不同海拔地区藏族青少年骨龄发育水平分析

了解不同海拔地区藏族青少年骨龄发育状况,为评价藏族青少年生长发育状况提供科学依据.方法 分层整群抽取西藏不同海拔高度地区12所中小学的2 232名青少年,采用CHN骨龄测定法对不同海拔地区居住的青少年骨龄发育状况进行调查,比较不同海拔地区藏族青少年骨龄发育差异.结果 绝大多数年龄组青少年骨龄低于日历年龄.高海拔地区和低海拔地区男女不同年龄组骨龄比较显示,部分年龄组差异有统计学意义(P值均<0.01);高海拔地区和低海拔地区男、女群体及总人群的骨龄比较显示,高海拔地区骨龄高于低海拔地区,差异均有统计学意义(P值均<0.01).结论 不同海拔地区藏族青少年骨龄发育有差异,较高海拔地区高于低海拔地区.     

综合干预对肥胖男性青少年血管生成素样蛋白2和血管内皮功能的影响

目的 观察运动结合饮食控制的综合干预方案对肥胖男性青少年血管生成素样蛋白2(angiopoietin-likeprotem 2,ANGPTL2)和血管内皮功能的影响,为运动降低肥胖男性青少年心血管疾病风险提供理论依据.方法 选取42名肥胖男性青少年和10名健康男性青少年分别为实验组和对照组,对实验组青少年开展6周运动结...     

郑州市男童青春期性征发育流行病学分析

目的描述郑州市7～18岁男童青春期性发育进程,为界定我国儿童少年青春期性发育状态提供依据。方法抽取郑州市9所城乡中小学校7～18岁男生,每个年龄组至少200人,检查青春期性征发育状况并询问首次遗精情况,运用概率单位回归法计算青春期重要发动事件平均年龄(中位年龄)及各主要百分位年龄。结果城市男童首次遗精平均年龄为13.75岁,乡村男童为14.50岁;外生殖器Tanner发育分期Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期的平均年龄分别为11.27岁、14.02岁、15.80岁和16.45岁,发育最早年龄7岁;阴毛发育Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期的平均年龄分别为13.22岁、14.37岁、16.10岁和16.67岁,发育最早年龄10岁;腋毛发育Ⅱ期、Ⅲ期的平均年龄为15.54岁和16.80岁,发育最早年龄11岁;胡须发育Ⅱ期、Ⅲ期的平均年龄为16.02岁和16.88岁,发育最早年龄11岁。睾丸容积≥4 mL的平均年龄9.98岁,≥12 mL的平均年龄12.41岁。结论男童睾丸最先发育,其次是外生殖器发育,然后是阴毛发育,约1 a后出现半数遗精,腋毛和胡须最后发育;外生殖器和第二性征发育及首次遗精年龄存在城乡差异。     

天津8~1O岁肥胖男童精细动作发展特点分析

了解8~10岁男性儿童精细动作能力随年龄增长的变化特点,为针对性改善肥胖儿童的运动能力和心理健康提供科学的理论依据.方法 选取天津市北辰区办学规模相当的2所普通小学的252名8~10岁男性儿童参加本研究,按照体质量指数(BMI)分为肥胖组(126人,8,9,10岁各42人)和正常体重组(126人,8,9,10岁各42人).所有受试者均进行插入钢针和移动钢针测试以评定其精细动作能力.结果 正常体重组中,不同年龄段儿童移动钢针时间差异有统计学意义(P=0.019),插钢针时间的差异无统计学意义(P=0.068),正常体重儿童的精细动作能力随年龄增长呈增加趋势.在肥胖组中,不同年龄段肥胖儿童插钢针(P=0.574)和移钢针时间(P=0.502)差异无统计学意义.同年龄肥胖组与正常组比较,3个年龄段肥胖组儿童插入钢针时间和移动钢针时间均慢于正常体重组(P值均<0.05).结论 8~10岁正常体重儿童的精细动作发展表现为随年龄增长而提高,肥胖儿童的精细动作发展较慢,未表现随年龄增长的特点.和同龄正常体重儿童相比,肥胖儿童的精细动作能力全面落后.     

