Renal effects of dental amalgam in children: the New England children's amalgam trial

BACKGROUND: Mercury is nephrotoxic and dental amalgam is a source of mercury exposure. METHODS: Children 6-10 years of age (n = 534) with two or more posterior teeth with caries but no prior amalgam restorations, were randomized to one of two treatments--amalgam or resin composite (white fillings)--used for caries treatment during 5 years of follow-up. The primary outcome was change in IQ, but important secondary outcomes were effects on markers of glomerular and tubular kidney function: urinary excretion of albumin, alpha-1-microglobulin (A1M), gamma-glutamyl transpeptidase (gamma-GT), and N-acetyl-beta-d-glucosaminidase (NAG). These markers were measured on several occasions during the trial, together with urinary mercury and covariates. We evaluated the results using repeated-measures analyses. RESULTS: There were no significant differences between treatment groups in average levels of renal biomarkers, nor significant effects of number of dental amalgams on these markers. There was, however, a significantly increased prevalence of microalbuminuria (MA) among children in the amalgam group in years 3-5 (adjusted odds ratio 1.8; 95% confidence interval, 1.1-2.9). Most of these cases are likely to be temporary MA, but 10 children in the amalgam group had MA in both years 3 and 5, versus 2 children in the composite group (p = 0.04). There were no differences in the occurrence of high levels of renal tubular markers (A1M, gamma-GT, or NAG). CONCLUSIONS: The increase in MA may be a random finding, but should be tested further. The results did not support recent findings in an observational study of an effect of low-level mercury on tubular biomarkers in children.     

尿蛋白系列与老年原发性高血压病

目的：探讨老年人血压的昼夜间的变化和与尿系列蛋白的关系，以寻找高血压早期肾损害的诊断指标。方法：应用动态血压监测（ＡＢＰＭ），和用ＥＬＩＳＡ法及我室自己改良的免疫比浊法，测定尿转铁蛋白（Ｔｆ）、微量白蛋白（Ａｌｂ）、免疫球蛋白（ＩｇＧ）、Ｎ－乙酰－β－Ｄ氨基葡萄苷酶（ＮＡＧ）及视黄醇结合蛋白（ＲＢＰ），对１２０例老年原发性高血压病患者进行了观察比较。结果：１２０例高血压病患者ＡＢＭＰ后发现有５７例     

中等强度的急性运动负荷对糖尿病患者尿NAG及白蛋白排泄率的影响

通过对４０例尿ＡＥＲ不同的ＮＩＤＤＭ患者及１０例健康人，进行单次６０％ＶＯ２ｍａｘ中等强度的急性运动负荷前，后尿ＮＡＧ及尿ＡＥＲ的测定，结果表明：１尿ＡＥＲ２０μｇ／ｍｉｎ的糖尿病患者，与正常对照组比较，中等强度的急性运动负荷前、后尿ＮＡＧ、尿ＡＷＲ无明显变化。     

Duration of sexual abstinence: epididymal and accessory sex gland secretions and their relationship to sperm motility

BACKGROUND: The data on the association between the abstinence period and sperm motility are conflicting. METHODS: Ejaculates from 422 men assessed for infertility were analysed according to the World Health Organization (WHO) guidelines. Seminal plasma neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc and fructose were measured. Three groups were defined according to the length of sexual abstinence: G2-3 (2-3 days), G4-5 (4-5 days) and G6-7 (6-7 days). RESULTS: The total percentage of progressively motile spermatozoa was significantly higher in G4-5 compared with G2-3 and G6-7 (medians 55 versus 47 and 42%; P=0.039 and P <0.001, respectively). The percentage of spermatozoa with tail defects was significantly higher in G6-7 compared with G2-3 and G4-5 (medians 14 versus 10 and 10%; P=0.011 and P=0.002, respectively). NAG was significantly lower in G2-3 compared with G4-5 and G6-7 (medians 23 versus 34 and 34 mU/ejaculate; P <0.001 and P=0.001, respectively). The same trend was found regarding zinc (medians 6 versus 8 and 8 mumol/ejaculate; P=0.001 and P=0.005, respectively). CONCLUSIONS: Within the time interval recommended by the WHO (2-7 days), the length of the abstinence period is associated with sperm characteristics and should be taken into consideration when interpreting results of semen analysis.     

