辽宁省沿海地区重点人群碘营养状况调查

目的了解全民食盐加碘后辽宁省沿海地区怀孕妇女、哺乳妇女、0￣2岁婴幼儿和学龄儿童等重点人群的碘营养状况。方法测定上述重点人群的尿碘、食用盐碘并检查学龄儿童甲状腺肿大情况。结果沿海地区实施全民食盐加碘后,儿童尿碘中位数为188.21μg/L,孕妇为159.69μg/L,哺乳妇女为164.16μg/L,0～2岁婴幼儿尿碘中位数195.4μg/L,其尿碘值低于20μg/L的比例均在10%以下。结论实施全民食盐加碘后,重点人群的碘营养状况得到显著改善,碘营养处于适宜水平。但相对于学生人群,孕妇和哺乳妇女的尿碘水平明显向低值转移。在人群总体碘营养状况较好的情况下,仍有相当部分的孕妇、哺乳妇女的碘营养未达到理想水平,需引起重视。建议在今后监测工作中,还需加强对孕妇、哺乳妇女等特需人群的碘营养监测。     

沿海地区人群碘营养状况调查

目的了解沿海碘盐普及情况不同的地区,人群尤其是孕妇、哺乳妇女等重点人群的碘营养状况.方法选取地处沿海的辽宁省大洼县、福建省福清县及福建省内陆的平和县,调查学生和孕妇、哺乳妇女的碘营养状况.结果共测定2 400名学生和1185名孕妇家中的盐碘、尿碘及学生甲肿率.盐碘覆盖率大洼县达到99.4%,福清县与平和县均＜90%,分别为63.6%和83.9%.3县学生尿碘中位数均＞100μg/L.3县孕妇、哺乳妇女的尿碘水平显著低于学生,福清与平和县孕妇、哺乳妇女尿碘中位数＜150 μg/L.结论 3县学生人群的碘营养状况良好;孕妇、哺乳妇女的尿碘水平显著低于学生,仍有相当部分的孕妇和哺乳妇女尿碘低于适宜水平,需加以关注,建议今后加强对孕妇和哺乳妇女的碘营养监测.     

沿海非高碘地区育龄妇女碘营养水平研究

目的探讨沿海非高碘盐地区育龄妇女的碘营养状况,为进一步制定碘缺乏病防治策略提供科学依据。方法收集碘盐覆盖率低的8个市（县）1 161名15～55岁的育龄妇女食用盐样和尿样,采用过硫酸氨消化-砷铈催化分光光度法测定尿碘,采用直接滴定法测定盐碘。结果8个市（县）1 161名妇女碘盐食用率为44.4%,尿碘中位数为120.0μg/L; 其中4.7%妇女尿碘中位数〈25μg/L为重度缺碘,15.5%妇女25μg/L〈尿碘中位数〈50μg/L为中度缺碘,23.1%妇女50μg/L〈尿碘中位数〈100μg/L为轻度缺碘,生育高峰时期的育龄妇女（15～35岁）尿碘水平最低为97.3μg/L。孕妇和哺乳期妇女严重碘缺乏的比例较高,分别为12.2%、11.9%,是非特殊生理时期妇女的2～3倍（χ^2=33.09,P〈0.001）。食用非碘盐的妇女引起严重碘缺乏是食用碘盐妇女的10倍（χ^2=209.52,P〈0.001）。育龄妇女的盐碘含量与尿碘水平有统计学线性相关（t=11.86,P〈0.001）,妇女碘缺乏与生活居住环境无统计学差异。结论育龄妇女,尤其是孕妇和哺乳期妇女,是碘缺乏病防治工作的重点人群,应加强育龄妇女的口服碘油丸强化工作。     

2005年河南省宝丰县重点人群碘营养调查

目的了解达标后河南省宝丰县重点人群的碘营养状况。方法尿碘测定采用酸消化砷-铈接触法；盐碘测定采用直接滴定法。结果孕妇尿碘中位数为187．7μg／L，低于50μg／L的比率为1．2％，低于100μg／L的比率为13．1％，不同孕期尿碘水平有显著差异；哺乳期妇女尿碘中位数为147．8μg／L，低于50μg／L的比率为1．8％，低于100μg／L的比率为15．9％；婴幼儿尿碘中位数为178．3μg／L，低于50μg／L的比率为0．9％，低于100μg／L的比率为8．0％；共调查家庭食用盐1036份，碘盐覆盖率为100．0％，中位数为28．8mg／kg。结论宝丰县重点人群的碘营养是适宜的，能够满足其生理需要。     

