Study on the Hook Effect in the Detection of Beta2-Microglobulin with Different Reagents in Fully Automated Biochemical Analyzers

Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.

Lrrk2 R1628P转基因小鼠尿液外泌体诱导帕金森病样病理变化

目的:探讨Lrrk2 R1628P转基因小鼠尿液外泌体能否诱导帕金森病(PD)样病理改变。方法:提取野生型(WT)和Lrrk2 R1628P转基因小鼠尿液外泌体,使用免疫印迹法检测尿液外泌体标记物TSG101和CD81,Y216位点磷酸化糖原合成酶激酶-3β(pGSK-3β-216)表达水平。在C57小鼠纹状体中分别注射WT小鼠(C57-WT组,n=8)和Lrrk2 R1628P小鼠尿液外泌体(C57-Lrrk2组,n=8)。注射前3天,注射后1、3、6个月,利用平衡木、挂线、转棒和旷场实验对小鼠进行行为学分析,免疫组化法分析脑组织中磷酸化α-突触核蛋白(pα-syn)的沉积情况,免疫印迹法检测脑组织中pα-syn的表达。结果:Lrrk2 R1628P小鼠尿液外泌体TSG101和CD81表达水平与WT小鼠比较,差异无统计学意义(P>0.05),pGSK-3β-216表达水平高于WT小鼠(P<0.001)。C57-Lrrk2组小鼠出现PD样行为学表型(P<0.001),皮层、纹状体和黑质中有pα-syn沉积,脑组织中pα-syn表达水平为(0.44±0.06),C57-WT组则无表达(P<0.001)。结论:小鼠纹状体中注射Lrrk2 R1628P转基因小鼠的尿液外泌体能够诱导PD样病理改变。

吉林省某医院成年人尿中邻苯二甲酸二(2-乙基己基)酯的暴露水平及其影响因素

目的评估成年人尿中邻苯二甲酸二(2-乙基己基)酯[di(2-ethylhexyl)phthalate,DEHP]代谢物水平及其影响因素。方法2022年3月本研究纳入吉林省某医院210名成年人,采集晨尿样并通过高效液相色谱串联质谱法测定尿液中5种DEHP代谢物(MEHP、MEOHP、MEHHP、MCMHP和MECPP)的水平。通过Spearman秩相关分析研究对象尿液中DEHP代谢产物浓度之间的关系,采用独立样本t检验比较每种变量不同项目间DEHP代谢产物水平的差异,使用多元线性回归模型分析所选因素与研究对象尿液中DEHP代谢产物水平之间的关系。结果MEHP和MEOHP检出率分别为98.6%和99.5%,MEHHP、MCMHP和MECPP的检出率均为100.0%。MCMHP的中位数浓度最高,为14.45μg/L(14.10μg/g肌酐)。在调整协变量后,主动吸烟与尿液MEOHP(β=-0.151,95%CI:-0.299~-0.004)显著相关;被动吸烟与MCMHP(β=-0.184,95%CI:-0.323~-0.045)、MECPP(β=-0.192,95%CI:-0.332~-0.051)和∑DEHP(β=-0.146,95%CI:-0.291~-0.001)显著相关;塑料水杯的使用与MEHHP(β=-0.147,95%CI:-0.284~-0.009)显著相关;护肤类化妆品的使用频率与MEOHP(β=-0.115,95%CI:-0.297~-0.012)和MEHHP(β=-0.194,95%CI:-0.337~-0.051)显著相关。结论本研究中成年人广泛暴露于DEHP,日常生活中不吸烟及远离二手烟、减少塑料水杯和护肤类化妆品的使用可降低DEHP的暴露水平。

Urine Metabonomic Analysis of Interventions Effect of Soy Isoflavones on Rats Exposed to Di-(2-ethylhexyl) Phthalate

