高碘地区防治监测指标优化研究

目的了解高碘地区停供碘盐状况及对重点人群碘营养的影响,为制定高碘监测方案提供依据。方法每个县的高碘地区分布及食盐供应情况,将其分为单纯高碘、高碘和非高碘共存即“混杂地区”、全部停供碘盐、碘盐和无碘盐共存4种地区类型,分别进行分层抽样监测。每个层次均按东、西、南、北、中随机抽取9个乡镇,每个乡镇随机抽取4个村。每个村抽取8户居民半定量检测食盐样,同时抽取其中4户各采1名家庭妇女随意尿样检测尿碘。不足9个乡镇的层次,每个村抽取15户居民盐样。不足5个乡镇的全部监测。每类地区各选择1所乡镇小学和1所农村小学,整群抽取100名儿童检查甲状腺,检测随意尿样尿碘,由本人检测自带家中食盐。结果调查了3个县市的31个乡镇的121个村。高碘地区19个乡镇,非高碘地区12个乡镇。共检测居民户食盐1354份,碘盐率45.6%,无碘盐率54.4%。高碘地区碘盐率32.6%,无碘盐率67.4%;非高碘地区碘盐率70.1%,非碘盐率29.9%。检测妇女和儿童尿样1660份,尿碘（UI）水平（474.7±391.5）μg/L,尿碘中位数（MUI）354.7μg/L。妇女MUI为449.3μg/L,UI〈100μg/L的样本比例占5.6%、100～300μg/L的占30.0%、〉300μg/L的占64.4%;儿童MUI为321.44μg/L,UI〈100μg/L的样本比例占6.0%、100～300μg/L的占39.8%、〉300μg/L的占54.2%。妇女与儿童的MUI差异有统计学意义。高碘地区MUI为409.1μg/L,非高碘地区MUI为305.2μg/L,二者差异有统计学意义。3个县市甲状腺肿大率分别为2.2%、11.5%和3.0%。结论无碘盐率体现干预效果,尿碘反映碘营养水平,建议高碘地区以居民户食盐和妇女尿碘为主要监测指标,并实行分层抽样监测。     

乌鲁木齐县大湾乡学龄前儿童IDD调查报告

为掌握了解学龄前儿童碘营养状况，按照《新疆维吾尔自治区碘缺乏病防治监测实施方案》的通知，我们对乌鲁木齐县大湾乡辖区内4所小学383名5～7岁学龄前儿童进行了IDD调查。经触诊查出甲状腺肿大率为4．96％，男女之间无差异（5．58％、4．35％）；碘盐半定量测定，学龄前儿童自带食用碘盐合格率为82．02％；碘盐覆盖率为100％。销售商店食用盐含碘量合格率为85．71％，居民食用碘盐含量合格率为87．01％，测定水样4份，水碘含量范围2．0～3．85μg／L，均值为2．78μg／L，测定尿样47份，尿碘中位数252．81μg／L，尿碘水平为98．75～596．58μg／L，尿碘均值为274．81μg／L。调查结果显示，学龄前儿童甲肿率、碘盐覆盖率、尿碘中位数、尿碘均值均已达到IDD的基本消除标准。     

吉林省磐石市农村婴幼儿碘营养水平调查

目的了解吉林省磐石市农村婴幼儿的碘营养水平，为制订碘缺乏病的防治策略提供依据。方法于2009年4月，选择吉林省磐石市宝山、明城、烟筒山3个乡为调查点，从3个乡的卫生院登记中抽取哺乳期妇女、0-2岁婴幼儿（哺乳期妇女的孩子）各50人。在1个月内连续3次收集哺乳期妇女、0-2岁婴幼儿的随意一次尿样，采集1次居民家中食用盐盐样、饮用水水样。采用直接滴定法测盐碘，砷铈催化分光光度法测定尿、水、乳汁含碘量。结果居民户盐碘中位数为30．2rag／kg、乳碘192．8μg／L、水碘2．8μg／L，哺乳妇女、0～2岁婴幼儿尿碘中位数分别为224．9μg/L、209．0μg/L。哺乳妇女的尿碘和乳碘0～6个月、7～12个月、13～24个月分别为207．0μg／L、212．6μg／L、235．5μg／L，147．5μg/L、249．0μg／L、196．8肛g／L尿碘随着哺乳时间的延长而增加，乳碘却相反；婴幼儿的尿碘0～6个月、7—12个月、13～24个月分别为238．1斗g／L、248．0μg／L、158．2μg／L，尿碘随着月龄的增加而减少。结论当前碘盐浓度（30mg／kg左右）对我省磐石地区哺乳期妇女、婴幼儿来说是适宜的。婴幼儿在母乳喂养的后期，要及时补充膳食营养，增加含碘丰富的食物，防止婴幼儿碘营养不良的发生。     

