全民食盐加碘10年后山西省高碘地区碘缺乏病病情调查

目的了解全民食盐加碘10年后山西省高碘地区碘缺乏病病情变化。方法在山西省应县高碘地区进行饮水含碘量调查,选出水碘>150μg/L的乡(镇),在这些乡(镇)进行高碘病情调查。儿童甲状腺检查采用触诊法,尿碘测定采用过硫酸铵消化砷铈催化分光光度法,智力测验采用中国联合型瑞文测验农村版(CRT-C_2),盐碘测定采用直接滴定法。结果共采集水样568份,发现水碘中位数>150μg/L乡(镇)6个。在6个高碘乡(镇),儿童甲状腺肿大率(7.19%)、隶碘中位数(528.3μg/L)均明显高于加碘曲(5.14%、490.0μg/L);儿童智商水平为107.7±13.2;高碘乡(镇)碘盐覆盖率>90.00%。结论食盐加碘10年后,高碘地区儿童尿碘增高、甲状腺肿大率明显上升,建议在高碘地区应尽快停止碘盐供应。     

河北省高碘地区8～10岁儿童碘营养状况调查

目的调查河北，肯高碘地区8～10岁儿童碘营养状况.方法采用人口比例概率方法抽样，盐碘测定采用直接滴定法，水碘测定采用砷铈接触法，尿碘测定采用过硫酸铵消化-砷铈催化分光光度方法结果检测居民饮用水样85份．水碘中位数为166．0μg／L；测定居民户盐样301份，盐碘中位数为28．8mg／kg，碘盐覆盖率为70．43％；检测8～10岁儿童一次即时尿样363份，尿碘中位数为418．8μg／L，尿碘〉300μg／L为248份，占总数的68．0％：水碘〉150μg／L调查点的儿童尿碘中位数与水碘中位数相关（r=0．539，P〈0．05），而与盐碘中位数不相关，结论河北省高碘地区8～10岁儿童碘营养过剩，碘盐加重了这种状况，应停止供应碘盐。     

山东省黄河下游流域水源性高碘地区调查结果分析

目的 了解山东省高碘水源分布和儿童甲状腺肿流行情况,探讨高碘对人体的危害.方法 在山东省郓城、嘉祥、东昌府3个县(区)的每个乡(镇)各抽取5个自然村,采集饮用水样检测含碘量,水碘测定采用砷铈氧化还原法.在饮水含碘量为150～300μg/L的13个乡(镇),每个乡分别选200名8～10岁儿童进行甲状腺触诊检查,从中选100例做尿碘检查,尿碘检测采用硫酸铵消化砷铈催化分光光度法,再从100例中选50例进行甲状腺B超检查.结果 3个县(区)均有高水碘乡(镇)存在,全部56个乡(镇)中,水碘超过150μg/L的乡(镇)有30个,其中水碘为150～300μg/L的乡(镇)有17个.在13个高碘调查乡(镇)中,有11个乡(镇)尿碘中位数超过400μg/L,其中3个已超过800μg/L;8～10岁儿童甲状腺肿大率触诊法有11个乡镇>5%,B超法有9个乡镇>5%,4个乡镇<5%.结论 黄河下游山东省境内存在着水源性高碘地区和地方性高碘甲状腺肿病区,表明水源性高碘对这一地区已经形成了较为严重的危害.应采取积极措施对这一地方性疾病进行有效地控制.     

高碘地区儿童碘营养甲状腺肿影响因素的研究

目的探讨河北省高碘地区儿童碘营养和甲状腺肿的影响因素。方法采用人口比例概率抽样方法（PPS）。结果有碘盐供应的高碘地区8～10岁儿童尿碘中位数为490．0μg／L，明显高于无碘盐供应点的360．9μg／L。儿童的尿碘中位数与水碘中位数相关（Spearman R=0．539，P=0．038〈0．05），而与盐碘中位数不相关。有碘盐供应高碘地区儿童的甲状腺肿大率为12．1％，高于无碘盐供应地区的8．6％。结论高碘地区水碘是影响儿童碘营养状况的主要因素，碘盐加重了高碘地区儿童的碘营养过剩和对儿童甲状腺的危害。     

内蒙古少数民族地区孕妇及乳母碘营养状况调查

目的了解内蒙古通辽地区孕妇、乳母碘营养状况,为指导本地区孕妇、乳母科学补碘提供依据。方法2011年,按照《全国碘缺乏病监测方案》中的抽样和检测方法,在随机抽样中选择8个旗县（市、区）,重点抽样选择2个旗县及2010～2011年各级盐业公司生产的部分碘盐,随机抽样监测采用直接滴定法（GB／T13025．7—1999）定量测定碘盐;重点抽样监测采用半定量法检测碘盐。共抽检120名孕妇、哺乳期妇女和400名8～10岁儿童尿样,采用过硫酸铵消化砷铈催化分光光度法测定尿碘。采用触诊法检查3963名8～10岁学龄儿童甲状腺肿大情况。结果共检测居民食用盐2328份,其中非碘盐率0．41％,碘盐覆盖率99．59％,碘盐合格率99．11％,合格碘盐食用率98．71％,碘盐中位数31．4mg／kg。重点抽样检测食用盐600份,碘盐覆盖率98．17％,非碘盐率1．84％。共检测120名孕妇、哺乳期妇女及400名8～10岁儿童的尿碘,其中孕妇尿碘中位数345．23μg／L,哺乳期妇女尿碘中位数245．07μg／L,8～10岁儿童尿碘中位数328．3μg／L。共抽检3963名8—10岁学龄儿童,检出甲状腺肿大106名,肿大率2．67％。结论通辽地区碘缺乏病防治工作取得了明显成效,各项指标均达到国家碘缺乏病消除标准。     

