Values of Donor Serum Lipids and Calcium in Predicting Graft Function after Kidney Transplantation:A Retrospective Study

Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal grafts.This study aimed to examine the value of these serum biomarkers for prediction of renal graft function.Methods The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,2019.The correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and evaluated.Results(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(P<0.05);(2)The donor’s BMI was significantly correlated with the incidence rate of DGF after KT(P<0.05);(3)For serum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[P<0.05,OR(95%CI):0.425(0.202–0.97)];(4)The serum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[P<0.05,OR(95%CI):0.184(0.045–0.747)and P<0.05,OR(95%CI):0.114(0.014–0.948),respectively].Conclusion The serum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.

Effects of Serum Calcium and Phosphorus under Different Feeding Conditions on Production Traits of Young Xinjiang Brown Bulls

[Objective] In the Xinjiang new era from October 2012 to February 2013, agricultural and animal husbandry Co. Ltd. feedlot Yining Tuogelake village used tethered and scattered feeding methods to conduct fattening young Xinjiang brown cattle experiment. [Method] The 16-month-old young Xinjiang brown bulls were se- lected totaling 68 heads, divided into scattered group and tethered group. Male claves were taken as test subjects from October to February of following year and body conformation linear evaluation were made, followed by measurement of body size indexes and Regular collection of Blood samples. [Result] In the two feeding ways, scattered group feeding improved the ADG of youth Xinjiang brown cattle bull calf （P〈0.01）, and the whole calf ADG 845.58g was significantly higher than that in tethered group at 619.11g, increasing by 36.58%; furthermore, scattered group in the December, January and February average daily weight gain was significantly higher compared with the tethered group at 13.61%, 32.32%, 53.47%, respectively. Scattered group feeding significantly increased the young calf serum phosphorus content （P〈0.01）, higher than the tethered group at 0.62%, 7.89%, 14.29% in February, December and January respectively. But the tethered feeding young cattle serum phosphorus content gradually declined. Of the two groups, male calf serum calcium content had little effects on the serum calcium with insignificant difference （P〉0.05）. Bulls by scattered feeding method was proved faster and better in the whole growth period, in terms of body height, body length, circumference, leg cir- cumference, rump length, waist high, sciatic wide, hip width basically in the contin- ued growth trend. [Conclusion] Scattered feeding can significantly improve the young Xinjiang brown cattle＇s daily gain, and accelerate the body height, heart girth and body length etc body growth. What＇s more, scattered feeding serum calcium and phosphorus content are significantly higher than tethered feeding.

An elevated preoperative serum calcium level is a significant predictor for positive peritoneal cytology in endometrial carcinoma

Objective:To evaluate preoperative serum calcium concentration and investigate the association between calcium level and positive peritoneal cytology in endometrial carcinoma(EC).Methods:A total of 510 patients who were diagnosed with EC and had surgery were initially enrolled in this study at Peking University People's Hospital between January 2012 and December 2016.Clinical characteristics and preoperative serum calcium,albumin,carbohydrate antigen(CA)125,CA19-9,carcinoembryonic antigen(CEA)were extracted from patient records and evaluated according to postoperative peritoneal cytology.Predictive factors were assessed with Cox univariate and multivariate analyses.Factors selected from multivariate analysis results were used to build a predictive model.Results:A total of 510 patients are identified in our database and 444 patients who fulfilled inclusion and exclusion criteria are included in this study.Univariate analysis revealed that ionized calcium concentration was closely related to positive peritoneal cytology,tumor grade and lymph-vascular space invasion(LVSI).Moreover,peritoneal cytology was significantly associated with hypertension,tubal ligation,serum CA125,CA19-9,CEA and ionized calcium level.Multivariate analysis revealed that albumin-adjusted calcium level,CA125 and tubal ligation were independent predictive factors of positive peritoneal cytology(P<0.05).A combination of ionized calcium level with the other two indexes yielded significantly great area under the curve(AUC=0.824).Conclusions:This study enhanced the value of preoperative ionized calcium level.We also identified several potential biomarkers to predict positive peritoneal cytology in EC patients before surgery.

Effects of Trinitrotoluene on Serum Phosphorylase A Activities and on Calcium Contents in Men and Rats

Wistar rats were exposed to trinitrotoluene (TNT) for 6 weeks. After initiation of TNT exposure, serum phosphorylase A activities and calcium contents were assayed for every 2 weeks. Both of these 2 parameters increased in rats treated with 50 and 100 mg TNT/kg b.w. at 3 intervals. Serum phosphorylase A activities and calcium contents of TNT exposure worker increased too.

