秦皇岛市儿童肠易激综合征的流行病学调查

采用多级整群随机抽样方法 对秦皇岛市共6所学校中840名小学生进行面对面流行病学问卷调查,计算肠易激综合征(IBS)的期间患病率,对其致病的相关危险因素进行单因素与多因素分析.结果 被调查的小学生符合罗马Ⅱ诊断标准的IBS患病率为4.6%,患病率无性别及区域性差异.多因素回归分析表明,辛辣食物、痢疾史、腹部手术史、服用大量抗生素史、受凉、疲劳、心情焦虑、心情压抑及内向性格9个因素为最具可能性的危险因素.认为IBS是秦皇岛儿童的常见病和多发病,心理因素、食物、不良外界环境因素及家庭环境因素等可能是诱发儿童IBS致病的相关危险因素.     

某部海岛官兵肠易激综合征的流行病学调查

目的探讨海岛官兵肠易激综合征(IBS)的患病率及相关危险因素。方法采取整群、分层、随机抽样的方法对某部4 358名海岛官兵进行流行病学问卷调查。结果共调查4 358人,全部男性,平均年龄(31.57±10.95)岁,应答率为97%。校正后符合Manning标准IBS的标化患病率为8.67%,符合罗马Ⅲ诊断标准IBS的标化患病率为4.86%,患病率无年龄差别。Logistic回归分析提示,滥用抗生素、食物过敏史、胃肠道感染、心情压抑或生活事件消极应对方式、精神紧张、外界恶劣环境等为最具可能性的危险因素,其OR值均>1。结论 IBS是海岛官兵的常见病和多发病,应引起重视;滥用抗生素、食物过敏史、胃肠道感染、心情压抑或生活事件消极应对方式、精神紧张、外界恶劣环境等可能是诱发海岛官兵IBS致病的相关危险因素。     

福建省青少年肠易激综合征的流行病学调查

目的分析城市中小学生肠易激综合征(IBS)的患病率、分布特征、致病的相关危险因素及焦虑性情绪障碍状况。方法采用多级整群随机抽样方法,对福建省两个地级市中4826名中小学生进行流行病学问卷调查。结果①校正后符合Manning及罗马Ⅱ诊断标准IBS的期间患病率分别是52．16％及17．10％,以高中生居多,男女患病率差异无统计学意义(P>0．05)。②Logistic回归分析揭示,年级、喜食辛辣或生冷食物、胃肠道感染、经常服用抗生素、遗传、经常因IBS症状而就诊、进食时吞咽困难、经常采用吞气来帮助终止打嗝、纳差、心情压抑11种因素为最具可能性的危险因素,其OR值均> 1。③4826名学生中有焦虑性情绪障碍倾向者占22．53％,男性17．84％,女性26．45％,两者差异有统计学意义(P<0．01)。④在儿童焦虑性情绪障碍筛查表(SCARED量表)5个领域的分值比较中,IBS学生高于非IBS学生,IBS就诊学生高于未就诊学生。结论①IBS是城市中小学生的常见病及多发病,患病率随年龄增长而上升;②不良饮食习惯、胃肠道感染、滥用抗生素、遗传及精神心理因素等可能是诱发城市中小学生IBS致病的相关危险因素;③焦虑性情绪障碍倾向发生率随年龄增长而上升。     

上海市松江社区居民肠易激综合征流行病学调查

目的 探讨上海市松江地区常住成年社区居民符合罗马Ⅲ诊断标准的肠易激综合征(IBS)患者的患病率、亚型、分布特征及危险因素等.方法 采用多级、分层、整群随机抽样法,在2010年4月至5月间,对上海市松江区共45个社区居民进行面访式问卷调查.IBS诊断采用罗马Ⅲ标准,分型采用Bristol粪便形状分型量表.同时完成焦虑自评量表、抑郁自评量表及睡眠质量评估量表.结果 完成调查并回收问卷合格者7648份(名),有效率为90％.抽样人数占上海市松江区总人口数的1.62％.共检出符合罗马Ⅲ标准的IBS患者970例,其中男性492例,女性478例.标化后IBS患病率为13.1％,其中男性为13.8％,女性为12.7％,男女比例为1∶0.92,男女检出率差异无统计学意义(P＞0.05).患病率在18～29岁年龄段最高(18.2％,P=0.000).符合罗马Ⅲ分型标准中最多见的是未定型(45.3％),其次在男性以腹泻型(27.0％)多见,女性则以便秘型(19.5％)多见.在肥胖组(x2=4.046,P=0.044)、受高等教育组(x2=31.210,P=0.000)、脑力劳动组(x2=8.409,P=0.015)、未婚组(x2=26.933,P=0.000)、非腹部手术组(x2=5.894,P=0.015)IBS的患病率高于对照组.有胃肠道感染史、腹部手术史、服用抗生素及止痛药物史IBS的患病风险分别提高5.105、3.388、2.949及2.811倍(P=0.000).多因素分析显示较多地食用辛辣食物,IBS患病危险提高1.69倍(P=0.000),而高蛋白质饮食则是保护性因素(OR=0.900,P=0.000).焦虑(OR=2.452,P=0.000)及失眠(OR =2.452,P=0.000)同样是IBS患病的危险因素.结论IBS是上海市松江区社区成人的常见病和多发病.胃肠道感染史、腹部手术史、服用抗生素及止痛药物、嗜好辛辣食物、焦虑及失眠可能是IBS患病的危险因素.     

