Improved GFR estimation by combined creatinine and cystatin C measurements.

Plasma creatinine may not reflect glomerular filtration rate (GFR) especially in the early stages of chronic kidney disease (CKD). Plasma cystatin C (cysC), however, has the potential to more accurately determine early GFR reduction. We sought to improve the creatinine-based GFR estimation by including cysC measurements. We derived a reference GFR from standard dual plasma sampling (99m)Tc-DTPA clearance in a training cohort of 376 randomly selected adult Chinese patients with CKD. We compared reference values to estimated GFR and applied multiple regression models to one equation based solely on cysC, and to another combining plasma creatinine (Pcr) and cysC measurements of the training cohort. The results were validated by testing an additional 191 patients. The difference, precision, and accuracy of the two estimates were compared with the modified Modification of Diet in Renal Disease (MDRD) equation for Chinese patients, and another estimate combining cysC and modified MDRD calculations. The estimated GFR combining Pcr and cysC measurements more accurately matched the reference GFR at all stages of CKD than the other equations, particularly in patients with near-normal kidney function.

[The microscopic observed for cells in mesocarp of part medicinal plant in Citrus L].

OBJECTIVE: To illustrate the microscopic characters of cells in mesocap of some of medicinal plants in Citrus of Rutaceae. METHOD: Microscopic observation and photograph were carried out. RESULT: It has been found that many of pavenchymatous cells are branches. It is spongy tissue that has huge room between cells. The thickening of cell wall is not obvious. The uneven thickness of walls of cells in mesocarp which is reported in the old documents are not found.

[Nursing study of social disability in schizophrenics].

To explore the factors of effect on social disability of schizophrenics and nursing to the schizophrenics, 100 discharged schizophrenics were investigated and studied, with Social Disability Screening Schedule (SDSS) and questionnaire of factors of effect on social disability. The result showed SDSS scores of 53% schizophrenics were over or equal 2, and the social disability were significant positive correlated with patient's age, treatment effect, education, psychosocial factors, compliance, recovery confidence, working chance, and family monthly average income. The result suggested that nursing of three aspect, including mental care, family education, and social support, was benefit for reducing the social disability of schizophrenics.

Predictive models for deposition of inhaled diesel exhaust particles in humans and laboratory species.

Mathematical and computer models of the respiratory tracts of human beings and of laboratory animals (rats, hamsters, guinea pigs) were used to estimate the deposition patterns of inhaled diesel exhaust particles from automobile emissions. The accuracy of these models was tested by comparing the calculated depositions in laboratory animals with actual laboratory data. Our goal was to be able to predict the relation between exposure to diesel exhaust particles and the deposition of these particles in the lungs of humans of various ages. Diesel exhaust particles are aggregates with a mass median aerodynamic diameter of approximately 0.2 micron. Their actual size depends on the conditions under which they are generated. Using an appropriate particle model, we derived mathematical expressions that describe the effects of diffusion, sedimentation, impaction, and interception on the deposition of these particles. Because of their small size, we found that most diesel exhaust particles deposited through diffusion, and that the role of the other mechanisms was minor. Anatomical models of the human lung from birth to adulthood, as well as models of the lungs of laboratory species were formulated mathematically using available morphometric data. We used these lung models, together with the corresponding ventilation conditions of each species, to calculate deposition of diesel exhaust particles in the lungs. Under normal breathing conditions, we calculated that 7 to 13 percent (depending on particle size) of inhaled diesel exhaust particles deposit in the alveolar region of the adult human lung. Although the breathing mode (nose or mouth breathing) did not appear to affect alveolar deposition, increasing the minute ventilation (the number of breaths per minute multiplied by the tidal volume) increased alveolar deposition significantly. The calculated deposition patterns for diesel exhaust particles in younger humans (under age 25) were similar. However, with the exception of alveolar deposition in very young children (under age two), predicted deposition was greater in the lungs of younger humans than in the lungs of humans age 25 or older. For an equal exposure, the surface minute dose (particle mass deposited per minute per unit surface area) of unciliated airways appeared to change profoundly with age. Predicted dose was maximal in the lung models of two-year-old children. At this age, the calculated dose was approximately twice as high as in the mature adult lung. Deposition predictions for laboratory species compared favorably with existing data. Distribution of deposition was found to be similar among all species studied, although surface minute dose decreased with body weight.