福建省部分水源微囊藻毒素污染调查

目的 报告福建省部分饮用水水源微囊藻毒素污染状况调查结果,探讨饮用水水源微囊藻毒素的危害及预防措施.方法 1998,2000年在厦门同安肝癌高发区抽样采集浅井水49份、自来水4份、水库水3份,竞争酶联免疫吸附法（ELISA）测定水样中微囊藻毒素;2001年8-9月份采集福州山仔水库微囊藻水华,小鼠生物法测定微囊藻水华急性毒性,高效液相色谱法定性、定量测定微囊藻毒素类型和含量.结果 厦门同安农村饮用水水源普遍存在微囊藻毒素污染,夏季藻类生长高峰期,水库水微囊藻毒素检出率100%,浅井水检出率77.5%;同安水源中优势藻为颤藻,其次为微囊藻.福州山仔水库微囊藻水华LD50为9.9 g藻浆/kg,平均死亡时间2.5 h.每克鲜藻浆含微囊藻毒素20.5μg,主要毒素类型为MC-RR,其次为MC-LR和MC-YR.结论 福建省部分饮用水水源存在微囊藻毒素污染,山仔水库微囊藻毒素主要类型为MC-RR,有明显的肝毒性.     

黄河水源水浮游藻类及藻类毒素污染状况动态研究

目的 :探讨黄河水源水浮游藻类和藻毒素污染状况及影响因素。方法 :于 1998年 5～ 12月在河南省S市、Z市、P市水源水设采样点 ,对水源水浮游藻类、藻类毒素污染情况及总氮、总磷、COD等指标进行了连续检测。结果 :河南省黄河水源水总氮检出范围为 2 5 7～ 6 .79mg/L ,总磷的检出范围为 0 0 1～ 0 .32mg/L ,蓝藻和绿藻为浮游藻类的优势种群。MC的阳性率 ( >2 0ng/L)为 82 6 1% ,最高达到 95 7 9ng/L。结论 :按照Carlson提出的富营养化指数TSI(TP)判定标准 ,结合TN、TP、COD及藻类密度等指标 ,认为河南省境内黄河水源水已呈现富营养化特征。磷是黄河水源水浮游藻类生长的主要限制因子 ,控制黄河水源水富营养化应以控制磷为主。     

IGF-1对IL-1诱导的兔关节软骨细胞NO和PGE2的影响

目的:检测合成性细胞因子胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)对损伤性细胞因子IL-1(interhukin-1)诱导的兔关节软骨细胞产生NO(nitric oxide)和前列腺素(prostaglandinE2,PGE2)的影响,探讨IGF-1在骨关节炎治疗中的作用机制.方法:实验分为IL-1β10μg/L组、IL-1β10 μg/L IGF-1 1μg/L组、IL-1β 10 μg/L IGF-1 10μg/L组、IL-1β 10 μg/L IGF-150 μg/L组、IL-1β 10 μg/L IGF-1 100 μg/L组、IGF-150 μg/L组和空白对照组.首先进行2月龄兔原代软骨细胞的培养并进行鉴定,然后将IL-1β 10 μg/L单独或与不同浓度的IGF-1共育于第2代兔关节软骨细胞,硝酸还原酶法测定实验组细胞上清液NO的含量,ELISA酶联免疫竞争法测定细胞上清液中PGE2含量,再对测定的NO和PGE＜2的浓度与IGF-1和IL-1的浓度进行有关的统计学分析.结果:IL-1β10μg/L组NO浓度为(89.971±10.224) μmol/L,PGE2浓度为(22.028±8.731)ng/L;空白组NO浓度为(12.404±8.809)μmol/L,PGE＜2浓度为(1.900±0.227)ng/L.IL-1β 10 μg/L组与空白组比较,NO和PGE＜2明显增加,差异有统计学意义(P＜0.05).在IL-1β均为10 μg/L时,IGF-1可以呈剂量依赖地降低IL-1诱导的兔关节软骨细胞NO和PGE2的升高,并且在50 μg/L时即可达到最佳浓度.结论:IL-1能增加软骨细胞培养中的NO和PGE2的产生.IGF-1在体外可以呈剂量依赖地降低IL-1诱导的兔关节软骨细胞NO和PGE2的升高,其最佳浓度为50 μg/L.     

