高血胆固醇症病人体内铁贮水平与心肌灌注 左心室功能的相关研究

目的评价血清铁参数与高血胆固醇症(HCL)病人心肌灌注、室壁运动异常及血管造影显示的冠状动脉疾病(CAD)程度的相互关系.方法选择38名具有高血胆固醇症(LDL-C＞3.38mmol/L)从未治疗过的男性病人(平均年龄59±6岁)作为HCL组和32名年龄匹配而胆固醇水平正常(NCL)的男性为NCL组,进行冠状动脉造影并在10d内行SPECT检查,应用99mTc-甲氧基异丙基异氰(MIBI)进行静息/负荷门控断层心肌灌注显像、室壁运动功能图像分析;同时测定血清铁参数、血脂及常规血液学参数.结果在HCL组发现血清铁蛋白(SF)与心肌灌注系数(r=0.70,P＜0.01),可逆系数(r=0.66,P＜0.01)和室壁运动系数(r=0.53,P＜0.05)之间呈显著性相关;而总铁结合力与灌注系数之间呈一弱(负)相关(r=-0.52,P＜0.05).在NCL组铁参数与灌注系数及室壁运动系数之间无显著性相关.多元回归分析证实血清铁蛋白水平是决定HCL病人中心肌灌注的独立因素(β=0.55,P＞0.05).铁参数与两组通过冠状动脉造影(CAG)进行评分所定义的CAD程度无关.结论体内铁贮水平升高与HCL病人心肌灌注和功能异常的严重性和程度有着密切的关系,但与CAD的造影显示的病变范围无关.血清铁蛋白水平增高,可增加铁介导的氧化应力和LDL过氧化作用,导致HCL相关的血管内皮功能紊乱并进一步损伤心肌灌注和室壁运动功能.     

子宫内膜异位症患者血清及腹腔液中血小板衍生生长因子、血管细胞粘附分子水平的变化及其意义

目的通过检测子宫内膜异位症(EMs)患者血清及腹腔液中血小板衍生生长因子(PDGF)、血管细胞粘附分子-(VCAM-1)浓度,探讨PDGF和VCAM-1在EMs发病中的作用。方法选取手术后病理证实为EMs的40例患者为EMs组,其中I~II期17例,III~IV23例;非EMs组20例作为对照组。应用酶联免疫吸附法(ELISA)检测血清及腹腔液中PDGF和VCAM-1水平。结果EMs组血清及腹腔液中PDGF、VCAM-1水平均明显高于对照组(P<0.01)。随EMs期别的增加,其血清和腹腔液中PDGF、VCAM-1含量呈上升趋势;EMsIII~IV期水平显著高于I~II期(P<0.05)。EMs患者PDGF与VCAM-1呈正相关性(P<0.05)。结论EMs患者PDGF、VCAM-1表达水平升高,在EMs的发生发展中具有重要作用。     

评价酶联免疫检测血清CYFRA21—1对非小细胞肺癌的诊断价值

目的评价检测ＣＹＦＲＡ２１┐１对非小细胞肺癌的诊断价值。方法用ＥＬＩＳＡ法测定７０例肺癌（ＬＣ）其中４７例非小细胞肺癌（ＮＳＣＬＣ），３例小细胞肺癌（ＳＣＬＣ）和２０例未分型肺癌、６４例肺部良性疾病患者及４０例健康人血清ＣＹＦＲＡ２１┐１浓度。试验的诊断性能用相对操作特征（ＲＯＣ）分析法估测之。结果测得全阈诊断准确率（ＯｖｅｒａｌＤｉａｇ┐ｎｏｓｔｉｃＡｃｃｕｒａｃｉｅｓ）ＬＣ为０．７５、ＮＳＣＬＣ为０．７６，ＳＱＣ为０．８３，ＡＤＥ为０．６７和ＳＣＬＣ为０．３８。在相应于特异性为０．９５的界定值３．４７μｇ／Ｌ处，各型的灵敏度分别为ＳＱＣ０．６２，ＬＣ０．５３，ＮＳＣＬＣ０．５１，ＡＤＥ０．４８和ＳＣＬＣ０．００。结论结果显示ＣＹＦＲＡ２１┐１是ＮＳＣＬＣ较灵敏和特异的一个标志物。未观察到ＴＮＭ各期间该标志物的平均水平有明显的差异；然而异常升高水平的患者的比例随病期的进展而显著增加，提示一系列检测ＣＹＦＲＡ２１┐１水平可能有助于监查ＮＳＣＬＣ患者的疗效。     

血清亚硝酸盐的快速测定

目的：建立一种无需去蛋白的血清亚硝酸盐的快速测定方法。方法：加入蛋白活化剂后，直接用Ｇｒｉｅｓ试剂显色分光光度测定。结果：方法的检测下限为０．２μｍｏｌ／Ｌ，相对标准差为５．１３％～８．８６％，回收率为９４．５％～９９．８％（平均为９７．８％）。血清ＮＯ－２浓度为１４．３８±０．２５μｍｏｌ／Ｌ时，批内变异系数为１．７５％，ＮＯ－２浓度为５．６９±０．２５μｍｏｌ／Ｌ时，批间变异系数为４．４６％。测定５５例正常人血清，得到血清中ＮＯ－２浓度的平均值分别为５．３６±２．１６ｕｍｏｌ／Ｌ；对糖尿病病人血清测定结果表明，亚硝酸盐浓度明显高于正常人。与去蛋白的Ｇｒｉｅｓ试剂分光光度法比较，结果无统计学差异。结论：用蛋白活化剂替代蛋白沉淀剂，减少操作步骤和干扰，测定准确、简便、快速，适用于血清中ＮＯ－２的测定。     

