IL-1、hs-CRP和亚临床甲减与妊娠期糖尿病的相关性研究

目的 探讨亚临床甲减、IL-1及hsCRP对妊娠期糖尿病的影响及其相关性.方法 选取2014年5月至2016年3月在唐山市协和医院妇产科检查的SCH合并GDM孕中期孕妇138例为观察组,根据促甲状腺素(TSH)的值,将其分为轻度亚临床甲减A组82例(TSH 2.5~4.22 mIU/L),重度亚临床甲减B组56例(TSH≥4.22 mIU/L).另选同期甲状腺功能正常的GDM孕妇50例为对照组.采用罗氏Cobas e601化学发光分析仪检测促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、空腹胰岛素(FINS);ELISA法检测血清白细胞介素1(IL-1);运用贝克曼DXC800全自动生化分析仪检测超敏C反应蛋白(hs-CRP),空腹血糖(FBS),糖化血红蛋白(HbA1c),计算胰岛素抵抗指数(HoMA-IRII),对结果进行分析比较.结果 研究B、A组TPOAb 、HoMA-IRI、IL-1、hsCRP水平高于对照组,研究B组IL-1、hsCRP高于研究A组,差异有统计学意义(P< 0.05);研究B组IRI高于研究A组和对照组,差异有统计学意义(P<0.05).研究A、B组TSH、IL-1、hsCRP与HoMA-IRI呈正相关,IL-1、hsCRP与TSH呈正相关,差异有统计学意义(P<0.05).结论 IL-1、hsCRP可能在SCH合并GDM的发生发展过程中起重要作用,SCH与GDM发生有一定相关性.     

唐山地区2012～2014年孕早期亚临床甲状腺功能减退的调查分析

目的 了解唐山地区2012 ～2014年孕早期亚临床甲减(SCH)发病情况,以减低SCH对孕妇及胎儿造成的不良后果.方法 对首次产检的孕妇建卡并进行游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)的检测,选取TSH＞ 2.5 mIU/L,F-T4浓度正常的孕妇,设计专用表格,记录孕妇的体能检查指征及相关病史.结果 孕妇的SCH发病率逐年升高,年龄＞30岁孕妇的SCH发病率较高,SCH孕妇复发性流产的发病风险较对照组升高,SCH孕妇的甲状腺自身抗体阳性比例较高.结论 唐山地区的孕妇孕早期SCH的发病率逐年上升,且有较高的复发流产比率,应该加大对于亚甲减的早期检测、干预,降低对孕妇及胎儿造成不良后果.     

安顺市不同孕期孕妇甲状腺激素参考范围的初建及临床探讨

目的 探索本地区(贵州省安顺市)在本实验条件下建立符合当地的妊娠期甲状腺激素参考范围及变化趋势,从而为临床上提供更有效而准确的实验数据.方法 选取2012年7月到2015年6月在贵州省安顺市人民医院建卡就诊不同孕期的妊娠期妇女2087例(原籍和生活地均在本地区).同时以孕周的不同,分为孕早期组(孕周＜13周)695例、孕中期组(孕周14 ～ 26周)788例、孕晚期组(孕周27 ～ 36周)604例.同时选取相同年龄段的育龄期妇女200例作为正常对照组.采用化学发光酶免疫分析法检测血清中TSH、FT3、FT4水平.所有检测数据进行统计学分析,组间比较采用方差分析,TSH、FT3、FT4随孕周变化趋势采用回归分析,率的分析采用x2检验.结果 正常对照组TSH、FT3、FT4结果分别为2.54±1.24mIU/L、5.21 ±0.49pmol/L、10.60±1.60pmol/L.孕早期TSH、FT3、FT4结果分别为2.09±1.59mIU/L、5.19±0.61pmoL/L、10.67±1.72pmol/L.孕中期TSH、FT3、FT4结果分别为2.59±1.31mIU/L、4.68±0.46pmol/L、8.71±0.91pmol/L.孕晚期TSH、FT3、FT4结果分别为3.06±1.57mIU/L、4.37±0.63pmol/L、8.53±0.59pmol/L.从而绘制出TSH、FT3、FT4在不同孕周的变化趋势图:TSH孕早期下降,孕中期开始升高,孕晚期高于正常;FT3、FT4变化方式基本一致:在孕早期与正常对照组基本持平,孕早期开始下降,孕晚期低于正常.然后再应用各孕期特异性甲状腺激素诊断参考值对各孕期孕妇重新进行亚临床甲减筛查结果为:孕早期为8.63％、孕早期8.29％、孕晚期6.95％,分别比非特异性甲状腺激素诊断参考值对各孕期孕妇进行亚临床甲减筛查所得结果高,差异具有统计学意义(P＜0.05).结论 建立本地区、本实验条件下不同孕期妇女血清甲状腺激素水平参考范围,从而真实体现孕期甲状腺激素水平变化,为临床上评价孕妇甲状腺功能带来可靠的依据.     

