1，25-（OH）2-D3大剂量间隙疗法治疗中重度继发性甲旁亢

目的:观察1,25-(OH)2-D3大剂量间隙疗法治疗中重度继发性甲旁亢的临床疗效。方法:回顾性分析1996～2005年93例全段甲状旁素(iPTH)>500pg/ml的接受小剂量1,25-(OH)2-D3(0.25!g,每日1次,口服)治疗8周无效而改用大剂量1,25-(OH)2-D3(2!g,每周2次,口服)间隙疗法的患者资料,包括性别、年龄、平均透析年限、治疗前后iPTH、碱性磷酸酶(AKP)的平均水平,1,25-(OH)2-D3的剂量、疗程。治疗过程中血清钙、磷、AKP的水平以及相关的影像学资料。结果:经口服2!g、每周2次1,25-(OH)2-D38周的治疗,有74例患者iPTH有明显下降,差异有统计学意义;19例因高钙磷乘积退出观察,疗效不明显。经B超、ECT检查发现17例甲状旁腺增生,行甲状旁腺全切加自身前臂种植术,术后疗效良好。结论:1,25-(OH)2-D3大剂量间隙疗法治疗中重度继发性甲旁亢是一种行之有效的方法。对于治疗无效患者,如有甲状旁腺增生者可考虑手术治疗。     

Dose-effect relations of loop- and thiazide-diuretics on calcium homeostasis: a randomized,double-blinded Latin-square multiple cross-over study in postmenopausal osteopenic women

BACKGROUND: Thiazide diuretics (TDs) reduce whereas loop diuretics (LDs) increase urinary calcium. We studied the effects of different doses of a TD and LD on electrolytes, calcitropic hormones and biochemical bone markers. SUBJECTS AND METHODS: In a five-period crossover study, comparing four active doses with placebo, 40 postmenopausal women with osteopenia were treated with different doses of LD bumetanide (n = 20, 0.5-2.0 mg per day) or TD bendroflumethiazide (n = 20, 2.5-10 mg per day). Each treatment period lasted 1 week. RESULTS: Urinary calcium decreased dose-dependently in response to the bendroflumethiazide. The best hypocalciuric effect was achieved by 5 mg day-1 of bendroflumethiazide. Total plasma calcium levels increased, whereas ionised calcium at ambient pH-values decreased because of increased pH-values in response to the bendroflumethiazide. Plasma PTH levels did not change, whereas a slight dose-dependent increase occurred in plasma 1,25(OH)2D levels. As a marker of bone formation, plasma osteocalcin levels increased. Conversely, bumetanide dose-dependently increased renal calcium losses with a concomitant increase in plasma PTH and 1,25(OH)2D levels. Plasma osteocalcin levels increased and bone-specific alkaline phosphatase levels decreased dose-dependently. CONCLUSION: Whether a LD or TD is chosen as diuretic therapy affects calcium homeostasis. The effects of LDs are potentially harmful to bone. Further studies are needed to evaluate whether long-term treatment with LDs causes osteoporosis. Until then, we suggest using, if possible, a TD rather than a LD as diuretic therapy in order not to risk deleterious effects on bone metabolism.     

维生素D受体Taq基因多态性与糖尿病视网膜病变的关系

目的探讨维生素D受体(VDR)Taq基因多态性与糖尿病视网膜病变(DR)的关系。方法应用片段长度差异等位基因特异性多聚酶链反应(FLDAS-PCR)技术,检测158例DR患者和198名正常对照者的VDRTaq基因多态性。结果VDRTaq基因型在DR患者中的分布为TT型106例,占67.1%,Tt型33例,占20.9%,tt型19例,占12.0%;在正常对照者中的分布为TT型165例,占83.3%,Tt型23例,占11.6%,tt型10例占5.1%。DR患者与正常对照者TT、Tt、tt基因型分布差异有统计学意义(P<0.05)。结论DR与维生素D受体Taq基因多态性有一定的关系。     

维生素D受体TaqⅠ基因多态性与糖尿病视网膜病变的关系

目的 探讨维生素D受体(VDR)TaqⅠ基因多态性与糖尿病视网膜病变(DR)的关系。 方法 应用片段长度差异等位基因特异性多聚酶链反应(FLDAS-PCR)技术，检测158例DR患者和198名正常对照者的VDRTaqⅠ基因多态性。 结果 VDRTaqⅠ基因型在DR患者中的分布为TT型106例，占67.1%,Tt型33例，占20.9%,tt型19例，占12.0%;在正常对照者中的分布为TT型165例，占83.3%，Tt型23例，占11.6%,tt型10例占5.1%。DR患者与正常对照者TT、Tt、tt基因型分布差异有统计学意义(P<0.05)。结论 DR与维生素D受体TaqⅠ基因多态性有一定的关系。 (中华眼底病杂志， 2006， 22： 94-96)     

DHCCR重组DNA细菌克隆

我们分别采用Ca~(2+)和Mg~(2+)处理大肠杆菌JM109进行转化实验,使含有1.25——双羟胆钙化醇受体(1,25—Dihydroxy cholecalciferol receptor,DHCCR)基因的质粒转化到细菌中进行克隆获得成功。经氨苄青霉素(AMP)培养基上筛选及限制性酶切分析,证明转化子为阳性。     

老年男性骨质疏松与相关影响因素的关系

INTRODUCTIONOsteoporosisisacommondiseaseintheoldpeople.Theincidenceofosteoporosisinmenislaterthaninwomen,andthemorbidityislower,sothestudyonthemaleosteoporosisseemstobedefi-cient.Butsomeinvestigationdatashowthatalmostone-thirdofallhipfracturesworldwideoccurinmen.Themortalityinmenisevidenthigherthaninwomenofthesameage犤1-2犦.Itisveryimportanttostudymoreissuesofmaleosteoporosis.Inordertosurveyitspathogeny,wemeasurethebonemineraldensityin97oldmenbydualenergyX-rayabsorptiometry(DEXA).Atthe…