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Objective:To evaluate the proper blood collection time and calculation formula by measuring the iohexol plasma clearance as a representative of glomerular filtration rate at the same time of routine enhanced computed tomography (CT) examination.Methods:The prospective study method was applied, and 9 subjects with normal renal function, who admitted in Civil Aviation General Hospital from September 2018 to June 2019, were included. A single bolus of a standard dose (5 ml) (iodine concentration: 350 mgI/ml) was injected. The concentration of iohexol was measured from heparin plasma at fasting state of the subject and at nine different times after the injection, respectively. More than 24 hours after the injection of the standard dose, an enhanced CT-level dose (50 ml) of iohexol was injected to the subject and the concentration of iohexol was measured at similar time points as the standard dose. Using a multi-point method of a standard dose as the standard, the clearance rate was calculated by three kinds of formulas including Groth and Aasted formula, Jacobsson formula and Fleming formula with the single-point method to assess iohexol plasma clearance at 0.5 to 8.0 hours post injection of enhanced CT-level dose. The correlation consistency and accuracy of the multi-point method and the single-point method, as well as the dual-point method and the single-point method were compared, and the proper blood collection time and calculation formula of the single-point method at regular enhanced CT-level dose were evaluated. The correlation between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed using Pearson correlation coefficient; the consistency between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed by bias using mean±standard deviation ( SD) and 95% confidence interval ( CI) of mean difference and so on. We assessed the concordance of GFR using GFR±5% ( P5),±10% ( P10) and 1±30% ( P30) intervals. Results:Compared with the multi-point method, the mean deviation of iohexol plasma clearance obtained by the three single-point methods increased gradually from 5 hours after the injection of iohexol ( P<0.05). Compared with the multi-point method, only 3 h results, which was calculated by the Groth and Aasted formula, reached a P value greater than 0.05, a correlation coefficient of 0.938, a mean deviation of (-5.2±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30,77.8% corresponding to P10, and 66.7% corresponding to P5; the 2, 3 and 4 hours results, which was calculated by the Jacobsson formula, reached P values greater than 0.05, when the blood collection time was 3 hours, the correlation coefficient was 0.938, and the mean deviation was the smallest, which was (1.5±6.2) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 88.9% corresponding to P10, and 66.7% corresponding to P5; the 2 and 3 hours results, which was calculated by the Fleming formula, reached P values greater than 0.05, when the blood collection time was 2 h, the correlation coefficient was 0.956, and the mean deviation was the smallest, which was (-4.5±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 77.8% corresponding to P10, and 55.6% corresponding to P5,Compared with the dual-point method, when Groth or Aasted formula was used, the mean deviation was the smallest at 3 hours, which was (-5.3±5.7) ml·min -1·1.73 m -2; when Jacobsson formula was used, the mean deviation was the smallest at 2 hours, which was (1.6±1.6) ml·min -1·1.73 m -2; when Fleming formula was used, and the mean deviation was the smallest at 2 hours, which was (-4.6±4.0) ml·min -1·1.73 m -2. Conclusion:At a regular enhanced CT-level dose, one blood collection can accurately measure the glomerular filtration rate, the proper time for blood collection can be 3 hours after iohexol injection, and the appropriate calculation formula can be Jacobsson formula.
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Calcium calculi account for about 80% of urolithiasis with high incidence and recurrence rate. Recurrent urolithiasis increases the risk of hypertension and chronic kidney disease. Comprehensive metabolic evaluation is of paramount importance for the prevention of calcium calculi. With deepening of the study on the pathogenesis of calculi, we find crystallization inhibitors, inflammation and oxidative stress molecules play an important role in the formation of calculi, and susceptibility gene sites of urinary calculi are identified in succession. These may be used as novel markers for the prevention and evaluation of urinary calculi. Models that predict the risk of kidney stone recurrence can help warn people at high risk.
