尿酚在苯的生物学监测实用价值的评估

本文以苯的新型生物学指标粘康酸的对照，评估了尿酚在不同苯接触浓度下的生物学监测效果，选择了三个接触的不同苯浓度范围工厂内的３２６名工人为研究对象，结果三个工厂受检者接触苯浓度的范围与几何均值分别为０．２９～８．６７ｍｇ／ｍ＾３，３．１２～５６．８７ｍｇ／ｍ＾３，１７．２５～３６８．５２ｍｇ／ｍ＾３与２．５３ｍｇ／ｍ＾３，２１．０１ｍｇ／ｍ＾３，９４．０７ｍｇ／ｍ＾３而尿酚与空气苯的相关系数分别为０     

苯的两种生物标志物现场应用价值的比较

选择了８６名苯接触工人进行现场研究。结果表明当空气苯浓度的几何均值为３１．８６ｍｇ／ｍ３时，代谢物粘康酸的几何均值为３．１５３ｍｇ／ｇ，尿酚则为３１．０２７ｍｇ／ｇ。接触的空气苯浓度分别与代谢物粘康酸和尿酚之间的相关系数为０．９０１２、０．７３０１。接触低浓度苯的人群尿酚与外接触的苯水平相关性较差；但粘康酸无论是在接触高的或低的苯浓度情况下，二者之间均有良好的相关性。粘康酸在对照组检出水平极低。提示：粘康酸可替代尿酚作为苯的生物学监测指标     

尿粘康酸在苯的生物监测中的应用价值

为研究苯暴露的生物标志物，应用改进的高压液相色谱法检测了１２８名苯接触工人及４０名对照人群的尿粘康酸含量，同时测定了其尿酚含量。结果表明，当空气苯浓度为４１．４９ｍｇ／ｍ３时，接触工人的尿粘康酸含量为（５．４７±７．９４）ｍｇ／ｇＣｒ，尿酚为（３９．０９±４２．５９）ｍｇ／ｇＣｒ。对照人群的尿粘康酸含量为（０．１３±０．０９）ｍｇ／ｇＣｒ，尿酚为（１６．０１±１１．３３）ｍｇ／ｇＣｒ（均为肌酐校正值，ｘＧ±ｓ）。苯接触工人的尿粘康酸含量与所接触的空气苯浓度及尿酚含量呈良好的相关，相关系数分别为０．９１８７，０．８２０４。尿粘康酸在人群中本底值低，反映苯的内吸收情况比尿酚更特异、敏感，更适于低浓度苯暴露的生物监测。     

尿中粘康酸HPLC方法检测在苯生物监测中的应用研究

尿粘康酸是苯代谢产物中的一个极小分支，由于其在体内极低的本底值而受到重视。本研究采用强阴离子交换树脂预处理尿样，用ＨＰＬＣ—ＵＶ检测苯作业工人班前班末尿粘康酸浓度，并与尿酚及个体苯加权平均浓度进行相关分析。研究发现，苯作业工人尿粘康酸与尿酚、苯加权平均浓度三者之间良好相关，尿粘康酸比尿酚具备更好的敏感性与特异性，并能在个体苯加权平均浓度约３．８ｍｇ／ｍ￣３水平区分个体苯接触，尿粘康酸在苯生物监测中前景广阔。     

苯接触的生物监测指标初步评估

目的：探索可客观反映职业性苯危害的灵敏指标。方法：测定苯作业车间空气苯浓度和３３名苯作业工人及４名非苯作业工人志愿者苯接触后呼出苯浓度、血苯含量及尿酚排出量，并进行相关性分析。结果：空气苯浓度（４．５～３４８ｍｇ／ｍ３）与血苯含量呈明显正相关（Ｐ＜０．０５）；血苯含量与尿酚排出量呈非常显著正相关（Ｐ＜０．０１）。结论：在低浓度苯接触时，血苯是一个与毒性相关联的特异性敏感苯吸收指标；尿酚排出量可用作高浓度苯接触工人的生物监测指标。     

