山东省黄河流域内地方性氟中毒病情调查

目的了解山东省黄河流域内地方性氟中毒病情现状,为制定防制策略提供科学依据。方法采用流行病学调查方法,水、尿氟含量测定采用氟离子选择电极法,8～12岁儿童氟斑牙诊断采用Dean法,X线摄片检查氟骨症。结果选择3个病区县的27个村进行了流行病学调查。水氟均值〉1.00mg/L的村25个（占92.59%）,最大值为9.67mg/L;8～12岁儿童氟斑牙总患病率为73.75%,氟斑牙指数为1.60;30岁以上成人的氟骨症临床和X线检出率分别为39.66%和29.78%;儿童和成人尿氟均值在1.50mg/L以上的人数分别占89.78%和91.87%,最高值分别为14.60mg/L和17.99mg/L。结论山东省黄河流域内地方性氟中毒病情尚未得到控制,防制形势依然十分严峻,须进一步加大防制力度。     

克山病患者的抗氧化酶活性及血管内皮功能

目的 观察山东省克山病患者的抗氧化酶活性和血管内皮功能，探讨二者与克山病发生发展的关系。方法 选择慢型、潜在型克山病患者57人、病区健康人34人、非病区健康人36人，分别采集清晨空腹外周血按试剂盒要求检测血清及红细胞GSH—Px、SOD、LPO、LT、NO、NOS含量及活性。结果 ①病区人群红细胞GSH—Px活性较非病区健康人明显降低（P＜0．01）；RBCSOD含量也较非病区健康人明显减少（P＜0．01）、RBCSOD活性减低（P＜0．01）；②克山病患者血清LPO含量明显升高，与病区和非病区健康人之间差异有统计学意义（P＜0．01），病区健康人又较非病区健康人明显升高（P＜0．01）；③克山病患者LT、NO和NOS含量明显高于病区健康人（P＜0．01），且慢型克山病患者与潜在型克山病患者之间差异有统计学意义（P＜0．01）。结论 克山病患者和病区健康人的红细胞抗氧化功能明显降低；血管内皮功能失调，二者在克山病发生发展中存在某种联动关系，加重心肌缺血、缺氧，导致心肌变性、坏死和瘢痕形成。     

砷致心血管系统损伤的研究现况和进展

砷是国际肿瘤机构(IARC)确认的人类致癌物质之一,长期暴露可引发皮肤等的部位肿瘤.砷吸收后通过循环系统分布到全身各组织、器官,对循环系统的危害首当其冲,临床上主要表现为与心肌损害有关的心电图异常和局部循环障碍导致的雷诺氏综合征、球结膜循环异常、心脑血管疾病等[1].作者将对近年来砷对心血管系统损伤的现场流行病学调查、临床研究和实验研究现况和进展做一简要概述.     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

人工合成Tuftsin类似物的免疫学活性初步研究

我们对人工合成的Tuftsin(Tu)类似物,一种免疫活性4肽,进行了免疫学活性的初步研究,发现它能增加小鼠脾单个核细胞的EA花环形成百分率,其活性与浓度在一定范围内成正相关。Tu类似物在100～1000nM时引起EA花环的增加有显著性,这与文献报道的Tuftsin促吞噬作用的最宜浓度大致相同。由于EA花环的形成依赖于细胞的IgG-Fc受体,我们的实验结果提示,文献报道的关于Tuftsin及其类似物的免疫增强作用,如促进吞噬、抗肿瘤和抗感染的作用等,也可通过它们能促进IgG-Fc受体在各种免疫细胞的表达来实现。Tuftsin被称为一种能在体内自然产生的佐剂,在国际已受到较大的注意。我们的研究只是初步的,Tuftsin及其类似物的免疫学活性与实际应用的可能性有待深入研究。     

山东省鲁北地区地方性氟中毒病情调查结果分析

目的了解山东省鲁北地区地方性氟中毒病情流行状况,进一步做好该病的防治工作。方法按照国家《地方病防治项目技术方案》的要求,于2008年对山东省鲁北地区的济阳、博兴、高青、广饶、武城、夏津、宁津等7县66个村的环境氟含量与地方性氟中毒病情流行情况进行了调查。结果7县66个村居民饮水含氟量有95.45%(63/66)的村超标,水氟含量(4.0 mg/L村24个(36.36%),水氟含量最高村为5.80 mg/L。检测7县儿童即时尿氟含量879人份,平均几何均值3.49 mg/L,93.06%(818/879)个体尿氟水平超标,个体最大值21.02 mg/L。检查66个村8~12岁儿童氟斑牙2 579人,平均检出率73.52%,缺损率23.85%,氟斑牙指数1.76。临床检查16岁以上成人38 463例,氟骨症阳性检出率为4.78%(1 840/38 463);X线摄片成人402例,X线氟骨症检出率为17.91%(72/402),临床与X线氟骨症均以轻度为主。结论鲁北地区外环境水氟含量严重超标,氟中毒病情尚未得到有效控制,仍存在一定程度流行。     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

