397名碘缺乏病区儿童DDST测试结果分析

在采用碘盐防治措施的碘缺乏病区，对３９７名６岁以下儿童作ＤＤＳＴ测定，结果表明：ＤＤＳＴ结果正常者占８５．１％，异常和可疑者占７．８％，不合作者占７．１％。对ＤＤＳＴ结果异常和可疑的３１名儿童进一步作了Ｇｅｓｅ ｌｌ测定，智力发育商低于正常者２９名，占９３．４％，ＤＤＳＴ假阳性比例占６．６％，说明ＤＤＳＴ信度较强。     

婴儿维生素A营养状况与麻疹疫苗免疫效果的关系

目的 探讨婴儿维生素A营养状况及其与麻疹IgG抗体浓度的关系.方法 采取对婴儿照料者进行24h膳食回顾调查和2日膳食记录相结合的方法,了解入选婴儿连续72 h进食的食物及数量.采用NCCW软件计算每人每日维生素A的平均摄入量,高效液相色谱法测定血清维生素A浓度,ELISA法测定麻疹特异性IgG抗体.结果 入选婴儿仅19.7％维生素A摄入量达到推荐摄入量的80％;维生素A营养不良发生率为67.2％;亚临床维生素A缺乏(SVAD)、可疑SVAD及正常对照者之间麻疹IgG抗体平均几何均数滴度倒数(GMRT)对数值有统计学差异(F=33.77,P=0.000),血清维生素A浓度与麻疹IgG抗体GMRT存在正相关(r=0.560,P=0.000).结论 血清维生素A可能与麻疹IgG抗体有效保护水平的维持有一定关系.     

反复呼吸道感染患儿血清维生素A水平变化及意义

目的观察反复呼吸道感染患儿血清维生素A（Vin）水平及其对免疫功能的影响。方法检测65例反复呼吸道感染患儿（感染组）及20例查体健康儿童（对照组）血清VitA水平;感染组予常规抗感染治疗,对42例处于亚临床状态VitA缺乏中的21例患儿加用VitA2周。4周后检测两组血VitA、IgG、IgA、IgM、C3、CD3＋、CD;CD4＋、CD3＋CD8＋及CD4＋／CD8＋水平。对各项免疫指标与VitA水平行Pearson相关性分析。结果感染组VitA水平明显低于对照组（P〈0．05）,免疫球蛋白除Igi、淋巴细胞亚型除CD;CDs＊外均明显低于对照组;感染组加用VitA的21例患儿血免疫指标除CD;CD;上升不明显外,余均明显高于未加用者,且临床症状恢复时间明显缩短。相关分析示血清VitA水平与IgA、CD3＋、CD;CD4＋、CD4＋／CD8＋呈正相关,与cDfcDf呈负相关,与IgG、IgM和C3无明显相关性。结论Vi认缺乏可能是导致儿童反复呼吸道感染的重要原因之一,对该病患儿在抗感染同时补充VitA有助于提高免疫功能,加速患儿康复。     

缺碘病区补碘后儿童身心发育的调查分析

吉林省６个县（市）１２所小学儿童在补碘１２年后调查发现，甲状腺肿大５．１３％，尿碘值＜５０μｇ／ｇ．Ｃｒ者占２０．９９％，ＴＳＨ＞１０μＩＵ／ｍｌ占０．５７％，有２１％儿童体内摄碘不足。智商均值９６．６３±１３．７３，但智商值向低值偏移，智力落后占６．１２％，超出正常地区２～３倍．听力减退占７．０２％骨龄延迟占６２．４％身高、胸围发育差者各占７．５２％和１０．４４％。亚临床克汀病患病率约４．３４％。对几项指标的诊断价值进行初步讨论。     

天津市学龄儿童碘营养状况调查分析

按不同地区的不同地理位置随机抽取８１所小学校８～１０岁学龄儿童计８５６０名，进行了碘营养状况调查，触诊法的甲肿率为３２．６％，Ｂ超对比甲肿率为２７％。尿碘中位数为９６．０６μｇ／Ｌ，其中最高的郊区、县达１３２．２μｇ／Ｌ，滨海区为１１８．３μｇ／Ｌ，而市中心六个区尿碘中位数仅为５８．４７μｇ／Ｌ。饮用水含碘量平均为３９．８μｇ／Ｌ，市区饮用水仅为５．６μｇ／Ｌ。同时对７９７名学生进行了瑞文氏智力测定，平均智商（ＩＱ）值为１０６．１８±１４．０６，其中极优秀者为３９人，占总数的４．９％，优秀人数为１１２，占１４．１％，二者合计占总调查人数的１８．９％。智力落后儿童１４人占１．７％。ＩＱ频数分布向中上水平偏移，市区、郊区、县与滨海地区的智力落后分布无明显差别（μ＝１．７６Ｐ＞０．０５）。调查的病情指标和生化指标均表明天津市属碘缺乏重病区，拟实施全民补碘措施。     

食盐加碘前后缺碘病区儿童生长发育调查

目的 研究碘缺乏病区学龄儿童在全民食盐加碘前后生长发育状况。方法 对该地区７～１４岁儿童（食盐加碘前２４７人,食盐加碘后２１１人）测定身高、下部量、休重,并计算Ｒｏｈｅｒｅｒ指数,测定尿碘。结果 食盐加碘前儿童尿碘中位数平均水平２６．１ｕｇ／Ｌ,其中〉１００ｕｇ／Ｌ者占５．４％;食盐加碘后儿童尿碘中位数平均水平３８４．７ｕｇ／Ｌ,〉１００ｕｇ／Ｌ者占９５．２％。提示碘营养差状态改善（Ｐ〈０．００１     

