高原地区213例儿童特应性皮炎易感因素相关性分析

目的：探讨高原地区儿童特应性皮炎（Atopic Dermatitis,AD）与血清IgE、IgA及IgG抗体、外周血微量元素锌和铁测定、及外周血嗜酸性粒细胞检测。方法：我院2009年1月—2010年12月皮肤科门诊就诊的213例儿童特应性皮炎（均来自西宁及周边地区,海拔为2 261m～3 791m）与同期356例健康儿童（均来自平原地区）对照分析。结果：213例患儿中,各项因素出现的阳性率均明显高于对照组,P〈0.001。在病例组中,发现血清IgA,IgG和外周血微量元素铁和锌显著降低,而血清IgE、外周血嗜酸性粒细胞升高。另外,71.8%患儿平时存在不良洗涤习惯;213患儿中母亲有过敏病史的占78.4%,而父亲有过敏病史的占35.7%。结论：高原地区儿童特应性皮炎与血清IgE抗体增高,IgA、IgG抗体降低,外周血微量元素锌和铁缺乏及外周血嗜酸性粒细胞增高与该病有密切的关系。     

不同海拔高血压患者血CGRP、ADM、MPO及BNP含量的相关性研究

目的：探讨不同海拔的高血压患者血降钙素基因相关肽（calcitonin gene-related pep-tide,CGRP）、肾上腺髓质素（adrenomedulin,ADM）、髓过氧化物酶（myeloperox-idase,MPO）、脑钠肽（brain natriuretic peptide,BNP）浓度的变化,以期对高血压的诊断、治疗和预后判断提供理论依据。方法：采用放射免疫法测定血浆CGRP、ADM含量,用比色法测定血清MPO含量,用Triage荧光免疫分析仪测定BNP含量。结果：高海拔及西宁地区高血压组患者血CGRP含量分别低于同海拔正常对照组（均P〈0.05）;高海拔及西宁地区高血压患者血ADM、MPO、BNP含量分别高于同海拔正常对照组（均P〈0.05）;高原地区高血压组及正常组血CGRP含量分别低于西宁地区高血压组及正常组（均P〈0.05）;高原地区高血压组及正常组ADM、BNP含量分别高于西宁地区高血压组及正常组（均P〈0.05）;高原地区高血压组及正常组血清MPO含量分别与西宁地区高血压组及正常组比较均无显著性差异（均P〉0.05）。结论：高海拔地区人群CGRP含量降低,ADM、MPO及BNP升高,这种趋势在高血压患者中更为明显,提示：海拔高度影响高原居住人群的血管活性物质分泌,可能是高原不适应,导致血压升高的因素之一。     

学习障碍儿童视觉及听觉注意力变化特点观察

目的：观察学习障碍（LD）儿童视觉注意力及听觉注意力的变化特点。方法：选择LD患儿247例为观察组,并抽取成绩居班级前40%的正常儿童247例为对照组。采用联合瑞文测试评定两组儿童的智商水平;采用上海心理健康研究所研发的持续注意力测试法进行持续视觉注意力和听觉注意力测试。结果：两组智商评分差异不显著（P〉0.05）。观察组视觉注意力异常率84.2%,听觉注意力异常率95.1%,同时存在视觉及听觉注意力异常率80.2%;对照组视觉注意力异常率34.8%,听觉注意力异常率27.9%,同时存在视觉及听觉注意力异常率18.6%。观察组视觉注意力异常率、听觉注意力异常率,以及同时存在视觉及听觉注意力异常率均非常显著高于对照组（P〈0.01）。结论：视觉注意力障碍和听觉注意力障碍可能是导致LD的重要原因之一。     

