地域、个人卫生及肠道功能对CAPD患者腹膜炎发生率的影响

目的探讨地域、个人卫生状况及肠道功能对持续性非卧床腹膜透析（CAPD）患者并发感染性腹膜炎的影响。方法选取2008～2014年在本院行腹膜透析置管术的CAPD患者133例,按腹膜炎诊断标准,分为腹膜炎组和非腹膜炎两组,记录CAPD患者一般资料（性别、年龄、居住地、文化程度、原发病等）,个人卫生,腹泻便秘等情况,分析这些因素与感染性腹膜炎之间的关系。结果两组患者长期居住地比较差异具有统计学意义（P＜0．05）,而两组患者性别、年龄、身高、体质量、体质量指数、文化程度、原发病、是否合并糖尿病相比较差异无统计学意义（ P ＞0．05）。对两组患者资料采用二分类 Logistic回归分析,结果表示地域（乡镇及农村）[OR＝5．876, P ＝0．000]、个人卫生中洗手[O R＝5．596, P ＝0．009]与刷牙[O R＝4．865, P ＝0．003]、腹泻[O R＝5．744,P ＝0．006]及便秘[OR＝2．332,P ＝0．016]是腹膜炎发生的影响因素。结论地域、个人卫生、腹泻便秘是腹膜炎发生的影响因素,在临床工作中应加强乡镇及农村患者对腹膜炎的预防意识,重视对腹膜透析患者的卫生教育,以减少腹膜透析相关性腹膜炎的发生。     

不同吸附剂对血甲基对硫磷灌流清除率的实验研究

目的比较HA230树脂、包膜活性炭、三菱化学SP825树脂和AmberliteXAD16树脂做灌流吸附材料对中毒血样中甲基对硫磷的灌流清除率。方法中毒血样反复流经装有吸附剂的灌流柱,灌流后血样用乙酸乙酯萃取净化,毛细管气相色谱法（火焰光度检测器）测定甲基对硫磷残留量,计算清除率。结果血液中甲基对硫磷浓度较低时,4种吸附剂均有较高的清除率;随着毒物浓度增加,清除率下降,但三菱化学SP825树脂的清除率优于其它3种吸附剂。当每毫升血甲基对硫磷加标量为30μg,吸附剂用量80mg时,三菱化学SP825树脂、HA230树脂和AmberliteXAD16树脂清除率接近,分别为98.6%、97.0%和98.2%,呈现平台趋势;而包膜活性炭120mg用量时,清除率可达96.0%,并可出现近似呈现平台现象,表明对甲基对硫磷的清除已近完全。结论 4种吸附剂中,三菱化学SP825树脂对血中甲基对硫磷清除效果最佳,HA230树脂次之,包膜活性炭和AmberliteXAD16树脂清除效果较前两种吸附剂稍差。     

Block-step asymmetry 5 years after large-head metal-on-metal total hip arthroplasty is related to lower muscle mass and leg power on the implant side

Background

Metal-on-metal articulations mimic the human hip anatomy, presumably lower dislocation rates and increase the range-of-motion. This study aims to measure the muscle mass and power of both legs in patients with unilateral metal-on-metal total hip arthroplasty, and to investigate their effect on block-step test, spatio-temporal gait parameters and self-reported function.

Methods

Twenty-eight patients (7 women), mean age 50 (28–68) years, participated in a 5–7 year follow-up. Patients had received one type unilateral large-head metal-on-metal total hip articulation, all of which were well-functioning at follow-up. Mean muscle mass was measured by the total-body Dual energy X-ray Absorption scans, and muscle power was measured in a leg extensor power rig. Block-step test and spatio-temporal gait parameters were measured with an inertial measurement unit. Self-reported function was assessed by the Hip Disability and Osteoarthritis Outcome Score.

Findings

We found a significant difference between the mean muscle mass of the implant-side leg and the non-implant-side leg in hip, thigh and calf areas (P < 0.008) and in mean muscle power (P = 0.025). Correlations between mean muscle mass and mean muscle power were significant for both the implant-side leg (r = 0.45, P = 0.018) and the non-implant-side leg (r = 0.51, P = 0.007). The difference in mean muscle power between legs correlated with block-step test asymmetry during ascending (r = 0.40, P = 0.047) and descending (r = 0.53, P = 0.006). Correlations between self-reported function and power of the implant-side leg were not significant.