藏族女性青少年血清钙磷及骨代谢生化标志物水平检测结果分析

目的了解藏族女性青少年血清钙、磷及骨代谢生化标志物水平,为藏族青少年生长发育研究提供相应资料。方法采用分层整群抽样方法,从拉萨市和那曲地区中小学生中抽取12～18岁藏族健康女性青少年336名,检测血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨性碱性磷酸酶(BAP)、骨钙素(BGP)水平。结果藏族女性青少年血清钙与年龄不相关(P>0.05),但拉萨地区明显高于那曲地区(P<0.05)。血清P,ALP,BAP,BGP水平与年龄均呈负相关(P值均<0.01),且各指标在多数年龄组表现为拉萨地区明显高于那曲地区(P值均<0.05)。除血清钙外,其他指标之间呈显著正相关(P值均<0.01)。结论藏族女性青少年血清钙、磷及骨代谢生化标志物水平随着年龄的增加、居住地海拔高度的增加,各指标水平逐渐降低。     

某高校2 409名男大学新生男科查体结果分析

目的了解新入校男大学生性器官发育和病变情况,为高校学生性健康教育及生殖健康教育提供参考。方法对某高校2005级2409名新入校男生进行男科查体。结果2409名男生检出包皮过长1421名,检出率为58.99%;包茎324名,检出率为13.45%;精索静脉曲张228名,检出率为9.46%。其中农村学生包皮过长、包茎、精索静脉曲张检出率依次为65.69%,17.06%和10.77%,城市学生检出率依次为48.03%,7.55%和7.33%。结论男大学新生外生殖器的卫生状况令人担忧,包皮疾患较多。应加强青少年生殖健康知识教育,同时有必要对青少年外生殖器疾患进行定期普查。     

男性性罪错青少年39例性健康知识态度行为调查

目的 了解男性性罪错青少年性健康知识、态度和行为,为开展青少年性健康教育提供科学依据.方法 采用不记名自填式问卷,对39名男性性罪错青少年进行凋查.结果 分别有25.6%和20.5%的青少年知道患性病的男性和患性病的女性可以没有任何明显症状;87.2%知道正确使用避孕套可降低感染艾滋病病毒危险性;74.4%同意只要对方给好处就可与其发生性行为的观点;犯罪前,有92.3%的人有过性交行为.结论 男性性罪错青少年缺少基本的性健康知识,应重视在性罪错青少年中开展性健康知识教育.     

中国1985与2010年不同地区青少年身高体重比较

了解我国1985-2010年东中西部地区儿童青少年生长发育水平的变化情况,为促进青少年身体健康发展提供参考.方法 以1985年和2010年全国中小学生体质与健康调研报告中身高、体重的数据为资料,采用加权平均值法对各地区数据进行合并分析.结果 1985年和2010,东部7~18岁青少年各年龄组身高水平均高于中、西部同龄青少年,差异有统计学意义(P<0.05).1985年东部地区7~ 14岁青少年体重平均值均大于中、西部地区,2010年东部地区7~17岁青少年体重平均值均大于中、西部地区差异有统计学意义(P<0.05).相较于1985年东、西部地区青少年平均身高差异增幅1.76~3.73 cm(城男)、1.29~ 3.44 cm(城女)、0.98~ 3.24 cm(乡男)、0.61~ 2.66 cm(乡女),2010年差异增幅2.02 ~6.50 cm(城男)、1.77 ~ 5.14 cm(城女)、1.77~ 5.84 cm(乡男)、1.85 ~ 5.38 cm(乡女)明显增大.1985年东、中部地区青少年身高差异增幅0.85~ 1.99 cm(城男)、0.82~1.82 cm(城女)、0.63~2.17 cm(乡男)、0.33~2.02 cm(乡女)同2010年差异增幅1.04~3.09 cm(城男)、0.86~ 2.90 cm(城女)、0.97~2.69 cm(乡男)、0.84~ 2.82 cm(乡女)相比略有增大.相较于1985年东、西部地区青少年平均体重差异增幅1.24~3.51 kg(城男)、0.69~2.74 kg(城女)、0.51~2.28 kg(乡男)、~ 0.30~1.79 kg(乡女),2010差异增幅2.11~7.16 kg(城男)、1.37~4.94 kg(城女)、2.36~7.00 kg(乡男)、1.29~5.28 kg(乡女)明显增大.2010年东中部地区青少年体重差异增幅0.65~3.40 kg(城男)、0.42~2.34 kg(城女)、1.55~2.98 kg(乡男)、0.24~2.46 kg(乡女)相比1985年差异增幅0.65~ 1.78 kg(城男)、0.06~1.39 kg(城女)、-0.11 ~ 1.40 kg(乡男)、-0.5~ 1.11 kg(乡女)有所增大.结论 我国东部儿童青少年生长发育水平高于中、西部同龄青少年.相较于1985年,2010年东部地区与中、西部地区之间青少年身高、体重差异均有所增大.     

