Beneficial role of intravenous calcitriol on bone mineral density in children with severe secondary hyperparathyroidism

Objectives: In this prospective study, the effect of calcitriol therapy on bone mineral density and osteopenia in patients with severe secondary hyperparathyroidism has been investigated. Materials and methods: The study was carried out on 24 chronic dialysis patients consisting of 13 boys and 11 girls, aged between 8–18 years. Patients were divided into 3 groups according to the severity of hyperparathyroidism and therapy regimens. Group I consisted of 5 patients with normal parathormon levels who did not receive calcitriol therapy. In group II and III, there were patients with secondary hyperparathyroidism. Group II consisted of 10 patients receiving oral calcitriol therapy. Group III consisted of 9 patients receiving intravenous (IV) calcitriol. Bone mineral density was measured by dual energy x-ray absorptiometry. Osteopenia was defined as a Z-score worse than −2. Bone mineral density was assessed as baseline and at the end of one year. Results: A significant improvement was observed in Z-score in the group III whereas the mean value of Z-score tended to be worse in group I and it was not significantly different in group II from the initial values. The better Z-score in group III was associated with more effective stabilization of alkaline phosphatase level and bone specific alkaline phosphatases (BAP) concentrations. Conclusion: Significant improvement of Z-score in group III suggested the beneficial role in IV administration of calcitriol in chronic dialysis patients. This revised version was published online in August 2006 with corrections to the Cover Date.     

人血中盐酸苯环壬酯的GC-MS/SIM定量测定

建立了血中盐酸苯环壬酯的GC-MS/SIM的定量分析方法。采用同位素标记物[²H₃]盐酸苯环壬酯为内标,以m/z138和m/z141为盐酸苯环壬酯和[²H₃]盐酸苯环壬酯的检测离子;方法线性度、回收率、相对标准偏差以及仪器的稳定性均达到定量测定的要求。其最低检测限为25pg·mL^-1血浆。该法应用于盐酸苯环壬酯Ⅰ期临床实验中的血药浓度测定,得到了准确、可靠的药代动力学和相对生物利用度数据,为盐酸苯环壬酯的新药报批提供了依据。     

三种国产氟喹诺酮药物体外抗菌作用

测试了国产氟哌酸、氟啶酸和甲氟哌酸等三种氟喹诺酮类药物(FQs)对8种共80株细菌的体外抗菌活性(MIC)及其对大肠杆菌2280杀菌作用的量效关系,结果表明,主种药物对大肠杆菌,阴沟扦菌、志贺氏菌属、沙门菌属、克雷白氏肺炎杆菌和金萄菌具有强大的抗菌活性(MIC90多≤1ug/ml)。对绿脓杆菌的作用较弱(MIC90为2—4ug/ml4株变形杆菌对三种FQS药物也较敏感(MIC为0、25—2ug/ml),但1株耐利福平杆菌的MIC为9ug/ml,提示利福平与FQS药物之间可能存在交叉耐药性。三种药物对大肠杆菌2280的杀菌量效关系呈双相变化,最强杀菌浓度为1—2ug/ml。本文对其临床意义进行了讨论。     

唑来膦酸联合骨化三醇对骨质疏松症患者骨代谢及骨密度的影响

〔摘 要〕 目的：探讨采用唑来膦酸联合骨化三醇治疗骨质疏松症患者对其骨代谢指标、骨密度水平及生活质量的影响。 方法：选取 2017 年 7 月至 2019 年 7 月深圳大学第一附属医院收治的 68 例骨质疏松症患者,按治疗方法不同分为观察组 及对照组各 34 例。对照组予以患者骨化三醇及钙剂进行治疗,观察组在对照组基础上予以患者唑来膦酸注射液进行治疗。 比较两组患者治疗前后的骨代谢及骨密度水平、国际骨质疏松生活质量评估表（QUALEFFO–41）评分以及治疗期间用药安 全性。结果：治疗后,观察组患者骨特异性碱性磷酸酶（BLAP）水平高于对照组,Ⅰ型胶原交联 C 端肽（β–CTX）、骨钙 素 N 端中分子片段（N–MID）及抗酒石酸盐酸性磷酸酶异构体 –5b（TRACP–5b）水平低于对照组,差异具有统计学意义 （P ＜ 0.05）;观察组患者的腰椎、股骨颈、髋部骨密度水平较对照组更高,QUALEFFO–41 评分中疼痛程度、社会功能、 心理状态、身体健康状况自我评价、活动性、日常及家务活动等评分均低于对照组,差异均具有统计学意义（P ＜ 0.05）; 两组患者治疗期间均无严重不良反应发生。结论：对骨质疏松症患者采用唑来膦酸联合骨化三醇进行治疗,可改善患者骨 代谢指标与骨密度水平,提高生活质量,疗效好、安全性佳。     

