碘盐防治对缺碘地区儿童智力的影响

本文报导了碘盐防治对缺碘地区儿童智力的影响。通过对病区和非病区231名7～13岁学龄儿童智力测试表明,病区在供碘盐前、后出生儿童的平均智商以及智力低下者的比值均有显著性差异;而非病区在相应时间出生儿童的智商却无显著性差异。提示:碘盐可改善缺碘地区儿童智力发育.     

哈密地区碘盐防治地方性甲状腺肿的监测调查

哈密地区原为地方性甲状腺肿病区,我们在全区推行碘盐防治后,人群甲状腺肿患病率明显下降,而临床医院提出近年甲状腺亢进(甲亢)患者增多,认为与碘盐推行有关,问题涉及碘盐普及方向。为此,我们进行了碘盐防治地甲病的监测调查。 一、调查方法 1.地方性甲状腺肿由我站专业人员普查,患者诊断及病区划分依照我国《地方性甲状腺肿防治工作标准(试行)》进行。     

1999年卫生部碘缺乏病专家咨询组会议纪要

１９９９年卫生部碘缺乏病专家咨询组会议于８月１０～１１日在青海省西宁市召开。卫生部疾病控制司许凯同志自始至终到会并指导；专家组成员参加了会议；有关人员列席了会议。与会人员共计２９人。会议内容：一、会议首先研讨了碘性甲亢问题。孙桂华等１２位代表就各地碘性甲亢的情况作了重点发言，吴艺捷（由阎玉芹代读）、王羽、卢倜章、马泰等提供了书面材料。１．会议的发言和讨论表明：已经实施碘盐多年的老病区未见碘性甲亢的报道；但未供应碘盐的轻病区、边缘性缺碘地区及大城市，在全民食盐加碘后，甲亢的发病率有所上升，但这与多…     

甲亢131碘治疗剂量修正的探讨

^131碘治疗甲亢，是有效的甲亢治疗方法之一，由于碘盐的普及应用，且甲状腺与碘代谢密切相关，直接关系到^131碘治疗甲亢的剂量及疗效。因此，我们对近10年来1080例甲亢^131碘治疗病人与10年前治疗的620例病人进行回顾性对比分析，探讨碘盐普及后^131碘治疗甲亢对^131碘治疗剂量的影响，以便获得更佳的治疗效果。     

碘缺乏病病区经食盐加碘后甲状腺功能亢进患病率升高的病因分析

目的 探讨在碘缺乏病(IDD)病区经碘盐防治后，甲状腺功能亢进(甲亢)患病率升高的原因及其可能的发病机制。方法 对来自于海陆丰地区(IDD高发区)的甲状腺疾病患者的临床资料进行统计分析，其中包括58例地方性结节型甲状腺肿患者和经^131I治疗的255例甲亢患者。结果 该地区甲亢患者绝大多数是在5年以上患有地方性结节型甲状腺肿的基础上发生的。未合并甲亢的地方性结节型甲状腺肿患者的甲状腺功能、血清甲状腺激素水平及甲状腺过氧化物酶抗体(TPOAb)水平均正常；而合并甲亢者血清甲状腺激素和TPOAb水平明显升高，经^131I治疗后，甲状腺功能恢复正常，但血清TPOAb仍维持高水平。结论 在IDD病区推行碘盐后．甲亢患病率增加的原因是部分原有的地方性结节型甲状腺肿患者在补碘后诱发了甲亢。其可能的发病机制是这部分患者存在甲状腺自身免疫缺陷。     

重庆市居民食用碘盐的抽样调查结果分析

重庆市居民食用碘盐的抽样调查结果分析陈静刘世玲皮运科刘大蓉肖邦忠蒋诗国李心术重庆市除原黔江地区和万县市部分区县为碘缺乏病老病区外，其余均为９０年代调查确定的碘缺乏病新病区。老病区从６０年代开始供应碘盐，新病区于１９９４～１９９６年先后实现普供碘盐。为...     

内蒙古城镇和农牧区、病区和非病区碘盐及碘缺乏病病情分析

目的了解内蒙古城镇、农牧区、病区、非病区碘盐和碘缺乏病现状。方法对１９９７年全区碘缺乏病中期评估资料进行分析。结果精制盐的碘化效果较粉碎盐好,但在内蒙古由于生活习惯,有５０％以上居民食用粉碎盐。城镇碘盐合格率高于农牧区,但因为多数城镇为历史非病区,碘盐普及时间短,故儿童甲肿率仍偏高。结论经过多年防治,病区儿童甲肿率已下降到５％以下,可粗制碘盐的质量尚有待提高。非病区碘盐合格率达到了９０％以上,但需要有可持续性的保障机制     

2002年广东省居民户碘盐监测及其质量分析

目的 为了解广东省居民食用碘盐及其质量状况。方法 按卫生部下发的《关于全国第四次碘缺乏病监测方案的实施意见》要求进行监测。结果 盐碘中位数为33．4mg／kg,居民户合格碘盐食用率为88．6％,碘盐覆盖率为92．4％。合格碘盐食用率达90％以上的有16个市,占76．2％,不同盐种碘盐合格率存在非常显性差异(P＜0．001),加碘精制盐的合格率明显高于日晒细盐和粗海盐,重病区和中病区的碘盐合格率明显高于轻病区和非病区。结论 广东省2000年实现消除碘缺乏病阶段目标后,全省碘盐供应及质量基本稳定,但在珠江三角洲及沿海地区仍然存在不少非碘盐冲销市场现象,个别地区盐碘浓度有偏高趋势。     