2002年商洛市碘缺乏病监测结果分析

目的 了解在现行碘盐含量标准条件下碘缺乏病病情势态及重点人群碘营养状态。方法 采用一次性点状调查方式，监测人群为儿童与妇女。结果 8～10岁儿童甲肿率为6．0％；尿碘中位数儿童为287．2μg／L，育龄妇女为278．2μg／L，哺乳妇女为251．3μg／L，孕妇为268．3μg／L；盐碘均数30．5mg／kg，合格率84．25％；饮用水碘中位数3．1μg／L；7～14岁学生智商总体评价为中下水平；健康教育问卷学生组平均61分，家庭主妇组平均68分。结论 商洛市碘缺乏病病情呈稳定下降势态；现行盐碘浓度适合商洛市现状，重点人群碘营养状况良好。     

丹东市区8～10岁儿童及孕妇尿碘测定结果分析

目的了解丹东市特需人群的碘营养状况.方法以随机抽样的方法选择儿童、育龄妇女和孕妇检测尿碘含量.结果 8～10岁儿童,患甲状腺肿164例的尿碘中位数172.2μg/L,无甲肿的135名儿童尿碘中位数为204.6μg/L.140例孕妇尿碘中位数为210.5μg/L,114例育龄妇女尿碘为240.8μg/L.结论甲状腺肿大的儿童尿碘低于正常儿童.孕妇与育龄妇女的尿碘水平接近.为提高人口素质,应做好这部分人群的补碘工作.     

盐碘含量调整后郑州市人群碘营养动态监测结果与分析

目的了解盐碘含量调整后郑州市重点人群的碘营养水平,为科学补碘提供依据。方法 2012年3月至2015年12月,每年采用分层随机抽样方法,采集居民户食用盐样3300份并按照《制盐工业通用试验方法碘的测定》(GB/T13025.7-2012)测定碘含量。在郑州市所辖11个县(市、区)的医院、妇幼保健院、计生部门的门诊收集新婚育龄妇女、孕妇、哺乳期妇女、0-2岁婴幼儿,在学校收集8-10岁儿童的尿样测定尿碘含量,分析不同人群的碘营养情况。结果2012-2015年盐碘中位数分别为28.20、28.20、27.32、27.50mg/kg。2012-2015年新婚育龄妇女尿碘中位数分别为190.00、205.80、196.00、203.40μg/L,孕妇尿碘中位数分别为190.80、207.30、204.18、193.57μg/L,哺乳期妇女尿碘中位数分别为161.06、163.77、167.88、164.37μg/L,0-2岁婴幼儿尿碘中位数分别为188.51、197.37、217.95、215.56μg/L,8-10岁儿童尿碘中位数分别为217.39、207.86、216.06、221.11μg/L。结论盐碘含量调整后,新婚育龄妇女、孕妇、哺乳期妇女和0-2岁婴幼儿碘营养水平处于适宜范围,8-10岁儿童略高于适宜标准。说明本次调整后的食盐碘含量是适宜的,既能满足儿童,又能满足孕妇和哺乳期妇女的碘营养要求。     

四川省重点人群碘营养调查结果分析

目的了解食用盐加碘新标准实施1年后四川省不同人群的碘营养水平,评价现行的碘盐浓度是否能满足不同人群的碘需求,为进一步调整碘盐浓度及其相关研究提供科学依据.方法采用一次性"点状"调查方式,选择城市及农村调查点各1区(县),对8～10岁小学生、20～40岁育龄妇女、妊娠3个月以上的孕妇、哺乳期妇女及她们的0～2岁婴幼儿尿碘及其家中盐碘、饮水碘等进行定量检测.结果调查城市和农村人群共计1000人,尿碘中位数155.5μg/L,合格碘盐食用率和加碘盐覆盖率分别为71.5%和80.1%,盐碘中位数32.8mg/kg.5种人群尿碘中位数水平排序为儿童＞婴幼儿＞孕妇＞哺乳妇女＞育龄妇女.城市人群尿碘水平以哺乳妇女最低(＜100μg/L),育龄妇女其次;农村人群则是育龄妇女最低,孕妇其次.2个调查点均未发现高碘水源.结论目前的碘盐浓度能够满足学龄儿童、婴幼儿和育龄妇女的碘需求,但孕妇和哺乳妇女还存在碘缺乏纠正不足的危险性,这部分人群应成为我们今后关注的重点.     

