中国营养平衡米膳治疗肾衰病人的Ca、P、K、Na、Mg平衡论证

用营养调查方法 ,对门诊 30例血透肾衰患者进行了调查 ,并对其进食中国营养平衡米(下称营养平衡米 )膳中Ca、P、K、Na、Mg进行了论证。临床表现为面黄肌瘦、苍白、浮肿、疲劳、消瘦、虚弱、无力、食欲不振、恶心呕吐、头晕、皮肤瘙痒、肌肉震颤、手足麻木、无精神等明显的营养不良表现 ,平均体重 5 3 5kg ,皮脂厚度 1 1 2cm ,血清总蛋白 6 7 31mg/dL ,白蛋白 37 4 9mg/dL ,RBC 2 4 1× 1 0 12 /L ,HGB 6 8 81g/L ,PLT 1 72 1× 1 0 9/L ,K 1 6 1 5mg/dL ,Na392 72mg/dL ,C1 2 88 2 2mg/dL ,Ca 6 2 8mg/dL ,P 6 1 1mg/dL ;氮质血症 (x) :BUN 31mmol/L ,Cr 1 0 0 2 6 μmol/L ;膳食中平均每人每日常量元素摄入量为Ca34 1 4 3mg、P 70 7 0 9mg、K1 2 1 5 5 6mg、Na 2 2 2 6 1 9mg、Mg 1 79 4 5mg ,以肾衰病人RDA标准为Ca 1 0 0 0 /1 5 0 0 ,P 6 0 0 ,K5 0 0 ,Na 1 0 0 0 ,Mg 2 0 0 /30 0 ,评价分别为 2 3%～ 34 %、 1 1 8%、 2 4 3%、 2 2 3%、 6 0 %～ 90 % ,则K、Na、P过量 ,而Ca、Mg不足。若改食用营养平衡米膳 ,摄入量分别为 1 4 2 3、 92 4、 1 4 32、 2 2 36、2 79mg ,达标率分别为 95 %～ 1 4 2 % ,1 5 4 % ,2 86 % ,2 2 4 % ,93%～ 1 4 9%。则达标率 1 0 0 % ,且比原来膳食中元素平衡。     

血透患者微量元素营养状况初步探讨

对门诊维持性血透肾衰患者进行了膳食营养调查。结果表明：（1）在临床检查中发现,血透肾衰患者面黄肌瘦,面色苍白,浮肿,疲劳;体质虚弱,四肢无力;精神不振,具有明显的营养不良的临床表现。（2）在膳食调查中发现,每人每日营养素摄入量为蛋白质41．54mg,热量5288kJ,钙104mg、铁4．86mg和锌8．86mg、硒35μg、铜2．28mg、锰2．86mg、镁76．50mg、磷448mg、钾752mg和钠1385．4mg;视黄醇当量368μg、vitarmin B10.58mg、vitamin B20.39mg、vitarnin C51mg、vitaminPP12.60mg和vitaminE0.38mg。提示血透肾衰患者蛋白质－热量营养不良,K、Na过量,而Ca、Mg、P等宏量元素和Zn、Cu、Fe、Mn、Se等微量元素和RE、vitamin B1、vitamin B2、vitamin C均未达到RDA要求。原因是主食营养不平衡。因此,建议对血透肾衰患者进食主食营养平衡米（NBR）和制订平衡食谱,开展透析日营养治疗和病人家庭营养治疗。改善血透肾衰患者微量元素营养状况。     

