血清纤维蛋白原水平及白蛋白/球蛋白比值与直肠癌患者生存预后的关系

目的探讨血清纤维蛋白原水平及白蛋白/球蛋白比值对直肠癌患者生存预后的影响。方法选取我科2010年1月至2013年1月收治的直肠癌患者120例,检测术前患者的血清FIB、AGR水平,根据血清FIB、AGR水平,分为FIB正常组(48例)和FIB高水平组(72例)、AGR正常组(45例)和AGR低水平组(75例);分析术前血清FIB、AGR与直肠癌患者的临床病理学特征关系,判断血清FIB、AGR对直肠癌患者生存预后的影响。结果患者检测术前血清FIB高水平组值6.53±1.28 g/L高于FIB正常组3.12±0.61 g/L,差异具有统计学意义(P<0.05);血清AGR低水平组值1.23±0.08低于AGR正常组值2.12±0.19,差异具有统计学意义(P<0.05)。血清FIB、AGR水平与直肠癌患者的BMI、肿瘤直径、TNM分期和淋巴结转移有关(P<0.05)。单因素分析显示:肿瘤直径>2cm、TNMⅢ期、淋巴结转移、FIB升高和AGR降低是影响直肠癌患者的危险因素(P<0.05);多因素分析显示:淋巴结转移、FIB升高和AGR降低是影响直肠癌患者生存预后的独立危险因素(P<0.05)。结论血清FIB、AGR值正常患者生存预后优于血清FIB升高、AGR降低患者;血清FIB水平升高、AGR水平降低可作为影响直肠癌患者生存率的的独立危险因素。     

Fluid distribution kinetics during cardiopulmonary bypass

OBJECTIVE:

The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass.

METHODS:

Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer''s acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT01115166","term_id":"NCT01115166"}}NCT01115166.

RESULTS:

The distribution half-time of Ringer''s acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p<0.02). The mass balance of sodium indicated a translocation from the intracellular to the extracellular fluid space in 8 of the 10 patients, with a median volume of 236 ml.

CONCLUSIONS:

The distribution half-time of Ringer''s solution during isovolumetric cardiopulmonary bypass was 8 minutes, which is the same as for crystalloid fluid infusions in healthy subjects. The intravascular albumin mass increased. Most patients were hypovolemic prior to the start of anesthesia. Intracellular edema did not occur.     

肝纤康防治肝纤维化的实验研究

目的：观察肝纤康对小鼠实验性肝纤维化的防治作用及其机制。方法：采用四氯化碳（CCl4）复制小鼠肝纤维化模型,同时予以肝纤康灌胃治疗,观察小鼠血清丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、白蛋白（Alb）、肝组织羟脯氨酸（Hyp）含量及肝组织病理改变。结果：模型组小鼠ALT、AST、Hyp显升高,Alb显降低,肝纤维化病变明显;给药组ALT、AST、Hyp明显降低,Alb明显升高,与模型且比较差异有显性（P＜0．01或P＜0．05）;并能明显减轻小鼠肝细胞损害和胶原纤维增生的程度。结论：肝纤康有较好的保护肝功能和防治肝纤维化作用。     

黄芪对免疫损伤性肝纤维化大鼠的治疗作用

目的:研究中药黄芪的抗肝纤维化作用,对比观察中药861合剂及其组分之一黄芪对肝纤维化的治疗作用。方法:采用大鼠白蛋白免疫损伤性肝纤维化动物模型,通过光镜、电镜观察、胶原免疫组化染色及胶原蛋白生化测定。结果,黄芪可使大鼠肝纤维化程度及超微结构的病理改变明显减轻,减少总胶原及Ⅰ、Ⅱ、Ⅴ型胶原在肝内的沉积,随着疗程的延长,作用更为显著。同时以肝总胶原蛋白含量为指标,黄芪的抗肝纤维化作用不如中药861合剂。结论:黄芪与其它成份组成中药复方可加强抗纤维化作用。     

