单细胞凝胶电泳检测酞酸酯类对DNA的损伤

目的应用单细胞凝胶电泳(SCGE)技术对增塑剂(DEHP)邻苯二甲酸二乙基己酯致小鼠胚胎成纤维细胞(3T6细胞)DNA损伤、损伤程度以及有无剂量-效应关系进行检测.方法将溶剂二甲基亚砜处理的3T6细胞作为阴性对照组,用H2O2染毒的3T6细胞作为阳性对照组(80μmol/L H2O2染毒),将不同浓度DEHP处理的3T6细胞设为4个剂量组(62.5,125,250,500μg/ml)进行SCGE检验.结果各染毒组细胞DNA损伤与阴性对照组比较,均有显著性差异(P＜0.05);且随DEHP染毒浓度增加,3T6细胞DNA损伤程度加重,有剂量-效应关系.结论 DEHP体外染毒对3T6细胞能造成损伤,且随剂量的增加有加重的趋势.     

化妆品中酞酸酯物质测定及女性人群暴露评估

目的检测化妆品中3种酞酸酯类化合物（phthalic acid esters,PAEs）的含量,并结合化妆品使用情况调查,对一般女性人群通过化妆品接触的PAEs进行暴露评估。方法采用气相色谱-质谱法检测上海市某化妆品连锁商店和某大型超市采集的护肤品、香水、美发产品和指甲油等55个化妆品样品中邻苯二甲酸二乙酯（DEP）、邻苯二甲酸二丁酯（DBP）和邻苯二甲酸二异辛酯（DEHP）3种PAEs类物质在55个样品中的含量;通过问卷调查某大城市一般女性人群的化妆品使用情况,并对其通过化妆品接触的PAEs进行暴露评估。结果55个化妆品样品中DEP、DBP和DEHP检出率分别为40.0%、83.6%和87.8%,平均检出浓度分别为3.775、0.043和0.059 μg/mL;结合使用情况评估一般女性人群经化妆品对DEP、DBP和DEHP 3种PAEs的日均暴露量分别为DEP 0.815 μg/d、DBP 3.117 μg/d和DEHP 1.049 μg/d。结论化妆品中DEP、DBP、DEHP 3种PAEs检出率较高,但检出量较低,一般女性人群经化妆品对3种PAEs的暴露量均远低于目前制定的暴露量上限。     

子宫肌瘤和卵巢囊肿与血清中PAEs暴露水平关系

目的 了解育龄女性血清酞酸酯类化学物(PAEs)的暴露水平, 分析PAEs与子宫肌瘤、卵巢囊肿的相关性。方法 在上海市第一妇婴保健院收集80例子宫肌瘤、67例卵巢囊肿和17例原发性不孕共164例妇科疾病患者和80例健康对照组血清, 采用气相色谱法(GC)检测其血清中PAEs的含量, 并分析其与妇科疾病的相关性。结果 244例女性中血清的邻苯二甲酸二乙酯(DEP)、邻苯二甲酸二丁酯(DBP)和邻苯二甲酸二(2-乙基-己基)酯(DEHP)检出率分别为26.2%、95.5%和92.2%, 几何均数分别为0.071、0.270 和0.193 mg/L;病例组血清中DBP水平(0.342 mg/L)明显高于对照组(0.165 mg/L), 差异有统计学意义(t=11.870, P<0.01);子宫肌瘤组血清DBP含量与年龄因素呈负相关(r=-0.267, P=0.028), 对照组血清中DBP含量与BMI值间存在正相关(r=0.270, P=0.017)。结论 子宫肌瘤和卵巢囊肿与血清PAEs水平存在一定的相关性。     

血清瘦素浓度与甘油三酯水平的相关性

目的　探讨血清瘦素浓度与甘油三酯 (TG)的关系。方法　测定 138例门诊与住院病人血清中瘦素和甘油三酯的水平 ,分析瘦素与甘油三酯等因素的关系。结果　男性和女性中不同 TG水平组的瘦素水平都不相同 (F =38.4 2 6 ,P <0 .0 0 1;F =30 .4 5 7,P <0 .0 0 1) ,随着 TG水平的升高 ,血清瘦素的水平在男性和女性都有升高的趋势 (F =6 7.0 77,P <0 .0 0 1;F =4 9.786 ,P <0 .0 0 1) ;女性瘦素的水平明显高于男性 (t=5 .0 5 7,P <0 .0 0 1) ;女性血清瘦素水平与 TG水平的 r=0 .5 83(P <0 .0 0 1) ,男性 r =0 .5 33(P <0 .0 0 1) ;女性中 TG的β=1.6 8(95 %CI :1.0 9～2 .2 6 ) ;男性组中 TG的β=0 .6 4 (95 %CI :0 .4 0～ 0 .88) ;控制性别和年龄两个因素后 ,血清中瘦素浓度与 TG水平的 r =0 .5 2 1(P <0 .0 0 1)。结论　血清中瘦素浓度与甘油三酯水平具有密切相关关系     

