2001-2005年黔江区燃煤污染型地方性氟中毒监测结果分析

目的了解和掌握近5年来黔江区以改炉改灶为主的综合性防治措施防治燃煤污染型地方性氟中毒的效果,为重庆市制定燃煤污染型地方性氟中毒防治措施提供科学依据。方法通过在黔江区监测点邻鄂镇（2001—2002年）、水田乡（2003—2005年）检查儿童氟斑牙、炉灶使用情况,测定儿童尿氟、粮食氟含量,收集连续5年的资料,进行纵向比较。结果黔江区邻鄂镇与水田乡儿童氟斑牙检出率从41．08％下降到32．80％;儿童尿氟从1．42mg／L下降到0．58mg／L;玉米氟含量在2．74—5．85mg／L之间,辣椒氟含量在4．48—157．95mg／L之间,呈下降趋势;两个乡镇改炉率在59．75％-100％之间,改炉合格率在40．25％-100％之间,呈上升趋势;改灶率38．30％-100％之间,改炉合格率在38．36％-100％之间,呈上升趋势。结论采取以改炉改灶为主的综合性防治措施防治燃煤污染型地方性氟中毒后。儿童氟斑牙、尿氟、粮食氟等氟毒性效应指标得到了改善．提示我们应继续坚持前期的防治措施,并加强健康教育宣传工作,完善炉灶的管理制度。     

重庆市燃煤污染型地方性氟中毒防治调查结果分析

目的了解重庆市燃煤型氟中毒病区的防治现状,为燃煤型氟中毒的防治决策提供科学依据。方法采用分层整群抽样的方法,运用统一设计的居民防治现状调查问卷,对抽查的病区村居民进行问卷调查。调查内容包括病区居民的燃料结构、炉灶使用情况和耕种方式等,计算改炉改灶的合格率、改炉改灶的正确使用率、炉灶的报废率。运用Dean's法检查所有调查村8～12岁儿童氟斑牙患病情况,计算氟斑牙的患病率、氟斑牙指数、缺损率。按照《地方性氟骨症的临床诊断标准》,调查所有病区村16岁及以上的成人,计算氟骨症患病率。结果本次共调查8个病区县9个乡镇12个村4512户,其中使用煤作为燃料的户数为4408户,占97.70%。使用炉灶的户数为4405户,使用率达到97.63%,正确使用率为47.92%。改炉正确使用率为61.77%,报废率为0.38%。改灶正确使用率为46.36%,报废率为0.21%。8～12岁儿童氟斑牙检出率为72.88%,缺损率为8.16%,氟斑牙指数为1.29。16岁及以上氟骨症检出率为1.92%。结论通过20年的以改炉改灶为主的综合性防治,重庆市燃煤型氟中毒病情逐渐减轻,病区类型和数量逐渐减少,说明以改炉改灶为主的综合性防治措施效...     

巫溪县燃煤型氟中毒防治现状

目的 了解巫溪县燃煤型氟中毒病情和防治措施落实进度及发展趋势,为制定防治燃煤型氟中毒措施提供依据.方法 运用Dean's法检查该县所有病区村8～12岁儿童氟斑牙(GB16396-1996)和检查16岁以上成人氟骨症(WS192-1999),计算氟斑牙检出率和成人氟骨症检出率.调查2005-2008年中央转移支付地方公共卫生地氟病防治项目改炉改灶现状,计算炉灶改造率、改炉改灶合格率、改炉改灶正确使用率.2005-2008年在改炉改灶前后分别检测儿童尿氟,计算几何均数.结果 儿童氟斑牙检出率为46.21%,成人氟骨症检出率为0,炉灶改造率为59.52%,合格率为97.16%,正确使用率为97.76%,尿氟几何均数改炉改灶前后均呈下降趋势.结论 巫溪县燃煤型氟中毒病区呈轻微流行,2005-2008年结合中央转移支付地方公共卫生地氟病防治项目进行了大规模的改炉改灶工作,要达到国家75%的目标还需改炉改灶3600余户.     

