2006年黑龙江省富裕县克山病病情监测分析

目的了解2006年富裕县克山病监测点富金监测村(44号)、龙山监测村(40号)克山病患病和发病情况。方法按照"克山病监测方案"及《克山病诊断标准》(GB17021-1997),对监测点区居民进行检诊。结果2006年2个点区共检诊432人,检出克山病病例10例,总检出率2.3%,其中潜在型6例,慢型4例,检出率分别为1.4%、0.9%,富金村(44号)有2例慢型克山病病例死亡,新检出3例潜在型,1例慢型病例。结论在历史轻病区有新检出的克山病病例和病例死亡出现,说明克山病区仍有致病因子的作用,必须坚持进行克山病监测,并提高现有病人的生活质量,加强克山病防治知识的宣传等。     

2000-2004年全国克山病病情监测5年汇总分析

目的研究2000—2004年克山病患病及发病趋势。方法根据卫生行业标准《克山病监测》（WS／T78—1996）及《克山病诊断标准》（GB17021—1997）在12个省对监测点区居民进行普查和克山病发病相关因素调查。结果5年问潜在型、慢型克山病年均检出率分别为3．8％和0．8％。各监测点区共新发潜在型克山病113例．新发现慢型克山病29例。人均发硒0．305mg／kg，粮硒0．017mg／kg。结论部分克山病省区病情不清．病区粮硒仍属低硒水平，有新病例检出。克山病仍然是一个严重的地方性公共卫生问题。克山病控制的重点应包括规范监测工作．慢型克山病现患的治疗。     

2004年黑龙江省富裕县克山病病情监测分析

目的了解克山病国家级监测点富裕县永进村2004年克山病患病和发病情况。方法对监测点区居民进行体检和心电图检查．对病人和可疑病人进行胸部X线片检查。结果永进村2004年无新发各型克山病病例。在检查的636人中，检出克山病现患病人16例，总检出率2．5％。其中潜在型10例，慢型6例，检出率分别为1．6％和0．9％。结论富裕县永进村克山病病情稳定，无新发病例，但继续进行病情监测、观察现患病人的病情变化．仍然是克山病监测的重点。     

2005年河北省张北县克山病病情监测报告

目的观察河北省2005年克山病病情。方法在河北省克山病历史重病区张北县战海乡水泉洼村设立监测点,将全部常住人口列为监测对象,根据《克山病监测》标准(WS／T 78-1996)及《克山病诊断标准》(GB 17021-1997)对监测点居民进行普查,随访2004年监测点在册克山病病人。结果监测点年内无急型、亚急型克山病发生,检出潜在型克山病(潜克)和慢型克山病(慢克)23人,检出率为4．59％,高于2004年检出率,但差异无统计学意义(P>0．05);监测点人群异常心电图检出率为14．34％;克山病病人心、胸比率异常检出率为52．63％;随访2004年监测点克山病病人27人,死亡2人,死亡率为7．4％。结论河北省张北县监测点克山病病情相对稳定,但病区存在的致病因素仍然对病区人群构成威胁。应加强病情监测工作,开展对克山病病人的治疗和管理。     

2005年全国克山病病情监测汇总分析

目的掌握2005年全国克山病患病及发病情况。方法按统一监测方案并根据《克山病诊断标准》(GB 17021-1997)对22个克山病监测点区居民进行查体,描12导联心电图,疑似病人摄2 m后前位X线胸片及居民发硒、粮硒测定。结果22个监测点潜在型、慢型克山病检出率分别为3．5％和0．6％;新检出潜在型克山病7例,慢型克山病1例;人均发硒0．349 mg／kg,粮食硒0．025 mg／kg。结论监测点仍有潜在型和慢型克山病新发病例出现,说明克山病仍然是一个严重的地方性公共卫生问题;工作重点应放在克山病监测、硒预防、患者管理、治疗以及加强防治队伍培训等方面。     

2007年黑龙江省富裕县永进村克山病病情监测结果分析

目的 了解2007年克山病监测点黑龙江省富裕县永进村人群患病、发病情况及内外环境的硒水平.方法 按全国克山病监测方案及《克山病诊断标准》(GB 17021-1997),对监测点区居民进行临床查体和心电图描记,可疑心脏异常者行X线胸部摄片;采集当地部分儿童头发和食用粮样(面粉),氢化物发生原子荧光法测定含硒量.结果 2007年在永进村共检诊282人,检出克山病19例,总检出率6.7%.其中潜在型克山病8例(有5例为新检出),慢型克山病11例,检出率分别为2.8%、3.9%.另外,还检出可疑克山病5例,其中可疑慢型2例,未检出急型、亚急型克山病病例.儿童发硒为(0.3197±0.0586)mg/kg;粮食硒为(0.0210±0.0062)mg/kg.结论 永进村仍有新的克山病病例检出,说明病区仍有致病冈索存在,因此,在病区建立完善的克山病监测疫情报告系统,提高各级防治人员对克山病的认识,仍是今后克山病防治的重点.     

