HCY水平对于2型糖尿病早期肾病的独立预测意义

目的研究血清同型半胱氨酸（HCY）水平与2型糖尿病（T2DM）早期肾病的关系。方法将收集到的112例T2DM患者作为观察组,按尿微量白蛋白含量分为三组：正常白蛋白组、早期肾病组和临床蛋白尿组,对HCY水平分别进行检测,与正常对照组进行分析比较。结果 T2DM早期肾病中HCY水平显著高于对照组,差异有统计学意义（P〈0.05）;T2DM各亚型HCY水平与对照组差异有统计学意义（P〈0.05）;且HCY的变化与尿微量白蛋白有一定相关性。结论血清HCY水平的变化与T2DM早期肾病密切相关,可作为T2DM早期肾病的预测因素,检测T2DM患者HCY水平有利于判断及诊断糖尿病早期肾病的发生。     

补肾活血祛痰方在女性生殖障碍中的应用及对HAMD的影响

目的 探讨补肾活血祛痰方在女性生殖障碍中的应用及对HAMD的影响。方法 选取2018年5月～2019年8月在我院接受生殖障碍治疗的女性患者98例为研究对象,按随机数字法分为对照组和研究组,每组49例,对照组应用常规治疗,研究组应用补肾活血祛痰方治疗,对比两组患者在治疗后的效果及HAMD的影响。结果研究组患者治疗后PRL、T、LH以及FSH各项性激素改善的水平均优于对照组(P0.05)。研究组患者治疗后受孕率高于对照组(P0.05)。研究组患者治疗后各个时段HAMD评分改善均优于对照组(P0.05)。结论 女性生殖障碍的治疗过程当中,补肾活血祛痰方的治疗取得了理想的效果,临床应当进一步推广应用。     

呼和浩特地区儿童体内维生素水平区间构建及临床应用探讨

目的：通过收集呼和浩特地区正常发育儿童检测体内维生素水平大数据,建立本地区儿童维生素正常值参考区间数据库,从而实现为临床准确判断儿童体内维生素水平并对与其相关疾病进行早期干预提供科学理论依据。 方法：选取 2016年1月－2019年7月在内蒙古幼保健院体检的呼和浩特地区健康儿童1月 ～ 14岁共29706例,按年龄阶段分为4组,应用“LK3000V维生素检测仪”对儿童体内维生素A、B1、B2、B6、B9、B12、C、D和维生素E浓度进行检测,并对检测结果进行统计学分析,计算均数±1.96标准差获得正常参考值区间。 结果：调查对象九种维生素水平性别差异均无统计学意义（P＞0.05）;不同年龄组维生素A、维生素B2、维生素B12、维生素D和维生素E水平存在统计学差异。 结论：呼和浩特地区儿童体内维生素水平无性别差异,其中维生素A、维生素B2、维生素B12、维生素D和维生素E体内水平具有年龄差异。基于以上检测大数据进行分析,从而对于不同地区使用同一种诊断标准的传统模式提出挑战,同时为呼和浩特地区儿童维生素体内水平按照年龄分组分别建立参考区间并在临床应用中提供循证支持。为临床应用提供诊断依据,做到早发现、早诊断、早治疗。     

重型颅脑损伤患者血钠水平的变化及与预后关系的探讨

目的观察重型颅脑损伤（STBI）患者血钠水平的变化并探讨STBI患者血钠水平与预后的关系。方法选择38例STBI患者,根据患者入院时格拉斯哥昏迷评分（GCS）分为A组、B组和C组,观察以上各组患者住院后第1d、第3d、第5d和第7d血钠水平的变化;并依据患者就诊时血钠水平将以上患者分为正常组,轻度组,中度组和重度组,根据格拉斯哥预后评分（GOS）,探讨STBI患者的血钠水平与预后的关系。结果入院后第1d各组患者血钠水平与GCS评分呈负相关性,不同GCS评分患者间血钠水平差异具有统计学意义;就诊时患者血钠水平与病死率呈正相关性,不同血钠水平患者间病死率比较,差异差异具有统计学意义。结论就诊时STBI患者血钠水平与其病程进展和预后密切相关,应重视患者血钠水平的纠正。     

Fish to meat intake ratio and cooking oils are associated with hepatitis C virus carriers with persistently normal alanine aminotransferase levels

