杭州市妊娠妇女尿碘及甲状腺功能分析

目的 研究杭州市妊娠妇女在不同妊娠期尿碘及甲状腺功能状况,为今后实施孕妇的碘营养监测或孕妇甲状腺功能筛查提供依据.方法 随机抽取杭州市五个调查点395人进行尿碘、血清TSH、FT3、FT4检测,采用酸消化砷.铈接触法测定尿碘,化学发光法测定TSH、FT3、FT4水平.结果 (1)妊娠早、中、晚期妇女的尿碘中位数分别为170.3、170.2、162.4μg/L,均显著低于非妊娠妇女(对照组中位数251.9μg/L,均P<0.05);(2)妊娠早期妇女TSH水平显著低于对照组(P<0.05);妊娠中、晚期妇女FT4、FT3水平显著低于对照组(P<0.05);(3)104例妊娠中期妇女中有8.7%的人FT4低于下限值,9.6%的人FT3低于下限值;97例妊娠晚期妇女中有22.7%的人FT4低于下限值,17.5%的人FT3低于下限值.结论 从群体的角度来看,大多数杭州市妊娠妇女碘营养处于适宜水平;不能以非妊娠妇女甲状腺功能指标来判定妊娠妇女的甲状腺激素水平;妇女妊娠期不仅要进行尿碘监测,且应进行甲状腺功能筛查.     

食盐加碘对不同碘环境地区人群甲状腺功能影响的研究

目的了解全民食盐加碘对不同碘环境地区人群甲状腺功能的影响,评价现行碘盐浓度条件下,不同地区人群碘营养水平,为调整碘盐供应策略和盐碘浓度提供依据.方法分别从外环境缺碘、不缺碘和高碘地区各选2个行政村作为调查点,再从每个调查点中随机抽取100名8～12岁在校学生.检测指标包括居民饮水碘含量、碘盐合格率、甲状腺肿大率、尿碘中位数及甲状腺功能检测(包括FT3、FT4、TSH、TGA、TMA).结果 2次检测显示缺碘地区和不缺碘地区学龄儿童甲状腺肿大率均在5%以下,高碘地区学龄儿童甲肿率均在10%以上.缺碘地区儿童甲状腺容积中位数最小,不缺碘地区居中,高碘地区最大.说明北京地区存在高碘性甲状腺肿.缺碘地区儿童尿碘中位数达到国际组织推荐的理想适宜水平,不缺碘地区儿童尿碘中位数也在基本适宜范围内.不缺北碘地区不存在明显碘过量问题,高碘地区则表现为碘过量.3类地区人群尿碘中位数随饮水碘含量的增高而增高.结论在食用同一标准加碘食盐的条件下,人群碘营养水平在很大程度上取决于外环境饮水碘含量.现行碘盐浓度完全可以满足缺碘地区人群的碘营养需求.不缺碘地区和高碘地区居民食用碘盐后,表现出自身免疫性甲状腺疾病增多倾向.缺碘地区居民食用碘盐后可出现一过性碘甲亢.不缺碘地区应适当下调盐碘浓度,高碘地区不应再供应加碘食盐.     

全民食盐加碘前后合肥市7~14岁儿童甲状腺吸^131碘率的变率

目的：了解全民食盐加碘防治方案在非碘缺乏病（IDD）地区的实施效果及其对儿童甲状腺功能的影响，方法：以合肥市7－14岁儿童为观察对，分别在全民食盐加碘前和加碘后，测定其太腺吸^[3]碘率的改变，并结合其他相关指标作分析，结果：加碘盐能明显抑制非病区儿童的甲状腺吸^[3]碘率，提高尿碘水平，但加碘后甲状腺肿大率的明显升高，过氯酸钾排泌的增加，血清甲状腺自身抗体和FT3水平和升高等，提示甲状腺吸^[3]碘率受抑制的机制可能较为复杂，结论：实施全民食盐加碘方案纠正儿童营养不足的效果肯定，但对非IDD病区儿童甲状腺有高碘损害的优虑，值得进一步探讨。     