生活饮用水系统微囊藻毒素LR含量调查及气候因素影响

目的了解某市生活饮用水系统微囊藻毒素（MC）污染情况,探讨当地温度、光照时数、降雨量等气候因素与微囊藻毒素-LR（MC-LR）含量相关性。方法 2008~2010年每年3月和9月,采集水源水、出厂水、管网水水样,采用高效液相色谱法检测水中MC-LR的含量;采用SPSS 18.0统计软件对数据进行统计学分析。结果 2008~2010年共检测了248份水样,有12份水样检出MC-LR,总检出率为4.8%,最高含量为0.115μg/L。3月和9月的水样中MC-LR检出率存在极显著性差异（P〈0.01）,水源水、出厂水和管网水水样中MC-LR检出率无显著性差异（P〉0.05）。MC-LR含量与温度、光照时数间存在较强的线性相关关系（P〈0.01）,与降雨量间无相关关系（P〉0.05）。结论某市生活饮用水系统受到以MC-LR为代表的微囊藻毒素的污染,但其值低于国家标准《生活饮用水卫生标准》（GB5749-2006）规定的限值0.001mg/L。温度、光照时数对MC-LR含量有重要影响。     

某市2008-2011年太湖水源生活饮用水水质监测分析及评价

目的分析2008-2011年某市太湖水源生活饮用水水质状况及变化趋势,为保障和改善居民饮用水卫生安全和卫生质量提供科学依据。方法依据《生活饮用水卫生标准》(GB 5749-2006)对2008-2011年某市太湖水源生活饮用水监测结果分析及评价。结果检测水样1 432份,合格1 331份,总合格率92.9%;年度合格率由2008年的80.5%提高到2011年的97.1%,差异有统计学意义(χ2=40.078,P0.001);不合格指标中,菌落总数、浑浊度和铁超标项次数最多,为主要不安全水质指标;对不同季节菌落总数超标率比较,差异有统计学意义(χ2=10.215,P0.017),其中第三季度最高(5.3%)。结论目前该市太湖水源生活饮用水水质基本符合GB 5749-2006的要求,少数管网水质存在微生物污染等安全隐患,今后工作中必须加强管网末梢水质的卫生监督管理。     

细胞外信号调节激酶和转化生长因子β1在哮喘气道重塑中的作用以及糖皮激素的调控

目的 研究细胞外信号调节激酶（ERK）和转化生长因子β1（TGF—β1）在哮喘气道重塑中的作用,探讨糖皮质激素对ERK、TGF—β1及哮喘气道重塑的调控。方法建立慢性哮喘动物模型,将30只SD大鼠随机分对照组、哮喘组、地塞米松干预组（DM组）。免疫组化测定肺组织中磷酸化的ERK（P-ERK）,ELISA测定血清中TGF—β1含量。体外培养大鼠气道上皮细胞,以BB型血小板源性生长因子（PDGF—BB）、U0126、布地奈德（BUD）作为工具药干预细胞,Western印迹检测细胞ERK磷酸化水平,ELISA法检测细胞上清液TGF—β1含量。结果哮喘组P—ERK平均吸光度和TGF—β1含量[分别为（31．1±2．2）和（28．1±7．4）μg/L]均较对照组[（12．8±2．4）和（13．6±2．7）μg/L]高（P〈0．01）,DM组[分别为（18．7±3．1）和（15．0±3．2）μg/L]较哮喘组低（P均〈0．01）。ERK的磷酸化与PDGF—BB存在浓度依赖关系,50μg/L时ERK磷酸化水平最高,高于对照组（P〈0．01）;U0126和BUD均可抑制ERK的磷酸化;各处理组细胞上清TGF—β1差异无统计学意义。结论ERK磷酸化、TGF—β1在支气管哮喘气道重塑中起重要作用;PDGF—BB不能通过ERK磷酸化诱导正常大鼠气管上皮细胞产生释放TGF—β1;糖皮质激素能抑制ERK磷酸化。     

SERUM CONCENTRATIONS OF HYALURONIC ACID, PROCOLLAGEN TYPE Ⅲ NH2-TERMINAL PEPTIDE, AND LAMININ IN PATIENTS WITH CHRONIC CONGESTIVE HEART FAILURE