男性泌尿生殖道线索细胞的调查及与不育相关性研究

目的探讨精液中线索细胞与男性不育的关系。方法对957例患者精液,直接涂片显微镜下查找线索细胞,阳性者再作革兰染色及细菌培养确证,同时进行精液参数分析。结果精液线索细胞检出率为23．5％（225／957）与细菌培养符合率为95．1％、精子活率、精子a级、a＋b级活力、密度及低渗肿胀率明显低于阴性组及正常对照组,而精子畸形率、精液pH值明显高于阴性组和正常对照组（P〈0．01）。30例不育者配偶依据Amsel诊断标准确诊为细菌性阴道病（Bv）28例（93．3％）。结论Bv病原体可通过性生活侵犯到男性泌尿生殖道各部位,影响精液质量,是不育的重要因素之一,并黏附于鳞状上皮形成线索细胞而对加德纳菌及短小球杆菌感染致不育的判断具有独特价值。     

瘦素在男性青春期发育中的作用

目的　探讨瘦素在男性青春期发育中的作用及其与胰岛素、生长激素、睾酮和雌二醇的相互关系。方法　筛选 7～ 17岁单纯性肥胖男生 15 0人 ,以相互身高相差不超过 2cm ,年龄相差不超过 3个月进行配比 ,选择正常组和营养不良组各 15 0人。结果　肥胖组血清瘦素水平显著高于正常组 ,正常组显著高于营养不良组。不论组别 ,男生血清瘦素水平均随年龄增长先升高再下降 ,肥胖组峰值为 16 96 μg/L(10～ 11岁 ) ,正常组和营养不良组分别为 10 2 5 μg/L和 5 0 8μg/L(11～ 12岁 )。男生血清瘦素水平从TannerG1期到G2 期显著上升 ,之后G2 4期出现逐步下降 ,G5期再次升高。 7～17岁血清胰岛素水平随年龄增长而升高 ,生长激素、睾酮和雌二醇水平于 10～ 11岁开始随年龄增长而升高。瘦素与胰岛素呈正相关 ,与生长激素呈负相关 ,与睾酮呈强负相关 ,与雌二醇无相关性。结论　瘦素可能有加速男性青春期发育的作用 ,而在启动和维持男性青春期发育中是非决定性因素。G5期瘦素水平再次增长具有抑制生长激素分泌作用 ,预示青春期发育结束。     

Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty

Background: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. Method: A total of 693 male adolescents aged 10–18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. Results: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (β = −0.377 to −0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (β = −0.205 to −0.584, p < 0.050). The strongest association was between trunk FM and SOS (β = −0.584, p < 0.001). Conclusion: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.     