中国外销普通型营养平衡米及其配膳的微量元素平衡研究

报告了中国外销普通型营养平衡米（下称营养平衡米）与普通籼米的TE含量、NSF值和INQ值,并将营养平衡米平衡米配膳和籼米配膳的NSF进行了比较。结果表明：每100g外销普通型营养平衡米Fe、Mn、Zn、Cu含量为0．719、1．043、1．391、0．439mg,均高于籼米的0．39、0．92、1．20、0．29mg;NSF值分别为19．97、208．60、46．37、109．75,均高于籼米的0．30、184．00、40．00、72．50,其各营养素含量对人体营养素供给量满足程度比普通米更接近人体营养平衡模式。营养平衡米的INQ值,幼儿组分别为0．24、2．76、0．46、1．16,均高于籼米的0．10、2．53、0．41、0．80,儿童组和成人组结果与幼儿组的一致,其各营养素含量比普通米平衡安全,长期食用,热量满足,各营养素达到RDA,不会出现肥胖等营养过剩或营养不良的危险,还可改善营养不平衡状况。营养平衡米膳的NSF值分别为29．808、115．280、173．028、171．234,高于籼米膳的25．35、105．44、170．48、156．33,其膳食的NSF值比普通米膳食NSF值更接近膳食NSF标准,更符合平衡膳食模式要求。证明营养平衡米及其配膳的微量元素TE平衡,且比籼米及其配膳的营养价值高。因此,当前很有必要推广食用营养平衡米,预防和改善当前营养不平衡状况和防治因Zn、Cu、Fe、Se引起的疾病,并促进儿童生长发育。     

开发中国营养平衡米提高老人健康水平

介绍了广州老人进食中国营养平衡米(下称平衡米)的效果.营养调查发现,180例广州老人Ca、P、Fe、Zn和Se摄入量分别为403、807、17、14 mg和46 μg,说明老人Ca、Zn、Se不足.原因是主食籼米矿物质营养不平衡.建议进食营养平衡米后,老人Ca、P、Fe、Zn 和 Se 摄入量分别提高到1 153、863、45、45 mg和111 μg,结果表明,进食平衡米可以提高广州老人矿物质营养水平,致使老人健康长寿.对此,建议开发和推广食用中国营养平衡米.     

广州老人进食中国营养平衡米的营养调查

介绍了广州老人进食中国营养平衡米（简称平衡米）的效果。营养调查发现，广州老人Ca,P,Fe,Zn和Se摄入量分别为403，807，17，14mg/d/人和46μg/d/人，说明老人Ca,Zn,Se不足，原因是主食籼米矿物质营养不平衡，进食平衡米后。老人Ca,P,Fe,Zn和Se摄入量分别提高到1153，863，45，45mg/d/人和111μg/d/人。结果说明，进食平衡米可以提高广州老人矿物质营养水平，使老人健康长寿。     

广东省某民办中学膳食中微量元素调查及其评价

为调查和评价民办中学膳食中微量元素营养情况,探讨最佳膳食模式,全面改善学生的营养,采用称质量法调查三天膳食。结果表明,每人每天微量元素摄入量(RDA)为:Ca523.00mg、Fe10.72mg、Zn10.91mg、Se58.07μg;用RDA标准评价,Ca、Fe、Zn、Se达标率(%)分别为:初中男生45.58、76.00、68.07、100.00;女生33.59、39.50、50.00、100;高中男生52.80、70.87、77.00、100.00;女生47.50、46.70、76.33、100.00。结论是该中学学生Se达标;Ca、Fe、Zn均未达标,有待研究最佳膳食模式,全面改善学生营养。     

排球运动员大强度训练期间血清七种微量元素变化的分析

为研究一个月大强度训练期间排球运动员血清微量元素含量的变化 ,分别收集了 2 0名排球运动员不同训练时段的血清样本 ,应用等离子体发射光谱法测定了Se、Fe、Cu、Zn、Ca、Mg、Mn的含量。结果表明 ,训练期间运动员血清Zn、Fe、Mg含量明显下降 (P <0 0 1～ 0 0 5 ) ;而Cu、Se、Ca、Mn含量均无显著性差异 (P >0 0 5 )。提示大强度训练期间 ,要保证运动员有充足的营养饮食和及时适量补充丢失的微量元素     

肝癌及癌旁组织中微量元素含量研究

为探讨肝癌患者的癌、癌旁和正常组织中微量元素含量的变化 ,收集了 3 0例肝癌患者的癌、癌旁及正常组织 ,应用等离子体发射光谱仪测定了Se、Zn、Cu、Fe、Mg、Mn、Mo的含量。结果表明 ,肝癌患者的正常、癌旁、癌组织Se、Zn、Mg、Mo的含量和Se/Cu、Zn/Cu、Fe/Cu、Mg/Cu、Mo/Cu的比值逐渐降低 (P <0 0 1～ 0 0 5 ) ,但Cu、Mn的含量则相反逐渐升高 ,Fe的含量和Mn/Cu的比值无显著差异 (P >0 0 5 )。本研究提示 ,微量元素含量的变化与肝癌发生、发展有相关性 ,对癌变过程的研究和临床治疗的指导具有重要意义     