Objective Di-(2-ethylhexyl) phthalate(DEHP) is a ubiquitous environmental contaminant.As an endocrine disruptor,it seriously threatens human health and ecological environmental safety.This study examines the impact of intervention with soybean isoflavones(SIF) on DEHP-induced toxicity using a metabonomics approach.Methods Rats were randomly divided into control(H),SIF-treated(A,86 mg/kg body weight),DEHP-treated(B,68 mg/kg),and SIF plus DEHP-treated(D) groups.Rats were given SIF and DEHP daily through diet and gavage,respectively.After 30 d of treatment,rat urine was tested using UPLC/MS with multivariate analysis.Metabolic changes were also evaluated using biochemical assays.Results Metabolomics analyses revealed that p-cresol glucuronide,methyl hippuric acid,N1-methyl-2-pyridone-5-carboxamide,lysophosphatidycholine [18:2(9 Z,12 Z)] {lyso PC [18:2(9 Z,12 Z)]},lyso PC(16:0),xanthosine,undecanedioic acid,and N6-acetyl-l-lysine were present at significantly different levels in control and treatment groups.Conclusion SIF supplementation partially protects rats from DEHP-induced metabolic abnormalities by regulating fatty acid metabolism,antioxidant defense system,amino acid metabolism,and is also involved in the protection of mitochondria.

Improvement of resolution in 2-D gel analysis by simple pre-treatment of human urine with EDTA

Regardless of thermodynamic stability, less complex proteome than plasma, convenient and noninvasive sampling of urine, reproducibility and comparability of the data among laboratories are challenges for the urine proteome analysis. Pretreatment of urine with 10 mM EDTA in conjunction with desalting methods to remove interfering molecules significantly improved the presentation of urine proteome on 2-D gels. Statistical analysis of the average ratio of the spot numbers on 2-D gels between EDTA-treated and non-treated samples were 1.35 ± 0.167, 1.26 ± 0.091, and 1.24 ± 0.095 for dialysis, ultrafiltration, and desalting column, respectively, with the p-value of 5.85 × 10–6 for the overall comparison. This result came from the fact that EDTA-treated samples showed better resolutions with less streaks and clearer spots on 2-D gels than the control samples. The results suggest that a simple and non-fractionating EDTA-treatment can be employed to the procedures for the high resolution 2-D gel analysis and other urinary proteomic analysis.

Changes of serum β2-MG, Cys C and urine mAlb levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy and their clinical significance

Objective:To investigate the changes of serumβ2 microglobulin(β2-MG),cystatin C(CysC)and urine microalbumin(mAlb)levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy and their clinical significance.Methods Sixty-eight patients with ureteral calculi admitted to the hospital between June 2018 and June 2019 were selected as the observation group.35 volunteers who received physical elimination in the hospital during the same period were selected as the control group.Levels ofβ2-MG,Cys C and urine mAlb in the observation group were compared before and after treatment,and compared with those in the control group.Changes in serumβ2-MG,Cys C and urine mAlb levels and renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr)]in patients with different prognosis in the observation group after treatment were analyzed.The value of serumβ2-MG,Cys C and urine mAlb levels in the diagnosis and treatment of ureteral calculi was analyzed with ROC curve.The correlations between serumβ2-MG,Cys C and urine mAlb levels and renal function indexes were analyzed.Results Serumβ2-MG,Cys C and urine mAlb levels in the observation group before treatment were significantly higher than those in the same group after treatment or those in the control group(P<0.05).Serumβ2-MG,Cys C and urine mAlb levels,BUN and SCr in patients with residual stones were significantly higher than those in patients without(P<0.05).ROC curve analysis showed that the sensitivity and the area under the curve of combined detection of serumβ2-MG,Cys C and urine mAlb levels for evaluating the curative effect of extracorporeal shock wave lithotripsy on ureteral calculi were significantly higher/larger than those of single detection of the three(P<0.05).Partial correlation analysis showed that serumβ2-MG,Cys C and urine mAlb levels were positively correlated with BUN and SCr(P<0.05).Conclusion There are obvious changes of serumβ2-MG,Cys C and urine mAlb levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy.The combined detection of the three indexes is helpful for the early diagnosis of ureteral calculi and the evaluation of renal function after lithotripsy.They can provide reference for protecting renal function in patients with ureteral calculi treated by extracorporeal shock wave lithotripsy.