2007年云南省洱源县和牟定县克山病监测报告

目的 掌握克山病发病消长趋势,指导和评价克山病防治工作.方法 按照"克山病病情监测方案"要求对监测点区居民进行普查,填调查表、详细询问病史、临床体检、描记心电图、各型克山病人及可疑病例拍摄2 m后前位X线胸片,按<克山病诊断标准>GB17021-1997进行诊断.结果 2007年洱源县和牟定县4个监测村共检诊1 693人,检诊率11.16%,检出克山病现患病例10例,检出率0.59%,其中潜在型克山病2例,慢型克山病8例,检出率分别为0.12%和0.47%.在检出的10例克山病现患病例中,病人年龄集中在5～15岁年龄段(6/10)及35～64岁年龄段(4/10),其他年龄段无病人,特别是5～15岁年龄段慢型克山病病人较多(4/8)值得注意.结论 洱源县和牟定县的克山病病情处于平稳低发势态,但5～15岁年龄段慢型克山病病人较多及牟定县慢型克山病患者检出率较高.     

2005年云南省克山病病情监测结果分析

目的为了全面掌握云南省克山病病情态势,科学指导和评价云南省克山病防制工作。方法按照《克山病监测》标准(W S/T78-1996)及《克山病诊断标准》(GB17021-1997)进行。监测内容包括临床检诊、心电图描记、可疑对象摄胸部后前位X线片。结果9个省级克山病监测点共检出克山病病例48例(1.03%),其中潜在型克山病(简称“潜克”)39例(0.84%),慢型克山病(简称“慢克”)9例(0.19%)。检出率与2004年相比,无显著性差异(χ2=1.362,P>0.05)。无急型克山病(简称“急克”)和亚急型克山病病例(简称“亚急克”)检出。全年累计新发慢克62例,发病率0.14/10万。结论目前云南省克山病病情处于平稳低发态势。克山病监测是了解克山病病情的一种科学手段,工作重点应放在病情监测、病情调查和对慢克病人的管理治疗,以及巩固和加强防治队伍建设等方面。     

辽宁省清原县2007年克山病病情监测分析

目的掌握我省克山病监测点区克山病病情及消长趋势,探讨其发病机理。方法扩大监测点检诊人数,采用更科学的抽样方法,了解急型、亚急型及慢型克山病(慢克)的发病情况。对监测点的流行病学人口资料进行调查。对克山病监测点全体居民户进行克山病普查(同步查体、描记心电图、心脏B超检查),必要的进行2m后前位X线胸片检查。结果监测点内检出慢克8例,潜克47例,总检出率6.56%。结论监测点区病情相对稳定,无急型、亚急型新发病例,但本年度监测仍然有慢型与潜在型病例检出。建议在病区进一步改善膳食模式的同时加强克山病知识的健康教育工作。     

陕西省黄陵县克山病8年监测结果分析

目的 观察陕西省黄陵县1995～2002年克山病病情变化。方法 在黄陵县的6个重病村设立监测点，全体居民均为监测对象，同时对全县慢型克山病（慢克）的发病情况进行监测，并对监测点3～15岁儿童内环境硒水平进行监测。结果 （1）6个监测点8年共检出慢克病人20例，潜在型克山病病人（潜克）282例，新发潜克病人14例。1995、1997、1999、2000和2002年克山病的检出率分别为4．3％、3．6％、7．5％、8，0％和8．5％；患病率为1．0％、2．4％、3．2％、3．6％和2．0％；潜在型克山病的新发生率为55．6／万、53．5／万、19．5／万、o／万和25／万；（2）8年全县共确诊慢克病人62例，死亡22例，15例死于慢性充血性心力衰竭，7例死于猝死；（3）监测点3～15岁儿童发硒与非病区儿童比较，差异无显著意义。结论 陕西省黄陵县监测点克山病的检出率呈缓慢上升态势，发病率呈平稳态势，但潜在型克山病仍有新发。     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.