Establishing the Prevalence of Osteomalacia in Arab Adolescents Using Biochemical Markers of Bone Health

Nutrition-acquired osteomalacia is a bone mineralization disorder associated with dietary calcium and/or solar vitamin D deficiency, risk factors considered common in the Middle Eastern region. Establishing less invasive, cheap, and widely available diagnostic markers for this underdiagnosed entity is essential, in particular for screening in high-risk groups. This study assessed the prevalence of biochemical osteomalacia in Arab adolescents. In this cross-sectional study performed between September 2019 and March 2021, adolescents aged 12–17 years from 60 different secondary and preparatory year schools in Riyadh, Saudi Arabia were included. Anthropometrics and fasting blood samples were collected. Biochemical osteomalacia was defined as any two of the following four serum markers of hypomineralization, namely low 25 hydroxyvitamin D (25OHD < 30 nmol/L), high alkaline phosphatase (ALP), low calcium (Ca), and/or inorganic phosphorous (Pi). A total of 2938 Arab adolescents [1697 girls; mean age (years) 14.8 ± 1.8; 1241 boys; mean age 15.1 ± 1.6] were recruited. Vitamin D deficiency was noted in 56.2% (n = 953) of girls and 27.1% (n = 336) of boys (p < 0.001). The overall prevalence of biochemical osteomalacia was 10.0% (n = 295/2938) and was higher in girls than boys (14.7% vs. 3.6%, p < 0.001). The prevalence of low serum Ca and/or Pi was also higher in girls than in boys (24.2% vs. 12.5%, respectively, p < 0.001), as well as elevated ALP (5.1% vs. 1.5%, p < 0.001). Overall, girls were 4.6 times (95% CI 3.3–6.4) more likely to have biochemical osteomalacia than boys. Screening of apparently healthy Arab adolescents revealed a high prevalence of deranged mineralization markers suggestive of biochemical osteomalacia, which was significantly more common in girls than boys and was likely associated with Arab traditional clothing and diet. The proposed combination of typically altered mineralization markers for the diagnosis of osteomalacia is, at best, suggestive until further comparisons with established diagnostic tools (histological analysis of bone biopsies) are conducted.     

绝经后女性血清脂联素与骨转换生化指标的关系

目的探讨绝经后女性血清脂联素(Adiponectin)与骨转换生化指标的关系。方法用酶联免疫吸附试验测定287名40～80岁健康绝经后女性血清脂联素以及血清骨特异性碱性磷酸酶(Bone alkaline phosphatase,BAP)和Ⅰ型胶原交联氨基末端肽(cross-linked N-telopeptide of type I collagen,NTx);用双能X线骨密度扫描仪(dual energy X-ray absorptiometry,DEXA)测定总体、腰椎正位、总髋部骨、左前臂骨密度(bone mineral density,BMD)以及体脂、瘦体质量;分析它们之间的关系。结果BAP与总体骨密度、腰椎BMD、髋部总体BMD、前臂BMD均呈负相关(r=-0.210、-0.236、-0.223、-0.226,P0.05),校正年龄和体质指数后,相关性都依然存在(r=-0.168、-0.187、-0.169、-0.175,P0.05)。NTx与总体BMD、腰椎BMD、髋部总体BMD、前臂BMD均呈负相关(r=-0.238、-0.232、-0.239、-0.221,P0.05),校正年龄和体质指数后,相关性都依然存在(r=-0.201、-0.189、-0.193、-0.185,P0.05)。脂联素与BAP、NTx均呈正相关(r=0.202、0.215,P0.05),校正年龄和体脂后,相关性都依然存在(r=0.169、0.183,P0.05)。脂联素与BAP以二次方程模型拟合程度最好,其最大决定系数(R2)为0.055;脂联素与NTx以二次方程模型拟合程度最好,其最大决定系数(R2)为0.089。绝经后骨质疏松(postmenopausal osteoporosis,PMO)女性血清脂联素水平较年龄相匹配的正常对照组增高(P0.05)。结论血清脂联素水平与骨转换生化指标呈正相关,提示脂联素可能为新型骨转换预测因子。     

