中枢神经系统白血病血清神经元特异性烯醇酶测定的临床意义

目的 探讨血清神经元特异性烯醇酶与中枢神经系统白血病之间的关系。方法 对确诊的30例急性白血病患者及匹配的正常人的血清神经元特异性烯醇酶进行测定。结果 中枢神经系统白血病组血清神经元特异性烯醇酶含量21．92 7．5μg/L均明显高于白血病组、对照组，差异有显著性。结论 血清神经元特异性烯醇酶可作为反映中枢神经系统白血病病情的生化指标。     

不同婴儿食品铝含量的测定

本文应用原子吸收光谱法测定母乳、牛奶、奶粉及不同喂养方式婴儿血清中锌、铜、铁及铝含量。母乳中锌、铜、铁含量均较牛奶丰富，铝含量低于牛奶；奶粉中锌、铜、铁含量高于牛奶，与母乳无显著差异，铝含量高于牛奶。母乳、牛奶及奶粉喂养的贫血患儿血清铝含量无显著差异，均明显低于铝中毒的血清铝水平。     

烧伤患者急性期反应物的变化及其临床意义

用环状免疫单扩散法观察了２７例烧伤患者伤后４６天以内血清急性期反应物前白蛋白、铜蓝蛋白、α＿１酸性糖蛋白、α＿１抗胰蛋白酶、转铁蛋白、Ｃ反应蛋白、纤维连接蛋白、补体成分Ｃ＿４、Ｃ＿（３ｃ）、触珠蛋白的变化趋势、试图探讨它们与病情发生、发展规律之间的关系。结果：Ｃ反应蛋白、α＿１酸性糖蛋白和α＿１抗胰蛋白酶在所有患者都升高，提示烧伤后组织损伤逐渐加重及伴发炎症、感染的存在；白蛋白、铜蓝蛋白、转铁蛋白和纤维连接蛋白在伤后均明显降低，提示伤后的分解代谢增加、贫血及网状内皮系统功能降低与之有关；触珠蛋白伤后明显降低且死亡组更明显，提示其作为具有过氧化物酶活性的保护作用降低是促进死亡的原因之一；伤后补体Ｃ＿４、Ｃ＿（３ｃ）在存活组升高而死亡组明显降低，因而可能被用于对患者病情和预后的判断。总之，观测急性期反应蛋白的变化规律，有助于及时发现患者病情的变化，以便临床及时采取相应措施。     

Reduction of Mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by Combined Treatment with Clofibrate and Nicotinic Acid

Consecutive survivors of a myocardial infarction from the Southern Hospital, below 70 years of age, were randomized into a Control group (n=276) and a Treatment group (n=279). The latter was openly prescribed the combination of clofibrate and nicotinic acid for serum lipid lowering. Each patient should remain in the study for 5 years and be seen regularly every 4 months at a special IHD outpatient clinic within the hospital. The concentration of serum cholesterol and triglyceride was lowered by 13% and 19%, respectively, in the Treatment group compared to the Control group. Total mortality was 82 cases in the Control group and 61 in the Treatment group, a 26% reduction (p<0.05). For patients above 60 years of age in the Treatment group the reduction in mortality was 28% (p<0.05). IHD mortality was reduced by 36% (p<0.01)in the Treatment group compared to the Control group. The beneficial effect of the serum lipid lowering treatment was related to the serum triglyceride concentration in two ways. First, it only occurred in patients with a triglyceride level >1.5 mmol/l (n=216). Secondly, it was most pronounced in the 44% of the treated patients who had a lowering of the serum triglyceride concentration by 30% or more, and in this subgroup the reduction of IHD mortality was 60% (p<0.01). For serum cholesterol there were no such relations. The difference between serum triglycerides and cholesterol concerning these relations to the treatment outcome may be due to the fact that hypertriglyceridaemia was the most common hyperlipidaemia among our patients, occurring in 50%, while hypercholesterolaemia only occurred in 13 %. Caution should be exercised in the interpretation of the results as the trial was not blind. However, the fact that the decrease in IHD deaths was directly related to the degree of serum triglyceride lowering indicates that it was the drug effect on serum lipids that was reponsible for the beneficial effect of the treatment.     

