Effect of sodium nitroprusside on the microrheological properties of red blood cells in different media

Red blood cell(RBC)aggregation as well as their deformation significantly affects blood microrheology.These processes depend on various factors,one of which is concentration of the nitric oxide,one of the main signaling molecule in the bloodstream.The purpose of this study was to investigate the effect of nitric oxide on the microrheological properties of red blood cells(RBCs)in RBC samples of various media after the addition of nitric oxide donor sodium nitroprusside in vitro.Microrheological properties were measured using laser aggregometer and ektacytometer based on diffuse light scattering and diffraction of laser light on a suspension of RBCs,respectively.The study found that heparin-stabilized blood showed increased RBC aggregation and deformation with sodium nitroprusside concentrations of 100,and 200M,while EDTA-stabilized blood showed slightly decreased aggregation and unchanged deformation.With washed RBCs in dextran solution,the addition of sodium nitroprusside(in the concentrations of 100,and 200M)resulted in decreased aggregation and increased deformation.These-ndings aid in our understanding of nitric oxide's effect on RBC microrheological properties.

Analysis of the relationship between 24-hour sodium and blood pressure and the dietary status based on mobile phone APP in the high-risk population of hypertension in Haikou

Objective:To understand the dietary intake of high-risk population with hypertension in Haikou,and to analyze the relationship between dietary intake and blood pressure,especially the relationship between sodium intake and blood pressure,so as to provide a scientific basis for salt reduction.Methods:A multi-stage cluster sampling 2021 was used from July to December to collect 3-4 cscs from each of the four districts in Haikou.A total of 15 cscs were collected,295 permanent residents aged 55-74 were recruited from 15 community service centers,with 20 eligible subjects from each community.The subjects underwent general physical examination,laboratory tests,and a dietary survey using the self-developed Android phone APP“Nutrition Assistant”(registration number:2021SR1547832).SPSS 21.0 was used 2 for t test,x^(2) test and multiple Regression analysis.Result:In Haikou,69.4%of the subjects had energy intake above energy requirement,and 44.8%had fat intake above the acceptable range of macronutrients.There were only differences in energy,carbohydrate,vitamin B 6 and sodium intake(t=-2.174,-1.990,2.333,-5.442,P=0.031,0.048,0.021,<0.001,respectively).There were significant differences in BMI,family history of chronic diseases,systolic blood 2 pressure and diastolic blood pressure(f value or x^(2) value were 4.260,19.045,139.916,36.864,P value were 0.015,<0.001,<0.001,<0.001,respectively).Multiple Regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure(t=12.964,P<0.001),systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg,respectively.Conclusion:The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced,and the intake of sodium salt was strongly correlated with blood pressure,it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension.

Distinguishing of Abuse Drugs in Urine and Blood Samples of Abusers in Iran

In this study, one hundred urine samples and one hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples referred who addicts in clinics of Welfare Organization, during of detoxification treatment or maintenance treatment were screened for abuse drugs presence. Age ranges of female patients were 35 ± 15 and age range of males patients were 42 ± 18. All patients filled questionnaire and satisfy forms too. All data were analyzed by t-test and were Anowa one way, and P 〈 0.05 was considered significant. The P value of this study was P = 0.000. In this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis and TLC （thin-layer chromatography） is appropriate confirmation method to drug abuse distinguishing. Also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse.

Evaluation of Abuse Drugs and Clinical Laboratory Tests Variations in Whole Blood ＆ Urine Samples of Abusers

