建瓴汤联合卡托普利对大鼠高血压及肾脏的影响

目的研究建瓴汤联合卡托普利对高血压大鼠的降压效应及肾脏保护作用。方法将60只SPF级雄性SD大鼠随机分出10只作为正常组予常规饮食;余50只大鼠予高盐饮食10周,建立高血压模型,造模成功后,将大鼠分为中药组(建瓴汤)、西药组(卡托普利)、西联组(卡托普利和氢氯噻嗪)、中西组(卡托普利和建瓴汤)、模型组(生理盐水),用药3月。分别在用药前、用药1月及3月时测量大鼠尾动脉血压,用药3月后检测各组大鼠尿微量白蛋白(m ALB)及尿N-乙酰-β-D-葡萄糖苷酶(NAG酶)浓度,光镜下观察肾脏病理形态学变化。结果 (1)血压:用药1月后,除中药组外各用药组血压与正常组比较无差异,与模型组比较均下降(P<0.01);用药3月后,与正常组比较,各用药组均无差异。(2)尿m ALB和尿NAG酶:与正常组比较,各组大鼠两指标均升高(P<0.01);与模型组比较,西药组两指标升高(P<0.01);与西药组比较,中药组、中西组均降低(P<0.01)。(3)肾病理形态学变化:中药组、中西组较西药组、西联组肾脏病变程度轻。结论建瓴汤单用有显著降压效应,与卡托普利联用时无协同降压作用,但能拮抗后者对高血压大鼠的肾脏损害作用。     

A novel laboratory procedure to validate American Urological Association guideline on vasectomy success and to diagnose obstructive azoospermia

The objective was to develop a laboratory procedure to validate American Urological Association (AUA) Guideline on vasectomy success when nonmotile spermatozoa are found in the post-vasectomy ejaculate. The neutral α-glucosidase (NAG) an epididymal protein assay modified to determine the activity at 30 and 90 min of incubation from 24 pre- and 47 post-vasectomy ejaculates. The difference between the two points in the relative activity was calculated and if the difference was nonsignificant will confirm vasectomy success. The mean differences in the relative NAG activity were significantly different in pre- and post-vasectomy ejaculates, respectively. The mean differences in the relative NAG activity were similar in post-vasectomy ejaculates with and without nonmotile spermatozoa. No difference in relative NAG activity in post-vasectomy ejaculates between two time points of incubation may be a reliable method to confirm occlusion of the vas deferens. It also validates the recommendation by AUA Guideline on vasectomy success in the presence of few nonmotile spermatozoa.     

Evaluation of the usefulness of novel biomarkers for drug-induced acute kidney injury in beagle dogs

As kidney is a major target organ affected by drug toxicity, early detection of renal injury is critical in preclinical drug development. In past decades, a series of novel biomarkers of drug-induced nephrotoxicity were discovered and verified in rats. However, limited data regarding the performance of novel biomarkers in non-rodent species are publicly available. To increase the applicability of these biomarkers, we evaluated the performance of 4 urinary biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), clusterin, total protein, and N-acetyl-β-D-glucosaminidase (NAG), relative to histopathology and traditional clinical chemistry in beagle dogs with acute kidney injury (AKI) induced by gentamicin. The results showed that urinary NGAL and clusterin levels were significantly elevated in dogs on days 1 and 3 after administration of gentamicin, respectively. Gene expression analysis further provided mechanistic evidence to support that NGAL and clusterin are potential biomarkers for the early assessment of drug-induced renal damage. Furthermore, the high area (both AUCs = 1.000) under receiver operator characteristics (ROC) curve also indicated that NGAL and clusterin were the most sensitive biomarkers for detection of gentamicin-induced renal proximal tubular toxicity. Our results also suggested that NAG may be used in routine toxicity testing due to its sensitivity and robustness for detection of tissue injury. The present data will provide insights into the preclinical use of these biomarkers for detection of drug-induced AKI in non-rodent species.     

