Strategy for urinary protein analysis

SUMMARY: Recent studies have highlighted the intrinsic toxicity of filtered proteins and their contribution to deterioration of renal function. In-depth analysis of proteinuria may assess the degree of glomerular and/or tubular involvement and help in the prognostication of an individual patient. One should consider not only the quantity but also the quality of the urinary protein. Apart from quantitating the total urinary protein, assessment of the quality of the protein may be achieved by performing sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) for an overview assessment follow by automated nephelometry or simple radial immunodiffusion measurement of specific proteins for calculating the selectivity index and detecting tubular dysfunction.     

Role of ultrasound therapy in the healing of tibial stress fractures

Background: Stress fracture is the single most common cause for the lost number of manpower days during training. The conventional treatment options begin with rest and cessation of precipitating activity. However the demands of military training provide little tolerance for prolonged periods of rest. In the recent past ultrasound therapy (UST) has been reported to speed up healing of stress fractures.     

A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff

BACKGROUND: A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self- service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. STUDY DESIGN AND METHODS: Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. RESULTS: Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. CONCLUSION: The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.     

黄芪植入可控降解胶原支架控释促血管生成的效应

目的：将中药黄芪载入胶原支架内,通过对胶原支架进行修饰,观察黄芪能否代替生长因子起到促进血管生成疗效,并了解黄芪与生长因子是否有协同作用. 方法：实验于2004-07-01/2006-07-01在德国亚琛工业大学生化研究所及江苏省中医院中心实验室进行.首先通过不同的EDC/NHS与肝素钠比例来交链修饰Ⅰ型胶原（EDC与NHS质量比固定为1∶0.6,EDC与肝素钠比例为0.2～4）,然后将1 mL黄芪注射液（相当于3 mg生药黄芪）载入修饰后的胶原内.体外通过甲苯胺蓝法测定修饰后胶原内肝素含量,胶原酶降解法测量胶原体外降解率,同时对胶原的亲水性及自由氨基团进行测定.体内通过鸡胚绒毛尿囊膜模型进行血管计数及血红蛋白测定. 结果：①体外实验结果：通过对胶原的修饰程度,可以控制胶原内的肝素含量、体外降解率、自由氨基团含量、亲水性大小.②体内实验结果：黄芪注射液1 mL载入修饰后的胶原较载入未修饰的胶原,可以明显促进鸡胚绒毛尿囊膜内微血管生成,提高胶原内血红蛋白含量（P＜0.01）,其疗效与重组人体血管内皮生长因子载入修饰后的胶原内相当,且与血管内皮生长因子有协同作用的趋势. 结论：通过对胶原的修饰来控制胶原的体外降解,载入黄芪后,使黄芪促血管生成疗效增强,达到与血管内皮生长因子载入后的疗效相当,其作用机制有待进一步研究.     

A new diagnostic workflow for patients with mental retardation and/or multiple congenital abnormalities: test arrays first

High-density single-nucleotide polymorphism (SNP) genotyping technology enables extensive genotyping as well as the detection of increasingly smaller chromosomal aberrations. In this study, we assess molecular karyotyping as first-round analysis of patients with mental retardation and/or multiple congenital abnormalities (MR/MCA). We used different commercially available SNP array platforms, the Affymetrix GeneChip 262K NspI, the Genechip 238K StyI, the Illumina HumanHap 300 and HumanCNV 370 BeadChip, to detect copy number variants (CNVs) in 318 patients with unexplained MR/MCA. We found abnormalities in 22.6% of the patients, including six CNVs that overlap known microdeletion/duplication syndromes, eight CNVs that overlap recently described syndromes, 63 potentially pathogenic CNVs (in 52 patients), four large segments of homozygosity and two mosaic trisomies for an entire chromosome. This study shows that high-density SNP array analysis reveals a much higher diagnostic yield as that of conventional karyotyping. SNP arrays have the potential to detect CNVs, mosaics, uniparental disomies and loss of heterozygosity in one experiment. We, therefore, propose a novel diagnostic approach to all MR/MCA patients by first analyzing every patient with an SNP array instead of conventional karyotyping.     