急性有机磷中毒患者的血钾变化及临床意义的探讨

目的：探讨急性有机磷中毒患的血清钾变化及其临床意义。方法：对68例发病6小时内的急性有机磷中毒的患入院后测定血清钾，并根据不同的中毒程度、中毒方式、发病时间分组在比较，并设正常对照组对照。结果：中毒各组均有明显的低钾血症，与对照组比较均有显性意义（P＜0．01）,且重度中毒组与中、轻度组比较亦有显性意义（P＞0．05），但两种不同的中毒途径与不同的中毒时间的组间血清钾的比较无显性意义（P＞0．05）。结论：急性有机磷中毒可致明显的低钾血症，中毒越重，低钾血症越明显。在发病早期应注意监测血清钾的变化，及时纠正低血钾，预防或减轻中毒后严重合并症的产生。     

常见阴离子对血清氯离子选择性电极法测定的影响

目的:研究离子选择性电极在测定血清氯时的影响因素。方法:用E-555电解质分析仪测定氟化钠、溴化钠、碳酸氢钠、硫氰化钾、碘化钾、铁氰化钾、硫化钠以及叠氮钠溶液,并将溴化钠、硫氰化钾、碘化钾、铁氰化钾、硫化钠、叠氮钠分别加入Cl~-均值为100mmol/L的混合血清中观察其具体的干扰情况。结果:所测8种物质中氟化钠、碳酸氢钠的影响较小,而溴化钠、铁氰化钾、碘化钾、铁氰化钾、硫化钠、叠氮钠的影响较大。结论:溴离子、碘离子、硫离子、氢氰根离子、叠氮钠对离子选择性电极法影响性较大,我们在工作中应加以重视。     

Special Pharmacokinetic Considerations in Children

Summary: Pediatric patients have greater degrees of pharmacokinetic variability and unpredictability than adults. This variability results from the effects of pharmacogenetics, age and growth, prior and current comedication, and disease. Newborns with seizures have the least predictable dosage requirements, and their needs change as drug-eliminating mechanisms mature in the neonatal period. Infants have the highest relative capacities to eliminate antiepileptics of any age group and require the largest relative doses. In addition to age-related trends, children demonstrate the same drug-specific, pharmacokinetic phenomena that adults do, including nonlinear phenytoin elimination, nonlinear valproate binding, and autoinduction of carbamazepine. Intercurrent illness and drug interactions further modify the age-related pharmacokinetic patterns in children and make dosage requirements even more unpredictable. Recent studies have shown that febrile illness can affect drug elimination, sometimes decreasing drug levels by 50% or more. Intermittent treatment with benzodiazepines administered either orally or rectally can be an important adjunct and help minimize this type of problem for children with marginally controlled epilepsy. Intermittent benzodiazepines are also helpful for children who have febrile seizures and who need only occasional antiepileptic protection.     

The Toxic Effects of Serum from Patients with Type 1 Diabetes Mellitus on Mouse Neuroblastoma Cells: A New Mechanism for Development of Diabetic Autonomic Neuropathy

The pathogenesis of diabetic neuropathy is incompletely understood. The possibility that humoral neurotoxic factors contribute as a cause of diabetic neuropathy was tested by application of serum from patients with Type 1 and Type 2 diabetes to mouse neuroblastoma cells, which have the characteristics of adrenergic neurons in culture. Serum from patients with Type 1 diabetes and somatic neuropathy significantly inhibited both proliferation and differentiation of neuroblastoma cells, while serum from patients with Type 1 diabetes but no symptoms of neuropathy and patients with Type 2 diabetes and neuropathy had no effect on proliferation, and serum from Type 2 patients only marginally inhibited differentiation. The effects of Type 1 diabetic serum could be reversed by pre-absorption of the serum to neuroblastoma cells, and were independent of glucose levels. Immunoglobulins precipitated from the sera mimicked the effects of whole sera. These results suggest that Type 1 diabetes mellitus causes a change in serum composition, possibly related to autoimmunity, that is capable of contributing to adrenergic autonomic neuropathy in diabetic patients.     

Serum modulates cyclic AMP-dependent morphological changes in cultured neurohypophysial astrocytes

The effects of serum on the morphological plasticity exhibited by pituicytes in explant cultures of the neurohypophysis of adult rats have been examined. Cultured pituicytes are normally nonstellate, protoplasmic, amorphous cells (< 25% are stellate with a distinct cell body and phase bright processes). After incubation (90 min) of pituicyte cultures in a HEPES buffered salt solution (HBSS) supplemented with isoproterenol or forskolin, the fraction of stellate pituicytes significantly increased. The increase in the fraction of stellate cells induced by isoproterenol was not reversed by subsequent incubation in isoproterenol-free HBSS for 90 min. In contrast, after stellation was induced in cultures by exposure to forskolin (90 min), the fraction of stellate cells was significantly reduced if these cultures were incubated in forskolin-free, serum (0.5%) supplemented HBSS for the same duration. Serum also blocked the increase in the fraction of stellate pituicytes induced by forskolin. These experiments suggest that serum components may have a significant role in controlling the plasticity of neuroglial relations in the neurohypophysis priviously demonstrated in vivo.     

冠心病中血糖与血清微量元素间的关系分析

对７５例冠心病患者依血糖水平分两组，进行１２种血清微量元素测定，旨在探讨微量元素与冠心病及糖尿病间的相互关系。结果发现锌、铬、锰、硒、钴元素高血糖组较对照组血清水平为低，呈非常显著差异（Ｐ＜０．０ｌ）；铜、镍元素增高，差异显著（Ｐ＜０．０５）；而锶、铁、砷、铅、铝元素两组间无显著差异（Ｐ＞０．１）。表明部分微量元素与冠心病及血糖间存在着密切联系。