山东省成人碘营养状况与相关特征

目的掌握山东省成人碘营养状况及相关特征,为全民减盐防控高血压干预提供科学依据。方法采用多阶段分层整群随机抽样方法,横断面调查20个县（市）、区的常居成年人,从膳食调查居民户中各收集1人的24h尿液进行尿碘浓度检测。结果全省检测成人尿样2036份,其尿碘水平均值为（349．02±296．39）μg／L,MUI为250．33μg／L;有8．20％、28．24％、22．64％和40．91％的成人碘营养状态分别表现为碘缺乏、碘适宜、碘充足、碘过多。丘岭、山地、平原地区的MUI分别为213．66μg／L、224．15μg／L、375．32μg／L;丘岭地区碘缺乏的比例最高为12．53％,平原地区碘过多的比例最高为58．82％。内陆MUI为270．58μg／L,沿海MUI为204．04μg／L;内陆多表现为碘过多占45．60％,碘缺乏占6．60％;沿海碘缺乏占13．21％,碘过多者达26．22％。MUI以鲁东沿海最低、鲁西平原最高。城市MUI为221．29μg／L,农村MUI为266．70μg／L;城市碘缺乏的占10．65％,农村碘过多的高达44．85％。男性MUI为265．20μg／L,女性MUI为235．13μg／L。结论山东省成人碘营养大部分处于充足和过量状态,仅部分呈现碘缺乏。全省的碘营养状况存在地势地貌、地理位置、城乡、性别差异。在减少食盐摄入控制高血压的同时,应对其进行碘营养评估。     

福建省2011年碘盐质量与不同人群碘营养状况分析

目的了解福建省食用盐碘含量调整前不同人群的碘营养现状,为今后评估调整效果提供依据。方法 2011年在福建省84个县(市、区),每个县按照东、西、南、北、中各随机抽取一定比例的乡(镇、街道),进行居民户食用盐碘含量监测;每个县各抽取5个乡(镇、街道),每个乡(镇、街道)抽取8～10岁20名儿童,检测其尿碘含量;在全省按照PPS法抽取30个县(市、区),每个县抽取3个乡(镇、街道),每个乡(镇、街道办事处)抽取孕妇和哺乳期妇女各5人检测尿碘。结果全省共监测24 277份盐样,盐碘中位数28.93 mg/kg,合格碘盐食用率为96.96%,碘盐覆盖率为98.21%,碘盐合格率为98.73%。8 440名8～10岁儿童尿碘中位数为192.0μg/L,内陆地区8～10岁尿碘中位数高于沿海地区儿童。孕妇尿碘中位数为147.2μg/L,低于WHO推荐的150～249μg/L;哺乳期妇女尿碘水平为134.1μg/L,达到WHO推荐的100μg/L。结论现有的碘盐浓度下福建省居民碘营养水平基本适宜,不存在碘过量的问题,需关注孕妇碘营养不足的问题。     