妊娠早期孕妇发生亚临床甲减的影响因素分析

目的调查本地区妊娠早期孕妇发生亚临床甲减(SCH)的患病情况及分析其影响因素。方法采用横断面流行病学调查方法,纳入妊娠早期孕妇2036例,按照TSH、FT4水平分为亚甲减组、正常对照组,描述两组孕妇一般情况,比较两组间实验室检测指标等因素的差异。结果2036例孕妇中亚甲减组116例(5.7%)。亚甲减组年龄、孕次、BMI的均值高于正常组,差异具有统计学意义(P<0.05)。实验室检测指标分析,亚甲减组血清TSH、TG-Ab、CHO水平高于正常组,FT4水平低于正常组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示BMI[OR=2.187(1.593~3.003)]、孕次[OR=2.584(1.184~5.638)]是妊娠早期发生亚临床甲减的危险因素(P<0.05);而FT4[OR=0.630(0.496~0.800)]则是其保护因素(P<0.05)。结论BMI、孕次是妊娠早期亚临床甲状腺功能减退发生的独立危险因素,低水平FT4也是以后发生SCH的危险因素,应积极检测并预防,以降低不良妊娠结局的发生。     

IL-18、hs-CRP在亚临床甲减孕妇血清中的变化及其意义

目的 探讨白细胞介素18(IL-18)和超敏C反应蛋白(high sensitivity-C reactive protein,hs-CRP)在亚临床甲减孕妇血清中的变化及其意义.方法 选取2013年10月至2015年3月在唐山市妇幼保健院妇产科检查的亚临床甲减(SCH)孕妇115例为观察组,根据甲状腺自身抗体情况分为A组(甲状腺自身抗体阳性的SCH孕妇)53例、B组(甲状腺自身抗体阴性的SCH孕妇)62例,另选同期健康体检孕妇50例为对照组.化学发光法检测促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb);ELISA法检测白细胞介素18(IL-18);全自动生化检测hs-CRP,对结果进行分析比较.结果 A组、B组孕妇血清IL-18和hs-CRP水平均高于对照组,差异有统计学意义(P＜0.05);A组血清IL-18水平高于B组,差异有统计学意义(P＜0.05).IL-18、hs-CRP与TSH呈正相关(r=0.494 ～0.627,P＜0.05).结论 IL-18、hs-CRP共同参与SCH的病理生理过程,可作为SCH早期诊断、治疗和预后判断的重要指标.     

甲状腺功能减退合并妊娠期糖尿病孕妇IGF-1、IL-6、TNF-α检测的临床意义

目的 探讨甲状腺功能减退合并妊娠期糖尿病孕妇血清IGF-1、IL-6、TNF-α的变化及临床意义.方法 选取2016年3月至2017年3月在唐山市协和医院妇产科检查的甲状腺功能减退或亚临床甲状腺功能减退合并GDM孕妇70例.根据甲状腺功能分为甲减合并GDM组(A组)32例;亚临床甲减合并GDM组(B组)38例;另选同期健康体检孕妇40例为对照组.采用罗氏Cobas e601化学发光分析仪检测促甲状腺素(TSH),血清游离甲状腺素(FT4);ELISA法检测血清胰岛素样生长因子(IGF-1),白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α),并对结果进行分析比较.结果 A组和B组IL-6和TNF-α水平高于对照组,IGF-1低于对照组;A组IL-6和TNF-α水平高于B组,IGF-1低于B组,差异有统计学意义(t=4.681～10.784,P＜0.05).A组和B组患者血清IL-6、TNF-α与TSH均呈正相关,IGF-1与TSH呈负相关;A组IL-6、TNF-α与FT4呈负相关,IGF-1与FT4呈正相关(γ=0.287 ～0.438,P＜0.05).结论 IGF-1、IL-6和TNF-α在甲减、亚临床甲减合并GDM的发病中起重要作用,这三种细胞因子水平的检测有助于探讨其在共病中的原因,从而指导疾病的诊断和治疗,具有一定的临床意义.     