OBJECTIVE: To explore the role of serum fibrotic indices including hyaluronic acid (HA), procollagen type III NH2 -terminal peptide (PCIIIP), and laminin (LN) in assessing the severity of myocardial fibrosis in chronic congestive heart failure (CHF). METHODS: Serum levels of HA, PCIIIP, and LN in 39 patients with CHF [14 with New York Heart Association (NYHA) functional class II, 21 with class III, 4 with class IV] and in 46 patients with NYHA functional class I were assessed by radioimmunoassay. RESULTS: The serum concentrations of HA, PCIIIP, and LN were 359.75 +/- 84.59 microg/L, 77.88 +/- 24.67 microg/L, 86.73 +/- 23.90 microg/L in CHF group, and 211.60 +/- 54. 80 microg/L, 64.82 +/- 23.99 microg/L, 82.26 +/- 23.98 microg/L in NYHA functional class I group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class I group (P < 0.05). However, no difference was found in the levels of PCIIIP and LN between CHF group and NYHA functional class I group. The serum HA concentration was negatively correlated with left ventricular ejection fraction (r = - 0.71, P < 0.05). CONCLUSION: Serum HA level may act as an indicator for myocardial fibrosis.     

Hepatic Histopathological Characteristics and Antioxidant Response of Phytoplanktivorous Silver Carp Intraperitoneally Injected with Extracted Microcystins

Objective To investigate the hispathological characteristics and antioxidant responses in liver of silver carp after intraperitoneal administration of microcystins （MCs） for further understanding hepatic intoxication and antioxidation mechanism in fish. Methods Phytoplanktivorous silver carp was injected intraperitoneally （i.p.） with extracted hepatotoxic microcystins （mainly MC-RR and -LR） at a dose of 1000 μg MC-LReq./kg body weight, and liver histopathological changes and antioxidant responses were studied at 1, 3, 12, 24, and 48 h, respectively, after injection. Results The damage to liver structure and the activities of hepatic antioxidant enzymes including catalase （CAT）, superoxide dismutase （SOD）, and glutathione peroxide （GPX） were increased in a time-dependent manner. Conclusion In terms of clinical and histological signs of intoxication and LD50 （i.p.） dose of MC-LR, silver carp appears rather resistant to MCs exposure than other fishes. Also the significantly increased SOD activity in the liver of silver carp suggests a higher degree of response to MCs exposure than CAT and GPX.     

子(癎)前期患者血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C的变化及其临床意义

OBJECTIVE: To investigate the changes and of serum cardiotrophin I (cTN I) and cystatin C in preeclampsia clinical significance thereof. METHODS: Peripheral blood samples were collected from 40 women with preeclampsia, aged 29 (18 - 39), with the medium gestational age of 35 weeks, and 40 age- and gestational age-matched controls. Serum cTN I and cystatin C were determined with ELISA and serum levels of creatinine kinase, creatinine, and uric acid were assayed by automatic biochemical analyzer. Comparison was made between the 2 groups. RESULTS: The serum cTn I of the preeclampsia group was 0.59 microg/L +/- 0.42 microg/L, significantly higher than that of the control group (0.09 microg/L +/- 0.22 microg/L P < 0.001), and the serum cystatin C of the preeclampsia group was 1.64 mg/L +/- 0.47 mg/L, significantly higher than that of the control group (1.08 mg/L +/- 0.19 mg/L, P < 0.001). And the serum cardiotrophin I and cystatin C concentrations of the patients with severe preeclampsia were 0.66 microg/L +/- 0.40 microg/L and 1.72 mg/L +/- 0.46 mg/L respectively, both significantly higher than those of the patients with mild preeclampsia (0.17 microg/L +/- 0.26 microg/L and 1.21 mg/L +/- 0.37 mg/L respectively, P < 0.001 and 0.05 respectively). CONCLUSION: Serum cTn I and cystatin C levels are elevated in preeclampsia and the elevation is associated with the severity of preeclampsia, suggesting that serum concentrations of cTn I and cystatin C are useful markers in the early diagnosis of cardiac and renal injury in patients of preeclampsia.     

