兰州市碘缺乏病碘盐干预效果评价

目的评价碘盐干预,为进一步加强和完善消除碘缺乏病的长效工作机制提供科学依据。方法采用PPS抽样法,1995～2009年在兰州市8个县区随机抽取8～10岁儿童进行甲状腺肿大率、尿碘、盐碘监测。结果经食盐加碘干预,8～10岁儿童甲状腺肿大率呈下降趋势,近4年达到国家碘缺乏病消除标准;尿碘中位数波动在100～300μg/L,均满足国家学龄儿童碘营养评价标准（尿碘中位数〉100μg/L）,尿碘合格率波动在67.01%～97.22%;碘盐合格率连续7年稳定在90%以上,各年碘盐中位数均达到国家标准（碘盐20～50mg/kg）。结论普及碘盐是改善人群碘营养状况、防治碘缺乏病的有效措施。     

2009年云南省楚雄州碘缺乏病调查分析

目的为全面掌握楚雄州碘缺乏病防治现状和存在的问题,了解缺碘地区居民户碘盐普及情况,动态评价人群碘营养状况及病情的消长趋势,为适时采取针对性防治措施和科学调整干预策略提供依据。方法采用人口比例概率抽样方法（PPS）,对8-10岁儿童碘营养状况（包括甲状腺肿大率、尿碘、克汀病患儿）及居民碘盐食用情况进行调查,对小学生及家庭主妇进行健康教育调查。结果居民合格碘盐食用率98.07%,非碘盐率0.995%,8-10岁儿童尿碘含量中位数大于或等于100μg/L,且尿碘含量低于50μg/L的比例不超过20%。8-10岁儿童甲状腺肿大率10%,未发现克汀病,五年级学生及家庭主妇知晓率分别为94.71%,93.48%。结论楚雄州达到了云南省2010消除碘缺乏病防治规划标准。     

2007～2009年兰州市碘缺乏病监测结果分析

目的评估兰州市碘缺乏病病情和人群碘营养状况,评价干预措施落实情况及效果,为2010年兰州市实现消除碘缺乏病的阶段目标和完善防治策略提供依据。方法按《全国碘缺乏病监测实施方案》要求进行,每年抽检32所学校,调查8～10岁儿童甲状腺肿大率、尿碘和碘盐。结果儿童甲状腺肿大率达到了国家控制碘缺乏病小于5%的目标,儿童尿碘中位数达到国家目标100μg/L以上,碘盐合格率达到国家目标90%以上。结论兰州市8～10岁儿童甲状腺肿大率、尿碘中位数、碘盐合格率均已达标,基本上消除碘缺乏病。     

2006年新疆伊宁县碘缺乏病防治效果评价

目的评价伊宁县基本实现消除碘缺乏病阶段目标后,以食盐加碘为主的防治现况,为如何更深层地解析可持续消除IDD目标提供科学依据。方法按伊宁县碘缺乏病病情分布区域随机抽取4个乡,在每个乡中确定人口最多的一个村为调查点;开展户用碘盐食用率、8~10岁儿童甲状腺肿大率和8~10岁儿童日间随机一次尿碘水平的调查和检测。结果4个乡的平均居民户碘盐食用率为61.1%,合格碘盐食用率为58.4%;8~10岁儿童甲状腺肿大率为15.9%;8~10岁儿童日间随机一次尿碘中位数为91.9μg/L。结论该县2000年实现基本消除碘缺乏病目标后,由于放松了碘缺乏病防治工作,使合格碘盐食用率、8~10岁儿童甲状腺肿大率和儿童尿碘中位数水平均恢复到达标前的水平。     

漳平市碘缺乏病病情4次监测结果动态分析

目的了解漳平市1995、1997、1999、2001年8～10岁儿童的碘营养水平及流行现状,为防治工作提供科学依据.方法按容量比例概率(PPS)抽样法,用触诊法检查甲状腺肿大率;采用砷铈酸消化法检验尿碘含碘量;采用直接滴定法测定盐碘含碘量.结果各年度8～10岁儿童肿大率分别为21.00%,8.50%,3.50%,4.25%,碘盐合格率分别为70.95%,76.19%,94.76%,97.1%,儿童尿碘中位数分别为254.17,285.40,342.02,346.6μg/L.结论监测结果表明,甲状腺肿大率、尿碘水平、居民合格碘盐食用率等消除碘缺乏病的重要指标,1999年已达到卫生部实现消除碘缺乏病阶段性目标的标准,说明漳平市多年坚持落实以食盐加碘为主的综合防治措施效果非常显著.     