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Objective:To report a Chinese family with a novel ABCD1 gene mutation at c.332T>G (p.V111G) site and discuss its clinical characteristics and molecular mechanism.Methods:The clinical data, laboratory examination, and imaging examination results were analyzed to make the clinical diagnosis of a middle-aged onset patient from the First Affiliated Hospital of Zhengzhou University in May 2017. High-throughput sequencing was used to discover a novel ABCD1 gene mutation. Sanger sequencing was used to find out whether other family members contain the same ABCD1 gene mutation. The pathogenicity of this mutation was explored by protein structure prediction and pathogenicity analysis. Adrenoleukodystrophy protein-green fluorescent protein (ALDP-GFP) and ALDP-GFP (V111G) plasmids were constructed and human embryonic kidney 293 cells were transfected, then immunofluorescence and Western blotting were used to explore the molecular mechanism of this mutation (completed in Henan Provincial People′s Hospital).Results:The proband (a 39-year-old male) was diagnosed as adrenomyeloneuropathy, a subset of X-linked adrenoleukodystrophy, with a novel heterozygous missense mutation in the ABCD1 gene at c.332T>G (p.V111G) site, and his mother and two daughters were all carriers. Protein structure prediction and pathogenicity results suggested that this mutation is pathogenic. Overexpression of ALDP-GFP (V111G) in the human embryonic kidney 293 cells resulted in a significant decrease in the expression levels of ALDP and the abnormal localization from the peroxisomal membrane to the cytoplasm, accompanied by significant down-regulation of LC3-Ⅱ/LC3-Ⅰ and beclin-1.Conclusion:c.332T>G (p.V111G) is a novel pathogenic mutation in the ABCD1 gene, which causes adrenomyeloneuropathy by impairing autophagy.
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Objective:The results of the two interferon-gamma release assay tests were compared, so as to provide reference for the laboratory to choose the detection method.Methods:Double blood samples of 96 suspected TB patients hospitalized in Civil Aviation General Hospital from July 2018 to December 2019 were collected, providing for TB specific antigen stimulation test by QIAGEN kit and Autobio kit respectively. ELISA and chemiluminescence were used to detect interferon-gamma, and the results were determined according to the manufacturer′s instructions. Based on the clinical or bacteriological evidence for diagnosis of tuberculosis, the consistency of the two kits was compared, and the diagnostic efficacy of tuberculosis was evaluated. At the same time, 60 samples of plasma stimulated by TB specific antigen in QIAGEN kit were randomly selected to detect interferon-gamma by ELISA and chemiluminescence respectively, and the consistency between the two interferon-gamma detection systems was compared. The Kappa coefficient were used to measure the consistency of the results. The ordinary linear regression and Bland-Altman plots were performed to show the differences of IFN-γ data between assays.Result:In 96 samples, the sensitivity and specificity of QIAGEN test were 81.82% (18/22) and 74.32% (55/74), and that of Autobio test were 72.73% (16/22) and 70.27% (52/74), respectively. The results of the two systems were consistent, Kappa value was 0.847, P<0.05. The area under ROC curve of QIAGEN test for diagnosis of tuberculosis was 0.807 (95% confidence interval: 0.702-0.911), while that of Autobio test was 0.765 (95% confidence interval: 0.640-0.889). Comparing the results of two systems for detecting interferon-gamma in the same plasma, the results of two systems were in good agreement ( R2=0.97, P<0.05); but there were significant differences in the levels of interferon-gamma in the same patient sample after stimulation with different negative and positive tubes ( R2=0.41, P<0.05). Conclusion:The results of γ-interferon release assay test of Autobio system and QIAGEN system are in good agreement, and the results of γ-interferon release assay test of the two systems are also in good agreement. Different amount of antigen coating, titer and test system may be responsible for the different release of interferon-gamma.
