高氟区孕妇体内氟水平与胎儿股骨改变率间关系探讨

本文以地方性氟中毒病区51名孕妇及其引产胎儿为研究对象。用氟电极法检测母体尿、血、脐带血、羊水的氟水平。同时对51例胎儿股骨全部进行了光镜观察,并分析了不同氟水平下胎儿股骨的病理改变率。结果表明,胎儿股骨的病理改变率随母体尿、血、羊水的氟水平增加而升高。当尿氟低于1.8ppm、母血氟低于0.93ppm、羊水氟低于0.018ppm 时,无胎儿股骨病理改变发生。当母尿氟高于4.0ppm、血氟高于1.3ppm、羊水氟高于0.07ppm 时,病理改变率分别为66.7%,63.2%,61.1%,RR 值各为12.7,7.6和5.5。研究结果提示,胎儿股骨病理改变率受母体氟水平影响,故可以用母体氟水平估测氟对胎儿有无影响。     

山西省临猗县饮水型地方性氟中毒与尿氟关系的研究

目的 了解山西省临猗县饮水型地方性氟中毒的患病情况,探讨氟中毒与尿氟之间的关系,为当地饮水型地方性氟中毒的防治提供依据.方法 2006年在临猗县饮水型地方性氟中毒重、中病区和非病区各选取1个村作为调查点,采用Dean法和离子选择电极法对当地居民进行氟斑牙和尿氟检查,对病区30岁及以上成年人进行前臂正位X线(包括肘与腕)拍片,进行氟骨症患病情况调查.结果 3个地区人群氟斑牙检出率明显不同(X~2=410.945,P<0.01),其中,中病区、重病区氟斑牙检出率分别为92.34%(253/274)、90.09%(291/323),明显高于非病区[23.27%(64/275),X~2值分别为274.927、268.287,P均<0.01].重病区氟骨症检出率[59.75%(141/236)]明显高于中病区[24.76%(52/210),X~2=183.578,P<0.01].3个地区人群尿氟水平差异有统计学意义(H=411.197,P<0.01),其中重病区为(4.69±0.17)mg/L、中病区为(4.86±0.13)ms/L、非病区为(1.75±0.04)mg/L;而氟骨症患病程度与人群尿氟之间呈直线相关关系(r=0.508,P<0.01).结论 山西省临猗县饮水型地方性氟中毒病区氟斑牙、氟骨症患病情况严重,氟骨症患病程度与尿氟水平相关.     

铝对氟中毒大鼠血清、骨、尿中氟含量的影响

目的 观察经氟铝单独、联合染毒的大鼠血清、骨、尿中的氟含量变化,分析不同剂量的铝对大鼠的氟蓄积量和氟排泄量的影响及其机制.方法 采用3×3析因设计方法,氟和铝各分3个水平,其中氟离子(F-)水平分别为0、50、200 mg/L,铝离子(Al3+)水平分别为0、100、200 mg/L.将雄性Wistar大鼠按体质量随机分成9组,饮水中添加氟和铝,实验期内动物自由进食,饲养18周后以出现明显氟斑牙为模型复制成功的判定指标.采集大鼠的血清、骨样、尿样,测定其中的氟含量.结果 氟对大鼠血清、骨、尿中的氟含量有影响(F值分别为166.74、577.81、160.96,P均＜0.01).氟和铝对血氟、骨氟、尿氟的影响具有交互作用(F值分别为7.95、5.13、6.94,P均＜0.01).当氟水平为50 mg/L时,铝水平为0、100 mg/L组的血清氟含量[(0.08±0.03)、(0.08±0.02)mg/L]高于200 mg/L组[(0.04±0.01)mg/L,F值分别为7.14、5.78,P均＜0.05].水氟水平为50mg/L时,铝水平为0 mg/L组时骨氟含量[(1996.53±383.73 )mg/kg]高于100、200 mg/L组[(1252.51±189.08)、(1160.63±129.63)mg/kg,F值分别为20.54、24.56,P均＜0.01];当氟水平为200 mg/L时,随着给铝剂量的增加,骨氟含量依次降低,分别为(4668.70±887.67)、(3920.30±528.31)、(3297.64±396.04)mg/kg,任意两组间比较,差异均有统计学意义(F值分别为15.59、52.31、14.38,P均＜0.01).当氟水平为50 mg/L时,铝水平为0 mg/L组的尿氟含量[(34.054±9.30)mg/L]高于100、200 mg/L组[(14.81±6.32)、(14.67±3.42)mg/L,F值分别为25.30、24.32,P均＜0.01];当氟水平为200 mg/L时,铝水平为0、100 mg/L组的尿氟含量[(57.14±21.38)、(51.75±8.39)mg/L]高于200 mg/L组[(34.84±9.30)mg/L,F值分别为30.04、20.31,P均＜0.01].结论 铝对氟有拮抗作用,且随着铝剂量的升高,拮抗作用加强.氟铝比例为1∶2时,铝即能较有效的拮抗氟地吸收.     