妊娠中期妇女甲状腺功能筛查结果分析

目的 探讨妊娠中期妇女甲状腺功能筛查的重要性,为妊娠中期妇女甲状腺疾病的诊疗提供依据.方法 选择277例妊娠中期妇女为妊娠组,162位非妊娠育龄妇女为对照组.采用放射免疫法(RIA)检测FT3、FT4,采用免疫放射法(IRMA)检测TSH.结果 ①妊娠组甲状腺疾病总患病率为14.08％ (39/277),对照组甲状腺疾病总患病率为8.02％(13/162),两组比较差异有统计学意义(P＜0.05).②妊娠组中甲亢(包含亚临床甲亢)患病率为1.44％(4/277),和甲减(包含亚临床甲减)患病率为12.64％(35/277)比较,差异有统计学意义(P＜0.05).对照组甲亢(包含亚临床甲亢)患病率为1.23％(2/162),和甲减(包含亚临床甲减)患病率为6.79％(11/162),差异有统计学意义(P＜0.05).妊娠组甲减(包含亚临床甲减)患病率较对照组升高,差异有统计学意义(P＜0.05).③两组FT3、FT4、TSH结果比较,妊娠组FT4水平低于对照组,差异有统计学意义(P＜0.05);妊娠组TSH水平低于对照组,差异有统计学意义(P ＜0.05);FT3水平无显著差异(P＞0.05).结论 妊娠中期妇女甲状腺疾病患病率增高,以甲减(包含亚临床甲减)居多,对妊娠中期妇女甲状腺功能进行筛查具有重要意义,妊娠期特异性甲状腺激素参考值范围有待明确.     

甲状腺功能减退与妊娠期血栓前状态的相关分析

目的 探讨甲状腺功能减退对凝血功能的影响,分析甲状腺功能减退与妊娠期血栓前状态的相关性.方法 选取2012年1月至2017年2月我院临床甲状腺功能减退孕妇46例为甲减组,亚临床甲状腺功能减退孕妇39例为亚临床甲减组,随机抽取50例甲状腺功能正常且无合并其他疾病的健康孕妇为对照组,比较3组受试者的甲状腺功能与凝血功能相关指标.结果 与对照组比较,甲减组的促甲状腺激素(TSH)、纤维蛋白(FIB)较高,游离甲状腺素(FT4)、凝血酶原时间(PT)较低,亚临床甲减组TSH较高,PT较低,差异均有统计学意义(P＜0.05).甲减组与亚临床甲减组比较,甲减组FIB较高,差异有统计学意义(P＜0.05).结论 甲状腺功能减退会导致妊娠期血栓前状态,增加患者体内血栓形成的风险,临床上应予重视并给予积极治疗.     

亚临床甲状腺功能减退合并妊娠期糖尿病对妊娠影响的研究

目的 研究妊娠期亚临床甲状腺功能减退(SCH)合并妊娠期糖尿病(GDM)的孕期并发症及妊娠结局.方法 选择140例妊娠合并SCH及122例甲状腺功能正常孕妇,常规进行妊娠期糖尿病筛查,分成SCH合并GDM组、SCH组、GDM组、正常组,观察记录4组孕妇孕期情况及妊娠结局.结果 妊娠合并SCH组的自然流产率及妊娠期糖尿病的发生率明显高于甲功正常组;SCH合并GDM组孕期胎儿生长受限、羊水过少、早产的发生率明显高于甲功正常组,且妊娠结局中胎儿窘迫、剖宫产、新生儿窒息的发生率亦明显高于甲功正常组,差异均有统计学意义(P＜0.05).结论 妊娠期SCH合并GDM对母儿造成的危害较大,应该尽早筛查进行治疗.     

妊娠亚临床甲减患者血清TSH、TPO-AB水平与妊娠结局的相关性研究

目的探讨妊娠期合并亚临床甲状腺功能减退(亚甲减)患者血清促进甲状腺素(TSH),甲状腺过氧化物酶抗体(TPOAb)水平与妊娠结局的关系。方法选取2016年1月至2017年2月在我院定期接受产前检查、定期围产保健且住院分娩的亚甲减患者300例,根据有无接受治疗分为亚甲减治疗组(n=189)和亚甲减未治疗组(n=111);根据血清TSH中位数水平分为高TSH水平组(n=95)和低TSH水平组(n=205);并根据血清TPOAb检测是否为阳性分为TPOAb阳性组(n=182)与TPOAb阴性组(n=118)。另选取同期300例健康孕妇为对照组。对各组妊娠结局进行统计分析。结果亚甲减未治疗组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于亚甲减治疗组及对照组(P<0.05)。亚甲减孕妇中,高TSH水平组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于低TSH水平组(P<0.05);TPOAb阳性组流产、早产、GDM、妊娠期高血压疾病、低出生体重儿发生率均明显高于TPOAb阴性组(P<0.05)。结论妊娠合并亚甲减可增加流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率,且血清TSH水平越高及TPOAb阳性,不良妊娠结局风险越高。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.