Serum Proteins Stabilized Calcium Phosphate Nanoparticles and Its Effect on Bel-7402 Cells

Hydroxyapatite has a high affinity to biological macromolecules, especially to proteins. Bovine serum proteins were extracted to be used as stablizer to prepare calcium phosphate nanoparticles . 167.7 nm and 87.7 nm particles were respectively prepared by using bovine serum protein fractions at the concentration of 0. 5 mg/mL and 1.0 mg/mL. As the polysaccharide stabilized hydroxyapatite nanoparticles, the protein-stablized nanoparticles also inhibited the proliferation rate of Bel-7402 cells. It suggested that proteins could be applied to prepare calcium phosphate nanoparticles and it also has the anticaneer effect.

Possible Correlation between INR and Serum Calcium

Experimental and clinical studies have shown that long term anticoagulation therapy with warfarin can induce vascular calcification which is preventable by vitamin K. Osteoporosis has been shown to be associated with vascular calcification. In the present study, we wanted to see, whether INR (International Normalized Ratio), a measure of prothrombin time, and serum calcium (corrected by albumin) correlate in laboratory data of 94 anticoagulation patients on warfarin therapy. When adjusted on age and sex, there was an inverse correlation between the two variables. Clinical relevance of this observation and explanation of lowered calcium levels in blood parallel to increase in INR-values remain to be studied further.

1,6-二磷酸果糖钙对海兰褐蛋鸡生产性能、蛋品质、血清生化指标和免疫指标的影响

试验旨在研究1,6-二磷酸果糖钙对海兰褐蛋鸡生产性能、蛋品质、血清生化指标和免疫指标的影响。试验选择800只健康、产蛋率相近的380日龄海兰褐蛋鸡,随机分成4组,每组20个重复,每个重复10笼,每笼1只鸡。对照组、低剂量组、中剂量组和高剂量组分别在基础日粮中添加0mg/kg、100mg/kg、200mg/kg和300mg/kg1,6-二磷酸果糖钙,进行为期9周的试验。结果显示:与对照组相比,中、高剂量组产蛋率显著提高(P<0.05),且与1,6-二磷酸果糖钙的添加量呈二次曲线关系(P<0.05);低、中和高剂量组破蛋率显著降低(P<0.05)。中、高剂量组蛋黄颜色和蛋壳强度显著提高(P<0.05),蛋壳强度与1,6-二磷酸果糖钙添加量呈二次曲线关系(P=0.024);低、中和高剂量组的蛋壳比例显著提高(P<0.05),且随1,6-二磷酸果糖钙添加量的增加呈线性升高(P=0.034)。低、中和高剂量组谷丙转氨酶活性显著降低(P<0.05);低、中剂量组总胆固醇含量显著降低(P<0.05),且总胆固醇含量与1,6-二磷酸果糖钙添加量呈二次曲线关系(P=0.004);中、高剂量组高密度脂蛋白含量显著提高(P<0.05);中剂量组低密度脂蛋白含量显著降低(P<0.05),且低密度脂蛋白含量与1,6-二磷酸果糖钙添加量呈二次曲线关系(P=0.036)。低、中和高剂量组的IgM和IgA含量均显著增加(P<0.05),其中IgA含量随1,6-二磷酸果糖钙添加量的增加呈线性升高(P=0.047)。分别对产蛋率、蛋壳强度、总胆固醇含量和低密度脂蛋白含量进行二次曲线方程拟合表明,当1,6-二磷酸果糖钙添加量分别为179、186、243和268mg/kg时,产蛋率、蛋壳强度、总胆固醇含量和低密度脂蛋白含量分别达到最佳。研究提示:日粮中添加200和300mg/kg1,6-二磷酸果糖钙较佳,基于产蛋率、蛋壳强度、总胆固醇含量和低密度脂蛋白含量考虑,适宜的1,6-二磷酸果糖钙添加量分别为179、186、243和268mg/kg。