汕头市高三学生肠易激综合征流行病学的调查分析

目的了解汕头市高三学生肠易激综合征（irrita blebowel syndrome,IBS）的患病率和依从性情况。方法采用整群随机抽样方法对汕头市3300名高三学生进行流行病学问卷调查,估算符合罗马Ⅲ标准IBS的期间患病率、依从性和危险因素。结果 IBS的患病率为13.39%,女性患病率显著高于男性（17.0%vs10.3%,P〈0.05）;在符合罗马Ⅲ标准的IBS患者中,38.01%（168例）为腹泻型;26.70%（118例）为便秘型;15.61%（69例）为混合型;19.68%（87例）为不定型;肠道感染史和进食辛辣食物等可能是危险因素。结论 IBS是高三学生的常见病及多发病但大多数没有专科诊治,依从性差。     

基于罗马Ⅳ标准的广西某高职院校学生肠易激综合征患病情况及发病危险因素的调查分析

目的探讨高职院校学生肠易激综合征(IBS)的患病情况及发病的危险因素。方法采用整群抽样方法,抽取广西壮族自治区某高职院校的大一新生2 626名,采用罗马Ⅳ标准对他们进行问卷调查诊断以了解学生IBS的患病情况,并对IBS发病的危险因素进行Logistic回归分析。结果根据罗马Ⅳ标准,高职院校新生的IBS总患病率为2. 70%,其中男生IBS患病率为1. 69%;女生IBS患病率为3. 00%。男女生IBS患病率比较差异无统计学意义(P 0. 05),不同民族新生IBS患病率比较差异无统计学意义(P 0. 05)。单因素分析结果显示,高职院校健康新生饮酒、受凉、乳制品摄入、劳累、情绪不佳、精神刺激等情况与新生IBS患者比较,差异有统计学意义(P 0. 05)。多因素Logistic回归分析显示,乳制品摄入、精神刺激是高职院校新生IBS发病的独立危险因素(P 0. 05)。结论进食乳制品及精神刺激是高职院校新生IBS发病的独立危险因素。学生普遍面临着较大学业压力,比较容易发生IBS,加强对他们进行健康教育,对提高他们的就诊意识,找到并祛除发病诱因,从而降低发病率,提高生活质量具有非常重要的意义。     

胃肠疾病与无先兆偏头痛之间的联系：一项横断面研究

背景:既往研究发现胃肠疾病患者头痛的发生率较高,而偏头痛患者常伴有胃肠道症状。了解疾病之间的关联可为其机制的研究和治疗提供新思路。目的:探索胃食管反流病(GERD)、功能性消化不良(FD)和肠易激综合征(IBS)与无先兆偏头痛(MWoA)的共患情况以及相关危险因素。方法:采用随机分层抽样的方法对陕西省2 696名成年农村居民进行问卷调查,依据ICHD-Ⅲβ诊断标准、蒙特利尔标准、罗马Ⅳ标准分别诊断MWoA、GERD、FD和IBS,计算单病患病率以及与MWoA的重叠患病率,比较MWoA组与非MWoA组之间GERD、FD和IBS的患病率,并分析各个疾病的相关危险因素。结果:本研究共收集有效问卷2 423份,GERD、FD、IBS的患病率分别为12.5%、15.6%、6.9%,MWoA的患病率为8.8%。MWoA组GERD(30.5%对10.7%)、FD(37.1%对13.5%)、IBS(27.2%对4.9%)的患病率均高于非MWoA组(P均0.001)。多因素分析显示,女性、高血压、运动系统慢性损伤疾病史均与GERD、FD、IBS以及MWoA的患病呈正相关。结论:GERD、FD和IBS与MWoA之间存在一定的关联。     

汶川地震灾区中学教师肠易激综合征的患病率和相关因素

目的:研究肠易激综合征(IBS)在地震灾区(汶川)中学教师中的患病率、发病特征、致病相关危险因素.方法:采用多级随机抽样方法,随机抽取地震灾区和非灾区3所中学269名教师进行IBS的流行病学调查.结果:校正后符合罗马Ⅱ诊断标准IBS的患病率为22.5%(95%CI:17.3%-24.7%).其中地震灾区患IBS有38例,患病率为27.9%(95%CI:20.4%-35.4%),非地震灾区患IBS有17例,患病率为15.7%(95%CI:8.8%-22.6%),经比较IBS在地震灾区的教师中患病率高于非灾区,差异有统计学意义(P<0.05);通过HAD量表调查发现,地震灾区和非灾区教师在焦虑焦虑和抑郁状况方面没有统计学意义,而患IBS教师发生率要高于非IBS教师,有统计学意义(P<0.05).结论:地震灾区教师IBS的患病率27.9%,高于非灾区教师的患病率.非灾区教师生理机能优于灾区教师,在焦虑和抑郁状况方面患IBS教师发生率要高于非IBS教师,说明地震应激事件可加重地震灾区教师的IBS发病,使其病情复杂化和治疗难度加大.     