高压氧对苯中毒预防作用的实验研究

将大鼠置实验用高压氧舱内,在２个大气压下吸９９５％纯氧,每天２ｈ,连续５ｄ,最后一次吸氧后,即给予低、高两种浓度（４５０ｍｇ／ｍ３、３００ｍｇ／ｍ３）的苯染毒,测定血中超氧化物歧化酶（ＳＯＤ）,丙二醛（ＭＤＡ）及谷丙转氨酶（ＡＬＴ）;尿中尿酚、反,反—粘康酸。结果：吸氧高浓度苯（４５０ｍｇ／ｍ３）染毒组较不吸氧高浓度苯染毒组ＡＬＴ、反、反—粘康酸显著下降（Ｐ＜００５）;ＭＤＡ显著上升（Ｐ＜００５）,而ＳＯＤ、尿酚则变化不明显。低浓度苯染毒大鼠吸氧组除尿酚,反、反—粘康酸较不吸氧组升高较为明显外（无统计学意义）,其余均无明显差异。结论：高压氧只能降低高浓度苯中毒的危险性,对低浓度苯染毒作用不明显。     

尿粘康酸作为苯接触人群生物学监测的指标

尿粘康酸作为苯接触人群生物学监测的指标曾年华，彭桂福，杨爱初，周炯亮，吴春刚通常认为尿酚是苯暴露者最方便的生物监测指标，但在空气苯浓度较低时，尿酚则缺乏特异性和敏感性，难以准确反映人体对苯的内吸收情况。因此，有必要应用新的、敏感的指标替代尿酚作为低浓...     

空气苯浓度与呼出苯及尿酚的关系研究

目的对苯接触水平和接触者可能受到的有害影响进行卫生学评价。方法对１０名苯接触者和６名志愿苯接触者进行研究,用苯呼出气作为生物学监测指标。结果班前呼出苯大多为未检出,班中及班后呼出苯与空气苯时间加权平均浓度均有密切相关;班前尿酚与空气苯时间加权平均浓度无相关,班后尿酚及次晨尿酚均与空气苯ＴＷＡ浓度密切相关;班中、班后呼出苯均与班后尿酚及次晨尿酚密切相关,且以班中呼出苯与班后尿酚的相关性最高（ｒ＝０．９３５３）。呼出苯的快速排出相为脱离接触１０分钟（占班后呼出苯８２．２５％）,其排出稳定相在脱离接触后９０分钟左右。接触空气苯浓度ＴＷＡ７．９～２１７．８ｍｇ／ｍ３时,无论是呼出苯或尿酚在接触后２４小时与空气苯均无相关。结论在呼出苯的快速排出相采集终末呼出气可反映工人当时的接触浓度,采集排出稳定相终末呼出气,其浓度较稳定可反映接触者吸收入血液的浓度,并以此来估测环境浓度与接触水平。呼出苯的呼吸排出规律以及采样方便、无损伤,检出灵敏,呼出苯作为接触水平监测指标较其他指标优越。     

尿粘康酸作为苯内接触剂量的应用

为将尿粘康酸（ＴＴＭＡ）应用于苯接触人群的检测，应用高效液相色谱－紫外检测器系统检测苯接触人群尿ＴＴＭＡ。结果显示，尿ＴＴＭＡ在苯接触人群中有显著增加，随着空气苯浓度的增加，尿ＴＴＭＡ增加显著，显示出良好的相关关系（ｒ＝０．９４０，Ｐ＜０．０５）。当苯接触浓度为均值２．４６２ｍｇ／ｍ３时，接触人群尿ＴＴＭＡ与对照组相比，其差异具有统计学意义。提示，尿ＴＴＭＡ可作为苯接触特异、灵敏的生物检测指标，尤其对于低苯接触。尿ＴＴＭＡ在男女苯接触人群中差异无显著性。甲苯可抑制尿ＴＴＭＡ的形成。应用协方差分析可粗略校正甲苯的混杂作用。     

呼出苯和血苯作为生物接触指标的研究

对两皮鞋厂的３０名（男１１名，女１９名）苯作业工人，分别监测其呼出苯、血苯、尿酚浓度和车间空气苯以及呼出苯的毒代动力学观察。结果表明各指标间都有明显的正相关（Ｐ＜０．０１）和好的线性关系。班前呼出苯分别为０．０２６（停止接触４０ｈ）和０．１３６ｍｇ／ｍ３（停止接触１６ｈ）；血苯班前班后平均浓度分别为３．２ｌ和１０μｇ／Ｌ；班前班后血／气分配系数分别为６．６７和７．６０。１６ｈ衰减率达９９％以上。故以呼出苯和血苯作为职业性苯接触的生物监测指标，简便、灵敏、特异性好。     