骨折患者初期血清钙磷浓度变化与骨折部位的相关性分析

目的探究骨折患者初期血钙、血磷、钙磷乘积水平变化并分析其与骨折部位的相关性。方法选取2021年1月~2023年11月四川省骨科医院收治的骨折患者1049例作为研究对象,按骨折部位粗分为两组:上半身部位骨折(n=478)和下半身部位骨折(n=571);细分十组:椎体骨折(n=108)、锁骨骨折(n=109)、上肢骨折(n=106)、手部骨折(n=104)、股骨颈骨折(n=103)、股骨粗隆间骨折(n=106)、髌骨骨折(n=101)、下肢骨折(n=103)、足部骨折(n=105)和其他骨折(n=104)。另选取同期健康体检人群110例作为对照组。全部患者于急诊当日和入院后24~48h两次抽取静脉血测定血钙、血磷,并计算钙磷乘积,比较三者水平变化并分析其与骨折部位的相关性。结果与对照组比较,骨折患者急诊当日和入院后24~48h,血钙(2.27±0.12 mmol/L,2.19±0.12 mmol/L vs2.35±0.10mmol/L)、血磷(1.00±0.20mmol/L,1.08±0.19mmol/L vs 1.15±0.15mmol/L)、钙磷乘积(28.10±6.00mg/dl,29.30±5.85mg/dl vs 33.41±4.87mg/dl)均降低,差异具有统计学意义(t=6.804,12.501;7.475,3.722;8.964,7.115,均P<0.01)。上、下半身骨折相比,急诊当日血钙、血磷和钙磷乘积下半身骨折低于上半身骨折(t=4.129,5.931,6.660,均P<0.01);入院后24~48h则仅钙、钙磷乘积下半身骨折低于上半身骨折(t=6.432,1.990,均P<0.05),差异具有统计学意义。沿时间轴比较,入院后24~48h与急诊当日相比,上、下半身骨折均表现出血钙降低而血磷升高(t=12.779,-5.730;16.919,-14.358),钙磷乘积则仅下半身骨折较急诊当日升高(t=-8.860),差异具有统计学意义(均P<0.01)。不同部位骨折患者入院后24~48h与急诊当日相比,除椎体骨折外,其余九组血钙均降低(t=6.233~11.349);除上肢骨折、手部骨折外,其余八组血磷升高(t=-7.770~-3.327);椎体骨折、股骨颈骨折、股骨粗隆间骨折、下肢骨折、足部骨折、其他骨折钙磷乘积升高(t=-5.819~-2.927),差异具有统计学意义(均P<0.01)。结论骨折患者急诊当日血钙、血磷和钙磷乘积均降低,24~48h后多数患者血钙持续降低,血磷和钙磷乘积逐渐回升,其水平变化程度与骨折部位有关。

饲料钙磷水平对禾花鲤生长性能、血清生化指标、骨骼及肝脏组织形态的影响

试验旨在探讨饲料中不同钙磷水平对禾花鲤生长性能、血清生化指标、骨骼及肝脏组织形态的影响。试验以氯化钙为钙源设2个钙水平:0、0.5%(A、B),以磷酸二氢钾为磷源设4个磷水平:0、0.5%、1.0%、1.5%(1、2、3、4),采用交叉组合制备A1(0钙、0磷)、A2(0钙、0.5%磷)、A3(0钙、1.0%磷)、A4(0钙、1.5%磷)、B1(0.5%钙、0磷)、B2(0.5%钙、0.5%磷)、B3(0.5%钙、1.0%磷)、B4(0.5%钙、1.5%磷)8组等氮饲料,选择初始体重为(4.46±0.02) g的禾花鲤1 440尾,随机分为8组,每组3个重复,每个重复60尾鱼,养殖60 d。试验结果表明:(1)禾花鲤的终末体重(FBW)、增重率(WGR)、特定生长率(SGR)在钙磷水平分别为0.5%、1.5%(B4)时达最大值,显著大于A4和B1组(P<0.05)。饲料系数(FCR)在钙磷水平分别为0.5%、1.5%时达最小值,显著低于A4和B1组(P<0.05)。(2)饲料磷水平升高显著降低禾花鲤粗脂肪含量(P<0.05)。粗蛋白含量随饲料磷升高而增加,与不添加钙组相比,添加钙减少蛋白质沉积。鱼体钙含量随磷水平升高而增加,但B4组禾花鲤钙含量显著低于B3组(P<0.05)。(3)血清谷草转氨酶(AST)和碱性磷酸酶(ALP)活性在钙磷水平分别为0.5%、1.0%时达最小值。总胆固醇(T-CHO)含量随饲料磷水平升高呈降低趋势。(4) X光片显示,A1组脊椎骨发生融合,A3、A4和B1组尾脊椎骨发生不同程度畸形。(5)当饲料钙水平为0时,饲料磷水平升高可缓解肝细胞空泡化,当磷水平为1.5%时造成脂肪堆积和核偏移;当钙水平为0.5%时,饲料磷水平升高可减少肝细胞损伤,且肝细胞完整性更好。综上所述,建议禾花鲤饲料钙磷水平分别为0.5%、1.0%~1.5%,有利于禾花鲤的生长及鱼体健康。