In this study, five hundred urine samples and five hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples of addicts in clinics of welfare organization, during detoxification treatment or maintenance treatment were screened for abuse drugs presence. The all of samples were tested through as a view of clinical laboratory methods. Age ranges of female patients were 35 ~ 15 and age range of males patients were 45 ~ 15. All patients filled questionnaire and satisfy forms too. First, all fresh urine and blood samples were examined to confirm presence drugs abuses, depend on their addiction and treatment, so all samples were confirmed by two tests. Then they were examined to other clinical laboratory tests. All data were analyzed by t-test and were Anova one way and two ways of Anova Turkey, and p 〈 0.05 was considered significant. The p-value of this study was p = 0.0001. The results of this study were showed that 4% of abusers had mild increase in hematocrite level and 2% of narcotic drugs abusers had mild lower level of blood sugars than normal range and 4% of participants had increase liver enzymes such ALT （alanine transferase）, AST （aspartat transferase）, ALP （alkaline phosphatease） and 1% of them had renal failure. Although blood level BUN （blood urea nitrogen） and creatinin were examined to evaluation of their renal failure .The results in Tabriz/Iran undrevision of welfare organization clinics were approximately showed that positive results of addiction are in each of urine and blood samples. Because some of abusers directly consumed full long time agonist or partial agonists＇ drugs such as methadone and buprenorphine for their maintenance therapy in clinics. Also doing test on blood samples has high importance in distinguishing and confirmation of drugs abuse in samples. Also in this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis, also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse, and serum levels of some other parameters showed all abusers patients situation such as liver and renal dysfimction through clinical laboratory tests.

Distribution of per-and polyfluoroalkyl substances in blood,serum,and urine of patients with liver cancer and associations with liver function biomarkers

Studies have shown that per-and polyfluoroalkyl substances(PFASs)may be hepatotoxic in animals or humans.However,data on clinical epidemiology are very limited.In this study,21PFASs were determined in patients with liver diseases,with the highest median concentrations detected in the serum sample(26.7 ng/mL),followed by blood(10.7 ng/mL)and urine(5.02 ng/mL).Higher total PFAS concentrations were found in hepatocellular carcinoma(HCC)patients compared to non-HCC patients,with significant discrepancies in serum and blood samples.Besides,significant correlations were also found among PFAS concentrations and age,gender,body mass index(BMI),and liver function biomarkers levels.For example,PFAS concentrations are significantly higher in males than in females;Several serum PFASs concentrations increase with age and BMI,while the serum perfluorohexane sulfonic acid(PFHxS)concentrations are negatively correlated with age.In addition,multiple regression models adjusted for age,gender and BMI found that increased serum perfluorobutane sulfonic acid(PFBS),perfluoroheptane sulfonic acid(PFHpS)and perfluorohexylphosphonic acid(PFHxPA)conentrations are correlated with elevated alkaline phosphatase(ALP),aspartate aminotransferase(AST),and alpha-fetoprotein(AFP)(p<0.05).Our results provide epidemiological support for the future study on the potential clinical hepatotoxicity of PFAS.

Use of sodium bicarbonate and blood gas monitoring in diabetic ketoacidosis: A review

Diabetic ketoacidosis(DKA) is a severe and toocommon complication of uncontrolled diabetes mellitus. Acidosis is one of the fundamental disruptions stemming from the disease process, the complications of which are potentially lethal. Hydration and insulin administration have been the cornerstones of DKA therapy; however, adjunctive treatments such as the use of sodium bicarbonate and protocols that include serial monitoring with blood gas analysis have been much more controversial. There is substantial literature available regarding the use of exogenous sodium bicarbonate in mild to moderately severe acidosis; the bulk of the data argue against significant benefit in important clinical outcomes and suggest possible adverse effects with the use of bicarbonate. However, there is scant data to support or refute the role of bicarbonate therapy in very severe acidosis. Arterial blood gas(ABG) assessment is an element of some treatment protocols, including society guidelines, for DKA. We review the evidence supporting these recommendations. In addition, we review the data supporting some less cumbersome tests, including venous blood gas assessment and routine chemistries. It remains unclear that measurement of blood gas pH, via arterial or venous sampling, impacts management of the patient substantially enough to warrant the testing, especially if sodium bicarbonate administration is not being considered. There are special circumstances when serial ABG monitoring and/or sodium bicarbonate infusion are necessary, which we also review. Additional studies are needed to determine the utility of these interventions in patients with severe DKA and pH less than 7.0.

