Carbohydrate-Deficient Transferrin During 3 Weeks' Heavy Alcohol Consumption

To study the effect of controlled heavy drinking of 60 g ethanol/day for 3 weeks on carbohydrate-deficient transferrin (CDT), a commercial double antibody kit (CDTect™) was used. By the end of the third drinking week, a statistically significant increase in the mean CDT level was observed. When compared to AST and γ-glutamyltransferase, CDT was a more informative marker. However, only in 2 of the 10 volunteers did CDT exceed the upper normal level (20 units/liter) recommended by the manufacturer. This indicates that the sensitivity of CDT to detect heavy drinking is lower than that previously reported. The higher accuracy has in general been obtained in studies comparing healthy controls with a low alcohol consumption to alcoholics with an alcohol consumption higher than that used in the present experiment. Our results suggest that it remains to be established whether CDT, although better than AST and γ-glutamyltransferase, will provide a clinically useful tool in identifying heavy drinkers in populations covering a wide range of alcohol consumption.     

非均匀性脂肪肝患者腹部超声表现和血脂变化特点*

目的 分析非均匀性脂肪肝患者肝脏超声和血生化指标变化特点。方法 2016年1月～2018年12月我院诊断的非酒精性非均匀性脂肪肝患者90例和同期在我院体检的健康者30例,均行超声检查和血生化指标检测。结果 在90例患者中,I型(局部浸润型) 23例(25.6%),II型(叶段浸润型)29例(32.2%),III型(弥漫性非均匀浸润型)38例(42.2%);II型组血清转铁蛋白(SF)为(254.2±98.7)μg/L,显著高于健康人【(175.1±98.4)μg/L,P<0.05】,III型组血清空腹血糖水平为(6.37±0.79)mmol/L,显著高于健康人【(4.85±0.53)mmol/L,P<0.05】,糖化血红蛋白水平为(6.94±0.81)%,显著高于健康人【(4.73±0.57)%,P<0.05】,尿酸水平为(418.3±40.5)μmol/L,显著高于健康人【(354.2±37.8)μmol/L,P<0.05】,SF为(287.3±105.1)μg/L,显著高于健康人【(175.1±98.4)μg/L,P<0.05】;II型血清谷草转氨酶(AST)水平为(51.5±13.4)IU/L,显著高于健康人【(24.2±9.3)IU/L,P<0.05】,谷胺酰转肽酶(GGT)水平为(59.3±31.2)IU/L,显著高于健康人【(29.8±10.1)IU/L,P<0.05】,III型组血清胆固醇水平为(4.7±0.8)mmol/L,显著高于健康人【(3.8±0.6)mmol/L,P<0.05】,甘油三酯水平为(3.2±1.5)mmol/L,显著高于健康人【(1.4±0.3)mmol/L,P<0.05】,AST为(60.2±18.7)IU/L,显著高于健康人【(24.2±9.3)IU/L,P<0.05】,谷丙转氨酶水平为(54.2±29.8)IU/L,显著高于健康人【(30.2±13.4)IU/L,P<0.05】,GGT为(59.3±31.2)IU/L,显著高于健康人【(29.8±10.1)IU/L,P<0.05】。结论 超声检查非均匀性脂肪肝诊断准确,能鉴别出轻度脂肪浸润或局限性的脂肪浸润肝组织,结合血生化指标检测,能为脂肪肝的临床诊断提供参考依据。     

eGFR and creatinine clearance in relation to metabolic changes in an unselected patient population

BackgroundIt is widely assumed that moderate to severe renal failure (creatinine clearance < 60 ml/min; or an MDRD-4 (Modification of Diet in Renal Disease equation) < 60 ml/min/1.73 m²) is associated with metabolic changes, often needing further assessment and treatment. We investigated whether such abnormalities are already present at earlier stages of kidney disease, as assessed by 24-hour urine sampling and MDRD-4 calculation.MethodsA select, retrospective cohort study was conducted. Creatinine clearance was measured by collecting 24-hour urines. The individual eGFRs were calculated with the MDRD-4 formula and patients were then divided by renal function category (< 15, 15–30, 30–45, 45–60, 60–90, > 90 ml/min(/1.73 m²)). Per clearance category the number of people with anaemia, hypokalaemia, uraemia and hyperphosphataemia was evaluated.ResultsThe median creatinine clearance rate was 67.3 ml/min (quartiles: 42.9–95.8) versus a median MDRD-4-eGFR of 51.6 ml/min/1.73 m² (35.8–67.7). Anaemia, hyperkalaemia, hypocalcaemia, and uraemia were found to be present at higher levels of creatinine clearance rate and eGFR than previously reported (p < 0.0005). This increased prevalence was more pronounced in elderly subjects, particularly with respect to anaemia (OR 2.71 and 2.02 for MDRD-4 and creatinine clearance respectively, p < 0.0005). The same holds for the proportion with uraemia (OR 1.85, p < 0.0005) and hypocalcaemia (OR 1.97, p = 0.011) for MDRD-4.ConclusionMetabolic changes in an in- and outpatient hospital population are present at earlier stages than was stated in recent guidelines, especially when creatinine clearance levels are used as indicators. This might have implications for testing and treatment of patients with suspected kidney disease and/or loss of renal function.     