Twenty-Two-Year Observation on Urinary Cadmium and β_(2)-Microglobulin in Inhabitants after Cessation of Cadmium-Exposure in Japan

Objective: This is an epidemiological survey that was conducted for 22 years to investigate the physical effects on inhabitants who had been exposed to cadmium (Cd) from processing of remnants discharged at the time of copper refinement. It was possible to obtain findings on physical effects 27 years after Cd exposure. Materials and Methods: Of the inhabitants who were 50 years old or younger in 1981 and who were living in the most contaminated area in the Kakehashi River basin, 68 (32 males and 36 females) who underwent all of the 5 screenings during the 22-year period were extracted as subjects. Early morning urine was collected for urinalysis, and Cd and ?2-MG concentrations were determined. Results: 27 years after cessation of Cd exposure, it was shown that urinary Cd concentrations were significantly decreased and urinary ?2-MG concentrations were significantly increased. Conclusion: Once exposed to Cd, it takes about 30 years for the Cd that remains in the body to decrease by half. Once renal tubular dysfunction occurs after Cd exposure, irreversible aggravation is inevitable.

2型糖尿病肾病患者并发肌少症与血清25-羟维生素D3及尿白蛋白肌酐比值的相关性

目的探究2型糖尿病肾病患者并发肌少症与血清25-羟维生素D3[25(OH)D3]及尿白蛋白肌酐比值(UACR)的相关性。方法选取2020年1月~2021年6月河北医科大学第一医院收治的315例2型糖尿病肾病患者作为研究对象,根据是否发生肌少症分为肌少症组(97例)和非肌少症组(218例),分析25(OH)D3及UACR与肌少症的相关性。结果肌少症组25(OH)D3水平低于非肌少症组,UACR水平高于非肌少症组,差异均有统计学意义(P<0.05);肌少症组四肢骨骼肌量指数(ASMI)与UACR呈负相关(P<0.05),与25(OH)D3呈正相关(P<0.05);UACR预测2型糖尿病肾病患者并发肌少症的曲线下面积为0.969(0.955~0.983),截断值为31.180 mg/g(灵敏度为92.8%,特异度为100.0%);25(OH)D3预测2型糖尿病肾病患者并发肌少症的曲线下面积为0.931(0.917~0.945),截断值为25.077 ng/mL(灵敏度为89.7%,特异度为82.1%)。结论2型糖尿病肾病患者肌少症的发生与血清25(OH)D3及UACR密切相关,应注意相关指标的筛查并进行相应的干预。

卡格列净治疗2型糖尿病的疗效观察

目的探讨卡格列净治疗2型糖尿病患者的疗效。方法收集2020年9月至2021年5月收治的2型糖尿病患者72例,按随机数字法分为试验组和对照组各36例,分别给予卡格列净或二甲双胍治疗6月,比较两组治疗前后糖化血红蛋白、空腹血糖、腰围、体重、尿酸、血脂、尿量、24小时尿电解质等。结果治疗6月后,两组空腹血糖、糖化血红蛋白均明显下降,组间比较差异无统计学意义(P>0.05)。治疗6月,试验组体重、体重指数、腰围较基线下降,差异均有统计学意义(P<0.01);但对照组较基线无统计学差异(P>0.05);试验组较对照组体重指数、腰围下降更多,差异有统计学意义(P<0.05)。试验组尿酸(UA)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)较基线改善(P<0.05);对照组LDL-C升高(P<0.05),治疗后试验组UA、LDL-C、TC较对照组低,HDL-C高(P<0.05)。对照组治疗前后尿量及尿电解质变化无统计学意义(P>0.05)。试验组治疗3月时尿量较基线增加,治疗3、6月时尿钠、尿镁及治疗6月时尿磷排泄量增加(P<0.05)。结论卡格列净降糖效果显著,能有效降低体重、减小腰围,降低UA、血脂,可使尿量出现短暂增加,可导致尿钠等尿电解质排泄增加。

