急性胰腺炎的早期实验诊断和严重程度判断

目的 探索急性胰腺炎早期诊断和病情严重程度的实验室检测指标.方法 以82例急性腹痛,其中急性胰腺炎39例(急性重型胰腺炎14例和急性轻型胰腺炎25例)和非胰腺急腹症43例,30例健康者为受试者;测定所有受试者血清淀粉酶(Amy)、脂肪酶(Lip)、白介素-6(IL-6),白介素-8(IL-8)和C-反应蛋白(CRP)浓度.结果 方差分析(F检验)显示5个标记物在所观察的疾病组间均存在明显统计学差异(P=0.000).ROC曲线分析显示:对急性胰腺炎的早期诊断,Amy(cut off=93U/L)和Lip(cut off=229U/L)有较高的敏感度(Se),均是94.9%,Lip还有较高的特异性(Sp)是82.2%.曲线下的面积(AUC)分别是0.961和0.935,优于其它标记物.对判断急性胰腺炎的严重度,CRP(cut off=12.3mg/L)和IL-6(cut off=6.5μg/L)的敏感度相近,分别是92.9%和92.7%,IL-8(cut off=76.8μg/L)次之,Se为89.6%,但Sp最高为100.0%.IL-6和IL-8之AUC分别是0.931和0.977,优于其它标记物.结论 Amy和Lip可能是急性胰腺炎的早期诊断指标,IL-6和IL-8可能是其严重程度的判断指标.联合检测Amy(和/或Lip)和IL-6(和/或IL-8)有利于急性胰腺炎的早期诊断和严重度判断.     

甘草RNA提取方法研究

目的从甘草不同组织中提取高质量的RNA,为进一步合成双链cDNA,构建甘草cDNA文库奠定基础。方法采用几种常用方法(高盐溶液法、LiCl沉淀法、CTAB法和SDS法)提取甘草不同组织的RNA,并以1%琼脂糖凝胶电泳和A260/A280,A260/A230的值作为指标。结果LiCl沉淀法对于甘草不同组织中的RNA具有更好的提取效果,条带清晰,完整性较好,且A260/A280和A260/A230值均接近于2.0,根部组织产量达0.220μg/mg,叶片组织产量达0.275μg/mg。结论采用LiCl沉淀法提取甘草不同组织中的RNA具有更好的效果,适于从富含多糖的植物组织中提取RNA。     

AMYLASE CONTENT OF MIXED SALIVA IN CHILDREN

Abstract. Rossiter, M. A., Barrowman, J. A., Dand, A. and Wharton, B. A. (Queen Elizabeth Hospital for Children, Hackney Road, London E.2 and the London Hospital, Whitechapel, London, E.l., England). Amylase content of mixed saliva in children. Acta Paediatr Scand, 63: 389, 1974.–Salivary amylase levels were determined in normal subjects from birth until adult life and in children with conditions sometimes associated with low pancreatic amylase such as malnutrition, coeliac disease and cystic fibrosis. Mixed saliva was collected under carefully standardised conditions and amylase was measured by the method of Dahlqvist. There was a wide scatter of values in the 84 normal subjects, but concentrations rose from very low levels at birth to reach adult levels by the age of 6 months to 1 year. Salivary amylase activity rose normally over ten weeks in one premature infant fed milk by gastrostomy. Thirteen children with coeliac disease and 9 children with cystic fibrosis mostly had normal salivary amylase concentrations. Six out of 12 malnourished children with jejunal villous atrophy of uncertain aetiology had low levels which rose to normal as recovery began.     

急性胰腺炎生化指标与CT分级的对比研究

目的研究CT表现与生化指标改变在急性胰腺炎病程病理变化的诊断价值。方法分析已确诊的急性胰腺炎75例,将CT图像改变分为5个级别,各级别分别与其相应的生化指标数值相比较分析。结果急性胰腺炎生化指标与CT表现对比如下:A级时,生化指标大多轻度升高,B级中度升高,C级显著升高,D级开始下降,E级显著下降。结论CT检查可以准确地反映B、C、D、E级的病理变化,明显优于血清、尿液淀粉酶值的改变,而对A级表现,CT诊断困难,此时应依靠临床症状及体征,结合血清、尿液淀粉酶及C反应蛋白的变化来作出诊断。     

