OBJECTIVETo investigate the change of the subfractions in existence (big and small polymers) of pulmonary surfactant (PS) and their influence on the decrease in PS activity during early postburn stage.

METHODSForty rabbits were employed in the study and were randomly divided into pre-burn, 0.5 postburn hour (PBH), 2 PBH, 6 PBH and 12 PBH groups with 8 in each group. The BALF (bronchial alveolar lavage fluid) was harvested from each rabbit. The BALF samples were centrifuged, and the supernatant (small polymer) and precipitation (big polymer) were harvested for the determination of the contents of the total phospholipids, lecithin, total protein, and albumin in both polymers.

RESULTSCompared with those in pre-burn group, the above chemical contents of PS in big polymer exhibited no change after burn (P > 0.05), but the contents of albumin and total protein increased obviously in small polymer (P < 0.01). In addition, all the contents in the small polymer increased with the elapse of time. The percentage of lecithin in total phospholipids in small polymers decreased along with the passage of time. The pre-burn contents of total phospholipids, lecithin, TP, albumin, and the percentage of lecithin in total phospholipid in small polymer were (2.23 +/- 0.40),(1.54 +/- 0.11), (16.67 +/- 1.34), (3.65 +/- 0.15) mg/ml and (77.2 +/- 3.7)%, respectively. The above indices in small polymer were (3.15 +/- 0.30), (1.77 +/- 0.08), (106.59 +/- 5.50), (11.21 +/- 0.92) mg/ml and (57.2 +/- 3.5)% respectively at 6PBH.

CONCLUSIONThe ratio of small to big polymers increased obviously, which might be an important factor in inducing the decrease in PS activity during early postburn stage leading finally to pulmonary injury.

Albumins ; analysis ; Animals ; Female ; Male ; Phosphatidylcholines ; analysis ; Phospholipids ; analysis ; Pulmonary Surfactants ; metabolism ; Rabbits ; Smoke Inhalation Injury ; metabolism

Familial dysalbuminemic hyperthyroxinemia (FDH) is an inherited disease characterized by increased circulating total thyroxine (T4) levels and normal physiological thyroid function. Heterozygous albumin gene (ALB) variants have been reported to be the underlying cause of FDH. To our knowledge, there have been no confirmed FDH cases in Korea. We recently observed a female patient with mild T4 elevation (1.2 to 1.4-fold) and variable levels of free T4 according to different assay methods. Upon Sanger sequencing of her ALB, a heterozygous c.725G>A (p.Arg242His) variant was identified. The patient's father and eldest son had similar thyroid function test results and were confirmed to have the same variant. Although the prevalence of FDH might be very low in the Korean population, clinical suspicion is important to avoid unnecessary evaluation and treatment.
Adult ; Albumins/*genetics ; Base Sequence ; Female ; Heterozygote ; Humans ; Hyperthyroxinemia, Familial Dysalbuminemic/*genetics ; Pedigree ; Radioimmunoassay ; Sequence Analysis, DNA ; Thyroxine/analysis

