Relative weight of glucose, insulin and parathyroid hormone in the urinary loss of phosphate by chronically diabetic rats

This report deals with the relationships between glucose (G) and insulin on the tubular transport of phosphate (P) in chronically diabetic rats with high plasma levels of parathyroid hormone (PTH). Alloxan-induced diabetes leads to phosphorus depletion of the soft tissues. This phenomenon appears associated with weight loss and negative P balances caused by the increased urinary P excretion. Administration of 2 IU of insulin/100 g body weight (bw) to diabetic rats normalized their P balance and body weight. The effect of parathyroid function on the P metabolism of diabetic rats was investigated with balance experiments. Diabetic rats, intact or thyroparathyroidectomized (TPTX), have a greater urinary excretion of P than their controls. However, in control rats, the ratio intact:TPTX for urinary P is 1.0:0.76, showing the antiphosphaturic effect of parathyroid ablation. For diabetic animals, on the other hand, the ratio is 1.0:1.44. The simultaneous deficit of insulin and PTH thus quadruples the urinary P loss, instead of compensating for each other. The contribution of insulin deficit and hyperglycemia to the defect in tubular reabsorption (TRP) was investigated with clearance experiments (done on anesthetized, perfused rats). Five experimental groups were used: Controls (C), diabetics (D), controls+glucose (C+G), diabetics+insulin (D+I) and diabetics+insulin+glucose (D+I+G). All experimental groups showed a linear relationship between the TRP of P and G. The regression equation for C is significantly different (F=40.1, P<0.001) from that of D animals. The slope value measure the number of μmoles of P per μmol of G reabsorbed. For C and D rats, the ratio P:G approximates 1:4 and 1:20, respectively. The increase in P:G ratios represents the competition between both substrates for tubular resorption. Glycemias up to 11 mM (C and D+I) exist concurrent with the P:G ratio 1:4. Glycemias above 25 mM (D, C+G and D+I+G) produce a P:G ratio of 1:20. Fractional excretion of P (FEP) increased significantly in untreated, chronically diabetic rats (0.47± 0.12 vs controls=0.05±0.01, P<0.001). After a single intramuscular injection of insulin, the FEP decreased as a function of insulin levels. To normalize the FEP of diabetic rats in short-term experiments, insulin had to be administered in doses that produce plasma insulin levels 25 times greater than normal. The general information afforded by the present experiments shows that in untreated, chronically diabetic rats, insulin deficit plays an indirect role. The absence of PTH enhances the effect of hyperglycemia. The latter and the concurrent tubular overload of glucose are the cause of hyperphosphaturia in these animals. Received: 10 September 1996 / Accepted in revised form: 18 April 1997     

重庆地区小儿肺炎细菌耐药性及抗生素应用分析

目的分析重庆地区小儿肺炎常见病原菌构成及其耐药性,探讨临床抗生素的合理应用.方法吸取1 165例小儿肺炎下呼吸道分泌物,利用microscan全自动微生物分析仪进行细菌鉴定、培养及药敏试验,并统计临床初始抗生素应用情况.结果细菌总分离数为392株(33.7%),其中革兰阴性菌257株(65.6%),前5位依次为肺炎克雷伯菌、流感嗜血杆菌、副流感嗜血杆菌、铜绿假单胞菌及大肠埃希菌;革兰阳性细菌为135株(34.4%),依次为肺炎链球菌、金黄色葡萄球菌、表皮葡萄球菌.药物敏感实验显示:铜绿假单胞菌与葡萄球菌呈多重耐药,其它细菌对抗生素敏感性差异较大,较敏感的有头孢呋辛、头孢曲松等;而泰能、阿米卡星、万古霉素则高度敏感.1 165例小儿肺炎使用抗生素种类达21种,使用率100%.单用一种者占38.5%,联合二种者占61.5%;无一例首选万古霉素或泰能.初始抗生素治愈率为76.7%(894/1 165例),好转率为18.5%(216/1 165例).结论重庆地区小儿肺炎病原菌以革兰阴性菌占优势,不同细菌对抗生素敏感性差异较大;临床多选用二、三代头孢菌素.积极监测细菌耐药性,有助于提供选择抗生素的依据,对提高疗效和避免耐药菌株的快速增长有重要意义.     

基底节脑出血开颅手术与钻颅抽吸治疗的疗效比较（附136例报告）

目的比较基底节脑出血开颅手术治疗与钻颅抽吸治疗的有效性与安全性。方法回顾性分析我院近5年来基底节出血行外科开颅治疗和钻颅抽吸治疗的所有病例，应用统计学方法进行疗效比较。结果共136例基底节出血病例，其中30例行外科开颅清除血肿治疗，106例行钻颅抽吸治疗。两组病例在年龄、出血量、意识状态等预后影响因素方面差异无统计学意义（P〉0．05）。基底节出血开颅手术治疗有效性与安全性与钻颅抽吸治疗相比差异无统计学意义（P〉0．05）。结论基底节出血外科开颅治疗有效性与安全性并不优于钻颅抽吸治疗。     

大肠菌群MPN检测法在药品微生物限度检查中的应用

采用大肠菌群作为卫生指示菌,对口服药品进行细菌学检验,实验结果表明有利于口服药品染菌状况的监督与控制。     

试论门诊管理

结合门诊管理的实践,对如何加强门诊管理进行了论述。主要为:①掌握门诊特点,确定门诊管理重点;②做好工作计划,实施目标管理;③充分发挥门诊部办公室的作用,承上启下,及时协调;④健全门诊管理组织,完善门诊管理规定;⑤抓好服务质量,方便病人就医;⑥加强质量考核,确保门诊工作质量。     

