RESUMEN
Objective:This study aimed to explore the feasibility and clinical value of monitoring the progression of early kidney injury in type 2 diabetic patients by assessment of the urinary C-terminal agrin fragment (uCAF) with enzymatic chemiluminescence immunoassay.Methods:A total of 251 patients with type 2 diabetes, who attended the Second Affiliated Hospital of Wenzhou Medical University from October 2018 to March 2020, were included in this retrospective analysis. One hundred and fifty-six participants undergoing health check-up at the Second Affiliated Hospital of Zhejiang University School of Medicine in February 2021 served as controls. Basic clinical information, glycosylated hemoglobin type A 1c and serum creatinine values were recorded, and urine specimens were collected for urinary creatinine, urinary α 1 microglobulin(uα 1M), urinary immunoglobulin G (uIgG), urinary albumin, urinary N-Acetyl-B-D-glycosaminidase (uNAG) and uCAF measurements. Based on the estimated glomerular filtration rate (eGFR), 251 patients were classified into G1~G5 stage groups with 116, 22, 28, 55 and 30 patients in each group. One hundred and sixty-six patients with early diabetic kidney disease (stage G1-G3) were divided into subgroups A1 (79), A2 (48) and A3 (39) according to the urinary albumin/creatinine ratio (UACR), the uα1M levels were divided into uα1M subgroup 1 (83 cases), uα1M subgroup 2 (42 cases), and uα1M subgroup 3 (41 cases), and uIgG subgroup 1 (83 cases), uIgG subgroup 2 (42 cases), and uIgG subgroup 3 (41 cases) according to uIgG levels. The Spearman method was used to analyze the correlation between uCAF levels and eGFR, UACR, uα1M and uIgG levels. Results:(1) The linear range of the uCAF detected by enzymatic chemiluminescence immunoassay was 3.97-2 000.00 ng/ml, with a detection limit of 2.28 ng/ml, intra-batch coefficients of variation of 1.15% and 1.57%, inter-batch coefficients of variation of 1.63% and 5.78%, and a biological reference interval of <95.35 μg/g Cr. (2) The uCAF level and positive rate (UACR≥30 mg/g) increased with the decrease of eGFR from G1-G3, uCAF level was negatively correlated with eGFR value ( r=-0.543, P<0.000 1), and the positive rate increased from 24.14% (28/116) to 85.71% (24/28) from G1-G3. The uCAF level and positivity rate decreased with the decrease of eGFR from G4 to G5. uCAF level was positively correlated with eGFR value ( r=0.495, P<0.001), and the positivity rate decreased from 30.91% (17/55) to 23.33% (7/30) from G4 to G5. (3) In patients with early diabetic kidney disease, uCAF levels and positivity rates increased gradually with the increase of UACR. uCAF levels were positively correlated with UACR values ( r=0.602, P<0.001), and the uCAF positivity rate reached 21.52% (17/79) in the A1 subgroup. (4) uCAF level was positively correlated with uα1M and uIgG levels in patients with early diabetic kidney disease ( r=0.757, 0.596, both P<0.001). Conclusion:Analytical performance of enzyme chemiluminescence immunoassay for the detection of CAF is satisfactory and could be used a biomarker for monitoring damage and progression of early diabetic kidney disease in patients with type 2 diabetes.
RESUMEN
Carbon emissions are one of the major constraints considered under a Cap-and-Trade (C-and-T) system, regarding the implementation of green technologies in the operations of emissions-generating companies. Green technology implementation, based on optimal pricing decisions, has become an inevitability due to rising carbon emissions. We studied the profit-maximizing behavior of a firm considering whether to implement of green technology due to subsidies offered on emission-reduction rates. In order to achieve the desired results, we used a simulation-based model and developed a conceptual model for the verification of functions. When the product price was high, the firm achieved a high profit, which was the main focus of the firm. The firm thus had sufficient resources to implement green technology. However, when the product price was low, the firm could achieve its goal of profit maximization, but did so without implementing green technology. To solve this problem, we studied government involvement in the market to incentivize emissions reduction and to benefit the firm. We decided to model emissions-reduction policy to encourage the implementation of green technology and support firm profits. We found that subsidies enabled a firm to maximize its profits while ensuring green technology implementation, while the firm would not have adopted green technology without subsidies or mandates. This study should help decision makers understand pricing strategies in the maximization of the profit. Additionally, this study helps demonstrate that the government plays an important role in monopolized markets by reducing negative externalities.
RESUMEN
Aim To set up a highly effective and automatic mouse sleep-wake bioassay system,and evaluate the system through analysis of the somnogenic effects of L-stepholidine(SPD),targeting at dopamine D1/D2 receptors in mice.Methods The animals were housed in an insulated and soundproof recording chamber maintained at a constant temperature and humidity on an automatically controlled 12 h light/12 h dark cycle.The electroencephalogram and electromyogram were recorded continuously for 48 hours and analyzed by SleepSign software.Saline was administered ip to the mice at 21:00 on the first day,and SPD was given on the next day at the same hour.The vigilance state was analyzed based on the polygraphic recordings by the same software.Results The system has been demonstrated to be highly efficient and stable in recording and reliable in analyzing sleep-wake behavior in mice.With the aid of the sleep bioassay system,we found that SPD significantly increased the total time spent in sleep during dark period,and prolonged durations of non-rapid eye movement sleep episodes,with a concomitant reduction in amount and EEG power density of wakefulness.SPD rendered no effect on rapid eye movement sleep.Conclusion Through the reliable mouse sleep bioassay system,we found that SPD promotes non-rapid eye movement sleep but not rapid eye movement sleep in mice.