吉林省2002～2003年地方性氟中毒全国重点监测结果分析

目的　调查监测县及监测点防治措施落实情况及防治效果。方法　按照“全国地方性氟中毒监测方案” ,调查监测县 2 0 0 2～ 2 0 0 3年防氟改水进度 ,10 0个防氟设施管理使用情况及水氟含量。用电极法检测居民饮水氟和 8～ 12岁儿童尿氟。采用Dean氏法调查 8～ 12岁儿童氟斑牙检出率。结果　监测县改水率为 82 .9% ,受益率 76.6%。 10 0个防氟设施中 ,85 %完好并可正常使用 ,但有 11眼防氟井水氟含量超过 1.0mg/L。 2个监测点饮水氟含量分别为 0 .49mg/L和 0 .5 8mg/L ;2 0 0 2～ 2 0 0 3年 8～ 12岁儿童尿氟含量分别为 (0 .76± 0 .2 2 )mg/L和 (1.19± 1.3 9)mg/L ;2个监测点 8～ 12岁儿童氟斑牙患病率分别为 3 4.0 %和 45 .2 % ,平均为 40 .3 %。结论　监测县多数病区已改水 ,多数防氟设施管理使用良好 ;儿童尿氟在正常范围 ;地方性氟中毒防治取得显著成绩。但仍存在一些问题 ,如防氟井管理、使用、维护不善等。今后应采取对策改善现况 ,从而促进地方性氟中毒防治工作。     

理县饮茶型氟中毒流行病学调查

目的 了解理县饮茶型氟中毒病情范围与流行状况.方法 采集饮用水样、(砖)茶水样和尿样用氟离子选择电极法检测氟含量,氟斑牙诊断采用Dean氏诊断标准,氟骨症诊断按照地方性氟骨症临床诊断标准.结果 饮用水样氟含量均符合国家饮用水卫生标准(1.0 mg/L);400份(砖)茶水氟含量均值为1.59 mg/L.400名8～12岁儿童氟斑牙检出率29.25％,尿氟算术均数为0.43 mg/L;400名16岁以上成人氟斑牙检出率46.25％,临床氟骨症检出率32.25％;400份成人尿氟算术均数为0.73 mg/L.结论 理县为饮茶型氟中毒轻病区,加强病情监测和健康教育是防治饮茶型氟中毒的关键.     

2002年新疆农三师地方性氟中毒调查报告

目的掌握新疆生产建设兵团农三师地方性氟中毒的病情现况,为今后地方性氟中毒的防治提供科学依据。方法在14个较大的农牧团场中心小学,采用分层整群抽样方法,调查8～12岁学生氟斑牙患病情况;检测饮水氟含量,8～12岁学生尿氟含量;调查改水情况。结果8～12岁学生氟斑牙总患病率为20.62%,维族患病率明显低于汉族,地方性氟中毒的流行主要集中在1个较小的区域(42团场)并达到轻病区水平;饮水氟浓度为1.11±1.06mg/L;8～12岁学生尿氟含量为1.45±1.02mg/L;改水率达到75%。结论生产建设兵团农三师地方性氟中毒病情在大部分地区基本得到控制,在一个较小局部区域存在轻病区水平的流行,应作为重点加大投入进行改水工作。     

地方性氟中毒病区与非病区群体尿氟含量分析

目的分析全国地方性氟中毒病区与非病区人群尿氟含量水平,以便确定地方性氟中毒病区与非病区尿氟含量临界值.方法现场调查与资料分析相结合.结果全国非地方性氟中毒病区以几何均数表示的群体尿氟含量中位数儿童 0.7mg/L、成人0.83mg/L;95%位数儿童为1.43 mg/L、成人为1.59 mg/L99%位数儿童为1.79 mg/L、成人为1.89 mg/L.饮水型和燃煤污染型病区儿童群体尿氟几何均数＞1.43 mg/L,饮水型、燃煤污染型和饮茶型病区成人群体尿氟几何均值均＞1.68 mg/L.结论全国地氟病病区与非病区群体尿氟含量儿童以1.4 mg/L、成人以1.6 mg/L为临界值,饮茶型病区成人尿氟含量更有代表性.     

内蒙古陈巴尔虎旗饮茶型氟铝联合中毒调查

目的查明内蒙古陈巴尔虎旗饮茶型氟、铝联合中毒原因。方法在陈巴尔虎旗3个牧区嘎查随机抽取93名20~50岁牧民进行发、血清、尿含氟、铝水平测定,并拍摄前臂、小腿、骨盆正位及腰椎正侧位X线片,同时检测饮水、牛奶、砖茶等氟和铝水平,以扎兰屯市地方病防治研究所的34名23~50岁职工为对照组。结果陈巴尔虎旗牧民发、血清、尿及饮用的奶茶含铝量分别是(22.34±8.06)mg/kg、(1.13±0.48)mg/L、(3.78±1.62)mg/L、(6.02±1.77)mg/L,含氟量分别是(1.21±0.63)mg/kg、(0.092±0.042)mg/L、(2.08±1.16)mg/L、(3.00±1.11)mg/L,饮水、牛奶含铝量分别是(39±16)μg/L、(0.553±0.179)mg/L,含氟量分别是(0.50±0.39)、(0.063±0.032)mg/L;对照组发、血清、尿铝分别是(5.80±2.14)mg/kg,(0.203±0.101)mg/L、(2.19±1.34)mg/L,含氟量分别是(1.17±0.68)mg/kg、(0.033±0.008)mg/L、(0.57±0.32)mg/L,牧民发、血清、尿铝及血清、尿氟均高于对照组(P<0.001)。牧民X线改变硬化型22.2%(20/88),疏松型37.5%(33/88),退行性变86.4%(79/88),对照组退行性变13.3%(4/30),其余改变未检出。结论陈巴尔虎旗牧区饮茶型氟中毒实际为饮茶型氟、铝联合中毒。     