骨化三醇联合西那卡塞对继发性甲状旁腺功能亢进的疗效及安全性分析

目的探讨骨化三醇联合西那卡塞对继发性甲状旁腺功能亢进(SHPT)的治疗效果。方法选取2021年8月至2022年7月于高州市人民医院血液净化中心接受血液透析并发甲状旁腺功能亢进的患者80例,采用随机数表法分为观察组和对照组,每组各40例。在两组患者均维持透析治疗的基础上,对照组给予西那卡塞治疗,观察组给予骨化三醇联合西那卡塞治疗,两组均维持治疗6个月。比较两组临床疗效,收集治疗前后的全段甲状旁腺激素(iPTH)、甲状旁腺体积、血钙水平、血磷水平、钙磷乘积指标进行比较。结果治疗前,两组iPTH、甲状旁腺体积、血钙水平、血磷水平、钙磷乘积差异比较,差异无统计学意义(P>0.05);治疗后,观察组血钙水平高于对照组,iPTH、血磷水平均低于对照组,甲状旁腺体积小于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率优于对照组,差异有统计学意义(P<0.05)。结论骨化三醇联合西那卡塞治疗血液透析患者SHPT的临床效果显著,患者的血钙水平升高而iPTH、血磷水平均降低,甲状旁腺体积缩小,值得临床推广应用。

sFLC、血清钙离子在多发性骨髓瘤患者诊断及预后判断中的应用价值

目的:探讨血清游离轻链(sFLC)、血清钙离子在多发性骨髓瘤(MM)患者诊断及预后中的临床应用价值。方法:选取2018年1月至2022年1月在河南省人民医院治疗的MM患者40例作为观察组,同时选取健康志愿者40例作为对照组,比较两组患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子等差异性,同时分析观察组不同国际分期系统(ISS)、不同化疗疗效及不同预后患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子等差异性。结果:观察组sFLC-κ水平[(98.39±21.19)对(12.01±4.45)mg/L]、sFLC-λ水平[(210.20±45.54)对(14.10±5.11)mg/L]、低钙血症比例(65%对0)均明显高于对照组(P<0.05),而sFLC-κ/λ比值[(0.44±0.10)对(0.87±0.12)]、血清钙离子[(1.98±0.46)对(2.42±0.40)mmol/L]明显低于对照组(P<0.05)。观察组ISS分期Ⅲ期患者sFLC-κ、sFLC-λ浓度、低钙血症比例和低钙血症病程均明显高于Ⅰ期和Ⅱ期患者(P<0.05),而sFLC-κ/λ、血清钙离子均明显低于Ⅰ期和Ⅱ期患者(P<0.05)。观察组有低钙血症患者sFLC-κ水平[(107.76±21.22)对(94.67±20.11)mg/L]、sFLC-λ水平[(245.54±41.12)对(205.54±50.22)mg/L]明显高于无低钙血症患者(P<0.05),而sFLC-κ/λ比值明显低于无低钙血症患者[(0.42±0.04)对(0.47±0.06);P<0.05]。化疗无效患者sFLC-κ水平[(107.29±20.14)对(91.11±18.92)mg/L]、sFLC-λ水平[(247.98±42.26)对(179.29±39.32)mg/L]明显高于化疗有效患者(P<0.05),而sFLC-κ/λ比值明显低于化疗有效患者[(0.43±0.10)对(0.50±0.09);P<0.05]。sFLC-κ、sFLC-λ、sFLC-κ/λ预测化疗无效的ROC曲线下面积分别为0.803、0.793和0.699,P<0.05。存活和死亡患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子、低钙血症比例和低钙血症病程比较差异无统计学意义(均P>0.05)。结论:sFLC、血清钙离子与MM患者ISS分期有关,sFLC水平在预测MM患者化疗疗效方面有一定应用价值,sFLC与血清钙离子在判断MM患者预后方面暂未发现有应用价值。

