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Objective@#To investigate the clinical significance of detection of urine renal injury biomarkers in children with primary nephrotic syndrome (PNS).@*Methods@#Seventy-nine children with PNS at the Department of Nephrology, Tianjin Children′s Hospital were enrolled from January to December 2016, who were given sufficient glucocorticoid for 4 weeks.According to the response to glucocorticoid, they were divided into steroid-sensitive nephrotic syndrome (SSNS) group (63 cases) and steroid-resistant nephrotic syndrome (SRNS) group (16 cases), then they were divided into simple type and nephritic type according to diagnostic criteria.Urinary levels of microalbuminuria (MAlb), transferrin (TfR), retinal binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), α1-microglobulin (α1-MG) and β2-microglobulin (β2-MG) were measured in the children before and after treatment, and the data were analyzed by the statistical method.@*Results@#Before treatment, the levels of RBP, NAG, α1-MG and β2-MG in the SSNS group [0.91(1.80) mg/L, 28.00(31.5) U/L, 8.40(14.2) mg/L, 0.45(0.35) mg/L]were lower than those in SRNS group[3.94(4.82) mg/L, 37.10(18.20) U/L, 11.10(21.42) mg/L, 0.66(1.41) mg/L], and the differences were statistically significant (all P<0.05); After treatment, the MAlb, TfR, RBP, NAG, α1-MG, β2-MG in the SSNS group [14.10(5.60) mg/L, 0.40(1.60) mg/L, 0.26(0.38) mg/L, 7.90(9.10) U/L, 2.00(4.40) mg/L, 0.27(0.35) mg/L] were lower than those before treatment[MAlb: 1 704.00(1 995.60) mg/L, TfR: 142.10(81.90) mg/L] and those after treatment in the SRNS group[557.90(1 857.17) mg/L, 117.40(102.10) mg/L, 4.19(5.15) mg/L, 38.80(32.43) U/L, 10.85(16.60) mg/L, 0.63(0.91) mg/L], and the differences were statistically significant (all P<0.05). However, before and after treatment, except for MAlb[before treatment: 2 258.75(2 028.43) mg/L], the indicators in the SRNS group were not significantly improved.Before treatment, the RBP in the SRNS group was significantly higher than that in the SSNS group in children with simple type PNS, and the RBP, NAG, α1-MG and β2-MG in the SRNS group were significantly higher than those in the SSNS group in children with nephritic type PNS (all P<0.05). According to receiver operating characteristic curve, there were obvious differences in the urinary levels of RBP, NAG and β2-MG, and area under curve(AUC) was 0.858, 0.837 and 0.679, respectively, all of which were <0.9, so the value of diagnosis was not high.Logistic regression analysis was used to identify RBP and NAG as influencing factors and to establish a model.Through the combined detection of these two indicators, the diagnostic value was higher (AUC was 0.956), and when the diagnostic sensitivity was 93.8%, the specificity could reach 82.5%.@*Conclusions@#Urinary RBP, NAG, α1-MG and β2-MG can early reflect tubular interstitial impairment in children with PNS, especially SRNS.Combined detection of RBP and NAG has certain value in predicting the efficacy of glucocorticoid.
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Objective To study the diagnosis value of serum retinol binding protein (RBP),cystatin C(Cys C) and β2 microglobulin (β2-M) in early renal injures of gcstational diabetes mellitus (GDM) patients.Methods 85 case of GDM pregnant women admitted to Shiyan Maternal and Child Health-Care Hospital from Jan.2009 to Jan 2015 were chosen as research objects,and were divided into simple diabetes group (35 cases),micro proteinuria group (30 cases) and massive proteinuria group (20 cases) according to the urinary albumin excretion rate (UAER),while 30 cases of healthy pregnant women were recruited randomly during the same period as control group.The 24h urine protein,serum RBP and renal function indicators [blood urea nitrogen (BUN),creatinine (Ser),Cys C and β2 M],the positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C,β2-M of the four groups were compared.Results The 24h urine protein in simple diabetes group,micro proteinuria group and massive proteinuria group were significantly higher than that in the control group (t=3.91～ 16.33,all P＜0.01),the difference between the 3 groups were statistically significant (t=6.78～ 16.94,all P＜0.01).The levels of BUN,Scr,Cys C,β2-M and RBP in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (t=3.68 ～ 18.54,all P＜0.01),there were significant difference in above indexes between micro proteinurine group and massive proteinuria group (t=4.70～ 10.87,all P＜0.01).The positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C and β2-M in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (x2 =20.27～38.57,all P＜0.01).There was no significant difference in the positive rates between micro proteinuria group and massive proteinuria group (x2 =0.62～0.93,all P＞0.05).The positive rate of combined detection of the three indicators was higher than that of the single detection in the same group (x2=3.97～6.65,P＜0.05 or P＜0.01).Conclusion The detection of serum Cys C,RBP and β2-M has a high clinical value in the diagnosis of early renal damage in patients with GDM.The positive rate of combined detection of 3 indexes was higher than that of single index.