大豆、硒粉、螺旋藻对高摄铝下氟中毒大鼠的干预效果

目的 观察高摄铝状态下氟中毒大鼠大豆、硒粉、螺旋藻的干预效果.方法 将断乳2周的SD纯系大鼠40只(雌雄各半)按体质量随机分为5组:对照组、高氟铝组、高氟铝加大豆组、高氟铝加硒组和高氟铝加螺旋藻组,每组8只.对照组食用非病区玉米加工的饲料(含氟5.20 mg/L,含铝6.80 mg/L),饮用自来水(含氟0.70 mg/L,含铝0.20 mg/L).其余各组均食用以病区玉米为主加工而成的饲料(含氟110.00 mg/kg,含铝19.70mg/L),饮用自来水配制的高铝水(含氟0.70 mg/L,含铝90.00 mg/L).高氟铝加大豆组在实验开始即添加大豆(大豆占饲料的30%),高氟铝加硒组和高氟铝加螺旋藻组在动物出现氟斑牙后饲料中分别添加硒(3.00mg/kg)、螺旋藻(1000.00 mg/kg),实验期为22周.大鼠处死前收集24 h尿液,用于尿氟、铝的测定;大鼠处死后取四肢骨用于骨氟、铝测定;电镜下观察大鼠股骨松质骨的超微结构变化.结果 ①骨氟:高氟铝组的骨氟[(204.07±63.78)mg/kg]高于对照组、高氟铝加大豆组、高氟铝加硒组和高氟铝加螺旋藻组[(30.06±6.11)、(54.12±14.56)、(30.44±5.02)、(105.08±21.07)mg/kg,t=0.62、0.53、0.62、0.35,P均<0.01];高氟销加硒组骨氟低于高氟钒加螺旋藻组(t=0.27,P<0.01).②尿氟:高氟铝组尿氟[(4.52±3.09)mg/L]高于对照组[(0.89±0.37)mg/L,t=0.23,P<0.01],低于高氟铝加硒组[(10.38±1.58)mg/L,t=0.34,P<0.01];高氟铝加硒组尿氟高于高氟铝加大豆组、高氟铝加螺旋藻组[(5.56±1.69)、(4.38±3.36)mg/L,t=0.28、0.35,P均<0.01].③骨铝:对照组骨铝[(3.32±3.02)mg/kg]明显低于高氟铝组、高氟铝加大豆组、高氟铝加硒组和高氟铝加螺旋藻组[(374.21±56.11)、(118.20±23.59)、(114.01±22.84)、(67.11±11.53)mg/kg,t=1.42、0.44、0.42、0.24,P均<0.05];高氟销组骨铝也明显高于高氟铝加大豆组、高氟铝加硒组、高氟铝加螺旋藻组(t=0.56、0.57、0.68,P均<0.01);高氟铝加螺旋藻组骨铝低于高氟铝加大豆组、高氟铝加硒组(t=0.11、0.10,P均<0.05).④尿铝:高氟铝组尿铝[(1.14±0.32)mg/L]高于对照组、高氟铝加大豆组[(0.73±0.11)、(0.66±0.10)mg/L,t=1.92、2.24,P均<0.05].高氟铝加大豆组尿铝低于高氟铝加硒组、高氟铝加螺旋藻组[(1.03±0.22)、(1.10±0.28)mg/L,t=1.73、2.06,P均<0.05].⑤扫描电镜下高氟铝组骨胶原纤维排列紊乱,骨小梁发生融合成片,小梁吸收孔大多消失,其损害最为严重.在干预组其骨胶原纤维走向大致可见,小梁融合现象较高氟铝组为轻,其中以高氟铝加硒组改善为显著,高氟铝加螺旋藻组次之,而高氟铝加大豆组的作用稍弱.结论 饲料中加大豆、硒粉、螺旋藻对高摄铝状态下氟中毒大鼠的骨损伤具有缓解作用,其中以硒粉的作用最为显著.螺旋藻次之,而大豆的作用稍弱.     

高氟区改水后8～12岁儿童尿氟水平动态观察

目的观察高氟区改水后儿童尿氟水平动态,探讨降氟后不同病区、不同年限氟中毒的防治效果.方法对轻、中、重病区改水1、3、5、7、9年各抽取2个病村(其30个村),每村随机抽取8～12岁儿童10例,采用氟离子选择电极法测定晨尿氟含量.结果饮用低氟水的年限越长,尿氟水平越低.轻、中病区较重病区下降明显,改水后不同年龄儿童尿氟均值差异不大,但个体间差异较大.总体尿氟均值已由改水前的5.28 mg/L 下降到1.91 mg/L,统计学处理(t=29.27,P＜0.001),差异有非常显著意义.结论改饮低氟水后机体摄氟减少,儿童尿氟水平随饮用低氟水年限延长而逐渐下降,亦反映了病区人群改水降氟防治氟中毒的效果.因此,儿童尿氟可做为防治氟中毒效果考核的客观指标.     