血清中锌浓度与糖尿病罹患风险相关性的Meta分析

目的系统评价血清中微量元素锌和糖尿病(diabetes mellitus,DM)发病风险的相关性。方法计算机检索中国知网(CNKI)、维普期刊资源整合服务平台、万方数据库和PubMed数据库中关于微量元素锌与糖尿病罹患风险的随机对照试验,检索时限从建库起至2016年10月。对纳入文献进行质量评价后,使用RevMan5.3和Stata12.0软件进行数据分析。结果最终纳入18篇文献,共3 428例研究对象,研究结果显示,糖尿病组人群中血清锌浓度比对照组人群低0.51mg/L[WMD=-0.51,95%CI(-0.54,-0.49),P0.001],差异具有统计学意义,亚组分析结果显示诊断方法、检测方法及文献质量不是异质性的来源,分层后整体效应的关联方向和大小不变。结论本次研究结果表明,锌的缺乏会增加糖尿病的罹患风险。     

慢性肾病患者血液透析与复发性栓塞性卒中的相关性分析

目的为降低慢性肾病患者的血液透析出现复发性栓塞性卒中的发生率,提高降低慢性肾病患者血液透析效果。方法选取自2017年5月至2018年5月间在海南医学院第一附属医院血液科进行血液透析的慢性肾病患者67例作为研究对象,所有的患者根据是否出现复发性栓塞性卒中分为研究组和对照组,检测两组患者血压及相关生化指标,并检测颈动脉粥样硬化情况,分析血液透析相关的危险因素与复发性栓塞性卒中发生的相关性。结果研究组患者收缩压(SBP)高于对照组(P0.05),研究组患者LDL-C、Alb、hs-CRP水平明显高于对照组(P0.05),研究组患者颈动脉粥样硬化及颈动脉斑块的发生率、颈内动脉内膜中层厚度(IMT)及颈动脉阻力指数均高于对照组(P0.05),高血压、平均血透龄、血脂异常、颈动脉粥样硬化、体重增长均为脑卒中的危险因素。结论慢性肾病患者的血液透析、高血压、血脂异常、颈动脉粥样硬化、体重增长为复发性栓塞性卒中产生的危险因素。     

临产母体血清中微量元素浓度与新生儿生长发育的相关性研究

临产母体血清中微量元素浓度与新生儿生长发育的相关性研究朱红，李海涛浙江省卫生防疫站（杭州３１０００９）妊娠时母体血液性质发生各种适应性改变，除血容量、内分泌物质与激素等变化外，必然伴有铜、铁、锌、钙、镁等金属元素成分的变化。而后者的改变，对母体的新陈...     

紫外分光光度法测定体外循环类医疗器械中DEHP溶出量

本文介绍一种体外循环类医疗器械中DEHP溶出量的测定方法,根据产品临床使用特点,以乙醇水溶液为浸提溶剂,使用合适的浸提方法,通过紫外分光光度法测定DEHP含量.该方法结果准确可靠,具有良好的线性关系,达到满意的效果.     

血清抵抗素水平与糖尿病肾病的相关性研究

[目的]观察血清抵抗素等因素在糖尿病组和健康对照组的组间差异及其与尿白蛋白排泄率的关系,以探讨抵抗素在糖尿病肾病发生发展中的作用,为临床上预防、治疗糖尿病肾病探索新的方法。[方法]选取住院的2型糖尿病患者56例,单纯2型糖尿病组18例;糖尿病肾病组38例,且其中伴有微量白蛋白尿(UAER20～200μg/min)组(G3)18例、临床糖尿病肾病(UAER﹥200μg/min)组20例;另选取糖耐量正常的健康对照组16例。分别测定血清抵抗素、糖化血红蛋白(HbAlC)、空腹血糖(FBG),并计算尿白蛋白排泄率(UAER),胰岛素抵抗指数(IRI),体重指数BMI等,观察以上指标在糖尿病组和健康对照组及血清抵抗素等因素的组间差异及其与尿白蛋白排泄率的关系。[结果]临床糖尿病肾病组血清抵抗素显著高于糖尿病微量白蛋白尿组、单纯2型糖尿病组和健康对照组,糖尿病微量白蛋白尿组血清抵抗素显著高于单纯2型糖尿病组和健康对照组。[结论]抵抗素在2型糖尿病及微量尿白蛋白的形成和发展中起着一定的作用。     

