杭州市新生儿脐带血TSH水平分析

用免疫放射法（ＩＲＭＡ）测定杭州市区１４２析新生儿滤纸血ＴＳＨ及４５６例８－１０岁儿意志水碘测定分析。杭州市区新生儿ＴＳＨ值≥５ｍＩＵ／Ｌ者占５２．３％，８－１０岁儿童尿碘值大于１００μｇ／Ｌ占３２．２％，小于１００μｇ／Ｌ者占６８．８％，８－１０岁在校学生甲状腺肿大率１０．０１％－１９．４７％（触诊法）１６．４５％（Ｂ超法）；居民户食用盐碘含量为０．１２ｍｇ／ｋｇ。调查表明杭州市区人群缺碘存在。     

缺碘地区母婴分娩状态性别体重对新生儿TSH水平的影响

为探讨缺碘地区母婴不同分娩状态及各种生理因素对新生儿促甲状腺激素（ＴＳＨ）水平分布的影响，应用免疫放射分析（ＩＲＭＡ）测定了１５７９名新生儿脐带血ＴＳＨ水平。结果发现，ＴＳＨ值＞５ｍＵ／Ｌ者所占百分数，城镇新生儿的为１９．７％，农村的为２５．９％（Ｐ＜０．０５），女婴的为２８．１％，男婴的为２１．４％（Ｐ＜０．０１），难产的为３１．８％，足月顺产的为２３．３％（Ｐ＜０．０５）；ＴＳＨ值≥２０ｍＵ／Ｌ者所占百分数，早产的为５．３％，足月顺产的为０．４％（Ｐ＜０．０１），重度缺氧的为１２．５％，正常的为０．４％（Ｐ＜０．０１）。提示不同地区、新生儿性别、母亲分娩状态及新生儿缺氧程度对新生儿ＴＳＨ水平分布有一定影响。因此应用新生儿ＴＳＨ评价人群中碘缺乏病流行状况时应当考虑这些因素     

陕西省部分地区新生儿TSH水平调查结果分析

目的 测定新生儿脐带血促甲状腺激素（ＴＳＨ）水平,诊断先天性甲状腺功能低下症,评价人群碘营养状况。方法 采用滤纸片（全血）ＴＳＨ酶联免疫测定方法。结果 ５个地区４０００份新生儿脐带血ＴＳＨ〉５ｍＵ／Ｌ者占２９．９％,〉１０ｍＵ／Ｌ者占１０。．８％,〉２０ｍＵ／Ｌ占１．７％,〉３０ｍＵ／Ｌ的有７例,经复查确诊１例为先天性甲状腺功能低下症,甲低检出率为０．２５‰。结论 该人群仍存在缺碘问题。     

湖北省新生儿脐带血TSH水平评价

目的了解湖北省特需人群（育龄及孕产妇女）的碘营养水平。方法采用免疫放射（ＩＲＭＡ）法。共测定湖北省４７个市（县）正常产新生儿脐带血５３３５例。结果湖北省新生儿ＴＳＨ＞５ｍＵ／Ｌ者占４９．７％。其中１９９８年新生儿ＴＳＨ值＞５ｍＵ／Ｌ者占４４．８％,比１９９７年的５４．９％明显下降（Ｐ＜０．０１）。结论特需人群（育龄及孕产妇女）的碘营养状有所改善,但距碘缺乏病消除标准仍有一定差距     

江苏省新生儿脐带血TSH抽样调查结果分析

目的 了解江苏省新生儿碘营养状况。方法 于１９９７年３～５月在全省范围按ＰＰＳ法抽取３０个点,检测新生儿脐带全血促有朱激素（ＴＳＨ）水平。结果 检测新生儿脐带血８６２份,ＴＳＨ中位数为３．５３５ｍＵ／Ｌ,〉５ｍＵ／Ｌ的脐血样品数占总样品数的３１．７％,与１９９５年（４１．４％）相比有所下降（Ｐ〈０．０５）,但仍远高于“新生儿ＴＳＨ〉５ｍＵ／Ｌ的比例〈３％”的碘缺乏病消除标准。同时发现新生儿ＴＳＨ水     

边缘性碘缺乏地区孕妇及新生儿垂体─甲状腺轴功能研究

边缘性碘缺乏地区孕妇及新生儿垂体─甲状腺轴功能研究贵阳医学院附属医院内分泌科时立新，马启玲，张家秀等在中国边缘性碘缺乏地区─上海市探讨孕妇及新生儿垂体─甲状腺轴功能。结果表明：（１）新生儿促甲状腺激素（ＴＳＨ）水平＞５ｍＩＵ／Ｌ者占６１．０％，＞１０...     