选择性钙通道拮抗剂辅助治疗对溃疡性结肠炎患者血清炎性因子及肠道菌群的影响研究

目的:探索选择性钙通道拮抗剂(SCCBs)辅助治疗对溃疡性结肠炎(UC)患者血清炎性因子及肠道菌群的影响。方法:选取2018年2月—2020年3月河南大学第一附属医院收治的86例UC患者作为研究对象,采用区组随机化法分为参照组与试验组,每组各43例。参照组予以常规治疗,试验组在参照组基础上予以相应的SCCBs辅助治疗,比较两组患者治疗前后的血清炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、肠道菌群水平及超氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果:治疗后,两组患者IL-6、IL-8、CRP及TNF-α水平均有所降低,且试验组患者IL-6、IL-8、CRP及TNF-α水平均显著低于参照组,差异有统计学意义(t=6.735、8.374、7.518、6.840,P<0.05)。治疗后,两组患者乳酸菌、肠球菌及双歧杆菌水平均有所提升,且试验组患者乳酸菌、肠球菌及双歧杆菌水平均显著高于参照组,差异有统计学意义(t=9.612、9.381、6.187,P<0.05)。治疗后,试验组患者SOD水平显著高于参照组,差异有统计学意义(t=7.549,P<0.05),试验组患者MDA水平显著低于参照组,差异有统计学意义(t=9.835,P<0.05)。结论:SCCBs辅助治疗应用于UC患者中,能够有效缓解患者的机体炎性反应,调节其肠道菌群,促进其结肠正常生理功能的恢复。

血清钙联合降钙素原对脓毒症并发急性呼吸窘迫综合征患者病情及预后评估的作用

目的:探讨脓毒症合并不同严重程度急性呼吸窘迫综合征(ARDS)患者血清钙和降钙素原(PCT)水平变化和临床价值。方法:收集2022-01-2023-12武汉大学人民医院重症医学科、呼吸重症科及感染科的199例脓毒症合并ARDS患者的临床资料进行回顾性分析。依据入院28天内的生存情况将患者分为生存组(n=98)和死亡组(n=101),根据ARDS严重程度分为轻度组(n=63)、中度组(n=73)和重度组(n=63)。比较死亡组和生存组的临床资料及实验室检测指标,不同严重程度ARDS患者的脓毒症指标、ARDS指标及血清钙水平,并运用受试者工作特征(ROC)曲线分析血清钙和PCT水平对脓毒症合并ARDS患者预后预测的价值。结果:死亡组序贯器官衰竭估计(SOFA)评分、PCT及氨基端前脑钠素(NT-proBNP)高于生存组,氧合指数(OI)、血氧分压(PaO_(2))、碳酸氢根离子(HCO_(3)^(-))、白细胞计数(WBC)及血清钙均明显低于生存组,且死亡组与生存组脓毒性休克占比差异有统计学意义(均P<0.05)。方差分析显示,轻度组组患者血清钙、PaO_(2)和OI水平低于中度组和重度组,重度组PCT和SOFA评分高于中度组和轻度组(P<0.05)。多因素Logistic回归分析表明,血清钙水平降低(OR=0.032,95%CI 0.002-0.662,P=0.026)、SOFA评分升高(OR=1.328,95%CI 1.097-1.607,P=0.004)是脓毒症并发ARDS患者死亡的独立危险因素(均P<0.05)。ROC曲线分析提示,血清钙、PCT以及两者联合预测脓毒症合并ARDS患者预后不良的曲线下面积(AUC)依次为0.650、0.689、0.721。结论:脓毒症并发ARDS患者血清钙水平降低,PCT水平升高,二者对脓毒症并发ARDS患者的严重程度及预后评估有一定价值。