高原地区武警执勤官兵自测健康状况分析与评估

目的 了解高原地区武警执勤部队官兵的健康状况.方法 选定475名来自平原地带（海拔高度约50 rn）,驻扎在海拔3600 ～ 4200 m高原地区6个月的武警某部官兵,采用自测健康评定量表SF-36,了解官兵的生理健康、社会健康及精神健康状况;与423名从该地区撤同至相同平原后6个月的武警官兵健康状况比较.结果 不同年龄、不同文化程度、不同级别高原地区执勤官兵自测健康情况存在统计学差异（P＜0.05）.其中,18岁以上组、高中及高中以上组的总体健康、生理健康、社会健康、精神健康评分明显高于18岁以下组和初中及初中以下组;干部组（95.58 ±7.30）和士官组（89.86±12.91）均明显高于义务兵组（86.27±13.68）,差异有统计学意义（P＜0.05）.平原地区部队官兵以上指标评分明显高于高原地区（P＜0.05）.结论 高原地区武警执勤官兵的总体健康良好,但不同年龄、不同文化程度、不同级别的官兵健康状况不同.当脱离该环境后,其健康水平可逐渐改善.     

多元逐步回归法判别头发中6种微量元素与儿童身高的关系

 目的为达到既经济又方便地了解头发中能影响身高的微量元素的目的.方法对3 564名儿童发样中的锌(Zn)、铁(Fe)、铜(Cu)、钙(Ca)、锰(Mn)和铅(Pb)等6种无机元素含量及身高进行多元逐步回归分析.取儿童后枕部头发约150mg,洗涤剂浸泡,并用自来水及去离子水洗净、烘干.精密称取,用混合酸进行消化处理后,用电感耦合等离子体发射光谱仪(ICP-AES)测定各元素含量..结果儿童头发中6种无机元素含量及身高数据经过多元逐步回归分析发现,影响女性儿童身高较明显的微量元素是Zn和Pb.影响男性儿童身高较明显的元素是Zn、Pb和Mn.结论女性儿童头发中Zn含量与身高呈正相关(P＜0.01),而Pb含量与身高则呈负相关(P＜0.01),男性儿童头发中Zn含量与身高呈正相关(P＜0.01),而Pb和Mn含量与身高则呈负相关(P＜0.01).     

驻高原地区武警某部官兵心身健康水平调查与分析

目的：调查了解驻高原地区武警某部官兵的心身健康水平,并分析其影响因素。方法：随机整群抽取高原地区某部武警官兵492例为观察组,平原地区某部武警官兵526例为对照组,采用中国军人心身健康量表、军人社会支持量表、自尊量表及一般自我效能感量表,对驻高原地区武警官兵的心身健康水平进行测评,并与平原地区武警官兵比较。结果：观察组肌肉骨骼症状、呼吸系统症状、心血管症状、神经系统症状、消化系统症状、生殖泌尿症状、睡眠状态、情绪状态、焦虑状态、行为状态、情感状态、语言状态、躯体化症状、心理症状及心身健康等因子分值,均非常显著高于对照组（P〈0.01）。Pearson相关分析结果显示,社会支持与心理症状、躯体化症状和心身健康呈非常显著正相关（P〈0.01）;自我效能感与心理症状、躯体化症状和心身健康呈非常显著负相关（P〈0.01）;自尊与心理症状呈显著负相关（P〈0.05）。多元逐步回归分析结果显示,社会支持和自我效能感进入以心身健康为因变量的回归方程（P〈0.05）。结论：高原地区武警官兵心身健康水平低于平原地区武警官兵,社会支持和自我效能是驻高原武警官兵心身健康的影响因素。     