NGAL、NAG和炎症指标对脓毒症患者急性肾损伤早期诊断的价值

目的探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、N-乙酰-β-D氨基糖苷酶(NAG)和血降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、WBC对脓毒症患者急性肾损伤(AKI)早期诊断的价值。方法回顾性分析60例脓毒症患者的临床资料,按照患者入ICU 7 d内是否出现AKI分为AKI组和非AKI组,各30例。分析比较两组患者血NGAL、尿NGAL、尿NAG和各项炎症指标的不同。运用ROC曲线评价各指标对AKI早期诊断的敏感性和特异性。结果两组比较,尿NGAL(log10)、血PCT、血hs-CRP的差异有统计学意义(P均<0.001)。两组血NGAL(log10)、尿NAG差异无统计学意义(P均>0.05)。ROC曲线:尿NGAL的AUC为0.882(P<0.001),血PCT的AUC为0.756(P<0.001),血hs-CRP的AUC为0.739(P=0.001);当尿NGAL≥155.5 ng/mL时,诊断早期AKI的敏感性为0.833,特异性为0.900;当血PCT≥1.08 ng/mL时,诊断的敏感性为0.600,特异性为0.833;当血hs-CRP≥93.5 mg/L时,诊断的敏感性为0.567,特异性为0.867。结论脓毒症患者尿NGAL、血PCT和hs-CRP升高,对AKI的早期诊断有一定的临床价值。     

耳穴贴压联合中医饮食调护对糖尿病肾病患者的影响

目的:观察耳穴贴压联合中医饮食调护对糖尿病肾病患者的影响。方法:将糖尿病肾病患者60例按随机数字表法分成2组,对照组30例患者采用耳穴贴压治疗,观察组30例患者采用耳穴贴压联合中医饮食调护治疗。对比2组患者治疗前后肾功能指标、血清糖化血红蛋白、尿微量白蛋白、24h尿蛋白定量变化和肾小管损伤情况。结果:2组治疗后,血尿素氮(BUN)、内生肌酐清除率(CCr)、24 h尿白蛋白排泄率(UAE)和血肌酐(SCr)水平均明显优于治疗前,差异有统计学意义(P<0.05);治疗后,观察组肾功能指标BUN、CCr、UAE低于对照组,SCr则有所提高,差异有统计学意义(P<0.05)。2组患者治疗后,尿蛋白定量、尿微量白蛋白和血清糖化血红蛋白水平均明显优于治疗前,差异有统计学意义(P<0.05);观察组治疗后尿蛋白、尿微量白蛋白、血清糖化血红蛋白指标低于对照组,差异有统计学意义(P<0.05)。2组患者治疗后,β2-微球蛋白(β2-MG)和N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平均明显优于治疗前,差异有统计学意义(P<0.05);观察组治疗后肾小管损伤指标β2-MG、NAG低于对照组,差异有统计学意义(P<0.05)。结论:耳穴贴压联合中医饮食调护在糖尿病肾病患者中疗效明确,可改善肾功能指标,减轻肾小管损伤,改善临床症状。     

pH、过氧化氢、白细胞酯酶、乙酰氨基葡萄糖苷酶联合筛查、诊断阴道炎评价

目的：评价pH、过氧化氢、白细胞酯酶、乙酰氨基葡萄糖苷酶联合筛查、辅助诊断阴道炎的方法可行性。方法选择阴道分泌物检查患者236例,分别进行p H、过氧化氢、白细胞酯酶、乙酰氨基葡萄糖苷酶四项联合检查,未染色显微镜检查,及相关确诊实验,通过诊断标准对患者确诊。对四联检测,应用独立项目判读结果的判读方案一,及应用两项联合判读结果的判读方案二,获得两种检测结果。用χ2检验分别统计四项联合检测两种结果与显微镜结果及诊断结果的一致性,并对四项联合检测实验进行诊断效能评价。结果四项联合检测两种结果均与显微镜结果及诊断结果一致程度较好,P值均为0．000（＜0．05）,但判读方案二有更高的kappa值,分别是0．914及0．862;四项联合检测判读方式一达到的诊断的灵敏度为94．2％、特异度为87．7％、Youden指数为81．9％;判读方式二达到的诊断灵敏度为90．5％、特异度为96．9％、Youden指数为87．4％。结论：pH、过氧化氢、白细胞酯酶、乙酰氨基葡萄糖苷酶四项联合检查,在不同结果判读方式下,对诊断阴道炎的特异度、灵敏度有影响。灵敏度高的判读方案一,较适用于筛查用途;而Youden指数更高的判读方案二,比较适合辅助诊断;可在此基础上进一步优化专项检测卡,用于基础医疗卫生的筛查与诊断。     

