透析液的研究及其发展

目前,使用的D-乳酸盐透析液和醋酸盐透析液都是非生理性离子透析液,透析患者常常发生一些毒性综合征。动物实验和临床研究发现,血中D-乳酸水平升高大于3mmol,即出现脑功能损害,血中醋酸盐浓度大于7mmol即可发生一系列并发症。尽管最近常用碳酸氢盐透析液替代醋酸盐,以改善临床症状。但是,所谓碳酸氢盐透析液中仍含有一定量非生理性醋酸盐(4 mmol).因此,对终末期肾衰患者如何选择使用接近生理的透析液是当今临床透析研究的重要课题。本文就作者最近的工作经验,重点综述透析液的研究进展。

碱透析气相色谱法测定蜜饯类食品中甜蜜素的含量

甜蜜素是一种新型的食品甜味剂,其在食品中含量的测定方法文献报道有比色法、薄层层析法、气相色谱法、顶空气相色谱法和高效液相色谱法。我国尚未规定标准测定方法。目前用气相色谱法测定均为酸透析法(下称酸法),此法的不足是试样溶液不能同时用于糖精钠、苯甲酸和山梨酸的测定。

碳酸盐透析的临床研究

醋酸盐透析(Ac-HD)应用于临床已近30年,近年发现部份患者出现'醋酸盐不耐受'现象,心血管不稳定及老年患者更不易耐受。而碳酸盐透析(Bi-HD)较接近于生理,付作用少,易为病者所接受。我们选择我院1984.3～1992.3八年间资料完整的163例终末期肾脏病尿毒症维持性血透Bi-HD104例6278次,Ac-HD 59例4762次进行系统的临床研究。

Environmental cues associated with morphine modulate release of glutamate and γ-aminobutyric acid in ventral subiculum

Objective To investigate whether environmental cues associated with different properties of morphine could regulate the extracellular levels of glutamate and y-aminobutyric acid （GABA） in the hippocampal ventral subiculum, which play a critical role in the reinstatement of drug-seeking behavior induced by environmental cues. Methods Conditioning place preference （CPP） and conditioning place aversion （CPA） models were used to establish environment associated with rewarding and aversive properties of morphine respectively. Microdialysis and high performance liquid chromatography were used to measure the extracelluar level of glutamate and GABA in the ventral subiculum under these environmental cues. Results Exposure to the environmental cues associated with rewarding properties of morphine resulted in a decrease （approximately 11%） of extracellular level of GABA in ventral subiculum, and exposure to the environmental cues associated with aversive properties of morphine resulted in an increase （approximately 230%） of extracellular level of glutamate in ventral subiculum. Conclusion Environmental cues associated with different properties of morphine modulate the release of distinct neurotransmitters in the hippocampal ventral subiculum possibly through different neural circuit.

Sorafenib induced tumor lysis syndrome in an advanced hepatocellular carcinoma patient

A 55-year-old male patient with hepatitis B-related liver cirrhosis was found to have advanced hepatocellular carcinoma.His AFP was initially 9828μg/L and rapidly dropped to 5597μg/L in ten days after oral sorafenib treatment.However,he developed acute renal failure, hyperkalemia,and hyperuricemia 30 d after receiving the sorafenib treatment.Tumor lysis syndrome was suspected and intensive hemodialysis was performed. Despite intensive hemodialysis and other supportive therapy,he developed multiple organ failure(liver, renal,and respiratory failure)and metabolic acidosis. The patient expired 13 d after admission.

Phosphate removal from aqueous solution by Donnan dialysis with anion-exchange membrane

The removal of phosphate from aqueous solution by Donnan dialysis with anion-exchange membrane was investigated.The results show that phosphate could be removed from aqueous solution without supplying external high pressure or electrical potential.Under the conditions of influent phosphate of 2.0 mg/L,counterion(Cl-)concentration of 0.1 mol/L,stirring speed of 500 r/min and phase temperature of 298 K,the removal of phosphate achieves 70.0%.Decreasing counterion concentration has little influence on the removal of phosphate,but phosphate amount in anion-exchange membrane increases significantly.With the increase of stirring speed and phase temperature,the removal efficiency of phosphate greatly is improved.Existing forms of phosphate in aqueous solution affected transport of phosphate and only strong acidic pH of feed solution(pH=3.0)decreases the removal of phosphate.Transport of phosphate is also accompanied by change of pH value of feed solution.In consequence,it might be a promise potential process for phosphate advanced wastewater treatment,especially in the area where high salted nature water can be utilized.