青春期女性骨发育、月经初潮与身高突增关系研究

目的研究青春期女性骨发育、月经初潮与身高突增关系，为提高青春期女性身体素质提供依据。方法2002年对贵阳市9—15岁健康女性248名测量身高，调查月经初潮发生情况，拍摄左手腕骨X光片，依据X光片用Grave法划分身高突增期，并作1a身高追踪。结果9岁组的个体约有5／6已进入了青春期身高突增，并有部分高峰期个体；身高突增高峰(PHV)发生在Grave骨化指标的钩骨第二期(H-2)和／或第三指中节指骨骺成骺帽(MP3=)的同时，1a的身高追踪结果与Grave的青春期突增分期法的结论一致。结论Grave法可用于中国女性青春期突增的判断。但综合考虑Grave指标、年龄和月经初潮可更好地判断和预测女性的青春期身高突增过程。     

染料木素对去卵巢大鼠骨代谢标志物和松质骨微结构的作用

目的观察染料木素对去卵巢大鼠骨代谢标志物和松质骨微结构的作用。方法 60只7月龄SD大鼠随机分为去卵巢组、假手术组、染料木素干预组[5mg（/kg·d）],分别在3周和15周处死。取血清测定骨钙素（OC）和耐酒石酸酸性磷酸酶5b（TRACP5b）,分离左胫骨行显微CT扫描,分析松质骨微结构。结果去卵巢第3周,染料木素干预组的血清OC和骨小梁间隔大于假手术组,差异有显著性（P〈0.05）;骨小梁数目小于假手术组;组织骨密度和骨小梁厚度大于去卵巢组（P〈0.05）。第15周,染料木素干预组的血清TRACP5b明显小于假手术组;染料木素干预组及去卵巢组的骨小梁数目均小于假手术组（P〈0.05）,骨小梁间隔则大于假手术组（P〈0.05）。结论染料木素对骨形成在去卵巢早期有促进作用,对骨吸收无明显的抑制作用。     

氟性骨损伤患者血清中骨形成抑制蛋白DKK-1的表达

[目的]观察氟性骨损伤患者血清dickkopf相关蛋白1(DKK-1)水平,分析氟性骨损伤的发生与DKK-1表达的相关性. [方法]采用自行设计的“氟与健康”量表对氟暴露人群进行问卷调查,在调查对象知情同意的前提下,采集静脉血及随机中段尿用于检测血氟、尿氟及血清中DKK-1蛋白浓度,并对其进行氟斑牙筛检及前臂正位X线检查.根据血氟浓度、氟斑牙及氟性骨损伤程度将调查对象分别分为不同氟负荷组、氟斑牙与否组及不同程度骨损伤组,分析不同组别之间DKK-1的差异. [结果]血清DKK-1在低、中、高氟负荷组的浓度分别为(19.60±0.52)、(17.74±0.80)、(14.31±1.20) μg/L,随氟负荷的增高血清DKK-1浓度依次降低,差异有统计学意义(P＜0.05).无氟斑牙组与氟斑牙组人群血清DKK-1水平差异无统计学意义(P＞0.05).无、轻、中、重度氟性骨损伤组血清DKK-1浓度分别为(19.16±0.76)、(15.86土1.35)、(13.27±0.45)、(12.42±0.04)μg/L;骨损伤组血清DKK-1浓度均低于无骨损伤组,差异有统计学意义(P＜0.05). [结论]氟性骨损伤患者血清DKK-1表达水平较低,提示高氟暴露可以致机体DKK-1蛋白表达下调,导致氟性骨损伤的发生.     

