上海市某社区脑卒中高危人群的危险因素现状分析

目的:了解和掌握本社区农村35岁以上常住居民脑卒中高危人群危险因素的分布状况,为本社区建立脑卒中高危人群干预体系提供依据.方法:采用分层随机抽样的方法,抽取本社区15个村的35岁以上常住居民共1694例,其中男性679人(40.1%),女性1015人(59.9%).脑卒中风险初筛评估危险因素包括高血压、血脂异常、糖尿病、房颤、吸烟、超重肥胖、缺少锻炼和脑卒中家族史等.结果:共有500人符合脑卒中高危对象标准,高危对象检出率为29.5%.男性的检出率高于女性(35.9%比25.2%,P<0.05).70岁及以上人群中的高危对象检出率最高,36~49岁人群的检出率最低(P<0.05).在高危对象中,脑卒中危险因素流行率的顺位为高血压86.8%,超重或肥胖46.2%,糖尿病38.6%,吸烟31.2%,缺少体育锻炼27.8%,血脂异常14.4%,房颤13.6%.女性高危对象中房颤和糖尿病的流行率高于男性(P<0.05).吸烟是男性高危对象的主要危险因素(61.9%).不同年龄组间缺少体育锻炼和超重或肥胖的流行率有明显差异(P<0.05).结论:本社区有较高比例的脑卒中高危人群;应针对不同性别和年龄的人群开展有针对性地健康教育及干预措施,积极防治高血压、糖尿病等慢性病,鼓励合理饮食,多参加体育活动,以减少社区人群发生脑卒中的风险.     

社区65岁以上老年人颈动脉斑块分析

目的:了解社区65岁以上老年人颈动脉斑块情况,以便及早干预,预防脑卒中.方法:分析2015年1月至2016年7月在门诊进行超声多普勒检查的2012例65岁及以上患者的颈动脉斑块患病现状,其中男性636例,女性1376例,平均年龄(74.58±7.28)岁.结果:共有1541例检出颈动脉斑块,总检出率为76.5%.男性颈动脉斑块的检出率高于女性(81.9%比74.1%,P<0.05).65~69岁、70~79岁和80岁及以上年龄组的颈动脉斑块检出率分别为61.9%、77.4%和92.2%,差异有统计学意义(P<0.05).结论:65岁老年人中有较高的颈动脉斑块检出率,年龄越大,检出率越高.     

2012-2016年虹桥社区65岁及以上老年人高血压和高血糖患病情况分析

目的:对虹桥社区65岁及以上老年人群的高血压和高血糖患病现况进行分析,为开展慢性病防治工作提供依据.方法:选择2012至2016年虹桥社区首次参与体检的5060名65岁及以上老年人为研究对象,其中男性2175名,平均年龄(76.05±7.09)岁,女性2885名,平均年龄(76.09±7.19)岁.分析老年人的高血压和高血糖患病现况.结果:高血压和高血糖的检出率分别为64.70％ 和24.85％;高血压和高血糖检出率均随年龄增高而上升(P均<0.01);高血压检出率男性为62.90％,女性为66.07％,差异有统计学意义(P<0.05).高血糖检出率男性为26.53％,女性为22.70％,差异有统计学意义(P<0.05).结论:本社区65岁及以上老年人群高血压和高血糖的检出率较高,需要进一步加强社区预防筛查工作,积极采取针对性的防治措施,以保证老年人群高质量的生活.     

奉贤区南桥社区学龄前儿童肥胖情况分析

目的：了解南桥社区学龄前儿童肥胖情况,以便制定有效的防治干预措施。方法：2014年5月对辖区内10所幼儿园共2379名儿童进行健康体检,并收集体检资料,进行回顾性分析。结果：学龄前儿童超重和肥胖的检出率分别占13.11%和6.89%。超重的发生率3～4岁组为15.56%,肥胖的患病率5～6岁组为8.62%,男童肥胖的患病率检出率为7.83%,女童检出率为5.88%,两者差异无统计学意义（P＞0.05）。结论：社区儿童超重、肥胖的患病率甚高,与不良生活方式、不合理饮食及缺少锻炼有关,需要社会、家庭、学校、医院齐抓共管。     

回眸探索中前行的药房托管

目的 了解托幼机构3～6岁儿童肥胖情况及影响因素.方法 随机抽查徐州市区2所幼儿园3～6岁的儿童527名,其中男童270名,女童257名,进行体格测量,采用WHO身高标准体重值为肥胖判断标准.同时对儿童家长进行问卷调查.结果 在调查的527名儿童中,肥胖儿童48人,肥胖率为9.11%,其中男童肥胖检出率13.33%,明显高于女童的肥胖检出率4.67%,P《0.01.5岁以上儿童肥胖检出率最高.结论 不良饮食习惯与遗传是影响儿童肥胖的主要因素.预防儿童肥胖应从健康教育人手,树立家长的正确健康观念,培养儿童健康的饮食运动习惯.     