南宁市35岁以下青年肠易激综合征患病情况及影响因素

目的:调查广西南宁市35岁以下青年肠易激综合征(irritable bowel syndrome,IBS)的患病情况及患病的影响因素,为提高本地区IBS的防治水平提供参考.方法:采用依据罗马ⅢIBS诊断标准并结合IBS相关流行病学因素设计的调查问卷对南宁市5个城区1214名35岁以下青年进行面访式调查,了解南宁市青年人群IBS患病率,并对其患病的影响因素进行分析.结果:(1)63例诊断为IBS,南宁市35岁以下青年IBS患病率为5.19%;(2)该人群患病情况在不同城区及职业差异有统计学意义,在校学生IBS的患病率明显高于在职人员(P0.05),被调查者是否存在喜食生冷食品、辛辣食物、水果、乳制品等饮食因素及受凉、劳累、情绪不佳、精神刺激等其他相关因素的患病率差异有统计学意义(P0.05),将可能与青年IBS患者发病有关的因素纳入多因素Logistic回归方程,结果提示,喜食生冷食品、水果是影响南宁市青年人群发生IBS的主要因素,其比值比(odds ratio,OR)值分别为2.255及2.076(P0.05).结论:南宁市35岁以下青年IBS患病率为5.19%.喜食生冷食品、水果是其患病的影响因素.     

睡眠质量与社区人群肠易激综合征相关性分析

目的 探讨上海市社区人群睡眠质量与肠易激综合征(IBS)患病率及两者之间的关系.方法 采用随机分层整群抽样方法,对上海市嘉定区江桥镇常住人群成年居民进行面访式问卷调查,回收有效调查问卷11 569份.采用罗马Ⅲ标准诊断IBS,阿森斯睡眠障碍量表进行自我评估,分析睡眠障碍与IBS之间的关系.结果 睡眠障碍在社区总人群、IBS患者及非IBS患者中发生率分别为21.00%、33.02%和18.74%.IBS组存在睡眠障碍比例高于非IBS组,两组间差异有统计学意义(P=0.004,OR=2.14,95%CI:1.92～2.39),即存在睡眠障碍的人群患IBS的危险性是无睡眠障碍人群的2.14倍.在IBS组,女性患者存在睡眠障碍的比例(37.24%)显著高于男性患者(28.41%),两组间差异有统计学意义(P=0.000,OR=1.50,95%CI:1.23～1.82),提示存在睡眠障碍的女性更易于患IBS.Logistic回归分析显示睡眠障碍是IBS的危险因素之一(OR=2.11,95%CI:1.89～2.36).结论 IBS患者常存在睡眠障碍,尤其是女性患者.     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

Effects of pinealectomy and melatonin administration on certain indices of ovarian hyperplasia and/or hypertrophy in rats with both ovaries intact or after unilateral ovariectomy

Abstract: In earlier studies from other laboratories it was shown that melatonin decreased ovarian weight in rats and inhibited compensatory hypertrophy of the remaining ovary after unilateral ovariectomy. This study was designed to examine the influence of melatonin on certain indices of ovarian hyperplasia and/or hypertrophy in adult female rats with both ovaries preserved and with either an intact pineal gland or with the pineal gland removed (pinealectomy, PX) or, finally, in sham-PX animals. Similar studies were conducted on rats after unilateral ovariectomy, referring the examined parameters to the remaining intact ovary. The studies included mitotic activity of granulosa layer cells and corpus luteum cells, ovarian weight, ovarian cross-sectional area, cross-sectional area of the granulosa layer of all the Graafian follicles and the cross-sectional areas of the corpora lutea, visible on the ovarian cross-section. On the basis of results, we conclude that: 1) the effect of PX on the processes of ovarian hyperplasia and hypertrophy may vary; analogously, exogenous melatonin administration may influence ovarian hyperplasia and hypertrophy in different ways; 2) PX and exogenous melatonin may, under certain conditions, exert similar biological effects, even synergistic effects; 3) melatonin inhibits ovarian growth processes, while the effects of PX are variable; 4) the results indicate that in experiments performed on rats, with the use of two control groups, i.e., intact and sham-PX, melatonin effects on these two groups may differ.