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Objective:To establish a method for iohexolquantification based on high performance liquid chromatography (HPLC) to measure the concentration of blood iohexolafterlow dose and contrast dose injection.Methods:Weperformed the method establishment and evaluation in this study. A HPLC-UV system (high performance liquid chromatography plus ultraviolet detector) was used to establish the method. The linearity, imprecision, recovery rate, limit of detection, lower limit of measuring interval and carryover of the method were evaluated. The stability of iohexol under different storage conditions, the differences of iohexolbetween serum and plasma concentrations, and the drug′s interference with the method were evaluated preliminarily. The single sample t test was used for the stability test of iohexolin samples, and the Wilcoxon symbol rank sum test was used for the comparison of iohexol concentrations between serum and plasma.Results:The linearity of iohexol ranging from 5 to 250 μg/ml ( R2=0.999 9) and from 250 to 4 000 μg/ml ( R2=0.999 8); when the concentration of iohexol was 20-3 000 μg/ml, the intra-and inter-assay coefficient of variation were 1.63% to 3.31% and 2.10% to 4.09%, respectively. The recovery rate was 94.17% to 106.13%; the limit of detection was 1 μg/ml and the lower limit of measuring interval was 5 μg/ml; it shows no carryover at the concentration of iohexol 4 000 μg/ml; after 48 hours at room temperature storage, the relative deviation of the concentration was -5.55% to +5.58%, after repeated freeze-thaw cycles 6 times at -80 ℃, the relative deviation of the concentration was -1.28% to+6.68%; there was no statistic difference between the measurement results between serum and plasma; valsartan and other drugs did not interfere with this methodsignificantly. Conclusion:Awide-range HPLC method for iohexolquantification has been established, which can stably and accurately detect the blood concentration of iohexol at low and contrast doses.
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The glomerular filtration rate, which reflects the filtration function of kidney, is defined as the amount of plasma filtered from the kidney per unit of time. It cannot be measured directly, but only indirectly by the clearance rate of substances with specific properties. At present, the estimated GFR based on creatinine and(or) cystatin C has been gradually popularized, and its estimated formulas are all mathematical fitting formulas based on measured GFR. Different estimated formulas refer to different GFR measurement methods, which may lead to differences in GFR estimation. In this paper, several factors of GFR measurement by the clearance rate of substances, including material characteristics, clearance types, blood collection times and time points of plasma clearance, and comparison of different GFR measurement methods, are reviewed, and the new GFR measurement materials are briefly introduced. The plasma clearance of iohexol has a good application prospect because of its operability, easy standardization and promotion. Metabolomics has the potential to discover new markers for the measurement of GFR.
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Objective:To investigate the role and influencing factors of case design in PBL teaching.Methods:Thirty-two six-year-program undergraduates from the Department of Medicine of Peking University in batch 2014 and batch 2015 were selected as the subjects. PBL teaching was used in the practice class of experimental diagnostics. The feedback effects of four times PBL courses were analyzed by collecting questionnaires for teachers, students, and supervisors. The data obtained from the five-point questionnaire and the question-and-answer questionnaire were analyzed by one-way ANOVA and statistics respectively. Then the problems in case preparation process are discussed and the experience of case design is summarized. SPSS 13.0 was used in this study.Results:The 5-point questionnaire showed that the average score of anemia PBL course was the highest among students' self-evaluation and mutual evaluation of teachers and students (4.84 points, 4.79 points), with statistical significance compared with other courses ( P<0.05). The question-and-answer questionnaire survey showed that 93.75% of the students generally agreed with the teaching model of anemia cases; 78.13% and 59.38% of the students believed that it was difficult to set up cases of infection and coagulation, which affected the classroom effect; and 50% of the supervisors thinked that the students' level should be taken into account in case design and oral expression should be avoided. Conclusion:Case design is the key to PBL teaching. Summarizing the experience of case design can lay a good foundation for the establishment of PBL teaching database.
