Transjugular Renal Biopsy Bleeding Risk and Diagnostic Yield: A Systematic Review

This study aimed to better define the safety and efficacy of transjugular renal biopsy (TJRB) based on published studies. Seventeen published articles were included (1,321 biopsies). Complications were classified as major if they resulted in blood transfusion or additional invasive procedures. All other bleeding complications were considered minor. Diagnostic tissue was obtained in 1,193 procedures (90.3%). The total incidence of bleeding complications among 15 articles with complete data was 202 of 892 procedures (22.6%): 162 (18.2%) minor and 40 (4.5 %) major. These results show that TJRB is a feasible procedure for obtaining renal tissue for diagnosis and that most complications are self-limiting.     

我国37年来细菌性痢疾菌群分布的分析

本文复习了我国37年(1949~1985)来自各地区报道的155 122株痢疾杆菌。分析菌群分布表明,平均仍以B亚群所占比例最高(80.5%),但八十年代以来有所下降(68.1%)。B亚群中流行亚群是2a与lb;但1a与2b比例有增加趋势。西北和中南地区A亚群比例近来明显增高,提示有关地区环境污染严重,饮水卫生差,亦可能与细菌毒力变异有关,防治中需特别注意。B:D亚群比值以华东地区最低,该比值同经济文化发达水平有一定关系。     

Ⅱ型糖尿病血浆PAI-1、t-PA检测的意义和结果评价

目的:通过对Ⅱ型糖尿病患者分组(伴血管病变组、胰岛素抵抗组、胰岛素抵抗伴血管病变组、Ⅱ型糖尿病组)检测PAI-1、t-PA抗原及活性,并计算抗原比和活性比,以评价各检测指标的临床价值。方法:采用ELISA法检测PAI-1及t-PA抗原,采用发色底物法检测PAl-1、t-PA活性。结果:189例标本总体患病组及分组后各组的PAI-1活性、t-PA活性及t-PA活性/PAI-1活性比值与正常对照组比较均有显著性差异(P<0.05)。患病组间除t-PA抗原,其余检测显示胰岛素抵抗组、胰岛素抵抗组伴血管病变组与Ⅱ型糖尿病组存在显著性差异(P<0.05)。结论:在上述检测指标中t-PA活性、PAI-1活性反映血管病变的发生较敏感,t PA/PAI-1的活性比值更具临床应用价值。     

Treatment of established osteoporosis with 1α (OH) vitamin D3 and low dose intermittent elcatonin (eel calcitonin derivative)

In addition to estrogen widely used all over the world for the prevention of postmenopausal osteoporosis, calcitonin and vitamin D derivatives are commonly employed to treat established osteoporosis at higher age in Japan. In order to critically assess the usefulness of vitamin D derivatives and calcitonin alone or in combination on the advancement of vertebral deformity at higher age, 32 osteoporotic patients with vertebral deformity with the mean age of 79 were randomly divided into 4 groups with indistinguishable age and severity of the vertebral deformity. Group 1 served as the control without specific medications for osteoporosis. Group 2 was treated with 10 units elcatonin (eel calcitonin derivative) injected intramuscularly twice a week. Group 3 was given 0.75 to 1.5μg/day 1α (OH) vitamin D₃ orally. Group 4 was given a combination of treatments used in Groups 2 and 3. In the lateral X-ray film of the spine taken prior to the test and every 6 months thereafter, the shape of the vertebral body T₈ through L₄ was monitored by measuring the anterior, central and posterior heights. Decrease of the vertebral height ratio; anterior or middle height/posterior or adjacent intact posterior height, by more than 20% of the original value or from above to below 0.80 both appeared to be inhibited during administration of 1α (OH) vitamin D₃. Such effect seems to be augmented by simultaneous administration of elcatonin. Actual decrease of vertebral height ratio values and the per cent fall from the original value significantly less in Groups 3 and 4 than in Group 1. Development of vertebral deformity assessed by the changes of the vertebral height thus appears to decrease during treatment with 1α (OH) vitamin D₃ especially together with calcitonin in established osteoporosis.     