老年2型糖尿病患者发生低血糖事件的相关因素分析

目的 探讨老年2型糖尿病患者发生低血糖事件的相关危险因素。方法 选择2019年7月至2021年6月在清华大学附属垂杨柳医院内分泌科就诊的94例老年(年龄≥65岁)2型糖尿病患者,根据动态血糖监测结果进行分组:血糖<3.9mmol/L且持续时间在15min以上的34例患者为低血糖组,余60例患者为无低血糖组。比较两组患者的临床资料,采用多因素logistic回归分析老年2型糖尿病患者发生低血糖事件的危险因素。结果 低血糖组的34例患者中,发生夜间低血糖者占61.8%。低血糖组患者的体重指数、血糖平均值均低于无低血糖组,高密度脂蛋白胆固醇、尿微量白蛋白、尿微量白蛋白/尿肌酐比值、血糖变异系数和平均血糖波动幅度均高于无低血糖组,差异有显著性(P<0.05)。多因素logistic回归分析显示,尿微量白蛋白/尿肌酐比值、血糖变异系数与低血糖事件的发生呈正相关(OR=1.043、1.305);体重指数和血糖平均值与低血糖事件的发生呈负相关(OR=0.815、0.704)。结论 血糖变异系数、尿微量白蛋白/尿肌酐比值、体重指数及血糖平均值是老年2型糖尿病患者发生低血糖事件的独立危险因素。

2型糖尿病或糖尿病肾病患者应用达格列净片治疗后短期尿液生化指标改变研究

目的观察2型糖尿病(T2DM)或糖尿病肾病(DN)患者应用达格列净片治疗后短期尿液生化指标改变。方法选择2020年10月至2021年12月于北京中医药大学东直门医院住院的40例T2DM或DN患者。在接受糖尿病及DN标准化治疗的背景下,测定患者口服达格列净片1周后,尿液生化指标的前后变化。结果治疗1周后,全部患者24 h尿钠、尿氯排泄、尿液阴离子间隙(UAG)及尿尿酸排泄水平显著高于治疗前[(193±57)mmol/24 h比(156±49)mmol/24 h、(170±51)mmol/L比(139±44)mmol/L、(65±22)mmol/L比(55±20)mmol/L、(3039±1233)μmol/24 h比(1540±1053)μmol/24 h],24 h尿肌酐排泄水平显著低于治疗前[(4436±1540)μmol/L比(5378±2366)μmol/L],差异均有统计学意义(均P<0.05);单纯T2DM患者24 h尿钠、尿氯排泄、尿尿酸排泄水平显著高于治疗前[(189±31)mmol/24 h比(136±14)mmol/24 h、(169±29)mmol/L比(122±20)mmol/L、(3447±1223)μmol/24 h比(2757±1129)μmol/24 h],差异均有统计学意义(均P<0.05);DN患者24 h尿钠、尿氯排泄水平显著高于治疗前[(196±70)mmol/24 h比(170±60)mmol/24 h、(171±63)mmol/L比(151±52)mmol/L],24 h尿肌酐排泄水平显著低于治疗前[(4412±1303)μmol/L比(5674±2618)μmol/L],差异均有统计学意义(均P<0.05);单纯T2DM患者和DN患者24 h尿蛋白定量与治疗前比较差异均无统计学意义(均P>0.05)。结论应用达格列净短期可改善患者尿液离子代谢排泄。

Determination of urinary 8-hydroxy-2′-deoxyguanosine by capillary electrophoresis with molecularly imprinted monolith in-tube solid phase microextraction

Urinary 8-hydroxy-2 -deoxyguanosine(8-OHdG) is an excellent marker of oxidative DNA damage.In this study,employing guanosine as dummy template a novel molecularly imprinted(MIP) monolithic capillary column had been synthesized,and that was used as medium of in-tube solid phase microextraction(SPME).Coupled with capillary electrophoresis-electrochemical detection(CE-ECD),the system of extraction and detection of 8-OHdG in urinary sample had been developed.Because of its greater phase ratio combined with conv...