山东省鲁西北地区地方性氟中毒流行病学调查

目的 了解山东省鲁西北地区地方性氟中毒的流行现状,为制定防制策略提供科学依据.方法 选择山东省鲁西北地区11个县进行水、人尿氟含量测定、8～12岁儿童氟斑牙诊断及临床和X线摄片检查氟骨症调查.结果 在11个县调查17个改水村,水氟均值≤1.00mg/L的村12个,占70.59%(12/17);>1.00mg/L的村5个,占29.41%(5/17);水氟最大值为4.46 mg/L;调查16个未改水村,水氟均值≤1.00 mg/L的村5个,占31.25%(5/16);>1.00 mg/L的村11个,占68.75%(11/16),水氟最大值为4.09 mg/L;8～12岁儿童氟斑牙总患病率为51.51%(701/1 361),氟斑牙指数为1.05,缺损率为6.25%(85/1 631);儿童尿氟均值在>1.40 mg/L的占60.86%(510/838),最高值为15.20 mg/L;>16岁成人的氟骨症临床和X线检出率分别为2.49%(454/18 257),15.79%(3/19);成人尿氟均值在>1.60 mg/L的占62.27%(406/652),最高值为25.44mg/L.结论 山东省鲁西北地区地方性氟中毒病情尚未得到有效的控制,防制形势依然比较严峻,须进一步加大防制力度.     

硒对砷致人脐静脉血管内皮细胞抗氧化功能及血管细胞黏附分子-1和胞间黏附分子-1表达的影响

目的 观察硒对不同剂量砷致体外培养的人脐静脉血管内皮细胞(HUVEC)抗氧化功能及胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)表达的影响.方法 调节处于对数期的HUVEC细胞密度为1.0×105/ml,分别加入0(含10％标准胎牛血清,对照)和砷浓度为0.05、0.1、0.5、1.5、3.0、6.0、12.0 μmol/L的三氧化二砷溶液及在此基础上加入0.1 μmol/L亚硒酸钠溶液培养48 h.采用分光光度法检测超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力和丙二醛(MDA)含量;采用酶联免疫吸附试验(ELISA)检测ICAM-1和VCAM-1的表达.结果 随着砷暴露浓度的升高,HUVEC细胞培养液中SOD、GSH-Px活力均呈下降趋势,而MDA含量和ICAM-1、VCAM-1的表达呈升高趋势.与对照组相比,砷浓度为0.1～12.0μmol/L时,HUVEC细胞培养液中SOD 、GSH-Px活力均降低,ICAM-1的表达均升高,差异有统计学意义(P＜0.05,P＜0.01);砷浓度为0.5～12.0 μmol/L时,HUVEC细胞培养液中MDA的含量和VCAM-1的表达均增加,差异有统计学意义(P＜0.01).砷浓度为0.05、0.5μmol/L时,加硒组HUVEC细胞培养液中SOD活力均高于不加硒组,差异有统计学意义(P＜0.05);砷浓度为0.05、0.1μmol/L时,加硒组HUVEC细胞培养液中GSH-Px活力均高于不加硒组,MDA含量和ICAM-1、VCAM-1的表达均低于不加硒组,差异有统计学意义(P＜0.05).结论 一定浓度的砷可使血管内皮细胞抗氧化功能降低,脂质过氧化反应增强,黏附分子表达增强,而硒可在一定程度上拮抗砷的损伤作用.     

2008年山东省地方性氟中毒病情调查结果分析

目的 分析山东省地方性氟中毒的病情现状,为制订防治策略提供科学依据.方法 2008年按照国家<2007年地方病防治项目技术实施方案>的要求,选择山东省19个县(市、区)以村为单位进行流行病学调查,氟离子选择电极法测定水氟和8～12岁儿童尿氟,Dean法诊断儿童氟斑牙,临床和X线摄片检查16岁以上成人氟骨症.结果 在19个县(市、区)中,共调查了186个村,水氟均值≤1.00 mg/L的村44个,占23.66%(44/186);＞1.00 mg/L的村142个,占76.34%(142/186);水氟最大值为8.88 mg/L.8～12岁儿童氟斑牙总检出率为66.35%(4518/6809),氟斑牙指数为1.55,缺损率为15.39%(1048/6809).儿童尿氟＞1.40mg/L的人数占83.29%(2149/2580),最高值为31.92 mg/L.16岁以上成人氟骨症临床和X线检出率分别为6.37%(5577/87 607)、20.23%(229/1132).结论 山东省地方性氟中毒病情仍然比较严重,防治形势依然比较严峻,须进一步加大防治力度.

Abstract：

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide scientific evidence for the development of control strategies. Methods According to "The National Technical Scheme for Endemic Disease Control in 2007", 19 counties were chosen to carry out the epidemiological investigation in 2008. Water and urinary fluoride were determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 were diagnosed by Dean method and skeletal fluorosis of adults over the age of 16 were examined clinically and by X-rays. Results In 19 counties, 186 villages were surveyed, 44 villages were found with mean water fluoride ≤ 1.00 mg/L, accounting for 23.66%(44/186);the value ＞ 1.00 mg/L in 142 villages,accounting for 76.34% (142/186);maximum water fluoride 8.88 mg/L. Total detection rate of dental fluorosis of children aged 8 to 12 was 66.35% (4518/6809), dental fluorosis index was 1.55, and defect rate was 15.39%(1048/6809). Children with urinary fluoride ＞ 1.40 mg/L was 83.29%(2149/2580), and the maximum value was 31.92 mg/L. Detection rates of skeletal fluorosis clinically and by X ray among adults over 16 years were 6.37%(5577/87 607) and 20.23% (229/1132), respectively. Conclusions Endemic fluorosis in Shandong province is still serious, prevention efforts need to be further increased.