不同碘营养状态对大鼠肝组织Ⅰ型5′脱碘酶的影响

目的研究不同碘营养状态对大鼠肝组织甲腺氨酸Ⅰ型5′脱碘酶（DI）表达水平及活性的影响。方法正常1月龄Wistar大鼠根据碘摄入量不同分为6组，饲养3个月后处死。放免法测定血清甲状腺激素水平。提取肝组织总RNA，以β—actin为内对照，半定量RT-PCR分析DI基因的表达水平。Chopra氏方法测定肝组织匀浆液中DI的脱碘活性。结果LI组TT4和FT4显著低于其他5组（P〈0．05），100HI组TT3和FT3显著低于其他5组（P〈0．05），100HI组TT4和FT4显著低于NI、5HI、10HI和50HI组（P〈0．05）。大鼠肝组织DI基因mRNA表达量6组间差异有统计学意义（P〈0．01），LI组显著高于其他5组（P〈0．05），不同剂量HI组和NI组相比差异均无统计学意义（P〉0．05）。大鼠肝组织DI活性6组间差异有统计学意义（P〈0．01），LI组显著高于其他5组（P〈0．05），50HI组和100HI组显著低于其他4个组（P〈0．05）。结论在碘缺乏状态下。大鼠出现以低T4为主要表现的甲状腺功能减退（甲减），DI活性和DI基因表达水平代偿性上调，使机体维持足够的T3水平，以避免周围组织出现器官性甲减。高碘仅在转录后水平影响DI，表现为直接抑制DI的活性。使血清TT3和FT3下降，机体出现失代偿性周围组织器官性甲减。DI对碘过量有一定的耐受能力，这种耐受性有一定的阈值。     

赣州地区孕妇血清维生素D水平研究

目的：探讨赣州地区孕妇血清维生素D水平。方法：抽取2134例孕妇空腹静脉血液进行血清25-OH维生素D检查,记录检查结果并统计学分析后,对189例维生素D缺乏孕妇再次实施25（OH）VitD检测,之后将其按抽签方式随机分为A组、B组和c组,A组每Et给予800IU维生素D制剂;B组每日给予400IU维生素D制剂;C组未给予任何药物干预措施。记录三组孕妇妊娠并发症发生率、25（OH）VitD检测结果。结果：2134例孕妇中34．96％孕妇维生素D检测结果正常,8．86％孕妇体内维生素D检测结果缺乏。C组孕妇发生妊娠并发症几率高达46．03％,与A、B组比较差异均有统计学意义（P〈0．05）;C组产妇并发症发生率最高,新生儿Apgar评分小于7分所占比例最高,且上述指标与A、B组比较差异均有统计学意义（P〈0．05）。结论：临床医生应及时有效的监测孕妇各时期体内维生素D含量,给予正确的饮食指导,必要时采用药物补充机体所需维生素D,降低妊娠并发症发生率,保障母婴身心健康。     

Timing of clamping and factors associated with iron stores in full-term newborns

OBJECTIVE

To analyze the impact of timing of clamping and obstetric, biological and socioeconomic factors on the iron stores of full-term newborns.

METHODS

Cross-sectional study between October 2011 and July 2012 in which hematological parameters were evaluated for newborns in Viçosa, MG, Southeastern Brazil. It involved collecting 7 mL of umbilical cord blood from 144 full-term not underweight newborns. The parameters investigated were complete blood count, serum iron, ferritin and C-reactive protein. The time of umbilical cord clamping was measured using a digital timer without interfering in the procedures of childbirth. The birth data were collected from Live Birth Certificates and other information was obtained from the mother through a questionnaire applied in the first month postpartum. Analysis of multiple linear regression was then used to estimate the influence of biological, obstetrics and socioeconomic factors on the ferritin levels at birth.

RESULTS

The median ferritin was 130.3 µg/L (n = 129, minimum = 16.4; maximum = 420.5 µg/L), the mean serum iron was 137.9 μg/dL (n = 144, SD = 39.29) and mean hemoglobin was 14.7 g/dL (n = 144, SD = 1.47). The median time of cord clamping was 36 seconds, ranging between 7 and 100. The bivariate analysis detected an association between ferritin levels and color of the child, timing clamping of 60 seconds, type of delivery, the presence of gestational diabetes and per capita family income. In multivariate analysis, the variables per capita income, number of antenatal visits and length at birth accounted for 22.0% of variation in ferritin levels.

CONCLUSIONS

Iron stores at birth were influenced by biological, obstetric and social characteristics. Tackling anemia should involve creating policies aimed at reducing social inequalities, improving the quality of antenatal care, as well as implementing a criterion of delayed clamping of the umbilical cord within the guidelines of labor.     

