颅脑损伤患者血浆ADH测定的临床意义

目的 :探讨颅脑损伤病人血浆抗利尿激素 (ADH)的变化 ,以及与低钠血症发生的机制。方法 :血浆ADH采用放射免疫分析 (RIA) ,血BUN、Cr测定采用酶法 ,血Na 、尿Na 测定采用离子电极法 ,随机对 75例单纯颅脑损伤病人伤后 1、7、1 4、2 1d血浆ADH进行测定 ,同时对血Na 测定值 <1 30mmol/L的 4 3例颅脑损伤并发低钠血症的病人血浆中ADH、BUN、Cr及 2 4h尿Na 进行测定。结果 :颅脑损伤后 1d、7d、1 4d三组中ADH含量明显高于对照组 (P <0 .0 1 ) ,伤后第 2 1d病人ADH含量较对照组差异无显著性 (P >0 .0 5 )。颅脑损伤并发低血钠症的病人 ,需要应用脱水剂 ,其ADH变化较不一致。 4 3例中A组 1 9例 ,系仍在使用脱水剂期间 ,测其ADH与对照组无差异性 (P >0 .0 5 ) ,与血钠浓度亦无相关性 (r=0 .2 0 )。B组 1 6例 ,停用脱水剂后出入量平衡 ,其ADH水平明显高于对照组 ,与血钠浓度呈负相关 (r=- 0 .6 7)。C组 8例 ,停用脱水剂后出量明显大于入量 (每天差额 >5 0 0ml)其ADH水平明显低于对照组 ,与血钠浓度呈正相关 (r=0 .87)。三组低钠血症病人 2 4h尿钠浓度明显高于对照组 (P <0 .0 1 )。结论 :颅脑损伤后ADH改变随情况而异。一般说来 ,ADH在伤后即升高 ,以后逐渐下降至正常 ,但亦有一些病例ADH反而降低 ,导致类似     

2型糖尿病血管病变时血浆ANP、BNP及CNP的变化及临床意义

目的：探讨血浆心钠素(ANP)、脑利钠肽(BNP)、C型利钠肽(CNP)在2型糖尿病血管病变时的变化及其临床意义。方法:应用酶联免疫吸附法(ELISA)测定正常对照组(9例)、2型糖尿病无血管病变组(34例)及2型糖尿病血管病变组(23例)血浆proANP、BNP fragment及NT-proCNP浓度，分析各组间血浆利钠肽水平的变化及相关因素。结果:2型糖尿病血管病变组血浆ANP、BNP明显高于另外2组（P<0.01），而血浆CNP明显降低（P<0.01），2型糖尿病血管病变组各亚组(微血管病变组、大血管病变组及微血管合并大血管病变组)间血浆利钠肽水平无明显差异（P>0.05）。2型糖尿病血管病变组血浆ANP与BNP间存在显著正相关（r=0.309, P<0.05），ANP与CNP（r=-0.374, P<0.05）以及BNP与CNP（r=-0.653, P<0.01）间存在显著负相关。结论:血浆ANP、BNP及CNP的联合检测可以作为简便、价廉、可靠的糖尿病血管病变的筛选指标。     