克拉玛依市特殊人群碘缺乏病监测结果分析

采用放射免疫法对克拉玛依市区５１０例新生儿脐带血ＴＳＨ和１２２例２～４岁儿童的ＴＳＨ及１２７例８～１０岁儿童尿碘进行测定,市区新生儿ＴＳＨ值〉５μＩＵ／ｍｌ 占２２．９％;２～４岁儿童ＴＳＨ值大〉５μＩＵ／ｍｌ占１．７％,８～１０岁儿童尿碘〉１００μｇ／Ｌ占９８．４％,〈１００μｇ／Ｌ 占１．６％。甲状腺肿大率为１６．６７％（触诊法）。调查结果表明克拉玛依市还存在着碘缺乏。     

Tg与TSH检测在碘缺乏病监测中的比较研究

通过对新生儿及孕妇Ｔｇ和ＴＳＨ的分析比较，以初步了解它们在碘缺乏疾病（ＩＤＤ）监测中的价值。结果表明：１．新生儿及孕妇Ｔｇ值均＜２０ｎｇ／ｍｌ，无向高值偏移现象，而２９．５％的新生儿和４．３％的孕妇其ＴＳＨ值向＞５ｍＩＵ／Ｌ的高值偏移；２．孕妇尿碘中位数为１２９μｇ／Ｌ，２３％的孕妇其尿碘值＜１００μｇ／Ｌ、作者认为采用新生儿脐血ＴＳＨ测定监测ＩＤＤ似较Ｔｇ更敏感。     

孕妇碘负荷对新生儿甲状腺功能及行为神经发育的影响

目的　探讨孕妇高碘负荷 对新生儿甲状腺功能及行为神经发育的影响。方法　生活在地方性高碘地区的孕妇２９１名,收集临产前尿样及出生后１５分钟内的脐带血样,并采集不同乡地下水样５份。酸式消化砷铈接触法测定微量碘, Ｅ Ｌ Ｉ Ｓ Ａ 测定脐血 Ｔ Ｓ Ｈ 和 Ｆ Ｔ４,新生儿２０项行为神经测定方法检查行为神经发育。结果　水碘浓度为４９５１±３３．７μｇ／ Ｌ;孕妇尿碘浓度中位数为８５３２μｇ／ Ｌ;脐血 Ｔ Ｓ Ｈ 中位数５００ｍ Ｕ／ Ｌ,其中, Ｔ Ｓ Ｈ＞ ５．００ｍ Ｕ／ Ｌ 的占５０８％ , Ｔ Ｓ Ｈ≥１０．００ｍ Ｕ／ Ｌ的占１３９％ ; Ｆ Ｔ４为１．４４±０．５１μｇ／ｄ Ｌ,其中 Ｆ Ｔ４＜ ０．８０μｇ／ｄ Ｌ 的为２７％ ;新生儿行为神经发育测定得分为３９０±１１。相关分析显示,孕妇尿碘水平与脐血 Ｔ Ｓ Ｈ 和 Ｆ Ｔ４水平无显著相关关系。新生儿行为神经发育正常。结论　孕妇高碘负荷对新生儿甲状腺功能及行为神经发育未见产生明显影响。     

单一测定空腹血糖在诊断糖尿病和糖耐量减低中的局限性

分析了经７５ｇＯＧＴＴ确诊的７９７例糖尿病（ＤＭ）和８１８例糖耐量减低（ＩＧＴ）患者的空腹血糖（ＦＢＳ）水平，并与１２８９例正常人作了比较。结果显示：７９７例糖尿病患者中ＦＢＳ≥７．８ｍｍｏｌ／Ｌ者有５０９例（６３．８６％）。ＦＢＳ≥７．８ｍｍｏｌ／Ｌ诊断糖尿病的敏感性和特异性分别为６３．８６％和９９．３０％，ＦＢＳ≥６．１１ｍｍｏｌ／Ｌ则敏感性和特异性分别为９４．２３％和９１．５４％，假阳性率和假阴性率均不到１０％。８１８例ＩＧＴ患者的ＦＢＳ值正常者（＜６．１１ｍｍｏｌ／Ｌ）占７９．７１％，与正常人重叠较多。提示ＦＢＳ≥７．８ｍｍｏｌ／Ｌ对糖尿病的诊断不是一个敏感的指标，若ＦＢＳ≥６．１１ｍｍｏｌ／Ｌ者应作进一步检查。而用ＦＢＳ不能估价ＩＧＴ。     

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.     

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.     

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.