上海市儿童Ⅰ型糖尿病发病率调查

根据ＷＨＯＤＩＡＭＯＮＤ方案所介绍的方法对上海市区１９８０～１９９１年０～１４岁儿童Ⅰ型糖尿病（ＩＤＤＭ）发病率进行了回顾性调查。上海市区０～１４岁儿童平均每年１０２２１５７人。所有病例来自医院和全市中、小学校。在１９８０～１９９１年期间０～１４岁ＩＤＤＭ患者实际调查数为７５例，其中男性３５例，女性４０例。ＩＤＤＭ粗发病率为每年０．６１／１０万（９５％ＣＩ：０．４８～０．７７），校正率为０．７２／１０万（９５％　ＣＩ：０．５７～０．９１）。１２年中１９８５年为发病高峰。以９岁儿童组发病率最高。与其他国家相比，上海市区儿童ＩＤＤＭ发病率是世界上最低的。     

生活方式对企事业单位人群代谢综合征患病影响的调查

目的 探讨生活方式对企事业单位人群代谢综合征（ＭＳ） 患病的影响。 方法 以 ２０１７ 年来我院体检的上海地区人群为研究对象，收集相关体检数据以及婚姻、职业、家族史、膳食、运动、吸烟和饮酒等生活方式信息，比较各因素在 ＭＳ 患者和非 ＭＳ 患者间的差异，分析 ＭＳ 的影响因素。 结果 ＭＳ 患病率为 １５ ６７％ （ 男２０． ５０％ ，女 ５． ０１％ ）。 男性（ＯＲ ＝ ３． ７５，９５％ ＣＩ：３． ０２ ～ ４． ６７）、年龄（ＯＲ ＝ １． ０７，９５％ ＣＩ：１ ０６ ～ １ ０７）、高血压家族史（ＯＲ ＝ １． ５１，９５％ ＣＩ：１． ３３ ～ １． ７０）、肥胖家族史（ＯＲ ＝ １． ３６，９５％ ＣＩ：１． １０ ～ １． ７０）、肉类及肉制品摄入２００ ～ ２９９ ｇ（ＯＲ ＝ ２． ０４，９５％ ＣＩ：１． ２５ ～ ３． ３３）和≥３００ ｇ（ＯＲ ＝ ２． ７０，９５％ ＣＩ：１． １８ ～ ６． ２０）、蛋类摄入 ２ 个（ＯＲ ＝１． ６５，９５％ ＣＩ：１． １３ ～ ２． ４２） 和≥３ 个（ＯＲ ＝ １ ７４，９５％ ＣＩ：１． ２２ ～ ２． ５２）、吃饭过快（ＯＲ ＝ １． ５８，９５％ ＣＩ：１ ３９ ～１ ８０）和吃饭过饱（ＯＲ ＝ １． ４８，９５％ ＣＩ：１． ２７ ～ １． ７２）、饮食喜咸（ＯＲ ＝ １． １７，９５％ ＣＩ：１ ０４ ～ １ ３３）、戒烟（ ＯＲ ＝１ ２２，９５％ ＣＩ：１ ０１ ～ １ ３２）和偶尔吸烟（ ＯＲ ＝ １． ２９，９５％ ＣＩ：１． ０２ ～ １． ６５） 及吸烟（ ＯＲ ＝ １． ３８，９５％ ＣＩ：１． １３ ～１ ６８）是 ＭＳ 的危险因素；主食摄入 ４００ ～ ５４９ ｇ（ ＯＲ ＝ ０． ６４，９５％ ＣＩ：０． ４２ ～ ０． ９８）、奶类摄入 ＜ ２５０ ｍｌ（ ＯＲ ＝０ ８０，９５％ ＣＩ：０． ６８ ～ ０． ９４）和 ２５０ ～ ４９９ ｍｌ（ ＯＲ ＝ ０． ８４，９５％ ＣＩ：０． ７２ ～ ０． ９８）、豆类摄入 ＜ １００ ｇ（ ＯＲ ＝ ０． ７５，９５％ ＣＩ：０． ６０ ～ ０． ９５）和 ２００ ～ ２９９ ｇ（ＯＲ ＝ ０． ５５，９５％ ＣＩ：０． ３３ ～ ０． ９３）、水果摄入 １００ ～ ３９９ ｇ（ ＯＲ ＝ ０ ７０，９５％ＣＩ：０． ５４ ～ ０． ９１）和 ４００ ～ ６９９ ｇ（ＯＲ ＝ ０． ６２，９５％ ＣＩ：０． ４０ ～ ０． ９５）、中度（ＯＲ ＝ ０． ７７，９５％ ＣＩ：０ ６４ ～ ０ ９３）和重度运动（ＯＲ ＝ ０． ４０，９５％ ＣＩ：０． １８ ～ ０． ９１）是 ＭＳ 的保护因素。 结论 ＭＳ 受多种生活方式因素综合作用的影响，应开展针对性的健康教育，促使该人群自觉采纳有益于健康的膳食结构、改变不良饮食习惯及喜好，加强运动锻炼，消除或减轻不良生活方式对 ＭＳ 的影响。     

