Back to basics: the urinalysis: a selected national survey and review

An accurately performed urinalysis is vital to the screening and assessment of renal disease. We sent questionnaires to nephrology training programs throughout the United States and compared techniques described in the responses to standard urinalysis methodology gleaned from literature review. There were notable deviations in performance and interpretation between the nephrologists and the standard urinalysis. It appears that additional emphasis should be place don this basic and important laboratory test. Further study is needed to determine if more accurate performance will influence patient diagnosis and outcome.     

3,5-二溴水杨醛Schiff碱的Cu(Ⅱ)螯合物研究

目的：寻找新型的抑菌药物。方法：以3，5-二溴水杨醛Schiff碱为配体合成了3种Cu(Ⅱ）新螯合物，并进行了初步抑菌活性实验。结果：合成的螯合物经元素分析，红外光谱确证其结构组成。结论：初步抑菌实验表明，合成螯合物对多种菌株有明显的抑菌活性。     

Review: Renal osteodystrophy--pathogenesis and treatment

Histologic bone changes of osteitis fibrosa and osteomalacia are commonly present in patients with end-stage renal disease. Although many patients are not symptomatic from these bone changes, some patients are severely disabled. Altered metabolism of vitamin D, calcium, phosphorus, and parathyroid hormone occurs in renal failure and contributes to the development of uremic bone disease. This article reviews the current theories of pathogenesis and treatment of renal osteodystrophy. In addition, the clinical presentation, pathogenesis, and treatment of the various aluminum-associated osteomalacic syndromes in uremia are discussed.     

Sexual dysfunction in the male dialysis patient: pathogenesis, evaluation, and therapy

Impotence is a common problem in male dialysis patients. Although dialysis patients may appear to have more reasons to be depressed than nondialysis patients, depression has not been found to be correlated with erectile dysfunction in this group. Primary testicular failure is common in male dialysis patients as is hyperprolactinemia. These disorders may be the cause of impotence in some of these patients. An algorithm for the evaluation and treatment of impotence in the male dialysis patient is presented. Successful renal transplantation is associated with improvement in the testicular failure, in the hyperprolactinemia, and in the erectile dysfunction of the male patient with end-stage renal disease.     

Detection of Hepatitis B Virus DNA Sequences in Liver in HBsAg Seronegative Patients with Liver Disease with and without Anti-HBc Antibodies

Excluding studies from Brechot and co-workers, little supporthas been found for a role of the hepatitis B virus in the pathogenesisof HBsAg seronegative patients with predominantly chronic liverdiseases, including primary liver cancer. In this study liverDNA from 59 predominantly British patients (four cases withpaired biopsies, 6–12 months apart) with different, mostlychronic, liver diseases was analysed by molecular hybridization.All were seronegative for HBsAg and serum hepatitis B virusDNA (dot blot hybridization) and their liver diseases were believedto be unrelated to hepatitis B virus infection. Hepatitis Bvirus DNA was detected in liver of 11 (18.6 per cent) patients;nine had episomal(3.2 Kb) DNA and eight had higher molecularweight bands suggesting integrated forms. Six patients werealso seronegative for anti-HBc. Patients of UK and non-UK originwere equally represented. Hepatitis B virus DNA was detectedin serum of six of nine patients tested using the polymerasechain reaction. The detection of hepatitis B virus DNA in liverand in serum by this assay in a significant proportion of patientswith chronic liver disease, hitherto unsuspected of being hepatitisB virus-related, suggests a possible role for this virus inlow- as well as high-prevalence countries.     

Cyclosporin nephrotoxicity in heart and lung transplant patients

Twenty-two patients with heart, lung or heart and lung transplants maintained on cyclosporin for periods ranging from 3 months to 10 years developed renal insufficiency which was investigated by renal biopsy. The histopathological changes were: (i) severe vascular and glomerular damage due to thrombotic microangiopathy (TM); (ii) a form of focal segmental glomerulosclerosis (FSGS); (iii) glomerular ischaemia. Rather than being separate entities, these changes appeared to represent a spectrum of pathology, some biopsies showing all three forms of glomerular injury. In all cases the glomerular changes were accompanied by arteriolar and arterial pathology, and we identified novel ultrastructural changes in the arteriolar endothelial basal lamina. Tubular atrophy was a consistent feature, the severity of which reflected the severity of the glomerular sclerosis, and which appeared to be a consequence of glomerular loss. Our findings are consistent with the nephrotoxic effects of cyclosporin being mediated chiefly via damage to preglomerular vessels and glomerular capillary endothelium. From an analysis of the clinical aspects of these cases, the effects of cyclosporin appear to be to some extent idiosyncratic, and therefore not entirely preventable, but strict monitoring of blood cyclosporin levels is essential to minimize the risk of permanent renal damage. Monitoring urinary protein in addition to plasma creatinine may detect the onset of FSGS, as proteinuria precedes creatinine elevation.      

Opportunities for the replacement of animals in the study of nausea and vomiting

Nausea and vomiting are among the most common symptoms encountered in medicine as either symptoms of disease or side effects of treatments. Developing novel anti-emetics and identifying emetic liability in novel chemical entities rely on models that can recreate the complexity of these multi-system reflexes. Animal models (especially the ferret and dog) are the current gold standard; however, the selection of appropriate models is still a matter of debate, especially when studying the subjective human sensation of nausea. Furthermore, these studies are associated with animal suffering. Here, following a recent workshop held to review the utility of animal models in nausea and vomiting research, we discuss the limitations of some of the current models in the context of basic research, anti-emetic development and emetic liability detection. We provide suggestions for how these limitations may be overcome using non-animal alternatives, including greater use of human volunteers, in silico and in vitro techniques and lower organisms.     

一叶萩碱全合成的研究

以1,4-环己二酮为原料经与哌啶缩合、还原、乙酸汞环合、碱催化分子内缩合等11步反应完成了一叶萩碱的全合成。合成品的熔点及光谱数据与天然一叶萩碱的熔点及光谱数据一致。