Dietary-Lifestyle Patterns Associated with Bone Turnover Markers,and Bone Mineral Density in Adult Male Distance Amateur Runners—A Cross-Sectional Study

Background: Excessive mileage can be detrimental to bone mineral density among long-distance runners. The negative effects of mileage could be alleviated by appropriate nutrition. The purpose of this study was to analyse the dietary-lifestyle patterns in relation to bone mineral density and bone turnover markers among amateur marathoners. Methods: A total of 53 amateur male distance runners were divided into two clusters by k-means cluster analysis. Bone mineral density was measured by dual X-ray absorptiometry (DXA). Blood was drawn to analyse bone resorption marker C-terminal telopeptide (cTX) and bone formation marker amino-terminal propeptide of type I collagen (PINP). Food frequency intake and lifestyle information were measured by multicomponent questionnaire KomPAN^®. Yearly average mileage per month was taken from each participant. Results: There were two distinguished clusters: Less-healthy-more-active-low-Z-score (LessHA) (n = 33) and More-healthy-less-active-high-Z-score (MoreHLA) (n = 20). LessHA had a lower frequency intake of pro-healthy food groups, a lower number of meals during a typical day, and a higher mileage training than the group of athletes who followed the MoreHLA. Athletes following the LessHA pattern also had a lower Z-score in the lumbar spine and femoral bone and a lower PINP. Conclusion: The current study suggests that pro-healthy dietary patterns and lower mileage may favour higher bone mineral density in male amateur marathoners.     

联合检测血清肿瘤标记物在恶性肿瘤诊断中的价值

摘要:目的　探讨联合检测血清肿瘤标记物在恶性肿瘤诊断中的价值。方法　选择2012年3月至2013年3月某院体检中心进行健康体检及门诊就诊患者共14280例。根据恶性肿瘤筛查表结果、患者临床症状及阳性体征综合判断,最终确定恶性肿瘤高危人群3587人,对其血清肿瘤标记物CA125、AFP、CEA、CA19-9、CA72-4、NSE进行检测。对血清肿瘤标记物异常升高患者进行全面检查和长期随访（12个月）。结果　随访1年发现恶性肿瘤患者59例,通过Cox回归多因素分析发现,CA125、CEA、CA19-9、CA72-4、NSE是早期筛查恶性肿瘤的危险因素（P＜0.05）,其中CEA（RR:8.325）、CA19-9（RR:6.761）、CA125（RR:2.231）是重要的危险因素。结论　联合检测血清肿瘤标记物有助于癌症的早期诊断、治疗,而且也是恶性肿瘤的危险因素。     

Depressive Symptoms and Subclinical Markers of Cardiovascular Disease in Adolescents

PurposeTo examine the association between depressive symptoms and subclinical markers of cardiovascular disease (CVD), specifically arterial stiffness, as indexed by pulse wave velocity (PWV), and carotid artery intima media thickening (IMT), in a sample of healthy adolescents, and to explore adolescent hostility as a potential moderator of depression on subclinical markers of CVD.MethodsOne hundred fifty-seven (n = 157) black and white adolescents between the ages of 16–21 completed a follow-up study of psychosocial stress and cardiovascular risk factors that included measures of PWV and carotid IMT. Psychosocial measures included the Center for Epidemiologic Studies Depression Scale (divided into tertiles), and the Cook–Medley Hostility Inventory subscales. Linear regression models controlled for sociodemographic variables, health behaviors, blood pressure, body mass index, and heart rate.ResultsResults show that more severe depressive symptoms were associated with higher levels of PWV (B = .17, R² = .30, ΔR² = .03, confidence interval = 2.2–47.0, p = .03) but not with higher IMT. Adolescent depression remained a significant predictor of PWV when controlling for adolescent hostility; hostility did not moderate the relationship between adolescent depression and PWV.ConclusionDepression may be important in the development of arterial stiffness in adolescence. Further research is needed to delineate the relationship in adolescence and young adulthood between depressive symptoms and the pathogenesis of CVD.     

急性冠脉综合征血清标志物诊断进展

急性冠脉综合征（Acute Coronary Syndrome,ACS）包括不稳定心绞痛（UA）,急性非ST段抬高性心肌梗死（NSTEMI）,急性ST段抬高性心肌梗死等一系列连续的心血管事件。目前主流的理论是将动脉粥样硬化,不稳定斑块,以及伴随的血小板聚集,血栓形成作为其病理生理基础。本文总结了一些关于ACS血清标志物作为辅助诊断的一些进展。