注意缺陷多动障碍患儿血清25（OH）D及微量元素表达水平及临床意义

目的 探究注意缺陷多动障碍(ADHD)患儿血清25羟基维生素D[25(OH)D]、微量元素表达水平及临床意义。方法 选取2019年4月至2020年11月本院诊治的84例ADHD患儿进行研究(ADHD组),依据ADHD分型标准将患儿分为注意缺陷为主型组(28例)、多动为主型组(33例)、混合型组(23例),并选取同期84例体检健康儿童进行对照研究(对照组)。采用高效液相色谱-串联质谱法检测所有受试儿童血清25(OH)D水平；检测血清铁(Fe)、磷(P)、镁(Mg)、钙(Ca)、铜(Cu)、锌(Zn)、铅(Pb)水平；Pearson法分析ADHD患儿血清25(OH)D水平与Cu、Zn、Pb水平的相关性；Logistic回归分析ADHD发生的影响因素；受试者工作特征(ROC)曲线分析血清25(OH)D、Zn、Pb水平对ADHD的诊断价值。结果 ADHD组血清25(OH)D、Cu、Zn水平均显著低于对照组(P<0.05),Pb水平显著高于对照组(P<0.05)；注意缺陷为主型组、多动为主型组、混合型组患儿血清25(OH)D、Fe、P、Mg、Ca、Cu、Zn、Pb水平比较,差异无统计学意义(P>0.05)；ADHD患儿血清25(OH)D水平与Cu、Zn水平均呈正相关(P<0.05),与Pb水平呈负相关(P<0.05)；25(OH)D、Zn是影响ADHD发生的保护因素(P＜0.05),Pb是影响ADHD发生的危险因素(P＜0.05)；血清25(OH)D、Zn、Pb水平诊断ADHD的曲线下面积(AUC)分别为0.773、0.770、0.772,截断值分别为21.01 ng/mL、16.05 μmol/L、50.69 μg/L,相应灵敏度分别为82.1%、77.4%、63.1%,特异度分别为67.9%、71.4%、88.1%；三者联合诊断ADHD的AUC为0.883,其灵敏度、特异度分别为81.0%、81.0%。结论 ADHD患儿血清25(OH)D、Cu、Zn水平降低,Pb水平升高,25(OH)D、微量元素水平与ADHD患儿类型无关,25(OH)D、Zn、Pb联合有助于临床筛查ADHD患儿。     

Acquired acrodermatitis enteropathica due to zinc‐depleted parenteral nutrition

Well‐known causes of zinc deficiency, also referred to as acrodermatitis enteropathica (AE), include defects in intestinal zinc transporters and inadequate intake, but a rare cause of acquired zinc deficiency discussed here is an iatrogenic nutritional deficiency caused by parenteral nutrition administered without trace elements. While zinc‐depleted parenteral nutrition causing dermatosis of acquired zinc deficiency was first reported in the 1990s, it is now again relevant due to a national vitamin and trace element shortage. A high index of suspicion may be necessary to diagnose zinc deficiency, particularly because early clinical findings are nonspecific. We present this case of acquired zinc deficiency in a patient admitted to a pediatric intensive care unit for respiratory distress and atypical pneumonia, who subsequently developed a severe bullous eruption due to iatrogenic zinc deficiency but was treated effectively with enteral and parenteral zinc supplementation, allowing for rapid re‐epithelialization of previously denuded skin.     

中药配方颗粒品种统一标准的有关问题探讨

通过参考《中国药典》2015年版和相关文献,结合国家药典委员会2016年发布的《中药配方颗粒质量控制与标准制定技术要求(征求意见稿)》,综合考虑中药配方颗粒的实际生产情况,对《关于中药配方颗粒品种试点统一标准的公示》中质量标准特异性、定量检测指标的选择和指标性成分转移率等方面进行讨论,根据讨论结果为中药配方颗粒质量标准的完善和提高提出了相关建议,为推进配方颗粒产业健康发展提供参考。     

A population of descending tyraminergic/octopaminergic projection neurons of the insect deutocerebrum

In this study, we describe a cluster of tyraminergic/octopaminergic neurons in the lateral dorsal deutocerebrum of desert locusts (Schistocerca gregaria) with descending axons to the abdominal ganglia. In the locust, these neurons synthesize octopamine from tyramine stress-dependently. Electrophysiological recordings in locusts reveal that they respond to mechanosensory touch stimuli delivered to various parts of the body including the antennae. A similar cluster of tyraminergic/octopaminergic neurons was also identified in the American cockroach (Periplaneta americana) and the pink winged stick insect (Sipyloidea sipylus). It is suggested that these neurons release octopamine in the ventral nerve cord ganglia and, most likely, convey information on arousal and/or stressful stimuli to neuronal circuits thus contributing to the many actions of octopamine in the central nervous system.     