EH患者血清利钠多肽及血栓素B_2水平的分析

目的：探讨原发性高血压（EH）患者血清ANP、BNP、CNP及TXB2水平的变化及其临床意义。方法：30例EH患者和正常人对照组分为2组;不同EH分期Ⅰ、Ⅱ、Ⅲ期分为3组,将测定结果进行统计分析。四项血清标志物均采用放射免疫分析。结果：EH患者组ANP、BNP、CNP及TXB2四项血清指标水平均较对照组升高非常显著（P均〈0.01）。Ⅰ期组EH患者血清ANP、CNP及TXB2三项血清标志物与对照组比较差异均无显著性（P均〉0.05）,而血清BNP则显著高于对照组（P〈0.05）;Ⅱ期组患者ANP水平显著高于Ⅰ期组和对照组（P〈0.05）,而BNP、CNP和TXB2三项血清标志物则非常显著高于Ⅰ期组和对照组（P均〈0.01）。Ⅲ期组结果显示,ANP、BNP、CNP和TXB2四项血清标志物均非常显著地高于Ⅱ期组、Ⅰ期组及对照组（P均〈0.01）,相关分析结果显示,患者ANP、BNP和CNP三项指标与自身的平均动脉压呈显著正相关（r=0.298,P〈0.01;r=0.409,P〈0.01;r=0.412,P〈0.01）。结论：本文四项血清指标水平显著升高,测定数据的变化与EH的发病及病情进展有关。     

扩张型心肌病患者血清韧粘素-C的变化及意义

目的: 探讨扩张型心肌病（DCM）伴心力衰竭患者血清韧粘素-C（TN-C）、脑钠肽(BNP)和Ⅲ型胶原前体氨端肽（PC-Ⅲ）的含量及意义。方法: 对30例DCM患者和30例健康对照者采血测定血清TN-C、 BNP和PC-Ⅲ含量。结果: DCM患者血清TN-C含量显著高于正常对照组（P<0.01）。心力衰竭越重，DCM患者血清TN-C、BNP和PC-Ⅲ含量增加越明显，TN-C与左室射血分数负相关（r=-0.894 7,P<0.01）、与BNP（r=0.952 2, P<0.01）和PC-Ⅲ（r=0.240 4, P>0.05）正相关。结论: DCM患者血清TN-C明显升高，血清TN-C可反映DCM患者心力衰竭的严重程度。     

利尿钠肽在诊断心力衰竭中的应用价值

探讨利尿钠肽的水平对心力衰竭（心衰）早期诊断的应用价值。采用放免法、ELISA法检测了129例心衰患者血浆中的心房利尿钠肽（ANP）、脑利尿钠肽（BNP）、N末端脑钠肽前体蛋白（NT-proBNP）水平,并与30例健康对照者进行了比较分析。结果显示,心衰患者血浆中的ANP、BNP、NT-proBNP显著高于健康对照组,且均随着NYHA分级的升高而逐渐增加,其含量在NYHA Ⅳ级时到达最高,心衰患者的血浆ANP、NT-proBNP水平与LVEF呈明显负相关。检测血浆中的ANP、BNP、NT-proBNP含量简便、快捷,可用于心衰诊断及NYHA分级判断。     

超声微泡介导转染FK12.6结合蛋白基因对心力衰竭犬心功能的影响

目的： 探讨白蛋白微泡介导的外源性pcDNA3.1-FKBP12.6质粒转染对心衰犬的治疗作用。方法: 以白蛋白微泡为载体，在超声破坏下将人工合成的pcDNA3.1-FKBP12.6质粒转染入快速起搏心衰犬心肌中。分别在转染后第4、14 d，通过超声和有创血流动力学检查测定左室内径和心功能，同时检测血浆心钠肽（ANP）、脑钠肽（BNP），评价FK12.6结合蛋白（FKBP12.6）基因对心衰的治疗效果。应用RT-PCR检测各组FKBP12.6基因的表达情况。结果: 超声微泡介导的转染可以提高心肌FKBP12.6 mRNA的表达。射血分数（EF）、缩短分数（FS）、血流动力学指标及血浆ANP、BNP在第4 d可见明显好转，并在14 d时保持稳定，但EF、FS和心输出量（CO）一直低于正常水平。在第4 d时LVEDD无变化，而左室舒张末期容积（LVEDV）下降（P<0.05），在14 d时2指标与对照组比较均缩小（P<0.05，P<0.01）。结论: 通过超声微泡介导转染FKBP12.6基因可以改善心脏功能，是心衰基因治疗的新手段。     

