乳腺癌患者血清胰岛素样生长因子-1及结合蛋白-3含量测定

目的探讨胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)在乳腺癌中的表达和意义,并研究其与化疗疗效的关系。方法运用酶联免疫吸附法(ELISA)检测32例乳腺癌患者(A组),20例乳腺良性肿瘤患者(B组)和15例健康人(C组)血清中IGF-1和IGFBP-3的含量。结果 A组血清中IGF-1水平为(628.25±124.50)μg/L,B组血清中IGF-1水平为(435.46±116.86)μg/L,C组血清中IGF-1水平为(413.65±104.12)μg/L,A组明显高于B、C组且差异有统计学意义(P<0.05),但B组与C组之间差异无统计学意义(P>0.05)。A、B、C组血清中IGFBP3水平分别为(3596.12±1056.32)μg/L、(3856.12±1142.39)μg/L和(3912.65±1153.14)μg/L,3组之间差异无统计学意义(P>0.05)。15例化疗有效的患者,化疗2周期后IGF-1水平较化疗前明显降低,而IGFBP3水平呈高表达(P<0.05)。结论血清IGF-1和IGFBP-3含量变化有助于乳腺癌的辅助诊断和化疗疗效预测。     

血清β2-微球蛋白、内脏脂肪素水平变化与老年高血压患者血压变异性的关联性分析

目的：探讨血清β2-微球蛋白(β2-MG)、内脏脂肪素(visfatin)水平变化与老年高血压患者血压变异性(BPV)的关联性。方法：选取某院2021年1月—2022年12月收治的120例老年高血压患者为研究组,同期120例血压正常体检老年人为对照组,根据24 h收缩压变异性(24 h SBPV)将研究组分为低BPV(35例,24 h SBPV<15%)、中BPV(47例,24 h SBPV为15%～20%)、高BPV(38例,24 h SBPV>20%)3个亚组。比较2组入院时血清β2-MG、visfatin水平、血压参数,分析入院时血清β2-MG、visfatin水平与血压参数的相关性,比较不同程度BPV患者入院时血清β2-MG、visfatin水平,分析入院时血清β2-MG、visfatin联合检测对老年高血压患者BPV程度的诊断价值。结果：研究组β2-MG[(5.46±1.13)mg/mL]、visfatin[(9.75±2.08)μg/L]水平高于对照组[(1.37±0.42)mg/mL、(2.86±0.61)μg/L],差异具有统计学意义(P<0.05);...     

2型糖尿病患者血糖、锌、铜和镁水平的临床分析

目的 探讨2型糖尿病(type Ⅱ Non insulin dependent diabetes mellitus,NIDDM)患者血糖、血清锌、铜、镁含量水平及临床意义.方法 对58例2型糖尿病患者和40例健康体检者应用日立7600型全自动生化分析仪使用酶反应速率法对其空腹血糖(FPG),锌、铜、镁分别进行检测,分析糖尿病患者血糖、锌、铜、镁异常改变的情况,并对其结果进行回顾性分析.结果 2型糖尿病患者的血糖均显著性高于健康人(P＜0.01);糖尿病患者血清锌和镁均低于健康人(P＜0.05),分别为(1.01±0.51)μg/ml和(0.68±0.35)mmol/ml;而血清铜则为(1.39±0.35)μg/ml高于健康人(P＜0.05).结论 NIDDM患者血清锌、铜、镁与血糖浓度密切相关,血清中锌、镁浓度与血糖水平呈负相关,铜则相反,因此,改善患者血糖情况可能在一定程度上缓解体内微量元素的代谢紊乱.     