巫山县燃煤污染型地方性氟中毒健康教育防治试点效果评估

目的：提高病区人群的健康意识，改变不良生活习惯，促使其主动参与预防工作；探索适合我市实际的防治机制。方法：调查柳坪、巫峡两地的地氟病基本情况，针对病区村的家庭主妇，3-6年级学生，乡村干部、医生、学校教师三级目标人群。运用健康教育手段传播地氟病防治知识．调查三级目标人群的地氟病防治知识知晓率。结果：柳坪、巫峡均属地氟病重度流行区，儿童尿氟几何均数为1．22mg／L，玉米、辣椒、土豆、大米、面条的氟含量均数分别为：3．00mg／kg、17．55mg／kg、0．64mg／kg、0．74mg／kg、0．77mg／kg；两个项目村三级目标人群地氟病防治知识得分基线调查分别为：27．04、4．57、未调查；中期评估分别为：92．00、88．41、100．00；终期评估分别为：93．19、99．12、100．00。改炉率100％，改灶率78．14％。结论：通过健康教育，两个项目村地氟病防治知识知晓率有明显提高，防病意识有一定程度的改变；在地氟病病区实施改炉改灶为主的综合措施过程中，地氟病的健康教育工作应先行。     

降氟除氟技术措施推广应用示范研究的防治现状分析

目的了解降氟除氟技术措施推广应用示范研究的6个示范村燃煤型氟中毒的防治现状,为实施降氟除氟技术措施提供科学依据。方法采用整群抽样法对6个示范村进行人户调查,调查示范村居民基本情况、卫生行为习惯、能源结构、健康教育知识知晓情况、炉灶使用等情况,计算居民地氟病防治知识知晓率、炉灶改造率和正确使用率。结果示范村村民饮食结构中,以大米（52．9％）、土豆（33．5％）、玉米（7．3％）、面食（6．3％）为主,其中玉米（6．52％）、薰肉（80．40％）、辣椒（18．07％）存在烤食或烤干的问题。空气氟监测30户中,封火期平均值为0．0083mg／m^3,范围在0．0003～0．0286mg／m^3之间;旺火期平均值为0．0037mg／m^3,范围在0．0003～0．0340mg／m^3之间。灶的改造率为84．23％,正确使用率为50．90％;炉的改造率为95．26％,正确使用率为63．66％,以户为单位的炉灶正确使用率为53．29％。户主地氟病危害知晓率为45．02％,防治措施知晓率为45．50％。结论6个示范村以煤作为主要燃料,以炉灶使用为主,仍然存在烤火取暖和烤食的生活习惯,人体摄入氟的途径中空气氟所占比重加大,村民炉灶的正确使用率低,地氟病危害和防治措施的知晓率均较低。因此,根据病区生活习惯、饮食结构、炉灶使用习惯等因素采取以排出室内空气氟为主的新型降氟除氟技术措施,辅之以改变饮食习惯,进一步加强地氟病危害和防治措施的健康教育宣传,可以达到降氟除氟的目的。     

2007年南安市饮用高氟水改水降氟工程调查分析

了解南安市地方性氟中毒病区改水完成后的患病情况以及改水工程质量，评价改水降氟措施的落实情况及防治效果。方法：抽查全市高氟病区8～12岁儿童79人，按Dean法查其氟斑牙患病情况，再从中采集74份尿样及病区17份水样用电极法测其尿氟及水氟含量。结果：南安市四个地氟病村的改水工程得到维护正常使用1个、新建1个，其他大部分改水设施均已损坏报废，群众饮用水以并自重新打井为主。儿童氟斑牙患病率从改水前53．4％降到改水后18．99％，尿氟中位数1．29mg／L，其中〈1．5mg／L占72，97％，水氟均值0.45mg／L，合格率93．33％。结论：改水降氟是饮用高氟水型地氟病区的主要防治措施，改水工程质量直接关系到地氟病控制成果的巩固，未经验收新的饮用水源存在安全隐患。高尿氟含量可能与当地食物有关。     