Sodium nitroprusside injection immediately before balloon inflation during percutaneous coronary intervention

BACKGROUND No reflow or slow flow frequently occurs during percutaneous coronary intervention(PCI)and it is associated with adverse outcomes.Strategies should be undertaken to prevent its occurrence.AIM To observe whether conventional target intracoronary administration of sodium nitroprusside immediately before balloon inflation can reduce the incidence of no reflow and slow flow,which are defined as thrombolysis in myocardial infarction flow grade≤II during PCI.METHODS A retrospective study was conducted in 740 patients with coronary artery disease admitted to Gansu Provincial Hospital of Traditional Chinese Medicine between January 2016 and October 2020.Among them,360 patients receiving sodium nitroprusside immediately before balloon inflation during PCI were enrolled in an experimental group between January 2019 and October 2020 and 380 patients receiving sodium nitroprusside after incident no reflow and slow flow during PCI were enrolled in a control group between January 2016 and January 2019.The occurrence of no reflow and slow flow was compared between the two groups and left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were detected 1 mo after the operation.RESULTS After treatment,the proportion of patients with thrombolysis in myocardial infarction flow grades 0 to II was lower in the experimental group than in the control group(P<0.05).At 1 mo after treatment,LVEDD was lower and LVEF was higher in the experimental group than in the control group(P<0.05).In terms of incidence of adverse cardiovascular events within 1 mo after treatment,in the experimental group,malignant arrhythmia occurred in three patients,intractable myocardial ischemia in three,congestive heart failure in four,and recurrent myocardial infarction in five;one patient died.In the control group,malignant arrhythmia occurred in eight patients,intractable myocardial ischemia in five,congestive heart failure in seven,and recurrent myocardial infarction in 14;two patients died.The incidence of adverse cardiovascular events was 4.4%in experimental group which was lower than that of the control group at 1 mo after operation(9.5%;P<0.05).CONCLUSION Administration of sodium nitroprusside into target vessels immediately before balloon inflation can significantly reduce the incidence of no reflow and slow flow,improve LVEDD and LVEF,and reduce the incidence of adverse cardiovascular events in patients treated by PCI.It is worthy of clinical promotion.

Epigenetics of epithelial Na^+ channel-dependent sodium uptake and blood pressure regulation

The epithelial Na^＋ channel （ENaC） consists of α, β, γ subunits. Its expression and function are regulated by aldosterone at multiple levels including transcription. ENaC plays a key role in Na^＋ homeostasis and blood pressure. Mutations in ENaC subunit genes result in hypertension or hypotension, depending on the nature of the mutations. Transcription of αENaC is considered as the rate-limiting step in the formation of functional ENaC. As an aldosterone target gene, αENaC is activated upon aldosterone- mineralocorticoid receptor binding to the cis-elements in the αENaC promoter, which is packed into chromatin. However, how aldosterone alters chromatin structure to induce changes in transcription is poorly understood. Studies by others and us suggest that Dot1a-Af9 complex represses αENaC by directly binding and regulating targeted histone H3 K79 hypermethylation at the specific subregions of αENaC promoter. Aldosterone decreases Dot1a-Af9 formation by impairing expression of Dot1a and Af9 and by inducing Sgk1, which, in turn, phosphorylates Af9 at S435 to weaken Dot1a-Af9 interaction. MR attenuates Dot1a-Af9 effect by competing with Dot1a for binding Af9. Af17 relieves repression by interfering with Dot1a-Af9 interaction and promoting Dot1a nuclear export. Af17^-/- mice exhibit defects in ENaC expression, renal Na^＋ retention, and blood pressure control. This review gives a brief summary of these novel fndings.

Developing a Questionnaire for Prediction of High Salt Intake Based on Salt Usage Behavior: Analysis from Dietary Habits and Urinary Sodium Excretion in Japan

Salt reduction policies have been implemented throughout the world as well as in Japan. However, most of the current questionnaires for estimating salt intake are apt to be based on empirical evidence. This study was aimed to develop and validate a questionnaire for predicting high salt intake based on salt usage using dietary behaviors that affect salt intake in cooperation with Niigata prefecture, Japan. The study was comprised of 760 participants aged 21 - 79 years (Men%: 49%) living in Niigata. Participants completed a questionnaire about dietary behaviors potentially relevant to salt intake. Second morning voiding urine for estimating dietary salt intake per day was collected on the same day. The relationship of estimated dietary salt intake to answers on the questionnaire was examined using analysis of covariance for age, gender, body mass index, and whether taking medication or not. Ten items on the questionnaire revealed an association with dietary salt intake per day: making oneself gorge on a meal, having ≥2 different staples per meal, having a 1-dish meal, number of simmered dishes per day, variety of pickled vegetables per day, having salt-cured fish eggs per day, quantity of soup consumed when eating noodles, preference for strong-tasting meals, frequency of eating out, and frequency of alcohol consumption.The current study identified 10 dietary behaviors that enabled the development of a salt intake questionnaire for identifying specific dietary behaviors for assessing regions and/or individuals when attempting to encourage salt reduction.

