2型糖尿病患者血清von Willebrand因子变化与微血管并发症的关系

目的 :探讨 2型糖尿病患者的微血管内皮细胞功能损伤与微血管并发症之间的关系。方法 :从 3 3 4名 2型糖尿病患者中选择合并微血管并发症但未合并大血管并发症者 3 2人作为微血管并发症组 ,并选择年龄与之匹配的无大血管及微血管并发症 55人作为无并发症组 ,观察二组患者血清vonWillebrand因子 (vWF)水平 ,并与年龄相接近的正常对照组 ( 4 0例 )比较。结果 :血清vWF水平正常对照组 0 .92U± 0 .44U/ml;无并发症组 1.15U± 0 .42U /ml ;微血管并发症组 1.3 7U± 0 .44U/ml;三组之间均有显著性差异 (P <0 .0 5～ 0 .0 1)。多因素Logistic回归分析表明vWF、空腹血糖分别与糖尿病人是否合并微血管病变显著相关 (ExpB分别为 3 .0 2 3 ,1.3 3 7,P <0 .0 5～ 0 .0 1) ,以vWF为应变量的多元逐步回归分析表明年龄、糖尿病病程、甘油三酯分别与vWF呈显著独立正相关 (B =0 .53 ,0 .3 5,0 .2 9,P <0 .0 5～ 0 .0 1)。结论 :在糖尿病患者中存在不同程度的微血管内皮细胞的损伤 ,此变化随着微血管并发症的进展呈进行性加重。以vWF升高所反映的微血管内皮细胞损伤是一项值得临床推广的研究方法     

糖尿病视网膜病变与血管性血友病因子和纤维蛋白原的关系

目的 :探讨糖尿病视网膜病变 (DR)与纤维蛋白原 (FIB)及vonWillebrand因子 (vWF)水平的关系及其临床意义。方法 :2型糖尿病人 10 4例根据病史及是否合并糖尿病微血管病变进行如下分组 :无并发症组 5 3例 (男 2 6例 ,女 2 7例 ) ,合并糖尿病视网膜病变组 5 1例(男 2 5例 ,女 2 7例 ) ,正常对照组 5 6例 (男 2 8例 ,女 2 8例 )。三组分别采用硫酸胺比浊法及双抗酶联免疫吸附法 (EUA)分别进行FIB、vWF的测定 ,并测定血压、糖化血红蛋白等指标。结果 :糖尿病患者血浆vWF、FIB水平较正常对照组明显升高 (P <0 .0 1) ,合并糖尿病视网膜病变组较无并发症组显著升高 (P <0 .0 1)。结论 :血浆FIB及vWF水平的升高与糖尿病视网膜病变的发生发展有关。     

2型糖尿病血管合并症与血清生长激素的关系

为探讨生长激素 (GH)在 2型糖尿病患者大血管病变的发病机制中的价值 ,采用RIA法对 180例 2型糖尿病患者血清GH进行了测定。结果表明 :无血管合并症的糖尿病组血清GH水平较对照组明显降低 (P <0 .0 5 ) ,有血管合并症的糖尿病组血清GH水平较对照组明显增高 (P <0 .0 1) ,这两糖尿病组间血清GH水平差异非常显著 (P <0 .0 0 1)。GH在 2型糖尿病患者大血管病变的发病机制中起着重要作用     

尿Ⅳ型胶原与糖尿病微血管病变的关系

目的 :探讨尿Ⅳ型胶原 (ⅣC)对糖尿病微血管病变早期诊断的价值。方法 :采用放射免疫分析法对 3 5例正常人及 86例糖尿病患者尿ⅣC进行测定 ,并与病程、年龄、血ⅣC、空腹血糖 (FBG)、胰岛素 (INS)及收缩压 (SBp)等指标作相关分析。结果 :对照组、糖尿病无微血管病变组、微血管病变组尿ⅣC浓度分别为77 70± 12 91μg/ 2 4h、88 74± 19 5 8μg/ 2 4h、12 9 99± 3 0 2 3 μg/ 2 4h。微血管病变组显著高于无微血管病变组及对照组 (p <0 0 0 1,0 0 0 1) ;无微血管病变组显著高于对照组 (p <0 0 1)。糖尿病患者尿ⅣC浓度与病程、血ⅣC及SBp呈正相关 (p <0 0 1,0 0 5 ,0 0 5 )。结论 :糖尿病患者尿ⅣC浓度随微血管病变进展而逐渐增高 ,可作为早期诊断微血管病变的指标     