Interpretations

Young patients have not fully regained muscle mass, muscle power and function 5–7 years after metal-on-metal total hip arthroplasty.     

Ferrous Fumarate Deteriorated Plasma Antioxidant Status in Patients with Crohn Disease

Background: Iron deficiency anaemia is a frequent complication of Crohn disease. Treatment with ferrous iron (Fe[Formula: See Text]) compounds is often unsatisfactory and is associated with gastrointestinal side effects. Theoretically, oral iron supplementation may even be harmful, because iron may reinforce intestinal inflammation by catalysing production of reactive oxygen species. We investigated the effect of ferrous iron on disease activity and plasma antioxidant status in patients with active Crohn disease. Methods: Ten patients with Crohn disease and iron deficiency and 10 healthy controls were given ferrous fumarate 120?mg for 7 days. The Crohn Disease Activity Index, gastrointestinal complaints and blood samples for antioxidant status, anaemia, inflammation and iron absorption were investigated on day 1 and day 8. Results: During 1 week of ferrous fumarate supplementation, the Crohn Disease Activity Index tended to increase (P?=?0.071). Patients experienced aggravation of diarrhoea, abdominal pain and nausea. Plasma-reduced cysteine was lower (P?=?0.038) in patients than it was in controls. One week of ferrous iron supplementation further decreased reduced cysteine (P?&;lt;?0.001) and significantly decreased plasma-reduced glutathione (P?=?0.004) in the patients. Serum iron increased significantly in patients after an oral iron load test (from 5.8?±?3.2?μmol/L to 30.9?±?13.1?μmol/L). Conclusions: Treatment of iron deficiency with ferrous fumarate deteriorated plasma antioxidant status and increased specific clinical symptoms in patients with active Crohn disease. Plasma reduced cysteine may be a sensitive indicator for oxidative stress in the intestine.     

64例血脂正常人胆固醇吸收与合成标志物检测

目的 了解健康成人胆固醇吸收与合成标志物的均值及分布情况.方法 入选北京安贞医院体检中心64例健康成人,常规测定肝肾功能、血清总胆固醇、高密度脂蛋白胆固醇、甘油三酯、空腹血糖等指标;采用气相色谱法测定胆固醇吸收与合成标志物.结果 5种非胆固醇类固醇总和平均值为1.02 mg/dL,约为胆固醇总量的0.72％,且存在个体差异;与女性比较,男性血清中7-烯胆甾烷醇水平升高(P＜0.05),而豆固醇水平较女性低(P＜0.01);合成标志物角鲨烯随着年龄的增长而降低,吸收标志物豆固醇随着年龄的增长而升高.结论 通过检测胆固醇吸收与合成标志物,了解健康个体间胆固醇吸收、合成标志物分布情况.     

Influence of nitrogen balance and intestinal glucose absorption on growth of rats recovery from early undernutrition

The present work analyses the role of food and water intake, nitrogen balance, “in vivo” D-glucose intestinal absorption and plasma insulin level in body weight gain by early malnourished male rats after two or four months of rehabilitation with normal diet. Malnutrition was applied “in uterus” and during the lactation period by reducing normal diet. At 3 and 5 months of age, the animals remained in metabolic cages during ten days, were then anaesthetized, and the plasma insulin level and “in vivo” D-glucose intestinal absorption were measured. Comparison of the ratio of weight gained to the amount of food consumed demonstrates a greater food efficiency in the malnourished animals at 3 months of age, which is explained by the increased nitrogen balance measured by 100 g of body weight. The evolution of body weight gain in the control and malnourished animals was similar at 5 months of age. If we compare the results at 3 and 5 months of age, the data suggests that early malnutrition can act by retarding age-associated physiological changes such as intestinal and pancreatic processes.     