骨化三醇胶丸对糖尿病肾病患者尿蛋白水平的影响

[目的] 探讨骨化三醇胶丸对糖尿病肾病(DN)患者尿蛋白水平的影响.[方法] 选取DN患者86例,随机分为两组,每组43例.对照组采用控制血压、血糖及血脂等基础治疗,观察组在上述治疗的基础上口服骨化三醇胶丸,治疗持续3个月.比较两组患者的治疗有效率及患者治疗前后的白蛋白排泄率(uAER)、血肌酐(SCr)和肾小球滤过率(eGFR)及尿蛋白/肌酐比值(UAlb/Cr)变化.[结果] 两组患者治疗后的uAER、SCr及UAlb/Cr水平均较治疗前明显降低(P<0.05),但观察组治疗后降低更明显,其差异均有统计学意义(P<0.05);两组治疗前后eGFR比较差异无统计学意义(P<0.05).与治疗前相比,两组患者治疗后的收缩压(SBP)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)及低密度脂蛋白胆固醇(LDL-C)明显下降(P<0.05),1.25二羟基维生素D3[1,25(OH)2D3] 及高密度脂蛋白胆固醇(HDL-C)较治疗前明显上升(P<0.05);观察组治疗后的FPG、HbA1c明显低于对照组,1,25(OH)2D3显著高于对照组,其差异均有统计学意义(P<0.05).患者治疗后的1,25(OH)2D3水平与临床疗效、治疗后的uAER、UAlb/Cr及血压有显著相关性(P<0.05).观察组有效率为83.72%(36/43),显著高于对照组62.79%(27/43),其差异有统计学意义(X2=4.807,P<0.05).[结论] 骨化三醇胶丸可有效改善DN患者的肾功能,并降低尿蛋白水平,值得临床推广应用.     

Cross-sectional and longitudinal associations between the active vitamin D metabolite (1,25 dihydroxyvitamin D) and haemoglobin levels in older Australian men: the Concord Health and Ageing in Men Project

Anaemia and low 25 hydroxyvitamin D (25D) and 1,25 dihydroxyvitamin D (1,25D) levels are common in older people and may adversely affect morbidity and mortality. While there is some evidence for an association between low serum 25D levels and anaemia, there are limited studies among community-dwelling older people. In addition, the relationship between anaemia and the active vitamin D metabolite, 1,25D, has not been investigated. The aim of this study was to examine the associations between serum 25D and 1,25D with anaemia in community-living men aged ≥70 years. Population-based, cross-sectional analysis of the baseline phase and longitudinal analysis of the Concord Health and Ageing in Men Project (CHAMP), a large epidemiological study conducted in Sydney among men aged 70 years and older, were performed; 1666 men were seen at baseline (2005–2007), 1314 men at a 2-year follow-up (2007–2009) and 917 at a 5-year follow-up (2012–2013). The main outcome measurement was haemoglobin levels as a continuous measure. Covariates included 25D and 1,25D, estimated glomerular filtration rate, demographic information, lifestyle measures, health conditions and medication information. The prevalence of anaemia (Hb < 13.0 g/dL, WHO definition) was 14.6 %. In cross-sectional analysis, serum 25D concentrations were positively associated with haemoglobin levels in unadjusted analysis (β value 0.004; 95 % confidence interval (CI) 0.0009, 0.007; p = 0.01), but the associations were no longer significant after multivariate adjustment. The association between 1,25D levels and haemoglobin levels was significant in unadjusted analysis (β value 0.003; 95 % CI 0.002, 0.004; p < 0.0001) and remained significant in adjusted analysis (β value 0.001; 95 % CI 0.004, 0.003; p = 0.01). Serum 1,25D (but not 25D) levels at baseline were significantly associated with changes in haemoglobin over 2 and 5 years in unadjusted (β value 0.002; 95 % CI 0.0009, 0.003; p < 0.0001) and in fully adjusted analyses (β value 0.001; 95 % CI 0.0004, 0.002; p = 0.001). Serum 1,25D, but not 25D, concentrations are independently associated with haemoglobin levels in older men in both cross-sectional and longitudinal analyses. This raises the question whether vitamin D metabolites may influence anaemia states, mediated through different biological pathways, or represent a time-dependent biomarker of chronic ill health.     