COPD患者血清ANP、BNP和CNP测定及其临床意义

目的：探讨慢性阻塞性肺疾病（COPD）患者血清心钠素（ANP）、脑钠肽（BNP）、C型钠尿肽（CNP）水平的变化及其临床意义。方法：采用放射免疫分析79例COPD患者和36例健康对照组血清ANP、BNP和CNP水平,并进行统计分析。结果：COPD组血清ANP、BNP和CNP水平显著地高于健康对照组（t=3.6841,P〈0.01;t=11.70,P〈0.01;t=2.177,P〈0.05）,但Ⅰ、Ⅱ、Ⅲ和Ⅳ级组间血清ANP、BNP和CNP水平方差检验无显著性意义（F=2.123、F=1.515、F=0.165,P均〉0.05）。相互间相关性分析揭示：ANP、BNP和CNP三者间均呈显著正相关（r=0.369,P〈0.01;r=0.354,P〈0.01;r=0.426,P〈0.01）。住院期间死亡的患者血清ANP、BNP和CNP水平显著地高于好转出院的患者（t=5.149,P〈0.01;t=4.875,P〈0.01;t=2.830,P〈0.01）。结论：COPD患者血清ANP、BNP和CNP显著升高,且与病人的稳定情况、肺动脉压力及预后相关。     

血浆脑尿钠排泄肽可作为预测急性心肌梗塞后进行性心室重塑的一项生化标志

近期研究认为，血桨脑尿钠排泄肽（BNP）水平是急性心肌梗塞后患者长期存活的重要独立预后标志，其机制可能与预测急性心肌梗塞后心室重塑有关。为此，作者选择了一组病例进行研究。病例与方法30例急性心肌梗塞患者，在急性心肌梗塞后的第2、7、14及30天分S踩集血标本进行血浆脑尿钠排泄肽（BNP）及动脉尿钠排泄肽（ANP）测定，并在人院时及发病后1个月采用左心室造影术评价左心室舒张末期容积指数（EDVI）、收缩末期容积指数（ESVI）及射血分数（FF），以上左心室造影的三项参数的变化值（急性期测定值一慢性期测定值）分别确定为…     

心力衰竭患者血浆脑钠肽与血清尿酸变化的临床价值

目的探讨测定心力衰竭（HF）患者血浆脑钠肽（BNP）、血清尿酸（UA）水平在临床应用中的意义。方法测定102例HF患者,按NYHA心功能分级分为：Ⅱ、Ⅲ、Ⅳ级及30例对照组血浆BNP、血清uA、左心房内径（LAd）,左室舒张末期内径（LVEDd）及左室射血分数（LVEF）。结果HF患者UA增高组血浆BNP、IAd、LVEDd均显著高于UA正常组;LVEF显著低于UA正常组（P〈0．05）。HF患者血浆BNP、血清UA均显著高于对照组（P〈0．05）,随HF程度的加重而显著增加。NYHA心功能分级Ⅲ、Ⅳ级患者LAd、LVEDd均显著高于Ⅱ级组;LVEF显著低于Ⅱ级组（P〈0．05）。结论血浆BNP、血清UA对HF患者的诊断、治疗、病情和预后判断具有重要意义。     

CHF患者血浆BNP检测的临床价值探讨

目的：探讨慢性心衰（CHF）患者血浆脑钠肽（BNP）检测的临床价值。方法：采用荧光免疫分析对341例CHF患者及55例健康对照者进行血浆BNP测定,同时以彩色多普勒超声心电动仪测定CHF患者左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）,并与血浆BNP水平作相关性分析。结果：CHF组患者血浆BNP水平明显高于健康对照者（P〈0.01）,且不同心功能患者之间的血浆BNP含量亦存在显著差异（P〈0.01）;CHF组患者血浆BNP水平与LVEF、LVESD、LVEDD呈现良好的相关性（r分别为-0.62、＋0.54和＋0.60,P均〈0.01）。结论：BNP是评价CHF患者心室功能的灵敏指标。     

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.