加味八珍汤治疗气血亏虚型肺癌癌因性疲乏的效果研究

目的：探讨加味八珍汤治疗气血亏虚型肺癌癌因性疲乏的效果。方法：选取成都新都东立中医医院、兴文县中医医院及四川省中西医结合医院收治的64例气血亏虚型肺癌患者,随机分组法分为观察和对照两组,各32例。对照组给予西医常规治疗,观察组在对照组的基础上联合加味八珍汤治疗。比较两组患者治疗后卡氏评分（KPS）评分改善情况、治疗前后T淋巴细胞亚群及中医症候积分。结果：观察组治疗后KPS评分改善率为46.88%（15/32）高于对照组KPS评分改善率21.88%（7/32）（P<0.05）;观察组患者治疗后CD3+（63.85±5.24）%高于对照组CD3+（57.35±3.20）%、CD4+（39.63±4.47）%高于对照组CD4+（34.52±3.26）%、CD4+/CD8+（2.06±0.41）高于对照组CD4+/CD8+（1.75±0.25）（P均<0.05）;观察组治疗后中医证后积分为（11.26±1.25）分低于对照组（18.62±2.58）分（P<0.05）。结论：加味八珍汤治疗联合常规治疗气血亏虚性肺癌癌因性疲乏患者能有效提高生活质量及免疫功能,缓解临床症状,值得临床推广。     

Vitamin D deficiency in children with bronchial asthma in southern Jordan: a cross-sectional study

ObjectivesTo assess serum 25-hydroxycholecalciferol (25-OH vitamin D) levels in Jordanian children with bronchial asthma, and to examine correlations between 25-OH vitamin D levels and asthma severity and control.MethodsA cross-sectional study was conducted at the Paediatric Chest Clinic, Al-Karak Governmental Hospital, Southern Jordan, between May 2015 and February 2016. Serum 25-hydroxyvitamin D level was determined in children aged 1–14 years diagnosed with bronchial asthma (6–14 years) or recurrent wheezing episodes (<6 years). Asthma severity was determined based on the Global Initiative for Asthma assessment, the Asthma Control Test, and the Childhood Asthma Control Test. Demographic and clinical characteristics were compared between patients with low and normal 25-OH vitamin D levels, and correlations between asthma severity and 25-OH vitamin D level were assessed.ResultsOut of 98 included children, 25-OH vitamin D levels were deficient and insufficient in 41 (41.8%) and 34 (34.7%) children, respectively. Only 23 (23.5%) had sufficient 25-OH vitamin D levels. A significant correlation was found between severity of asthma symptoms and 25-OH vitamin D deficiency.Conclusion25-OH vitamin D deficiency is highly prevalent in Jordanian children with bronchial asthma and correlates significantly with asthma severity.     

骨增量技术在口腔种植中的应用进展

种植术区的骨质、骨量是种植手术成败的关键因素之一,临床上常常因为患者缺牙区骨量不足而使得种植医生及患者对种植牙望而却步,随着骨增量技术的发展,使得种植手术的适应证不断扩大,常见的骨增量技术包括骨劈开术、骨挤压术、引导骨再生技术、牵张成骨术、上颌窦提升术及骨移植术等,这些技术的单独及联合应用均不同程度地增加了种植手术的成功率,本文就骨增量技术在牙种植的应用进展作一综述。     

核苷类抗艾滋病药物研发近况

获得性免疫缺陷综合征的治疗仍是人类目前尚未攻克的一道医学难题。在查阅文献的基础上,综述、介绍了近年来上市的、包括复方制剂在内的几种核苷类抗艾滋病新药以及正在研究中的新化合物。     

益气通督手法治疗小儿脾虚泻的多中心随机对照研究

目的:对益气通督手法治疗小儿脾虚泻的疗效进行评价。方法:将275例患儿采用多中心、随机、对照方法分为观察组(n=137)和对照组(n=138),观察组采用益气通督手法治疗,对照组采用中医院校教材《推拿学》中所规定手法治疗。治疗7天后比较两组疗效。结果:观察组治愈率为83.2%,对照组治愈率为69.6%,差异有统计学意义(P<0.05),观察组疗效优于对照组。两组平均治愈时间比较,观察组平均治愈时间(3.22±1.04)天,对照组平均治愈时间(4.20±1.11)天,差异有统计学意义(P<0.05),观察组短于对照组。结论:益气通督手法治疗小儿脾虚泻疗效确切,起效快,适宜普及推广应用。     

运脾增液汤治疗慢性功能性便秘气阴两虚证46例的临床观察

目的 观察运脾增液汤治疗慢性功能性便秘气阴两虚证的疗效.方法 将87例慢性功能性便秘患者随机分为治疗组和对照组,治疗组46例采用运脾增液汤,对照组41例采用麻仁丸,两组均15 d为1个疗程.结果 治疗组治愈率71.7%、显效率23.9%,总有效率97.8%;对照组治愈率14.6%、显效率14.6%.总有效率87.8%,治疗组疗效较对照组有显著性差异(P＜0.05).结论 运脾增液汤治疗慢性功能性便秘气阴两虚证有效.