沈阳市1～6岁儿童血铅水平及相关因素的调查

目的：了解沈阳地区1～6岁儿童血铅水平的现状及其影响因素。方法：采用原子荧光光谱法(原子荧光光谱仪AF-610A)测定沈阳市2682名1～6岁幼儿园儿童血铅水平(BPb)，并对其个人及家庭相关因素进行问卷调查。结果：儿童平均BPb98、33μg／L，铅中毒发生率30.21％；乡镇儿童的BPb显著高于城区；儿童平均每天在马路上的时间、父母文化程度、每天是否喝牛奶、父母职业层次、居住楼层是沈阳市儿童BPb升高的主要危险因素。结论：目前我市1-6岁儿童铅中毒发生率接近中国城市儿童平均水平，但BPb均值高于中国城市儿童BPb均值，郊区县儿童的BPb高于城区儿童，应引起注意和重视。     

儿童血铅水平与智力发育关系的研究

目的:探讨呼和浩特市区内学龄儿童血铅水平及其对智力发育的影响。方法:用微量血原子吸收光谱法对32例7~8岁儿童进行血铅测定,采用WISC-R进行智商测定。结果:受测试儿童血铅范围在0.193~0.821μmol/L,平均血铅水平0.417μmol/L,血铅≥0.483μmol/L(100μg/L)13例,占40.6%。高铅组智商(IQ)值低于低铅组。结论:呼市地区儿童血铅状况值得注意,高血铅对儿童智力发育有较大影响。     

胜利油田2～13岁儿童血铅水平流行病学调查

目的了解胜利油田儿童血铅水平及铅中毒的年龄、性别、地域分布特点。方法采用分层整群随机抽样的方法,对胜利油田2~13岁3419名儿童进行末梢血铅含量的测定。结果胜利油田2~13岁儿童血铅水平均值为57.54μg/L,血铅值≥100μg/L者为13.02%,血铅值≥200μg/L者为1.14%。胜利油田中心城区儿童血铅平均值为58.69μg/L,明显高于生活区和远郊地区。随着年龄的增长,血铅水平及铅中毒检出率呈上升趋势。男童血铅平均值60.85μg/L明显高于女童血铅平均值53.75μg/L(p<0.01)。结论(1)与国内外相关报道资料相比,胜利油田2~13岁儿童的平均血铅水平及铅中毒检出率均较低。(2)儿童血铅水平存在明显的性别差异、年龄差异和地域差异。     

临沂市区学龄前儿童血铅水平调查

目的了解临沂市区学龄前儿童血铅水平及铅中毒流行状况.方法采用整群抽样方法抽取临沂市区1 228名学龄前儿童,对其进行血铅含量检测并统计分析.结果 1228名学龄前儿童血铅水平均值为0.366μmol/L (75.8μg/L).其中血铅含量≥0.483μmol/L(100μg/L)者210例,铅中毒率为17.1%.不同性别间学龄前儿童血铅水平均值和铅中毒率均无显著性差异(P＞0.05).结论临沂市区学龄前儿童血铅水平较高,应引起高度重视.     

3992例儿童血铅检测结果分析

目的:为了解儿童血铅水平状况。方法:采用钨舟原子吸收光谱法,检测了3992例(男2550例,女1442例)体检儿童静脉血铅含量。结果:本次调查儿童平均血铅水平(69.6±37.1)μg/L。血铅≥100μg/L的儿童有512例,占总人数的12.8%,其中高铅血症495例,占总人数的12.4%,铅中毒17例,占总人数的0.4%;0岁～3岁组平均血铅水平(60.7±20.5)μg/L,4岁～6岁组平均血铅水平(71.9±39.1)μg/L,7岁～14岁组平均儿童血铅水平(73.6±40.4)μg/L。结论:儿童男女性别间差异无显著性,但随着年龄的增长血铅水平明显升高,血铅水平增高的比例亦相应增加。     

218名儿童血铅含量调查及相关因素分析

目的探讨柳州市城中区3～6岁儿童血铅含量及其影响因素.方法随机抽取柳州市城中区某幼儿园3～6岁218名儿童血样,用原子吸收石墨炉法测定血铅,同时对个人及家庭情况进行调查.结果218名儿童血铅平均值为(0.46±0.20)μmol/L,血铅浓度≥0.483 μmol/L的儿童73名,占总数的33.49%;与血铅水平相关的因素有:儿童的不良习惯、儿童的饮食嗜好、父母从事铅暴露作业、直接进食清晨的自来水、家住大街、公路边等.结论城中区儿童血铅含量处于国内中等水平,应继续引起高度重视.     