A SIX-YEAR RETROSPECTIVE STUDY ON THE RELATIONSHIP OF SODIUM-LITHIUM COUNTERTRANSPORT WITH BLOOD PRESSURE AND SODIUM SENSITIVITY IN CHILDREN

Red-cell membrane sodium-lithium countertransport (Na+-Li+CT) and sodium sensitivity (SS) were measured in 300 children in Hanzhong.By comparison and retrospective study, the results showed:①In children with higher blood pressure(HBP) and positive rainily history (FH+),Na+-Li+ CT rate was signiricantly higher than that in controls (P<0. 01).②6-year retrospective review of blood pressure evolution, the blood pressure increased degree (ASBP) in children with higher Na+-Li+ CT rate was much greater than that in those with lower one (P<0.05), and at the same time,the percentiles of systolic blood pressure (PSBP) for children with higher countertransport mostly kept rising or kept higher levels during this period.③In children with SS, Na+-Li+ CT rate was increased than that in SR group (P<0. 01),and was correlated to the concentration of intra-erythrocytic Na+ (P= 0.004).These suggest that, as intermediate phenotype of essential hypertension, red-cell membrane sodium-lithium countertransport defect could participate in the regulation of blood pressure and pathogensis or hypertension development in children.

Potential effect of Silybum marianum L. and Cistus ladaniferus L.extracts on urine volume, creatinine clearance and renal function

Objective:To investigate the diuretic and renal effects of Silybum marianum L.and Cistus ladaniferus L.in normal rats.Methods:Four groups of rats were used in each experiment.The first group received water,the second group received Cistus ladaniferus L.extract(100 mg/kg b.wt),the third group received Silybum marianum L.extract(100 mg/kg b.wt),and the fourth group received furosemide(10 mg/kg b.wt).Variables including urine volume,plasma and urine sodium,potassium and creatinine,and creatinine clearance were measured.Two experiments were conducted.A single dose of each intervention was used and the variables were measured during 24 h,and the interventions were given daily for a total of 8 d and the variables were measured during various intervals.Results:The single dose of each plant extract increased urine volume at all-time intervals and increased urine sodium and potassium excretion without affecting plasma sodium and potassium(P<0.05).On the day 8 after daily administration,the plant extracts induced a significant diuresis and natriuresis without affecting serum electrolytes(P<0.05),while furosemide caused hypokalemia.Both plant extracts significantly increased creatinine clearance(P<0.05).Conclusions:Silybum marianum L.and Cistus ladaniferus L Increase creatinine clearance and have a significant diuretic effect without affecting serum electrolytes.Silybum marianum L.is more potent than furosemide or Cistus ladaniferus L.

Association of a Tobacco-specific Nitrosamine Carcinogen with Urinary Cotinine,Urinary Sodium Excretion,and Total Energy Intake in Adolescents and Children

This study investigated the association of a tobacco-specific nitrosamine carcinogen,4-(methylnitrosamino)-1-(3-pyridy1)-I-butanol(NNAL)with urinary cotinine(uCot),urinary sodium(uNa)excretion,systolic blood pressure(sBP),and total energy intake in adolescents and children in relation to the subjects'age.A total of 790 subjects aged 6-19 years were evaluated.NNAL,uCot,corrected NNAL(cNNAL),the NNAL/uCot ratio,uNa,sBP,and nutrient intake were measured.A strong association between uCot and cNNAL was observed in children who were 11 years of age(r=0.881,P<0.001);however,no significant association was noted in adolescents who were 19 years of age.The uNa level was significantly higher(133.9 mmol/L vs.107.8 mmol/L,P<0.001)and sBP was significantly lower(105.3 mmHg vs.110.6 mmHg,P=0.012)in adolescents with elevated NNAL than in those without elevated NNAL.NNAL was significantly higher in subjects with increased uNa excretion than in those without increased uNa excretion.NNAL was positively correlated with uNa(r=0.183,P<0.001)and negatively correlated with sBP(r=0.142,P<0.001).Non-smokers with elevated NNAL/uCot ratios had significantly lower total energy intake than those without elevated NNAL/uCot ratios(1729.0 kcal/day vs.1911.0 kcal/day,P=0.008).The relationship between NNAL and uCot varied according to the subjects'age.NNAL seems to play a role in decreasing sBP by enhancing uNa excretion.Insufficient nutrient intake may contribute to endogenous formation of NNAL in non-smoking adolescents and children.

