短期使用苯那普利对肾小球滤过膜通透性的影响

目的 :研究肾小球滤过膜对不同分子量蛋白质通透性能对苯那普利短期治疗的反应性。方法 :根据聚丙烯酰胺凝胶电泳和 2 4小时尿蛋白定量 ,计算出大分子量和中分子量尿蛋白排泄量。口服苯那普利 10mg/d ,共两天 ,测定用药前后2 4小时尿蛋白总量、尿蛋白圆盘电泳、平均动脉血压等。结果 :用药后大分子尿蛋白、平均动脉血压明显降低 ( 1.15± 0 .89)g/ 2 4hvs ( 0 .84± 0 .74)g/h ,P <0 .0 1;( 14 .19± 1.96)kPavs ( 12 .76± 1.12 )kPa ,P <0 .0 1) ,2 4小时尿蛋白总量、中分子尿蛋白数减少无显著性 ( 3 .16± 2 .2 4)g/ 2 4hvs ( 2 .83± 2 .2 7) g/ 2 4h ,P >0 .0 5 ;( 1.72± 1.2 2 )g/ 2 4hvs ( 1.62± 1.47) g/ 2 4h ,P >0 0 5 )。结论 :短期使用苯那普利可改善肾小球滤过膜对大分子蛋白的通透性。     

二氢嘧啶酶的分离纯化与性质研究

二氢嘧啶酶产生菌Pseudomonasputida 980 1经过超声波粉碎及分级盐析 ,DEAE 纤维素和羟基磷灰石柱层析 ,SephadexG 2 0 0凝胶过滤得到纯化 2 49倍的酶液。SDS PAGE显示为单带 ,单体分子量为 380 0 0 ,SephadexG 2 0 0凝胶过滤测得分子量为 15 6 0 0 0。二氢嘧啶酶对苯海因的km 为 2 .39× 10 -2 mol/L ,其最适 pH和最适温度分别是 8.5～ 8.7和 34℃～ 35℃。 1mmol/L的EDTA和 β 巯基乙醇对酶活力有强烈的抑制作用。     

Measurement of the ratio of glomerular filtration rate to plasma volume from the technetium-99m diethylene triamine pentaacetic acid renogram: comparison with glomerular filtration rate in relation to extracellular fluid volume

Individual kidney glomerular filtration rate (IKGFR) can be measured from the renogram from the rate of uptake of technetium-99m diethylene triamine penta-acetic acid (^99mTc-DTPA). A blood sample is required to derive IKGFR in millilitres per minute, which is then usually normalised to body surface area. We describe a technique which does not require a blood sample, is already normalised for plasma volume and uses the robust Patlak plot for measuring renal uptake. The rate of kidney uptake, dR(t)ldt, at time = 0, as a fraction of the injected dose, is equal to the fraction of the plasma volume (PV) filtered per minute, i.e. IKGFR/PV. The gradient dR(0)/dt cannot be accurately measured directly but is equal to [ · LV(0)], where is the renal uptake constant (proportional to IKGFR) and LV is the count rate over a left ventricular ROI. LV(0) was obtained by extrapolation of LV(t), while a is the slope of the Patlak plot up to 3 min. GFR/PV (i.e. right plus left kidneys) in patients with normal renal function was about 0.04 min^–1, as would be expected from normal values of GFR (120 ml/min) and plasma volume (3 l). GFR/PV correlated significantly with the ratio of GFR to extracellular fluid volume (ECV), measured from the terminal exponential of the plasma clearance curve (GFR/PV = 3.2.GFR/ECV + 5.3 ml/min/1 [r = 0.82,n = 82]). GFR/PV (r = 0.74) and GFR/ECV (r = 0.82) both correlated inversely and non-linearly with plasma creatinine in 43 studies where the measurement was made within 1 week of the^99mTcDTPA study. They also correlated significantly with the plasma cyclosporin trough level in 14 patients with dermatomyositis on the 30 occasions when this measurement was made within 1 week of the renogram (r = –0.38,P < 0.05 for GFR/PV andr = –0.77,P < 0.001 for GFR/ECV). The ratio of GFR/PV to GFR/ECV is the ratio of extracellular fluid volume to plasma volume, and this was 4.0 (SD 0.99). We conclude that both GFR/PV and GFR/ECV can be easily measured with^99mTc-DTPA and are physiologically valid expressions of GFR. Although GFR/PV and GFR/ECV correlate with each other, the question is raised as to which of the two fluid volumes is the most appropriate for normalising GFR. Correspondence to: A.M. Peters     

Evaluation of a high sodium-low potassium cold-storage solution by the isolated perfused rat kidney technique