妊娠中、晚期孕妇甲状腺功能的变化及与碘摄入量的关系

目的 了解缺碘及非缺碘地区妊娠中、晚期孕妇甲状腺功能的变化。方法 应用免疫放射分析技术，检测了90例孕妇（缺碘地区孕妇30例，非碘缺乏区健康孕妇60例）妊娠中、晚期和临床产后及30例非碘缺乏区健康非孕妇女血清TSH水平、游离T3（FT3）、游离T4（FT4）及总T4（TT4）水平。恒温消解法检测了两组孕妇临产时尿碘水平。结果 （1）妊娠中、晚期孕妇TSH水平升高，游离甲状腺激素水平下降，尤以妊娠晚期为著。（2）与正常孕妇比较，缺碘地区孕妇妊娠中期和临产后TSH水平升高，差异均有显著性（P＜0．01）；缺碘地区孕妇妊娠中，晚期和临产后FT3、FT4水平显著降低（P＜0．01）；缺碘地区孕妇临产时尿碘水平显著低于正常孕妇（P＜0．01）。结论 妊娠期孕妇表现为相对的甲状腺功能低下，以妊娠晚期为著，尤在缺碘地区。     

从孕妇妊娠初期尿碘水平看我国食盐加碘政策

目的探讨我国食盐加碘政策对孕妇妊娠初期尿碘水平的作用。方法用酸消化砷铈接触法检测孕妇妊娠1～4个月的尿碘水平,分析了1995～2001年间全部数据。结果孕妇尿碘随着全民食盐加碘政策的全面实施,1996～2000年间孕妇尿碘中位数明显高于其他各年度(P<0.01),同时>500μg/L的频数分布增加,随着2000年加碘浓度的下调,2001年尿碘水平明显下降,表现为尿碘中位数低于200μg/L,>500μg/L的频数分布减少,同时<100μg/L的频数分布增加。结论对碘缺乏危害的重点人群,在坚持现有的全民食盐加碘政策的同时,应大力开展孕妇尿碘监测,同时进行有针对性的补碘和健康行为指导。     

抚顺市城区孕妇尿碘水平分析

1994年前我国的碘缺乏病防治工作,只对农村和小城市碘缺乏病区居民供应碘盐,而大城市城区居民食用未加碘食盐。为了实现消除碘缺乏病目标,我国政府决定自1995年起逐步施行全民食盐加碘,此后我市对城区居民供应了碘盐。由于碘的排泄水平与摄入水平有很好的相关性,尿碘排泄量又占总排泄量的90%以上,基本代表了机体碘的摄入量犤1犦。为此,1996～2001年对我市城区孕妇尿碘进行了测定,以了解全民食盐加碘后人群碘营养状况,为今后补碘防治碘缺乏病工作提供依据。1材料与方法1.1一般情况抚顺市地处山区,城区人口133万,属大城市。以往认为城区是非碘…     

甘肃省临泽县重点人群碘营养及甲状腺功能现况调查

目的了解甘肃省临泽县居民重点人群碘摄入量的现况和甲状腺功能状态,为食盐碘化量的标准提供科学依据。方法采用分层抽样方法按东、南、西、北、中随机选择1个乡,每个乡选择8~10岁儿童20名(男女各半)、18~49岁成年男性、未孕育龄妇女、孕妇和哺乳期妇女各10名,测定血清TSH、FT4、FT3、甲状腺过氧化物酶抗体(Tm Ab)、甲状腺球蛋白抗体(TGAb)及尿碘;同时测定所选乡镇所有水源水的水碘含量,调查3个乡60名8~10岁儿童家庭食盐摄入量。结果水碘中位数为6.18μg/L,盐碘中位数为28.8 mg/kg,合格碘盐食用率为99.0%,人均日摄盐量为(4.7±0.9)mg/kg;8~10岁儿童、18~49岁男性、未孕育龄妇女、孕妇和哺乳期妇女5种人群尿碘中位数分别为180.6μg/L、161.0μg/L、199.3μg/L、135.1μg/L和104.9μg/L,不同人群的TSH(χ~2=42.580)、FT4(F=23.375)、FT3(F=51.859)、TG Ab(χ~2=15.594)和TM Ab(χ~2=14.675)差异均有统计学意义(均P0.05);8~10岁儿童的TSH、FT4和FT3均高于其他人群,差异有统计学意义(χ~2=12.680,P0.05),育龄妇女的TGAb和TMAb阳性率最高为20.4%,差异有统计学意义(χ~2=31.560,P0.05);各人群甲状腺功能异常主要为亚临床甲状腺功能减退症和亚临床甲状腺功能亢进症,8~10岁儿童亚临床甲状腺功能减退症最高为7.8%,差异有统计学意义(χ~2=2.758,P0.05),未孕育龄妇女亚临床甲状腺功能亢进症最高为7.4%,差异有统计学意义(χ~2=6.445,P0.05)。结论临泽县是碘缺乏地区,在目前碘摄入量下,尿碘显示孕妇和哺乳期妇女碘营养不足,8~10岁儿童和未孕育龄妇女甲状腺疾病潜在的危险性相对较高。     