Metformin associated lactic acidosis in Auckland City Hospital 2005 to 2009

AIM： To determine the incidence, clinical characteristics and outcomes of patients with metformin associated lactic acidosis （MALA）.METHODS： Auckland City Hospital drains a population of just over 400000 people. All cases presenting with metabolic acidosis between July 2005 and July 2009 were identifed using clinical coding. A retrospective case notes review identifed patients with MALA. Prescribing data for metformin was obtained from the national pharmaceutical prescribing scheme.RESULTS： There were 42 cases of metabolic lactic acidosis over 1718000 patient years. There were 51000 patient years of metformin prescribed to patients over the study period. There were thirty two cases of lactic acidosis due to sepsis, seven in patients treated with metformin. Ten cases of MALA were identified. The incidence of MALA was estimated at 19.46 per 100000 patient year exposure to metformin. The relative risk of lactic acidosis in patients on metformin was 13.53 （95%CI： 7.88-21.66） compared to the general population. The mean age of patients with MALA was 63 years, range 40-83 years. A baseline estimated glomerular fltration rate was obtained in all patients and ranged from 23-130 mL/min per 1.73 m^2. Only two patients had chronic kidney disease G4.Three patients required treatment with haemodialysis. Two patients died.

Use of hyaluronic acid for sperm immobilisation and selection before intracytoplasmic sperm injection:A systematic review and meta-analysis

AIM:To appraise critically the published randomised controlled trials(RCTs)reporting on the effectiveness of using hyaluronic acid(HA)for sperm immobilisation and selection before intracytoplasmic sperm injection(ICSI).METHODS:Two authors used the PICO Method in order to perform a comprehensive literature search of the standard medical databases in June 2015.Data from the included studies was extracted independently by two authors using a predefined pro-forma.Review Manager(RevM an)was used to calculate the combined outcomes where multiple studies contributed with their results.Risk ratio(RR)with a 95%CI using the Mantel-Haenszel method was calculated for binary data variables.Heterogeneity was measured using the χ2 test and quantified using I2.In case of substantial heterogeneity(P < 0.10 for χ2 test or I2 > 50%)the combined outcome was calculated using the random effects model.The results from the meta-analysis were displayed as forest plots.The guideline of the Cochrane Collaboration was used to assess the risk of bias and it was illustrated as a risk of bias graph.RESULTS:The systematic literature search identified 166 different studies related to sperm immobilisation and selection for ICSI.Eleven RCTs involving 13719 oocyte intracytoplasmatic injections with sperm immobilised and selected using HA or polyvinylpyrrolidone(PVP)were included in this systematic review and metaanalysis.There was low heterogeneity among the included trials(χ2 = 16.86,df = 11,P = 0.11; I2 = 35%).There was no statistical difference between HA and PVP groups in terms of fertilisation rate(RR = 1.01; 95%CI:0.99-1.03; z = 0.75; P = 0.45),good embryos rate(RR = 1.01; 95%CI:0.96-1.06; z = 0.30; P = 0.76),live birth rate(RR = 1.15; 95%CI:0.86-1.54; z = 0.92; P = 0.36),clinical pregnancy rate(RR = 1.04; 95%CI:0.92-1.17; z = 0.62; P = 0.53)and implantation rate(RR = 1.17; 95%CI:0.94-1.46; z = 0.40; P = 0.16).The quality of most of the included studies was moderate to poor because of unclear randomisation technique,inadequate allocation concealment and blinding.CONCLUSION:This systematic review and metaanalysis provides evidence of similar efficiency between using HA or PVP for sperm immobilisation and selection before ICSI.

正常人下呼吸道上皮细胞衬液中含有大量的转化生长因子β

转化生长因子β(TGF-β)是分子量25000道尔顿的蛋白质,是由两个亚基通过二硫键连结而成的同聚体或杂聚体.近来,作者在人肺泡巨噬细胞(AM)基因结构的研究中发现,正常静息状态的AM 能表达TGF-β结构基因和释放调节肺实质细胞生长的TGF-β,从而推论下呼吸道上皮细胞衬液(ELF)中可能含有TGF-β。