河北省高碘地区8～10岁儿童碘营养状况调查

目的调查河北，肯高碘地区8～10岁儿童碘营养状况.方法采用人口比例概率方法抽样，盐碘测定采用直接滴定法，水碘测定采用砷铈接触法，尿碘测定采用过硫酸铵消化-砷铈催化分光光度方法结果检测居民饮用水样85份．水碘中位数为166．0μg／L；测定居民户盐样301份，盐碘中位数为28．8mg／kg，碘盐覆盖率为70．43％；检测8～10岁儿童一次即时尿样363份，尿碘中位数为418．8μg／L，尿碘〉300μg／L为248份，占总数的68．0％：水碘〉150μg／L调查点的儿童尿碘中位数与水碘中位数相关（r=0．539，P〈0．05），而与盐碘中位数不相关，结论河北省高碘地区8～10岁儿童碘营养过剩，碘盐加重了这种状况，应停止供应碘盐。     

贵州省未达到消除碘缺乏病目标地区的流行现状调查

目的了解贵州省碘缺乏病(IDD)防治现状。方法按国家IDD监测方案,抽取贵州省5个地区11个县对学校儿童甲状腺肿大率、尿碘及碘盐等进行横断面调查。结果8～10岁学生平均甲状腺肿大率9.66%,最低2.8%,最高15.78%,年龄组间差异有显著意义,居民户盐碘中位数32mg/kg,碘盐覆盖率99.47%,合格率92.11%,儿童尿碘中位数263.9μg/L,其中<100μg/L占6.1%,<300μg/L占52.5%,≥300μg/L占41.31%。结论贵州省碘盐覆盖率、合格率较往年明显上升,儿童尿碘水平趋于更为合理,但8～10岁学生甲状腺肿大率仍处于较高水平。     

2002年商洛市碘缺乏病监测结果分析

目的 了解在现行碘盐含量标准条件下碘缺乏病病情势态及重点人群碘营养状态。方法 采用一次性点状调查方式，监测人群为儿童与妇女。结果 8～10岁儿童甲肿率为6．0％；尿碘中位数儿童为287．2μg／L，育龄妇女为278．2μg／L，哺乳妇女为251．3μg／L，孕妇为268．3μg／L；盐碘均数30．5mg／kg，合格率84．25％；饮用水碘中位数3．1μg／L；7～14岁学生智商总体评价为中下水平；健康教育问卷学生组平均61分，家庭主妇组平均68分。结论 商洛市碘缺乏病病情呈稳定下降势态；现行盐碘浓度适合商洛市现状，重点人群碘营养状况良好。     

2005年河南省宝丰县重点人群碘营养调查

目的了解达标后河南省宝丰县重点人群的碘营养状况。方法尿碘测定采用酸消化砷-铈接触法；盐碘测定采用直接滴定法。结果孕妇尿碘中位数为187．7μg／L，低于50μg／L的比率为1．2％，低于100μg／L的比率为13．1％，不同孕期尿碘水平有显著差异；哺乳期妇女尿碘中位数为147．8μg／L，低于50μg／L的比率为1．8％，低于100μg／L的比率为15．9％；婴幼儿尿碘中位数为178．3μg／L，低于50μg／L的比率为0．9％，低于100μg／L的比率为8．0％；共调查家庭食用盐1036份，碘盐覆盖率为100．0％，中位数为28．8mg／kg。结论宝丰县重点人群的碘营养是适宜的，能够满足其生理需要。     

2000～2004年新疆库尔勒市妇尿碘水平观察

目的掌握新疆库尔勒市孕妇群体碘营养状况。方法2000～2004年期间采集库尔勒市各医院实施围产期保健的孕妇尿样，采用国家规定的检测方法测定尿碘。结果孕妇尿碘中位数分别为287．0μg／L，253．9μg／L，234．81μg／L，217．Oμg／L，189．8μg／L，呈逐年回落趋势；结合2000—2004年期间生产企业的碘盐监测结果，其碘盐合格率均在100％以上，2000年碘盐浓度调整前均数为49．1mg／kg，2001—2004年调整后分别为36．5mg／kg，39．0mg／kg，29．1mg／kg，28．3mg／kg，比调整前分别下降了25．7％，20．6％，40．7％，42．4％。结论库尔勒市孕妇群体尿碘水平在国家调整碘盐浓度后仍维持在国家推荐的最佳尿碘值范围内，其整体碘营养状况良好。     

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.     

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.     

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.     

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.