内皮抑素和血管抑素表达与大肠肿瘤侵袭转移的关系

目的探讨内皮抑素和血管抑素在大肠肿瘤组织中的表达,与大肠癌不同阶段的关系及临床意义。方法应用免疫组织法检测20例正常大肠组织、20例大肠腺瘤和60例大肠癌及其组织中内皮抑素和血管抑素的表达情况。应用χ2检验对内皮抑素和血管抑素两者在大肠肿瘤不同阶段的表达关系进行统计分析,两者表达间的相关性探讨采用spearman相关分析。结果内皮抑素和血管抑素阳性表达与大肠肿瘤不同阶段的关系spearman相关系数分别为-0.438、-0.362,两者的表达与大肠癌的Dukes分期、淋巴结转移显著相关(P<0.05),均与腺瘤的类型无相关性。结论内皮抑素和血管抑素可以抑制大肠癌的侵袭转移。内皮抑素和血管抑素在大肠癌组织中呈低表达,且两者的阳性表达率随着临床分期的进展而降低,提示其与大肠癌的发生、发展、浸润及转移有明显关系。两者在大肠癌组织中的表达呈明显的一致性,对两者进行联合检测,有助于大肠癌的早期诊断、治疗及预后的评估。     

硝酸甘油对哮喘患者一氧化氮内皮素的影响及机制

目的　了解哮喘患者肺泡巨噬细胞（ＡＭ） 、支气管上皮细胞（ＢＥＣ） 源性一氧化氮（ＮＯ）、内皮素（ＥＴ）的分泌状态及硝酸甘油（ＮＴＧ）对哮喘患者ＡＭ、ＢＥＣ产生ＮＯ、ＥＴ的影响及机制。方法　分离纯化了１５ 例轻、中度哮喘发作期患者、７ 名健康受试者ＡＭ、ＢＥＣ,并分为哮喘未干预组、哮喘ＮＴＧ干预组和健康对照组,用放射免疫法和镀铜镉还原法分别测定ＡＭ、ＢＥＣ培养４８ 小时上清液中ＥＴ、ＮＯ·２／ＮＯ·３ 浓度,用原位杂交的方法检测ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ、ＥＴｍＲＮＡ 的表达。结果　（１） 健康受试者ＡＭ、ＢＥＣ分泌少量ＮＯ和ＥＴ及少量ｉＮＯＳｍＲＮＡ 、ＥＴｍＲＮＡ表达;（２）哮喘患者ＡＭ、ＢＥＣ源性ＮＯ、ＥＴ水平及ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ、ＥＴｍＲＮＡ表达与各组比较差异有显著性（ Ｐ均＜ ０－０５）;（３）ＮＴＧ 促进哮喘患者ＡＭ、ＢＥＣ源性ＮＯ产生（ Ｐ均＜０－０５）,明显抑制ＥＴ产生和ＥＴｍＲＮＡ 的表达,与对照组比较差异均无显著性（ Ｐ均＞ ０－０５） ,ＮＴＧ同时抑制哮喘患者ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ的表达,与健康对照组、哮喘未干预组比较差异有显著性（Ｐ均＜０－０５） ;（４） 除哮喘ＮＴＧ     

Lipid disorders and their relevance to outcomes in chronic kidney disease

Cardiovascular disease is the major cause of death in patients with chronic kidney disease (CKD). Cardiovascular disease and many other complications of CKD are mediated by oxidative stress, inflammation, and dyslipidemia. This review provides a concise overview of the nature and mechanisms of CKD-induced lipid disorders and their adverse consequences. Lipid abnormalities in end-stage renal disease are characterized by: (a) reduced serum apoA-1 and high-density lipoprotein (HDL) concentrations, impaired HDL maturation and defective HDL antioxidant, anti-inflammatory and reverse cholesterol transport properties; (b) impaired clearance of very low-density lipoprotein and chylomicrons by the muscle and adipose tissue and of their remnants by the liver leading to hypertriglyceridemia, accumulation of intermediate-density lipoprotein and chylomicron remnants, and (c) oxidative modification of LDL and lipoprotein remnants favored by their structural abnormalities, oxidative stress, and impaired HDL antioxidant activity. Together these abnormalities result in: (a) uptake of oxidized LDL and remnant particles by macrophages and resident cells in the artery wall which along with impaired HDL-mediated reverse cholesterol transport causes foam cell formation and atherosclerosis, (b) production of inflammatory mediators and reactive oxygen species by leukocytes and macrophages in response to stimulation by oxidized LDL and phospholipids leading to intensification of oxidative stress and inflammation, (c) dissemination of oxidative stress by circulating oxidized lipids and lipoproteins via lipid peroxidation chain reaction, (d) heightened injurious effects of oxidative stress and inflammation due to diminished antioxidant, anti-inflammatory and antithrombotic activities of HDL, and finally (e) impaired ability of very low-density lipoprotein and chylomicron to deliver lipid fuel to muscle and adipose tissue contributing to muscle weakness and cachexia which commonly occur in end-stage renal disease patients.     

