辽宁省饮水型地方性氟中毒病区病情调查

目的掌握辽宁省饮水型地方性氟中毒的流行现况,评价改水措施的防病效果。方法按病区分层抽取的85个病区村进行8-12岁儿童氟斑牙、16岁以上成人临床氟骨症的普查,采集饮用水和儿童尿样进行氟含量的检测。结果抽样病区8-12岁儿童氟斑牙检出率为16.74%,尿氟几何均值0.97 mg/L。8-12岁儿童氟斑牙检出率重病区高于中病区,中病区高于轻病区,未改水病区儿童尿氟水平明显高于改水病区。16岁以上人群临床氟骨症检出率为4.98%,随着年龄的增长氟骨症检出率逐渐升高。结论地方性氟中毒病情随着病区水氟含量的增高而逐渐加重。     

乐昌市饮水型地方性氟中毒新发病区监测与控制效果评价

目的了解乐昌市饮水型地方性氟中毒新发病区病情现状,评价控制措施的实施效果。方法按照国家监测方案《饮水型地方性氟中毒监测》对病区村进行监测,调查改水工程运行状况并检测水氟含量;采用Dean氏检查病区村8~12岁儿童氟斑牙患病情况,并检测儿童尿氟含量。结果病区村改水工程运转良好,2011~2015年水氟含量均值分别为0.26、0.20、0.3、0.3、0.38 mg/L。2004、2011~2015年岩前村8~12岁儿童氟斑牙检出率分别为44.4%、17.8%、11.1%、6.67%、11.4%、5.9%。2011年和2015年8~12岁儿童尿氟几何均值为0.99 mg/L和1.07mg/L。结论该病区村改水工程运转良好,水氟含量、儿童氟斑牙患病情况达到国家控制标准。     

辽宁省地方性氟中毒的流行和防治现状

目的 了解辽宁省地方性氟中毒(简称地氟病)流行现状和防治措施落实情况.方法 对改水和未改水饮水型地氟病病区分层抽样开展饮用水含氟量筛查和8-12岁儿童氟斑牙,16岁以上成人临床氟骨症病情普查,检测8-12岁儿童志愿者尿氟.结果 全省普查842个未改水村(屯)和1829个改水村(屯),未改水村(屯)居民饮用水水氟0.01-7.10 mg/L,平均(0.96±0.64)mg/L,29.2%(246/842)的未改水村(屯)饮用水含氟量＞1.2 mg/L,在1829个改水村(屯)中调查了1234个降氟改水工程,水氟0.06-7.67 mg/L,工程正常运行且水氟≤1.2 mg/L的工程占调查工程的68.31%(843/1234),已改水村(屯)有31.69%(391/1234)的工程没有发挥其降氟改水作用.普查12127名8-12岁儿童和85 636名16岁以上成人,儿童氟斑牙检出率为24.4%(2960/12 127),成人临床Ⅱ度及以上氟骨症检出率为2.22%(1900/85 636).轻,中,重病区儿童氟斑牙检出情况比较,差异有统计学意义(X2＝19.25,P＜0.01),重病区儿童氟斑牙检出率较高,个别未改水的重病区村(屯)儿童氟斑牙检出率达到100%,成人临床Ⅱ度及以上氟骨症检出率为18.03%(97/538).重病区和轻病区(未改水及工程报废)儿童尿氟中位数分别为2.01,2.00 mg/L.结论 辽宁省未改水的饮水型地氟病中,重病区的病情仍然十分严重,工程停运或报废病区仍亟须落实降氟改水防治措施.     

武山县饮水型地方性氟中毒防治监测结果与分析

目的了解甘肃省武山县饮水型地方性氟中毒病情变化和防治措施落实效果,为及时调整防治策略提供科学依据。方法采用随机抽样法,对抽取的病区村进行地方性氟中毒有关指标调查,8-12岁儿童氟斑牙采用Deans分度诊断;水氟测定采用生活饮用水标准检验方法（GB/T5750.6）,尿氟测定采用离子选择电极法（WS/T89-1996）;临床和X线氟骨症诊断采用地方性氟骨症诊断标准（WS 192-1999）。结果改水后84.62%水样水氟含量符合国家饮用水标准（≤1.0 mg/L）;8-12岁儿童尿氟均值0.90 mg/L,8-12岁儿童氟斑牙检出率平均为29.17%,氟斑牙指数0.19;临床氟骨症检出率23.65%,成人尿氟均值2.67 mg/L。结论武山县以改水为主的综合性防治措施取得了良好的防治成效,改换水源是预防饮水型地氟病最有效的方法。     

2008年福建省饮水型地方性氟中毒病区监测结果分析

目的了解福建省地方性氟中毒轻、中病区现状。方法按照分层整群抽样的原则,抽取轻病区村6个,中病区村4个作为调查点,每个调查点测定饮用水氟、8～12岁儿童氟斑牙和尿氟、对16岁及以上成人进行临床氟骨症检查和X线检查。结果10个病区村饮水氟均值均低于1.0 mg/L,9个村儿童氟斑牙低于30%,10个病区村儿童尿氟几何均数均未超过1.4 mg/L。临床氟骨症检出率4.42%,X线氟骨症检出率19.82%。结论饮水型氟中毒实施改水措施效果显著,临床与X线氟骨症诊断标准的衔接还有待于进一步探讨。     

