The relationship between measurement of in vivo brain glutamate and markers of iron metabolism: A proton magnetic resonance spectroscopy study in healthy adults

Fundamental human studies which address associations between glutamate and iron metabolism are needed. Basic research reports associations between glutamate and iron metabolism. Human studies report sex differences in iron metabolism and glutamate concentrations, which suggest that these relationships may differ by sex. We hypothesised associations would be apparent between in vivo glutamate and peripheral markers of iron metabolism, and these associations would differ by sex. To test this, we recruited 40 healthy adults (20 men, 20 women) and measured (a) standard clinical biomarker concentrations for iron metabolism and (b) an in vivo proxy for glutamate concentration, glutamate with glutamine in relation to total creatine containing metabolites using proton magnetic resonance spectroscopy studies with a two‐dimensional chemical shift imaging slice, with voxels located in bilateral dorsolateral prefrontal cortices, anterior cingulate cortices and frontal white matter. Only the female group reported significant associations between peripheral markers of iron metabolism and Glx:tCr concentration: (a) right dorsolateral prefrontal cortex Glx:tCr associated positively with serum transferrin (r = .60, p = .006) and negatively with transferrin saturation (r = ?.62, p = .004) and (b) right frontal white matter Glx:tCr associated negatively with iron concentration (r = ?.59, p = .008) and transferrin saturation (r = ?.65, p = .002). Our results support associations between iron metabolism and our proxy for in vivo glutamate concentration (Glx:tCr). These associations were limited to women, suggesting a stronger regulatory control between iron and glutamate metabolism. These associations support additional fundamental research into the molecular mechanisms of this regulatory control.     

Metabolic changes of prefrontal cerebral lobe, white matter and cerebellum in patients with post-stroke depression*☆ A proton magnetic resonance spectroscopy study

BACKGROUND： Proton magnetic resonance spectroscopy （IH-MRS） non-invasively detects changes in chemical substances in the brain, which reflects the pathological metabolism.
OBJECTIVE： To investigate changes in N-acetyl-aspartate （NAA）, choline （Cho）, creatine （Cr）, and myoinositol （MI） in the gray and white matter of cerebral prefrontal lobe and cerebellum of patients with differential degrees of post-stroke depression （PSD） using ^1H-MRS.
DESIGN： A case control study.
SETTING： The First Affiliated Hospital of the Dalian Medical University.
PARTICIPANTS： A total of 38 patients with stroke （28 male and l0 female patients, aged 40 to 79 years） were selected from the Department of Neurology, 1st Affiliated Hospital, Dalian Medical University, from February to October in 2004. All subjects met the DSM-IV criteria for cerebrovascular disease and depression. The degree of depression was defined according to Hamilton criteria. 38 patients with PSD were divided into two groups according to the time after ischemia, 20 patients in the acute group with less than 10 days after ischemic attack （mild： 16 patients, moderate/severe： 4 patients） and 18 patients in the chronic group with more than l l days after ischemic attack （mild： 15 patients, moderate/severe： 3 patients）. Seventeen healthy volunteers with matching age from 41 to 80 years were examined as a control group. The study was approved by the Medical Ethics Committee of the University Medical Center Utrecht, and each participant signed an informed consent form.
METHODS： Spectra were acquired by multi-voxel point-resolved spectroscopy （PRESS） sequence with GE signal.5T MR/i, localized in prefrontal cerebral lobe and cerebellum. Values of NAA, Cho, MI, and Cr ere compared between different graded PSD patients and control subjects with one-way analysis of variance in software SPSS 11.5.
MAIN OUTCOME MEASURES： Metabolite concentration in different brain regions of interest. Difference in metabolites b     

Creatine has no beneficial effect on skeletal muscle energy metabolism in patients with single mitochondrial DNA deletions: a placebo-controlled, double-blind 31P-MRS crossover study