山西省高碘地区分布特征与高碘危害的流行病学调查

目的查清山西省高碘地区分布特征,为病区划分、干预措施实施提供依据。方法在山西省进行20个县(市、区)的水碘及病情调查,甲状腺检查采取触诊和B超法,尿碘测定采用砷铈催化分光光度法,盐碘测定采用砷铈氧化还原法,智力测定采用瑞文测验。结果在调查20个市(县、区)的160个乡镇中,共检测水碘1 872份,有29个乡镇水碘中位数高于150μg／L。高碘乡镇儿童尿碘中位数460．50μg/L,儿童甲状腺(B 超法)肿大率13．08％,平均智商114,合格碘盐食用率72．20％;非高碘乡镇儿童尿碘中位数310．30μg／L,儿童甲状腺(B超法)肿大率7．32％,合格碘盐食用率83．13％,平均智商112。结论山西省在10个市(县、区)的29 个乡镇有高碘分布,高碘乡镇儿童甲状腺肿大率、尿碘中位数、智商都显著高于非高碘乡镇,盐碘仍是导致高碘甲状腺肿的一个重要原因,以停供碘盐为主的防治措施有待进一步落实。     

2005年四川省克山病监测结果分析

目的了解四川省克山病病情现状。方法根据《2004年国家地方病防治项目克山病监测技术方案》要求,对监测点区居民进行询问并记录克山病病史,听、叩诊心、肝、肾,测量血压,描记12导联心电图,对克山病病人及可疑病例拍摄心脏正位X线片。观察急型、亚急型、自然慢型、潜在型克山病检出率及转归情况。用荧光法测定人群发硒、环境水硒、粮食中硒,并调查病区人群经济水平和日常生活膳食结构。结果克山病临床检诊率93．1％,各型克山病临床总检出率2．23％;重点人群(3-14岁儿童)检出率1．50％,非重点人群(15- 70岁成人)检出率3．47％;心电图检查的异常率13．5％;儿童发硒(0．3669±0．0990)mg／kg,粮食硒(0．0105±0．0066)mg／kg,水硒均值<0．25μg／L。结论目前四川省仍有亚急型、慢型克山病新发,儿童潜在型克山病检出率相对较高。     

广州市某小学学习障碍儿童碘营养状况调查

目的了解广州市某小学学习障碍(LD)儿童碘营养状况。方法用砷-铈接触法测定尿碘,用放射免疫分析法(RIA)测定静脉血清T4,用免疫放射分析法(IRMA)测定静脉血清TSH。用学习困难儿童筛查量表结合平时成绩选出ID组及对照组。用瑞文智力测验测定智商。结果学习障碍组尿碘中位数为216．6 μg／L,<100μg／L者占22．8％;对照组尿碘中位数为247．9μg／L,<100μg／L者占3．7％。两组尿碘中位数差异无统计学意义(Z=-1．37．P>0．05),但两组尿碘值<100μg/L与≥100μg/L的人数构成差异有统计学意义 (X2=8．65,P<0．01)。两组血清T4均在正常范围(54-174 nmol／L)内。学习障碍组血清TSH(中位数2．2 mU／L)>3．1 mU／L者占18．8％;对照组血清TSH(中位数1．9 mU／L)>3．1 mU／L者占12．9％,两组TSH>3．1 mU/L与<3．1 mU／L人数构成差异无统计学意义(X2=3．85,P>0．05)。学习障碍组智商为97．8±13．1;对照组智商为117．4±1．8;两组智商的差异有统计学意义(t=8．26,P<0．01)。结论广州市学习障碍儿童多数碘营养状况良好;学习障碍组尿碘值<100 μg／L者较对照组多,提示学习障碍儿童部分人缺碘,缺碘与学习障碍的关系,有待进一步探讨。学习障碍儿童智商较对照组低。     

广东省6188名3至14岁儿童血脂水平及影响因素分析

目的了解广东省3～14岁儿童血清胆固醇、甘油三酯、高密度脂蛋白胆固醇的水平及相关影响因素。方法运用多阶段整群随机抽样方法,抽取广东省大城市、中小城市、2类农村各3个区（县）,1类农村4个县,每个县（区）抽取3个街道（乡）、6个居委会;共对3～14岁6188名儿童检测了血脂。用面对面询问调查获得儿童个人及家庭基本情况,体检获取体重、身高数据;血脂采用酶法进行检测,使用Saturno 300生化分析仪和日立7060自动生化分析仪进行测定。结果经过标准人口年龄构成及地区人口权重处理后,广东省3～14岁儿童甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）均值分别为0．80mmol／L,3．50mmol／L,1．28mmol／L。TG均值大城市与1类农村,中小城市与2类农村之间差异无统计学意义（P〉0．05）。TC均值中小城市最高（4．00mmol／L）,其次是大城市（3．72mmol／L）,1类农村与2类农村之间差异无统计学意义（P〉0．05）。四类地区HDL—C均值两两之间均有统计学意义。儿童高TG、高TC和低HDL—C的百分率分别为2．2％,2．1％和8．0％。城市、1类农村、男性、低体重及7．0～9．9岁为高TG的保护因素;对于高TC,家庭人口数3～4人,年龄7．0—9．9岁,大城市、中小城市和1类农村都是危险因素;男性,家庭经济收入800～9999元,中小城市,1类农村是低HDL—C的保护因素。结论广东省儿童血脂仍然处于较低的水平,居住地区、家庭人口数、年龄和性别是血脂的主要影响因素,但对TG、TC和HDL—C水平的影响是不同的。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.