糖尿病人头发中的铬、锰、铁与铜含量水平

采用催化极谱方法分析了 98例 (糖尿病人 47例 ,对照组健康人 5 1例 )头发样品中的微量元素铬 (Cr)、锰 (Mn)、铁 (Fe)、铜 (Cu)、锌 (Zn)、硒 (Se)和宏量元素钙 (Ca)、镁 (Mg)含量水平。结果显示 ,糖尿病人头发样品中的Cr( 0 99± 0 75 )× 1 0 - 6 、Mn( 1 3 0± 0 90 )× 1 0 - 6 和Cu( 8 5 0± 1 40 )× 1 0 - 6 分别显著低于对照组头发样品中的Cr( 1 5 5± 0 97)× 1 0 - 6 、Mn( 2 3 0± 1 60 )×1 0 - 6 和Cu( 1 0 40± 2 90 )× 1 0 - 6 ,Cr、Mn、Cu的显著性水平分别为P =0 0 0 1 ,P <0 0 0 1和P <0 0 0 1。而糖尿病人头发样品中的Fe( 1 9 0 0± 9 0 0 )× 1 0 - 6 ,则显著高于对照组头发样品中的Fe( 1 6 0 0± 8 0 0 )× 1 0 - 6 ,其显著性水平P为 0 0 2 3。但糖尿病人与健康人头发样品中的Zn、Se、Ca和Mg含量水平之间的差别并不显著。这些结果与其他一些研究所得的结论基本一致。     

益气活血中药复方对冠心病患者治疗前后微量元素的影响

为探讨益气活血复方调整冠心病患者微量元素达到平衡,纠正异常相关因素的作用机制,选择冠心病患者80例及健康人5 7例,分别测定了冠心病患者治疗前后和健康人血清中微量元素含量。结果表明,益气活血复方组和西药组治疗后,均见Se,Cr,Mn ,Mg ,Sr,Cu,K ,Na,Ca等微量元素含量明显升高,Zn含量,w(Zn) /w(Cu) ,Fe含量明显下降,P <0 0 5或P <0 0 1。虽然益气活血复方组和西药组治疗后,元素上升与下降的趋势基本相同,但益气活血复方对元素的影响更明显,尤其是Zn,Co含量,w(Zn) /w(Cu)下降,Cu ,Cr,Mn,Sr含量上升,差异极显著,P <0 0 1。提示益气活血复方能调节体内微量元素的平衡,恢复心肌功能,防治冠心病     

血液透析联合血液灌流治疗急性肾功能衰竭的临床效果分析

目的分析急性肾功能衰竭采取血液透析联合血液灌流治疗的临床效果。方法选取2010年1月—2015年1月期间惠州市中医医院收治的24例急性肾功能衰竭患者作为研究对象,按治疗方法的不同将本组患者分为两组,对照组12例患者接受单纯血液透析治疗,观察组12例患者接受血液透析联合血液灌流治疗,治疗2个月后,对两组患者的临床指标及临床效果进行统计对比。结果观察组治疗后CRP、Cr、BUN、MMS指标优于对照组,差异有统计学意义(P0.05);观察组治疗有效率为91.67%(11/12),高于对照组75.00%(9/12),差异有统计学意义(P0.05)。结论对急性肾功能衰竭患者的治疗,采取血液透析联合血液灌流治疗的临床效果显著,促进患者康复,在临床中具有良好的应用价值。     

