Regulation of fluid intake in dogs following water deprivation

Whereas water loss in land living animals occurs continuously, water intake takes place discontinuously. At the normal operating set point of plasma osmolality, urine is more concentrated than plasma due to secretion of vasopressin. Thus animals operate around a state of mild dehydration. As water loss occurs, the severity of dehydration and thirst increase in intensity and at some point water intake occurs. Sufficient water is consumed to return plasma osmolality to the normal operating set point. Food intake and water balance are interdependent as food provides the osmoles which determine obligatory renal solute excretion. When dry food with the same osmotic content was substituted for canned food (water content 74%), dogs increased water intake from 24.2 +/- 4.3 to 62.2 +/- 8.8 ml/kg. Urine output and urine osmolality were unchanged, as under conditions of normal hydration, near maximal urine concentration is achieved. Changing water intake is the only available variable to maintain water balance. During water deprivation, the major renal mechanism appears to be natriuresis. In rehydration, satiety mechanisms ensure appropriate water intake and renal sodium conservation restores sodium balance.     

成分输血在临床中的应用

成分输血是现代输血学的重要标志之一。临床医生要了解成分输血的知识,遵循科学用血、合理用血、节约用血的原则,根据病情有针对性地开展成分输血。成分输血的重点,应当是血液的有形成分,即以红细胞和血小板为主的成分输血。本文就成分输血的特点与临床应用等有关问题进行综述。     

健康儿童血浆游离氨基酸与体格生长的研究

本文采用丹酰氯聚酰胺薄层分析法研究了65名3～7岁健康儿童的血浆游离氨基酸,研究其与体格生长的关系.结果表明:赖氨酸,甘氨酸,羟脯氨酸,与年龄别身高、体重和身高别体重百分位成正相关.并有显著意义.异亮氨酸.赖氨酸.甘氨酸在营养优组中显著高于差组.提示血浆游离氨基酸对健康学龄前儿童的体格生长发挥重要的生理作用.     

多器官功能衰竭患儿血糖血乳酸血渗透压的改变

对５０例ＭＯＦ患儿血糖血乳酸血渗透压进行了检测，并与３５名健康儿童进行比较。结果显示危重患儿血糖血乳酸明显高于对照组，血糖血乳酸呈正相关，提示高血糖是危重患儿应激状态下的主要代谢改变。当患儿血糖＞１５ｍｍｏｌ／Ｌ血乳酸）５ｍｍｏｌ／Ｌ时，其死亡率明显增加，因此血糖血乳酸的变化可作为ＰＩＣＵ的常规监测指标。     

血浆置换治疗97例重型肝炎并发症的防治

目的探讨血浆置换治疗重型肝炎时并发症的发生原因及防治措施。方法回顾血浆置换治疗97例重型肝炎时出现的并发症的有关资料，分析各种并发症发生的原因。结果26．6次治疗中共出现并发症131次，发生率达49.3％。按发生率高低依次为皮疹、麻木和（或）搐搦、血压下降、胸闷、失衡综合征、置管处渗血、体外循环凝血及置管处渗液。结论血浆置换治疗重型肝炎时并发症的发生率高，但经处理均能缓解，可以在严密监护下实施。     

Thrombophilic risk factors and unusual clinical features in three Italian CADASIL patients

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetically transmitted cerebrovascular disease. Typically, the first clinical manifestation is migraine and the full clinical spectrum of the disease with recurrent strokes of the subcortical type, cognitive, and mood disorders is seen during the fourth and fifth decades of life. Vascular risk factors are usually absent in CADASIL patients and the diagnosis of the disease is particularly suspected in young adults with cerebrovascular events of unknown cause, diffuse leukoencephalopathy on computed tomography or magnetic resonance imaging, and a history of cerebrovascular diseases or dementia in many family members. We describe three Italian CADASIL patients who presented to medical attention for cerebrovascular events occurred after the age of 55 and had, in addition to hypertension and hyperlipidemia, thrombophilic risk factors such as hyperhomocysteinemia, elevated levels of lipoprotein(a), and antiphospholipid antibodies. Symptoms possibly related to cortical involvement, such as dysphasia and visual field deficits, were reported by two of these patients. We conclude that a diagnosis of CADASIL should not be disregarded in patients with vascular risk factors and presenting with symptoms not immediately referable to subcortical damage at ages more advanced than commonly reported.     

人红细胞胆固醇含量的增龄变化

用胆固醇酶联试剂显色法检测１８９例健康成人红细胞胆固醇和血浆胆固醇含量，结果表明，健康成人的Ｅ－Ｃｈ含量随增龄而升高，并呈直线相关；Ｐ－Ｃｈ含量也随增龄而升高，并呈直线相关；Ｅ－Ｃｈ含量呈直线正样关。提示Ｅ－Ｃｈ含量检测可作为反映机体衰老程度的一项客观指标。     

Vascular Access for Therapeutic Plasma Exchange

Abstract: Adequate venous access is an essential component of therapeutic plasma exchange (TPEX). The simplest kind of venous access is venipuncture of antecubital veins, but this technique may be limited by venous size or scarring following the procedure, requiring the placement of a specialized vascular access device (VAD). VADs provide reliable central venous access and may remain in place for several weeks or months, depending on the VAD and the venous site chosen. Their use, however, is potentially limited by the risk of complications. We discuss indications for insertion, choice of catheter and access site, and complications of VAD placement for TPEX.     

检测胞浆抗原用于急性白血病免疫分型

目的:探讨胞浆抗原在急性白血病免疫分型中的临床意义。方法:用流式细胞仪检测42例初治急性白血病患者胞浆抗原CyCD_3,CyCD_(22),CyCD_(79a)和MPO。结果:T—ALL阳性胞浆抗原主要表达在CyCD_3,阳性率占88.9％。B—ALL阳性胞浆抗原主要表达在CyCD_(79a),AML主要表达CyMPO。结论:CyCD_3和CyCD_(79a),及MPO可分别作为T—ALL,B—ALL和AML系列特异性标志,对正确诊断白血病提供非常有价值的依据。     

肾脏疾病患者治疗前后血浆内皮素水平动态变化及其意义

目的 为了探讨肾脏疾病患者血浆内皮素水平与肾脏疾病病情程度的关系,为肾脏疾病治疗效果的评价提供依据.方法 采用放射免疫分析(RIA)观察了77例肾脏疾病患者治疗前后血浆内皮素水平的动态变化,并与60例正常对照组比较.结果 正常对照组血浆内皮素浓度为43.1±15.2ng/L,肾脏疾病患者治疗前血浆内皮素水平为161±83.8ng/L,治疗后为97.4±52.7ng/L,均高于正常对照组(P值均<0.001).肾脏疾病治疗后内皮素水平明显下降(P<0.001),与BUN,Cr水平的下降具有一定的相关性(相关系过分别为0.54,0.55).结论血浆内皮素水平随着肾脏疾病严重程度的增加而升高,血浆内皮素水平可作为肾脏疾病治疗效果评定的指标之一