Changes in urinary excretion of water and sodium transporters during amiloride and bendroflumethiazide treatment

AIM： To quantify changes in urinary excretion of aquaporin2 water channels （u-AQP2）, the sodium-potassium-chloride co-transporter （u-NKCC2） and the epithelial sodium channels （u-ENaC） during treatment with bendrofumethiazide （BFTZ）, amiloride and placebo.METHODS： In a randomized, double-blinded, placebo-controlled, 3-way crossover study we examined 23 healthy subjects on a standardized diet and fuid intake. The subjects were treated with amiloride 5 mg, BFTZ 1.25 mg or placebo twice a day for 4.5 d before each examination day. On the examination day, glomerular filtration rate was measured by the constant infusion clearance technique with 51Cr-EDTA as reference substance. To estimate the changes in water transport via AQP2 and sodium transport via NKCC2 and ENaC, u-NKCC2, the gamma fraction of ENaC （u-ENaCγ）, and u-AQP2 were measured at baseline and after infusion with 3% hypertonic saline. U-NKCC2, u-ENaCγ, u-AQP2 and plasma concentrations of vasopressin （p-AVP）, renin （PRC）, angiotensin Ⅱ （p-ANG Ⅱ） and aldosterone （p-Aldo） were measured, by radioimmunoassay. Central blood pressure was estimated by applanation tonometry and body fuid volumes were estimated by bio-impedance spectroscopy. General linear model with repeated measures or related samples Friedman’s two-way analysis was used to compare differences. Post hoc Bonferroni correction was used for multiple comparisons of post infusion periods to baseline within each treatment group.RESULTS： At baseline there were no differences in u-NKCC2, u-ENaCγ and u-AQP2. PRC, p-Ang Ⅱ and p-Aldo were increased during active treatments （P 〈 0.001）. After hypertonic saline, u-NKCC2 increased during amiloride （6% ± 34%; P = 0.081） and increased significantly during placebo （17% ± 24%; P = 0.010）. U-AQP2 increased signifcantly during amiloride （31% ± 22%; P 〈 0.001） and placebo （34% ± 27%; P 〈 0.001）, while u-NKCC2 and u-AQP2 did not change signifcantly during BFTZ （-7% ± 28%; P = 0.257 and 5% ± 16%; P = 0.261）. U- ENaCγ increased in all three groups （ P 〈 0.050）. PRC, AngⅡ and p-Aldo decreased to the same extent, while AVP increased, but to a smaller degree during BFTZ （ P = 0.048）. cDBP decreased significantly during BFTZ （P 〈 0.001）, but not during amiloride or placebo. There were no significant differences in body fuid volumes.CONCLUSION： After hypertonic saline, u-NKCC2 and u-AQP2 increased during amiloride, but not during BFTZ. Lower p-AVP during BFTZ potentially caused less stimulation of NKCC2 and AQP2 and subsequent lower reabsorption of water and sodium.

Effect of Xuesaitong Combined with Autologous Platelet-rich Gel on Blood Glucose,AT-III,TNF-αand 24-h Urinary Protein Level in Patients with Diabetic Foot

[Objectives]To investigate the clinical effect of different doses of Xuesaitong combined with autologous platelet-rich gel(APG)on patients with diabetic foot(DF).[Methods]90 patients with diabetic foot admitted to our hospital from February 2017 to February 2019 were enrolled in the study.According to the random number table method,the subjects were divided into study group A and B and control group C.Group A was given a low dose of Xuesaitong combined with APG,while group B was given high-dose Xuesaitong combined with APG and group C was treated only with APG.Patients in the three groups were observed and the changes of related indexes were detected.[Results]After treatment,with regard to the three groups,the fasting blood glucose,2-h postprandial blood glucose level,HbA1c,TNF-α,Hcy,blood urea nitrogen(BUN),creatinine(Cr)and 24-h urine protein levels were all decreased,yet AT-III level was increased,and granulation tissue coverage and thickness,wound clearance rate were increased,while the repair time of ulcer surface was significantly reduced.The above indexes were all significantly different(P<0.05).Compared with the control group C,the changes of the indexes in the study group A and B were the same as above,and the difference was significant(P<0.05).Compared with the study group A,the level of AT-III in group B was significantly increased(P<0.05),while TNF-α,Hcy,BUN,Cr and 24-h urine protein levels were significantly decreased(P<0.05).There was no significant difference in the other indexes between groups A and B(P>0.05).[Conclusions]Xuesaitong combined with APG could effectively reduce the blood sugar level of DF patients,improve the clinical indexes,promote wound healing,and the high-dose group had more significant advantages and was worthy of promotion.