地尔硫卓在非体外循环下冠状动脉旁路移植术中的应用

目的 评价地尔硫卓在非体外循环冠状动脉旁路移植术(OPCABG)中的临床效果.方法 接受OPCABG的40例冠心病患者,随机均分为两组,麻醉诱导后分别泵注地尔硫卓1～3μg·kg-1·min-1(A组)或硝酸甘油0.5～2.0μg·kg-1·min-1(B组).记录诱导前、用药30 min、移植血管远端吻合中、出手术室前4个时点的血流动力学指标;术后24、48h采血测量血清肌酸激酶同工酶(CK-MB)和肌钙蛋白T(cTnT).结果 与B组比较,A组术中血流动力学较为稳定(P<,0.05);A组术后24 h和48 h血清CK-MB[(24.32±42.75)U/L vs.(39.37±35.50)U/L和(21.50±14.12)U/L vs.(35.40±46.59)U/L]和cTnT[(0.17±0.23)ng/ml vs.(0.32±0.28)ng/ml和(0.20±0.25)ng/ml vs.(0.37±0.48)ng/ml]水平均明显低于B组(P<0.05).结论 在OPCABG手术期间使用地尔硫卓能显著降低心肌氧耗,提供较好的心肌保护,无明显不良反应.     

糖化血红蛋白和N末端脑钠肽原与急性冠脉综合征心功能的关系

目的 探讨糖化血红蛋白(HbA1c)和N-末端脑钠肽前体(NT-proBNP)的表达水平与急性冠脉综合征(ACS)患者心功能的关系.方法 检测ACS患者68例(A1组,38例,合并糖尿病;A2组,30例,无糖尿病)和健康体检者20名(B组)血清HbA1c和NT-proBNP水平.结果 A1组血清HbA1c水平明显高于A2组和B组[(9.47±1.62)％ vs.(5.86±0.31)％和(5.64±0.22)％](P＜0.01),但A2组和B组之间无统计学差异(P＞0.05).A1、A2组血清NT-proBNP均明显高于B组[(441.84±78.63) μg/ml、(217.31±34.52) μg/ml vs.(86.33±15.26) μg/ml] (P＜0.01),且A1组NT-proBNP高于A2组(P＜0.01).在ACS患者,血清HbA1c和NT-proBNP水平随着心功能病情加重而明显增加(P＜0.05或P＜0.01).ACS患者血清HbA1c和NT-proBNP水平呈显著正相关(r=0.524,P＜0.05).结论 ACS患者血清HbA1c和NT-proBNP水平明显升高;联合检测血清HbA1c和NT-proBNP可以用于ACS患者心功能的评估.     

血清降钙素原、白细胞介素-6、C反应蛋白及白细胞计数检测在呼吸道感染诊断中的临床价值评价

目的 分析血清降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)及白细胞计数(WBC)检测在呼吸道感染诊断中的临床价值。方法 选择200例呼吸道感染患者,将100例细菌感染患者设为A组, 100例非细菌感染者设为B组;另选择100例健康体检者作为对照组。比较三组PCT、IL-6、CPR、WBC水平;A组和B组血清PCT、IL-6、CPR、WBC单独及联合检测的阳性检出率。结果 A组血清PCT、WBC、IL-6、CPR水平分别为(1.87±0.22)μg/L、(12.27±2.16)×10⁹/L、(38.32±4.96)pg/ml、(13.32±3.10)mg/L, B组分别为(0.74±0.10)μg/L、(9.18±1.89)×10⁹/L、(26.04±2.12)pg/ml、(11.14±2.74)mg/L,对照组分别为(0.30±0.02)μg/L、(6.22±1.20)×10⁹/L、(7.47±2.41)pg/ml、(7.12±1.01)mg/L。三组血清PCT、WBC、IL-6、CPR水平比较差...     