2002、2003年度内蒙古地方性氟中毒重点监测报告

目的掌握内蒙古地方性氟中毒(地氟病)病区改水后病情的消长情况,为今后地氟病的防治工作提供科学的依据。方法调查监测点8～12岁儿童氟斑牙患病情况,对监测点井水、居民户饮用水及8～12岁儿童尿样中的氟进行检测。结果2002、2003年度土左旗监测的100个改水井水氟含量合格率分别为97%和98%;监测村2002、2003年度8～12岁儿童氟斑牙检出率分别为54.04%和64.00%,氟斑牙指数分别为1.00和1.02;2002、2003年度8～12岁儿童尿氟几何均数均在正常水平,分别为1.00和1.20mg/L;监测村2年度居民家中饮水氟均为0.36mg/L。结论对于饮水型地方性氟中毒病区,改换水源是最好的预防手段。     

2010年安徽亳州市饮水型地方性氟中毒监测分析

目的 掌握毫州市饮水型地方性氟中毒病情及降氟改水工程等防治措施落实情况,为进一步开展防治地氟病工作提供科学依据。方法  2010年在市辖3个县(区)谯城区、涡阳县、蒙城县的地氟病监测点,对所有改水工程运行情况、水氟含量进行了调查。对每县区的3个固定监测村的人口学资料、水氟含量、8~12岁儿童氟斑牙、25岁以上成人氟骨症等情况开展了调查工作。结果 共调查了134个集中式改水设施,无经费运行或损坏的有14个,水氟>1.0mg/L的有93个。共采集9个病区村的48份水样,全市水氟浓度检测结果的算术平均值范围为1.37mg/L,最大值为4.91mg/L。726名8~12岁儿童氟斑牙检出率为21.26%(158/726),缺损率为1.24%(9/726),氟斑牙指数为0.74;25岁以上成人X线氟骨症检出率为15.4%(69/448)。结论 亳州市饮水型地氟病病情尚未完全控制,防控形势仍很严峻,需进一步加强降氟改水监管力度,使群众能够饮用低氟水。     

河北省南水北调中线工程供水区地方性氟中毒调查

目的 了解南水北调中线工程河北省供水区内地方性氟中毒（地氟病）现况。方法 普查河北省供水区内7个地级市27686个行政的水氟含量和改水现状。对饮水含氟量超过1．0mg/L病区村按轻、中、重分层,随机的51个村进行重点调查。结果 普查的27686个行政村中饮水氟含量超标率38．27％,4534眼改水井中仍有367％的井水氟超标,大部分传统改水降氟措施效果不佳。重点调查的51个村中,8－12岁在校生8183人氟斑牙患病率25．04％,16－65岁660人右前臂X线正位片氟骨症检出率3．94％,氟斑牙与氟骨症患病率随水氟浓度升高而升高,随饮水用氟水的增长而增高。结论 南水北调河北省供水区水氟含量超标严重;病区人民长期饮用高氟水是该地区饮水型氟中毒的主要原因。实施南水北调中线工程是控制该地区地氟病流行的根本措施。     

2006年甘肃省地方性氟中毒防治现状调查

目的 了解甘肃省地方性氟中毒(简称地氟病)病区分布和改水降氟工程运行现状.方法 2006年在甘肃省地氟病病区,对未改水村进行水源水氟检测:对已改水村进行降氟改水工程运行情况调查和水氟测定;在已查出的高氟村,对儿童进行氟斑牙和成人氟骨症患病情况调查.水氟测定采用氟离子选择电极法,儿童氟斑牙调查采用Dean法,氟骨症诊断执行<地方性氟骨症临床分度诊断>(GB 16396-1996)标准.结果 共调查了26个县、1997个村的不同类型饮用水源,水源水含氟量>1.0 mg/L的村占29.94%(598/1997).共调查各类改水工程1215处.能正常供水的工程占工程总数的94.90%(1153/1215),间歇供水工程和已报废工程分别占工程总数的2.96%(36/1215)和2.14%(26/1215).出厂水水氟均值≤1.0 mg/L的工程占检测工程数的90.79%(1084/1194),末梢水水氟均值≤1.0 mg/L的工程占检测工程数的91.75%(1068/1164).共检查8～12岁儿童86 390人,儿童氟斑牙检出率为22.47%(19 414/86 390).共检查16岁以上成人142 211人,临床Ⅱ度及以上氟骨症检出率为4.20%(5967/142 211).结论 甘肃省少部分病区高氟水源依然存在,降氟改水工程报废和超标现象普遍;部分病区儿童氟斑牙和成人氟骨症尚在流行,防治任务依然艰巨,应加大改水力度,提高防病改水效益.     

西安市饮水型地方性氟中毒病情调查结果分析

目的了解西安市饮水型地方性氟中毒(地氟病)病情现状,用于指导全市地氟病防治。方法Dean法进行儿童氟斑牙诊断,X线拍片检查氟骨症,离子选择电极法测定水氟、儿童尿氟。结果儿童氟斑牙患病率为31.53%,尿氟均值为1.41mg/L,成人氟骨症X线检出率为44.74%。结论西安市属于地方性氟中毒轻病区,但有些地方病情仍很严重,建议继续加强病区改水,只有长期提供合格的低氟水,病情才能得到有效控制。     

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.