大黄素干预大鼠慢性胰腺炎胰腺纤维化进展的研究

目的研究大黄素对大鼠慢性胰腺炎模型胰腺纤维化的干预作用及可能机制。方法胰管内注射三硝基苯磺酸(TNBS)制备大鼠慢性胰腺炎模型,用不同剂量(20、40、80 mg/kg)的大黄素鼻饲干预,生理盐水作为对照。放射免疫法检测血清透明质酸(HA)和层粘连蛋白(LN)水平;观察大鼠胰腺组织的病理学变化,并应用 Van Gieson 染色分析胰腺胶原纤维含量;Western 印迹分析检测大鼠胰腺组织中的转化生长因子(TGF)-β_1蛋白含量。结果 (1)小剂量、中剂量、大剂量大黄素处理组血清透明质酸水平分别为87μg/L±22μg/L、78μg/L±25μg/L、62μg/L±19μg/L,均显著低于模型对照组(113μg/L±27μg/L,均 P<0.05);血清层粘连蛋白水平分别为67μg/L±14μg/L、57μg/L±12μg/L和44μg/L±10μg/L,均显著低于模型对照组(86μg/L±17μg/L,均 P<0.05);(2)大黄素处理组胰腺纤维化程度轻于模型组,且随大黄素剂量的增加纤维化程度呈减轻趋势,大剂量大黄素组纤维化减轻程度与模型对照组相比,差异有统计学意义(P<0.05);(3)胰腺胶原纤维阳性染色所占面积,小剂量、中剂量、大剂量大黄素组分别为39%±7%、38%±4%、36%±5%,大剂量大黄素组纤维化程度轻于模型对照组(42%±6%),差异有统计学意义(P<0.05);(4)TGF-β_1蛋白表达量,小剂量、中剂量、大剂量大黄素组分别为44.3%±2.1%、39.2%±1.8%、28.8%±1.6%,与模型对照组(60.7%±1.7%)相比,大剂量大黄素组低于模型对照组(P<0.05);大剂量大黄素组与中、小剂量组比较,差异均有统计学意义(均 P<0.05)。结论大黄素具有抗大鼠慢性胰腺炎模型的胰腺纤维化作用,此作用与 TGF-β_1蛋白表达有关。     

南澳县水中氟化物的背景值及相关水质指标测定

目的：测定南澳县水源水中氟化物的背景值及其它相关水质指标。方法：氟化物测定用茜素锆比色法；氨氮用纳氏比色法：亚硝酸盐氮用重氮化偶合比色法；硝酸盐氮用马钱子碱比色法；总硬度用EDTA滴定法。结果：21个水样中，有20个水样的氟化物含量均低于饮用水卫生标准（1mg／L），仅有后宅的一口靠近海边水井的水中氟化物含量较高（2．4mg／L）。结论：南澳县的水源属于低氟化物水源。     

重组人生长激素对败血症大鼠肠粘膜屏障功能保护作用的机制研究

目的观察重组人生长激素(RHGH)对败血症大鼠肠粘膜屏障功能的保护作用并探讨其可能的作用机制。方法采用腹腔注射E.COLI复制大鼠败血症模型。42只健康雌性SD大鼠随机分为正常对照组(C组)、败血症组(S组)及RHGH治疗组(T组),S组及T组又依观察时点再分为1D、3D两个亚组(T1D,T3D,S1D,S3D)。应用RT-PCR、免疫组化、放射免疫等方法,动态观测肝组织IGF-1MRNA表达情况、肠粘膜BCL-2蛋白表达水平及细菌移位、血浆生长激素(GH)及胰岛素样生长因子-1(IGF-1)水平及肠道形态等指标的变化情况。结果1RHGH能明显减轻败血症大鼠肠粘膜结构损伤,减轻肠道细菌移位。2T组大鼠肠粘膜BCL-2表达水平(T1D:2441±117;T3D:3628±235)明显高于S组水平(S1D:321±36;S3D:1873±57)(P<0.01)。3T组大鼠血浆GH水平〔T1D:(1.28±0.24)ΜG/L;T3D:(2.14±0.48)ΜG/L〕显著高于S组水平〔S1D:(0.74±0.12)ΜG/L;S3D:(0.60±0.18)ΜG/L〕(P<0.01)。4T组大鼠血浆IGF-1水平〔T1D:(168.94±65.67)ΜG/L;T3D:(201.56±64.98)ΜG/L〕明显高于S组水平〔S1D:(116.72±13.96)ΜG/L;S3D:(107.50±23.53)ΜG/L〕(P<0.05)。5T组大鼠肝IGF-1MRNA表达水平〔T1D:(0.98±0.20);T3D:(1.76±0.17)〕显著高于S组水平〔S1D:(0.38±0.09);S3D:(0.46±0.10)〕(P<0.01)。结论RHGH可能通过抑制肠粘膜上皮细胞凋亡及GH/IGF-1的作用来维护败血症大鼠肠粘膜屏障功能。     