永春县碘缺乏病病情监测结果分析

目的评价永春县碘缺乏病防治效果,为制定防治方案提供依据.方法采用人口容量比例概率抽样法(PPS),随机抽取8～10岁儿童,检查甲状腺肿、尿碘,进行碘缺乏病防治知识问卷调查,并检测其家庭碘盐含量.结果儿童甲状腺肿大率触诊法为10.70%,尿碘中位数为234.21μg/L,学生碘缺乏病防治知识知晓率为93.9%,家庭碘盐合格率为99.53%.结论通过落实以食盐加碘为主的综合性防治措施,效果是显著的,但当儿童甲状腺肿大率降至较低水平时,再下降的速度较为缓慢.     

山东省学龄儿童碘营养状况评估

目的 了解山东省碘缺乏病达到消除标准2年后的防治现状。方法 采用分层整体抽样法对1200名8～10岁学龄儿童的碘营养状况及居民户碘盐食用情况进行评估。结果 儿童甲状腺肿大率、尿碘中位数均已达到国家碘缺乏病消除标准，居民户合格碘盐食用率略低，碘缺乏病健康教育状况不甚理想。结论 山东省学龄儿童碘营养状况良好，碘摄入量能基本满足机体生长发育需要，但需要继续抓好碘盐供应。     

涪陵区全民供碘盐防治碘缺乏病效果评价

目的了解并掌握涪陵区人群供碘盐防治碘缺乏病现况,为2010年涪陵区消除碘缺乏病提供依据。方法采取东、西、南、北、中5个方位抽取5个乡（镇）进行样品采集,用触诊法检查8～10岁儿童甲状腺肿大率情况,儿童尿碘采用过硫酸铵-砷铈催化分光光度法测定,并分别对抽取的乡（镇）部分学校开展碘缺乏病防治知识问卷调查。结果 2006～2009年碘盐覆盖率为93.3%～97.5%,合格碘盐食用率为91.1%～95.6%;儿童甲状腺肿大率（触诊法）由14.84%下降至5.75%;尿碘中位数为166.1～207.4μg/L;碘缺乏病防治知识知晓率为92.4%～91.3%。结论涪陵区人群服碘盐消除碘缺乏病取得了显著效果。     

集贤村地方性甲状腺肿和地方性克汀病的流行病学调查

目的与24年前集贤村的地方性甲状腺肿和地方性克汀病流行情况进行对比，评估干预效果，为今后的防治工作提供科学的依据。方法对全村地方性甲状腺肿和地方性克汀病流行情况进行了普查，采集部分学生血、尿等样品进行测定并测试智商水平。结果全村居民甲状腺肿大率从1979年的74．O％，下降到2002年的18．6％。7～14岁儿童甲状腺肿大率由1979年的77．94％，下降到2002年的8．33％。地方性克汀病人数1979年为145人，2002年为80人，均为24年前诊断的旧病例，近24年来未见有新发克汀病病例。人群尿碘平均数从1979年的168．00μg／gCr上升到2002年的327．43μg／L。从1979年到2002年，智商测试结果显示出高智商所占的比率明显增高。结论多年的碘盐干预、口服碘化钾以及注射碘油等方法，对控制病情、改善人群碘营养状况起到了明显作用。     

福建省龙岩市碘缺乏病病情监测结果分析

目的 了解福建省龙岩市碘缺乏病病情现状,评价防治措施效果,为制订防治策略提供依据.方法 2006和2007年期间,在福建省龙岩市7个县(市、区),每个县(市、区)按容量比例概率抽样法(PPS)确定30所小学,每所小学抽取40名8～10岁学生,进行甲状腺触诊检查,同时抽取7名学生采集尿样和家中盐样,进行尿碘及盐碘测定,计算甲状腺肿大率、尿碘中位数、合格碘盐食用率、碘盐覆盖率、碘盐合格率和非碘盐率.结果龙岩市8～10岁儿童甲状腺肿大率为0.94%(79/8438),尿碘中位数为259.12μg/L,合格碘盐食用率为97.86%(1462/1494),碘盐覆盖率为99.46%(1486/1494),碘盐合格率为98.38%(1462/1486),非碘盐率为0.54%(8/1494).结论 龙岩市的碘缺乏病防治工作达到国家消除碘缺乏病标准.     

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.