日本的Ⅰ型糖尿病

日本的Ⅰ型糖尿病ＳｈｉｇｅｎｏｂｕＮａｇａｔａｋｉ（长泷重信）亚洲Ｉ型糖尿病的特征据信亚洲Ｉ型糖尿病发病率远低于欧洲和美国，芬兰的发病率是每年３０例／１０万，而亚洲是每年０．４～０．８例／１０万。可是，日本人胰岛细胞抗体（ＩＣＡ）阳性率在自身免疫性甲...     

宁夏再生障碍性贫血的流行病学调查

目的：调查１９９５～１９９６两年宁夏全区的再生障碍性贫血（ＡＡ）的发病情况。方法：流行病学调查法结果：ＡＡ年平均发病率为０．３６／１０万,９５％的可信区间为０．２４～０．４８／１０万,标化率为０．３５／１０万;男性发病率为０．４７／１０万,标化率为０．４６／１０万,女性发病率为０．２４／１０万,标化率为０．２４／１０万;汉族发病率为０．４６／１０万,标化率为０．４７／１０万,回族发病率为０．１７／１０万,标化率为０．１７／１０万。结论：宁夏地区 ＡＡ的发病率低于全国平均水平,差异有显著性（ Ｐ＜０．０１）,男性高于女性,汉族高于回族,有一定的地区分布和年龄高峰特征,但与血型、季节无明显关系。     

Ⅳ型胶原放射免疫分析的研究

目的：建立Ⅳ型胶原（ＣＩＶ）测定的放射免疫分析法。方法：从人胎盘组织提纯ＣＩＶ，免疫兔获得特异抗血清，制备１２５￣Ⅰ－ＣＩＶ标记抗原并建立ＣＩＶ放免分析法。用此法检测９０名正常人和１５０例各种肝病患者血清ＣＩＶ含量。结果：该法标准曲线工作范围２５～８００μｇ／Ｌ，灵敏度１０μｇ／Ｌ，批内和批间变异系数分别为４．７％和６．３％，平均回收率９５．０％。用该法测定正常人血清ＣＩＶ含量为９２．１±１１．０μｇ／Ｌ：慢活肝，肝硬化和原发性肝癌组血清ＣＩＶ水平显著高于正常组（Ｐ值＜０．０１）；急性肝炎组略有升高。慢活肝，肝硬化和原发性肝癌组高于急性肝炎和慢迁肝组（Ｐ值＜０．０１）。结论：建立的ＣＩＶ放射免疫分析法具有简便、灵敏、特异的优点，对肝纤维化及肝硬化的诊断具有临床实用价值。     