山东省滨州市地方性氟中毒防治现状调查分析

目的了解滨州市饮水型地方性氟中毒病区的病情变化趋势。方法采用流行病学调查方法,对惠民、博兴、邹平地方性氟中毒病区水氟及儿童氟斑牙患病率进行了调查。结果未改水病区、改水工程正常病区及改水工程报废病区饮用水含氟量分别为1.00±0.76 mg/L、1.34±1.05 mg/L、2.24±1.21mg/L;改水工程报废病区饮用水含氟量明显高于改水正常病区(t=2.06,P<0.05);改水工程报废病区饮用水含氟量明显高于未改水病区(t=3.00,P<0.01);未改水病区饮用水含氟量与改水工程正常病区有差异,但无统计学意义(t=1.01,P>0.05);改水降氟工程报废的病区儿童氟斑牙患病率为62.87%,缺损率13.12%,改水降氟工程正常运转病区氟斑牙患病率为59.45%,缺损率14.92%,而未改水病区氟斑牙患病率小于30.00%。三类病区儿童氟斑牙患病率经统计学处理显示高度显著性差异(χ2=210.06,P<0.01),改水降氟工程正常运转病区儿童氟斑牙患病率高于未改水病区(χ2=140.61,P<0.01),改水降氟工程报废的病区儿童氟斑牙患病率高于未改水病区(χ2=467.37,P<0.01),改水降氟工程报废的病区儿童氟斑牙患病率高于改水降氟工程正常运转病区,但无统计学意义(χ2=0.99,P>0.25);改水工程报废病区儿童氟斑牙患病情况存在显著差异(χ2=21.04,P<0.01),随着年龄的增长其儿童氟斑牙患病率也有增高的趋势,但无明显相关性(r=0.37,P>0.25)。结论山东省滨州市地方性氟中毒病情仍然较重,防病措施必须加强。     

氟铝联合对雄性大鼠性激素的影响

目的 了解氟铝联合对雄性大鼠性激素的影响.方法 选用断乳2周的健康SD雄性大鼠16只,按体质量随机分为4组,每组4只,分别为对照组及铝、氟、氟铝组.对照组和铝组喂饲的玉米饲料68%来自于非病区(含氟、铝各为5.2、6.8 mg/kg),分别给含铝0、90.0 mg/L的饮水;氟组、氟铝组给含68%的燃煤型氟中毒病区煤烘玉米饲料,含氟、铝量为106.0、19.7 mg/kg,并分别给予含铝0、90.0 mg/L的饮水.实验第90天后以出现明显氟斑牙为模型复制成功的判定指标.采集大鼠血样,用时间分辨免疫荧光法进行血清中睾酮(T)、雌二醇(E2)的测定.结果 大鼠血清T水平氟铝组[(15.994±6.558)μg/L]明显高于对照组[(3.317±0.635)μg/L],差异有统计学意义(P＜0.05),铝组[(8.134±3.134)μg/L]、氟组[(1.868±0.367)μg/L]、氟铝组[(12.687±2.979)μg/L]与对照组比较,差异无统计学意义(P＞0.05).大鼠血清E2氟组[(0.172±0.030)nmol/L]明显低于对照组[(0.319±0.072)nmol/L],差异有统计学意义(P＜0.05),铝组[(0.282±0.012)nmol/L]、氟铝组[(0.265±0.047)nmol/L]与对照组比较,差异无统计学意义(P＞0.05).氟和铝两因素存在交互作用(F=9.82,P＜0.05).结论 氟铝联合作用影响雄性大鼠性激素的水平.     