哈尔盖地区上呼吸道感染100例心电图分析

目的：探讨哈尔盖地区移居、世居上呼吸道感染患者心电图特征。方法：将100例上呼吸道感染患者,根据世居、移居情况进行分组。世居组：世居当地三代以上的藏族50例,男34例,女16例,平均年龄（43.8±5.4）岁;移居组：由平原移居哈尔盖镇（3-10）年时间的汉族50例,男40例,女10例,平均年龄（51.2±3.6）岁;确诊上呼吸道感染当天记录第1次常规12导联心电图,此后第1周末和第2周末各记录一次心电图。对照组：四川成都地区健康体检汉族50例,男29例,女21例,平均年龄（39.1±4.5）岁;相关资料进行对比分析。结果：高原移居组和世居组各个心电图的异常比率均明显高于平原健康组,其差异具有统计学意义（P〈0.05）,移居组各心电图的异常比率高于世居组,其差异具有统计学意义（P〈0.05）,以ST-T改变、Ⅰ度房室传导阻滞、完全性右束支传导阻滞为著。两组比较,差异均有统计学意义（P〈0.05）。结论：世居、移居组具有高原心电图特征,高原地区上呼吸道感染后可出现某些特征心电图改变,甚至出现心肌炎或急性高原病,表现急性心肌低氧损伤,高原地区上呼吸道感染是急性高原肺水肿加重的诱因,从心电图上可能给予一定预示。     

芪蛭消瘀方对青海地区高脂血症患者血清可溶性黏附分子的影响

目的：研究芪蛭消瘀方对青海地区高脂血症患者血清可溶性细胞黏附分子含量的影响。方法：选择青海地区高脂血症患者,随机分为治疗组和对照组,治疗组58例口服芪蛭消瘀方治疗,对照组30例口服绞股蓝总甙片治疗,进行对照观察。结果：治疗组降低TC、TG和LDL的疗效分别是82.76%、86.21%、和84.48%,而对照组则分别是63.3%、63.3%和33.3%,治疗组升高HDL的总有效率是82.75%,对照组升高HDL的总有效率为43.3%,Rad it分析方法检验,两组血脂疗效有显著差异,（P〈0.05或0.01）,治疗前后自身比较,血清sELAM、sICAM-1、sVCAM-1及血清IL-1β、TNF水平显著下降（P〈0.01）。两组治疗后比较,有显著性差异（P〈0.05,P〈0.01）。结论：中药芪蛭消瘀方有明显调节脂质代谢及降低高脂血症患者血清可溶性细胞黏附分子水平的作用。     

245例青海藏区儿童微量元素测定结果分析

目的：了解青海藏区儿童5种微量元素的水平.方法：取无名指末梢血20μL加入0.6mL溶血剂中,在BH5100型原子吸收光谱仪上进行测定.结果：男女儿童比较5种微量元素均无显著差异（P＞0.05）.245例青海藏区儿童5种微量元素的缺乏情况：缺铁占首位70例（28.6％）;其次是缺锌65例（26.5％）;缺钙35例（14.3％）,缺铜、镁少见.结论：应加强对家长的健康教育,注意儿童合理饮食、纠正偏食的不良习惯,应注意补锌与补钙要合理搭配.同时应定期进行微量元素的测定,以便早期发现、早期预防、早期治疗.     

超声心动图对高原暴露人群返回平原初期心功能的评价

目的：应用超声心动图评价高原暴露人群返回平原初期的心功能,旨在了解人体在高原脱适应期心脏形态和功能的改变情况。方法：选择在4 200m海拔高原地区驻扎50d返回低海拔地区后的168名战士为试验组,55名未上高原的同一单位战士为对照组,超声心动图测量左室舒张期最大径（LVD）、右室舒张期横径（RVD1）、上下径（RVD2）、右房横径（RAD）、肺动脉内径（PAD）、三尖瓣反流速度（TRV）、肺动脉收缩期峰值流速（PAV）、肺动脉瓣反流速度（PRV）、右室射血时间（RVET）、心率（HR,bps）、左心室短轴缩短率（FS）、射血分数（ejection fraction,EF）等参数,进行统计分析。结果：与对照组相比,试验组LVD、RVD1、RVD2增大（P〈0.01）,RVET缩短（P〈0.01）,PRV增快,RAD稍增大（P〈0.05）,HR减慢（P〈0.05）;FS、EF显著降低（P〈0.01）。PAD、PAV及TRV的组间差异无统计学意义。结论：高原暴露人群返回低海拔地区初期,其左右心室增大、肺动脉压力增高,左室收缩功能降低,提示高原脱适应期有心脏功能的改变。     