江苏省全民食盐加碘后学龄儿童尿碘水平的动态变化

目的了解全民食盐加碘政策的实施及现行食盐加碘浓度调整对学龄儿童尿碘水平的影响。方法对1997～2002年问尿碘监测结果的动态变化进行分析。结果1997～2002年间学龄儿童尿碘中位数均在100μg/L以上；碘盐浓度调整后尿碘水平下降，但人群的碘营养仍是充足的。结论现阶段食盐加碘浓度是适宜的，但需进一步提高碘盐的质量。     

缺碘地区食盐加碘后孕产妇碘营养及甲状腺功能的观察

目的　了解缺碘地区食用合格碘盐后孕产妇碘营养状况及甲状腺功能 ,为妊娠和哺乳期是否需要额外补碘提供依据。方法　检测孕产妇在不同时期尿碘、耳垂血TSH值。结果　检测孕产妇尿碘 492人次、尿碘中位数 179.7μg/L ,其中农村为 165.7μg/L、城市为 2 0 4.2 μg/L ,均已达到正常需要量。检测孕产妇耳垂血TSH值489人次 ,中位数为 1.946mU/L ,其中 >5mU/L的占 6.7%。结论　在全民食盐加碘后 ,孕产妇碘摄入量可以满足机体需要量 ,机体碘营养状况良好 ,对这一特需人群无需额外补充碘制剂     

孕妇妊娠不同时期碘营养及甲状腺功能的动态变化研究

目的研究孕妇妊娠不同时期碘营养及甲状腺功能的动态变化情况。方法选取我院2015年3月~2016年5月接收的196例常规产前检查的妊娠期妇女,根据妊娠周期分为孕早期组(n=52,1~12周)、孕中期组(n=70,13~27周)和孕晚期组(n=74,28~40周),另选取同期63例于我院进行健康体检的女性志愿者作为对照组,对比各组间碘营养水平及FT4、TSH、FT3水平。结果孕早期组和孕中期组尿碘中位数水平均达到世界卫生组织提出的碘足量水平,孕晚期组尿碘中位数水平低于世界卫生组织提出的碘足量水平,处于碘缺乏状态。经统计学检验可知,孕早期组尿碘水平高于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕中期组和孕晚期组尿碘水平分布情况比较差异无统计学意义(P0.05)。孕早期组碘缺乏发生率低于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕早期组碘足量发生率高于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕早期组FT4、FT3水平与对照组相比,差异无统计学意义(P0.05);孕中期组和孕晚期组FT4、FT3水平低于对照组,差异具有统计学意义(P0.05)。孕早期组TSH水平低于对照组,差异具有统计学意义(P0.05)。孕中期组和孕晚期组TSH水平与对照组相比,差异无统计学意义(P0.05)。随着妊娠期的延长FT4、FT3水平呈逐渐降低趋势,各组间差异具有统计学意义(P0.05),TSH水平呈逐渐上升趋势,孕中期组和孕晚期组TSH水平高于孕早期组,差异具有统计学意义(P0.05);血清FT4、TSH、FT3水平先升高后降低,再升高后趋于稳定变化。孕早期组碘营养状态与甲状腺功能指标TSH呈U形关系曲线。结论孕妇妊娠不同时期碘营养及甲状腺功能呈特异性动态变化,妊娠中晚期较易出现碘营养缺乏和甲状腺功能减退情况,妊娠期应加强对碘营养和甲状腺功能的筛查,并根据筛查结果指导妊娠期妇女合理正确补碘,避免妊娠期甲状腺相关疾病的发生。     

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.     

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.     

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.     

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.