饮水型地方性氟中毒病区成人尿氟检测结果分析

目的了解吉林省饮水型地方性氟中毒病区成人的尿氟含量情况,为今后地方性氟中毒防治工作的开展提供科学依据。方法采用单纯随机抽样方法,先在16个病区县中抽取5个县(市、区),再在每个县(市、区)随机抽取3个病区自然村作为调查点;改水调查点采集并测定1份末梢水样水氟含量;未改水调查点采集并测定东、西、南、北、中五个方位的5份水样水氟含量;采集并测定调查点18岁以上且在当地居住5年以上人群尿样尿氟含量;水样采集与保存采用生活饮用水标准检验方法(GB/T 5750.2);水质分析质量控制采用生活饮用水标准检验方法(GB/T 5750.3);水氟检测采用生活饮用水标准检验方法(GB/T5750.5),并按照生活饮用水卫生标准(GB 5749-2006)评价水氟含量是否合格;尿氟检测采用尿中氟化物测定-离子选择电极法(WS/T 89-2015)。结果共调查了15个病区自然村,改水村占53.33%;未改水村占46.67%。在8个改水村中,水氟含量合格的6个,占监测工程的75.00%;水氟含量超标的2个,占25.00%;7个未改水村水氟含量均超标,1.2 mg/L<水氟含量≤2.0mg/L的村有5个,占71.43%;水氟含量>2.0 mg/L且≤4.0 mg/L的村有2个,占28.57%。共检测成人尿样753份,尿氟波动范围0.09~3.72 mg/L,几何均值1.39 mg/L。其中,在6个改水且水氟含量合格村共检测成人尿样300份,波动范围0.37~2.31mg/L,几何均值为1.31 mg/L;在2个改水但水氟含量超标村共检测成人尿样102份,波动范围0.98~2.67 mg/L,几何均值为1.60 mg/L;在7个未改水村共检测成人尿样351份,波动范围0.09~3.72 mg/L,尿氟几何均值为1.39 mg/L。结论尿氟是反映群体氟摄入水平和机体氟蓄积状态的客观指标,未改水、改水且水氟含量超标病区尿氟水平仍相对较高,还需进一步加强降氟改水工作的落实。     

地方性氟中毒病区与非病区群体尿氟含量分析

目的分析全国地方性氟中毒病区与非病区人群尿氟含量水平,以便确定地方性氟中毒病区与非病区尿氟含量临界值.方法现场调查与资料分析相结合.结果全国非地方性氟中毒病区以几何均数表示的群体尿氟含量中位数儿童 0.7mg/L、成人0.83mg/L;95%位数儿童为1.43 mg/L、成人为1.59 mg/L99%位数儿童为1.79 mg/L、成人为1.89 mg/L.饮水型和燃煤污染型病区儿童群体尿氟几何均数＞1.43 mg/L,饮水型、燃煤污染型和饮茶型病区成人群体尿氟几何均值均＞1.68 mg/L.结论全国地氟病病区与非病区群体尿氟含量儿童以1.4 mg/L、成人以1.6 mg/L为临界值,饮茶型病区成人尿氟含量更有代表性.     

不同含氟量低氟砖茶预防饮茶型氟中毒效果评价

目的对不同含氟量低氟砖茶预防饮茶型氟中毒效果进行评价。方法选择内蒙古自治区克什克腾旗达来诺日镇罕达罕嘎查、哈达英格嘎查居民分别为饮用含氟量(204.5±10.2)、(308.2±15.4)mg/kg低氟青砖茶预防试验点,选择伊金霍洛旗苏布尔嘎苏木苏布尔嘎嘎查居民为饮用含氟量(115.8±38.4)mg/kg、四子王旗吉生太镇南号一组和南号二组居民为分别饮用(200.6±20.5)mg/kg、(301.9±28.4)mg/kg低氟普洱砖茶预防试验点。开展预防试验前,用Dean法检查20～70岁成人氟斑牙,临床和X线法检查氟骨症,并根据《地方性氟骨症诊断标准》(WS192-2008)进行氟骨症诊断。用便携双能X线机检查预防试验前、预防试验24个月后成人骨密度,用氟离子选择电极法检测预防试验点饮用水、砖茶、砖茶饮料、居民尿含氟量,计算居民日经砖茶饮料摄氟量。结果预防试验点氟斑牙检出率54.84%～79.63%;临床氟骨症检出率50.91%～65.69%;X线氟骨症检出率44.30%～65.17%,X线重度氟骨症检出率2.27%～8.86%,预防试验点均为地方性氟中毒重病区。成人骨密度0.451～0.508,骨量减少和骨质疏松检出率38.6%～62.5%。饮水含氟量均≤1.0 mg/L;砖茶含氟量805.6～918.5 mg/kg;预防试验前砖茶饮料含氟量罕达罕嘎查(2.16±1.12)mg/L、哈达英格嘎查(2.82±1.38)mg/L、苏布尔嘎嘎查(1.61±0.74)mg/L、南号一组(3.95±1.22)mg/L,南号二组(3.56±1.39)mg/L;成人尿含氟量罕达罕嘎查(2.78±1.57)mg/L、哈达英格嘎查(2.96±1.80)mg/L,苏布尔嘎嘎查(1.53±0.70)mg/L,南号一组(2.82±1.47)mg/L,南号二组(2.76±1.79)mg/L;经砖茶饮料摄氟量罕达罕嘎查(8.12±5.84)mg/d,哈达英格嘎查(6.42±5.04)mg/d,苏布尔嘎嘎查(3.95±2.42)mg/d,南号一组(8.31±4.49)mg/d,南号二组(6.66±4.73)mg/d。预防试验后24个月骨密度罕达罕嘎查0.527±0.083,显著高于预防试验前(t=3.65,P<0.01),哈达英格嘎查0.443±0.131、苏布尔嘎嘎查0.471±0.110、南号一组0.446±0.118、南号二组0.444±0.099,与预防试验前比较差异均不显著;砖茶饮料含氟量罕达罕嘎查(1.18±0.45)mg/L、哈达英格嘎查(1.60±0.85)mg/L、苏布尔嘎嘎查(0.62±0.29)mg/L、南号一组(1.16±0.35)mg/L、南号二组(1.60±0.71)mg/L,均显著低于预防试验前(P<0.05),苏布尔嘎嘎查显著低于其他预防试验点(P<0.01),罕达罕嘎查显著低于哈达英格嘎查(P<0.05),南号一组显著低于南号二组(P<0.05),苏布尔嘎嘎查、罕达罕嘎查、南号一组符合小型集中式供水国家标准(GB5749-2006氟化物<1.2 mg/L);尿含氟量罕达罕嘎查(2.35±1.04)mg/L、南号一组(2.12±0.96)mg/L显著低于预防试验前(P<0.05),哈达英格嘎查(2.81±1.00)mg/L、苏布尔嘎嘎查(1.47±0.69)mg/L、南号二组(2.48±1.17)mg/L低于预防试验前,但差异均无显著性;经砖茶饮料日摄氟量罕达罕嘎查(2.99±1.71)mg/d、哈达英格嘎查(3.66±2.22)mg/d、苏布尔嘎嘎查(1.75±1.26)mg/d、南号一组(3.08±1.56)mg/d、南号二组(3.52±2.42)mg/d均显著低于预防试验前(P<0.05),苏布尔嘎嘎查显著低于其他预防试验点(P<0.01),苏布尔嘎嘎查、罕达罕嘎查、南号一组经砖茶饮料日摄氟量在国家卫生标准允许限量内(WS/T 87-1996允许限量3.5 mg/d)。结论饮用低氟砖茶可有效预防饮茶型氟中毒,含氟量≤(204.5±10.2)mg/kg低氟砖茶预防效果更为显著。     