连续血液净化治疗对感染性休克患者生化指标和氧合指数的影响

目的观察连续血液净化(CBP)对感染性休克患者生化指标和氧合指数的影响.方法30例感染性休克患者在抗感染、液体复苏、机械通气、去甲肾上腺素维持平均动脉压(MAP)>65mmHg等治疗基础上予以连续血液净化治疗.观察比较治疗后24h、48h时与治疗前血生化指标的变化,以及各时点血流动力学及氧合指数的变化情况.结果感染性休克患者经CBP治疗24h和48h后血气、生化指标血pH值、乳酸、HCO3-、BE等明显得到改善(P<0.01或P<0.05),而肾功能指标变化差异无统计学意义;感染性休克患者经CBP治疗2h、6h或12h后血流动力学及氧合指数均得到明显改善(P<0.01或P<0.05),而去甲肾上腺素剂量在治疗6h后明显减量(P<0.01或P<0.05).讨论 CBP对感染性休克患者有血流动力学稳定,清除物质多,有效纠正内环境、电解质及酸碱平衡紊乱等作用,对危急重症患者抢救和延长生存期起到积极作用.     

PINP在诊断骨质疏松症中的应用

目的 探讨用于诊断骨质疏松症的较敏感生化指标。方法 采用放免法测定46例骨质疏松性骨痛。34例非重力骨折及24例健康者血PINP水平和其它相关指标。结果 骨痛和骨折两组患者PINP水平均明显高于正常对照组(P<0.01);PINP与其它骨形成指标有较好相关性。结论 PINP由于在血循环中较稳定,可作为诊断骨质疏松症的较敏感指标。     

青蒿琥酯抗日本血吸虫童虫和成虫作用的研究

目的 观察青蒿琥酯对不同阶段日本血吸虫的损害作用,揭示青蒿琥酯的杀虫机制.方法小鼠感染尾蚴18 d时给予青蒿琥酯300 mg/kg,24 h后灌注法收集童虫,并用紫外吸收法和Bradford标准曲线法测定青蒿琥酯对日本血吸虫18 d童虫DNA和蛋白质含量的影响;分别将10条虫体在含有3H胸腺嘧啶核苷的培养基中培养24 h后,用滤膜法和匀浆法测定青蒿琥酯对标记核苷掺入童虫DNA的影响;感染血吸虫尾蚴21 d的小鼠一次性灌服青蒿琥酯300 mg/kg,给药后21 d,灌注法收集成虫,观察青蒿琥酯对日本血吸虫成虫生殖器官大小及生殖细胞发育的影响;小鼠感染血吸虫33 d时给予同样的青蒿琥酯进行治疗,24 h和48 h后处死小鼠,将肝脏制作组织切片,在光镜下观察同等剂量青蒿琥酯引起的成虫肝移和形态学变化的影响.结果 青蒿琥酯体内作用18 d的虫体,24 h后,童虫的DNA和蛋白质含量均较对照组明显减少,减少率分别为23.0%和33.6%(P＜0.01);在含有3H胸腺嘧啶核苷的培养基中培养24 h后,童虫摄入标记的核苷及核苷掺入童虫DNA的量较对照组也明显减少,减少率分别为61.1%和40.8%(P＜0.01);21 d给药组小鼠体内雌虫卵巢的成熟、发育受到了抑制;药物作用于虫体33 d后能明显引起虫体形态的变化,特别是虫体体表.结论 青蒿琥酯能减少日本血吸虫童虫蛋白质和DNA的含量,能明显抑制虫体对标记核苷的摄入以及标记核苷掺入虫体DNA的量,能引起虫体体表明显的组织形态学变化,并且能抑制雌虫卵巢的发育,降低或抑制雌虫的产卵,能有效减轻血吸虫病的病情和控制传播.     