云南省芒市碘缺乏病历史重病区人群碘营养状况调查

目的了解德宏州芒市历史重病区碘缺乏病防治现状,以及病区人群碘营养状况。方法抽取1个碘缺乏病历史重病区乡,再抽3个历史病情较重的村进行调查,采集居民食用水样、盐样,以及居民户中育龄妇女的尿样,并对采集尿样的育龄妇女进行甲状腺B超检查;对抽取村(镇)小学的8-10儿童进行问卷调查、采集尿样,并进行甲状腺B超检查。结果水样检测结果均10μg/L;盐碘中位数为21.8 mg/kg,碘盐合格率为92.11%;8-10岁儿童尿碘中位数为162.51μg/L,100-200μg/L的比例为41.6%;普通妇女尿碘中位数为214.63μg/L,100-200μg/L的比例30.57%;乳妇尿碘中位数为105.25μg/L,100μg/L的比例为57.1%;孕妇尿碘中位数为125.48μg/L,150-250μg/L的比例为33.33%;儿童和妇女的甲状腺肿大率分别为1.59%和7.18%。结论德宏州外环境缺碘,普通人群碘营养状况良好,8-10岁儿童碘缺乏病防治知识知晓率较高,碘缺乏病防治效果显著,新标准食用盐碘含量可满足普通人群的日常碘需要。     

2006 - 2012 年双流县重点人群尿碘监测结果分析

目的了解四川省双流县4类人群的尿碘水平,为科学防治碘缺乏病提供依据。方法每年按东、西、南、北、中5个方位随机抽取孕妇、哺乳期妇女、0～2岁婴幼儿、8～10岁学龄儿童各10名,采用尿中碘的砷铈催化分光光度测定法检测,检测中每批样品均带标准物质,以保证检测质量。结果儿童尿碘中位数181．30μg／L,低于50μg/L占4．0％,低于100μg／L占16．6％;0～2岁婴幼儿尿碘中位数200．50μg／L,低于100μg／L的占18．2％;孕妇尿碘中位数138．00μg／L,尿碘中位数低于150μg／L,低于150μg／L的比例占48．7％;乳母尿碘中位数147．50μg／L,低于100μg／L的占30．4％。结论双流县儿童、0～2岁婴幼儿、乳母的碘营养水平均在适宜的范围,而孕妇的碘营养水平不稳定,应加强碘缺乏病健康教育和健康促进工作。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

Results of treatment of fistula-in-ano

To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.     

Intake of energy drinks in association with alcoholic beverages in a cohort of students of the School of Medicine of the University of Messina

BACKGROUND: Energy drinks (ED) are a widely used group of beverages known for their stimulant effects on central nervous system (CNS). The main components of ED are caffeine, taurine, carbohydrates, glucuronolactone, inositol, niacin, pantenol, and beta-complex vitamins. The studies evaluating the effects of ED describe improvements in attention and/or reaction times and indices of alertness. It has been also shown that combination of caffeine and glucose, fundamental constituents of ED, can ameliorate deficits in cognitive performance and subjective fatigue during extended periods of cognitive demand. Moreover, the associated ingestion of alcohol and ED has recently been observed to be becoming more and more widespread. METHODS: With the aim to know the habits and uses of students, we administered a questionnaire containing questions regarding ED drinking alone or in association with alcoholic beverages. Five hundred students of the School of Medicine of the University of Messina were interviewed, and 450 filled the questionnaire. RESULTS: A total of 56.9% of students declared using ED. A great part of users (48.4%) associate frequently ED and alcohol. In particular, 35.8% of ED + alcohol users have used ED + alcohol more than 3 times in the last month. Distinguishing the users into 2 groups (users of ED + alcohol and users of both ED and ED + alcohol), we observed in the second group a major use of cocktail containing a mix of ED and alcoholic beverages. This difference between the 2 groups is less represented about the ingestion of ED + alcohol in the night. CONCLUSIONS: Our data indicate that association of ED + alcohol is very popular among students. This behavior can be dangerous. In fact, the combination of ED + alcoholic drinks can reduce adversive symptoms of alcohol intoxication including the depressant effects. As consequence, users of ED + alcoholic beverages might not feel the signs of alcohol intoxication, thus increasing the probability of accidents and/or favoring the possibility of development of alcohol dependence.