内皮素和一氧化氮/一氧化氮酶检测对老年糖尿病与血管病变患者临床价值的研究

探讨内皮素(ET)、一氧化氮/一氧化氮酶( NO/NOS)在糖尿病与血管病变患者中的变化。ET采用放射免疫分析法,NO/NOS采用酶法。结果是:(1)糖尿病组ET水平(68.80±37.35)pg/mL)较对照组(41.70±21.50pg/mL)显著升高(P<0.001);NOS水平(2.75±1.49U/mL)明显高于对照组(1.12±0.56U/mL),P<0.01;NO水平(49.32± 16.32μmol/L)明显低于对照组(54.60 ±15.60μmol/L),P<0.05。(2)糖尿病合并血管病变组ET水(80.1140.25pg/mL)显著高于无并发症组(62.73±24.29pg/mL),P<0.001;NOS水平(4.02 ± 0.59U/mL)明显高于无并发症组(2.51±1.19U/mL),P<0.001;NO水平(42.25 ± 10.10/μmol/L)明显低于无并发症组(52.16±14.59mol/L,P<0.05;NO/NOS(11.99±7.05)明显低于无并发症组(26.9±13.15),P<0.001提示 ET、NO/NOS与糖尿病的发生和发展有关,联合检测不仅可作为糖尿病及其血管并发症的重要依据,还将有助于糖尿病合并血管病变的预防和治疗。     

212例糖尿病患者慢性大血管与微血管并发症5年随访

目的 :本文对北京地区 2 12例糖尿病患者进行 5年随访 ,以了解其糖尿病慢性并发症 ,包括大血管及微血管病变情况。方法 :分别对体重指数 (BMI)、血压、心电图、眼底、血脂、尿白蛋白排泄率(UAER)等进行分组检查。结果 :2 12例糖尿病患者中冠心病患病率由 1995年 8.0 %升高至 2 0 0 0年 14 .2 % (P >0 .0 5) ;脑卒中患病率由1995年 7.5%升高至 2 0 0 0年 8.5% (P >0 .0 5) ;糖尿病肾病由 1995年 2 9.2 %升高至 2 0 0 0年 4 7.2 % (P <0 .0 1) ;糖尿病视网膜患病率由 1995年 9.0 %升高至 2 0 0 0年 2 4 .5% (P <0 .0 1)。 2 12例糖尿病患者按血压 <14 0 /90mmHg和血压≥ 14 0 /90mmHg分组随访 ,发现其脑卒中、糖尿病肾病患病率二组间有显著性差异 (P <0 .0 5～ 0 .0 1)。结论 :糖尿病视网膜病变和糖尿病肾病的发生随病程延长明显增多 ,糖尿病时大血管并发症亦随病程延长有增加趋势。对此应早期进行干预治疗 ,尤其是降压治疗     

2型糖尿病微血管并发症与高血压的关系

2 型糖尿病 (DM)发病率高 ,DM微血管并发症为患者致死、致残的主要原因。而高血压为大血管病的一般危险因素[1] ,其与微血管病变关系的研究少见报告。为此 ,我们探讨了高血压对DM患者微血管并发症的影响 ,现将结果报告如下。1　资料和方法1.1　资料16 2例 2型DM患者 (男 6 4例 ,女 98例 )均为住院病人 ,年龄 5 3.32± 7.98岁。DM的诊断依据 1997年美国糖尿病协会 (ADA)标准[2 ] 。微血管病变以糖尿病肾病 (DN)和糖尿病视网膜病变 (DR)为代表[3 ] 。其中DN诊断以尿白蛋白排泄率 (UAER)大于 2 0ug/min为依据 (放射免疫方法 ) ;DR诊…     

