海南岛五市县儿童青少年先天性心脏病流行病学调查报告

1984～1991年期间,对海南岛五市县的儿童81 921人进行了先心病流行病学调查,实检人数79 628人,普查率97.2%。检出先心病215例,首次获得海南岛先心病患病率2.7‰,汉族先心病患病率3.04‰,黎族患病串1.74‰;5岁以下患病率3.78‰,6～19岁患病率2.55‰;女性患病率明显高于男性。     

儿童肥胖的预防和治疗:美国内分泌学会根据专家共识制定的临床指南

与1963～1970年的调查相比,1999～2000年的肥胖患病率在6～11岁儿童中增加了4倍,在12～19岁青少年中增加了3倍.于1976～1980年间,婴幼儿(0～23个月)的肥胖患病率从7.2%增至11.6%,2～5岁儿童从5%增至13.9%.儿童肥胖的总患病率为17.1%.同期,6岁以上儿童中的超重发生率增加了 2.5倍,达37.2%.     

上海市6～18岁少儿肥胖患病率调查

目的　研究上海市 6～ 18岁年龄组的儿童青少年肥胖和超重患病率情况。　方法　采用整群系统抽样的方法随机抽取上海市区、郊区各一个区 ,普查区内所有中小学学生共 6 5 0 0 6名 (郊区 4 0 310名 ,市区 2 4 6 96名 )的身高、体重。以体质指数 (BMI)评价调查对象的肥胖患病率 ,并比较标化患病率的差异。　结果　 (1)调查对象肥胖粗患病率为 3 5 8% ,超重标化患病率为 3 30 % ;超重粗患病率达 13 2 5 % ,标化患病率为 12 95 %。 (2 )总体上肥胖和超重的标化患病率市区显著高于郊区 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1) ;女性的发病率显著低于男性 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1)。 (3)肥胖和超重患病率随年龄增加显著减低 (P <0 0 0 1)。　结论　本组的肥胖患病率稍高于我国 1996年全国性调查的 0～ 7岁组儿童肥胖患病率 ,远低于美国上世纪 90年代末期的水平 ;各年龄组肥胖患病率随年龄增加而逐渐减低 ,与西方发达国家青少年肥胖患病率随年龄增加而增高的趋势有显著的不同。     

贵州省燃煤型地方性氟中毒流行病学调查

目的　评价贵州省地方性氟中毒 (地氟病 )流行现状、影响因素及防制效果。方法　采用横断面调查方法 ,2 0 0 1年 5～ 9月对全省燃煤地区乡镇中心小学 8～ 12岁学生氟斑牙患病情况进行了调查 ,同时对原烧柴地区进行了地氟病线索调查。结果　在 85 7个乡镇中调查 772个 (受检率 90 .0 9% ) ,查出病区乡 5 92个 (检出率76 .6 8% ) ,其中轻病区乡 5 19个 (占 87.6 7% ) ,中病区乡 4 9个 (8.2 8% ) ,重病区乡 2 4个 (4.0 5 % )。病区人口约190 0万人 ,全省燃煤地区 8～ 12岁儿童氟斑牙患病率为 5 6 % ,缺损率为 6 .5 % ,推算 8～ 12岁氟斑牙儿童约 110万人。重病区仍然主要分布在省境内西北地区的毕节地区和六盘水市。与 1986年调查结果比较 ,儿童氟斑牙患病率 <30 %的乡镇无明显变化 ,30 %～ 80 %的乡镇检出率增高 ,而 >80 %的乡镇数明显减少。在约 4 0 %的由烧柴转为烧煤的乡镇发现氟中毒病人。结论　贵州省地方性氟中毒流行得到明显控制 ,但形势仍然严峻 ,病区有扩大趋势。     

