哺乳妇女口服200mg碘油胶丸后乳汁碘及婴幼儿尿碘排泄研究

目的了解200 mg碘油胶丸对哺乳妇女乳汁碘及婴幼儿尿碘的有效保护期,并探索碘排泄规律。方法在阿克苏地区库车县牙哈镇四村选择了109名近半年内未服用过碘油丸的19～36岁哺乳期妇女及20天～18个月婴幼儿,用现场干预的方法,并于服药后的第1、3、7、14、30、50、75、100 d分别采集实验组及对照组的妇女乳汁及婴幼儿尿样,进行碘含量测定。结果本次研究哺乳妇女口服200 mg碘油胶丸后,乳汁碘及婴幼儿尿碘中位数在干预后第一天达到峰值,其值为1004.1μg/L、1383.9μg/L,1～7 d维持高值段,7～14 d碘值下降较快,14 d以后碘值缓慢下降,75～100 d碘值缓慢上升。干预组与对照组经非参数wilcoxon秩和检验显示,除了乳汁碘100 d外,干预组均大于对照组,差异有统计学意义(P<0.05)。结论库车牙哈镇哺乳期妇女通过口服200 mg碘油胶丸可对婴幼儿尿碘最长保护期为100 d。     

秦巴山区孕妇及乳母碘营养状况分析

目的：了解秦巴山区陕西省的柞水,安康2县孕妇及乳母碘营养状况,为研究分析该地区弱智儿童的病因和为\干预措施提供依据。方法：采用酸消化砷铈催化分光光度法测定孕妇及乳母尿碘和母乳碘含量,采用放免分析法测定孕妇及乳母血清T3,T4,TSH含量。结果：柞水,安康2县孕妇及母尿碘中位数分别为235．7ug/L,214.3ug/L,低于国家尿碘标准推荐下限值（100ug/L)者,孕妇占1．6％,乳母占6．7％,T3中位数孕妇为0．7ug/L,乳母为0．6ug/L,低于标准界值（0．8ug/L),孕妇占67．2％,乳母占69．4％,孕妇T4中位数为95．6ug/L,低于正常界值100ug/L 者占58．3％,乳母T4中位数为63．0ug/L,低于正常界值57．0ug/L者占40．3％,TSH结果高于正常界值5．0mU/L者,乳乳母分别占25．0％,23．8％,母乳碘中位数为163．1ug/L,在正常范围,结论;2倒孕妇,乳母人群近期碘入关况良好,但甲状腺各项指标不容乐观,与尿碘分析结果有一定背离,说明体内碘吸收利用状况较差。     

天津市部分高校在校生碘干预前后尿碘与膳食总摄碘量的关系

目的了解碘营养干预前后人群尿碘水平的变化情况，探讨砷铈催化分光光度法所测定的尿碘与膳食总摄碘量间的关系。方法天津市161名大学生健康志愿者，随机分为7组．每组给予不同剂量的碘营养补充剂。补碘第0、2、4周采集一次空腹晨尿，采用砷铈催化分光光度法测定尿中含碘量，碱性苦味酸法测定尿肌酐：7日膳食记录法了解经食物摄入碘的情况。结果给予碘补充剂后。各剂量组尿碘水平均高于补碘前。差异有统计学意义（P〈0．01）；而第4周虽比第2周尿碘略有升高。但差异无统计学意义（P〉0．05）。肌酐校正的尿碘中位数为271．28μg／g Cr，尿碘排泄量中位数为324．54μg／d，膳食摄人碘量中位数为329．71μg／d，尿碘与膳食碘进行相关性分析，r=0．463（P〈0．01）。校正尿碘值比未校正尿碘值与膳食摄碘量的相关系数高（第2、4周校正前r值为0．583、0．593，校正后为0．708、0．733），补碘后比补碘前的校正尿碘值与膳食摄碘量的相关系数高。结论尿碘测定结果及膳食调查结果获得的机体总碘量基本一致。经肌酐校正的尿碘更能准确地反映膳食摄碘量，而且高碘摄人时两者关系更密切。     