血钙、25-羟维生素D及尿酸水平与良性阵发性位置性眩晕的相关性研究

目的探讨血钙、25-羟维生素D及尿酸水平与良性阵发性位置性眩晕(BPPV)的相关性。方法选取96例BPPV患者纳入眩晕组,依据眩晕严重程度的不同进一步分为轻度眩晕组30例、中度眩晕组42例和重度眩晕组24例,另选取63例无BPPV的健康体检人员纳入对照组。比较各组研究对象的血钙、25-羟维生素D及尿酸水平,分析血钙、25-羟维生素D及尿酸水平与BPPV患者眩晕严重程度的相关性。随访3个月,统计BPPV患者复发率。结果中度眩晕组、重度眩晕组的血钙、25-羟维生素水平均低于轻度眩晕组和对照组,尿酸水平和眩晕障碍量表(DHI)总分及功能、情感、躯体维度评分均高于轻度眩晕组和对照组,差异有统计学意义(P<0.05);重度眩晕组的血钙、25-羟维生素水平均低于中度眩晕组,尿酸水平和DHI总分及功能、情感、躯体维度评分高于中度眩晕组,差异有统计学意义(P<0.05);轻度眩晕组的血钙、25-羟维生素、尿酸水平和DHI评分与对照组比较,差异无统计学意义(P>0.05)。BPPV患者眩晕严重程度与血钙、25-羟维生素D水平呈负相关(r=-0.557、-0.467,P<0.05),与尿酸水平呈正相关(r=0.504,P<0.05)。BPPV患者3个月内复发率为8.33%(8/96);与血钙≥2.11 mmol/L、25-羟维生素D≥30 ng/mL、尿酸≤428μmol/L的患者分别比较,血钙<2.11 mmol/L、25-羟维生素D<30 ng/mL、尿酸>428μmol/L的患者BPPV复发率均更高,差异有统计学意义(P<0.05)。结论BPPV患者血钙、25-羟维生素D水平异常降低,尿酸水平异常升高。BPPV患者眩晕严重程度与血钙、25-羟维生素D水平呈负相关,与尿酸水平呈正相关。

HNCOCa^(+)的光谱和成键:基质隔离和计算研究

金属(异)氰化物是星际介质中金属化合物的主要组成部分.它们的氧化物-金属(异)氰酸作为潜在的星际分子也备受关注.然而,作为金属(异)氰酸的前体,阳离子HNCOM^(+)的研究却非常有限.本文通过红外光谱、同位素取代和量子化学计算,对HNCOCa^(+)进行了详细研究.为了进行对比,还探索研究了HNCOBe^(+)和HNCOBa^(+)阳离子.结果表明,金属阳离子与HNCO反应可以生成HNCOCa^(+)和HNCO-Be^(+),但未观测到HNCOBa^(+)的生成.HNCOCa^(+)中非对称和对称NCO伸缩振动频率(2362.6和1330.4 cm^(-1))高于自由的HNCO分子(2268.5和1320.3 cm^(-1)),但比HNCOBe^(+)(2426.4和1355.2 cm^(-1))低.这些频率的变化是由HNCOBe^(+)和HNCOCa^(+)中NCO单元内的电荷极化导致.成键分析表明,HNCO-Be^(+)键倾向于共价性质(54%),而HNCO-Ca^(+)键则具有较高的静电性质(57%).在HNCO-Ba^(+)键中,占主导的静电相互作用(64%)导致了低的O-Ba键能,这解释了其在实验中未被制备的原因.

血清钙磷乘积对老年骨质疏松性椎体骨折的预测价值探讨

目的 分析血清钙磷乘积对老年骨质疏松性椎体压缩骨折(OVCF)的预测价值。方法 回顾性分析2018年7月至2022年6月收治的因老年OVCF行椎体成形术患者100例为观察组,选取同期同数量年龄、性别相匹配的因脊柱退变性疾病行手术治疗的患者为对照组,比较两组入院时的一般资料及实验室指标,通过Logistic回归分析老年OVCF发生的相关影响因素,绘制ROC曲线,比较其评估老年患者OVCF风险发生的效能,并与亚洲人骨质疏松症自我评估工具(OSTA)进行对比分析,进一步探讨血清钙磷乘积对老年OVCF的预测价值。结果 观察组白蛋白、血清钙、磷、钙磷乘积、校正血钙、校正钙磷乘积、OSTA指数均低于对照组(P<0.05)。Logistic回归分析表明,血清钙、磷、钙磷乘积、校正血钙、校正钙磷乘积及OSTA指数升高是老年OVCF的保护因素。ROC曲线结果显示,血清钙磷乘积、校正钙磷乘积及OSTA对老年OVCF诊断的AUC值分别为0.810、0.772、0.659,且血清钙磷乘积及校正钙磷乘积预测老年OVCF的效能优于OSTA指数。结论 血清钙磷乘积及校正钙磷乘积对老年OVCF的发生具有预测价值。