OBJECTIVE: To evaluate the clinical value of Dachengqi decoction in the treatment of sepsis complication with gastrointestinal dysfunction via gastric antrum cross-sectional area (CSA) measured by bedside ultrasound. METHODS: A parallel group randomized controlled trial was conducted. A total of 80 patients with sepsis with gastrointestinal dysfunction admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to October 2022 were enrolled. According to whether patients agree to use Dachengqi decoction after admission, all patients were divided into Dachengqi decoction group (observation group) and conventional treatment group (control group) by 1 : 1 randomization, each group has 40 patients. Both groups were treated with fluid resuscitation, anti-infection, maintaining stable respiratory circulation, early nourishing feeding, promoting gastrointestinal motility, and regulating intestinal flora. The observation group was treated with Dachengqi decoction on the basis of western medicine, 30 mL decoction was taken in the morning and evening. Both groups were treated for 7 days. The CSA of the two groups was measured by bedside ultrasound before and after treatment. The gastric residual volume (GRV1 and GRV2) were calculated by formula and traditional gastric tube withdrawal method. The gastrointestinal dysfunction score, acute physiology and chronic health evaluation II (APACHE II), intraperitoneal pressure (IAP), serum preprotein (PA), albumin (Alb), white blood cell count (WBC), procalcitonin (PCT), hypersensitivity C-reactive protein (hs-CRP), length of intensive care unit (ICU) stay and incidence of aspiration were detected to evaluate the clinical efficacy of Dachengqi decoction, the correlation and advantages and disadvantages between CSA measured by bedside ultrasound and other evaluation indicators of gastrointestinal dysfunction in sepsis were also analyzed. RESULTS: There were no significant differences in the indicators before treatment between the two groups, which were comparable. In comparison with the pre-treatment period, CSA, GRV, gastrointestinal dysfunction score, APACHE II score, IAP, WBC, PCT, and hs-CRP of the two groups after treatment were significantly decreased, PA and Alb were significantly increased, and the observation group decreased or increased more significantly than the control group [CSA (cm²): 4.53±1.56 vs. 6.04±2.52, GRV1 (mL): 39.85±8.21 vs. 53.05±11.73, GRV2 (mL): 29.22±5.20 vs. 40.91±8.97, gastrointestinal dysfunction score: 0.87±0.19 vs. 1.35±0.26, APACHE II score: 11.54±3.43 vs. 14.28±3.07, IAP (cmH₂O, 1 cmH₂O ≈ 0.098 kPa): 9.79±2.01 vs. 13.30±2.73, WBC (×10⁹/L): 9.35±1.24 vs. 12.35±1.36, PCT (μg/L): 3.68±1.12 vs. 6.43±1.45, hs-CRP (mg/L): 24.76±5.41 vs. 46.76±6.38, PA (mg/L): 370.29±45.89 vs. 258.33±34.58, Alb (g/L): 38.83±5.64 vs. 33.20±4.98, all P < 0.05]. The length of ICU stay (days: 10.56±3.19 vs. 14.24±3.45) and incidence of aspiration (12.5% vs. 25.0%) were lower than those in the control group (both P < 0.05). Correlation analysis showed that CSA measured by bedside ultrasound was positively correlated with GRV2, gastrointestinal dysfunction score, APACHE II score, and IAP (r values were 0.84, 0.78, 0.75, 0.72, all P < 0.01) and negatively correlated with PA and Alb (r values were -0.64 and -0.62, both P < 0.01). CONCLUSIONS The Dachengqi decoction can significantly improve the clinical symptoms of septic patients with gastrointestinal dysfunction, reduce systemic inflammatory response, improve nutritional status, and shorten ICU hospital stay. Bedside ultrasound monitoring of CSA is a simple, accurate and effective means to evaluate gastrointestinal dysfunction, which is worthy of further clinical promotion.
Humans ; C-Reactive Protein/analysis* ; Pyloric Antrum ; Sepsis/therapy* ; Plant Extracts ; Procalcitonin ; Albumins ; Prognosis ; Intensive Care Units ; Retrospective Studies

Through the present delta value check used in quality control programs is a powerful tool for detecting random errors in clinical chemistry analysis, it has some problems, such as missed true errors and delays in reporting time, because it also has the potential of showing erroneous positive results. Recently, new calculation methods for delta check with delta difference, delta percent change, rate difference, and rate percent change have been suggested by Lacher and Connelly (Clin Chem 34:1966-1970, 1988). Based on this new delta check method, we made the new criteria of which calculation method is applied to the clinical chemistry tests, i.e., the differential application of rate and delta check, and selectively applied the new method to 17 chemistry tests in order to solve the above problems. The applied criteria were the time dependence of the test item and the coefficient of variation of the absolute delta difference. Calcium, inorganic phosphorus, total protein, albumin, sodium, potassium, and chloride were classified as delta difference calculation method group; glucose and cholesterol as delta percent change group; creatinine, total and direct bilirubin as rate difference group; and urea nitrogen, uric acid, ALP, ALT, and AST as rate percent change group. With the previous criteria by Whitehurst et al. (Clin Chem 221:87-92) for 5045 specimens, the check-out rate was 47.8% (2,411 out of 5,045), and the positive predictive value was 0.41% (10 out of 2,411). For the new criteria, the check-out rate was 12.7% (621 out of 5,045), and the positive predictive value was 1.8% (nine out of 621).(ABSTRACT TRUNCATED AT 250 WORDS)
Albumins/analysis ; Bilirubin/analysis ; Calcium/analysis ; Chemistry, Clinical/methods/*standards ; Clinical Laboratory Information Systems/*standards ; Creatine/analysis ; Glucose/analysis ; Phosphorus/analysis ; Quality Control ; Reference Values ; *Sensitivity and Specificity ; Specimen Handling ; Urea/analysis ; Work Simplification

OBJECTIVETo assess the health effects of dusts in enzyme production plants.