重度烧伤患者不同营养护理的效果观察

目的分析重度烧伤患者不同营养护理的效果观察,研究重度烧伤患者临床诊疗的医学价值。方法选择鹰潭市解放军第一八四医院2013年5月至2013年9月收治的60例重度烧伤患者为实验对象,将其随机分为实验组(30例)与对照组(30例),对照组患者采用一般饮食护理,实验组患者在对照组的基础上采用肠内营养支持予以护理,观察两组患者接受护理治疗后的实际情况。结果通过比较实验组与对照组患者治疗前后的血红蛋白与血清白蛋白等临床资料,计算两组患者的氮平衡,经过对比与分析后得出结果为:实验组患者的血清白蛋白与氮平衡分别为(45.6±4.1)g/L、(1.54±0.30)g,而对照组患者的血清白蛋白与氮平衡分别为(32.7±3.9)g/L、(0.92±0.30)g,实验组患者的临床治疗效果明显优于对照组,结果差异显著(P0.05),具有统计学意义。结论在重度烧伤患者的临床治疗过程中采用肠内营养支持的护理措施,能够显著提升临床护理的质量,对患者的疾病症状起到有效的控制,降低患者出现并发症状的几率,极大地改善患者的生活质量。     

Improved Treatment and Utilization of Rice Straw by <Emphasis Type="Italic">Coprinopsis cinerea</Emphasis>

As one of the most abundant renewable resources, rice straw is an attractive lignocellulosic material for animal feeding or for the production of biochemical. An appropriate pre-treatment technique is essential for converting rice straw to rich fodder or biofuel. Based on previous work, Coprinopsis cinerea can grow on rice straw medium and therefore it is useful for the treatment of rice straw. However, little is known regarding its degradation systems and nutrition values. In this study, we firstly found that C. cinerea could grow rapidly on rice straw without any additives by the production of a series of enzymes (laccase, cellulase, and xylanase) and that the microstructure and contents of rice straw changed significantly after being treated by C. cinerea. We propose that a possible underlying mechanism exists in the degradation. Moreover, C. cinerea has a high nutrition value (23.5% crude protein and 22.2% total amino acids). Hence, fermented rice straw with mycelium could be a good animal feedstuff resource instead of expensive forage. The direct usage of C. cinerea treatment is expected to be a practical, cost-effective, and environmental-friendly approach for enhancing the nutritive value and digestibility of rice straw.     

GC-MS separation and quantitation of 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid and hippuric acid from plasma of patients with renal failure: Application to blood purification methods

Solid-phase extraction, capillary GC, and mass selective detection have been used to determine 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (furanpropionic acid) and hippuric acid in the plasma of patients with chronic renal failure. The concentrations of furanpropionic acid and hippuric acid were found to be highly elevated and reached levels of 4.56 ± 2.37 mg/dl (10 to 20-fold higher than normal) and 12.90 ± 14.06 mg/dl (40 to 60-fold), respectively. Treatment by hemodialysis and hemofiltration effectively eliminated hippuric acid (on average by 66 and 56%, respectively) but had little effect on furanpropionic acid. Intermittent peritoneal dialysis gave the best long-term results. Both components were maintained at a lower level than by hemodialysis and hemofiltration.     

Present status of hemoperfusion/hemodialysis in Italy

The use of charcoal hemoperfusion in the treatment of chronic renal failure has been proposed and applied by several authors. The availability of coating membranes of increased biocompatibility currently allows a safer and wider use of this purifying technique. It has been recently demonstrated that long-term treatment with combined hemodialysis/hemoperfusion yields an improvement of certain dialysis-resistant uremic signs in patients on regular dialysis treatment, while in selected patients it affords a marked reduction (up to one-third) in the overall time of treatment per week. The tolerance of long-term treatment is good. In line with these findings, a multicenter study has been carried out in Italy with two main aims: (1) to see whether long-term treatment with charcoal hemoperfusion is really safe and substantially free from side effects; (2) to verify in a larger and more varied population of patients whether such long-term treatment actually improves certain uremic signs persisting despite adequate dialysis treatment. A third phase of the multicentric study (reducing the weekly time of treatment) is currently being worked on. Five nephrology and dialysis departments took part in the study: in Bologna, Rome, Chieti, Ancona, and Lecce.     

The relation of various metabolic bone markers in renal hemodialysis patients classified by serum estradiol levels

The bone metabolic markers showed the significant differences in age and sex of the hemodialysis patients with renal insufficiency. It is likely that the evaluations of bone change and biochemical metabolic markers should be based on serum estradiol level, sex and age of the renal hemodialysis patients.     