Prevention of Mother-to-Child Transmission of HIV and Paediatric HIV Care and Treatment Monitoring: From Measuring Process to Impact and Elimination of Mother-to-Child Transmission of HIV

Progress towards achievement of global targets for the prevention of mother-to-child transmission of HIV (PMTCT) and paediatric HIV care and treatment is an integral part of global and national HIV and AIDS responses. This paper documents the development of the global and national monitoring and reporting systems for PMTCT and paediatric HIV care and treatment programmes, achievements and remaining challenges. A review of the development of the monitoring and reporting process since 2002–2016 was conducted using existing published literature and taking into account changes in WHO HIV treatment guidelines, global HIV goals and targets, programmatic and methodological developments, and increased need for interagency partnerships, coordination and harmonization of global monitoring and reporting mechanisms. The number and type of indicators reported increased and evolved from monitoring of existence of national policies and guidelines, service delivery sites and trained health workers and coverage of PMTCT and paediatric HIV interventions to measuring outcomes and impact in reducing new HIV infections and AIDS related deaths, including efforts to validate elimination of mother-to-child transmission of HIV. These changes were required to mirror changes in WHO and national PMTCT and HIV treatment guidelines. The number of countries reporting PMTCT coverage increased from 53 in 2003 to over 130 in 2015. National monitoring processes have also expanded in scope and the capacity to report on disaggregated data by type of ARV regimen and for paediatric HIV care and treatment has increased. Monitoring of PMTCT and paediatric HIV programmes has contributed a rich body of evidence that helped monitor how quickly countries were adopting and implementing the latest WHO HIV treatment guidelines for pregnant and breastfeeding women and children. The reported data and experiences were instrumental in shaping global policies, national programmes, and investment choices.     

Measuring the communication of social support from adult children

Further knowledge of the nature and significance of the relationships of elderly persons to their adult children requires the application of social support scales tapping the quality and content of their interactions. Scaling efforts must further address conceptual and operational specification, the differentiation of sources and dimensions of support, the objectification of self-report scales, and construct validity. Respondents to this survey are a community, stratified probability sample of adults aged 50 and older (N = 1,174). Measures employed include 2 items reflecting instrumental support and 17 items designed to tap Cobb's (1976) definition of expressive support as consisting of information that one is loved, esteemed, and embedded in a social relationship characterized by mutual caring and obligation. Factor analyses consistently discern one instrumental and three expressive dimensions of support: Caring and Concern, Social Integration, and Love and Affection. These subscales are differentially correlated with sociodemographic characteristics of the parents and adult children, as well as with depression and disability. Implications of these and other findings are discussed.     

不同地区孕妇缺碘状况及干预补碘效果的调查研究

目的研究新疆生产建设兵团3个不同地区（轻度、中度、重度缺碘地区）4组孕妇碘营养水平,及采取干预补碘前后尿碘的变化,分析评价干预效果。方法选择碘盐覆盖率、尿碘水平不同的三类缺碘地区,调查孕妇服碘化油胶丸前后的尿碘水平。结果干预前4组孕妇的尿碘中位数分别为119.90、147.20、214.00和167.10μg/L,尿碘值〈100μg/L的比例分别是30.0%、4.3%、42.9%和20%;干预后1个月4组孕妇中位数分别为172.25、148.70、164.50和229.80μg/L;尿碘值〈100μg/L的比例分别是25.0%、22.2%、19.5%和0;干预后3个月中位数分别为150.00、103.60、176.60和219.60μg/L;尿碘值〈100μg/L的比例分别是25.0%、47.8%、13.8%和13.8%;干预后6个月中位数分别为119.90、147.20、214.00和167.10μg/L;尿碘值〈100μg/L的比例分别是25.0%、15.4%、13.8%和0;干预后9个月中位数分别为173.95、185.20、208.50和262.21μg/L;尿碘值在〈100.0μg/L的比例分别是21.9%、10.3%、26.1%和0。结论干预补碘可以使缺碘地区的孕妇尿碘中位数向高值偏移,能明显改善碘缺乏地区碘营养状况;在中度缺碘地区的孕妇用较小剂量200mg能满足自身的碘需求,在重度缺碘地区的孕妇用较大剂量400mg能满足自身的碘需求,特别是在干预后1个月、3个月,干预措施对尿碘的升高影响明显。     