湖南省祁阳县学龄期儿童血铅水平现状调查

目的了解湖南省祁阳县学龄期儿童体内血铅水平和外环境铅暴露情况以及分布特征,为科学防治学龄期儿童铅中毒提供依据。方法采用分层单纯随机抽样方法抽取2016年祁阳县工业区黎家坪镇、非工业区下马渡镇、县城关镇6~12岁儿童各200人,采用钨舟原子吸收光谱法测定血铅水平。结果祁阳县600名学龄期儿童体内血铅水平为(73.98±18.21)μg/L,其中血铅水平≥100μg/L者28人,铅中毒率为4.67%,且均为轻度铅中毒;不同地区学龄期儿童血铅水平和铅中毒率差异均有统计学意义(χ~2=12.89,P0.05);男童的血铅含量(75.73±19.16)μg/L高于女童的(72.34±17.14)μg/L,且男童(6.55%)铅中毒检出率高于女童(2.90%),差异有统计学意义(χ~2=4.48,P0.05)。结论祁阳县学龄期儿童血铅水平虽然低于湖南省其他县市,但是长时间、低水平的潜在铅暴露危险性大。相关部门应加强对于人群血铅水平的监测,尤其是学龄期儿童。     

儿童铅中毒的防治

当儿童血铅（BPb）水平≥100μg/L（0.483μmol/L）,不管是否有相应的临床症状、体征和其他血液生化改变,就可诊断为铅中毒[美国国家疾病控制中心（CDC）于1991年制定].有报道我国五个地区0～6岁儿童的血铅水平,见表1.……     

浙江省诸暨市儿童血铅浓度调查分析

目的探讨浙江省诸暨市1～7岁血铅浓度及铅中毒发生率,为开展儿童铅中毒的防治提供理论依据。方法对2009年6～12月间来我院体检的1280名儿童应用LK98B型微量元素分析仪测定血铅浓度。结果 1280例儿童血铅水平平均(65.67±23.26)μg/L,铅中毒发生率为15.63%。男、女童血铅水平及铅中毒发生率分别为(70.13±24.13)μg/L、20.59%和(61.50±24.12)μg/L、10.00%,男童血铅水平、铅中毒发生率高(P0.05)。各年龄组间血铅水平有差异(P0.05),铅中毒检出率随年龄的增大而增加。结论诸暨市儿童血铅浓度偏高,随着年龄的增大,中毒呈增高趋势,应引起高度重视,积极预防儿童铅中毒。     

两种诊断标准下2 141名学龄前儿童血铅水平分析

目的:了解不同诊断标准下北京市丰台区2006年学龄前儿童血铅水平。方法:采取整群分层随机抽样的方法,选择北京市丰台区6所城区幼儿园和6所农村幼儿园在园2~6岁儿童2 141名儿童,测定其血铅值,分别以卫生部《儿童高血铅症和铅中毒分级和处理原则(试行)》和美国CDC制定儿童铅中毒标准为依据进行分析。结果:丰台区学龄前儿童血铅水平均数为73.90μg/L,其中血铅水平≥100μg/L的比例为10.46%;儿童血铅水平存在显著的性别差异,男童血铅水平≥100μg/L发生率高于女童,且具有统计学意义。血铅水平以2岁组儿童血铅水平最高;儿童血铅水平无显著的地域差异,城市儿童血铅水平和血铅≥100μg/L的发生率与农村儿童无差别(P>0.05)。结论:两种诊断标准相比,国内标准引入"高血铅症"概念,缩小了"铅中毒"的范围,但是两种不同的诊断标准,防治原则却基本相同,"高血铅症"同样应引起足够警惕和重视,无论在哪一种诊断标准下,都应积极防治铅损伤,保护儿童健康。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.