口腔内幽门螺杆菌与儿童龋齿及口腔卫生状况的关系

目的 探讨口腔内幽门螺杆菌(Hp)对儿童龋齿和口腔卫生的影响.方法 对某幼儿园203名儿童龋齿和口腔卫生状况进行调查,并采用1 min尿素酶试剂盒检测所有研究对象口腔Hp感染情况.结果 儿童Hp总检出率为60.10％,男性检出率为33.00％,女性检出率为27.09％；各年龄段口腔内Hp阳性和阴性男女构成比以及Hp总检出率差异无统计学意义(P＞0.05).龋齿总患病率为50.25％；口腔Hp阳性者和阴性者龋齿患病率分别为56.56％和40.74％,两者龋齿患病率差异有统计学意义(P＜0.05).口腔Hp阳性者和阴性者牙菌斑指数的中位数分别为3.84和3.43,两者口腔卫生状况间差异有统计学意义(P＜0.01).结论 口腔内Hp与儿童龋齿患病率和口腔卫生状况有关,口腔内感染Hp是儿童儿童龋齿患病率升高和口腔卫生状况差的可能因素.     

青岛市城阳区儿童超重、肥胖患病率调查

目的了解青岛市城阳区儿童超重和肥胖患病现状。方法以随机整群抽样的方法,抽取青岛市城阳区5450名儿童测查身高、体重,以中国学龄儿童超重、肥胖筛查体重指数（BMI）分类标准计算超重和肥胖的患病率。结果青岛市城阳区3～18岁儿童超重、肥胖总检出率分别为12.8%、9.0%,其中男童分别为13.9%、9.9%,女童分别11.6%、8.4%。4～7岁肥胖检出率女童大于男童,差异无统计学意义（P〈0.05）。7～13岁男童和女童肥胖检出率差异无统计学意义（P〉0.05）。13～18岁肥胖检出率男童大于女童,差异无统计学意义（P〈0.05）。结论青岛市城阳区儿童超重和肥胖日益增多,必须加强对儿童肥胖的防治。     

遗传因素对青少年血压的影响

目的 分析遗传因素对青少年血压的影响.方法 采用整群抽样方法,对上海市青浦区2所初级中学和2所高级中学的11～ 17岁4175名在校学生采用问卷调查的形式收集父母高血压史,同时测量血压、身高、体质量.调查时发现血压超过正常水平的调查对象,在1个月内复测血压.结果 参加调查的学生共4175名,其中女性2183名(52.3％),男性1992名(47.7％);血压正常者占72.5％(3025名),女性76.3％(1666名),男性68.3％(1361名),男女比较差异有统计学意义(P＜0.05);正常高值血压占18.0％(750名)[女性14.2％(310名),男性22.1％(440名)];1级高血压为8.3％(344名)[女性8.2％(179名),男性8.3％(165名)],2级高血压为1.3％(54名)[女性1.3％(28名),男性1.3％(26名)].女性超重和肥胖的检出率分别为6.7％(147名)和3.0％(66名);男性为13.7％(271名)和6.3％(125名),男女超重比例差异有统计学意义(P＜0.05).父亲和/或母亲有高血压史者占13.0％(541名),男性为12.6％(251名),女性为13.3％(290名).高血压遗传背景的检出率在各级血压分组间差异无统计学意义(P＞0.05).结论 遗传因素对青少年高血压无明显影响,超重和肥胖可能与血压水平增高有关.     

学龄前儿童肥胖的综合干预研究

目的：了解辖区学龄前儿童单纯性肥胖发生情况,评估综合干预对减少肥胖发生的有效方法。方法：选择8所二类幼儿园2012年和2013年入园的1618名儿童进行体重和身高测量,对所有肥胖儿童采取合理饮食、适当运动和健康教育综合干预1年,对干预前后肥胖的检出率和肥胖程度的变化进行比较。结果：入园儿童单纯性肥胖的检出率为6.86%,、干预1年后,相应的单纯性肥胖检出率为4.76%,儿童肥胖检出率差异有统计学意义（P＜0.05）。肥胖儿童的肥胖程度有所减轻。结论：合理饮食、适当运动和健康教育综合干预措施是预防和控制学龄前儿童肥胖的有效方法。     

教职工肥胖病与相关影响因素的分析

目的了解教职工肥胖及肥胖程度对慢性病的影响情况,为学校的预防保健工作提供依据。方法对1691份完整体检资料进行统计,男性399份,女性1292份,其中分不同肥胖程度对慢性病的患病率进行比较分析。结果肥胖总检出率17.27%,男性22.31%,女性15.71%,男性与女性在肥胖检出率差异有统计学意义(χ2=9.28,P<0.01),超重总检出率为34.68%、男性38.6%、女性23.14%,男性与女性差异有统计学意义(χ2=37.12,P<0.01)。高血压、高血脂、高血糖、脂肪肝等慢性病的患病情况均随肥胖程度的不断加重而呈上升趋势。结论教职工是肥胖症的高发人群,随肥胖程度的加重,慢性病的患病率也随之升高。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.