Intraindividual variability of paracetamol absorption kinetics after a semi-solid meal in healthy volunteers

Objective: The absorption kinetics of paracetamol is dependent on gastric emptying and its measurement was proposed as a non-invasive method to estimate gastric emptying rate. The objective of this study was to evaluate the intraindividual variability of paracetamol absorption kinetics after a semi-solid meal. Methods: The pharmacokinetics of paracetamol was studied on two occasions in 15 healthy volunteers without Helicobacter pylori antibodies. A 1-g dose of paracetamol was given as a solution together with a standardised semi-solid meal and the subjects stayed in the supine position. Results: For most of the subjects, the time course of paracetamol concentrations was similar on the two occasions. The intraindividual variability was low, with coefficients of variation of 38.3%, 8.0% and 3.8% for time to maximum plasma concentration, maximum concentration and area under the plasma concentration – time curve until 6 h, respectively. Conclusion: The assessment of paracetamol absorption kinetics is reproducible when the drug is given together with a semi-solid meal in Helicobacter pylori-negative healthy subjects. Received: 21 July 1997 / Accepted in revised form: 14 October 1997     

153Sm-EDTMP吸收剂量的MonteCarlo和MIRD算法比较

目的以153Sm-乙二胺四甲撑膦酸(153Sm-EDTMP)治疗鼻咽癌多发性骨转移为例,分别用蒙特卡罗法(Monte Carlo,MC)和MIRD方法计算153Sm-EDTMP治疗后病灶和骨髓等靶器官的吸收剂量,探讨其临床应用之不同.方法基于病人时序性SPECT/CT扫描和累积尿液的放射性测定,利用优化的MC EGS4程序和MIRD方法分别计算病灶和其他靶器官的吸收剂量.结果MC EGS4法计算结果提示病灶内剂量分布不均匀.患者注射153Sm-EDTMP 33.6×37 MBq,左髂骨转移病灶最高吸收剂量约为5.6 Gy,病灶边缘的吸收剂量为2.0 Gy,以病灶区最高剂量点为参考点,则椎体、皮质、骨髓、脊髓和盆腔组织仅相当于最高剂量的37%、12%、13%、21%和2%;MIRD方法的计算数据仅能粗略提示全身红骨髓吸收剂量,为2.39 Gy.结论MC EGS4方法能准确计算病灶、骨髓和其他靶器官的内照射吸收剂量,故可以真正指导核素临床治疗;而MIRD仅能大致评估153Sm-EDTMP的骨髓毒性.     

Determination of detection efficiency curves of HPGe detectors on radioactivity measurement of volume samples

An efficiency calibration method has been developed to measure radioactivity of volume samples with HPGe detectors. The method has two main procedures. One is a point-source calibration at a representative point near the detector. The position of the representative point is determined by Monte Carlo simulations. The other is correction for absorption by a sample matrix and a sample container. This paper presents application of the method for obtaining efficiency curves for volume samples in the energy range from 22 to 1836 keV. In addition to the standard volume sources of cement and water matrices, measurement was made with some kinds of environmental samples that are often used in environmental monitoring for radiation control works. The composition of the environmental sample was determined by elemental analysis. For these samples, measured absorption correction factors were compared with those by the Monte Carlo simulations. As a result, detection efficiency curves were obtained with good accuracy for variety types of volume samples.     

Effects of Chronic Alcohol Consumption on Enzyme Activities and Active Methionine Absorption in the Small Intestine of Pregnant Rats

The present study evaluates the effect of chronic alcohol intake on the intestinal transport of methionine during pregnancy. For this purpose, we have used an in vitro technique that allows measurement of the unidirectional influx of the amino acids across the brush-border membrane of the rat mid-jejunum, and the basolateral membrane enzyme Na⁺,K⁺-ATPase was also evaluated in the duodenum and jejunum. For chronic alcohol treatment, the rats were fed a liquid diet containing ethanol (36% of calories) or an isocaloric diet (pair-fed control) for 5 weeks before and during pregnancy. Animals were killed at 21 days of gestation. Results from the kinetic analysis revealed that chronic ethanol treatment reduces the maximum transport (J_m) of methionine uptake when compared with controls. Further experiments performed in the presence and absence of sodium have shown that ethanol selectively inhibited Na⁺-dependent methionine transport. At the same time, this treatment significantly reduced the levels of Na⁺,K⁺-ATPase in ethanol-fed rats compared with the controls. Alterations in methionine intestinal transport in pregnant alcohol-fed rats may contribute to the ethanol-induced fetal growth abnormalities.