Increased risk of renal dysfunction with percutaneous mechanical thrombectomy compared with catheter-directed thrombolysis

Objective

Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus.

Effect of declining renal function on bone density in aging women

Summary The factors that are responsible for trabecular bone loss in aging women are not completely understood. To evaluate declining renal function as a possible factor, we studied 19 Caucasian women (average age 67) who were from 6 to 41 years postmenopausal. Trabecular bone density was quantitated by computerized tomography of the spine. Serum calcium, phosphorus, and creatinine were normal in all subjects. Creatinine clearance averaged 74 ml/min (range 38–122), decreased with age (r=−0.60,P=0.003), and was inversely related to serum creatinine (r=−0.51,P=0.01). Bivariate regression demonstrated that bone density decreased with age (r=−0.59,P=0.004); controlling for the effect of creatinine clearance weakened this correlation to r=−0.45 (P=0.03); controlling additionally for 1,25-dihydroxyvitamin D [1,25(OH)₂D] and parathyroid hormone (PTH) reduced the correlation coefficient to r=−0.34 (P=0.11). Bone density also decreased in direct proportion to the decrement in creatinine clearance (r=0.44,P=0.03); controlling for the effects of 1,25(OH)₂D and PTH reduced this correlation coefficient to r=0.34 (P=0.11). These results suggest that occult renal insufficiency may contribute to bone loss in aging women, and that this effect may be mediated in part by 1,25(OH)₂D and PTH. In this age group renal function should be assessed by measuring creatinine clearance rather than the serum creatinine concentration since renal insufficiency can be masked by apparently normal circulating creatinine levels.     

1,25(OH)2D3对应用糖皮质激素治疗的肾病患者骨代谢的影响

目的观察1,25(OH)2D3对应用糖皮质激素治疗的原发性肾脏病患者骨代谢的影响。方法将16例原发性肾脏病患者随机分为治疗组和对照组。治疗组在应用糖皮质激素治疗的同时给予0.25μg的1,25(OH)2D3,每日1次口服,碳酸钙0.75,每日3次口服。对照组单纯给予碳酸钙0.75,每日3次口服。所有患者在治疗前及治疗12周时应用双能X线吸收法骨密度仪测定腰椎和股骨颈的骨密度,同时测定有关骨代谢指标,包括血全段甲状旁腺素,骨钙素,尿脱氧吡啶啉,血钙、磷以及血清白蛋白,24小时尿蛋白定量、尿钙和尿磷。结果治疗12周时两组患者的腰椎和股骨颈骨密度均下降,两组间比较无显著性差异(P>0.05);治疗12周时对照组患者的骨钙素较治疗前明显下降(P<0.05),而治疗组无明显差异;尿脱氧吡啶啉在两组中均下降,但治疗组下降明显(P<0.05);两组患者血全段甲状旁腺素、24小时尿钙和尿磷治疗前后及组间比较均无显著性差异(P>0.05);应用1,25(OH)2D3治疗者无1例出现高钙血症。结论应用糖皮质激素治疗12周的原发性肾脏病患者其腰椎及股骨颈骨密度下降明显。1,25(OH)2D3可促进骨形成,抑制骨的吸收。     

Determination of vitamin D3 and 25-hydroxyvitamin D3 in foodstuffs by HPLC UV-DAD and LC–MS/MS

In order to generate new data for vitamin D content for the Canadian Nutrient File, a method for the quantification of vitamin D₃ and 25(OH)D₃ in foodstuffs has been modified and improved. Vitamin D₃ was quantified using reverse phase liquid chromatography (LC) with UV-diode array detector (UV-DAD), while 25(OH)D₃ was measured by triple quadrupole mass spectrometry (APCI MS/MS). Quantification was by internal standards (IS) using vitamin D₂ and 25(OH)D₂. A Certified Reference Material (CRM-421 containing vitamin D₃) and a control sample (internally generated reference material of ground pork containing both vitamin D₃ and 25(OH)D₃) were used as validation and quality control tools. Limit of detection for both compounds was 0.04 μg/100 g. Accuracy for vitamin D in the CRM-421 was 99% (0.142 mg/kg for a target of 0.143, n = 10). Recovery of vitamin D₃ in ground pork was 97% (88% absolute recovery). For 25(OH)D₃, a recovery of 94% (73% absolute recovery) was obtained. Using this method, data for vitamin D₃ and 25(OH)D₃ content in a variety of foods (pork, beef, eggs, poultry, fish, and dinners) have been generated.     