南昌地区亚临床甲状腺功能减退症的筛查分析

目的　了解南昌地区亚临床甲状腺功能减退症 (SCH)的患病率。方法　于 1997年 12月～ 1998年 6月 ,对南昌地区的四县五区 2 110人 ,其中成人 14 4 2人 ,年龄为 (18～ 70岁 ) ;儿童 6 6 8人 ,年龄为 (3岁～ 6岁 11个月 ) ,进行甲状腺激素筛查测定。结果　 (1)南昌地区SCH总患病率 6 .1% ,其中成人患病率为 4 .6 % ,儿童患病率 9.1% ,儿童患病率高于成人 (P <0 .0 0 1) ;(2 )女性患病率为 7.4 % ;男性患病率为 4 .9% ,女性患病率高于男性 (P <0 .0 5 ) ;(3)SCH患病率与年龄结构比表明 :成人组 :6 0岁以上年龄组患病率最高 10 .4 % ,其次 5 0岁组 (5 .7% )和 18岁组 (5 .6 % ) ,但后两组比较差异无显著性 ,说明两个年龄段皆为患病高峰期。儿童组则以 3岁年龄组 ,患病率最高 (15 .9% ) ,其次是 6岁年龄组 (9.5 % ) ,两者自比或与成人组比较 ,差异皆有显著性 (P <0 .0 5 ) ;(4)SCH的患病率与甲状腺肿的发生无明显相关性。结论　南昌地区SCH的患病率较高 ,SCH的发生与性别和年龄相关     

中国12个地区中老年人糖尿病患病率调查

目的　调查中国 4 0～ 99岁一般人群中糖尿病和糖耐量低减 (IGT)的患病现状。方法采用分级整群抽样方法 ,在 1997年 8月～ 1998年 8月期间横断面调查中国 12个地区的 4 0～ 99岁居民2 9 5 5 8人。结果　中国 4 0～ 99岁一般人群中糖尿病的标化患病率为 5 .89% (95 %CI:5 .6 2 %～ 6 .16 % ) ,IGT标化患病率为 5 .90 % (95 %CI:5 .6 3～ 6 .17% ) ,12个地区之间的糖尿病标化患病率和IGT标化患病率有显著性区别 (χ2 =84 .5 ,P <1× 10 -5) ,城乡之间的糖尿病患病率 (城 :6 .8% ,乡 :3.8% ,χ2 =12 4 .2 ,P <1× 10 -5)和IGT患病率 (城 :6 .1% ,乡 :5 .3% ,χ2 =11.6 ,P =0 .0 0 0 7)有显著性区别 ,总体上各年龄组之间的糖尿病患病率 (χ2 =12 4 .2 ,P <1× 10 -5)和IGT患病率 (χ2 =11.6 ,P =0 .0 0 0 7)也有显著性区别 ,并呈现增龄性上升的趋势。结论　中老年人糖尿病患病率有地区和城乡差别 ,总体上有随年龄增长而增加的现象     

江苏省高碘和适碘乡甲状腺功能亢进症的流行病学对比研究

目的 通过对高碘与适碘乡人群甲状腺功能亢进症(甲亢)发病率的流行病学调查,分析高碘与甲亢的发生关系.方法 2006年,在江苏省选择饮用水含碘量较高的沛县孟庄乡(水碘中位数为1284.1μg/L)和饮用水含碘量适宜的邳州市新集乡(水碘中位数为77.9 μg/L),对两乡的所有人群进行甲状腺疾病筛查,对筛查出的可疑者进行检查及确诊,比较两乡甲亢患病率以及与人口学特征分布之间的差异.结果 高碘乡调查17471人,查出甲亢病人26人,患病率为1.49‰,其中男性患病率为0.75‰(7/9264),女性为2.32‰(19/8207);标化患病率为1.48‰.适碘乡调查12 765人,查出甲亢病人27人,患病率为2.12‰,其中男性患病率为0.96‰(7/6823),女性为3.26‰(20/5942);标化患病率为2.02‰.高碘乡甲亢患病率和标化患病率显著低于适碘乡(u值分别为2.88、2.89,P均<0.01).高碘乡女性患病率(2.32‰)低于适碘乡(3.37‰,u=4.03,P<0.01).高碘乡和适碘乡甲亢患病率均以20～50岁年龄组为高(19.36/万～38.96/万).高碘乡甲亢患者中Graves病占50.00%(13/26),显著高于适碘乡[29.41%(5/17),χ2=5.853,P<0.01].结论 长期慢性高碘摄入并没有增加甲亢发病危险,与适碘乡相比,高碘乡居民甲亢患病率反而下降,女性患病率高于男性.     

