肝纤康防治肝纤维化的实验研究

目的：观察肝纤康对小鼠实验性肝纤维化的防治作用及其机制。方法：采用四氯化碳（CCl4）复制小鼠肝纤维化模型,同时予以肝纤康灌胃治疗,观察小鼠血清丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、白蛋白（Alb）、肝组织羟脯氨酸（Hyp）含量及肝组织病理改变。结果：模型组小鼠ALT、AST、Hyp显升高,Alb显降低,肝纤维化病变明显;给药组ALT、AST、Hyp明显降低,Alb明显升高,与模型且比较差异有显性（P＜0．01或P＜0．05）;并能明显减轻小鼠肝细胞损害和胶原纤维增生的程度。结论：肝纤康有较好的保护肝功能和防治肝纤维化作用。     

持续小剂量速尿联合白蛋白治疗婴儿急性脑水肿的临床观察

目的:探讨持续小剂量速尿联合白蛋白对急性脑水肿的疗效。方法:将32例急性脑水肿随机分为持续小剂量速尿(0.1~0.2mg/kg/h,持续15~20h/d)联合白蛋白治疗组(观察组)16例,常规甘露醇(0.5g/kg/次,间隔4~6h)治疗组(对照组)16例。结果:观察组脑水肿完全缓解,明显优于对照组,血清钠明显高过对照组,死亡率显著低于对照组。结论:持续小剂量速尿联合白蛋白能有效减轻脑水肿,降低颅内压。     

2型糖尿病颈动脉内膜中层厚度与尿蛋白排泄率变化的临床意义

目的分析2型糖尿病患者颈动脉内膜中层厚度（IMT）与尿蛋白排泄率（AER）变化之间的关系。方法76例2型糖尿病患者与28例对照组应用高频B超测量IMT，测量尿AER值。结果2型糖尿病组IMT及AER明显高于对照组（P〈0．01及P〈0．05），糖尿病≥10年组IMT及AER升高也大于糖尿病〈10年组（P〈0．05）。结论随着糖尿病病程进展，IMT与病程、AER关系密切，监测IMT、AER可预测2型糖尿病大血管、微血管病变的早期变化。     

Effect of protein-bound uraemic toxins on the thermodynamic characteristics of human albumin

The ability of albumin to bind drugs and other lipophilic organic acids is decreased in chronic renal failure by the accumulation of albumin-bound uraemic toxins such as hippuric acid, indoxyl sulphate and 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF). This furan acid is the most highly bound and is not removed by haemodialysis. The inhibitory effects of these three uraemic toxins on the interaction of three marker ligands sodium octanoate (for medium chain fatty acids), salicylic acid and phenol red (bilirubin site/site I) with albumin have been investigated by differential scanning microcalorimetry and flow microcalorimetry. CMPF was the most potent inhibitor and its binding site coincided with that of bilirubin (site I). Indoxyl sulphate binds to the site for medium-chain fatty acids and tryptophan (site II) and hippuric acid, the weakest inhibitor, inhibited binding to the salicylic acid site.     

The molecular adsorbents recycling system as a liver support system based on albumin dialysis: a summary of preclinical investigations, prospective, randomized, controlled clinical trial, and clinical experience from 19 centers

Artificial liver support aims to prolong survival time of patients with liver failure by detoxification. Albumin as a molecular adsorbent in dialysis solution is capable of attracting even tightly albumin-bound toxins from blood into the dialysate if a specific dialysis membrane is used and if the albumin's binding sites are on-line-purified by a sorbent/dialysis-based recycling system (i.e., molecular adsorbents recycling system, or MARS). The MARS technology has been shown to remove water-soluble and albumin-bound toxins and to provide renal support in case of renal failure. Fourteen centers have reported that MARS treatment improved mental status of patients with liver failure and hepatic encephalopathy. In treating liver failure and cholestasis, MARS was associated with hemodynamic stabilization, improvement of hepatic and kidney function, and disappearance of pruritus. In hepatic failure and hepatorenal syndrome, a prospective, randomized, controlled trial of MARS treatment was able to prolong survival time significantly. MARS has been used in 26 patients with acute liver failure or primary graft dysfunction. Nineteen centers reporting on 103 patients have shown that MARS treatment is safe, easy to handle, feasible, and effective.     

Blood-brain barrier integrity is unaltered in human brain cortex with diabetes mellitus

Diabetes-related cognitive dysfunction has been recognized for many years in humans, but the pathogenesis of this condition is poorly understood. Evidence from animal studies suggests that altered function of the blood-brain barrier (BBB) could be a potential cause contributing to this disease. This study aimed to investigate whether the permeability of the BBB is affected in the brains of persons with diabetes mellitus (DM). On postmortem prefrontal and temporal cortex of diabetic patients and controls, immunohistochemical stainings were carried out using specific antibodies against three proteins (PAL-E, IgG and albumin), which are considered as markers for the vascular permeability status of the BBB. Rare or no PAL-E staining was found in the capillaries of the prefrontal and temporal cortex parenchyma, in both DM and control materials. IgG and albumin were localized in and directly around blood vessel walls in the prefrontal and temporal cortex. No obvious differences in the staining pattern of IgG and albumin were observed between brain samples of persons with DM and controls. This study suggests that the BBB in diabetic patients is well maintained.     

溴甲酚绿法测定血清白蛋白条件研究

目的利用分光光度法对溴甲酚绿法测定血清．白蛋白的条件进行了研究，结果在pH3．7Britton-Robinson（B-R）缓冲液中，溴甲酚绿（BCG）与血清白蛋白能形成稳定的绿色复合物；BCG-血清白蛋白复合物的最大吸收波长631nm比溴甲酚绿445nm本身红移，吸光度与白蛋白的含量在最大吸收波长下呈线性关系；白蛋白浓度在0-0．5g／L范围内符合Beer定律，该方法选择性高、重复性好、测定含量范围宽，操作简单，测定结果与双缩脲法相吻合。     

新诊断糖尿病病人检测尿微量白蛋白的意义

微量白蛋白尿是反映肾小球疾病和损伤的一个非常灵敏的指标，对于糖尿病肾病的早期诊断具有十分重要的意义。我们检测了新诊断糖尿病病人的尿微量白蛋白，旨在探讨新诊断糖尿病中早期糖尿病肾病的发生率及尿微量白蛋白对糖尿病肾病的早期诊断价值。     

Kolloide in der Intensivmedizin

Die Normovol?mie ist essentiell im Rahmen der Behandlung von Patienten w?hrend Narkose, in der Notfall- und Intensivmedizin. Grunds?tzlich stehen zur Volumensubstitution kristalloide L?sungen und kolloidale L?sungen zur Verfügung. In Europa ist die kombinierte Verwendung beider L?sungen anerkannter Standard. Differenzierte überlegungen zum Einsatz der verschiedenen Kolloide sind beim kritisch kranken Erwachsenen notwendig, da sowohl Humanalbumin als auch die künstlichen Kolloide Dextran, Gelatine und Hydroxyethylst?rke spezifische Effekte und typische Nebenwirkungen haben. Diese spielen unter den Gegebenheiten, die der Intensivpatient mit Organdysfunktionen und Organversagen aufweist, eine besondere Rolle. Die klinisch relevanten Daten zu allen Substanzen werden unter besonderer Berücksichtigung der Intensivmedizin diskutiert.

---