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Objective@#To explore the effect of 4R crisis management theory on reducing urinary tract infections in Department of Urology severe craniocerebral injury.@*Methods@#A randomized controlled clinical trial was conducted. From January 2018 to January 2019, 92 patients with indwelling urinary catheter were selected as the study subjects in the Department of Urology, Jiangsu People's Hospital. The control group was given routine nursing of indwelling catheter, while the observation group was given nursing of indwelling catheter with 4R crisis management theory on the basis of the control group. The incidence of catheter-associated urinary tract infections (CAUTI), the occurrence time of CAUTI, the days of indwelling catheter, the days of hospitalization and the urine culture bacteria were observed.@*Results@#The incidence of CAUTI, occurrence time and days of indwelling catheter in the observation group were 8.70% (4/46), (12.417 ± 3.542) d, 5 (3, 12), while those in the control group were 30.43% (14/46), (9.762 ± 2.874) d, 9 (4, 21). There were significant differences in CAUTI incidence, occurrence time and days of indwelling catheter between the two groups (χ2=7.168, t=5.838, Z=5.192, P < 0.01 or 0.05); there was no significant difference in hospitalization days between the two groups (P > 0.05). Seven pathogenic bacteria were detected in urine culture of control group and three pathogenic bacteria were detected in observation group. The number of pathogenic bacteria in observation group was less than that in control group.@*Conlousion@#4R crisis management theory can effectively reduce the incidence of CAUTI, delay the occurrence of CAUTI, shorten the days of indwelling catheter, and reduce the pathogenic bacteria in urine culture, which is worthy of clinical application.
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Objective To explore the effect of 4R crisis management theory on reducing urinary tract infections in Department of Urology severe craniocerebral injury. Methods A randomized controlled clinical trial was conducted. From January 2018 to January 2019, 92 patients with indwelling urinary catheter were selected as the study subjects in the Department of Urology, Jiangsu People's Hospital. The control group was given routine nursing of indwelling catheter, while the observation group was given nursing of indwelling catheter with 4R crisis management theory on the basis of the control group. The incidence of catheter-associated urinary tract infections (CAUTI), the occurrence time of CAUTI, the days of indwelling catheter, the days of hospitalization and the urine culture bacteria were observed. Results The incidence of CAUTI, occurrence time and days of indwelling catheter in the observation group were 8.70% (4/46), (12.417 ± 3.542) d, 5 (3,12), while those in the control group were 30.43% (14/46), (9.762 ± 2.874) d, 9 (4,21). There were significant differences in CAUTI incidence, occurrence time and days of indwelling catheter between the two groups ( χ2=7.168,t=5.838,Z=5.192,P<0.01 or 0.05); there was no significant difference in hospitalization days between the two groups ( P >0.05). Seven pathogenic bacteria were detected in urine culture of control group and three pathogenic bacteria were detected in observation group. The number of pathogenic bacteria in observation group was less than that in control group. Conlousion 4R crisis management theory can effectively reduce the incidence of CAUTI, delay the occurrence of CAUTI, shorten the days of indwelling catheter, and reduce the pathogenic bacteria in urine culture, which is worthy of clinical application.
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Objective@#To explore the association between the 21-gene recurrence score (RS) and clinicopathologic characteristics as well as prognosis in patients with axillary lymph node negative, hormone receptor (HR) positive breast cancer.@*Methods@#The clinicopathologic data of 439 early breast cancer patients who underwent 21 gene RS testing was retrospectively analyzed. According to the 21 gene RS, the patients were divided into low risk (295 cases), intermediate risk (111 cases) and high-risk (33 cases) group. The relationship between the 21 gene RS and clinicopathological characteristics, treatment, recurrence and metastasis was analyzed. Univariate and multivariate statistical analyses were used to analyze the risk factors for relapse free survival (RFS).@*Results@#Tumor grade, estrogen receptor (ER), progesterone receptor (PR) and Ki-67 index were significantly different among the 3 risk cohorts (P<0.001 for all). After a median follow-up of 32 months, the recurrence rate in low risk group (3.7%) was significantly lower than that in the intermediate-high risk group (9.0%), the locoregional recurrence (LRR) rate of low, intermediate and high risk group was 2.4%, 6.3% and 9.1%; and the distant metastasis (DM) rate in low risk group was 1.4% and 2.1% in the intermediate-high risk group. Univariate analysis showed RS, ER status and endocrine therapy were prognostic factors for RFS (P<0.05 for all). Multivariate analysis showed that RS was an independent significant predictor for RFS (P=0.04).@*Conclusions@#The 21-gene RS is related to tumor grade, ER, PR and Ki-67 index. RS is an independent risk factor for RFS in patients with hormone receptor positive early-stage breast cancer.
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Objective@#To establish comprehensive laboratory reference intervals for Chinese children.@*Methods@#This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex.@*Results@#In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old.@*Conclusion@#This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.
