水平差异均无统计学意义(P>0.05),但组间差异有统计学意义,HDF HFHD组明显低于CHD组(P<0.05)。结论透析方式是影响尿毒症患者血清AGEs水平的主要因素;长期血液透析滤过联合高通量透析对AGEs清除作用明显优于常规血液透析治疗;HDF、HFHD治疗是清除尿毒症患者体内AGEs的一条重要途径。     

冠心病患者血清SAA、NO水平与心功能指标及临床预后的相关性分析

目的分析冠心病患者血清淀粉样蛋白A(SAA)、一氧化氮(NO)水平与心功能指标及临床预后的相关性。方法选择2016年7月至2017年7月该院收治的98例冠心病患者为冠心病组,同期28例于该院体检健康者为对照组。采用胶乳增强免疫比浊法检测SAA水平,硝酸还原酶法检测NO水平,多普勒彩色超声诊断仪检测左心室射血分数(LVEF)水平。冠心病组随访1年,记录预后情况。比较两组各指标水平间的差异,分析SAA、NO水平与LVEF水平和预后的相关性。结果冠心病组SAA水平高于对照组(P0.05),NO、LVEF水平低于对照组(P0.05);冠心病组SAA水平与LVEF水平呈负相关(r=-0.417,P0.05),NO水平与LVEF水平呈正相关(r=0.368,P 0.05);冠心病组随访1年期间,发生心血管事件21例(21.43%),死亡9例(9.18%);冠心病组发生心血管事件患者SAA水平高于未发生心血管事件患者(P0.05),NO、LVFE水平低于未发生心血管事件患者(P0.05);冠心病组存活患者SAA水平低于死亡患者(P0.05),NO、LVEF水平高于死亡患者(P0.05);冠心病组SAA水平与不良预后呈正相关(r=0.528,P0.05),NO水平与不良预后呈负相关(r=-0.391,P0.05)。结论冠心病患者SAA、NO水平与心功能和预后密切相关,对于评估病情和预后具有较高的价值。     

黄芪总黄酮对尿毒症患者血清诱导的内皮细胞凋亡的影响

目的探讨黄芪总黄酮(TFA)对尿毒症患者血清诱导的内皮细胞凋亡的影响。方法收集22例健康志愿者和25例规律血液透析的尿毒症患者血清。以人脐静脉血管内皮细胞(HUVECs)为研究对象,设立对照组(细胞同步化后加入健康志愿者血清)和尿毒症组(细胞同步化后加入尿毒症患者血清)。细胞同步化前6h,在尿毒症组的一部分细胞中加入0.5、1.0、2.0mg/mL TFA预先进行干预,分别得到低剂量组、中剂量组、高剂量组细胞。细胞培养24h后,于显微镜下观察细胞形态;MTT法检测细胞增殖活力;黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性;硝酸还原酶比色法测定一氧化氮(NO)水平;彗星实验法检测细胞DNA损伤;TUNEL法检测细胞凋亡。结果与对照组比较,尿毒症组细胞增殖活力、SOD活性、NO水平均降低(P<0.01),DNA拖尾率、细胞凋亡指数(AI)均升高(P<0.01);与尿毒症组细胞比较,不同剂量干预的各组细胞增殖活力均增加(P<0.05),NO水平均升高(P<0.01);与尿毒症组比较,中剂量、高剂量组SOD活性增加(P<0.05),DNA损伤拖尾率降低(P<0.05)。结论 TFA可减少尿毒症患者血清诱导的内皮细胞凋亡,其可能机制与抗氧化应激有关。     

血液透析患者心血管事件发生与血清脂联素、炎症标志物的关系

目的探讨尿毒症血液透析患者心血管事件的发生与血清脂联素、炎症标志物的关系。方法应用ELISA法测定30例体检健康者与60例慢性肾衰尿毒症血液透析患者血清脂联素的水平；凝固法测定血浆纤维蛋白原（Fbg）水平，免疫比浊法测定血清C反应蛋白（CRP）。慢性肾衰尿毒症分为发生心血管事件组和未发生心血管事件组。结果尿毒症发生心血管事件组和未发生心血管事件组患者血脂联素、CRP水平明显高于健康对照组（P〈0．05或P〈0．01）。发生心血管事件组患者血脂联素水平明显低于未发生心血管事件组，而CRP、Fbg水平明显高于未发生心血管事件组（P〈0．05或P〈0．01）。简单相关分析尿毒症患者脂联素与CRP、Fbg水平的关系表明脂联素与CRP、Fbg成负相关。结论尿毒症血液透析患者血脂联素、CRP水平升高。低脂联素、高CRP、Fbg水平是尿毒症血液透析患者发生心血管事件的危险因素。脂联素通过减轻炎性反应对尿毒症血液透析患者具有保护作用。     

血液透析联合血液灌流在尿毒症患者中的应用及其对外周血FGF-23水平的影响和预后危险因素分析

目的探讨血液透析联合血液灌流在尿毒症患者中的应用及其对外周血FGF-23水平的影响和预后危险因素。方法选取尿毒症患者70例,随机将其分为对照组和观察组,每组35例。对照组患者采用普通血液透析治疗,观察组则在对照组的基础上加用血液灌流治疗。采用酶联免疫吸附测定法(ELISA)检测并比较两组患者治疗前后的血清FGF-23、血清IL-6、TNF-α水平。对两组患者进行为期1年的随访,对患者死亡情况进行单因素分析,并予以Logistic回归分析。结果治疗前两组患者血尿素氮、肌酐及血清瘦素水平、血清FGF-23水平、血清IL-6、TNF-α水平比较,差异未见统计学意义(P0.05);治疗后观察组血尿素氮、肌酐及血清瘦素水平、血清FGF-23水平、血清IL-6、TNF-α水平低于对照组(P0.05);治疗后,观察组并发症发生率(8.57%)低于对照组(17.1%)(P0.05);透析前,死亡者Hb、Alb水平均低于存活者,并发症发生率高于存活者,差异有统计学意义(P0.05)。经Logistic回归分析,透析前Hb、Alb水平是透析患者的保护因素,而并发症是患者的危险因素(P0.05)。结论血液透析联合血液灌流治疗尿毒症效果显著,能改善外周血FGF-23水平,降低并发症发生率,且能有效缓解炎症反应。透析前Hb、Alb水平与并发症均与患者预后密切相关。     

肝硬化患者血一氧化氮、内皮素-1的变化及其临床意义

目的探讨肝硬化患者血中一氧化氮(NO)、内皮素-1(ET-1)水平的变化及其临床意义。方法 70名肝硬化患者根据肝功能Child-pugh分级分为A、B、C三组。分别检测肝硬化组及对照组血中ET-1、NO含量,其中NO采用硝酸盐还原法,ET-1采用放射免疫法测定。结果肝硬化患者血中ET-1、NO明显高于对照组水平,肝硬化各组随着肝功能损伤加深,血浆ET-1水平逐级升高,血清NO水平B、C组明显高于A组。结论肝硬化患者血ET-1、NO水平高于对照组,且与肝功能的损伤程度有一定的关系。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.