CalliSpheres可载药微球动脉栓塞化疗治疗膀胱癌并出血的疗效及安全性分析

目的 探讨CalliSpheres可载药微球动脉化疗栓塞治疗膀胱癌并出血的可行性及安全性。方法 选取接受CalliSpheres可载药微球经导管动脉化疗栓塞(DEB-TACE)治疗的11例膀胱癌并出血患者,采用改良实体瘤疗效评价标准(mRECIST)评价3个月、6个月的治疗效果,并记录患者治疗前后血尿复发情况、血液指标变化、不良反应及并发症发生情况。结果 11例患者均完成介入栓塞治疗,技术成功率100%。肉眼血尿均在术后48~72 h消失。患者首次治疗后3个月和6个月的客观溶解率(ORR)分别为72.73%和63.64%,疾病控制率DCR分别为90.91%和81.82%。随访9个月时11例患者均生存。术后并发症包括膀胱区疼痛8例,恶心、呕吐6例,发热2例,均经对症处理后缓解。未出现异位栓塞等严重并发症。结论 应用CalliSpheres载药微球动脉栓塞化疗治疗膀胱癌并出血疗效显著,安全性好,值得推广。

耐碳青霉烯类革兰阴性菌致泌尿系结石患者并发尿源性脓毒血症6例报告及文献复习

目的探讨泌尿系结石患者耐碳青霉烯类革兰阴性菌(CRGNB)感染致尿源性脓毒血症的临床特点与治疗策略。方法回顾性分析新疆医科大学第一附属医院收治的6例因CRGNB感染致尿源性脓毒血症的泌尿系结石患者的临床数据,结合近几年国内外治疗该疾病的指南和相关文献重点分析其临床感染特征和临床抗感染用药。结果6例患者均为院内获得性感染,具有输尿管支架管置入史及侵入性操作史,均进行细菌培养实验,并检出CRGNB共7株,采用单药或多药联合的治疗方案,经抗感染治疗均好转。其中病例3、4、6依据药敏试验最小抑制浓度(MIC)值选择用药,疗效良好。结论泌尿系结石患者CRGNB感染致尿源性脓毒血症多发于细菌培养阳性、侵入性操作患者,抗感染治疗有效,需根据患者具体情况和细菌耐药性变化灵活调整用药策略,以达到最佳治疗效果。

基于表面增强拉曼光谱的肾结石患者体液代谢谱特点及应用价值

目的分析基于表面增强拉曼光谱(SERS)的肾结石患者体液代谢谱特点,探讨其应用价值,为肾结石患者的筛查工作提供参考。方法纳入福建省立医院泌尿外科确诊的25例肾结石患者(结石组)和25例健康体检者(对照组),采集其血液、尿液样本,利用SERS测量样本光谱,再进行平均谱和差异谱绘制。采用主成分分析结合线性判别分析(PCA-LDA)对归一化数据进行处理。最后采用受试者工作特征(ROC)曲线评估PCA-LDA方法的效能。结果结石组患者的体液(血液、尿液)拉曼光谱与对照组之间存在差异。根据既往报道的拉曼峰暂定分配,推测血浆和尿液中各有11种代谢物与肾结石有关,其中结石组尿液中的磷脂酰肌醇、苯丙氨酸、棕榈酸/脂肪酸等含量高于对照组,而尿嘧啶、糖原等成分的含量低于对照组。结石组患者血浆中的甲基带含量高于对照组,而糖原、磷脂酰肌醇、蛋白质-酪氨酸、苯丙氨酸、棕榈酸/脂肪酸、羟脯氨酸/酪氨酸和脂类的含量低于对照组。结论采用SERS检测可发现肾结石患者的尿液和血液代谢成分与健康体检者存在差异,结合PCA-LDA与ROC分析法可能有助于肾结石患者的筛查。