严重烧伤脓毒症患者骨骼肌蛋白分解代谢的临床研究

目的分析严重烧伤脓毒症患者骨骼肌蛋白降解变化及其生物学机制。方法收集同期收治的20例严重烧伤脓毒症患者(烧伤脓毒症组)和12例整形患者(对照组)的血、24h尿和股四头肌标本,通过放免法测定血浆皮质醇和肿瘤坏死因子(TNF)-α含量,高效液相-色谱分析法检测股四头肌内3-甲基组氨酸(3-MH)含量以及尿中3-MH排出量,核糖核酸印迹法检测股四头肌内编码泛素、E2-14k和蛋白酶体C2亚基的mRNA表达变化。蛋白免疫印迹法检测股四头肌内蛋白酶体C2亚基的蛋白表达变化。结果烧伤脓毒症组血浆内皮质醇含量(478±56)μg/L和TNF-α含量(22·4±3·8)μg/L均显著高于对照组血内皮质醇含量(72±12)μg/L和TNF-α含量(0·5±0·1)μg/L(均P<0·01)。烧伤脓毒症组股四头肌内3-MH含量(4·3±0·6)μmol/g及24h尿内3-MH排出量(456±25)μmol均显著高于对照组股四头肌内3-MH含量(2·5±0·4)μmol/g和24h尿内3-MH排出量(202±29)μmol(均P<0·01)。烧伤脓毒症组股四头肌泛素mRNA2·4kb条带和1·2kb条带的表达分别较对照组增强51%和32%,差异有统计学意义(P<0·01);E2-14k mRNA1·2kb条带的表达较对照组增强75%,差异有统计学意义(P<0·01);蛋白酶体C2亚基mRNA和蛋白表达分别较对照组增强39%和130%,差异有统计学意义(P<0·01)。结论重症烧伤脓毒症时骨胳肌蛋白降解显著增强,体内糖皮质激素及TNF-α含量增加,从基因水平激活细胞内蛋白降解途径-泛素系统是重症烧伤脓毒症患者骨胳肌蛋白降解增强的原因之一。     

尖锐湿疣患者血清白细胞介素18和干扰素γ水平的研究

目的 :研究白细胞介素 18(IL- 18)和干扰素 γ(IFN- γ)在尖锐湿疣发病机理中的作用。方法 :采用酶联免疫吸附 (EL ISA)法 ,测定了 30例尖锐湿疣患者血清 IL- 18、IFN- γ含量。结果 :尖锐湿疣患者组的血清 IL- 18、IFN- γ水平显著高于正常人组 (IL- 18:132 .0 0± 5 2 .92 μg/ L vs5 0 .79± 2 3.4 8μg/ L,P<0 .0 1;IFN- γ:80 .83± 2 0 .4 6 μg/ Lvs2 0 .71± 11.18μg/ L,P<0 .0 1) ,且 IFN- γ水平增高与 IL- 18水平增高呈正相关 (r=0 .75 4,t=6 .0 81,P<0 .0 1)。结论 :在人类乳头瘤病毒感染时 ,机体的抗感染免疫有一定的激活 ,产生 IL- 18、IFN- γ等抗病毒因子 ,这可能与病毒最终被清除有一定关系。     

液质联用测定血清中地氯雷他定及人体药动学研究

目的:研究地氯雷他定血清浓度测定方法及其在健康人体内的药动学.方法:18名健康男性志愿者单剂量口服地氯雷他定片, 在设计的时间点取静脉血,采用高效液相色谱-质谱法(HPLC-MS)测定血药浓度.药动学参数采用3P97程序计算.结果:单次口服10mg地氯雷他定片后的主要药动学参数tmax、Cmax、AUC0-t、AUC0-∞、t 1/2(ke)、Ke、CL,分别为(1.611±0.366)h 、(4.455±1.990)μg·L -1、(58.50±21.34)μg·L-1·h-1、(60.59±22.32)μg·L -1·h-1、(20.303±5.833)h、(0.0372±0.0116)h-1和(0.1 838±0.0563)L·h-1.结论:地氯雷他定在研究人体内口服吸收较快,约1.5 h达血药浓度峰值,平均消除半衰期为20 h.     