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Objective To explore the safety and cosmetic effect of nipple-sparing modified radical mas tectomy and immediate tissue expander implantation with single circumaereolar incision.Methods 30 patients were enrolled in Peking Union Medical College Hospital between Jan.2014 and Dec.2015.All the patients were categorized according to surgical incision (single circumaereolar incision group vs double incisions group).Data on clinicopathological parameters,average hospital stay,complications and overall cosmetic effect were retrospectively collected.Data was performed with Chi-square test,Fisher exact test and t-test.Statistical significance was defined as P＜0.05.Results 19 patients were enrolled in single circumaereolar incision group,and 11 patients in double incisions group.There was no significant difference for operation duration (P=0.093) and average hospital stay (P=0.339).After follow-up for 19.1 months,ranging from 8 to 31 months,no patients developed seroma or arm lymphedema.There was no statistical significance between the two groups in terms of sensation in nippleaereolar area (P=0.973),bilateral symmetry (P=0.650) and overall cosmesis (P=0.483).Conclusion single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness,reliable oncological safety and decent cosmetic effect.
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Box-Behnken design-response surface methodology was used to optimize the transformation from chlorogenic acid to neochlorogenic acid.Based on single factor experiments,the experiment design were developed by box-benhnhen central composite design with causal factors of the reaction temperature,time and PH to neochlorogenic acid.The optimum transformation conditions were as follow:reaction temperature at 107℃,reaction time of 60 min,the PH of 4.72.Under the optimum extraction technology conditions,the productivity of neochlorogenic acid was 64.20％.Neochlorogenic acid was isolated and purified.The determination and characterization of neochlorogenic acid was detected by HPLC,1H-NMR,13C-NMR and ESI-MS.The results showed that the content of neochlorogenic acid reached to 98.78％ and the yield of 87.37％.
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Objective To observe the clinical efficacy ofTiaozhong YifeiPrescription combined with Western therapy for treatment of cough variant asthma (CVA) remission. Methods Totally 90 patients with CVA remission were randomly divided into TCM group, Western therapy group and TCM and Western therapy group, 30 cases in each group. TCM group was givenTiaozhong YifeiPrescription, 1 dose per day, morning and evening; Western therapy group was given salmeterol xinafoate and fluticasone propionate powder for inhalation, each 1 suction, 2 times a day, inhalation; a mixture ofTiaozhong YifeiPrescription and xinafoate and fluticasone propionate powder for inhalation was given to TCM and Western therapy group, the same as above, continuous treatment for 12 weeks. TCM syndrome score, EOS, IgE, pulmonary function and safety index were observed in the three groups before and after treatment. The recurrence rate and the number of colds after three-month treatment were observed.Results TCM syndrome scores in the three groups decreased after treatment (P0.05). After treatment, the maximum expiratory flow in TCM and Western therapy groupwas higher than that before treatment and lower than that in the Western therapy group (P0.05). 1 mild adverse reaction was found in the TCM and Western therapy, and no obvious adverse reactions were found in other groups (P<0.05).ConclusionTiaozhong Yifei Prescription has good clinical efficacy for CVA.
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Estimated glomerular filtration rate ( eGFR ) is important for diagnosis and staging of chronic kidney disease ( CKD ) , disease risk evaluation and prediction of prognosis , precise dosing and public health management .Automatic reporting eGFR when creatinine and/or cystatin C is measured could improve the quality of service of clinical laboratory .Here we discussed the clinical significance of automatic reporting of eGFR , the status of automatic reporting of eGFR at home and abroad , and matters needing attention when eGFR was reported by clinical laboratory .Wish eGFR to play a better role in clinical practice .