The purpose of our randomized, double-blind, placebo-controlled crossover study in 15 patients with chronic progressive external ophthalmoplegia (CPEO) or Kearns-Sayre syndrome (KSS) because of single large-scale mitochondrial (mt) DNA deletions was to determine whether oral creatine (Cr) monohydrate can improve skeletal muscle energy metabolism in vivo. Each treatment phase with Cr in a dosage of 150 mg/kg body weight/day or placebo lasted 6 weeks. The effect of Cr was estimated by phosphorus-31 magnetic resonance spectroscopy ((31)P-MRS), clinical and laboratory tests. (31)P-MRS analysis prior to treatment showed clear evidence of severe mitochondrial dysfunction. However, there were no relevant changes in (31)P-MRS parameters under Cr. In particular, phosphocreatine (PCr)/ATP at rest did not increase, and there was no facilitation of post-exercise PCr recovery. Clinical scores and laboratory tests did not alter significantly under Cr, which was tolerated without major side-effects in all patients. Cr supplementation did not improve skeletal muscle oxidative phosphorylation in our series of patients. However, one explanation for our negative findings may be the short study duration or the limited number of patients included.     

联合检测cTnI、MYO和CK-MB mass对病毒性心肌炎诊断的评价

目的 探讨联合检测心肌肌钙蛋白(cTnI)、肌红蛋白(MYO)和肌酸激酶同工酶MB质量(CK-MB mass)对病毒性心肌炎(VMC)的诊断价值.方法 在61例VMC和74例非病毒性心肌炎(NVMC)患儿及46例健康对照组中,用微粒子化学发光免疫分析法检测血清cTnI、MYO、CK-MB mass,并用连续监测法测定血清LDH、AST、CK和α-HBDH的活性.cTnI、MYO和CK-MB mass不同组合的诊断效率运用矩阵决策法评价.结果 入院当日VMC组cTnI(0.46±0.21μg/L)、MYO(98.7±38.2μg/L)、CK-MB(6.1±4.2μg/L)均明显高于NVMC组(分别为0.06±0.04、39.2±26.8、2.2±1.7μg/L)和对照组(分别为0.07±0.04、36.5±24.7、2.1±1.5μg/L,P＜0.01).cTnI、MYO、CK-MB mass联合检测对VMC诊断的灵敏度、特异性、阳性预报值、阴性预报值和诊断准确度分别为90.16%、85.14%、83.33%、91.30%和87.41%,其特异性、阳性预报值和诊断准确度明显比四种心肌酶联合检测法高(P＜0.05),而灵敏度和阴性预报值与后者相比差异无显著性(P＞0.05).MYO对VMC初诊的灵敏度较高,特异性欠佳,阳性持续时间短;cTnI与CK-MB对VMC诊断的特异性好,持续时间长,初诊时的灵敏度不够理想.VMC患者康复时以MYO恢复最快,CK-MB次之,cTnI最慢.结论 联合动态检测cTnI、MYO和CK-MB mass可使VMC的诊断效率进一步提高.     

磷酸肌酸含血心停搏液对联合瓣膜置换术心肌保护作用研究

目的观察含血圣.托马斯(STH2)液加入外源性磷酸肌酸(CP)后对重症瓣膜病患者联合瓣膜置换术心肌保护作用。方法40例同期行二尖瓣、主动脉瓣置换术患者随机分为两组,CP治疗组在含血STH2心灌注液中加入CP,对照组用等量含血STH2液,分别切开主动脉根部经冠状动脉窦直接灌注,观察心脏复搏情况、术后机械通气及监护室停留情况。两组分别于麻醉诱导前、诱导后、主动脉阻断开放后6h、16h,采集患者中心静脉血,测血细胞比积(HCT)、磷酸肌酸激酶同工酶(CK-MB)、心肌钙蛋白I(cTn-I)。结果CP治疗组心脏自动复搏率较对照组高,术后多巴胺用量较对照组少,两组术后CK-MB、cTn-I较术前高,CP治疗组较对照组高。结论CP加入心停搏液中能显著提高心肌保护作用。     

AMI患者早期CK同工酶亚型的高压电泳图谱分析

目的探讨CK同工酶亚型在AMI胸痛发作后24h内的变化规律,为AMI患者的早期诊断提供依据。方法采用REP全自动高压电泳仪检测AMI胸痛发作后不同时间以及对照组的CK-MM1、CK-MM2、CK-MM3、CK-MB1、CK-MB2等指标并进行荧光扫描,同时在Olympus2700全自动生化分析仪上测定CK、CK-MB的总活性,对所得数据进行恰当的统计分析。结果在AMI患者胸痛发作24h内,CK同工酶亚型有一特殊的变化规律:4~6h内,CK-MB2、CK-MM3开始升高,8~12h达高峰,92%的病人CK-MB2/CK-MB1>1.5,同时91%的病人CK-MM3/CK-MM1>0.5。结论CK同工酶亚型CK-MM3/CK-MM1、CK-MB2/CK-MB1的检测可作为AMI早期诊断的指标。     