正念减压改善肠易激综合征的效果

目的:探讨肠易激综合征(IBS)治疗方法。方法:对门诊就诊志愿者69例进行正念减压疗法6个月,应用症状自评量表和炎症性肠病问卷对干预前后效果评估情绪、情感状态及社会功能。结果:正念减压(MBSR)训练前后SCL-90结果比较躯体化有显著变化(t=3.753,P0.01),焦虑(t=2.219)、敌对(t=20.60)、抑郁(t=2.032)、人际关系敏感(t=3.141)及恐怖(t=2.772),变化有统计学意义(P0.05),强迫症状、偏执及精神病性变化不明显(P0.05);炎症性肠病问卷肠道症状(t=-2.085),全身症状(t=-2.542)、情感功能(t=-2.088)、社会功能(t=-3.259)及总分(t=-3.314)均有统计学意义(P0.05)。结论:MBSR训练能够改善IBS患者心身状态和社会功能,提升了幸福感。     

大学生心理污名与防御机制的关系:自我概念的中介作用

目的:探讨大学生心理污名、防御机制及自我概念之间的关系。方法:用问卷调查的方法对1332名大学生的心理污名、自我概念及防御机制的状态进行调查,并从三者之间的关系角度进行分析。结果:大学生的自我概念在心理污名与不成熟的防御机制之间起中介作用,如"生理自我"在"自我疏离"与"不成熟的防御机制"之间的中介效应值为-0.131,占总效应的39.92%;"生理自我"在"逃避现实"与"不成熟的防御机制"之间的中介效应值为-0.123,占总效应的39.7%。结论 :自我概念在心理污名与不成熟防御机制间起部分中介作用。     

初中生自尊和网络攻击行为的关系:人际关系的中介作用

目的:调查初中生的自尊、人际关系和网络攻击行为,并分析人际关系在自尊和网络攻击行为的关系中是否起到了中介作用。方法:采用同伴提名、人际关系综合诊断量表、罗森伯格自尊量表和少年网络攻击行为评定量表对江苏省连云港市2所普通中学共601名初中生进行测量。结果:1网络攻击行为在性别(t=3.154~4.544,P0.01)、是否参与过网络游戏(t=2.095~2.517,P0.05)、年级(F=4.002,P0.05)和同伴关系类型(F=6.158~13.035,P0.001)上都存在显著差异;2自尊与网络攻击行为(r=-0.242~-0.294,P0.001)、自尊与人际关系(r=-0.084~-0.153,P0.05)、人际关系与网络攻击行为都显著相关(r=0.112~0.188,P0.05;人际交往中的异性交往维度和网络攻击中的反应性攻击维度相关不显著);3人际关系在自尊和网络攻击行为的关系中起到部分的中介作用,效应量为7.33%。结论:自尊既直接影响初中生的网络攻击行为,又通过人际关系间接地影响网络攻击行为。对初中生网络攻击行为的干预可从提高自尊水平和改善人际关系、包括同伴关系入手。