食用油及其加热产物中酞酸酯类增塑剂的分析

[目的 ]了解食用油和厨房油烟冷凝物中酞酸酯类增塑剂的含量。 [方法 ]采用毛细管柱气相色谱 质谱联用仪 (GC/MS)的选择离子监测方式 (SIM)对样品检测。 [结果 ]食用油中邻苯二甲酸二丁酯 (di n butylphthalate ,DBP)和邻苯二甲酸二辛酯 (di n octylphthalate ,DOP)的最高含量分别为 2 98mg/L和 2 4 16mg/L ,厨房油烟冷凝物中DBP和DOP最高含量分别为 13 3 70mg/L和 2 2 2 0 5mg/L ,全程回收率 :DBP为 90 1%～ 10 3 3 % ,DOP为 92 1%～ 10 2 2 %。 [结论 ]食用油包装材料中的增塑剂会溶移到食用油中。应为制定食用油中DBP和DOP的最高允许含量进行安全性评价     

持续低效缓慢血液透析与普通血液透析在终末期糖尿病肾病患者中的对照研究

目的:比较终末期糖尿病肾病持续低效缓慢血液透析与普通血液透析的效果.方法:2017年1月～2020年2月选取160例终末期糖尿病肾病患者展开探究分析,选择随机数字表法分为两组,即对照组(n=80)和观察组(n=80),对照组行普通血液透析,观察组持续低效缓慢血液透析.结果:PO4、BUN、β2-MG以及ALB等指标血清...     

糖尿病肾病患者使用血液透析机透析的时机观察

目的:探究糖尿病肾病患者使用血液透析机透析的时机。方法:回顾性分析本院2012年1月~2017年12月收治的42例行血液透析的糖尿病肾病患者的临床资料。其中,有24例患者在血肌酐达到707μmol/L时开始行长期血液透析(正常组),剩余18例患者透析前患者血肌酐在224~675uomL/L间,均因不同病情提前开始进行血液透析治疗(提前组)。结果:正常组中有13例患者死亡,剩余11例患者均已出现程度不一的血管病变情况,且均须通过血液透析机行长期透析。提前组中有2例死亡,4例须每周行2次长期透析,2例须每7~10d内行1次透析,有1例患者在出院1年后每周行1次血液透析,1例患者行肾移植,8例患者未再行透析治疗。结论:提前进行血液透析能够减缓糖尿病肾病进展至终末期肾功能衰竭的速度,并有效延长透析间隔时间,降低并发症发生率。     

420名大学生血清酞酸酯水平及其与性激素的关系研究

[目的]观察大学生人群对常用增塑剂酞酸二异辛酯[di（2-ethylhexyl）phthalate,DEHP]及酞酸二丁酯（djn-butyl phthalate,DBP）的暴露情况,了解DEHP水平与男性血清雌二醇（estrogen,E2）、睾酮（testosterone,T）之间的关系。[方法]选择某大学沪籍新生420名为研究对象（18～19岁,男216人,女204人）,静脉采集血清样本,使用气相色谱-质谱联用仪（GC-MS）测定血清中酞酸酯水平。样品预处理采用正己烷液相提取,洗脱采用温度程序,标准曲线采用五点法。采用全自动酶联免疫吸附及化学发光反应测定激素水平。[结果]DEHP、DBP的检出限均为0．1μg/L;二者回收率分别为91．3％～94．0％和91．2％～94．1％;变异系数分别为0．49％～2．79％和0．61％-3．42％;线性范围1-10000μg/L;背景污染未检出。420份血清中有88份（男41份,女47份）DEHP浓度高于检出限;检出样品的平均浓度（M）为54．14μg/L,四分位数间距（Qr）为40．22μg/L。检出率及浓度在性别间差异无统计学意义（P〉0．05）。DBP仅捡出7份（男1份,女6份）;检出样品平均浓度M为10．17μg/L,QR为9.30μg/L。高于检出限的41名男性（检出组）的DEHP浓度与T水平呈正相关关系（h=0．347,P=0．048）。与低于检出限的59名男性（未检出组）相比,检出组的E2水平较高（P=0．035）.随着E2浓度升高,DEHP也趋向于被检出（β=-0．017,OR=0．983,P=0．021）[结论]该人群DEHP检出率明显高于DBP,男性DEHP浓度与T水平呈正相关关系。E2浓度与男性DEHP检出与否有关,检出组E2浓度高于未检出组。     