血清肌酸激酶自主研发生化诊断试剂的临床研究

目的 进行自主研发的血清肌酸激酶(CK)生化诊断试剂自身的性能评价及研发试剂与进口优质CK生化诊断试剂对CK实验诊断检测的可比性及偏倚评估,确认研发试剂是否符合临床要求,能否应用于临床.方法 自主研发血清CK生化诊断试剂自身的性能评价:做空白吸光度、重复性和线性检测.两种试剂的比对和偏倚评估依据美国临床实验室标准化协会 EP9-A文件标准,科学设计试验方案,以进口德国Olympus(Olympus)的诊断试剂为对照组(X),国内中生北控生物科技公司(中生)诊断试剂为实验组(Y),在日本Olympus AU5421自动生化分析仪上测定血清CK含量.标本选择高、中、低值CK含量的临床患者血清100份,每天10份,每份标本正序、倒序各测定1次,记录测定结果,作统计学分析.结果 自主研发血清CK生化诊断试剂空白吸光度、重复性和线性检测符合要求,X组试剂和Y组试剂对临床标本血清CK的检测结果经统计学处理显示:方法内重复性检查DX′i≤4DX′、DY′i≤4DY′,离群点检查Eij≤4 E,Eij′≤4E′,线性回归r=0.999 3、系统误差的估计值及其置信区间|Clow,Chigh|小于允许误差,系统误差符合国际标准要求.结论 自主研发的CK生化诊断试剂与公认的优质进口Olympus生化诊断试剂两者间具有良好的相关性;自主研发的CK生化诊断试剂自身性能良好,安全性和有效性符合临床应用要求.     

磷酸肌酸钠治疗小儿传染性单核细胞增多症心肌损害的疗效观察

目的:探讨磷酸肌酸钠治疗小儿传染性单核细胞增多症(IM)伴心肌损害的疗效.方法:IM伴心肌损害患儿64例随机分为治疗组与对照组各32例,两组患儿均给予更昔洛韦及对症治疗,在此基础上治疗组加用磷酸肌酸钠(CP)治疗,对照组加用1,6-二磷酸果糖(FDP)治疗,疗程均为14天,观察治疗前后病人心肌酶谱、肌钙蛋白和心电图改变情况.结果:两组患儿治疗前心肌酶水平相似且高于正常值,治疗后两组心肌酶均显著下降(P＜0.01), 治疗组心肌酶改善及总有效率均显著优于对照组(P＜0.05);心电图改善率、肌钙蛋白I阴转率两组无明显差别(P＞0.05).结论:CP 可治疗小儿IM心肌损害,其效果优于FDP.     

Mulligan手法治疗腰椎小关节紊乱的临床疗效

目的：观察运用Mulligan手法治疗腰椎小关节紊乱的临床疗效。方法：82例腰椎小关节紊乱患者随机分为观察组(n = 41)和对照组(n = 41),观察组采用Mulligan手法治疗,对照组采用腰部斜扳法治疗。隔天治疗一次,共治疗三次。2组患者分别在治疗前、治疗后进行视觉模拟评分法和JOA腰背痛疗效评价系统评定,并进行肌酸激酶(CK)和乳酸脱氢酶(LDH)检验。结果：治疗后,观察组VAS评分较治疗前及对照组治疗后有明显下降(P<0.05);观察组血清CK检验数值较治疗前有明显下降(P<0.05);对照组血清CK检验数值较治疗前,观察组与对照组血清LDH检验数值较治疗前均无统计学差异(P>0.05);观察组显效率(含痊愈)及总有效率较对照组有明显升高(P<0.05)。结论：Mulligan手法对腰椎小关节紊乱的疗效明显,可以有效的减轻疼痛,调整腰椎关节,调节腰部周围肌群平衡,从而恢复腰部运动功能。