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Hydrogen evolution from water electrolysis is one of the effective ways to obtain clean hydrogen energy in the future. Pt-based materials are the efficient catalysts in hydrogen evolution reaction, but it is expensive, difficult to recycle, which impedes its application in the development of hydrogen energy and economy. Therefore, it is the key trend to develop efficient non-noble metal electrocatalysts with the aim of providing cost-competitive hydrogen energy. In this review, we highlighted the recent research efforts toward the synthesis of noble metal-free electrocatalysts for the hydrogen evolution reaction ( HER) , mainly focusing on nanomaterial catalysts supported on carbon fiber materials. We reviewed several important kinds of heterogeneous non-noble metal electrocatalysts, including sulfides, selenides, carbides, phosphides, and oxides. In the discussion, emphasis was given to the synthetic methods of these HER electrocatalysts, and the strategies for performance improvement. In addition, this paper also briefly summarized the application of carbon fiber material as substrate in the field of electroanalytical chemistry.
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<p><b>OBJECTIVE</b>To investigate the safety and efficacy of trastuzumab administered concurrently with anthracycline-containing adjuvant regimen for breast cancer.</p><p><b>METHODS</b>It is a prospective, randomized and controlled trial. Participants were randomized to receive trastuzumab administered concurrently or sequentially with anthracycline-containing adjuvant regimen. The primary endpoint was cardiac safety. The second endpoints were disease-free survival (DFS) and overall survival (OS).</p><p><b>RESULTS</b>One hundred and nine breast cancer patients were enrolled and randomized in this trial. Fifty-five participants received trastuzumab administered concurrently with anthracycline-containing adjuvant regimen and 54 patients received trastuzumab administered sequentially with anthracycline. The primary cardiac event was asymptomatic decrease in the left ventricular ejection fraction (LVEF). There was no significant difference between concurrent and sequential groups in cardiac event rates (9.1% vs13.0%, P = 0.556), neither of LVEF values at basline or at 3, 6, 9 and 12 months during trastuzumab treatment (P > 0.05). Four patients (7.3%) in the concurrent group suffered local recurrences or distant metastases, and 6 participants (11.1%) in the sequential group had distant metastases. There was no significant difference between the two groups in DFS (P = 0.724). There was no death in both groups.</p><p><b>CONCLUSIONS</b>Trastuzumab administered concurrently with anthracycline is a safe adjuvant regimen for breast cancer and does not increase cardiac events. Further research is needed to determine the efficacy of this treatment regimen.</p>
Sujets)
Adulte , Femelle , Humains , Adulte d'âge moyen , Anthracyclines , Anticorps monoclonaux humanisés , Protocoles de polychimiothérapie antinéoplasique , Utilisations thérapeutiques , Tumeurs du sein , Traitement médicamenteux , Anatomopathologie , Chirurgie générale , Carcinome canalaire du sein , Traitement médicamenteux , Anatomopathologie , Chirurgie générale , Traitement médicamenteux adjuvant , Survie sans rechute , Études de suivi , Tumeurs du foie , Métastase lymphatique , Récidive tumorale locale , Études prospectives , Débit systolique , TrastuzumabRésumé
Objective To compared two classical rat models of nephrotic syndrome and to provide some reference data to researchers.Methods Thirty male SD rats were randomly divided into control group,puromycin aminonucleoside-induced nephrotic syndrome (PAN) group and adriamycininduced nephrotic syndrome (ADR) group.The body weight,twenty four hour proteinuria level,serum albumin concentration,cholesterol concentration,creatinine and urea concentration were measured.The renal pathology change was evaluated.The drug toxic effects,administration methods and the costs were also compared.Results There was no significant difference in body weight and hair color between control group and PAN group.Compared to control group,the body weight of the rats significantly decreased at day 15 and day 21 in ADR group (P ＜ 0.01),accompanied by epilation and diarrhea.Compared to control group,the 24-hour urinary protein levels increased significantly at day 10 (P ＜ 0.01),day 15 (P ＜ 0.01),and reached the peak level at day 15 (P ＜ 0.01),day 21 (P ＜ 0.01) in PAN group and ADR group respectively.Compared to control group,the serum albumin concentration decreased significantly at day 10 (P＜0.01),and return to normal level at day 15.The serum cholesterol concentration was increased significantly at day 10 (P ＜ 0.01) and return to normal at day 15 in PAN group.Compared to control group,the serum albumin concentration was decreased significantly at day 15 (P＜0.05) and return to normal at day 21 in ADR group.No significant difference of serum creatinine and serum urea nitrogen levels were found among three groups.Compared to control group,the width of foot process increased significantly at day10 (P ＜ 0.01) and day 15 (P ＜ 0.05) in PAN group and ADR group respectively.To successfully induce a nephrotic rat model (per 100 g),the cost of PAN group was 3.1 times of ADR group (578.10 yuan vs 186.94 yuan).Conclusions Nephrotic syndrome can be induced by both PAN and ADR.The administration of PAN via intraperitoneal injection is more convenient as compared to ADR via tail intravenous injection.Compared to ADR,PAN can induce nephrotic syndrome model more rapidly,with more consistent detection index,and less toxic effects,but its cost is more expensive.
