Cystatin C单独或联合血清肌酐评估GFR的意义

肾小球滤过率（GFR）是评价肾功能的重要指标，而GFR不能常规测得，只能利用血清肌酐水平来评估GFR。但是影响肌酐水平的因素很多，特别是肌肉代谢等因素的影响。由于肌酐存在诸多的干扰因素，近年来血清半胱氨酸蛋白酶抑制剂C（Cystatin C）被认为是可能取代肌酐成为评价GFR的指标，许多研究表明Cystatin C水平与GFR的关联程度比肌酐更好。但也有研究认为血清Cystatin C与基于肌酐、年龄、性别和种族的GFR计算公式的结果相当。     

Comparison of adult oral health in Australia, the USA, Germany and the UK

Background:  Australian adults reportedly have poor oral health when compared to 28 other OECD countries. The Australian ranking was based on edentulism and caries experience data from selected age groups that apparently were collected in 1987–88. The objective of this study was to compare the oral health of Australian adults with that of three other western countries that have comprehensive oral health survey data.
Methods:  Published data were obtained from the NHANES 2003–2004, the Fourth German Oral Health Study 2005 and the UK Adult Dental Health Survey 1998. Data from the Australian NSAOH 2004–06 were analysed to generate comparable age-specific estimates using nine dental clinical indicators, two measures of oral hygiene behaviour and two of dental attendance.
Results:  Australia had the best oral health based on two clinical indicators, was equal first on three indicators and ranked second in the remaining clinical indicators. Australia ranked first or second based on dental flossing, use of mouthwash and frequency of dental attendance.
Conclusions:  The oral health of the Australian adult population was among the best of the four nations studied.     

Antibodies to hydrocortisone in reagent red cells causing positive antibody screening tests

When a patient's serum contains a temperature-independent antibody reacting with all antibody screening and antibody identification panel cells but with few or no units of blood used for crossmatching, one should suspect an antibody against a constituent of the suspension medium of the reagent blood cells. This observation is confirmed by negative reactions with a) washed reagent cells or b) another manufacturer's cells that do not contain the same additives. Two patients are described with antibodies to hydrocortisone that are present in one manufacturer's antibody screening cells and identification panels. The hydrocortisone was added by the manufacturer to prevent hemolysis of the reagent red cells. The patient's antibodies were IgM, complement independent, and nonneutralizable by prior incubation with hydrocortisone. The addition of hydrocortisone to other manufacturers' reagents converted previously negative reactions to the same level of positivity as was seen with the reagent from the index manufacturer. Antibodies to reagent constituents can cause delays in finding compatible blood. It is suggested that manufacturers delete irrelevant additives or those of questionable necessity from their reagents.     

The mucosal immune system in IgA nephropathy

Summary: IgA nephropathy is a clinically and histologically defined syndrome of unknown aetiology, which may have various causes in different parts of the world. Immunologically it is characterized by deposition of IgA1, probably polymeric IgA, in the mesangium and is frequently associated with IgG, C3 and components of the alternative pathway of the complement cascade. the disease can go into complete remission in children, but in adults it usually has a progressive course, characterized by the appearance of proteinuria and hypertension and loss of glomerular filtration rate (GFR). Histologically the development of glomerulosclerosis and tubulo-interstitial changes correlate with a clinical progressive course. the mucosal immune system is characterized by high plasma IgAl antibody responses after parenteral immunization with viral or bacterial vaccines. However, following nasal challenge with a bacterial neoantigen, IgA nephropathy patients appear to have a defective mucosal immune response in their nasal washes, in their bone marrow and in their plasma IgA1 antibody levels.     

Neuropsychiatric symptoms and quality of life in Alzheimer disease.

OBJECTIVE: Authors examined the impact of neuropsychiatric symptoms in Alzheimer disease (AD) patients' and caregivers' quality of life (QOL) and assessed the relationship of caregiver distress to neuropsychiatric symptoms and caregiver QOL. METHODS: Sixty-two patients with probable or possible AD and their caregivers participated. Neuropsychiatric symptoms of patients were assessed with the Neuropsychiatric Inventory (NPI). QOL of both patients and caregivers was assessed using the QOL-Alzheimer's Disease (QOL-AD) scale. Each patient and caregiver completed patient QOL ratings; caregivers also completed caregiver QOL assessments. RESULTS: Caregiver QOL-AD was negatively correlated with agitation/aggression, anxiety, disinhibition, irritability/lability, and total NPI score. Patient QOL on both patient and caregiver ratings was negatively correlated with depression. Patient-reported QOL-AD ratings at different levels of cognitive functioning were not correlated with caregiver-reported ratings. The lack of relationship between patient and caregiver assessments of patient QOL was evident in both mildly and moderately affected patients. Caregiver QOL was negatively correlated with distress related to agitation/aggression, disinhibition, irritability/lability, and total NPI distress. CONCLUSION: Neuropsychiatric symptoms of AD patients adversely affect both patient and caregiver QOL. These results suggest that identifying and treating neuropsychiatric symptoms in AD may improve both patient and caregiver QOL.     

B cells and monocytes are not developmentally affected in a case of reticular dysgenesis

We report a patient with reticular dysgenesis (RD) who received an HLA-identical marrow graft and remained free of infection in spite of incomplete haematological recovery. Mixed chimerism was achieved and resulted from the presence of autologous B cells and monocytes and grafting of donor T cells. Granulocyte recovery was impaired. The B cells were CD5⁺ (B1 cells) and appeared to be functional, since serum immunoglobulin levels became normal after the graft. The findings described here suggest that in some cases the defect selectively affects different cell types, including the more abundant leucocyte populations, granulocytes and T lymphocytes. However, B cells and monocytes appear to be relatively spared in this case of RD. Furthermore, the present case may provide insight into the mechanism involved in the expansion of distinct B cell subpopulations (B1 and B2 cells).