血清脱氢表雄酮水平与女性性早熟关系的探讨

目的:探讨血清脱氢表雄酮与女性性早熟之间的关系.方法:60例特发性中枢性早熟(ICPP)女童,62例单纯乳房早发育(PT )女童及31例与年龄匹配的青春前期健康女童,采用ELISA法测定血清脱氢表雄酮(DHEA) 及硫酸脱氢表雄酮(DHEAS)浓度,并对ICPP儿童进行达菲林治疗前、后的对比研究,随访其子宫、卵巢、骨龄及血清DHEA、DHEAS的变化.结果:①ICPP组血清Log(D HEA)、Log(DHEAS)为(0.81±0.36)μg/L,(2.31±0.31)μg/L,PT组为(0.72 ±0.30)μg/L,(2.31±0.28)μg/L,对照组为(0.32±0.26)μg/L(2.16±0.2 7)μg/L,三组比较差异有显著性意义(P<0.05);ICPP组与PT组两组之间比较差异无显著意义(P>0.05);TannerⅢ期的DHEA、DHEAS明显高于TannerⅡ期的DHEA、DHEA S,P<0.0 5.②经双变量相关分析,Log(DHEA)与身高、骨龄、子宫容积、卵巢容积呈正相关,与Lo g(LH峰值)、Log(FSH峰值)、体质指数(BMI)无相关性; Log(DHEAS)与身高、骨龄、卵巢容积呈正相关,与Log(LH峰值)、Log(FSH峰值)、子宫容积、BMI无相关性.③达菲林治疗3个月时,血清Log(DHEA)、Log(DHEAS)较治疗前明显下降 (P<0.05).治疗12个月时,血清Log(DHEA)、Log(DHEAS)与治疗前比较,差异无显著意义(P>0. 05),但子宫容积、卵巢容积、骨龄与年龄的比值治疗前、后比较差异有显著意义(P 均<0.05).结论:①性早熟女童血清DHEA和DHEAS水平增高,并随着Tanne r期的进展而升高;②血清DHEA和DHEAS水平随下丘脑-垂体-性腺轴的抑制,其浓度会有暂时性下降;③血清DHEA与性早熟女童生长加速、骨龄进展有关.     

血清蛋白B亚型和神经元特异性烯醇化酶对早期判断体外循环术后脑损伤的意义

目的探讨血清S100蛋白B亚型（S100B）和神经元特异性烯醇化酶（NSE）水平对早期判断体外循环手术后脑损伤的应用价值。方法心脏病手术患者48例,体外循环组（n=40）和非体外循环组（n=8）,于手术前、后24h和48h检测血清S100B和NSE的浓度,术后48h根据“心脏术后神经功能状况评估法”计算脑损伤指数（DQ）。结果在体外循环术后24h和48h血清S100B（0．61μg／L±0．18μg／L,0．37μg／L±0．12μg／L）和NSE（10．14μg／L±3．87μg／L,5．77μg／L±2．31μg／L）的浓度均高于术前水平（0．05±0．03μg／L,2．98±1．49μg／L）（均P〈0．01）,而非体外循环组术后S100B（0．05μg／L±0．03μg／L,0．04μg/L±0．03μg／L）和NSE（2．91μg／L±1．56μg/L,2．87μg/L±1．41μg／L）与术前浓度（0．04μg／L±0．03μg／L,2．76μg/L±1．23μg／L）无差异（均P〉0．05）。体外循环术后24h和血清S100B和NSE的水平与年龄、体外循环时间及主动脉阻断时间相关（均P〈0．05）。血清S100B和NSE的水平与DQ均呈正相关（r=0．739P〈0．01,r=0．371P〈0．05）。结论血清S100B和NSE均为判断体外循环术后脑损伤的特异性指标,但联合检测血清S100B和NSE的特异性最高。     