老年高血压尿常规检验中常用四项指标的应用价值分析

目的对老年高血压尿常规检验中常用四项指标的应用价值进行分析。方法 100例老年高血压患者,根据高血压分级不同分为Ⅰ级组(34例)、Ⅱ级组(46例)、Ⅲ级组(20例);根据病程不同分为A组(0~10年, 35例)、B组(11~20年, 45例)和C组(>20年, 20例)。比较不同分级、病程组患者24 h尿蛋白定量、N-乙酰-β-D氨基葡萄糖苷酶、尿微量白蛋白、尿β2微球蛋白水平。结果Ⅰ级患者24 h尿蛋白定量、尿微量白蛋白、尿β2微球蛋白、N-乙酰-β-D氨基葡萄糖苷酶水平低于Ⅱ级、Ⅲ级患者,Ⅱ级患者低于Ⅲ级患者,差异具有统计学意义(P<0.05)。A组患者24 h尿蛋白定量为(0.26±0.12)g/L,尿微量白蛋白为(8.86±0.69)mg/L,尿β2微球蛋白为(146.42±20.31)μg/L,N-乙酰-β-D氨基葡萄糖苷酶为(2.56±1.21)μmol/L;B组患者24 h尿蛋白定量为(0.47±0.06)g/L,尿微量白蛋白为(30.50±1.40)mg/L,尿β2微球蛋白为(479.27±21.53)μg/L, N-乙酰-β-D氨基葡萄糖苷酶为(4.49±1.53)μmol/L;C组患者24 h尿蛋白定量为(0.81±0.03)g/L,尿微量白蛋白为(65.45±1.42)mg/L,尿β2微球蛋白为(1078.52±29.53)μg/L, N-乙酰-β-D氨基葡萄糖苷酶为(7.72±2.21)μmol/L。B组、C组患者24 h尿蛋白定量、尿微量白蛋白、尿β2微球蛋白、N-乙酰-β-D氨基葡萄糖苷酶水平高于A组,C组患者高于B组,差异具有统计学意义(P<0.05)。结论老年高血压患者通过尿常规四项指标可以及早发现早期肾功能损害情况,其指标的变化状况与高血压患者的分级、病程呈正相关。     

血清β2-微球蛋白对食道癌、肝癌及肠癌辅助诊断的价值

目的 探讨血清β2-微球蛋白(β2-MG)对食道癌、肝癌及肠癌辅助诊断的价值.方法 选择2009年10月-2011年5月我院食道癌、肝癌及肠癌患者226例(肿瘤组),正常体检人群200例作为对照(对照组).用化学发光法测定正常人群、肿瘤患者血清β2-MG,并对其结果进行统计学处理.结果 肿瘤组β2-MG的含量高于对照组[(4513.2±619.8) ng/ml vs.(1668.3±88.9) ng/ml,P＜0.05];两组人群中,年龄51-80岁血清中β2-MG含量高于年龄30-50岁者(P＜0.05).食道癌、肝癌、肠癌三种不同肿瘤患者中,肝癌β2-MG阳性检出率最高,血清β2-MG含量最高.结论 血清β2-MG含量在食道癌、肝癌、肠癌患者中增高,对其相关肿瘤的辅助诊断有一定的临床意义.     

老年下肢骨折患者全麻术后认知功能障碍研究

目的研究下肢骨折的老年患者全身麻醉手术后,出现认知功能障碍的原因。方法我院2010年1月至2012年1月的老年下肢骨折全麻患者98例,患者均行术前术后神经心理测试,在麻醉前后2、4、24h采集患者肘静脉血4ml进行酶联免疫试验测定血清Aβ(1-40)。对认知障碍患者和无认知障碍患者在出血量、手术时间、体重以及血清Aβ(1-40)水平等方面差异进行统计分析。结果 98例患者中有46例发生认知功能障碍,发生率为46.9%。认知障碍组和无认知障碍组患者在出血量和体重方面差异有统计学意义,手术时间方面比较差异无统计学意义。而认知障碍组患者术前术后血清Aβ(1-40)水平明显高于无认知障碍组,两者差异有统计学意义。结论若老年患者血浆Aβ水平在围术期升高而且在手术后24h持续较高的水平,将有可能发生全麻术后认知功能障碍。     

β-内酰胺类抗生素过敏患者血清IL-2及sIL-2R表达

目的 探讨白细胞介素2(IL-2)及可溶性白细胞介素2受体(sIL-2R)与β-内酰胺类药物过敏之间的关系.方法 采用ELISA检测70例β-内酰胺类药物过敏反应患者(A组)与20例正常人(B组)外周血血清IL-2及sIL-2R的水平.采用放射免疫吸附(RAST)方法检测过敏患者血清中特异性IgE抗体.结果 A组血清IL-2水平显著高于B组(P<0.05)(4.110 ng/ml vs.2.070ng/ml).A组中IgE抗体阳性患者sIL-2R水平高于抗体阴性者(3.300 ng/ml vs.2.345 ng/ml)(P<0.05).结论 β-内酰胺类抗生素过敏反应的发生中,外周血血清IL-2水平升高;特异性IgE抗体阳性的过敏反应与sIL-2R水平升高有关.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.