HIV/HCV重叠感染患者病情进展的相关因素研究

探讨HIV/HCV重叠感染患者病情进展的原因和影响预后的相关因素.选择HIV/HCV重叠感染患者这一特定人群,按照疾病进展分成艾滋病组(AIDS)和HIV感染组(free of AIDS),回顾性分析两组间免疫功能、HIV病毒载量、肝脏功能的差异,探讨可能影响病情进展的相关因素.艾滋病组与HIV感染组比较:艾滋病组患者的细胞免疫功能(CD 4T、CD 8T)均低于HIV感染组,差异非常显著(P＜0.001;P=0.003);HIV病毒载量在艾滋病组明显高于HIV感染组,差异显著(P=0.005);艾滋病组的肝脏功能(ALT、AST)明显高于HIV感染组(P值分别为0.043、0.002);蛋白合成指标(TP、ALB)艾滋病组较HIV感染组低下,差异非常显著(P＜0.001).以Logistic回归分析,CD 4T、感染时间和ALB是预测疾病进展的独立危险因素(P＜0.001).回归方程预测准确率为97.0%.HIV/HCV重叠感染可加快病情进展,ALB与CD 4T细胞数及感染时间是预测艾滋病病程进展的独立危险因素.     

Relation between HbA1c and incident cardiovascular disease over a period of 6 years in the Hong Kong population

Aim

The current trend on diabetes management advocates replacing the paradigm from a uniform to an individualized patient-centered haemoglobin A_1c (HbA_1c) target, but there is no consensus on the optimal HbA_1c level. The study aimed at examining the association between HbA_1c and the risk of cardiovascular diseases (CVD) for diabetic patients with different characteristics, in order to identify patient-centered treatment targets.

Analysis of Plasma Albumin,Vitamin D,and Apolipoproteins A and B as Predictive Coronary Risk Biomarkers in the REGICOR Study

Introduction and objectives

New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function.

Risk factors of delay in restoration of hepatic reserve capacity and local recurrence after radiofrequency ablation therapy for hepatocellular carcinoma (HCC).

BACKGROUND:: Effects of radiofrequency ablation (RFA) on hepatic reserve capacity have not been evaluated thoroughly thus far. The aim of our study is to evaluate the factors that influence to hepatic reserve capacity and local recurrence after RFA. PATIENTS AND METHODS:: We studied a total of 243 patients (310 nodules). The study parameters included rates of local recurrence after undergoing RFA as well as factors for delaying recovery of post-RFA albumin levels (age, gender, the presence and absence of anti-HCV antibody, platelet count, GPT level, prothrombin time (PT), Child-Pugh grade, pre-RFA albumin level, alpha-fetoprotein (AFP) level, the number of nodules, tumor size in diameter, hepatic blood control and the coagulation volume after undergoing RFA. RESULTS:: Rates of local recurrence were 6.5%, 10.4% and 12.0% at 1, 2 and 3 years after undergoing RFA, respectively. In the hepatic reserve capacity studies, it took 1.9 and 5.8 months for 50% and 80% of cases, respectively, to restore serum albumin levels to pre-treatment levels after undergoing RFA. There were significant differences in the time of delay in restoration of serum albumin levels with regard to two factors: patients' age >/=60 years (p=0.0351) and tumor size over 3.5cm in diameter (p<0.001). CONCLUSION:: We cosidered that RFA is a safe and efficacious modality, but thorough attention was necessary for such patients with tumor size over 3.5cm in diameter before undergoing RFA, especially in elderly patients.     

酸碱滴定法定量测定白蛋白制品中辛酸钠含量

本文报道的用酸碱滴定法定量测定白蛋白制品中辛酸钠含量,是通过使用混合溶解液使水醚两相混溶后直接滴定。运用三因素调优法原理,选择出混合溶解液中各组份的最佳浓度及其用量和最佳萃取条件。方法的回收率为99.8％±0.89％(n=16),变异系数CV为0.89％(n=16),说明该法准确可靠。