老年患者靶控输注瑞芬太尼和丙泊酚的临床评价

目的:探讨老年患者靶控输注(target-controlled infusion , TCI)不同血浆浓度瑞芬太尼和丙泊酚的临床安全性和可行性,并评价Marsh参数应用于老年人丙泊酚TCI系统的性能.方法:30例老年患者,随机分为三组,每组10例.A组,丙泊酚复合硬膜外组;B组,丙泊酚复合瑞芬太尼(血浆浓度4 μg/L)组;C组,丙泊酚复合瑞芬太尼(血浆浓度7 μg/L)组.3组病例丙泊酚TCI的血浆浓度均为3 mg/L.观察患者麻醉及术中的脑电双频指数(bispetral index, BIS)、心率、血压、心率变异性等指标,并抽取桡动脉血,检测丙泊酚的血浆浓度.结果:(1)B, C组(血浆浓度4,7 μg/L)的瑞芬太尼能有效抑制插管反应,但C组(血浆浓度7 μg/L)麻醉诱导时低血压和窦缓的几率增加;(2)3组患者术中均能维持足够的麻醉深度(BIS值＝45～60);(3)瑞芬太尼联合丙泊酚TCI不影响老年患者的苏醒; (4)Marsh参数的丙泊酚TCI系统用于我国老年患者偏离性(MDPE)为11.17%、精确度(MDAPE)为12.16%.结论: 血浆浓度4,7 μg/L的瑞芬太尼联合丙泊酚麻醉均能安全应用于老年患者的临床麻醉,但应用血浆浓度7 μg/L的瑞芬太尼在麻醉诱导时应注意加强监测.采用Marsh参数的丙泊酚TCI系统可安全有效地应用于我国老年患者.     

Iodine deficiency and goitre in schoolchildren in Melbourne, 2001

OBJECTIVE: To assess iodine status and goitre prevalence in a sample of schoolchildren in Melbourne. DESIGN: Cross-sectional study of urinary iodine excretion and presence of goitre in a sample of schoolchildren from Years 5-12 attending two urban schools. PARTICIPANTS: 607 children aged 11-18 years consented to thyroid gland palpation and 577 provided a urine sample on the day of examination in August 2001. OUTCOME MEASURE: Iodine status of the study population, based on median urinary iodine values categorised as normal (> or = 100 microg/L), mild (50-99 microg/L) or moderate-severe (< 50 microg/L), and classified according to sex, school year and presence of goitre. RESULTS: 76% (439/577) of students had abnormal urinary iodine values, with 27% (156/577) having values consistent with moderate-severe deficiency. The median urinary iodine excretion for the total group was 70 microg/L, with values for school years 5-12 ranging from 62 microg/L (Year 12) to 76 microg/L (Year 9). The median urinary iodine value in girls was lower than that in boys (64 microg/L v 82 microg/L), and girls had significantly lower urinary iodine values overall (P < 0.002). There was no association between goitre grade and moderate-severe (< 50 microg/L; P = 0.39) or mild (50-99 microg/L; P = 0.07) urinary iodine deficiency. CONCLUSIONS: We found mild iodine deficiency in a cohort of schoolchildren in Melbourne. Our results support other data showing mild iodine deficiency in Sydney and Tasmania and the argument for a national study of iodine nutrition.     

Iron stores in low-income pregnant Mexican women at term

BACKGROUND: Iron stores can be depleted during pregnancy. Serum ferritin is the most useful non-invasive test to assess iron stores in women of reproductive age. Iron status of pregnant Mexican women at term from a low-income group was investigated through serum ferritin determinations. METHODS: Hemoglobin and serum ferritin were measured in 201 low-income urban women with at-term pregnancy receiving attention at a public university hospital. Hemoglobin cut-off value was 110.0 g/L. Depending on their serum ferritin concentration, women were divided into three groups: group I, iron deficiency, serum ferritin <12 microg/L; group II, borderline iron stores, serum ferritin >or=12 microg/L and <30 microg/L, and group III, normal iron stores, serum ferritin >or=30 microg/L. RESULTS: Mean SF value in the entire group was 7.0 +/- 6.4 microg/L, with a mean Hb of 110.1 +/- 15.8 g/L. One hundred seventy-two women (85.6%) had empty iron stores. Ninety-two women (46%) in the entire group had iron deficiency anemia, as did 79 (46%) of the 172 iron-deficient women. During their pregnancy, 165 women (82%) did not ingest any supplemental iron and 131 (65%) did not receive any prenatal care. CONCLUSIONS: We documented a high prevalence of iron deficiency and iron deficiency anemia, together with practically no prenatal care utilization and no supplemental iron ingestion in this low-income group. A serum ferritin concentration >or=12 microg/L was always accompanied by a normal hemoglobin concentration. These data suggest that prenatal care and iron supplementation may be considered as major determinants of maternal iron stores to prevent iron deficiency anemia.