化学发光免疫法与RIA法测定人血清抗TgAb和抗TpoAb结果的比较

比较CLIA和RIA法测定抗甲状腺球蛋白抗体 (抗TgAb)和抗甲状腺过氧化物酶抗体 (抗TpoAb)的临床应用意义。对经临床诊断甲状腺功能检查及病理证实的 37例慢性淋巴细胞性甲状腺炎患者 ,30例甲亢患者及36例患有内分泌疾病的患者 (包括甲状腺结节、甲状腺癌、糖尿病及库兴氏综合征 )和 35名正常人 ,用CLIA和RIA两种方法分别测定其血清的抗TgAb和抗TpoAb水平 ,并进行比较。结果表明 :(1 )CLIA和RIA法的批内变异分别为 3.0 %和 1 0 .0 % ,批间变异分别为 3.9%和 1 5 .0 % ;(2 )正常人抗TgAb水平分别为CLIA法是 2 5 .9± 9.6U/mL ;RIA为 1 1 .2± 2 .8% ,抗TpoAb水平分别为CLIA法是 31 .4± 6 .7U/mL ;RIA是 8.7± 3.0 % ;(3)慢性淋巴细胞性甲状腺炎患者分别用CLIA法测定抗TaAb为 2 92 .6± 334.1U/mL(1 7例 ) ,RIA为 5 6 .4±1 1 .2 % (2 1例 )。而用CLIA法测定抗TpoAb为 5 0 4 3.3± 31 96 .1U/mL(1 7例 ) ,RIA为 35 .4± 6 .9% (2 1例 ) ,该结果显示CLIA法所测抗TgAb和抗TpoAb水平均明显高于正常人 (P <0 .0 0 1 ) ,特别是抗TpoAb水平比正常人高百倍以上 ,说明其特异性更高 ;(4 )甲亢患者及内分泌病患者 ,用CLIA法测定抗TgAb为 2 0 2 .3±5 0 6 .3U/mL和 2 8.7± 1 5 .0U/mL ;用RIA法为 2 8.8± 2 0 .2 %和 1     

血管内皮生长因子水平与糖尿病患者微血管病变的观察

血管内皮生长因子 (VEGF)是促进新生血管形成的主要细胞因子 [1 ] 。糖尿病视网膜病变是全身微血管病变的一部分 ,也是糖尿病患者重要的慢性并发症。我们通过测定不同视网膜病变期患者血清中 VEGF水平 ,观察 VEGF与糖尿病患者微血管病变的关系。1　材料与方法1.1　实验对象　糖尿病患者 5 2例 ,诊断依照 1985年 WHO制定糖尿病诊断标准和全国眼底病学组制定的糖尿病视网膜病变诊断标准分为 :单纯型视网膜病变组 (SDR) 4 1例 ,年龄 6 1.1± 10 .9岁 ;增殖型视网膜病变 (PDR)组 11例 ,年龄6 3.1± 18.9岁 ;无视网膜病变 (NDR) 33例 ,…     

急性心肌梗死大鼠血清血管内皮生长因子含量的变化

目的和方法 :探讨急性心肌梗死大鼠模型血清血管内皮生长因子 (VEGF)含量的变化及其意义。 88只雄性SD大鼠 ,其中 80只结扎左冠状动脉导致心肌梗死 ,8只开胸但不结扎冠状动脉作对照组。于心肌梗死后 1h ,3h ,6h ,12h ,2 4h和 2d ,3d ,5d ,7d ,14d分别从右心房抽取血样品 (n =8)。用敏感、特异的酶连接免疫吸附测定法测定血清样品中的VEGF含量。结果 :8只假手术对照鼠的血清VEGF浓度为 (6 6 99± 17 83)pg/mL。心肌梗死后 6h组血清VEGF水平达到 (12 5 6 8± 2 8 0 7)pg/mL(与对照组比P <0 0 1) ,结扎后 2 4h组达高峰 (2 40 6 1± 70 6 3pg/mL ,与对照组比P <0 0 1) ,然后逐渐下降 ,但术后 14d组仍显著高于对照组 (10 7 6 4±30 13pg/mL ,P <0 0 1)。结论 :心肌梗死大鼠血清VEGF水平持续显著升高 ,可能对心肌梗死后的血管生成起重要作用     

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.     

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.     

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.     

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.