对比分析终末期糖尿病肾病、非糖尿病肾病血液透析患者并发症发生情况

目的:对比终末期DN患者与非DN患者的血液透析并发症发生情况,为改善患者生存质量及生存率提供参考。方法:选取2014年7月~2016年6月,在本院治疗的110例慢性肾衰竭患者,所有患者均接受血液透析治疗,其中,DN患者55例作为观察组,非DN患者55例作为对照组,对比两组患者的生存情况及并发症情况。结果:两组患者1年存活率无明显差异(P>0.05);观察组患者的3年存活率明显低于对照组(P<0.05);观察组患者低血糖、心血管并发症、脑血管意外、感染、消化道出血、动静脉内痿闭塞等并发症发生率均明显高于对照组(P<0.05)。结论:终末期DN患者进行血液透析治疗并发症较多,且生存率较低,应给予针对性干预,做好并发症预防。     

Phthalate Concentrations and Dietary Exposure from Food Purchased in New York State

Background: Phthalates have been found in many personal care and industrial products, but have not previously been reported in food purchased in the United States. Phthalates are ubiquitous synthetic compounds and therefore difficult to measure in foods containing trace levels. Phthalates have been associated with endocrine disruption and developmental alteration.Objectives: Our goals were to report concentrations of phthalates in U.S. food for the first time, specifically, nine phthalates in 72 individual food samples purchased in Albany, New York, and to compare these findings with other countries and estimate dietary phthalate intake.Methods: A convenience sample of commonly consumed foods was purchased from New York supermarkets. Methods were developed to analyze these foods using gas chromatography–mass spectroscopy. Dietary intakes of phthalates were estimated as the product of the food consumption rate and concentration of phthalates in that food.Results: The range of detection frequency of individual phthalates varied from 6% for dicyclohexyl phthalate (DCHP) to 74% for di-2-ethylhexyl phthalate (DEHP). DEHP concentrations were the highest of the phthalates measured in all foods except beef [where di-n-octyl phthalate (DnOP) was the highest phthalate found], with pork having the highest estimated mean concentration of any food group (mean 300 ng/g; maximum, 1,158 ng/g). Estimated mean adult intakes ranged from 0.004 μg/kg/day for dimethyl phthalate (DMP) to 0.673 μg/kg/day for DEHP.Conclusions: Phthalates are widely present in U.S. foods. While estimated intakes for individual phthalates in this study were more than an order of magnitude lower than U.S. Environmental Protection Agency reference doses, cumulative exposure to phthalates is of concern and a more representative survey of U.S. foods is indicated.     

血液透析患者血浆游离氨基酸浓度的分析

尿毒症常存在着氨基酸代谢异常［１］。血液透析虽可纠正部分尿毒症症状,但氨基酸代谢紊乱等情况继续存在甚至加重。氨基酸代谢紊乱是血透患者营养不良的一个重要因素。本研究对２４例血透患者食物中必需氨基酸的摄入和血浆游离氨基酸进行了测定和分析。１　对　象　与　方　法１．１　临床资料　　２４例血液透析患者（男１４,女１０）,平均年龄４４．６（３３～６２）岁。基础病均为慢性肾小球肾炎。另选１２例性别和年龄相配对的健康正常人作对照。１．２　膳食摄入分析　　先对患者进行膳食记录宣传教育,由患者连续记录三天（含透析…     

Association between Reduced Serum Zinc and Diastolic Dysfunction in Maintenance Hemodialysis Patients

Diastolic dysfunction is an emerging challenge among hemodialysis (HD) patients, and the associations between serum zinc with echocardiographic parameters and diastolic function remain uncertain. A total of 185 maintenance HD patients were stratified by the tertiles of serum zinc level to compare their clinical characteristics and echocardiography. Correlations of serum zinc levels with echocardiographic parameters were examined using Pearson’s analysis. Univariate and multivariate logistic regression analyses were performed to investigate the determinants of E/e’ ratio >15 and left atrial volume index (LAVI) > 34 mL/m², both indicators of diastolic dysfunction. Patients belonging to the first tertile of serum zinc level had a significantly higher E/e’ ratio and LAVI. Serum zinc levels were negatively correlated with E (r = −0.204, p = 0.005), E/e’ ratio (r = −0.217, p = 0.003), and LAVI (r = −0.197, p = 0.007). In a multivariate analysis, older age, diabetes, coronary artery disease, and lower serum zinc levels (OR = 0.974, 95% CI = 0.950–0.999, p = 0.039) were significantly associated with E/e’ ratio >15. Furthermore, diabetes and lower serum zinc levels (OR = 0.978, 95% CI = 0.958–0.999, p = 0.041) were significantly associated with LAVI >34 mL/m². Reduced serum zinc level was significantly associated with diastolic dysfunction among HD patients. Further prospective studies are warranted to investigate whether zinc supplementation can attenuate cardiac dysfunction in maintenance HD patients.     