加味瓜蒌桂枝汤治疗颈椎病实验观察

目的探讨《伤寒论》中加味瓜蒌桂枝汤与颈椎病的关系。方法对122例5种证型颈椎病患者治疗前后血浆降钙素(CT)和骨化三醇(1,25(OH)2D3)测定和对63例5种证型颈椎病患者治疗前后血浆CT、1,25(OH)2D3的测定。结果颈椎病患者血浆CT浓度呈异常升高(162.399±66.017)ng/L,而1,25(OH)2D3在正常范围内波动(34.162±17.339)ρg/ml,风寒湿型以CT最高值,1,25(OH)2D3最低值为特点(171.693±58.154)ng/L,(29.789±15.899)ρg/ml,痰湿阻络型以CT最低值,1,25(OH)2D3最高值为特点(147.988±71.64)ng/L,(38.294±22.203)ρg/ml,其它证型的血浆CT,1,25(OH)2D3水平呈平行状态。经加味瓜蒌桂枝汤治疗后,痰湿阻络型治疗前后血浆CT,1,25(OH)2D3无差异(0.1>P>0.05,P>0.5),肝肾不足型与气滞血淤型血浆治疗前1,25(OH)2D3无差异(0.2>P>0.1,0.5>P>0.2)。结论说明颈椎病是以血浆CT异常升高为特点的钙代谢紊乱,加味瓜蒌桂枝汤对颈椎病的钙代谢紊乱有较好的调节作用。《伤寒论》太阳证中“项背强几几”很可能与血浆CT,1,25(OH)2D3代谢紊乱有一定关系。     

不同稀释液配制的结合疫苗免疫持久性研究

目的 了解分别用Al(OH)3佐剂、生理盐水配制Hib结合疫苗和A、C群脑膜炎球菌结合疫苗的免疫持久性.方法 分别用两种稀释液配制Hib结合疫苗和A、C群脑膜炎球菌结合疫苗,各自免疫小鼠,采集分离血清用ELISA测定血清IgG抗体滴度,计算血清抗体GMT和阳转率及不同免疫针次的免疫持久性.结果 两种稀释液配制的Hib结合疫苗和A、C群脑膜炎球菌结合疫苗均可产生明显的抗体应答和免疫记忆反应,但在刺激机体快速产生免疫应答,加强免疫后的回忆反应,抗体滴度及免疫持久性方面有明显差异.生理盐水配制的结合疫苗较Al(OH)3盐水配制的结合疫苗可刺激机体快速产生抗体应答,但Al(OH)3盐水配制的结合疫苗具有更好的抗体GMT和免疫持久性.结论 Al(OH)3盐水配制的结合疫苗具有较好的免疫原性.     

Management of preterm prematurely ruptured membranes: a retrospective comparison of observation versus use of steroids and timed delivery

A retrospective study of 38 women with preterm prematurely ruptured membranes was performed. Twenty were treated with intravenous hydrocortisone followed by timed delivery between 48 and 72 hours after initiation of steroid therapy. Eighteen were managed expectantly, with observation for labor and infection. There were no significant differences between steroid-treated patients and observed patients in the incidence of neonatal respiratory distress syndrome, perinatal mortality, or maternal or neonatal infections.     

Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis

Bacteriologic cultures of sputum and specimens obtained at thoracotomy from 17 patients with cystic fibrosis were compared. All organisms found in the surgical specimens were found in the sputum. Only two surgical specimens failed to yield any organisms. The most frequently isolated organisms were Pseudomonas aeruginosa (41%) and Pseudomonas cepacia (35%). Serotypes of P. aeruginosa and antibiogram results on both P. aeruginosa and P. cepacia further supported the concordance of the isolates from the two sources. In addition, anaerobic cultures were obtained in specimens from 10 patients with CF and revealed two patients with anaerobic colonization of the lower respiratory tract. These findings also correlated well with the sputum cultures. The correlation of sputum and lung specimen culture results supports the value of sputum culture in the management of lung disease in CF.