新疆南部四村哺乳妇女补碘前后乳汁碘的观察

目的了解乳母服用200 mg碘油胶丸前后乳汁碘的动态变化。方法在新疆阿克苏地区库车县牙哈镇的4个村选择109名近半年内未服用过碘油丸的19～36岁哺乳期妇女,采用现场干预的方法,并于服药前、服药后的第1、3、7、14、30、50、75、100 d分别采集服药组及对照组乳汁,进行碘含量测定。结果阿克苏地区库车县牙哈镇的四村乳母109人(服药组59人、对照组50人),服药前乳汁碘中位数为89.5μg/L,口服200 mg碘油胶丸后,乳汁碘中位数于第一天达到高峰,为1 004.1μg/L,服药后100 d乳汁碘中位数为152.3μg/L,补碘干预可提高乳碘水平。结论口服200 mg碘油胶丸可达到较好的干预效果。     

新疆缺碘地区重点人群口服碘油丸的随机化干预研究

目的评价新疆缺碘地区重点人群(孕妇及哺乳期妇女)有针对性口服碘油丸后的干预的效果。方法利用随机对照的设计进行干预研究,以县为单位将新疆按概率比例规模抽样方法(PPS)抽取30个县随机分为干预组与对照组进行口服碘油丸干预效果的研究。排除无法参加研究的研究对象,最终参与随机干预研究的研究对象有1 020名,其中干预组为402名,对照组为618名,在给予干预组有针对性的口服碘油丸后,分析随机化干预的效果。研究对象纳入调查的标准:30个县(市)的17~50岁,怀孕3个月以内的孕妇、哺乳期妇女,且尿碘水平低于250μg/L。结果在给予干预组有针对性口服碘油丸后,干预组尿碘中位数为206.9μg/L,对照组尿碘中位数为172.2μg/L,经统计检验干预组与对照组的尿碘均数有统计学差别(Z=3.98,P=0.000 1),干预组尿碘均数较对照组高,干预效果明显。结论随机化干预研究提示进行有针对性口服碘油丸后,可以提高孕妇及哺乳期妇女的尿碘水平,本研究可以为碘缺乏重病区实行针对性地口服碘油丸的措施提供依据。     

环青海湖地区重点人群投服碘油丸前后碘营养状况的调查

目的了解青海省环湖地区重点人群的碘营养状况,以及服用碘油丸后的变化情况,为今后在青海省推广碘盐困难地区和边远地区对重点人群投放碘油丸提供可靠的理论依据。方法盐碘检测采用半定量方法进行;尿碘检测采用WS／T 107-1999标准进行:水碘检测采用砷铈氧化还原法;8-10岁学龄儿童甲状腺检查采用触诊法进行。结果环湖地区孕妇、哺乳妇女尿碘中位数分别为96．0、90．6μg／L,8-10岁儿童、育龄妇女的尿碘中位数虽高于100μg／L,但<50μg／L的比例均>20％;服碘油丸前农牧区儿童、妇女的碘营养水平较城镇低,尿碘中位数均<80 μg／L。服药后5组重点人群的尿碘水平均有不同程度的提高,以农牧区的提高最明显。结论青海省环湖地区5组重点人群的碘营养状况不理想,以孕妇、哺乳妇女缺碘最严重,8-10 岁儿童的尿碘水平不能完全反映其他重点人群的碘营养水平。     

全民碘盐与碘油丸防治碘缺乏病对比研究

目的 碘缺乏病全民碘盐和碘油丸防治效果比较。方法 2种方法防治1年结果对比研究。结果 甲状腺肿大率的下降率（即有效率）：碘油丸组大别山区为63.4%，巢湖大、中、小剂量组分别为25%，54%和72.2%。全民碘盐组则分别为53%，83.4%，71.3%和66.3%。尿碘水平：碘油丸组巢湖大剂量组和大别山区均值在643.5-981.0μg/L；而全民碘盐组均处400μg/L（中位数）左右。结论 碘油丸方法存在问题较多，而全民碘盐效果显著，且平稳安全。2种方法都有高碘损伤存在。建议碘盐剂量适当低调和要有地区个别化。强调加强管理是有效达标的关键。     