丝裂霉素C与5—Fu用于抗青光眼滤过性手术的对比研究

采用随机、双讯，前瞻对照的方法比较了丝裂霉素Ｃ（ＭＭＣ）和５－氟尿嘧啶对难治性青光眼小梁切除手术的安全性和有效性。３９例病人随机分成二组，一组使用ＭＭＣ，另一组使用５－Ｆｕ。结果提示：（１）ＭＭＣ组手术成功率高于５－Ｆｕ组；（２）ＭＭＣ组角膜上皮缺损发生率，结膜创口渗漏率明显低于５－Ｆｕ组。     

社区人群空腹血糖受损对估算肾小球滤过率的影响研究

背景 估算肾小球滤过率(eGFR)是反映慢性肾脏病严重程度的量化指标之一。研究表明糖尿病前期血糖升高可增加慢性肾脏病风险,但对eGFR直接影响报道较少。目的 探讨社区人群中空腹血糖(FPG)受损患者血糖水平对eGFR的影响。方法 选择2020年1—12月于南昌大学第二附属医院体检中心体检的人群,收集一般资料与临床资料(包括既往史、性别、年龄、体质指数、血压、尿酸、血脂、FPG、尿常规、血肌酐),经相应纳入标准与排除标准筛选,最终纳入28 601例受试者。根据FPG水平将受试者分为FPG升高组(5.6 mmol/L≤FPG<7.0mmol/L)、FPG正常组(3.9 mmol/L≤FPG<5.6 mmol/L),比较两组一般资料与临床资料。为明确FPG对e GFR影响,采用个案匹配控制对两组受试者进行多因素(性别、年龄、平均动脉压、尿酸、总胆固醇、体质指数)匹配,采用Mann-Whitney U秩和检验比较匹配后两组一般资料。采用Spearman秩相关检验分析FPG与eGFR在FPG升高组、FPG正常组及匹配后FPG升高组、FPG正常组间的相关性。结果 共获得FPG正常组患者...     

Pulmonary and haemodynamic effects of extracorporeal circulation in the cat and the beneficial effects of prostacyclin

Side-effects of a veno-venous extracorporeal system and possible beneficial effects of prostacyclin (epoprostenol) are analyzed on the cat. Three groups were studied; one control group without extracorporeal circulation and two groups with an extracorporeal flow of 10–12 ml/kg/min, one of which was given prostacyclin (70–110 ng/kg/min). The extracorporeal circulation triggered a decrease in arterial saturation (from 99 to 91 %) and carbon dioxide elimination (increase in arterial to end-tidal PCO₂ by about 1 kpa) a metabolic acidosis (pH7.20), a platelet consumption (50%) and shortened survival time, side-effects reduced by prostacyclin. Further, there was a marked increase in haemoglobin concentration indicating hypovolemia via capillary fluid filtration. None of these side-effects were seen in the control group. Extracorporeal circulation as a trigger for pulmonary dysfunction and for impaired tissue nutrition with possible beneficial effects of prostacyclin is discussed, and also from a clinical point of view (i.e. extracorporeal lung assistance, ECLA), on the basis of the results.     

Testosterone in a Cyclodextrin-Containing Formulation: Behavioral and Physiological Effects of Episode-like Pulses in Rats

Testosterone, administered in the form of an inclusion complex with 2-hydroxypropyl--cyclodextrin by subcutaneous injection, enters the circulation in a manner markedly similar to the natural episodic release by the testes. The effects of a regimen of once-a-day administration of complexed testosterone to adult (castrated or intact) rats and to senescent (intact) rats were investigated. Although this procedure left the castrated animals with concentrations of circulatory hormone far below physiological levels for much of the day, a significant improvement in androgen-sensitive behavior and physiology was obtained. Furthermore, the testosterone effects were more pronounced when high doses were used periodically rather than when the same total amount of testosterone was equally divided among doses. The same supplementation to intact rats intensified androgen-sensitive behavior and physiology over normal levels. In senescent rats uniform pulses of the testosterone complex also improved behavior and physiology. Specifically, spermatogenesis was stimulated and, notably, the treatment increased muscle weight without substantial enlargement of the prostate. Since the testosterone–cyclodextrin complex also can be effectively administered as a sublingual tablet, the data suggest that similar regimens may be recommended for elderly men suffering from decreases in muscle mass.     

Renal hemodynamics and renal O2 uptake during hypoxia in the anesthetized rabbit

Summary The effects of hypoxic hypoxia on renal hemodynamics and metabolism have been studied in anaesthetized mechanically ventilated rabbits. Acute hypoxia (F₁O₂=0.10,PaO₂=35 torr) induces at constant mean arterial pressure a 45% decrease in RBF, GFR, and whereas free water clearance increases. These alterations were still apparent 50 min after resuming normal arterial oxygenation. In order to assess the role of the stimulation of catecholamine release in these observations, two other sets of experiments were performed: 1) the animals were ventilated with the same hypoxic gas mixture but after adrenergic blockade (phentolamine: 0.2 mg·kg·min^–1 i.v.), 2) hypoxia was induced by ventilating the animals with CO (F_ICO=0.002) at constantPaO₂. Increase in renal vascular resistance and reduction of renal O₂ uptake were still observed. This indicates that adrenergic stimulation cannot fully explain the renal vasoconstriction encountered in hypoxia. The role of a local vasoactive factor, especially that of the renin angiotensin system is discussed. The apparent O₂ cost of Na reabsorption was not greatly modified by any type of hypoxia and the Na:O₂ ratio remained close to the value observed in normoxic animals. This indicates that the kidney may adapt to hypoxia by reducing its O₂ demand keeping unaltered its tubular function and basal O₂ needs.