METHODSThe concentration of enzyme-containing dusts, the enzyme and the wheat-containing dusts and their health effects on workers were investigated in three enzyme production plants. Air samples were collected by high volume sampler and personal sampler. Total dust was weighed and its content of enzyme was analyzed by enzyme activity method. Health effects were assessed by the questionnaire, the pulmonary function and the skin prick test.

RESULTSIt was found that the geometric mean of enzyme-containing dust was 8.91 mg/m(3), the industrial enzyme was 1.68 mg/m(3), and the wheat-containing dust was 6.93 mg/m(3). The enzyme-containing dust higher than 20 mg/m(3) caused eye symptoms. The wheat-containing dust at 6.93 mg/m(3) might result in skin and nose symptoms. The sensitization could be observed in enzyme and wheat exposed workers.

CONCLUSIONAdverse effects may arise for the health of the workers if the concentration of enzyme-containing dusts and the wheat-containing dusts is up to a certain limit and it is necessary to make the limit of these indexes.

Adolescent ; Adult ; Albumins ; adverse effects ; Dust ; analysis ; Enzymes ; analysis ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Respiratory Function Tests ; Skin Tests ; Surveys and Questionnaires ; Triticum

OBJECTIVETo develop a method for quantitative collection of exhaled gas in anesthetized dogs at given time following intravenous administration of octafluoropropane (OFP)-containing human albumin micropheres for assessing the gas kinetics of OFP.

METHODSOFP-containing albumin micropheres were administered intravenously at 0.4, 0.8 and 1.2 ml/kg, respectively, in anesthetized and ventilated dogs. The exhaled air samples were analyzed by gas chromatography-tandem mass spectrometry (GC-MS-MS).

RESULTSThe correlation curve between the area under curve (AUC) and administered dose was roughly linear (Y=1162.5X-417.38, r square=0.949 9). The total recovery rate was (119.49-/+27.62)% which was not significantly different from the rate of 100% (P>0.05). GC-MS-MS was accurate, sensitive, precise and applicable for OFP determination.

CONCLUSIONThe sampling method is useful for characterizing OFP pharmacokinetics in dogs, and also applicable for studying the pharmacokinetics of other gas-containing drugs.

Albumins ; administration & dosage ; analysis ; pharmacokinetics ; Animals ; Dogs ; Exhalation ; Female ; Fluorocarbons ; administration & dosage ; analysis ; pharmacokinetics ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Injections, Intravenous ; Male ; Microspheres ; Reproducibility of Results

OBJECTIVETo explore the relationship between continuous thrombocytopenia and sepsis in patients with severe burns.

METHODSClinical data of 148 severely burned patients admitted to our,two burn centers from January 2007 to December 2011 and conforming to the study criteria were retrospectively analyzed. All patients were divided into sepsis group (n =44) and non-sepsis group (n = 104) according to the presence or absence of sepsis within post burn day (PBD) 30. The data of age, gender, total burn area, full-thickness burn area, fluid infusion volume within post burn hour (PBH) 24, plasma concentration of calcium ion on PBD 1, plasma concentration of albumin on PBD 1, platelet count on PBD 1, acute physiology and chronic health evaluation (APACHE) II score on admission, the presence or absence of hypovolemic shock or inhalation injury on admission, the presence or absence of disseminated intravascular coagulation (DIC) within PBH 48, operation or no operation within PBD 3, thrombocytopenia duration within PBD 10, and mortality were statistically compared between two groups to screen the independent risk factors of sepsis. Data were processed with t test, chi-square test, single factor Logistic regression analysis, and multi-factor Logistic regression analysis.