现行碘盐浓度与高碘甲状腺肿之间关系的探讨

目的：通过对山西省碘缺乏病6年监测结果的分析以及与山西省高 地区甲状腺肿对比研究,探讨全民食盐加碘后尿碘浓度的变化是否会引起高碘甲状腺肿。方法：运用山西省6年病情监测结果及高碘地区调查资料。结果：（1）碘盐中位数逐年上升并趋于稳定,基本上控制在20－60mg/kg;（2）儿童尿碘中位数逐年上升,并稳定在300－400ug/L左右;（3）儿童甲状腺肿大率逐提年下降,从1995年10．9％下降至2000年的3．7％;（4）高碘地区甲肿率为11．1％,尿碘中位数为1111．2ug/L。结论：现行碘盐浓度以及儿童尿碘中位数在400ug/L左右不会引起高碘危害。     

停供碘盐后水源性高碘地区人群碘营养水平的调查

目的了解停供碘盐3年后水源性高碘地区人群碘营养水平，为制订水源性高碘地区干预策略提供依据。方法采用两阶段抽样方法，分别从水碘为〉50～150、〉150—300、〉300～500、〉500州L的行政村中共选定335名调查对象进行横断面调查，检测被调查对象的尿碘和生活饮用水水碘。结果调查对象的家庭生活饮用水水碘中位数为431．5μg/L，8～10岁学龄儿童尿碘中位数为833．0μg／L，I〉300μg／L占81．9％：育龄妇女尿碘中位数为986．7μg／L，≥300μg／L占83．9％；成年男子尿碘中位数为960．5μg／L，≥300μg／L占76．7％。随着饮用水水碘的升高，上述3组人群尿碘水平均有明显升高，差异有统计学意义（H值分别为38．884、58．700、50．452，P〈0．05）。结论3组人群碘营养水平均为碘过量，提示在水源性高碘地区仅采取停供碘盐的干预措施来减少碘的摄人量效果不明显．建议在水源性高碘地区停供碘盐的同时进行改水降碘。     

孕妇、0～2岁婴幼儿及其母亲尿碘调查分析

目的 了解广州市孕妇、0-2岁婴幼儿及其母亲碘营养现状和规律。方法 在所辖12个区、县抽样调查孕妇、0-2岁婴幼儿及其母亲、非妊娠育龄妇女尿碘。结果 非妊娠育龄妇女、孕妇、0-2岁婴幼儿母亲的尿碘中位数分别为250．3μg／L、212．8μg／L和198．3μg／L;尿碘＜100μg／L分别占9．9％、14．9％和16．2％；尿碘≥800μg／L分别占5．8％、3．2％和1．6％。统计检验上述三人群尿碘均值相互间差异有显性。0-2岁婴幼儿的尿碘中位数为260．8μg／L，高于800μg／L占10．1％；其中0-1岁(含1周岁)尿碘中位数为266．2μg／L，其低于50μg／L占1．8％;1-2岁的尿碘中位数为242．8μg／L，其低于100μg／L占13．3％。在0-1岁婴幼儿中，母乳喂养子女尿碘高于非母乳，差异有显性；不管何种喂养方式，母子尿碘相关。孕期尿碘变化呈孕中期略低。结论 广州市孕妇、0-2岁婴幼儿及其母亲碘营养是充足的，但孕妇、母亲尿碘低于非妊娠育龄妇女，其低尿碘比例也高于非妊娠育龄妇女，提示要加强孕妇、母亲的碘营养。特别要关注孕中期碘营养，防止出生前缺碘损伤。     

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.