保妇康栓在CO_(2)点阵激光治疗压力性尿失禁中的应用

目的观察保妇康栓在CO_(2)点阵激光治疗压力性尿失禁中的应用效果。方法选取2021年10月至2022年8月在江西省妇幼保健院妇科就诊的60例压力性尿失禁患者为研究对象,根据随机数字表法分为观察组(30例)和对照组(30例),观察组采用CO_(2)点阵激光治疗压力性尿失禁后应用保妇康栓,对照组单纯应用CO_(2)点阵激光治疗压力性尿失禁。比较两组患者治疗前后的国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分、1 h尿垫试验结果。同时比较两组患者的不良反应外阴瘙痒、阴道疼痛、阴道流血、阴道干涩发生情况。结果观察组治疗后的尿失禁次数、尿失禁量少于对照组,对生活的影响评分、ICI-Q-SF总分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后的1 h尿垫试验尿垫重量低于对照组,差异有统计学意义(P<0.05)。观察组的阴道瘙痒、阴道疼痛、阴道流血、阴道干涩发生率低于对照组,差异有统计学意义(P<0.05)。结论保妇康栓可以提高CO_(2)点阵激光治疗压力性尿失禁中的治疗效果,降低不良反应的发生率。

Role of serum β2-microglobulin, glycosylated hemoglobin, and vascular endothelial growth factor levels in diabetic nephropathy

BACKGROUND Diabetic nephropathy(DN)is a common complication of type 1 and type 2 diabetes that can lead to kidney damage and high blood pressure.Increasing evidence support the important roles of microproteins and cytokines,such asβ2-microglobulin(β2-MG),glycosylated hemoglobin(HbA1c),and vascular endothelial growth factor(VEGF),in the pathogenesis of this disease.In this study,we identified novel therapeutic options for this disease.AIM To analyze the guiding significance ofβ2-MG,HbA1c,and VEGF levels in patients with DN.METHODS A total of 107 patients with type 2 diabetes mellitus complicated with nephropathy and treated in our hospital from May 2018 to February 2021 were included in the study.Additionally,107 healthy individuals and 107 patients with simple diabetes mellitus were selected as the control groups.Changes inβ2-MG,HbA1c,and VEGF levels in the three groups as well as the different proteinuria exhibited by the three groups were examined.RESULTS Changes inβ2-MG,HbA1c,and VEGF levels in the disease,healthy,and simple diabetes groups were significantly different(P<0.05).The expression of these factors from high to low were evaluated in different groups by pairwise comparison.In the disease group,high to low changes inβ2-MG,HbA1c,and VEGF levels were noted in the massive proteinuria,microproteinuria,and normal urinary protein groups,respectively.Changes in these factors were positively correlated with disease progression.CONCLUSION The expression of serumβ2-MG,HbA1c,and VEGF was closely correlated with DN progression,and disease progression could be evaluated by these factors.