血尿淀粉酶检验指标在急性胰腺炎诊断中的应用

目的：运用实验室血尿淀粉酶检验指标对急性胰腺炎的诊断提供参考。方法：观察我院2010-2011年收治的急性胰腺炎患者19N,探讨在不同的病变过程中血尿淀粉酶的变化情况。结果：19例急性胰腺炎患者血尿淀粉酶测定指标都不同程度的高出正常值,其中有2例误诊。结论：急性胰腺炎（Ap）起病急,发展迅速,演变复杂,临床表现不典型,容易误诊,导致不良后果。因此,凡遇突然发作的持续性腹痛,应详细询问病史,认真查体,结合血尿淀粉酶测定,综合分析,可减少误诊。     

联合检测ADA、CEA、CRP、淀粉酶在鉴别结核性和恶性胸腔积液中的诊断价值

目的：探讨联合检测腺苷脱氨酶（ADA）、癌胚抗原（CEA）、C反应蛋白（CRP）和淀粉酶在鉴别结核性与恶性胸腔积液中的诊断价值。方法：选取胸腔积液患者117例,分为结核组72例和恶性组45例,每组均留取胸腔积液检测ADA、CEA、CRP和淀粉酶。结果：结核组胸腔积液ADA和CRP均高于恶性组,差异有统计学意义（P〈0．001）;恶性组胸腔积液CEA和淀粉酶均高于结核组,差异有统计学意义（P〈0．001）。结论：联合检测腺苷脱氨酶（ADA）、癌胚抗原（CEA）、C反应蛋白（CRP）和淀粉酶对于结核性和恶性胸腔积液的鉴别诊断有更高参考价值,胸腔积液中ADA和CRP增高时支持结核性胸腔积液诊断,而CEA和淀粉酶增高则倾向于诊断恶性胸腔积液。     

Transtracheal puncture: a forgotten procedure

Transtracheal puncture has long been known as a safe, low-cost procedure. However,with the advent of bronchoscopy, it has largely been forgotten. Two researchers havesuggested the use of α-amylase activity to diagnose salivary aspiration, but thenormal values of this enzyme in tracheobronchial secretions are unknown. We aimed todefine the normal values of α-amylase activity in tracheobronchial secretions andverify the rate of major complications of transtracheal puncture. From October 2009to June 2011, we prospectively evaluated 118 patients without clinical orradiological signs of salivary aspiration who underwent transtracheal puncture beforebronchoscopy. The patients were sedated with a solution of lidocaine and diazepamuntil they reached a Ramsay sedation score of 2 or 3. We then cleaned the cervicalregion and anesthetized the superficial planes with lidocaine. Next, we injected 10mL of 2% lidocaine into the tracheobronchial tree. Finally, we injected 10 mL ofnormal saline into the tracheobronchial tree and immediately aspirated the salinewith maximum vacuum pressure to collect samples for measurement of the α-amylaselevel. The α-amylase level mean ± SE, median, and range were 1914 ± 240, 1056, and24-10,000 IU/L, respectively. No major complications (peripheral desaturation,subcutaneous emphysema, cardiac arrhythmia, or hemoptysis) occurred among 118patients who underwent this procedure. Transtracheal aspiration is a safe, low-costprocedure. We herein define for the first time the normal α-amylase levels in thetracheobronchial secretions of humans.     

Extrinsic compression of pancreactic duct by intragastric balloon treatment and its potential to cause acute pancreatitis: two case reports and clinical discussion

We describe two cases of increased pancreatic enzyme levels after intragastric balloon (IGB) placement possibly related to extrinsic pancreatic duct compression, followed by a short review of the literature.Case 1 is the first, to our knowledge, of a patient with asymptomatic increase of pancreatic enzymes due to pancreatic duct compression, with unknown clinical significance. We hypothesize that this finding maybe can be relatively common in IGB users and almost certainly an important risk factor for the development of acute pancreatitis (AP). On the other hand, case 2 reports an AP that occurred one day after IGB placement, presented with nausea and vomiting, making AP a differential diagnosis of initial IGB intolerance.