The isolated perfused rat kidney (IPK) model was used to assessinitial renal function after 24 h preservation in 3 differentcold storage solutions: EuroCollins (EC), a solution preparedaccording to the formulation of Belzer's solution (High-K⁺ UW)and a high Na⁺-low K⁺ Belzer UW solution (High Na⁺ UW). GFR and FR_Na were measured after 24 h cold storage in each ofthe solutions during 60 min, and were compared to values obtainedin a control group in which renal function was measured immediatelyafter the kidneys had been harvested. ATP and CP were measuredin fresh renal tissue, in kidneys preserved for 24 h in eachsolution, in control IPK, and in reperfused IPK after they hadbeen preserved for 24 h. Main results showed that preservationin either solution caused a dramatic decrease in GFR and inFR_Na within the first 60 min following reperfusion of cold-storedkidneys. However FR_Na was significantly higher in the High-Na⁺UW group. ATP and CP content were decreased to 10% of basalvalues in all experimental groups after cold-storage. Normothermicreperfusion of IPK after cold-storage induced a restorationof ATP levels, but CP content decreased further. There was nosignificant difference in ATP and CP content between cold-storagesolutions, nor any correlation between metabolic and functionalparameters.     

生物素-亲合素斑点免疫金渗滤试验检测血清中登革病毒4型抗原

目的建立用斑点免疫金渗滤试验（ＤＩＧＦＡ）检测血请中登革病毒抗原的方法。方法一株ＤＶ４型特异性单克隆抗体点加于硝酸纤维膜上,以捕获血清中的ＤＶ４抗原。借助黄病毒组反应性单克隆抗体、生物素化革抗鼠ＩｇＧ抗体、金标ＳＰＡ和金标亲合素,建立用ＤＩＧＦＡ检测血清中登革病毒抗原的方法。结果常规ＤＩＧＦＡ检测的敏感性高于病毒分离,而生物素一亲合素ＤＩＧＦＡ（ＢＡ－ＤＩＧＦＡ）的敏感性又高于常规的ＤＩＧＦＡ。常规ＤＩＧＦＡ可检测到５、０ＴＣＩＤ５０的病毒抗原,ＢＡ－ＤＩＧＦＡ可检测到４３ＴＣＩＤ５０的病毒抗原。结论作者建立的ＢＡ－ＤＩＧＦＡ简便、快速、敏感、特异,可用于快速诊断登革病毒４型感染。     

Influence of serum albumin on renal function in nephrotic syndrome

 Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), determined by the clearances of inulin and para-aminohippuric acid, were evaluated in 119 children with different types of nephrotic syndrome and in different stages: the nephrotic stage (serum albumin <25 g/l), recovery stage (25–35 g/l), and remission (>35 g/l). GFR in the nephrotic stage was significantly lower than in remission and in controls, and was lowest at onset of the disease (84±6, 111±4, and 119±2 ml/min per 1.73 m²). ERPF was higher in the nephrotic stage than in recovery, especially in children with histological lesions. Thus the filtration fraction (FF) was greatly decreased in the nephrotic stage. In patients investigated both in the nephrotic and the remission phase, GFR and FF increased significantly. There was a direct correlation between the serum albumin concentration and FF and an inverse correlation between mean arterial pressure (MAP) and GFR and FF in all patients, a direct correlation between the serum albumin concentration and GFR in minimal change nephrotic syndrome patients, and an inverse correlation between ERPF and serum albumin in children with histological lesions. In conclusion, GFR and FF were decreased and ERPF increased in the nephrotic stage, normalizing in remission. The low GFR in the nephrotic stage was thus not dependent on hypoperfusion. We suggest that the low GFR is dependent on a very low ultrafiltration coefficient. The direct correlation between GFR and serum albumin and the indirect correlation between GFR and MAP suggest compensatory mechanisms that increase the ultrafiltration pressure to counteract the severely reduced ultrafiltration coefficient. Received: 19 November 1997 / Revised: 11 April 1998 / Accepted: 14 April 1998     

Efficiency of Superfine Glass Fiber Membrane\= Filters for Depleting Leukocytes

ＩｎｔｒｏｄｕｃｔｉｏｎＩｎｔｈｅｄｏｎｏｒｂｌｏｏｄｃｏｌｅｃｔｅｄｂｙｂｌｏｏｄｃｅｎ－ｔｅｒｓ,ｌｅｕｋｏｃｙｔｅｓｈａｖｅｎｏｔｈｅｒａｐｅｕｔｉｃｆｕｎｃｔｉｏｎｔｏｐａｔｉｅｎｔｓｂｕｔｍａｙｉｎｄｕｃｅｍａｎｙｓｉｄｅｅｆｅｃｔｓ．Ｃｏ...     

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma

AIMS: To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma. METHODS: All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success. RESULTS: At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient. CONCLUSION: A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.