Effect of time exposure to high altitude on zinc and copper concentrations in human plasma

BACKGROUND: Research has focused mainly on the relationship of zinc and copper contents and physical stresses like running, cycling, etc. It has also been reported that other forms of stresses change the concentration of these trace elements in humans. However,there are no reports on the effects of high altitude induced hypoxic stress on the plasma levels of these metals. Since hypoxia is one of the important stresses, we considered it appropriate to observe the changes in the levels of zinc and copper concentrations and in certain related zinc and copper enzymes and hormones in the plasma of human volunteers on acute induction to high altitude. From these findings, we intended to ascertain whether supplementation of these trace elements would be required for optimal health under such conditions. HYPOTHESIS: On acute induction to hypoxia, contents of these trace elements may change as the requirements of stressed organs and tissue may increase. Hence, further supplementation may be beneficial under hypoxic stress for better adaptability. METHOD: Volunteers were divided into two groups: with and without zinc and copper salt supplementation. Blood samples were collected at sea level and on induction to acute hypoxia on days 3 and 10. Trace mineral contents and their related enzyme (alkaline phosphatase) and hormone (ceruloplasmin) levels were determined in plasma samples. RESULTS: Plasma zinc contents were significantly reduced upon induction to high altitude in the non-supplemented group, but not in the zinc-supplemented group. Alkaline phosphatase activity increased significantly upon induction to the high altitude stress. The enzyme activity remained elevated up to day 10 of the stress. Plasma copper contents and ceruloplasmin activity did not change upon induction to high altitude. CONCLUSION: Under hypoxic stress, circulating levels of zinc and alkaline phosphatase in plasma changed appreciably as plasma zinc was transported into the organs and tissues. However, circulating levels of copper and ceruloplasmin in plasma did not change, indicating no extra supplementation of copper is required under hypoxic stress.     

Assignment of unknown persons to their geographical origin by determination of stable isotopes in hair samples

Analysing the isotope ratio of light elements in human tissue of an unknown person helps to reconstruct the life history with regard to geographical origin and/or typical food supply. In this study the isotope ratios of the bio-elements in hair samples of 111 persons from 13 different countries all over the world were measured with the aim of provenance determination. The results indicated that individuals from Costa Rica and Brazil can be differentiated from typical European individuals by δ¹³C, Australians by δ³⁴S and δ²H in hair samples. The combination and evaluation of the data by multivariate statistical analysis considerably improved origin assignment. Investigation of hair samples from a number of individuals from one particular region (southern Germany) yielded remarkable variation of isotopic values indicating different nutritional habits. The possibilities and limitations of this method in its current state are demonstrated and discussed.     

Multi-element stable isotope analysis of H,C, N and S in hair and nails of contemporary human remains

This paper presents a comparison of the isotopic ratios of hydrogen, carbon, nitrogen and sulphur of three pairings of hair and nail tissue taken from contemporary human remains. Our aim was to examine the possibility of a direct comparison of isotopic data in hair with that of nail tissue for forensic purposes. The results indicate that stable isotope ratios of the elements were best comparable between human scalp hair longer than 3 cm and the distal end of the nails. There were no distinct variations between finger and toenails. Our isotopic data for bulk hair and nail confirmed that hair samples were slightly enriched in ¹³C but depleted in ¹⁵N compared to nail samples. Furthermore, our data reveal that δ³⁴S values in nail samples were more variable than in hair samples. Direct comparison of the corresponding segments of hair and nail samples may be difficult due to individual differences especially for δ¹⁵N and δ²H. Hair may have an isotopic composition more consistent with the ingested food within a specific time than is provided by nail. It can be concluded that once a hair is formed, no further metabolic changes of the isotopic pattern should occur. Nevertheless, our data suggest that there was a change in isotope ratios particularly for δ²H along the hair shaft. Interpretation of the isotope data in corresponding segments of hair and nail for forensic purposes must consider particular variations, especially for chronological considerations.     