新疆阿拉山口口岸城区鼠类近况调查研究

目的 掌握阿拉山口口岸城区鼠、蚤密度、种群构成、季节消长规律等,为鼠疫防制提供依据.方法 2006年4月～2007年3月采用夹夜法对口岸鼠情进行监测,并利用微量血凝法检测F1抗体及抗原.结果 通过1年的调查,在城区布放有效板夹6 845个,捕获鼠形动物290只,鼠密度为4.2%,居民生活区高于作业区(P＜0.01),经过鉴定隶属2目4科6属6种,优势种为褐家鼠和小家属,分别占41.3%和34.3%;从口岸城区捕获鼠体表采集蚤288只,隶属3科5属6种;捕获鼠平均染蚤率为13.5%,总蚤指数为1.0,其中褐家鼠的染蚤率和印鼠客蚤指数分别为22.5%和2.4;共检测鼠血清52份,鼠脏器材料86份,结果均为阴性.结论 新疆阿拉山口口岸灭鼠灭蚤工作应把重点放在居民区,同时兼顾作业区;加强对城区褐家鼠和印鼠客蚤的监测和控制;密切关注口岸郊区的鼠、蚤情况,这对疫情的早发现、早控制具有现实意义.     

我国新时期水利血防面临的挑战与对策

血吸虫病的传播与流行严重威胁我国人民身体健康、阻碍经济社会发展。水利血防是指在血吸虫病流行区,利用水利工程结合血吸虫病防治措施,发挥控制钉螺孳生繁殖和扩散等防治作用,从而有效控制血吸虫病传播与流行的一种防治策略。本文回顾了我国血吸虫病防治策略和水利血防的历史沿革,以及水利血防在推进我国血吸虫病防治进程中的重要作用,分析了在当前我国的血吸虫病防治工作正在向传播阻断和消除阶段推进的新时期,水利血防工作所面临的问题和挑战,并提出了相应的水利血防对策建议:开展水利血防新策略研究;加强水利血防新技术研究,提高水利血防工程的效率和适用性;加强水利血防工程技术指导,完善工程评估体系建设等。     

Human, small round structured viruses, caliciviruses and astroviruses

Epidemiological studies on SRSVs, human calicivirus and astroviruses have been limited by the problems of establishing them in cell culture and the inability to transmit them to animals or to use strains from animals as a source of antigen for diagnostic tests. The use of EM and the subsequent development of RIAs and EIAs in a few research centres has shown that they are a cause of outbreaks and sporadic cases of diarrhoea and vomiting. SRSVs have increasingly been recognized as a major cause of outbreaks of gastroenteritis in the community and in hospital wards. The symptoms of illness are generally mild and of short duration and patients seldom require medical attention. However, because of the high attack rates and large numbers of persons of all age groups involved, there is often considerable economic loss and disruption of services. Evidence is accumulating that polluted water, molluscan shellfish, and contaminated cold foods are major sources of infection. Recently a SRSV has been shown to be the cause of epidemics and sporadic cases of waterborne enterically transmitted non-A, non-B hepatitis (hepatitis E virus) which have occurred in the USSR, India, Mexico and Africa. Astroviruses and human caliciviruses are occasional causes of outbreaks of vomiting and diarrhoea in infants and the elderly which can necessitate the closure of hospital wards and cause considerable disruption. Symptoms are generally mild and of short duration and therefore the majority of cases are unlikely to be investigated by laboratories. Diagnosis of infections is at present limited to the few laboratories that have developed their own assays or have access to electronmicroscopy facilities.     