血清脂质结合唾液酸测定对肺部病变的诊断价值

本文介绍正常人113名,肺部恶性病变49例及肺部良性病变33例的血清LSA测定结果,正常人血清LSA含量平均值为0.1243±0.0358g/L。特异性97.40％,男女间无差异,48例肺癌血清LSA平均值0.2698±0.0915g/L,敏感性85.40％;33例良性病变LSA平均值0.1712±0.0767g/L,特异性78.79％。肺癌患者血清LSA较良性病变明显升高,故测定血清LSA对鉴别良恶性病变有一定价值。     

Prospective randomized study of D-Trp6-LHRH versus buserelin in long desensitization protocols for medically assisted conception cycles

In a prospective, controlled, randomized study where two differentagonists were used, we compared three different long desensitizationprotocols for induction of multiple follicular growth in medicallyassisted conception cycles. In protocol A, 30 patients wereinjected with buserelin twice a day for 15 days prior to ovarianstimulation until human chorionic gonadotrophin (HCG) administration.In protocol B, 30 patients were injected with a single doseof long acting Triptorelin (3.75mg) 15 days before the ovarianstimulation onset. In protocol C, 30 patients were injectedwith the long acting Triptorelin 4 weeks before ovarian stimulationfollowed by daily administration of 0.1 mg of the same agonistuntil HCG injection. There was no difference in the ovarianresponse to exogenous gonadotrophin stimulation, except forthe presence of premature luteinization in two patients in groupB. A significantly higher number of mature oocytes was collectedfrom patients with protocol A; however, the fertilization andcleavage rate demonstrated no significant difference among thethree groups of patients. The ongoing pregnancy rate and theimplanation rate per treatment cycle were very similar in thethree study groups. When the convenience, cost and side-effectsfor the patient are being considered, protocol B should be selectedas the first choice when the agonist is utilized for the purposeof inducing pituitary desensitization before and during ovarianstimulation.     

Measurement of free and total hydroxyproline by automated flow injection of serum or urine samples from maintenance hemodialysis patients with renal osteodystrophy

An automated measurement of total and free hydroxyproline in serum or urine is presented that uses flow injection analysis. After exclusion of nonspecific substances, hydroxyproline was oxidized by chloramine- T and L-cysteine with Ehrlich's reagent. The linearity obtained was from 3.8μmole/ L to 1.22 mmole/L with good precision (CV <3%). Comparison of the proposed method with HPLC yielded r = 0.939 as the correlation coefficient. Reference intervals of free and total hydroxyproline are 1.4–9.7 μmole/L, 3.8–27.2 μmole/L for serum, and 10.0–72.5 μmole/L, 25.2–303.6 μmole/L for urine, respectively. Serum free and total hydroxyproline levels in renal osteodystrophy patients on maintenance hemodialysis (N = 71) were significantly higher than in controls (P<0.0001). This method is superior to the use of HPLC with regard to stability of the color reaction. The measurement of serum free and total hydroxyproline is a useful marker for therapeutic observation of renal osteodystrophy patients. © 1994 Wiley-Liss, Inc.     

How can we predict ureteral obstruction after gynecological surgery? The changes in Doppler resistive index and plasma creatinine and magnesium concentrations after surgical, unilateral ureteral obstruction in a rabbit model

The aim of this study is to evaluate the changes in Doppler resistive index (RI) and plasma creatinine and magnesium concentrations after unilateral ureteral obstruction in a rabbit model. Fourteen adult female rabbits were used in this study. In seven rabbits, the left ureter was ligated with silk suture, and the control group was sham operated. Before surgery and on the second and seventh days after surgery, blood samples were obtained to measure plasma creatinine and magnesium concentrations. Doppler RIs of both kidneys were also measured before surgery and on the second and seventh days after the surgical procedure. With regard to magnesium levels, there was a significant within-subjects sessions difference [F(2, 20) = 15.21, P= 0.001] indicating a decrease through sessions. Magnesium concentrations decreased significantly at the postoperative second and seventh days compared to preoperative baseline levels (P= 0.003 and P= 0.001, respectively). Multifactorial analysis of variance was applied for each session separately with laterality, and groups as factors. The Doppler RI and the creatinine level did not show any significant differences or interactions for all sessions (P > 0.05). The decreasing plasma magnesium concentration after surgery may indicate ureteral injury; however, Doppler studies and creatinine levels may not be useful as well.     

Day-to-day variations in serum iron,serum iron binding capacity,serum ferritin and erythrocyte protoporphyrin concentrations in anaemic subjects

Day-to-day variations in serum iron, serum iron binding capacity, serum ferritin and erythrocyte protoporphyrin were determined on 2 successive days in 48 patients with anaemia. The correlation coefficients between the paired determinations were 0.86, 0.89, 0.95 and 0.95, and the day-to-day coefficients of variation (in per cent) were 33, 11, 12 and 13 for serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin, respectively. Thus, in patients with anaemia, day-to-day variations in serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin are at least as high as in healthy controls. The results indicate important limitations in the use, particularly, of serum iron in the clinical investigation of anaemia.