Correlation of serum magnesium levels and cardiac digitalis intoxication

A prospective study was undertaken to compare the prevalence of hypomagnesemia and hypermagnesemia in patients with cardiac digitalis toxicity and in digitalized patients without toxicity. During an 8 month period on a general medical service, there were 38 patients with “definite” or “possible” digitalis toxicity, by serial electrocardiographic studies, among 120 digitalized patients whose serum magnesium levels were obtained. Serum magnesium concentrations were measured by atomic absorption spectrometry.Hypomagnesemia was present in 21 percent of patients with and 10 percent of those without digitalis toxicity. Hypomagnesemia was not more prevalent in patients with toxicity but relatively lower serum levels of digoxin or digitoxin. The presence of hypermagnesemia was significantly greater in patients with toxicity (18 percent) than in those without toxicity (5 percent), and appeared to be related to a significantly greater prevalence of abnormal renal function in the former group. The potential value of magnesium administration in hypomagnesemic patients with cardiac digitalis toxicity warrants investigation. Caution should be exercised in the administration of magnesium sulfate to digitalis-toxic, azotemic patients who may already be hypermagnesemic.     

《生物化学》课程中PBL教学法的实践及体会

PBL（Problem-based learning）教学模式是以学生为中心,教师为引导,从临床疾病入手的探究式教学方法。多年来,该法显现出了传统教学方法无法比拟的优点。但经典的PBL教学法传入我国后,因为教学体制和教学资源的限制,无法全盘实施。结合我校的具体情况,在单门课程的部分章节中有针对性地开展PBL教学法,通过培养学生的自学能力和解决问题的能力,最终达到提高教学质量的目的 。     

医学高校生物化学教学的探索

生物化学是临床医学最重要的基础课之一。在教学中从教学内容、教学方法和手段等几个方面,对医学高校生物化学教学改革进行了探索。     

补肾强骨汤对家兔骨折愈合的影响

目的探讨中药验方＂补肾强骨汤＂对家兔骨折愈合的影响。方法将21只体重为2.0～2.5 kg的雄性兔全部造成左侧桡骨骨折模型后,随机分为三组：中药实验组、中药对照组和自然愈合组,每组7只,中药实验组给予口服＂补肾强骨汤＂,中药对照组给予口服三七片,自然愈合组不予任何治疗。主要观察指标：分别于造模后第2、4、6周行血清碱性磷酸酶（AKP）、血钙、血磷含量的检测及将各组实验兔摄正位X线片,采用盲法读片,将外骨痂和骨折线采用5分制标准进行半定量后评价骨折愈合过程中外骨痂和骨折线的情况。结果造模后血生化及X线中药对照组与自然愈合组比较,差异无统计学意义（P〉0.05）;中药实验组与其余两组比较差异有统计学意义（P〈0.05）。中药实验组与自然愈合组比较,差异有统计学意义（P〈0.01）,中药实验组与中药对照组比较,差异有统计学意义（P〈0.05）。结论 ＂补肾强骨汤＂具有促进骨折愈合的作用。     

标本溶血对生化检验结果的影响及处理对策

目的分析研究标本溶血对生化检验结果的影响及处理对策。方法随机选择本院2011年8～11月在门诊进行体检的65例正常人的血标本作为研究对象,采用全自动生化分析仪对正常和溶血标本中的15项生化指标含量进行检测。结果研究对象血液的总胆红素（TBIL）、直接胆红素（DBIL）、总蛋白（TP）、清蛋白（ALB）、肌酸激酶（CK）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）、钾（K＋）、葡萄糖（GLU）、尿酸（UA）的值在溶血和不溶血标本中差异有统计学意义（P〈0.05）;三酰甘油（TG）、尿素氮（BUN）、肌酐（Cr）、钙（Ca2＋）的值在溶血和不溶血的标本中差异无统计学意义（P〉0.05）。其中TBIL、DBIL、TP、ALB、CK、ALT、AST、LDH、K＋的值更能说明溶血对血液生化指标有影响（P〈0.01）。结论溶血对较多的生化检验项目有影响,为尽量避免或减少标本的溶血,要求医务工作者采血时规范操作,对血标本的运送、分离和检测过程严格把关,使检验结果更准确可靠。     

不同月龄SPF级SD大鼠血液学及生化指标的变化

目的探讨不同生长期SPF级SD大鼠的血液学指标及生化指标的差异。方法采用血液分析仪分别测定SPF级SD大鼠2月龄、3月龄、4月龄、7月龄、8月龄时血液白细胞(WBC),红细胞(RBC),血红蛋白(HGB),红细胞压积(HCT),平均红细胞体积(MCV),平均红细胞血红蛋白量(MCH),平均红细胞血红蛋白浓度(MCHC),血小板(PLT)等指标;运用全自动生化测定仪测定其谷丙转氨酶(ALT)、谷草转氨酶(AST)、总蛋白(TP)、白蛋白(ALB)、血糖(GLU)、尿素氮(BUN)、肌酐(CREA)、甘油三酯(TG)等指标。结果结果表明大鼠RBC数量随年龄增长逐渐增大,雄性大鼠PLT数量逐渐增大,MCV减小,雌性HGB、HCT逐渐增大,且WBC、RBC、HGB、HCT数量随年龄增长呈现雌雄差异,雌性值偏小;大鼠各血液学指标均有较大的波动,其中以WBC和PLT的波动范围最大;随年龄的增长,雄性大鼠TP值逐渐减小;雌性大鼠TG逐渐升高;TP、ALB、BUN呈现雌雄差异,且雌性偏高;大鼠各生化指标均有较大的波动,以AST的波动范围最大。结论研究结果表明:大鼠的部分血液学及生化学指标存在性别及年龄的差异。     