Smoking cessation or reduction in pregnancy treatment methods: a meta-evaluation of the impact of dissemination

Active and passive exposure to tobacco smoke during pregnancy and infancy is the most serious and preventable cause of adverse maternal, fetal, and infant outcomes in the United States. The multiple risks of tobacco exposure to mothers and infants are definitive, and the clinical and economic benefits of cessation have been documented. This article provides a synopsis of the state of the science and art in this specialized area and reviews the evidence for validity of patient assessment methods and the effectiveness of smoking cessation/reduction treatments for pregnant women. A synthesis of 4 topics is presented: (1) the validity of patient reports of smoking status and recent trends during pregnancy and postpartum; (2) definition of "Best Practice" smoking cessation methods for pregnant women; (3) the effect of dissemination of effective clinical practice methods among the 800,000+ pregnant US smokers each year; and (4) the evidence for the cost-benefit of improved maternal and infant outcomes from cessation.     

胆管癌细胞无自分泌CCK、胃泌素机制

目的明确胆管癌细胞是否存在胆囊收缩素（ｃｈｏｌｅｃｙｓｔｏｋｉｎｉｎ,ＣＣＫ）、胃泌素（ｇａｓｔｒｉｎ）自分泌机制。方法采用免疫组织化学及放射性免疫分析技术,探测了胆管癌细胞ＱＢ、ＯＣ及４２例胆管癌标本中ＣＣＫ８和Ｇａｓｔｒｉｎ１７的表达,胆管癌细胞ＱＢ、ＯＣ培养上清及细胞提取液中ＣＣＫ８和Ｇａｓｔｒｉｎ１７的含量,胆管癌患者手术前后空腹血浆ＣＣＫ８和Ｇａｓｔｒｉｎ１７浓度的改变。结果发现胆管癌细胞ＱＢ和ＯＣ及胆管癌标本中均无ＣＣＫ８和Ｇａｓｔｒｉｎ１７的表达;ＱＢ和ＯＣ中未检测到ＣＣＫ８和Ｇａｓｔｒｉｎ１７的存在;胆管癌患者手术前后空腹血浆胆囊收缩素、胃泌素含量无明显变化。结论胆管癌细胞无自分泌胆囊收缩素、胃泌素现象存在。     

人参及其主要成分抗糖尿病作用机制

临床和实验研究表明人参及其活性成分具有调节糖脂代谢，抗糖尿病和肥胖的作用。由于有效成分组成和含量的不同，导致其作用机制具有复杂性和多样性，涉及糖脂代谢的多个方面，主要与抑制食欲和肠道葡萄糖与脂肪的吸收；影响糖脂代谢通路，增加能量消耗；调节过氧化物酶体增殖物活化受体γ（PPARγ）活性和表达，改善胰岛素抵抗；促进胰岛素合成和释放以及抗胰岛β细胞凋亡；抗氧化应激和抗炎作用有关。今后需要对人参不同有效部位和单体成分进行进一步的研究，明确其抗糖尿病和肥胖的确切有效成分和作用机制。     

长期染砷致家兔肝脏蛋白巯基水平及巯基代谢相关酶活力下降

目的 探讨长期砷暴露对家兔肝脏蛋白巯基水平及与巯基代谢相关酶活力的影响及机制。方法 家兔以自由饮水方式慢性暴露于无机3价砷（iAs^Ⅲ）及5价砷（iAs^Ⅴ），18周后，测定肝脏组织中蛋白巯基、非蛋白巯基、硫氧还蛋白（TRX）水平，以及硫氧还蛋白还原酶（TR）、谷胱甘肽还原酶（GR）活性，同时检测血、尿及毛发中无机砷及其代谢产物甲基砷（MMAs）和二甲基砷（DMAs）。结果 经过18周的砷暴露，两个染毒组血和尿中iAs、MMAs、DMAs以及毛发中iAs、DMAs均显著高于对照组；iAs^Ⅴ组血中iAs、MMAs及尿中MMAs水平显著低于iAs^Ⅲ组，而尿及毛发中iAs水平显著高于iAs^Ⅲ组。iAs^Ⅴ组总巯基及蛋白巯基水平显著低于对照组。iAs^Ⅵ组TRX水平、TR及GR活力以及iAs^Ⅲ组TR活力与对照组相比亦显著下降。结论 家兔长期砷暴露导致肝脏中蛋白巯基水平及与巯基代谢密切相关的TR、GR活力显著下降，提示慢性无机砷暴露会引起肝脏内氧化及抗氧化失衡从而引发组织氧化损伤。     