甘南州饮茶型地方性氟中毒流行现状分析

目的 了解甘肃省甘南藏族自治州(简称甘南州)饮茶型地方性氟中毒(简称地氟病)流行情况,为预防控制饮茶型地氟病提供科学依据.方法 采用整群随机抽样等方法调查甘南州8个县(市)有饮用边销茶习惯的病区村分布情况以及儿童和成人的氟斑牙、氟骨症患病情况,并采集水样、茶样和尿样检测氟含量.结果 甘南州5个县(市)22个乡(镇)60个村成人日均茶氟摄人量大于3.5 mg,年人均砖茶消耗量为0.42 kg;检测生活饮用水1 072份,水氟含量0.05 ～ 0.83 mg/L;检测茶样1 164份,茶氟均值308.76 mg/L,超标茶样607份、超标率52.15％;检查8～12岁儿童1 374人,未发现氟斑牙患病儿童;检测8～12岁儿童尿样1 248份,尿氟值0.08～1.38 mg/L,尿氟均值0.46 mg/L;调查25岁以上常住人群2 221人,未检出氟骨症患者;检测成人尿样257份,尿氟值0.03～ 1.42 mg/L,尿氟均值0.67 mg/L.结论 目前甘南州未发现饮茶型地氟病流行,但农牧区供应的边销茶50％以上超标,部分人群仍饮用方包茶和砖茶;今后应继续加强饮茶型地氟病监测,加大市场监管和健康教育宣传工作.     

山西省三级地方性氟中毒实验室外质控网络运行分析

目的总结2009—2013年山西省三级地方性氟中毒实验室外质控网络运行情况,切实巩固地方性氟中毒实验室质控工作成果,建立全省地方性氟中毒实验室质控考核工作的长效机制。方法分析山西省地方性氟中毒实验室外质控网络考核工作反馈率、合格率等数据,总结人员、设备、培训等情况。结果 2009—2013年,除2010年有2个市级、2个县级地方性氟中毒实验室考核结果出现可疑值外,几乎每年市级及县级地方性氟中毒实验室反馈率和合格率均为100.0%;5年的外质控网络运行,使全省三级地方性氟中毒实验室能力建设和人员素质逐步提高,质控考核合格率位于全国前列。结论技术培训、实验室全过程质量控制和外质控网络运行是提高地方性氟中毒实验室检测质量和检测水平的重要手段。     

2002年昭阳区燃煤型氟中毒调查结果分析

目的了解云南省地氟病重病区的病情现况,并为制定相应的防治策略提供科学依据.方法按照<云南省地方性氟中毒重点调查实施方案>,抽取西城、太平、靖安及小龙洞4个乡(办事处)为调查点.结果儿童氟斑牙检出率为27.0%,其中小龙洞(53.1%)、太平(34.1%)、靖安(23.6%)、西城(5.9%);儿童尿氟几何均数1.58mg/L;玉米氟含量中位数9.66mg/kg,辣椒氟含量中位数49.86mg/kg.结论改炉改灶工作取得了一定的效果.     

2004～2005年山东省梁山县地方性氟中毒重点监测结果分析

目的 了解2004～2005年山东省梁山县地方性氟中毒防治工作现况及重点监测点东徐村地氟病病情变化. 方法 按照全国地方性氟中毒监测方案的要求,调查梁山县的改水进度,已改水工程管理、使用、饮水含氟量现况;对重点监测点东徐村10户居民末梢水含氟量进行检测,调查该点8～12岁儿童氟斑牙患病率、氟斑牙指数以及即时尿氟含量等. 结果 监测县梁山共有地氟病村215个,已完成降氟改水139个(128处改水降氟设施),改水完成率64.7%;128处改水设施能够正常使用的69处,占53.9%;69处正在使用的降氟设施水含氟量≤1.0 mg/L的2年检测平均为72.1%,水氟最高达4.28 mg/L.重点监测点东徐村10户末梢水含氟量每年检测均在0.5 mg/L以下且持续稳定;8～12岁儿童氟斑牙患病率两年分别为8.33%和6.25%,氟斑牙指数分别是0.24和0.18,尿氟含量几何均值在1.0 mg/L左右,已完全达非病区标准. 结论 改水降氟是控制饮水型地方性氟中毒行之有效的主要措施,但是监测县改水降氟措施落实进度缓慢,改水设施的正常利用率不高,对此,应加大投入,强化管理,加快改水降氟工作步伐,在整体上有效控制地方性氟中毒的发生.     

尿肌酐标化尿氟含量的探讨

目的 在地方性氟中毒流行区的调查中，目前多数采用尿氟含量来评价人群氟暴露水平。本研究是探讨尿氟含量是否适合用尿液中氟浓度(mg/L)来表示。方法 选择3个地区(高氟区、改水区和对照区)的儿童作为研究对象。采用电极法测尿氟、苦味酸比色法测尿肌酐。结果 采用尿液中氟浓度(mg/L)和尿肌酐(mg/g肌酐)，在3个地区比较时，结果基本一致。结论 建议在人群调查时采用尿液中氟浓度(mg/L)来表示氟含量。     

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.