尿液胰岛素样生长因子结合蛋白-7与金属蛋白酶组织抑制剂-2在脓毒症急性肾损伤中的应用价值

目的分析尿液胰岛素样生长因子结合蛋白-7(IGFBP-7)和金属蛋白酶组织抑制剂-2(TIMP-2)在脓毒症急性肾损伤(AKI)中的早期预测价值。方法选取2020年1月—2021年12月山西省人民医院急诊科监护室收治的脓毒症患者58例,并根据KDIGO的诊断标准分成脓毒症AKI组22例和非AKI组36例。分别在入组后0 h、24 h、48 h、72 h采集患者尿液及血液标本,并检测血肌酐(SCr)与尿IGFBP-7、TIMP-2水平。分析SCr、尿IGFBP-7、TIMP-2与脓毒症AKI的相关性。受试者工作特征曲线(ROC)分析SCr、尿IGFBP-7及TIMP-2在脓毒症早期急性肾损伤中的诊断价值。结果与非AKI组比较,AKI组各时点SCr、尿IGFBP-7、尿TIMP-2水平均升高,差异具有统计学意义(F/P=147.848/<0.001、330.849/<0.001、136.777/<0.001)。SCr与尿IGFBP-7、尿TIMP-2均呈正相关(r/P=0.680/<0.001,0.392/0.002),尿IGFBP-7与尿TIMP-2呈正相关(r/P=0.618/<0.001)。ROC曲线分析显示,SCr、尿IGFBP-7、尿TIMP-2及尿IGFBP-7联合TIMP-2预测脓毒症AKI的曲线下面积(AUC)分别为0.586、0.907、0.738、0.914,尿IGFBP-7、尿IGFBP-7联合TIMP-2优于SCr(Z/P=4.117/<0.001,4.196/<0.001);尿IGFBP-7、尿IGFBP-7联合TIMP-2优于尿TIMP-2(Z/P=2.663/0.008,3.378/0.008)。结论尿IGFBP-7、尿TIMP-2与尿IGFBP-7联合TIMP-2均可以作为早期预测脓毒症急性肾损伤发生的指标,且尿IGFBP-7、尿IGFBP-7联合TIMP-2的预测价值优于尿TIMP-2。

Uamy/Ucr比值及尿胰蛋白酶原-2水平评估急性胰腺炎患者预后的临床价值

目的探讨尿淀粉酶/尿肌酐(Uamy/Ucr)比值及尿胰蛋白酶原-2(TPS-2)水平对急性胰腺炎(AP)患者预后的评估价值。方法选取2019年3月—2021年5月在成都市第三人民医院收治的104例AP患者,根据其预后情况分为存活组(n=71)和死亡组(n=33)。比较两组患者的临床资料,采用化学比色法检测血清钙(Ca^(2+))水平,采用动脉血气分析仪检测动脉血氧分压(PaO_(2))水平,采用酶联免疫法检测Uamy和Ucr水平,采用免疫层析法检测尿TPS-2水平,应用受试者工作特征(ROC)曲线分析Uamy/Ucr比值和尿TPS-2对AP患者预后的预测价值。结果死亡组患者年龄、体质指数(BMI)、合并高血脂、Ca^(2+)和PaO_(2)水平与存活组比较差异有统计学意义(P<0.05);死亡组患者Uamy和Ucr均高于存活组(P<0.05);死亡组患者Uamy/Ucr比值和尿TPS-2阳性率分别为90.91%、93.94%,高于存活组的56.92%、53.52%(P<0.05)。ROC曲线分析显示,Uamy/Ucr比值、尿TPS-2及联合检测预测AP患者死亡的曲线下面积(AUC)分别为0.694、0.702、0.858(P<0.05)。结论AP患者预后与其年龄、血清Ca^(2+)和PaO_(2)水平有关。Uamy/Ucr比值及TPS-2水平对AP患者预后有较高的预测价值。

络风宁2号方对慢性心力衰竭利尿剂抵抗患者的临床研究

目的:观察络风宁2号方对慢性心力衰竭利尿剂抵抗患者的心功能及尿液水通道蛋白2(AQP2)表达的影响。方法:选取2019年1月至2021年1月北京中医医院顺义医院收治的慢性心力衰竭合并利尿剂抵抗患者70例作为研究对象,按照随机数字表法分为对照组和观察组,每组35例。将24 h尿量、血浆氨基末端脑钠肽前体(NT-proBNP)、尿液水通道蛋白2(AQP2)水平以及心力衰竭患者的疗效评价标准作为评价指标,分别于治疗前、治疗2周后进行评估。结果:治疗前2组患者24 h尿量、血浆NT-proBNP、尿液AQP2水平比较,差异无统计学意义(P>0.05)。治疗2周后,与治疗前比较,2组患者24 h尿量、血浆NT-proBNP、尿液AQP2水平均有所改善,差异有统计学意义(P<0.01或P<0.05);治疗后观察组24 h尿量明显高于对照组(P<0.05),NT-proBNP水平、尿液AQP2水平均较对照组下降(P<0.05)。2组总有效率比较,差异无统计学意义(P>0.05),但体现出观察组较优的趋势。结论:络风宁2号方能够增加慢性心力衰竭患者的尿量、减轻水钠潴留状态、改善利尿剂抵抗情况,改善心功能;同时本研究也表明联合监测血浆NT-proBNP及尿液AQP2水平,可作为慢性心力衰竭患者水液失衡的新靶点。