Attitudes and preferences of Korean-American older adults and caregivers on end-of-life care

A growing body of literature suggests that diverse attitudes toward the end of life exist across and within ethnic minority groups. This focus-group pilot study examined social and cultural factors influencing views of Korean-American older adults and caregivers on advance care planning and hospice care. A total of 20 older adults and 16 caregivers in west central Florida participated in one of four focus groups. This study found diverse attitudes among Korean Americans toward end-of-life care and cultural and structural barriers to advance care planning and hospice use. Older adults and caregivers both expressed a lack of knowledge about advance care planning and hospice and agreed that the family would make the final decision about the end-of-life care, while acknowledging the challenge of initiating communications about treatment preferences. They interpreted the Korean value of filial piety to support both curative and palliative treatment. The traditional norm of home death and importance of physician communication influenced preferences for hospice and advance care planning, respectively. Future outreach and education efforts should include development of culturally sensitive educational and communication tools and collaboration with ethnic community organizations and healthcare providers in the dissemination and education of these instruments.     

江滩地区纳潮引水药浸法杀灭钉螺的现场评价

［摘要］　目的　比较江滩地区纳潮引水药浸法与单纯喷洒法现场灭螺效果。方法　在2块相邻有螺江滩上分别采用纳潮引水药浸法灭螺（灭螺药为26%四聚·杀螺胺乙醇胺盐悬浮剂）与单纯26%四聚·杀螺胺乙醇胺盐悬浮剂喷洒法灭螺，在灭螺前后分别进行螺情调查并计算灭后活螺密度。结果　纳潮引水药浸法灭螺后1年和2年活螺密度下降率分别为72.19%和100.00%，单纯喷洒法灭螺后1年和2年活螺密度下降率分别为5.93%和18.15%。结论　有螺江滩纳潮引水药浸法灭螺效果明显优于单纯喷洒法灭螺，纳潮引水药浸法灭螺持续开展2年以上效果更佳。     

胃癌组织COX-2、nm23-H1蛋白及其mRNA表达与胃癌浸润转移的关系

目的 探讨胃癌组织中环氧合酶-2（COX-2）、转移抑制基因23-H1（nm23-H1）蛋白及其mRNA表达与胃癌浸润转移的关系。方法 采用免疫组化SP法和原位杂交技术，检测57例胃癌组织中COX-2、nm23-H1蛋白及其mRNA。结果 COX-2、nm23-H1蛋白及其mRNA的表达均与胃癌浸润深度、淋巴结转移及TNM分期有关；COX-2、nm23-H1蛋白及其mRNA的表达均无相关性。结论 COX-2促进胃癌浸润转移，nm23-H1抑制胃癌浸润转移，两者通过各自独立的途径发挥作用。     

PTTG、VEGF-C 的表达及微淋巴管密度与非小细胞肺癌临床病理特征的关系

目的检测非小细胞肺癌（non-small cell lung cancer,NSCLC）、癌旁组织及肺良性病变组织中垂体瘤转化基因（pituitary tumortrans-forming gene,PTTG）及血管内皮生长因子-C（vascular endothelial growth factor,VEGF-C）的表达和微淋巴管密度（lymphatic microvessel density,LMVD）值,并探讨三者间的相互关系。方法应用实时荧光定量PCR和免疫组织化学方法检测非小细胞肺癌组织中PTTG、VEGF-C mRNA和蛋白及LM-VD的表达,分析PTTG、VEGF-C及LMVD与NSCLC临床病理特征的关系,以及PTTG、VEGF-C和LMVD三者之间的相互关系。同时,对随访资料进行生存分析,绘制生存率曲线,探讨PTTG、VEGF-C对肺癌患者预后的影响。结果PTTG、VEGF-C mRNA和LMVD值在不同性质的肺病变组织中的表达均有显著性差异（P均〈0.05）,在不同年龄、性别、是否吸烟、肿瘤大小、组织学类型及分化程度间无显著性差异（P均〉0.05）,在TNM分期、淋巴结转移与否及预后组间有显著性差异（P均〈0.05）。PTTG、VEGF-C蛋白表达在淋巴结转移与否及预后组间有显著性差异（P均〈0.05）。生存率曲线显示PTTG、VEGF-C高表达者生存时间均短于低/无表达者（P=0.030,0.027,n=65）。PTTG在肺癌组织中的表达与VEGF-C、LMVD密切相关,随着PTTG强度增加,VEGF-C分级及LMVD值亦增加。结论PTTG、VEGF-C的过度表达促使肿瘤微淋巴管的生成,进而促进了肿瘤细胞淋巴结转移。PTTG和VEGF-C表达可作为判断NSCLC生物学行为及肺癌患者预后的良好指标,VEGF-C有望成为肺癌抗淋巴管治疗的新靶点。     