Effect of hypothermia on renal sodium reabsorption

Summary The relationship between sodium reabsorption and oxygen consumption was studied in an isolated rabbit kidney preparation perfused with blood at 37, 28 and 19° C. When the temperature was lowered from 37° C to 28° C and to 19°C the rate of oxygen consumption and of the maximal P.A.H. excretion (Tm P.A.H.) decreased more than that of sodium reabsorption.TheQ ₁₀ for sodium reabsorption is about 1.8, while that for maximal P.A.H. excretion is 2.5. Some hypothesis on the possible mechanisms of the lowQ ₁₀ of the Na⁺ reabsorption are forwarded.Preliminary reports have been published [Boll. Soc. Ital. Biol. Sper.43, 1019–1023 (1966) and44, 1784–1787 (1967);45, 860–862 (1969) and45, 863–865 (1969)].     

Single nephron glomerular filtration rate ratios of superficial,intercortical and juxtamedullary nephrons in rats during development

Summary In 20, 40 and 60-day-old rats the filtration rate was studied, using Baines modification of Hanssen's Na₄Fe(¹⁴CN)₆ method enabeling the determination of single nephron glomerular filtration rate (SNGFR) ratio between superficial (S), intercortical (I) and juxtamedullary (J) nephrons. The proximal tubule lengths were determined as well. A close correlation was obtained between age and S/I, I/J and S/J of proximal tubule lengths and between age and I/J, S/J¹⁴C-activities of ferrocyanide. Presented findings confirm the data on the increasing role of superficial nephrons in the course of postnatal development of rat.     

Passive elastic properties of the rat abdominal vena cava

The quasistatic passive venous elastic properties were studied in-vitro on 6 cylindrical segments of abdominal vena cava from Wistar rats. Using noncontact methods of deformation measurement, diameters and axial force of the segments were analyzed as a function of simultaneous axial stretch and internal pressure in the physiological range of 0–2.7 kPa. The elasticity of the wall tissue was investigated in terms of moduli of elasticity in the circumferential, axial and radial direction. Results show that the pressure-diameter relationship is highly nonlinear, indicating that veins are extremely compliant at lowest pressures and rather stiff beginning from some 0.7 kPa of pressure. The axial force decreases with pressure at small prestretches, increases at large, but remains constant for the in-vivo prestretch. The venous wall tissue is markedly anisotropic in the entire physiological range of deformations.     

Incremental repeated acquisition in the rat: acute effects of drugs

Rats lever pressed for food and learned new response sequences on three levers. At the beginning of each daily session, responses on only one of the levers produced food. After meeting criterion on one lever, the task was "incremented" so that sequential responses on two levers were required and so on up to five sequential responses. Each new required response was added in front of the previously performed sequence. Sequences of lever presses required to produce food changed each session. Following establishment of stable acquisition behavior, the acute effects of d-amphetamine (0.30-3.0 mg/kg), diazepam (0.125-4.0 mg/kg), morphine (0.30-10.0 mg/kg), pentobarbital (1.0-17.5 mg/kg), and chlorpromazine (0.10-3.0 mg/kg) were examined. All drugs decreased the number of response sequences completed in a dose-dependent fashion. Response rates generally decreased at or below those doses that caused an increase in errors. For d-amphetamine, the profound disruption of incremental repeated acquisition behavior was primarily due to drug-induced perserverative responding. Pentobarbital and chlorpromazine increased errors both when the sequence was incremented and within the sequence whereas diazepam only increased errors when the sequence was incremented. Morphine generally increased within sequence errors without affecting errors when the sequence was incremented.     

伤病比在医院维权中的运用

为了保证民法的公平原则,避免医疗纠纷赔偿案件审理中忽视患者本身病情所致的不良后果的情况,对损伤与疾病对患者预后的影响进行了研究.介绍了伤病比的来源,论述了伤病比在医疗纠纷处理中的适用 范围,伤病比的级别与医院承担的赔偿额度.指出应增强伤病比意识,促进医与法的完美结合.