糖尿病性肾病患者尿N-乙酰-β-D-氨基葡萄糖苷酶活性及其同功酶改变

本文测定了64例糖尿病患者24小时尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)活性及其同功酶NAG-B含量。结果表明:在糖尿病早期即有尿NAG活性增高。在糖尿病伴肾损害者,尿NAG、NAG-B活性均明显上升。同时还讨论了血清NAG活性与微血管病变的关系。     

鼻咽癌相关基因NAG7对鼻咽癌细胞周期及凋亡的影响

背景与目的NAG7基因是我室克隆的鼻咽癌相关的肿瘤抑制候选基因,其功能与作用机制目前尚不清楚.研究鼻咽癌相关的潜在抑瘤基因NAG7对鼻咽癌细胞系(HNE1)细胞周期和细胞凋亡的影响,并探讨其作用机制.方法采用脂质体转染技术将NAG7基因导入HNE1细胞,建立稳定表达NAG7的细胞株,Northernblot分析转染细胞NAG7基因的表达,并采用流式细胞技术检测细胞周期、细胞周期素及细胞凋亡的改变,并用westernblot验证.结果NAG7基因重表达的HNE1细胞与空载体转染的HNE1和HNE1细胞相比G0/G1期细胞数增加(P<0.05),S期细胞数减少;细胞凋亡数目增加(P<0.05);细胞周期素A、D1、E表达明显降低(P<0.05),细胞周期素B1表达降低,Westernblot检测亦证实cyclinD1和cyclinE表达明显下调.结论NAG7的重表达导致细胞周期素表达下调,从而延缓细胞经G1期进入S周期及诱导细胞凋亡增加进而抑制NPC细胞的过度增殖.     

糖尿病肾损伤早期诊断的尿液联合检测

目的 通过对糖尿病（DM）患者尿液中微量白蛋白（mAlb）、β2微球蛋白（β2-MG）、N-乙酰-β-D氨基葡萄糖苷酶（NAG）、转铁蛋白（TRF）等进行检测，探讨其联合检测对糖尿病肾损伤早期诊断的临床意义。方法利用免疫比浊法、酶法检测50例健康体检者及204例DM患者尿液中mAlb排泄率、β2-MG、NAG、TRF含量，尿蛋白定性及血BUN、CR测定，并分组比较。结果血BUN、CR及尿蛋白阴性糖尿病患者尿液中mAlb、β2-MG、NAG、TRF均明显高于对照组（P〈0．01），后四项联合检测较单项检测阳性率高。结论尿液联合测定有助于了解DM患者的肾损伤情况，其对糖尿病肾病（DN）的预防和早期诊断有重要意义。     

Quantification of L-type fatty acid binding protein in the urine of preterm neonates

We measured urinary excretion of L-type fatty acid binding protein (L-FABP) in preterm neonates on days 1, 5-10, and 25-30 of life. Urinary L-FABP levels (expressed as the ratio to creatinine) in preterm neonates were considerably higher than those of healthy adults. They did not change significantly during the study period. Urinary L-FABP levels showed significant positive correlation with those of urinary N-acetyl-beta-D-glucosaminidase activity on day 1, and with those of 8-hydroxy-2'-deoxyguanosine on days 25-30. These results suggest that L-FABP is expressed in the neonatal kidney. Our results may also point to potential effects of proximal tubular damage and oxidative stress on urinary excretion of L-FABP.