Spectroscopic whole-blood indicators of end-stage renal disease and the hemodialysis treatment

The diffuse reflection spectrum in the 500-1670 nm region for whole blood taken from healthy subjects and end-stage renal disease (ESRD) patients was measured to test the feasibility of optically monitoring ESRD and its treatment by hemodialysis. Spectral regions where optical absorption significantly differed between healthy subjects and ESRD patients were used to form a multiple linear discriminant classification model. With this model a total of 41 whole-blood samples were classified into healthy, pretreatment and posttreatment ESRD classes. 96.7% of original and cross-validated cases and 100% of independent validation cases were correctly classified, indicating ESRD and its treatment exhibit characteristic spectral features in whole blood. Upon comparison of the discriminant model variables with a few key clinical blood parameters, model variables were found to significantly correlate with hematocrit and plasma levels of urea and potassium (P<0.05). The results of this study suggest that the optical signature of whole blood conveys basic clinical status information, and provides a path for investigating improved indices of hemodialysis toxicity, adequacy and patient outcome.     

Determination of creatinine-related molecules in saliva by reversed-phase liquid chromatography with tandem mass spectrometry and the evaluation of hemodialysis in chronic kidney disease patients

The serum concentrations of creatinine (Cre) and urea are used for the determination of the renal function. However, the use of blood is not always suitable due to the invasive, hygienic and infection problems during its sample collection and handling. In contrast, saliva is relatively clean and the samples can be quickly and noninvasively collected and easily stored. Therefore, the simultaneous determination of Arginine (Arg), creatine (Cr) and Cre in the saliva of chronic kidney disease (CKD) patients was performed by UPLC-ESI-MS/MS together with the saliva of healthy volunteers. The evaluation of hemodialysis of CKD patients was also carried out by the determinations before and after the dialysis. An HS-F5 column was used for the simultaneous determination of Arg, Cr and Cre in the saliva. These molecules were rapidly separated within 4 min and sensitively determined by the multiple reaction monitoring (MRM) of the precursor ion [M+H]⁺ → product ions (m/z 175.1 → 70.1 for Arg; m/z 132.0 → 44.1 for Cr; m/z 114.0 → 44.1 for Cre). The concentration of Cre in the CKD patients was higher than that in the healthy persons. The concentrations of Cre in the saliva of the patients before hemodialysis were moderately correlated with the serum Cre concentrations (R² = 0.661). Furthermore, the concentration in the saliva obviously decreased after hemodialysis (before 0.73 mg/dL, after 0.25 mg/dL; p < 0.02). Thus, the proposed detection method using saliva by UPLC-MS/MS is useful for the evaluation of the renal function in CKD patients. The present method offers a new option for monitoring the hemodialysis of CKD patients.     

Effect of hemodialysis on left and right ventricular function--evaluation using electrocardiogram gated radionuclide ventriculography

Eighteen outpatients with chronic renal failure undergoing hemodialysis (HD) were studied. Immediately before and after HD, the left and right ventricular function measured by electrocardiogram gated radionuclide ventriculography (RNV). By HD, body weight changed 58.6 +/- 7.50 kg to 57.2 +/- 6.80 kg and BUN level changed 67.9 +/- 29.00 mg/dl to 37.1 +/- 18.96 mg/dl and creatinine level changed 11.3 +/- 3.90 mg/dl to 6.8 +/- 2.48 mg/dl. Before HD, cardiac output was 8.08 +/- 1.50 l/min and cardiac index was 5.00 +/- 0.87 l/(min m2). Left ventricular function improved (LVEF changed 60.4 +/- 6.85% to 64.2 +/- 8.7%, LVEF/LVET changed 0.237 +/- 0.048%/ms to 0.254 +/- 0.021%/ms) between before and after HD, but there was not significant difference. Right ventricular function improved (RVEF changed 41.2 +/- 8.00% to 50.0 +/- 11.96, RVEF/RVET changed 0.167 +/- 0.028%/ms to 0.209 +/- 0.059%/ms) between before and after HD, and there was significant difference (p less than 0.05).