Single‐port laparoscopic cholecystectomy: A comparative study in 106 initial cases

Introduction: Laparoscopic cholecystectomy has been the standard of care for gallbladder diseases since the late 1980s. Many surgeons have rapidly adopted single‐port laparoscopic cholecystectomy for gallbladder pathologies. The aim of the present study was to analyze the clinical outcome in initial single‐port laparoscopic cholecystectomy. Methods: Data from 106 consecutive single‐port laparoscopic cholecystectomies between May 2008 and April 2009 were analyzed retrospectively. We divided the patients into two groups – an early group (group I, n=56) and a late group (group II, n=50) – to compare clinical outcomes. During each procedure, only one longitudinal transumbilical incision, 1.5 to 2.0 cm in length, was made to access the abdominal cavity. A multichannel port system was assembled with existing devices. Standard laparoscopic instruments were used to perform each cholecystectomy. Results: Patient demographics did not differ between the two groups. Of the eight cases that were converted to conventional laparoscopic surgery, seven were part of group I (P=0.063). Mean operation time for single‐port laparoscopic cholecystectomy was significantly shorter in group II (58.2 versus 71.6 min, P=0.004). There were two operative complications in group I, which were successfully managed with laparoscopic surgery. There was no statistical difference in occurrence of operative complication and hospital stay between the two groups. Conclusion: Single‐port laparoscopic cholecystectomy can be safely performed for various gallbladder lesions in selected cases, and the operation time improved with accumulation of cases.     

消旋棉酚拆分的研究——Ⅲ.胺缩棉酚理化性质的研究

本文报道消旋棉酚与15种不同结构的光学活性胺缩合产物的薄层色谱性质和核磁共振氢谱数据,以及8个光学活性胺与光学活性棉酚缩合物的光学稳定性,并探讨了结构与这些性质的关系。     

Expression of mdr-1 in refractory lymphoma: quantitation by polymerase chain reaction and validation of the assay [published erratum appears in Blood 1995 Dec 15;86(12):4710]

Measurement of P-glycoprotein and the gene that encodes it, mdr-1, is an important tool for assessing the impact of multidrug resistance in clinical cancer. We evaluated mdr-1 expression by a quantitative polymerase chain reaction (PCR) assay in 78 biopsy samples from 48 patients with refractory lymphoma enrolled on a trial of infusional chemotherapy (EPOCH) in which R-verapamil was added as an antagonist of P-glycoprotein in a subset of patients whose tumors were unresponsive to treatment. Expression of mdr-1 was detectable in all biopsies at the time of enrollment on study, and a fourfold or greater increase in mdr- 1 expression was noted in 42% of patients at the time of treatment failure. Expression of mdr-1 was also detectable in biopsies from patients at the time of diagnosis of lymphoma. An endogenous control gene, beta 2-microglobulin, was quantitated for normalization of the mdr-1 values. The use of beta 2-microglobulin expression for normalization was validated in a subset of samples by comparing Northern blots detecting beta 2-microglobulin, beta actin, and GAPDH gene expression. Immunoblot analysis suggested that no major discrepancy was present between mRNA expression and protein level. Immunophenotyping of lymphomatous lymph nodes showed that infiltration of tumor cells ranged from 8% to 95% and of normal T cells from 1% to 83%. Expression of mdr-1 in normal T cells and monocytes was also shown to be low. The mdr-1 levels in patient samples were independent of T- cell contamination, suggesting that the presence of normal cells has at best a small impact on mdr-1 measurements. Expression of mdr-1 in lymphoma can be quantitated by PCR, and wide variations in expression can be observed. Increased expression in patients with refractory disease supports an important role for Pgp in drug resistance in lymphoma. These studies will aid in the design and interpretation of clinical trials in lymphoma.