RESULTSBetween two groups, there were statistically significant differences in total burn area, full-thickness burn area, plasma concentration of calcium ion on PBD 1, plasma concentration of albumin on PBD 1, APACHE II score on admission, presence or absence of hypovolem- ic shock on admission, presence or absence of inhalation injury on admission, presence or absence of DIC within PBH 48, and mortality (with t values from 2.433 to 4.082, χ2 values from 8. 818 to 31.528, P < 0.05 or P < 0.01). Furthermore, the duration of thrombocytopenia within PBD 10 in sepsis group was (5.2 ± 2.4) d, which was significantly longer than that in non-sepsis group [(2.9 ± 1.9) d, t =6. 189, P <0.01]. There were no statistically significant differences in the other indexes between two groups (with t values from 0.971 to 1. 250, χ2 values respectively 0. 054 and 1.529, P values above 0.05). Single factor and multi-factor Logistic regression analysis indicated that APACHE II score on admission and duration of thrombocytopenia within PBD 10 were closely related to occurrence of sepsis (with odds ratio respectively 1. 140 and 1.569, P values below 0.01).

CONCLUSIONSDuration of thrombocytopenia within PBD 10 is one of the risk factors for sepsis in severely burned patients, which can reflect pathophysiological changes in the body, thus providing predictive value for the occurrence of sepsis.

Aged ; Albumins ; Burn Units ; Burns ; blood ; complications ; diagnosis ; Humans ; Predictive Value of Tests ; Regression Analysis ; Retrospective Studies ; Sepsis ; blood ; etiology ; Shock ; blood ; etiology ; Thrombocytopenia

BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS: Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS: The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of <30, 30-300, and >300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS: The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.
Adult ; Aged ; Aged, 80 and over ; Albumins/*analysis ; Creatinine/*urine ; Diabetes Mellitus, Type 2/pathology/urine ; Female ; Humans ; *Immunoassay ; Male ; Middle Aged ; Prediabetic State/pathology/urine ; Reagent Strips/chemistry

The aim of this cross-over study was to investigate whether albumin infusion before furosemide administration could potentiate the diuretic action of furosemide. Seven patients with nephrotic syndrome were given the following infusions in random order on two separate days: 1) a sham solution followed by 160 mg of furosemide, 2) 100 ml of 20% human albumin followed by 160 mg of furosemide. Urine and serum furosemide concentrations were measured by high-performance liquid chromatography. The increment of urine volume was greater in albumin preinfusion than in furosemide alone. However, the increments of sodium and chloride excretions between furosemide alone and albumin preinfusion were not different. No significant differences in the pharmacokinetic parameters between the two treatments were observed: area under the concentration-time curve (AUC: 12.7+/-2.2 vs 15.1+/-4.4 g/ml hr), total plasma clearance (253+/-41 vs 256+/-54 ml/min), volume of distribution (341+/-34 vs 494+/-153 ml/kg), elimination half life (4.0+/-1.1 vs 4.6+/-0.8 hr), and urine furosemide excretion of the administered amount (16.5+/-7.3 vs 7.5+/-1.6%). In conclusion, these data show that albumin preinfusion potentiated diuresis, but not natriuresis, of furosemide without any change in the pharmacokinetics of the agent in patients with nephrotic syndrome.
Adolescence ; Adult ; Aged ; Albumins/*pharmacology ; Cross-Over Studies ; Diuretics/*pharmacology ; Drug Synergism ; Female ; Furosemide/*pharmacology ; Human ; Male ; Middle Age ; Nephrotic Syndrome/*drug therapy/metabolism ; Serum Albumin/analysis

OBJECTIVETo investigate the relationship between microalbuminuria and arterial compliance in hypertensive and diabetes patients.

METHODSA total of 200 patients with essential hypertension and/or diabetes were studied. Albumin/creatinine ratio (ACR) was determined. Carotid to femoral Pulse Wave Velocity (PWV), C(1) and C(2) were measured by a Complier Colson device and DO-2020, respectively.

RESULT(1) C(1) and C(2) were lower and PWV higher in high ACR group than in normal ACR group (P < 0.01). (2) In patients younger than 60 years, C(1) was lower and PWV higher in high ACR group than that in normal ACR group (P < 0.01). In patients older than 60 years, C(1), C(2) were lower in high ACR group than in normal ACR group.

CONCLUSIONThe results indicated that compliance of large and small vessels in hypertensive and diabetic patients decreased with increasing ACR.

Adult ; Aged ; Albumins ; analysis ; Albuminuria ; Arteries ; physiopathology ; Creatinine ; urine ; Diabetes Mellitus ; physiopathology ; urine ; Elasticity ; Female ; Humans ; Hypertension ; physiopathology ; urine ; Male ; Middle Aged