Assessment of microalbuminuria and glycated hemoglobin in type 2 diabetes mellitus complications

ObjectiveTo relate microalbuminuria with the degree of glycaemic control in type 2 diabetic patients and determine the prevalence of poor glycemic control amongst the normotensive diabetes mellitus (NDM) and hypertensive diabetes mellitus (HDM) with or without microalbuminuria.MethodsA total of 95 type 2 diabetes mellitus patients and 30 healthy controls were randomly selected and studied. 17 of the 95 patients were normotensive diabetic with microalbuminuria, 40 of them were HDM presenting with microalbuminuria and 38 were NDM without microalbuminuria. Their blood was obtained for fasting plasma glucose and glycated haemoglobin while their urine was obtained for albumin and creatinine estimation and the ratio was calculated.ResultsOut of the 95 diabetic patients studied, 57 (60%) of them had microalbuminuria while 38 (40%) had normoalbuminuria. The mean ages in the diabetics with microalbuminuria were higher than those without microalbuminuria (P=0.054 6). The mean glycated haemoglobin was the highest (5.95±2.06)% in NDM with microalbuminuria when compared with HDM with microalbuminuria (5.83±1.62)% and that in (5.66±2.49)% in NDM without microalbuminuria (P=0.000 9). Similarly, fasting plasma glucose was the highest (9.09±4.31) mmol/L in NDM with microalbuminuria than those without microalbuminuria (7.70±3.33) mmol/L (P=0.000 1). The prevalence of poor glycaemic control was the highest (29%) in NDM with microalbuminuria while the least (21%) in NDM without microalbuminuria.ConclusionsThe risk of microalbuminuria increases with poor glycemic control. Persistent increase in glycated haemoglobin may be an indicator of worsening albumin creatinine ratio and diabetic nephropathy. Therefore, regular screening for microalbuminuria in addition to continuous (3-monthly) glycated HbA1c estimation is advised.     

丙肝病毒单片段抗体检测分析

目的 探讨丙型肝炎病毒感染者抗.HCV各区段抗体的反应性及单片段抗体ELISA测定临床应用的可行性和应用价值.方法 留取经2种第三代丙肝病毒总抗体ELISA检测试剂A、B检测结果为阳性的血清36份、可疑血清2份、阴性血清40份,用丙肝单片段抗体检测试剂C对其进行检测,并以CHIRON公司第三代免疫印迹丙肝抗体确认试剂D检测结果作为对照.结果 78份血清中,抗HCV-C、NS3、NS4、NS5四区单片段抗体阳性检出率分别为44.87%、47.44%、30.77%、28.21%;单片段抗体检测试剂C的阳性率为43.59%,与第三代总抗体检测试剂A、B的阳性率(分别为48.72%和46.15%)无显著差异;试剂A、B检出的阳性血清36份中,根据试剂C的核心区、NS3、NS4及NS5区单片段抗体检测结果综合判断确定阳性结果34份,不确定结果2份,阳性符合率为94.44%;2份可疑血清根据单片段抗体检测结果综合判断均为不确定结果;40份阴性血清中,单片段抗体检测检出阴性结果40份,阴性符合率为100%.试剂C对所有78份血清检测结果为阳性34份,不确定4份,阴性40份;而确认试剂D检测结果为阳性34份,不确定3份,阴性41份.结论 NS3区和c区为抗-HCV ELISA检测中的主要血清学标志;单片段检测试剂C与第三代总抗体检测试剂A、B之间的检出率无显著差异,结果符合良好,且与国际上公认的CHIRON第三代免疫印迹丙肝抗体确认试剂检测结果高度一致.单片段抗体检测在临床判断病情、病毒复制情况及预后方面较总抗体检测能提供更多信息.     

A step forward for the undulation pump total artificial heart

In the University of Tokyo, various types of total artificial heart (TAH) have been studied. Based on the experiences of TAH research, the development of the undulation pump total artifical heart (UPTAH) started in 1994. The undulation pump is a small-size, continuous-flow, displacement-type blood pump, and the UPTAH is a unique implantable total artificial heart that uses the undulation pump. To date, three models of UPTAH have been developed. The first model, UPTAH1, was developed to investigate the possibility of reducing the size of the device so it could be implanted in small adults, such as Japanese patients, in 1994. The second model, UPTAH2, which was the prototype of the animal experimental model, was developed in 1996 to investigate the possibility of survival with the UPTAH. The third model, UPTAH3, which is the present model, was developed in 1998 to enable long-term survival in animal experiments and to investigate the pathophysiology of the UPTAH. From July 1996 to October 1999, 22 implantations of UPTAH2 or UPTAH3 were performed in goats. In spite of the limitation of their small chest cavity, the UPTAH could be implanted into the chest of all goats. Using UPTAH3, survival of 31 days could be obtained. The research and development of UPTAH are ongoing.