维生素D简介

文章就维生素D的结构、来源、在人体内的代谢、主要生理功能、应用及合成的现状作了简要介绍,旨在使读者对维生素D有一个全面的了解。     

Therapeutic role of low-carbohydrate ketogenic diet in diabetes

IntroductionChanges in dietary habits influence the glycemic level. Preliminary studies using the low-carbohydrate ketogenic diet (LCKD) were found to be quite promising in controlling diabetes mellitus. Therefore, the objectives of this study are to investigate the therapeutic effects of LCKD in experimental diabetic rats following the administration of streptozotocin (STZ).Materials and methodsAdult rats were divided into three groups: normal diet, LCKD, and high-carbohydrate diet. Each group was subdivided into normal, sham, and diabetic groups. Diabetes was induced by a single intraperitoneal injection of STZ (55 mg/kg). Specific diets were given to each group of animals for a period of 8 wk and then the animals were sacrificed. The rats were monitored daily for food and water intake, whereas body weight, urine output, and blood glucose levels were monitored weekly. The histology of the islets of Langerhans was studied by histochemical methods.ResultsThe results showed that LCKD was effective in bringing blood glucose level close to normal (P < 0.01). Food and water intake and urine output were increased in all groups except the LCKD group (P < 0.01). The body weight was significantly reduced in all diabetic animals except in the LCKD group (P < 0.01). Histologic studies showed significant decrease in the islet size and number of β cells in all the diabetic groups.ConclusionThis study indicates that LCKD has a significant beneficial effect in ameliorating the diabetic state and helping to stabilize hyperglycemia.     

Biochemical and genetic analysis of Leigh syndrome patients in Korea

Sixteen Korean patients with Leigh syndrome were identified at the Seoul National University Children’s Hospital in 2001–2006. Biochemical or molecular defects were identified in 14 patients (87.5%). Thirteen patients had respiratory chain enzyme defects; 9 had complex I deficiency, and 4 had combined defects of complex I + III + IV. Based on the biochemical defects, targeted genetic studies in 4 patients with complex I deficiency revealed two heteroplasmic mitochondrial DNA mutations in ND genes. One patient had the mitochondrial DNA T8993G point mutation. No mitochondrial DNA defects were identified in 11 (68.7%) of our LS patients, who probably have mutations in nuclear DNA. Although a limited study based in a single tertiary medical center, our findings suggest that isolated complex I deficiency may be the most common cause of Leigh syndrome in Korea.     

Immunohistochemical expression of hormone receptors and the histological characteristics of biochemically hormone receptor negative breast cancers

Background  Most of the discordant cases between biochemical and immunohistochemical (IHC) assays for hormone receptor (HR) status in breast cancers are due to negative findings from the biochemical assay but positive IHC findings. However determining HR status based on IHC only in biochemically HR negative breast cancers has never been studied. The aim of this study is to examine the histological characteristics in immunohistochemically HR positive but biochemically HR negative breast cancers. Methods  IHC staining for HRs in 345 biochemically HR-negative breast cancers was done. The relationship between HR status by IHC and the histological characteristics was assessed. Results  In 345 cancers, 105 (30.4%) were estrogen receptor- (ER) or progesterone receptor- (PR) positive by IHC. The enzyme-immunoassay (EIA) HR titer was higher in immunohistochemically HR-positive tumors (ER: 2.7 fmol/mg protein; PR: 0.8 fmol/mg protein) than in negative tumors (0.6 fmol/mg protein in both HRs). IHC-assessed ER positivity on histological sections was high in some tumor types, such as mucinous carcinoma (77.8%), invasive micropapillary carcinoma (66.7%), and infiltrating ductal carcinoma of no special type with abundant stroma (60.2%). Among infiltrating ductal carcinomas of no special type, low nuclear grade tumors were all ER positive and high nuclear grade tumors showed low ER positivity by IHC, even in biochemically HR negative cancers. Conclusion  The IHC-assessed HR status may reflect tumor cell behavior, such as overall and disease-free survival and endocrine response, better than HR status as assessed by the enzyme-immunoassay method. Immunohistochemically HR-positive but biochemically HR-negative breast cancers include infiltrating ductal carcinomas of no special type with low nuclear grade and some tumor types with high stromal content. We can assess the true HR status by IHC especially these tumors.