尿N—乙酰—β—葡萄糖苷酶和血清胱抑素C联合检测在糖尿病肾病诊断中的意义

目的研究尿N-乙酰-β-葡萄糖苷酶（NAG）和血清胱抑素C（Cys—C）在糖尿病肾病患者不同阶段尿中及血中的表达水平．探讨其在糖尿病肾病诊断中的意义。方法收集我院住院的2型糖尿病患者252例,根据尿微量白蛋白排泄量（UAE）分成3组：正常蛋白尿组81例（A）：〈30mg／d;微量蛋白尿组85例（B）：（30～300）mg／d;大量蛋白尿组86例（C）：〉300mg／d。收集患者的尿标本及血标本分别检测尿NAG及血清胱抑素C水平等。结果①尿NAG与对照组相比明显升高,且随着糖尿病肾病的发展逐渐升高。②血清胱抑素c在正常蛋白尿期就已经开始升高,随着糖尿病。肾病的进展逐渐升高,且其升高早于肌酐的升高。③血清胱抑素C联合尿NAG检测可明显提高早期糖尿病肾病的诊断率。结论尿NAG和Cys—C是糖尿病‘肾病早期诊断的指标,二者联合检测可提高糖尿病肾病早期的诊断率。     

尿沉渣及尿RBP、NAG检测与急性肾衰肾活检相关性

目的探讨尿沉渣检查及尿RBP、NAG检测能否反应急性肾衰患者的肾脏病理损伤。方法100例急性肾衰患者在肾脏病理活检前一日或当日取晨尿进行尿沉渣相差显微镜镜检及ELISA法和生化法分别测定RBP、NAG,比较不同病理改变的尿沉渣及尿RBP、NAG分泌特点。结果肾小球增殖性病变（PGD）为主的65例患者中60例为Ⅰ类尿沉渣谱（92．3％）,RBP、NAG正常或略有增高;非肾小球增殖病变（NPGD）为主的10例患者中9例为Ⅱ类尿沉渣谱（90．0％）,3例（30．0％）伴急性肾小管坏死的患者尿RBP、NAG异常;小管间质病变（TID）为主的25例中23例为Ⅲ类尿沉渣谱（92．0％）,尿RBC、NAG明显增高。结论尿沉渣镜检、尿RBP、NAG测定在一定程度上能反应肾脏病理损伤的部位及程度,具有一定的临床意义。     

尿酶与尿肌酐的比值诊断2型糖尿病的评价

目的探讨尿血管紧张素转化酶（ACE）、尿微量白蛋白（mALB）、尿N-乙酰-B-D氨基葡萄糖苷酶（NAG）水平和它们与尿肌酐（Cr）的比值在2型糖尿病肾脏疾病的诊断价值。方法利用速率法测定健康对照组50例和2型糖尿病组65例的尿血管紧张素转化酶（ACE）、尿微量白蛋白（mALB）、尿N-乙酰-B-D氨基葡萄糖苷酶（NAG）水平和与尿肌酐（Cr）的比值。结果2型糖尿病患者尿ACE、尿mALB、尿NAG明显高于正常对照组,差异显著（P〈0．05）,尿ACE、尿ACE／尿cr、尿NAG、尿NAG／尿cr、尿mALB、尿mALB／尿Cr诊断2型糖尿病的敏感度分别为83％、90％、77％、88％、79％、85％,特异度分别为73％、86％、69％、83％、70％、81％。结论尿ACE／尿Cr是诊断2型糖尿病肾病的特异性指标,对2型糖尿病肾脏损害有较高诊断价值。     

补阳还五汤对早期糖尿病肾病转化生长因子β1(TGF-β1)的作用

目的:应用补阳还五汤治疗早期糖尿病肾病观察对转化生长因子β₁的作用。方法:将75例早期糖尿病肾病患者随机分组,对照组15例,补阳还五汤组30例,贝那普利组30例,分别采取常规的基础治疗,常规基础治疗加用补阳还五汤、常规基础治疗加用贝那普利,并测定治疗前,6周,12周血清转化生长因子β₁,同时观察尿微量白蛋白（U-mA）、尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）的指标情况,研究其对血中转化生长因子β₁的作用。结果:中药治疗组的血清转化生长因子β₁,尿微量白蛋白比对照组明显减少。结论:补阳还五汤可减少早期糖尿病肾病转化生长因子β1及尿微量白蛋白。     

血清NAG活性测定对PLC诊断及疗效观察的临床价值

目的：探索血清N—乙酷—β—D—氨基葡萄糖苷酶(NAG)活性测定对原发性肝癌(PLC)诊断和疗效观察的临床价值。方法：以硝基苯酚比色法测定未经治疗的PLC患者(30例)和治疗后的PLC患者(35例)的血清NAG值，并分别与正常人(44例)血清NAG值进行比较。结果：两组PLC患者血清NAG值均高于正常对照组，差异有统计学意义；在PLC患者中，未经治疗者的血清NAG值又高于经治疗者，差异也有统计学意义。结论：血清NAG测定对于PLC的辅助诊断和疗效观察都有一定价值，是一项可应用于临床的生化检测指标。     

Eradication of early P. aeruginosa infection in children <7 years of age with cystic fibrosis: The early study

Objective

Antibiotic eradication treatment is the standard-of-care for cystic fibrosis (CF) patients with early Pseudomonas aeruginosa (Pa)-infection; however, evidence from placebo-controlled trials is limited.