血微量元素水平与小儿反复呼吸道感染相关性研究

目的探讨小儿反复呼吸道感染与血微量元素的关系。方法选择64例反复呼吸道感染患儿(RRI组)与64例健康儿童(对照组)作为研究对象,取末梢血60μl,同时检测铁、锌、钙、铜、镁、铅等6种元素。结果 RRI组血中铁、锌、钙、铜、镁水平较对照组存在不同程度缺乏,其中铁、锌、钙、铜与对照组比较差异有统计学意义著(P<0.05),而RRI组血铅水平明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论小儿反复呼吸道感染与血中微量元素有一定相关性,在治疗小儿反复呼吸道感染的同时应重视微量元素的补充及铅过量的防治。     

A case of abuse in which children were forced to take tablets containing scopolamine: segmental analysis of hair for scopolamine by ultra performance liquid chromatography-tandem mass spectrometry

Our laboratory received hair samples of three children after alleged exposure to Feminax tablets, which contain scopolamine as an ingredient; it was regarded as an offense by the police because a woman had repeatedly beaten her children and forced each of them to take four to ten Feminax tablets per day. Neither blood nor urine samples of the children had been obtained at the time of the alleged offense. Thus, hair strands were obtained from the children as specimens in acquiring evidence of the offense. We conducted segmental hair analysis of scopolamine using ultra performance liquid chromatography (UPLC)-tandem mass spectrometry (MS-MS), which is highly sensitive and specific, and enabled the measurements of scopolamine at subpicogram-permilligram levels present in the hair segments. By our UPLC-MS-MS analysis, it was found that the concentrations in the hair segments ranged from 0.3 to 1.1 pg/mg and that exposure to scopolamine had continued for at least several months prior to the hair sampling for all children. Because of our scientific evidence, the mother pleaded guilty to the offense against her children despite her denial at the outset of the investigation.     

Hair analysis does not allow to discriminate between acute and chronic administrations of a drug in young children

There are many differences between the hair from children and that of adult subjects, the hair being thinner, more porous with a different growth rate from the usual 1 cm/month observed in adults. In order to determine whether hair analysis could discriminate between chronic use and acute administration of a drug in children like in adults, we analyzed hair from 18 children aged between 1 day and 15 years in whom the administration of different drugs was known (single therapeutic administration or acute intoxication). A strand of hair was sampled within 1 to 45 days after treatment or intoxication. Analysis was conducted using LC/MS/MS. In the 10 youngest children, aged between 1 day and 29 months, the compounds administered in hospital or responsible for intoxication (lidocaine, ropivacaine, diazepam, midazolam, levetiracetam, morphine, ketamine, methadone, buprenorphine, THC, MDMA) were found in all segments of the hair independently of the time of sampling (1–45 days after ingestion). The concentrations detected were similar along the hair shaft, showing a radial diffusion and incorporation of the analytes in the hair of young children from the sebum. Concentrations could be very high when sampled shortly after administration (72 ng/mg for methadone, 75 ng/mg for MDMA after 3 days) and lower when sampling later (1.2 ng/mg for MDMA after 45 days). In these cases, hair analysis allowed to highlight the compounds responsible for intoxication even when they had disappeared from the blood or urine but should not be used to discriminate long-term exposure to a drug. In the eight remaining children aged from 34 months to 15 years, the drugs used in hospital (lidocaine, diazepam, morphine) or responsible for intoxication (THC, codeine, buprenorphine) were not found in any analyzed segments sampled 1 to 5 days after administration of the drugs, in agreement with the non-incorporation of the drugs from the sebum into the hair. For those children aged over 34 months, hair analysis allows to determine the chronic administration of a drug, like in adults.