山东省人群碘盐普及率及其影响因素

为掌握山东省碘缺乏病（IDD）病区的非碘盐分布、来源、特征及其影响因素,对山东省IDD病区30676户居民进行了碘盐半定量检测、IDD知识与购盐行为调查,结果显示食用碘盐率为90．4％（非碘盐率9．6％）,91个县（市、区）中有35个碘盐覆盖率在90％以下,平原、沿海地区的非碘盐比例较高,为13．2％和11．1％,47．4％的非碘盐来自村办商店,52．6％来自流动商贩。仅有41．4％的非碘盐居民户知道什么是IDD,居民户购食盐考虑价格因素的占43．3％,考虑是否加碘的31．3％、依据生活习惯的18．5％。山东省非碘盐分布具有区域性,居民户IDD知识贫乏,导致购盐首先考虑价格因素和生活习惯。     

沈阳市东陵区地方性甲状腺肿病区人发中碘的中子活化分析

本文报告了地方性甲状腺肿病区和非地方性甲状腺肿病区75例人发中碘的中子活化分析。结果表明,病区在常年投服碘盐的情况下,人体中碘的含量,病人和非病人之间无显著性差异,并且达到非病区人群的水平。此结果与尿碘检测相一致。     

Options for screening for colorectal cancer

Unlike other types of cancer, there are several options for screening for colorectal cancer (CRC). The most extensively examined method, faecal occult blood testing (FOBT), has been shown, in three large randomized trials, to reduce mortality from CRC by up to 20% if offered biennally and possibly more if offered every year. Recently published data from the US trial suggest that CRC incidence rates are also reduced by up to 20%, but only after 18 years. In this study, the number of positive slides was associated with the positive predictive value both for CRC and adenomas larger than 1 cm, suggesting that the reduction in CRC incidence was caused by the identification and removal of large adenomas. In this respect, this study supports the concept that removing adenomas prevents CRC. More efficient methods of detecting adenomas include the use of colonoscopy or flexible sigmoidoscopy (FS). Considerable evidence exists from case-control and uncontrolled cohort studies to suggest that endoscopic screening by sigmoidoscopy reduces incidence of distal colorectal cancer. However, in the absence of evidence from a randomized trial, several countries have been reluctant to introduce endoscopic screening. Three trialsare currently in progress (in the UK, Italy and the US) to address this issue. Two of these trials are examining the hypothesis that a single FS screen at around age 55-64 might be a cost-effective and acceptable method for reducing CRC incidence rates. Recruitment and screening are now complete in both studies and the first analysis of results on incidence rates is expected in 2004. Colonoscopy screening at 10-year intervals has recently been endorsed in the US on the basis that the reductions in incidence observed with distal CRC screening can be extrapolated to the proximal colon. However, data are lacking and a pilot study for a trial of the acceptability and efficacy of colonoscopy screening is in progress in the US. It has also been suggested that FOBT testing should be used to detect proximal CRC missed by sigmoidoscopy screening, but the small amount of published data suggest that supplementing FS with FOBT offers very little advantage over FS alone. Other forms of CRC screening are under investigation and represent exciting options for the future. Extraction of DNA from stool is now feasible and a number of research groups have shown high sensitivity for CRC using a panel of DNA markers including mutations in k-ras, APC, p53 and BAT26. Data so far indicate that, with the exception of k-ras, these markers are highly specific and therefore represent a significant improvement over FOBT. Whether these tests will replace or supplement existing methods of screening has yet to be determined. It has been suggested that BAT26, which is a marker of microsatellite instability, a feature of proximal sporadic CRC, might be a useful adjunct to sigmoidoscopy screening. Others have suggested that a test for occult blood should be included with the DNA markers to further increase sensitivity. It is not yet known how sensitive these markers are for adenomas--it is only by detecting adenomas that CRC incidence rates can be reduced. A final exciting new option for screening is virtual colonoscopy (VC), which by screening out people without neoplasia allows colonoscopy to be reserved for patients requiring a therapeutic intervention. The sensitivity of VC for large adenomas and CRC appears to be high, although results vary by centre and there is a steep learning curve. Sensitivity for small adenomas is low, but perhaps it is less essential to find such lesions. Some groups have suggested that virtual colonoscopy might be a useful option for investigating patients who test positive with stool-based screening tests. Whichever CRC screening method is finally chosen (and there is no reason why several methods should not ultimately be available), high quality endoscopy resources will always be required to investigate and treat neoplastic lesions detected.     

Indications for surgery for aortic regurgitation

Aortic valve replacement for isolated aortic regurgitation (AR) is usually not indicated unless the regurgitation is severe. However, not all patients with severe AR require aortic valve replacement. This review focuses on the causes of AR and the pathophysiology of acute versus chronic AR, and the attendant adaptive mechanisms of the left ventricle that ultimately determine their different natural histories. Aortic valve surgery must be performed in a timely manner to prevent cardiac death, ameliorate symptoms, and limit late postoperative excess mortality.