燃煤污染型氟病区改灶降氟的研究

燃煤污染型氟中毒病区的形成,主要是病区居民沿用室内明火烧煤的落后方式,使燃煤过程中释放的氟污染了室内空气和食物,从而引起氟中毒的流行。我们通过改变简陋的烧煤方式,在改灶降氟方面进行了研究。改建的炉灶由进风口、炉桥、炉膛、炉盖、烟囱5个部分组成。为使烧煤充分,热效应高,建造炉膛时,设有保温层和回火圈,盖板用铸铁制造。     

奉节县燃煤污染型地方性氟中毒防治效果调查分析

目的 了解奉节县燃煤型氟中毒防治效果,为地氟病防治工作提供科学依据.方法 运用Dean's法检查奉节县所有病区村8～12岁儿童氟斑牙(GB16396-1996),计算氟斑牙检出率、缺损率、氟斑牙指数.对儿童氟斑牙检出率≥30%的病区村全部开展入户调查,调查病区村居民的燃料结构、房屋结构、炉灶使用情况、主食结构等.随机抽查3个病区村150名8～12岁儿童尿氟(WS/T89-1996),计算几何均数.结果 儿童氟斑牙检出率为35.40%,缺损率为1.57%,氟斑牙指数为0.48.病区村由2003年179个降至2009年的120个,达到控制病区村标准的有59个.120个儿童氟斑牙检出率≥30%的病区村中,燃煤使用率87.58%;台灶经常使用率12.70%,有排烟设施的占13.30%;炉子中无排烟设施铁皮炉使用率87.35%,有排烟设施降氟炉使用率12.65%.主食以大米为主,占92.32%.2004年与2008年尿氟几何均数分别为0.84、0.62 mg/L.检测96个病区村玉米和辣椒各480份,氟含量均值分别为(1.73±1.97)mg/kg、(5.34±4.66)mg/kg.结论 奉节县燃煤型氟中毒病区病情呈轻微流行,2004-2008年中央转移支付地方公共卫生专项资金地氟病防治项目的实施取得显著效果.建议加强对现有未达到控制标准的病区村继续实施改炉改灶项目和健康促进工作.     

2013年河南省孟津县燃煤污染型地方性氟中毒防制考核分析

目的：调查河南省孟津县燃煤污染型氟中毒病区现状,考核评价综合防制效果。方法2013年在河南省孟津县燃煤污染型氟中毒病区随机抽取3个乡（镇）,每个乡（镇）随机抽3个病区村,各随机抽取10户居民户,调查所有病区村8～12岁儿童氟斑牙情况,居民户炉灶使用以及乡（镇）中心小学健康教育开展效果。结果调查90户居民户炉灶使用情况,全部正常使用,98.89%的居民户厨房和卧室分离,使用炉灶多样化,电磁炉52户、沼气炉23户、液化气炉13户,冬季使用燃煤取暖的居民户为67.78%;调查333名8～12岁儿童,氟斑牙检出率5.01%;调查166名5年级小学生,防治知识知晓率为100%。结论河南省孟津县燃煤污染型氟中毒病区已经达到消除标准,建议今后进行定期监测,保证防控效果。     

黔南州4县煤氟、植物氟及尿氟检测结果分析

为掌握我州地方性氟中毒，属燃煤型氟病区的煤氟和部分居民家里受煤烟不同程度污染的玉米、稻谷、辣椒的氟含量，为今后通过改灶降氟可控制或大大降低燃煤污染型地氟病的发生和流行提供科学依据。笔于2001年11月首次对龙里、贵定、长顺、惠水4县境内煤厂及部分居民     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.