不同起搏方式对病窦综合征患者远期效果的影响

为了解不同起搏方式对病窦综合征特别是慢－快综合征患者心功能及房性心律失常的影响，利用超声心动图、体表心电图及Ｈｏｌｔｅｒ检查，对２１１例病窦综合征患者采用自身对照方法进行回顾性分析。结果发现：生理性起搏（ＡＡＩ／ＤＤＤ）组术后左室射血分数（ＬＶＥＦ）、心输出量（ＣＯ）明显增加（ＡＡＩ：５３．５±６．１％ｖｓ４７．２±７．８％，４．９５±０．５７Ｌ／ｍｉｎｖｓ４．２０±０．６２Ｌ／ｍｉｎ；ＤＤＤ：５２．５±６．８％ｖｓ４４．３±０．１％，５．１２±０．７１Ｌ／ｍｉｎｖｓ４．４１±０．３８Ｌ／ｍｉｎ；Ｐ均＜０．０１），左房内径（ＬＡＤ）无明显变化；ＤＤＤ组Ｅ／Ａ比值明显增加（０．９８±０．０９ｖｓ０．８７±０．１５，Ｐ＜０．０１），ＡＡＩ组Ｅ／Ａ比值呈增加趋势（Ｐ＝０．０５７）。房性心律失常发生率明显减少（１５．９％ｖｓ５０％，Ｐ＜０．０１）。非生理性起搏（ＶＶＩ）组术后ＬＶＥＦ、ＣＯ明显下降（４４．１±４．７％ｖｓ４８．３±４．３％，３．７７±０．４２Ｌ／ｍｉｎｖｓ４．１７±０．８５Ｌ／ｍｉｎ，Ｐ均＜０．０１），ＬＡＤ明显增大（３９．２６±２．３７ｍｍｖｓ３６．８１±２．３５ｍｍ，Ｐ＜０．０１），Ｅ／Ａ比值呈?     

原发性高血压为Ⅱ型糖尿病发病独立预测因素──非糖尿病人群465例6年前瞻性观察

报告４６５例非糖尿病人群中（ＮＧＴ３１６人，ＩＧＴ１４９人）高血压对糖尿病发病率的影响。调整年龄、性别影响后高血压组（ｎ＝１４０例）之６年糖尿病发病率为４４．６％，显著高于非高血压组的１９．７％（ｎ＝３２８例）。多因素（１ｏｇｉｓｔ）回归分析显示排除空腹血糖与ＢＭＩ这两个与６年糖尿病发病显著正相关的重要因素影响后高血压组较血压正常组仍有较高的糖尿病发病危险（ＯＲ＝１．８，９５％可信限１．０３～３．２１，Ｐ＜０．０５）。剔除服用降压药物者及未到实验终点而失访的８６例后再分析结果仍显示收缩压（ＳＢＰ）高者有较高的糖尿病发病危险（ＳＢＰ升高２０ｍｍＨｇ之糖尿病发病ＯＲ为１．５，９５％Ｃｉ１．１～２．３，Ｐ＝０．０２６），表明非糖尿病人群中高血压是糖尿病发病的独立预测因素。     

慢性粒细胞白血病预后因素回顾性队列研究

目的 研究影响慢性粒细胞白血病（ＣＭＬ）生存的预后因素。方法 回顾性队列研究１５８例ＣＭＬ的病例资料，生存曲线用Ｋａｐｌａｎ－Ｍｅｉｅｒ法，预后因素单变量分析用Ｌｏｇｒａｎｋ检验，多变量分析用逐步Ｃｏｘ回归模型。结果 中位生存时间１４８０ｄ（４年），５年生存率４７．１％（９５％ＣＩ，３６．７％～５６．９％），１０年生存率２４．８％（９５％ＣＩ，１５．０％～３５．８％）。急变类型以急粒变、急粒单变和     

房山农村肺结核传染源控制效果评价（1981～1990）

本文对房山区１９８１～１９９０年肺结核传染源控制情况进行评价。结果：１０年间涂阳肺结核登记率由７４．０／１０万，降到４．１／１０万。Ｐ／Ｉ值由３．１，降至０．３。人口传染源率由９８．５／１０万，降至１７．６／１０万，１０年下降了８２．１％。可见，在１９８１～１９９０年本区在实施肺结核传染源控制方面是成功的和快速的。     

免疫抑制酸性蛋白单克隆抗体MI2体外抗肿瘤作用的观察

作者采用ＭＴＴ比色法观察了本室自制免疫抑制酸性蛋白单克隆抗体ＭＩ＿２的体外抗肿瘤作用。结果表明：ＭＩ＿２在浓度为７．８１ｍｇ／Ｌ时即可明显抑制胃癌细胞株ＳＧＣ７９０１的生长（抑制率７．５％±２．４％Ｐ＜０．０１），并见剂量依赖性表现；在ＬＡＫ细胞与ＳＧＣ７９０１胃癌细胞的效靶比为１０：１时，加入１．９５ｍｇ／Ｌ的ＭＩ＿２即可明显增强ＬＡＫ细胞的细胞毒作用（增强效应为２０６．３％Ｐ＜０．０１），其作用也呈剂量依赖性表现。作者还发现ＭＩ＿２的这种抗肿瘤作用与补体无关。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.