Thyrotropin-releasing hormone immunoreactivity in human blood, urine, spinal fluid, amniotic fluid, saliva, and gastric juice

TRH immunoreactivity levels were measured in human blood, urine, saliva, spinal fluid, amniotic fluid and gastric juice. Urinary TRH excretion during a 48-h period was measured in 11 healthy persons. Blood and urinary TRH immunoreactivity were measured at 2 and 5 h, respectively, after administration of 40 mg of TRH. All the samples were prepurified by SP-Sephadex-C-25 cation-exchange chromatography and subjected to reverse-phase high-pressure liquid chromatography (HPLC). TRH immunoreactivity levels were then measured by our TRH radioimmunoassay. The TRH immunoreactivity (TRH-ir) levels found in urine were 14.6 +/- 2.5 pmol/l; in blood 7.5 +/- 2.0 pmol/l; in spinal fluid 2.8 +/- 1.4 pmol/l, and in gastric juice 23.2 +/- 7.1 pmol/l. In all of the amniotic fluid and saliva samples, in almost one half of the blood and spinal fluid samples, and in almost one third of the gastric juice samples, TRH-ir was below the detectable limit. In blood and urine samples taken after oral administration of TRH, TRH-ir was eluted at the same time as synthetic TRH. The recovery of synthetic TRH added to the samples ranged from 36 to 99%. In all of the biological fluid samples, endogenous TRH-ir was eluted at the same time in HPLC, at 15-18 min, as was synthetic TRH which had been added to the samples. Urine was found to contain two TRH immunoreactive peaks, the second of which was eluted at the same time as synthetic TRH. No diurnal variation in urinary TRH excretion or TRH-ir levels was found.(ABSTRACT TRUNCATED AT 250 WORDS)     

Determination of prolactin, growth hormone, beta-endorphin, and cortisol in both maternal plasma and amniotic fluid during human gestation

This study focuses on PRL, GH, beta-endorphin and cortisol in maternal blood and amniotic fluid during human pregnancy. Maternal blood and amniotic fluid samples were obtained from 18 normal pregnant women in the second trimester, 12 full-term gravidas having spontaneous delivery, and 10 full-term gravidas having elective cesarean section. Two gravidas bearing anencephalic fetuses in the third trimester were also studied. In the second trimester women, levels of PRL (3215.9 +/- 458.9 micrograms/l), GH (19.1 +/- 1.7 micrograms/l) and beta-endorphin (11.1 +/- 0.9 pmol/l) were significantly higher in the amniotic fluid than in maternal plasma. In addition, PRL was significantly correlated with beta-endorphin (r = 0.670) and with GH (r = 0.547) in the amniotic fluid. However, amniotic fluid cortisol levels (0.27 +/- 0.18 nmol/l) were significantly lower than plasma cortisol levels. The amniotic fluid of the women with anencephalic fetuses had normal levels of PRL, GH and beta-endorphin. In full-term gravidas, plasma PRL levels were significantly lower in women with vaginal delivery than in those with elective cesarean section, and there was a significant negative correlation between plasma PRL and beta-endorphin, and between plasma PRL and cortisol levels. Plasma GH levels in women with vaginal delivery showed no significant difference from those in women with cesarean section. Examination of amniotic fluid yielded no significant differences in the levels of PRL, beta-endorphin and GH between these two groups.(ABSTRACT TRUNCATED AT 250 WORDS)     