Association of Reduced Free T3 to Free T4 Ratio with Lower Serum Creatinine in Japanese Hemodialysis Patients

Purpose: Low T3 syndrome is defined by a fall in free triiodothyronine (FT3) in spite of normal serum thyroid-stimulating hormone (TSH) and often normal free thyroxin (FT4). A low FT3/FT4 ratio, a relevant marker for low T3 syndrome, is known as a risk of mortality in hemodialysis (HD) patients, as well as low muscle mass in the general population. Because of the local activation of T4 to FT3 in muscle tissue, we examined the association of FT3/FT4 ratio with serum creatinine, a marker of muscle mass and strength in HD patients to investigate the significance of muscle tissue in the development of low T3 syndrome in HD patients. Methods: This was a cross-sectional study derived from our prospective cohort study, named DREAM, of Japanese HD patients. After the exclusion of patients with treated and untreated thyroid dysfunction, 332 patients were analyzed in the study. Results: The serum FT4 and TSH of HD patients (n = 332) were 0.9 ± 0.1 ng/dL. and 2.0 ± 0.9 μIU/mL, which were within the respective normal range, while serum FT3 was 2.2 ± 0.3 pg/mL. As many as 101 out of 332 (30.4%) HD patients exhibited a serum FT3 less than the normal lower limit of 2.2 pg/mL. The serum FT3/FT4 ratio correlated significantly positively with serum creatinine, and inversely with serum log CRP and total cholesterol, while it exhibited a tendency towards positive correlation with serum albumin. Multiple regression analysis, which included serum creatinine, albumin, and log CRP, simultaneously, in addition to sex, age, diabetic kidney disease or not, log HD duration, body mass index, systolic blood pressure, and Kt/V, as independent variables, revealed an independent and significant positive association of serum creatinine, but not serum albumin or CRP, with the serum FT3/FT4 ratio. Conclusions: The present study demonstrated an independent and positive correlation of serum creatinine with the serum FT3/FT4 ratio in HD patients. The lack of association of the serum FT3/FT4 ratio with serum albumin and CRP suggested the presence of a creatinine-specific mechanism to associate with serum FT3/FT4 ratio. Because of the local activation of T4 to T3 at muscle tissue, a lower muscle mass may be causatively associated with low T3 syndrome.     

Variability over 1 Week in the Urinary Concentrations of Metabolites of Diethyl Phthalate and Di(2-Ethylhexyl) Phthalate among Eight Adults: An Observational Study

Background

Phthalates are metabolized and eliminated in urine within hours after exposure. Several reports suggest that concentrations of phthalate metabolites in a spot urine sample can provide a reliable estimation of exposure to phthalates for up to several months.

Objectives

We examined inter- and intraperson and inter- and intraday variability in the concentrations of monoethyl phthalate (MEP), the major metabolite of diethyl phthalate, commonly used in personal care products, and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), a metabolite of di(2-ethylhexyl) phthalate (DEHP), a polyvinyl chloride plasticizer of which diet is the principal exposure source, among eight adults who collected all urine voids (average, 7.6 samples/person/day) for 1 week.

Methods

We analyzed the urine samples using online solid-phase extraction coupled to isotope dilution–high-performance liquid chromatography–tandem mass spectrometry.

Results

Regardless of the type of void (spot, first morning, 24-hr collection), for MEP, interperson variability in concentrations accounted for > 75% of the total variance. By contrast, for MEHHP, within-person variability was the main contributor (69–83%) of the total variance. Furthermore, we observed considerable intraday variability in the concentrations of spot samples for MEHHP (51%) and MEP (21%).

Conclusions

MEP and MEHHP urinary concentrations varied considerably during 1 week, but the main contributors to the total variance differed (interday variability, MEHHP; interperson variability, MEP) regardless of the sampling strategy (spot, first morning, 24-hr collection). The nature of the exposure (diet vs. other lifestyle factors) and timing of urine sampling to evaluate exposure to phthalates should be considered. For DEHP and phthalates to which people are mostly exposed through diet, collecting 24-hr voids for only 1 day may not be advantageous compared with multiple spot collections. When collecting multiple spot urine samples, changing the time of collection may provide the most complete approach to assess exposure to diverse phthalates.