     

Detection of drugs in human hair for clinical and forensic applications

Summary While hair has for sometime been analyzed for assessment of trace elements, it is only in recent years that attention has been focused on this matrix as a possible means of evaluating drug impregnation. This technique was applied to treated subjects and drug abusers for determination of drug consummation. The method involved decontamination in ethanol, solubilization in sodium hydroxide at 100°C for 10 min, extraction in chloroform/isopropanol/n-heptane (50:17:33, v/v), separation on a BP-5 capillary column (GC) and detection by mass spectrometry. Hair samples were analysed for barbiturates, antidepressants, benzodiazepines, -blockers, nicotine, opiates, benzoylecgonine, cannabis and amphetamines.     

Terminal restriction fragment length polymorphism profiling of bacterial flora derived from single human hair shafts can discriminate individuals

Human hairs are the trace evidence most commonly encountered at many crime scenes. However, they have not been effectively utilized for actual criminal investigations because of the low accuracy of their morphological inspection, low detection rate of short tandem repeat (STR) typing, and the problem of heteroplasmy in mitochondrial DNA analysis. Here, we examined the possibility of individual discrimination by comparing profiles of bacterial flora on hair. We carried out the profiling of terminal restriction fragment length polymorphisms (T-RFLP) of the amplified bacterial 16S ribosomal RNA (rRNA) gene from hair samples. Compared with existing STR typing methods that use hair roots, this method using hair shafts allowed the detection of stable bacterial DNA. We successfully obtained the T-RFLP profile from single hair shafts of all volunteers tested. The profiles were specific to each individual, and multiple profiles obtained from the individual him/herself showed higher similarity than those from different individuals. These individual-specific profiles were stably obtained from samples from most volunteers, when collected again after 6 months. Storage of the collected hair samples at −30 °C was effective for obtaining reproducible T-RF profiles. When unidentified hair samples collected in the laboratory were compared with a pre-constructed database, 17 of 22 hairs were assigned to a small group of people, including the corresponding individuals. These results show that T-RFLP analysis of bacterial flora on a hair shaft found at a crime scene could provide useful information for narrowing down a suspect.     

急进高原健康人凝血-纤溶指标研究

目的：研究不同海拔高度健康人群凝血纤溶系统的变化及对机体的影响;方法北京组（海拔50m,n=34）、沱沱河组（海拔4700m,n=34）志愿者,应用美国Courter公司生产的ACL9000型全自动凝血分析仪,检测凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FBG）、纤溶酶原（PLG）、纤溶酶抑制物（PL—IN）、D-二聚体（DD）七项凝血-纤溶指标。结果：沱沱河组PT、TT、APTT、DD均高于平原组,FBG、PLG、PL—IN均低于平原组,（P〈0．05）。提示高原缺氧血液高凝,纤溶亢进。结论：健康人群进入高海拔地区凝血-纤溶系统指标较明显的变化,高原地区缺氧,机体血管内皮损伤、红细胞增生等可能是引起这种变化的主要原因。提示在高原地区疾病诊治,尤其是重危病人的抢救中应高度重视凝血-纤溶系统的变化。     

Multielement analysis of human hair and kidney stones by instrumental neutron activation analysis with the k0-standardization method.

This paper focuses on the evaluation of the k₀ method of instrumental neutron activation analysis in biological materials. The method has been applied in multielement analysis of human hair standard reference materials from IAEA, No. 085, No. 086 and from NIES (National Institute for Environmental Sciences) No. 5. Hair samples from people resident in different parts of Malaysia, in addition to a sample from Japan, were analyzed. In addition, human kidney stones from members of the Malaysian population have been analyzed for minor and trace elements. More than 25 elements have been determined. The samples were irradiated in the rotary rack (Lazy Susan) at the TRIGA Mark II reactor of the Malaysian Institute for Nuclear Technology and Research (MINT). The accuracy of the method was ascertained by analysis of other reference materials, including 1573 tomato leaves and 1572 citrus leaves. In this method the deviation of the 1/E¹⁺ epithermal neutron flux distribution from the 1/E law (P/T ratio) for true coincidence effects of the γ-ray cascade and the HPGe detector efficiency were determined and corrected for.