盐池县改饮低氟水八年防治地方性氟中毒效果

本文报道了宁夏盐池县马儿庄,改水8年防治地方性氟中毒,在水氟、氟斑牙、氟骨症患者症状与体征、尿氟、以及骨X线片骨密度、骨结构等方面的变化。水氟多次检测稳定在0.8mg/L。成人氟斑牙改水前后病损改变不大,而改水后出生的儿童,却基本不患氟斑牙或病损程度极轻。氟骨症患者的症状与体征明显减轻占52.8％。精选26例X线拍片动态随诊对比观察,骨密度、骨结构明显减轻占76.92％。连续8年尿氟检测,由改水前15.61mg/L,分别降至5.80、5.01、3.71、3.07mg/L,第一年下降幅度最大。除第6与第8年两个样本均值无显著性外(P>0.05),其他各年都有极显著性(P<0.01)。但该病区均值仍高于宁夏非病区正常上限2.60mg/L水平。     

2009年青海省湟源县地方性氟中毒病情监测结果分析

目的 掌握青海省湟源县饮水型地方性氟中毒病情变化和防治措施落实效果.方法 2009年将湟源县所有地方性氟中毒病区村按改水前水含氟量分为轻、中两类,分别抽取1、2个病区村作为监测点,共抽取3个监测村;每村采集出厂水和末梢水水样进行水氟测定;对监测村所有8～12岁儿童进行氟斑牙检查,并按年龄组采集儿童尿样进行尿氟测定;对监测村16岁及以上成人进行临床氟骨症检查,并采集20人份的尿样,检测尿氟;在3个监测村中选择1个村进行X线氟骨症检查.按照<生活饮用水标准检验方法非金属指标>(GB/T 5750.6-2006)测定水氟,尿氟测定采用氟离子选择电极法(WS/T 89-1996),氟斑牙诊断采用Dean法,成人氟骨症诊断按<地方性氟骨症临床诊断标准>(WS 192-2008).结果 共检测12份水样,水氟为(0.35 ±0.43)mg/L.共检查8～12岁儿童122名,氟斑牙检出率为34.43%(42/122);检测96例儿童尿样,尿氟几何均数为0.89 mg/L.对834名16岁及以上成人进行氟骨症检查,临床氟骨症检出率为47.72%(398/834):检测65例成人尿样,尿氟几何均数为1.10 mg/L;对甘沟村35名成人进行了X线氟骨症检查,检出率为31.4%(11/35).结论 湟源县的3个监测村饮用水含氟量正常,但氟中毒病情仍然很严重,应密切监测,分析原因,改进防治措施.

Abstract：

Objective To investigate the prevalence change of drinking water type of endemic fluorosis and the effect of control measures implemented in Huangyuan county of Qinghai province. Methods In 2009, all the endemic fluorosis villages in Huangyuan county were divided into two degrees, light and medium, according to the water fluorosis content before implementing the improving water project, 1 to 2 villages were selected from each degree village, respectively,as monitoring sites, and a total of 3 villages were selected. Source water and tap water samples were collected from each village and water fluoride concentration was determined. Dental fluorosis of all children aged 8 to 12 of monitoring villages was examined, and urine samples were collected by age group of children for determination of urinary fluoride. Clinical skeletal fluorosis of adults over 16 years of age was examined, and 20 copies of adults urine samples were collected to determine urinary fluoride. One village was selected in the 3 villages monitored to conduct X-rays examination of skeletal fluorosis. Water fluoride was tested in accordance with the "Non-metallic Targets Test Methods for Drinking Water" (GB/T 5750.6-2006); urinary fluoride was tested by fluoride ion-selective electrode method (WS/T 89-1996); dental fluorosis was diagnosed using Dean method;adult skeletal fluorosis was diagnosed by "Clinical Diagnostic Criteria for Endemic Skeletal Fluorosis"(WS 192-2008). Results Twelve water samples were assayed, water fluoride was (0.35 ± 0.43) mg/L. The detectable rate of dental fluorosis of 122 children aged 8-12 was 34.43%(42/122) and the geometric mean urinary fluoride was 0.89 mg/L of the 96 children. Of the 834 adults aged 16 and over, clinical detection of skeletal fluorosis was 47.72% (398/836) and geometric mean urinary fluoride was 1.10 mg/L of the 65 cases of adult urine samples assayed, detection rate of X-rays was 31.4% (11/35) in Gangou village of the 35 adults examined.Conclusions In Huangyuan county, water fluoride of the 3 surveyed villages are normal but the endemic fluorosis is still serious. It should strengthen monitoring and analyze the causes and improve prevention measures.     