Efficacy of Oral Zinc Sulfate Supplementation on Clearance of Cervical Human Papillomavirus (HPV); A Randomized Controlled Clinical Trial

Aim: Human Papillomavirus is one of the most crucial infectious disease in gynecology disease. To assess the efficacy of supplemental zinc treatment in clearance of HPV infection. Methods: Eighty zinc-sufficient women between 21-55 years, with positive HPV DNA testing, and abnormal cervical cytology in Pap test (ASCUS or LISL) were randomly divided to case (n=40) and control group (n=40). Case group received oral tablets of zinc sulfate twice a day for 3 months while control group received no placebo. During follow-up patients underwent repeat HPV DNA test and PAP test and were evaluated for clearance/persistence of HPV infection and regression/progression in the lesion grading. Results: As far as demographics, serum zinc levels and the relevant risk factors for persistence of HPV were concerned, there was no significant difference between two groups, except for the frequency distribution of HR-HPV which was significantly higher in case  group. Zinc treatment for 3 months reduced the risk of persistence of HPV infection and progression from baseline cytology (OR = 0.130) (CI 95% 0.04-0.381; p <0.001) and 0.301 (95% CI 0.777-0.116; p = 0.012), respectively. Age, initial cytology, HPV type, and contraceptive method were not related to persistence of HPV. Serum zinc levels increased in the casr group as a result of oral zinc consumption for 3-month period, though without any statistical significance (p = 0.407). Conclusion: The results of the following study suggested that oral intake of zinc sulfate supplement for 3 months increases the rates of HPV clearance and resolution of pre-existing cervical lesion.     

Correlates of toenail selenium and its cross‐sectional association with metabolic syndrome

Background

The present study aimed to identify independent correlates of toenail selenium levels and to examine the association between toenail selenium levels and metabolic syndrome in Korean adults.

Methods

Cross‐sectional analysis was conducted using baseline data from the Trace Element Study of Korean Adults in the Yeungnam area, an ongoing cohort study of Korean adults over the age of 35 years. The baseline survey consisted of questionnaires on demographics, lifestyle characteristics and medical information. Dietary information was obtained through a validated semi‐quantitative food frequency questionnaire. Toenail selenium levels were quantified using neutron activation analysis. Biomarkers associated with metabolic syndrome were obtained from biennial medical check‐ups.

Results

In the multivariable‐adjusted analyses, independent lifestyle and dietary correlates of higher selenium levels were alcohol drinking (4.62% higher than nondrinking) and egg intake (0.43% higher per weekly serving), whereas current smoking (5.42% lower than nonsmoking) and vegetable consumption (0.05% lower per weekly serving) were associated with lower toenail selenium levels. In the multivariable adjusted logistic regression, no significant association was observed between toenail selenium levels and metabolic syndrome (odds ratio = 1.33, 95% confidence interval = 0.58–3.05).

Conclusions

Multiple lifestyle and dietary factors influenced toenail selenium levels, although no meaningful association was observed between toenail selenium levels and metabolic syndrome in Korean adults. Future prospective large‐scale cohort studies are required to determine whether there is a causal relationship between selenium levels and metabolic syndrome in Korean adults.

     

下颌前突患者下颌支矢状劈开截骨术后髁突运动轨迹的改变

目的:研究双侧下颌支矢状劈开截骨术对下颌前突患者髁突运动轨迹的影响。方法:采用ARCUSdigma下颌三维运动轨迹描记仪,以髁突运动中心为参考点,研究30例正常受试者、14例下颌前突患者手术前后开口、前伸和左右侧向髁突运动的轨迹。用SPSSV11.0统计软件包进行配对t检验和成组t检验。结果:下颌前突患者术前、术后、正常组左侧髁突的运动轨迹与右侧基本相同,左侧髁突与右侧的开口、前伸和侧方运动范围无显著性差异(P>0.05)。术前组与正常组髁突运动轨迹差别较大,术前开口、前伸和侧方运动范围均小于正常组(P<0.05);术后与正常组髁突运动轨迹接近,术后开口、前伸和侧方运动范围与正常组无统计学差异;术前与术后组髁突运动轨迹差别较大,术前开口、前伸和侧方运动范围均显著小于术后组(P<0.05)。结论:下颌前突患者手术后,随着术后正畸治疗及咬合自我调整,建立了正常的咬合引导关系,使下颌功能运动趋向正常。     

病理性瘢痕微量元素的初步研究

目的：探讨病理性瘢痕微量元素含量的变化规律。方法：应用三电极直流等离子体-原子发射光电直读光谱仪检测：①瘢痕疙瘩、增生性瘢痕、扁平瘢痕、正常皮肤组织的Zn、Cu、Fe、Mn、Se 5种微量元素含量；②瘢痕疙瘩和增生性瘢痕周围皮肤5种微量元素含量；③瘢痕疙瘩和增生性瘢痕中央部和边缘部组织5种微量元素含量。结果：瘢痕疙瘩和增生性瘢痕组织5种微量元素含量较扁平瘢痕和正常皮肤均减少，且较自身正常皮肤均显著性下降，而瘢痕疙瘩与增生性瘢痕间、扁平瘢痕与正常皮肤间、瘢痕疙瘩和增生性瘢痕患者自身皮肤与正常皮肤间差异无显著性意义；瘢痕疙瘩内部微量元素含量存在差异，其中央部5种微量元素含量较边缘部均增高，差异具有显著性意义，而增生性瘢痕中央部和边缘部差异无显著性意义。结论：瘢痕疙瘩和增生性瘢痕组织中微量元素变化与瘢痕的病理、生理改变有着密切的关系。