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Objective To investigate the clinical application of serum retinal binding protein and cystain C determination in hem-orrhagic fever with renal syndrome(HFRS).Methods The serum concentrations of RBP,CysC,Urea and Cr were detected for 124 patients with HFRS(patients group)and 100 healthy people who underwent physical examination during the same period(control group),the date were analysed by SPSS19.0 software.Results The concentrations of RBP,CysC,Urea and Cr increased signifi-cantly in febrile stage of HFRS,arrived at peak in oliguria stage,and then declined gradually,there were statistically significant differences between each stage and negative control stage(P <0.05).RBP and CysC had a good positive correlation with Urea and Cr,the correlation coefficient between RBP and Urea or Cr were 0.826 and 0.892,respectively(P <0.05)while with CysC were 0. 841 and 0.924,respectively(P <0.05).The positive rates of RBP,CysC,Urea,Cr in febrile stage were 85.48%,95.16%,69.35%, 83.06% respectively,while in convalescent stage were 67.74%,74.19%,46.77% and 58.06% respectively.Conclusion RBP and CysC are good indicators for diagnosing HFRS,which also have good correlation with Urea and Cr,which are recommended in clini-cal application.
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Objective To investigate the preparation of the internal quality controls for urinary retinal binding protein(RBP)de-tected by the latex enhanced immunoturbidimetry assay and its performance evaluation.Methods The urine specimens from the pa-tients with nephropathy and healthy people with physical examination were collected,centrifuged by 3 500 r/min for removing sedi-ment,urinary RBP levels were adjusted to the low value for healthy population and the high value for the patients with nephropa-thy;then conducted the anticorrosion,packed and stored at -20 ℃.By using the urinary RBP commodity kits,the latex enhanced immunoturbidimetry was adopted to detect urinary RBP,the intra-batch and inter-batch precisions were detected respectively.Then the high and low values of self-prepared controls were detected once per day for consecutive 5 months.The data were processed by using the SPSS13.0 software.Then the performance of self-prepared urinary RBP quality control was evaluated.Results The intra-batch imprecision of 2 levels of urinary RBP controls was less than 5% and the inter-batch imprecision was less than 6%;the stable period by storage at -20 ℃ was at least 5 months,the imprecision had no statistical difference within 5 months(P >0.05).Conclu-sion The high and low levels of self-prepared urinary RBP quality controls can meet the operating requirements of internal quality controls.
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Objective To investigate the clinical significance of retinal binding protein (RBP) and Cystatin C in blood and urine in patients with chronic kidney disease (CKD).Methods One hundred and twenty-one patients with CKD in Nephrology Laboratory of The People's Hospital of Xinjiang Uygur Autonomous Region from Aug.2012 to Jan.2013 were served as the case group.Sixty healthy check-up people were considered as control group.Enzyme linked immunosorbent assay was used to detect RBP and Cystatin C in urine,and the immune turbidimetry testing was applied to detect RBP and Cystatin C in blood.The receiveroperating characteristic (ROC) curve and area under curve (AUC) were applied to evaluate the sensibility and diagnostic value of indexes in CKD.Results The positive rate of RBP,Cystatin C in urine and blood were 89.6％,92.6％,52.5％,59.5％ respectively of 12 patients in case group,higher than those in control group (all value were 0,P ＜0.001).ROC curve showed that the sensitivity of urine RBP and Cystatin C were higher than that in blood of case group.AUC of RBP,Cystatin C level in urine and blood were 0.915,0.974,.655,and 0.623 respectively.And 95％ confidence interval were 0.877-0.954,0.956-0.992,0.575-0.736,0.543-0.702 respectively,and the differences are statistically significant (P ＜ 0.001).Conclusion The sensitivity of urine cystatin C and RBP are significantly higher than that in blood,which might be served as a diagnostic marker of CKD and can provide important basis for clinical diagnosis.
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ObjectiveThrough different disease period the serum β2-microglobulin (β2-MG),Retinal binding protein (RBP) and Cystatin C (Cys-C) joint test,to evaluate the clinical value of the combination detection of early diagnosis of acute kidney injury (AKI).MethodsOur choice in March 2011 to February 2012 in the same period and 88 patients with AKI physical examination in 63 cases,in the new HITACHI7600-020 automatic biochemistry analyzer and into test sample β2-MG,RBP and Cys-C content.ResultsThe patients with AKI of serum β2-MG,RBP and Cys-C compared with the control were significantly increased,the differences were significant ( P ＜ 0.05 or P ＜0.01 ).ConclusionSerum β2-MG,RBP and Cys-C are sensitive idicators in early diagnosis of AKI,three united detection help early diagnosis AKI,clinical doctors can provide reliable accurate valuable diagnostic basis for guidance.
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Objective To survey the serum level changes of retinal binding protein 4(RBP4)in newly diagnosed type 2 diabetes,and to explore related factors of RBP4 level.Methods According to body mass index(BMI),95 newly diagnosed type 2 diabetes in Beijing Hospital from April to October of 2002 were divided into obese-diabetic group(BMI≥25),normal-weighted diabetic group(BMI