2009年陕西省饮水型氟中毒监测结果分析

目的 掌握陕西省饮水型氟中毒改水工程运行情况及降氟效果,为饮水型氟中毒防治工作提供科学依据.方法 2009年对陕西省西安、宝鸡和榆林3个市16个县48个自然村进行监测.在未改水村按东、西、南、北、中采集5份水样,在已改水村采集3份末梢水和1份出厂水,用氟化物离子选择电极法(GB/I'5750-2006)检测水氟.对监测村所有在校8～12岁儿童采用Dean法进行氟斑牙检查,16岁以上成人全部进行临床氟骨症检查,抽取30%的项目县,每个县选择1个村,对已诊断的临床氟骨症患者进行X线拍片检查,临床和X线氟骨症诊断采用<地方性氟骨症诊断标准>(WS 192-2007).每个村采集8～12岁儿童尿样30份、16岁以上成人尿样20份,用<尿中氟化物的测定离子选择电极法)(WS/T 89-1996)检测尿氟.结果 22处运行正常的改水工程中,出厂水超标8处,占36.36%(8/22);工程报废5处.共检测水样202份,已改水村出厂水和末梢水水氟中位数分别为0.72、0.62mg/L,水氟超标率分别为36.36%(8/22)、31.94%(23/72);未改水村水氟中位数为1.00 mg/L,水氟超标率为39.81%(43/108).8～12岁儿童氟斑牙检出率为16.06%(367/2285),氟斑牙指数为0.30,流行程度为阴性;16岁以上成人临床氟骨症检出率为5.09%(1542/30 272),共有198人拍摄X线片,阳性68人,检出率为34.34%(68/198).共检测儿童尿样1051份,尿氟几何均数为0.95mg/L;共检测16岁以上成人尿样914份,尿氟几何均数为1.16 mg/L.结论 陕西省饮水型氟中毒流行范围较大,病情程度较为严重,防治任务还很艰巨.进一步加大病区改水力度,加强病情监测、健康教育和改水工程的管理工作是防治地方性氟中毒的关键.

Abstract：

Objective To investigate the running conditions of the water improvement projects and the role of these projects in reducing fluoride in drinking-water type of fluorosis in Shaanxi province, and provide a scientific basis for prevention and control of the disease. Methods Forty-eight villages of 16 counties in Xi'an, Baoji, and Yulin cities of Shaanxi province were monitored in 2009. Five water samples were collected randomly in water unimproved monitoring villages by the position of east, west, south, north, and center parts. In water improved monitoring villages, 3 tap water and one source water samples were collected. Water fluoride was tested using fluoride ion selective electrode method according to the "Standard Testing Methods for Drinking Water" (GB/T 5750-2006). All school children aged 8 to 12 in monitored villages were examined their dental fluorosis using Dean criteria. All people over 16 years old were examined clinical skeletal fluorosis, and 30% of the project counties were randomly selected, then randomly selected one village among these counties, clinically diagnosed patients with skeletal fluorosis were examined again by X-ray using "Diagnostic Criteria of Endemic Skeletal Fluorosis"(WS 192-2007). Urine samples of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected, urinary fluoride was tested according to "the Determination of Urinary Fluoride by Ion Selective Electrode Method" (WS/T 89-19%). Results Of the 22 water improvement projects that in normal operation, fluoride level of 8 source waters exceeded the standard, accounting for 36.36%(8/22), and projects scrapped 5. Two hundred and two water samples were tested. In water improved historical diseased areas, the median of water fluoride of source water and tap water were 0.72,0.62 mg/L, respectively, and the average rate of water fluoride exceeded the standard ere 36.36%(8/22) and 31.94%(23/72), respectively. In water unimproved historical diseased areas, the median of water fluoride was 1.00 mg/L, and the average rate of water fluoride exceeded the standard was 39.81%(43/108). Detection rate of dental fluorosis among children aged 8 to 12 was 16.06% (367/2285), dental fluorosis index was 0.30, and the prevalence was negative. Detection rate of clinical skeletal fluorosis among adults over 16 years old was 5.09%(1542/30 272), a totally of 198 people had X-ray film taken, positive 68, the positive detection rate was 34.34%(68/198). One thousand and fifty-one copies of children's urine samples were tested, geometric mean of urinary fluoride was 0.95 mg/L; nine hundred and fourteen copies of adults urine samples were tested, geometric mean of urinary fluoride was 1.16 mg/L Conclusions Drinking-water type of fluorosis affects a large area in Shaanxi province, the disease is still serious, and the task of prevention remains very arduous. Further intensify the water improvement project in diseased areas, and strengthen disease monitoring, health education and water improvement project management is the key to prevention and control of endemic fluorosis.     