2005年北京市碘缺乏病监测结果分析

目的评价全民食盐加碘实施10年来北京市碘缺乏病的预防效果,了解北京市城乡居民碘营养状况,掌握碘缺乏病病情消长趋势。方法采用人口比例概率抽样方法确定监测对象;B超和触诊法检测8- 10岁学生甲状腺大小;尿碘检测用改进的酸消化砷-铈触诊法;食盐含碘量检测按GB／T 13025．7-1999直接滴定法。结果儿童尿碘中位数235．6μg／L,尿碘值<50μg／L的儿童占0．5％;盐碘均值32．1 mg／kg,碘盐覆盖率93．0％,合格碘盐食用率913％;8-10岁儿童甲状腺肿大率1．2％;儿童智商均值114．07。结论北京市学龄儿童碘营养状况达到适宜水平;北京市已经实现了消除碘缺乏病的目标。     

2018—2022年湖北省荆州市碘缺乏病监测及碘营养水平评价

目的 监测荆州市8～10岁儿童及孕妇食用盐碘含量和碘营养水平,为持续消除碘缺乏病和科学补碘提供依据。方法 2018—2022年每年在荆州市8个县(市、区)抽取200名儿童和100名孕妇,采集其家中食用盐盐样和调查对象尿液样本,检测盐碘含量和尿碘含量。对儿童进行甲状腺B超检查,测定其甲状腺容积。结果 2018—2022年荆州市共监测儿童和孕妇食用盐样12 000份,盐碘中位数为24.51 mg/kg,碘盐覆盖率为99.59%,合格碘盐食用率为93.92%。儿童尿样8 000份,尿碘中位数为272.14μg/L,处于碘超适宜量水平。儿童尿碘低于100μg/L比例为6.78%,尿碘高于300μg/L的比例为41.25%,儿童甲状腺肿大率为0.85%。孕妇尿样4 000份,尿碘中位数为169.78μg/L,处于碘适宜量水平,但尿碘低于150μg/L比例占45.10%。结论 荆州市儿童甲状腺肿大率,儿童和孕妇合格碘盐食用率、尿碘中位数均持续符合国家碘缺乏病消除标准,需持续开展碘盐监测和重点人群健康教育。     

周口市8～10岁儿童碘营养状况调查结果分析

目的了解全民食盐加碘地区的水碘水平和儿童碘营养状况,为今后碘缺乏病防治提供科学依据。方法分别在周口市实行全民食盐加碘的10个县(市、区),按照东、西、南、北、中方位和随机原则抽取五所小学,每所小学抽8～10岁儿童50名,男女各半采用触诊法检查儿童甲状腺肿大情况,直接滴定法检测食用盐碘、砷铈催化分光光度测定方法检测儿童尿碘、砷铈氧化还原法检测水碘。结果实施全民食盐加碘12年后,周口市各县(市、区)儿童甲状腺发病率均低于0.78%、碘盐中位数均大于25.40mg/㎏、碘盐率>94.09%、尿碘中位数>159.5μg/L,10个县(市、区)的水碘浓度均﹤10μg/L,儿童尿碘浓度>300μg/L的频数分布均偏高。结论周口市为低碘地区,通过全民食盐加碘已经实现消除碘缺乏病防治目标,但存在尿碘浓度偏高的现象,建议调整食盐加碘浓度,以维持人群适宜的碘营养水平。     

重庆市碘缺乏病高危地区重点人群碘营养状况调查与分析

目的 了解重庆市碘缺乏病高危地区重点人群碘营养状况,有针对性地提出防治对策.方法 2007年4-5月,在重庆市城口、巫溪县的6个乡(镇),搜索所有的1997年1月1日以后出生的疑似地方性克汀病(地克病)儿童;在每个乡分别抽取8～10岁儿童200人,进行甲状腺检查、智商测定和采集尿样测定尿碘;在每乡抽取妇女(孕妇和哺乳期)40人,进行家庭食用盐碘测定和调查居民碘盐覆盖率及采集尿样测定尿碘.儿童甲状腺检查采用诊法和B超法,智商测定采用<中国瑞文联合型测验>(CRT-RC2)农村版,尿碘测定采用酸消化砷铈分光光度法,盐碘测定采用直接滴定法.结果 城口、巫溪县乡镇医院报告疑似地克病6例,排除5例,另外1例为外地出生;8～10岁儿童甲状腺触诊法肿大率为9.58%(92/960),B超法肿大率为8.89%(65/731);儿童平均智商(IQ)为103.32,尿碘中位数为319.15 μg/L;妇女尿碘中位数为248.42 μg/L,居民碘盐覆盖率为98.82%(336/340).结论 重庆市城口、巫溪县儿童碘营养状况良好,未发现当地出生的新发地克病患儿;8～10岁儿童甲状腺肿大率和尿碘,妇女尿碘和居民碘盐覆盖率达到基本消除碘缺乏病标准.     

沧州市碘缺乏病高危地区监测报告

目的了解我市连续两年碘盐覆盖率低于80%地区的居民碘营养状况。方法根据《全国碘缺乏病监测方案（试行）》要求,B超法检测8～10岁儿童甲状腺容积;尿碘检测采用砷铈催化分光光度测定法;盐碘检测：现场进行半定量检测。结果 8～10岁儿童1 500人,甲状腺肿大45人,甲状腺肿大率3.00%;8～10岁儿童尿1 431份,尿碘中位数为206.77μg/L;育龄妇女采尿362份,尿碘中位数196.10μg/L。结论 2007年～2008年连续两年碘盐覆盖率低于80%的县,目前尚未造成人群碘营养不足。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.