甲状旁腺功能减退症-妊娠哺乳期-血钙波动

本文报告一例甲状旁腺功能减退症病例,患者平素病情稳定,妊娠哺乳期血钙出现较大波动。妊娠期血钙下降、尿钙排泄增加,需增加药量。哺乳期血钙增加,出现高钙血症,需停用活性维生素D;至哺乳17个月时药物剂量仍低于孕前水平。本文对妊娠哺乳期母体钙稳态的生理变化进行总结,并对甲状旁腺功能减退症患者妊娠哺乳期的钙稳态变化及相关机制进行文献复习。

NT-proBNP、PCT及血清钙与胆管结石继发急性梗阻化脓性胆管炎病情程度的相关性

目的探讨N末端脑利钠肽前体(NT-pro BNP)、降钙素原(PCT)及血清钙与胆管结石继发急性梗阻化脓性胆管炎(AOSC)病情程度的相关性。方法根据术后1周内是否出现脓毒症或脓毒症性休克,将患者分为轻度组(仅继发性AOSC),中度组(AOSC合并脓毒症),重度组(AOSC合并脓毒症性休克)。采用Spearman相关性分析NT-pro BNP、PCT及血清钙与入院24 h AOSC严重程度的关系,用受试者工作特征曲线(ROC)分析三指标对AOSC合并脓毒症的预测。结果入院24 h时,轻、中、重度组NT-pro BNP、PCT水平依次升高,血清钙水平依次降低(P<0.05);Spearman相关性显示,NT-pro BNP、PCT与入院24 h AOSC严重程度呈正相关(r=0.600、0.615,P<0.05),与血清钙呈负相关(r=-0.516,P<0.05)。ROC曲线显示,NT-pro BNP、PCT及血清钙对AOSC合并脓毒症预测AUC为0.905,对AOSC合并脓毒症性休克预测AUC为0.882,三者联合预测效能高于单项检测。结论NT-pro BNP、PCT与胆管结石继发AOSC病情程度呈正相关,与血清钙呈负相关,三指标联合检测对AOSC病情进展程度具有较高的预测价值。

Effect of Electrolyte Disturbance on Prognosis of Patients with Traumatic Brain Injury

Objective:To investigate the prognostic value of electrolyte disturbances in patients with traumatic brain injury(TBI).Methods:Cases of TBI patients admitted to the Department of Neurosurgery at Dezhou Second People’s Hospital from September 2015 to September 2021 were analyzed to examine the impact of electrolyte disturbances on patient prognosis and to establish a risk prediction model.Results:Patients with electrolyte disturbances had poorer prognoses,with serum sodium and serum calcium levels significantly affecting the outcomes of patients with traumatic brain injury.Conclusion:Serum sodium and calcium levels may serve as potential prognostic markers in patients with traumatic brain injury.

阿仑膦酸钠辅助碳酸钙D3片对老年2型糖尿病合并骨质疏松患者的临床效果观察

目的:探讨2型糖尿病合并骨质疏松老年患者应用阿仑膦酸钠辅助碳酸钙D3片治疗的临床效果。方法:抽签法将2021年2月至2022年2月期间我科老年2型糖尿病合并骨质疏松患者95例分为两组,均采用控制血糖等基础治疗外,对照组47例口服碳酸钙D3,观察组48例口服碳酸钙D3加阿仑膦酸钠,持续治疗1 y后,采用临床疗效、血清激素水平、骨密度、骨代谢指标及药物安全性评价两组治疗临床效果。结果:观察组总有效率93.75%(45/48)高于对照组的总有效率78.72%(37/47),与治疗前比较,两组25-羟基维生素D、Wards三角区、股骨粗隆、股骨颈、腰椎L1~4部位骨密度均明显增加,甲状旁腺素、β-胶原片段、骨钙素及骨碱性磷酸酶水平均明显下降(P<0.05),其中观察组变化值均较对照组更为显著,差异有统计学意义(P<0.05)。两组不良反应无明显差异(P>0.05)。结论:2型糖尿病合并骨质疏松老年患者应用阿仑膦酸钠辅助碳酸钙D3片口服治疗,可有效调节其血清激素水平、骨密度和骨代谢指标,安全且疗效较好。