蛇纹石降氟前后的砖茶水对大鼠骨代谢的影响

目的通过骨代谢实验研究蛇纹石降氟前后砖茶水对机体氟代谢的影响,为探讨蛇纹石降氟在病区人群中应用提供科学依据。方法按饮茶型氟中毒病区居民的砖茶饮用习惯熬制砖茶水,再用活化后的蛇纹石进行降氟,得到蛇纹石降氟后砖茶水。以Wistar大鼠为实验对象,进行3个月骨代谢实验,各实验组动物分别饮用含氟为50．0、15．0、5．0 mg／L的砖茶水和含氟为15．0、5．0、1．5 mg／L的蛇纹石降氟砖茶水,对照组饮用自来水。实验结束后,检测骨氟、尿氟、尿羟脯氨酸、血氟、血钙、血磷、降钙素、甲状旁腺素。结果氟大于5．0mg／L 的各实验组,尿氟、骨氟、血氟、血磷均高于对照组,差异有统计学意义(P<0．05);氟大于15．0 mg／L的各实验组,尿羟脯氨酸高于对照组(P<0．01);血钙、降钙素、甲状旁腺素与对照组相比差异无统计学意义(P>0．05)。含氟相同的降氟1组与茶氟2组(F-,15．0 mg／L)相比,前者的尿氟高于后者,差异有统计学意义(P<0．01);降氟1组与茶氟2组(F-,15．0 mg／L)、降氟2组与茶氟3组(F-,5．0mg／L)相比,前者的骨氟低于后者(P<0．01)。结论蛇纹石降氟不但可以降低砖茶水中的氟,降低了饮茶氟元素的摄入,还可以促进氟的排泄,降低氟在骨骼中的沉积。     

FETAL ORIGIN OF AMNIOTIC FLUID INSULIN IN THE HUMAN MOTHER

To investigate the origin of insulin in amniotic fluid amniocenteses were carried out in pregnancies with live, dead and anencephalic fetuses. Amniotic fluid insulin of pregnant women bearing live fetuses was 9.0 ± 2.1 μU/ml; in six women with dead foetuses amniotic fluid insulin was not detected. A significant positive correlation was observed between gestational age and the amniotic fluid concentration of insulin. In the amniotic fluid of the four women bearing anencephalic fetuses, the amount of hormone was within normal limits (10.0 ± 1.4 μU/ml). Intravenous glucose administration (0.33 g/kg body weight) to the mother does not influence levels of insulin in amniotic fluid, but brought about changes in amniotic fluid glucose concentration. These findings support the conclusion that human amniotic fluid insulin is of fetal rather than maternal origin.     

Fluoride intake and excretion in children of Hermosillo, Sonora, Mexico

OBJECTIVE: To estimate the fluoride intake and urinary excretion among 8-9 year-old school children. MATERIALS AND METHODS: A cross-sectional study was conducted from February to November 1997. Study subjects were 31 male children from Hermosillo, Mexico, living in three neighborhoods with different drinking water fluoride levels. Fluoride intake was measured through water intake and collection of food samples ingested in 24 hr. Fluoride excretion was measured in 24-hour urine samples. The fluoride concentration was measured by the potentiometer method using a fluoride-specific ion electrode. RESULTS: Statistically significant differences of fluoride levels in drinking water were found in the 3 different neighborhoods: 2.77, 0.78 and 0.54 mg/L, respectively (p < 0.01). The daily mean intake of fluoride for the neighborhood with the highest fluoride level was 5.41 mg/d, while mean intakes for the other two neighborhoods were 2.31 and 1.51 mg/d, respectively. Thirty-two percent of the children had fluoride intake above the recommendation values for this age group; sixty per cent of these children lived in the neighborhood with the highest fluoride level. Drinking water accounted for 63% of total fluoride intake, and the mean water intake was 1.8 liters. The mean excretion of fluoride was 1.61 mg/24 hours (range 0.18 to 8.1 mg/24 hr). Stepwise multiple regression showed an association between drinking water fluoride and fluoride urinary excretion (R2 = 0.56 p < 0.001). CONCLUSIONS: Fluoride intake in the neighborhood with the highest fluoride level was twice the daily recommended value for 8-9 year-old children. Drinking water was the main source of fluoride intake. The English version of this paper is available at: http://www.insp.mx/salud/index.html.