Aim: Dietary habits are involved in the development of chronic inflammation; however, the impact of dietary profiles of hepatitis C virus carriers with persistently normal alanine transaminase levels (HCV‐PNALT) remains unclear. The decision‐tree algorithm is a data‐mining statistical technique, which uncovers meaningful profiles of factors from a data collection. We aimed to investigate dietary profiles associated with HCV‐PNALT using a decision‐tree algorithm. Methods: Twenty‐seven HCV‐PNALT and 41 patients with chronic hepatitis C were enrolled in this study. Dietary habit was assessed using a validated semiquantitative food frequency questionnaire. A decision‐tree algorithm was created by dietary variables, and was evaluated by area under the receiver operating characteristic curve analysis (AUROC). Results: In multivariate analysis, fish to meat ratio, dairy product and cooking oils were identified as independent variables associated with HCV‐PNALT. The decision‐tree algorithm was created with two variables: a fish to meat ratio and cooking oils/ideal bodyweight. When subjects showed a fish to meat ratio of 1.24 or more, 68.8% of the subjects were HCV‐PNALT. On the other hand, 11.5% of the subjects were HCV‐PNALT when subjects showed a fish to meat ratio of less than 1.24 and cooking oil/ideal bodyweight of less than 0.23 g/kg. The difference in the proportion of HCV‐PNALT between these groups are significant (odds ratio 16.87, 95% CI 3.40–83.67, P = 0.0005). Fivefold cross‐validation of the decision‐tree algorithm showed an AUROC of 0.6947 (95% CI 0.5656–0.8238, P = 0.0067). Conclusion: The decision‐tree algorithm disclosed that fish to meat ratio and cooking oil/ideal bodyweight were associated with HCV‐PNALT.     

Metal presence in hair after metal‐on‐metal resurfacing arthroplasty

The elevation of metal levels in serum and urine during post‐operative follow‐up is a frequent find following the implantation of certain models of metal‐on‐metal hip prostheses. Among 45 patients with the same resurfacing prostheses, chromium (Cr) and cobalt (Co) levels in serum and urine were determined at 3, 4, 5, and 6 years after surgery. In the same period, levels of Cr, Co and molibdene (Mo) in scalp hair were also measured. Mean Cr and Co levels in serum were 8.29 µg/L (SD 17.97) and 8.38 µg/L (SD 21.97), respectively, whereas in urine levels were 16.20 µg/L (SD SD 32.55) and 75.40 µg/L (SD 190.86), respectively. In hair, mean Cr level were 163.27 µg/g (SD 300.62), mean Co level 61.98 µg/g (SD 126.48), and Mo 31.36 µg/g (SD 37.86). A high concordance was observed between chromium‐urine and chromium‐serum and between cobalt‐urine and cobalt‐hair. A moderate concordance was present between cobalt‐urine and cobalt‐serum, and between cobalt‐hair and cobalt‐serum. Eleven patients required revision surgery, five of them due to metallosis and periarticular cyst. At 1 year after reintervention, analytics were performed again and the following decrease rates were found: 42.8% in Cr levels, 51.1% in Mo levels, and 90.3% in Co levels. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:2025–2031, 2013     

Serum albumin level during intestinal exfoliative rejection: a potential predictor of graft recovery and patient outcome

Exfoliative rejection is a severe complication after intestinal transplant. The assessment of mucosa histology is restricted to the area reached by endoscopy. We aim to evaluate the serum albumin (SA) value as a parameter of graft damage and clinical prognosis in intestinal exfoliative rejection (ExR). The present study is a retrospective analysis of 11 episodes of ExR occurred in a cohort of 26 patients. SA levels were measured 24 h after diagnosis and twice a week thereafter and then correlated with parameters of clinical and graft histological recovery (HR). During ExR, all patients had very low SA levels, reaching a minimum average of 1.9 ± 0.3 g/dL. According to the value of albumin levels at ExR diagnosis, the patients were grouped finding a correlation with their clinical evolution. Six ExR episodes presented with severe hipoalbuminemia (<2.2 g/dL; p < 0.05) that correlated with worse patient and graft outcome, ranging from graft loss and need for re‐transplantation to delayed clinical and HR. SA at ExR diagnosis may be an indicator of the severity of the ExR process, and it could also be used as an early predictor of patient and graft outcome.     

Tacrolimus trough levels after month 3 as a predictor of acute rejection following kidney transplantation: a lesson learned from DeKAF Genomics

Most calcineurin inhibitor (CNI)‐based protocols reduce blood trough goals approximately 2–3 months post‐transplant in clinically stable kidney transplant recipients. The CNI target trough level to prevent rejection, after reduction, is unknown. Using a multivariate Cox proportional hazards model, we determined the association of time‐varying tacrolimus (TAC) trough levels with acute rejection (AR) occurring in the first 6 months post‐transplant, but specifically we assessed this association after 3 months. A total of 1930 patients received TAC‐based immunosuppression prior to AR in a prospective study. Of the 151 (7.8%) who developed AR, 47 developed AR after 3 months post‐transplant. In an adjusted time‐varying multivariate model, each 1 ng/ml decrease in TAC trough levels was associated with a 7.2% increased risk of AR [hazards ratio (HR) = 1.07, 95% confidence interval (CI) (1.01, 1.14) P = 0.03] in the first 6 months. There was an additional 23% increased risk of AR with each 1 ng/ml decrease in the TAC trough levels in months 3–6 [HR = 1.23, 95% CI (1.06, 1.43) P = 0.008]. In conclusion, lower TAC trough levels were significantly associated with increased risk of AR in the first 6 months post‐transplant with additional risk of AR between months 3 and 6 post‐transplant. The timing and practice of TAC dose reduction should be personalized based on the individual's risk factors.