郑州-乌鲁木齐客运乘务员秋季营养调查

[目的]了解客运乘务员的营养状况,分析其特殊的工作环境及作息规律所形成的膳食特点对该工种人员健康状况的影响。[方法]①膳食调查（称重法）;②体格检查;③生化检验;④列车员一日生活观察及能量消耗测定。[结果]76名乘务人员平均每人每日摄取蛋白质95.1g,优质蛋白比占38%,脂肪168.1g,糖381g,热量3417kcal（14.30MJ）;钙、磷、铁充足,钙︰磷=1︰2.86;维生素A摄取缺乏,维生素B2摄入轻度不足,其他维生素均为充裕。体格检查见个别人有舌肿大、舌裂隙、舌乳头肿大、牙龈肿胀、出血、萎缩等维生素缺乏体征,暗适应时间平均为34.4s。生化检查维生素B1排出量﹤200μg者占43.42%,维生素B2排出量﹤350μg者占30.26%,维生素C排出量均在3mg以上。[结论]应当减少动物脂肪摄入量,适当增加动物内脏、绿色蔬菜摄入;改进烹调方法,减少淘米时间;适当提高早餐热量供应,降低晚餐热量摄取比例。     

肠杆菌科细菌微量生化数码鉴定板研制及应用研究

目的：研制一种肠杆菌科细菌微量生化数码鉴定板,为微生物鉴定提供一种新的检测手段。方法：作者根据不同细菌的生化反应特性,利用微生物代谢产物,配制高纯度生化基质、采用无菌脱水干燥技术,使不同生化反应培养基吸附在相应结构坚实、透明度高、反应易见的聚苯乙烯载体内。选用15项细菌生化反应按一定顺序排列构成YKS-15 e肠杆菌科细菌微量生化数码鉴定板,同时编制了相应的细菌编码鉴定手册,并进行了真实性、可靠性评价。结果：经6株标准菌株验证：阳性、阴性生化反应明显,结果准确。所有反应均可12 h内完成。60株从各类临床标本分离鉴定临床菌株经肠杆菌科细菌微量生化数码鉴定板与VITEK32法检测,符合率达96.97%。可对24个属85种肠杆菌科细菌进行鉴定。结论：该鉴定板使用方便、具有简易化、标准化、快速化、生化反应明显、结果准确等特点。     

扶正解毒颗粒拮抗硫酸镍诱发大鼠睾丸某些生化指标的变化

目的探讨中药扶正解毒颗粒(FJK)对硫酸镍(NiSO4)致大鼠睾丸某些生化指标变化的拮抗作用。方法40只Wister雄性大鼠随机分为5组:生理氯化钠(NS)组;NiSO42.5mg/kg染毒组,NiSO4连续染毒30d;FJK10.0、5.0、2.5g/kg3个处理组,3组NiSO4染毒方法和剂量同染毒组,于第10天同时灌胃给予FJK处理。各组均于第31天处死大鼠,制备睾丸组织匀浆并提取线粒体。结果睾丸组织匀浆中NS组和NiSO4组谷胱甘肽过氧化物酶分别为(40.88±7.24)和(18.20±4.24)×103U/g,总抗氧化能力为(6.38±0.84)和(2.60±0.82)×103U/g,脂质过氧化物为(1.61±0.33)和(3.07±0.28)mol/g,活性氧为(5.36±2.37)和(9.71±1.62)×103U/g,2组间各项指标差异有非常显著性(P<0.01);经FJK拮抗处理后,3个FJK组上述各项指标的NiSO4毒作用均显示减轻(P<0.05或0.01)。各组大鼠睾丸细胞线粒体中总抗氧化能力、脂质过氧化物和活性氧水平的变化情况与睾丸组织匀浆相似。结论中药FJK对Ni-SO4所诱发的谷胱甘肽过氧化物酶活力、总抗氧化能力、脂质过氧化物和活性氧含量异常变化具有逆转作用。     

稀释后测定ALT、AST值的临床意义

目的：探讨用全自动分析仪测定ALT、AST结果与实际不符的原因和解决办法。方法：迈瑞300全自动分析仪速率法检测ALT、AST。结果：有一些ALT、AST测定值太低甚至为零，经过稀释后其结果与稀释前相差很大。结论：遇到过低的结果寻找原因，查看曲线避免报告结果与临床不符。