儿童糖尿病研究进展

第 6 4届美国糖尿病学会 (ADA)年会有关儿童糖尿病的论文共 80余篇 ,内容涉及儿童糖尿病流行病学调查、临床病学特征及其治疗等。本文仅就相关内容作一介绍。1　儿童糖尿病流行病学调查美国一项六中心调查研究发现 ,儿童糖尿病 (包括 1型和 2型 )的患病率大大超过人们的想象 ,0～ 4岁为 14 .1%、5～ 9岁为 2 4 .7%、10～ 14岁为 32 .6 %、15～ 19岁为 2 0 .7% ,且具有种族差异性。其中非西班牙白人最高 (6 5 % ) ,太平洋岛人最低 (2 % )。有调查发现 ,大约 80 %儿童糖尿病为 1型糖尿病 ,而儿童 2型糖尿病以西班牙人及非裔美国人较多 (1770…     

心血管病与基因突变(4)心房间隔缺损和心室间隔缺损的外科治疗

心房间隔缺损 (ASD)和心室间隔缺损 (VSD)的外科治疗例数居各种先天性心脏病 (先心病 )手术例数之首 ,5 0余年来 ,经历了闭式手术、低温麻醉直视手术、体外循环直视手术到目前方兴未艾的微创外科手术几个阶段。1　发病率及外科治疗史1.1　发病率　　近年来统计 ,新生儿中先心病的发病率为 6 .0 0‰～14.0 0‰ ,上海市出生婴儿为 6 .87‰ ,成都、合肥及福州的学龄前儿童分别为 3.10‰、2 .39‰和 2 .80‰ ,哈尔滨中、小学生为3.10‰ ,而高原地区的青海中小学生高达 8.80‰～ 13.70‰ ,广东成人为 1.0 8‰。全国 34个单位 195 0年至 1984年…     

深圳城区成年人峰值骨密度和骨质疏松患病率的调查

目的　调查深圳城区健康人群峰值骨密度 (PBM )和骨质疏松患病率 ,以期为深圳地区骨质疏松症防治工作提供理论依据。方法　三年调查期间体检的健康成年人 747名 ,年龄 2 0～70岁 ,每 5岁一个年龄段分为 10组 ;用双能X光骨密度仪测量骨密度并得到峰值骨密度 (PBM )值。结果　男性各部位PBM值出现在 2 5～ 2 9岁 ,女性除Ward’s部位PBM值出现在 3 0～ 3 4岁外 ,其余部位PBM值均出现在 3 5～ 3 9岁。骨质疏松患病率 :女性 5 0岁为 2 3 % ,60～ 70岁为 67% ;男性 60～70岁为 5 4%。深圳城区女性髋部PBM高于南宁 (P <0 .0 1)和广州 (P <0 .0 5 )而与北京相近 ,腰部PBM低于北京、南京 (P <0 .0 5 )而高于南宁 (P <0 .0 1)。男性PBM腰部和髋部低于北京 (P <0 .0 5 ,P <0 .0 1) ,高于南宁 (P <0 .0 1) ,与广州、南京相似。结论　 1.女性骨质疏松症于绝经后五年出现高峰 ;老年时期骨质疏松症又达一个高峰 ,且老年女性骨质疏松患病率明显高于老年男性。2 .骨质疏松的预防应从青少年时期提高PBM开始     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

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.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.