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Urinary excretion of albumin indicates kidney damage and is recognized as a risk factor for progression of kidney disease and cardiovascular disease,resulting a widespread clinical utilization of urine albumin measurement.Considerable inter-method difference has been reported for urine albumin,there are no available reference materials and no reference measurement procedures for urine albumin.This review discusses the clinical utilization of urine albumin in recent years,the principles of existing measurement systems and difference of results among systems,and the current status of work about reference materials and reference measurement procedures.
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Objective By investigating precision,linearity and accuracy of 9 commonly urine albumin assay systems (8 of immuno-turbidimetric assays and 1 of immuno-nephlometric assay),and comparing the concordance of measurement results,to elucidate the quality of the existing analytical systems.Methods Referring to Clinical and Laboratory Standards Institute (CLSI) EP15-A2,two mixed urines with U-Alb levels of 20 mg/L and 200 mg/L were made to validate precision; Referring to CLSI EP14-A2,fourty fresh urines were selected to evaluate matrix effect of saline diluted European Reference Materials (ERM) DA 470 and saline diluted urine,also to reflect the variation of measurement results among systems; Referring to EP6-A,saline diluted urines (10 levels) were made to validate linearity; Taking the theoretical concentration of precisely saline-diluted ERM-DA 470 as the target value,accuracy of each assay system was evaluated.Maximal allowable coefficient variation (CV) of ≤ 15％ was taken as the acceptable precision for each assay system,as rccommcnded by International Federation of Clinical Chemistry (IFCC)-and National Kidney Disease Education Program (NKDEP) ; maximum allowable bias of ≤25％ was taken as criteria for accuracy evaluation as used in Proficiency Test (PT) sponsored by College of American Pathologists (CAP).Results At level of micro-albuminuria(20-200 mg/L),all 9 systems total CVs were ≤ 15％ ; No matrix effect or interference were found in saline diluted ERM DA 470 and saline diluted urine.For A,B,E,F,G and I systems,validated linear regions were close to those stated in kit instruction;For C,D and H systems,the lower limits of validated linear region (18.7,3.6 and 12.0 mg/L,respectively) were higher than those stated in kits instruction (0,0.9 and 5.0 mg/L,respectively) ;For B and C systems,the lower limits of validated linear region were close to the upper limits of reference interval stated in kit instruction.When urine albumin was ≤ 12.6 mg/L,A,E,F,G and I systems showed good accuracy,absolute biases at all dilution were below 3 mg/L,D system showed higher positive bias (5.0-14.4 mg/L),B,C and H systems' biases were not evaluated because of high in-batch CV (the CV of B system≥ 18.1％,of C system ≥ 14.5％,of H system ≥ 39.1％); when U-Alb ranged in 25.2-201.0 mg/L,all 8 systems' relative biases were ≤25％,except D systems,which showed an un-acceptable positive bias (15.9％-44.3％).Good concordance among systems' results was present at level of microalbuminuria(20-200 mg/L),with CV among systems ＜ 15％ ;when urine albumin was ＜ 20 mg/L,CV among systems increased as allumin concentration decreased.The main contribution of variation came from B,C and H systems,which lower limits of linearity were relatively high.Conclusions At level of microalbuminuria(20-200 mg/L),except D system,the other 8 systems show good precision and accuracy;at low level of urine albumin(＜20 mg/L,especially ＜ 10 mg/L),precision and accuracy of some systems(B,C and H system) needs to be improved.