四川短尾鼩雄性信息素2-庚酮诱导雌性发情行为

本研究以四川短尾鼩Anourosorex squamipes为研究对象,首次对劳亚食虫目Eulipotyphla雄性尿液中2-庚酮的通讯功能进行报道。采用气相色谱-质谱联用分析去势雄性四川短尾鼩尿液中的挥发性成分,与正常雄性尿液进行对比,选取消失的化学成分中相对含量最高的作为候选信息素;采用阴道脱落细胞涂布验证候选信息素;将候选信息素对不同动情时期的雌性进行行为选择实验。结果表明:与正常雄性尿液中的132种挥发性化学成分对比,去势雄性尿液中有21种成分消失,其中,2-庚酮相对含量最高;与去势尿液和蒸馏水比较,在正常尿液和2-庚酮处理条件下,雌性的发情比例更高且时间更长;除潜伏期外的6项行为参数在不同动情时期均有显著/极显著的差异。这表明2-庚酮是四川短尾鼩的一种雄性信息素,对同种雌性具有化学通讯功能。本研究为四川短尾鼩信息素作为引诱剂应用于有害动物的防治提供了科学依据。

2型糖尿病患者骨密度变化的相关危险因素分析

目的探讨2型糖尿病患者骨密度年变化率相关的危险因素,为降低2型糖尿病患者骨折风险提供理论依据。方法选取2018年1月—2019年1月在同济大学附属同济医院内分泌代谢科就诊的2型糖尿病患者,符合入选和排除标准后,通过面对面的问卷调查形式收集153名患者的基线临床资料,收集患者血常规、肝肾功能、糖脂代谢相关指标、尿微量白蛋白/肌酐比值、骨转换相关指标,并使用双能X线骨密度仪测定研究对象的骨密度(腰椎、股骨颈和全髋)。将随访患者按照尿白蛋白/肌酐比值(urine albumin creatine ratio,UACR)水平分为3组:对照组(UACR<30 mg/g)、微量白蛋白尿组(30 mg/g≤UACR<300 mg/g)、大量白蛋白尿组(UACR≥300 mg/g),平均随访(1.7±0.7)年,分析各部位骨密度的变化并分析相关危险因素。结果在153名研究对象中,40.5%为老年男性,59.5%为绝经后女性。在老年男性中,股骨颈、腰椎、全髋骨密度年变化率组间均无显著性差异(P>0.05)。在绝经后女性患者中,与对照组相比,大量白蛋白尿组股骨颈骨密度下降最快[-0.71(-3.21-0.41)%vs 1.25(-0.743.61)%,P=0.029],其余部位的骨密度年变化率组间无显著差异(P>0.05)。单因素相关分析提示,绝经后女性患者UACR与股骨颈骨密度年变化率呈显著负相关(r=-0.241,P=0.022),血红蛋白与股骨颈骨密度年变化率呈显著正相关(r=0.244,P=0.020)。多元线性回归分析发现,在校正了性别、糖尿病病程、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、血红蛋白、初次股骨颈骨密度之后,UACR和股骨颈骨密度年变化率并无相关性。但即便校正了性别、糖尿病病程、eGFR、UACR、初次股骨颈骨密度之后,血红蛋白与股骨颈骨密度年变化率仍呈正相关(B=0.064,95%CI:0.0050.122,P=0.032)。结论2型糖尿病患者的血红蛋白水平与股骨颈骨密度下降相关,改善2型糖尿病患者的低血红蛋白水平可能有助于延缓其骨密度的下降。但该结论仍需要在更大样本的前瞻性研究中验证。