Expression of e-cadherin and catenins in early gastric cancer

E-cadherin and its associated cytoplasmic proteins including alpha-, beta-, and gamma-catenin play a pivotal role in the maintenance of normal tissue architecture and the suppression of cancer invasion. The purpose of this study was to evaluate the expression of E-cadherin and alpha-, beta-, and gamma-catenin in a larger sample of early gastric cancer, and to examine the relation between these expressions and various clinicopathologic variables. The expression of E-cadherin and alpha-, beta-, and gamma-catenin was investigated using immunohistochemical technique with formalin-fixed, paraffin-embedded tissue specimens obtained from 108 patients who underwent surgery for early gastric cancer. In the gastric mucosa of noncancerous areas, epithelial cells showed equally strong membranous expression of E-cadherin and alpha-, beta-, and gamma-catenin proteins at the cell-cell boundaries. Reduced expression of E-cadherin and alpha-, beta-, and gamma-catenin was demonstrated in 43.5%, 39.8%, 42.6%, and 50% of cancer tissues, respectively. Whereas 34 tumors (31.5%) displayed preserved expression of all four E-cadherin-catenin complex components, 21 tumors (19.4%) displayed reduced expression of all components of this complex. Reduced expression of E-cadherin and alpha- and gamma-catenin occurred more frequently in diffuse than in intestinal types of cancer, and decreased expression of E-cadherin and alpha-, beta-, and gamma-catenin correlated with poor differentiation. The expression of E-cadherin and beta- and gamma-catenin did not correlate with the patient's age, gender, tumor size, location, macroscopic type, depth of invasion, or lymph node metastasis. Only reduced expression of alpha-catenin correlated with lymph node metastasis. Reduced expression of all four E-cadherin-catenin complex components correlated with poorly differentiated and diffuse-type cancers, but not with the patient's age, gender, tumor size, location, macroscopic type, depth of invasion, or lymph node metastasis. These results suggest that dysfunction of the E-cadherin-catenin complex occurs in an early stage of carcinogenesis, playing a crucial role in disruption of tissue architecture and loss of differentiation in early gastric cancer.     

LIPID PROFILES AND CARDIOVASCULAR DISEASE IN THE WHICKHAM AREA WITH PARTICULAR REFERENCE TO THYROID FAILURE

The age and sex distribution of ischaemic heart disease (IHD), other vascular disorders and serum lipid concentrations and the possible association between these factors and thyroid failure have been examined in a community survey. A past history of IHD occurred in 7.5% of males and 4.8% of females.‘Chest pain on effort’was found in 7.4% of males and 7.8% of females and‘possible infarction’in 5.4% of males and 3.8% of females. Major ECG changes were found in 4.7% of both sexes and minor changes in 6.5% of males and 11% of females. Intermittent claudication was present in 4.8% and cerebrovascular accidents had occurred in 2% of the sample. Diastolic blood pressures greater than 100mmHg were found in 13% of all males and 11% of all females. Cholesterol concentrations were normally distributed. Mean cholesterol rose by approximately 0.25 mmol/1/decade in both sexes to reach a maximum in the 55–64 years age group and declined slightly thereafter. Trigly-ceride values were skewed to the right and increased by 0.2 mmol/1/decade in males up to the 45–54 years age group and by 0.1 mmol/1/decade in females to a peak in the 65–74 years age group — and declined after these ages. Electrophoresis revealed Type IIa patterns in 3% of males and 9% of females, IIb in 1% of both sexes and Type IV in 13% of males and 3% of females. There was no association in males between IHD and thyroid antibodies or minor degrees of thyroid failure. There was a weak association between minor ECG changes and minor degrees of hypothyroidism (but not thyroid antibodies) in females which was independent of other variables. The significance of this observation depends upon the interpretation of the ECG abnormalities and will only be established by longitudinal studies. No association was noted between lipid concentrations and thyroid antibodies or minor degrees of hypothyroidism.