西维来司他钠联合乌司他丁对ARDS患者炎性反应、血气水平的影响

目的比较西维来司他钠联合乌司他丁对急性呼吸窘迫综合征(ARDS)患者的影响。方法选取2021年5月至2023年5月诊治的202例ARDS患者进行研究,按抛硬币法将所有患者分为A组(n=101例,乌司他丁治疗)和B组(n=101例,西维来司他钠联合乌司他丁治疗)。记录2组患者生命体征(血压、心率、体温、呼吸)、炎性反应[降钙素原(PCT)、内毒素脂多糖(LPS)、溶酶体酶(LE)]、血气指标[氧合指数(PaO_(2)/FiO_(2))、血乳酸(Lac)、活性碳酸酐酶(CA)]、肺功能[肺动态顺应性(Cdyn)、预测性呼气末正压(PEEP)、气道阻力(Raw)]水平及不良反应变化。结果治疗后,2组患者心率、体温、呼吸水平显著降低(P<0.05),而血压水平显著增加(P<0.05),2组患者生命体征指标无显著变化(P>0.05);2组患者PCT、LPS、LE、Lac、PEEP、Raw水平显著降低(P<0.05),且B组低于A组(P<0.05);2组患者PaO_(2)/FiO_(2)、CA、Cdyn水平显著增加(P<0.05),且B组高于A组(P<0.05);2组不良反应无显著差异(P>0.05)。结论西维来司他钠联合乌司他丁治疗ARDS效果显著,可有效改善患者生命体征指标、炎性水平、血气指标和肺功能。

泌尿系统疾病诊断中应用尿液沉渣隐血检验及尿液分析仪的价值

目的探讨尿液沉渣隐血检验及尿液分析仪在泌尿系统疾病诊断中的应用价值,以期为临床早期明确诊断、制订治疗方案提供参考依据。方法选取我院2020年6月至2022年6月就诊的260例泌尿系统疾病患者作为研究对象,入院后均行尿液沉渣隐血检验及尿液分析仪检测,以干化学试带法检验结果为“金标准”,比较尿液沉渣隐血检验、尿液分析仪检测单独、联合检查对红细胞、白细胞阳性诊断结果、诊断效能,并比较其对于不同类型泌尿系统疾病的检出率。结果与尿液沉渣隐血检验、尿液分析仪单独诊断比较,联合诊断对于红细胞阳性诊断灵敏度96.20%、准确度95.38%较高,漏诊率3.80%较低(P<0.05);与尿液沉渣隐血检验、尿液分析仪单独诊断比较,联合诊断对于白细胞阳性诊断灵敏度95.06%、准确度95.38%较高,漏诊率4.94%较低(P<0.05);且联合诊断对肾小球病、肾结石、急性肾炎综合征、肾肿瘤检出率高于尿液沉渣隐血检验、尿液分析仪单独诊断(P<0.05)。结论尿液沉渣隐血检验、尿液分析仪联合应用可有效提高泌尿系统疾病诊断效能,为临床早期诊断、鉴别疾病类型提供参考,以针对性制订治疗方案,改善预后。

小剂量肝素钠与低分子肝素钙对脓毒症治疗作用的对比研究

目的:对比小剂量肝素钠与低分子肝素钙治疗脓毒症的效果。方法:选取2021年10月—2022年10月脓毒症患者100例,随机分为观察组和对照组,每组50例。对比两组患者的治疗效果。结果:对照组弥散性血管内凝血8例(16.0%),观察组弥散性血管内凝血1例(2.0%),观察组临床疗效高于对照组(P<0.05)。随访1个月,观察组病死率低于对照组(P<0.05)。观察组各项凝血指标显著优于对照组(P<0.05)。观察组各项炎性因子水平低于对照组(P<0.05)。两组治疗后急性生理与健康评分(APACHEⅡ)优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。结论:低分子肝素钙相比小剂量肝素钠治疗脓毒症更加可行,可降低并发症发生率,改善短期预后。