白藜芦醇的雌激素样作用研究

为研究白藜芦醇在体内的雌激素样作用 ,给刚断乳小鼠分别皮下注射和灌胃不同剂量的白藜芦醇 ,观察该物质对子宫和阴道的影响。结果显示 ,2 0mg kg .BW的白藜芦醇可明显促进未成熟小鼠阴道开口 (P <0 0 5 )和阴道上皮角化 ,显著增加子宫重量及其系数 (P <0 0 5 ,P <0 0 1) ,并可使子宫内膜柱状上皮增厚或腺体增生。结果表明白藜芦醇在体内具有雌激素样作用。而口服白藜芦醇的雌激素活性明显弱于皮下注射     

A study of tubular potassium secretory capacity in older patients with hyperkalaemia

Objectives: Sustained hyperkalaemia usually indicates a defect in renal potassium (K⁺) excretion and can be due to severe impairment of glomerular filtration rate (GFR). The major determinants of renal K⁺ secretion were studied in hyperkalaemic and normokalaemic elderly subjects to probe the major determinants of hyperkalaemia in this setting.Design: The transtubular potassium gradient (TTKG) provides an index of tubular K⁺ secretion and normally rises in patients with significant hyperkalaemia. Both GFR(glomerular filtration rate) and TTKG were assessed at baseline and repeated after 3 hours following ingestion of 0.1mg of fludrocortisone in three groups.Setting: An acute general hospital in the West of Ireland.Participants: 23 subjects in total; 8 older patients with unexplained hyperkalaemia (OHK), 8 older patients with normokalaemia (ONK) and 9 young normokalaemic controls (YNK).Measurements: The GFR was either measured by 24 hour creatinine clearance estimation or calculated using the Cockroft and Gault formula.TTKG was calculated using a specific formula.Results: Mean baseline TTKG was similar in all three groups and consequently inappropriately low in hyperkalaemic subjects. Three hours post fludrocortisone, the TTKG had risen significantly from baseline levels in the young subjects only (from 7.5+/-0.09 to 11.6+/-1.1, p<0.05). No significant increase was noted in either older group at this timepoint.Conclusions: The inappropriately low baseline TTKG in the OHK group as well as the absence of a response to fludrocortisone indicate tubular insensitivity to aldosterone. GFR values in both OHK (40.06+/-2.31) and ONK (55.58+/-6.1) groups were significantly lower than those in the YNK group (101.66+/-6.9). In aggregate, these findings indicate that older hyperkalaemic patients typically have both impairment of glomerular filtration and renal tubular K⁺ secretion and highlights the requirement for vigilance in elderly patients when using medications which interfere with tubular function.     

野战医疗队配属陆军部队跨区演练实践

对医院野战医疗队与部队卫生机构联合编组救护所参加大型跨区演练活动进行总结，并梳理联合救护所在演训和保障过程中存在的问题和困难，具有较好的现实参考意义，丰富我军卫勤部队与部队卫勤联合演训的理论。     

Analysis of the reduction of trans-fatty-acid levels in the foods of Argentina

Abstract

Adverse health effects found to be caused by the industrial trans fatty acids (TFAs) encouraged significant changes in the food supply. A working model was implemented based on a multisectoral approach to monitor progress in the reduction of TFAs in compliance with Argentine food regulations. We analysed the fatty-acid profiles of commercial foods over the entire country comparing the results before and after the deadline for the compliance. A 93% adherence in the foods was obtained after the finalisation of the deadline for the compliance with the limited use of partially hydrogenated vegetable oils. The analytical monitoring was a key tool operating for the compliance by the food manufacturers. The industrial TFAs were mostly replaced by semisolid fractions of vegetable oils containing high percentages of saturated fatty acids. Promising innovations for the food industry were established that provided more healthful alternative substitutes for TFAs.     

经腹疝囊隔离术治疗小儿斜疝397例分析

目的探讨经腹疝囊隔离术治疗小儿腹股沟斜疝的临床效果。方法回顾性分析笔者所在医院1985年1月至2005年12月采用经腹疝囊隔离术治疗小儿腹股沟斜疝397例临床资料。结果本组397例（480侧疝）均治愈出院，平均手术时间20min，未发生阴囊血肿水肿等手术并发症。术后随访231例，随访率58．2％，随访时间1～2年，无复发病例。结论经腹疝囊隔离术是治疗小儿腹股沟斜疝简单、有效的手术方式。     

北京和广州市3岁以上人群反式脂肪酸食物消费状况调查分析

目的调查北京和广州两市3岁以上不同人群反式脂肪酸的摄入量以确定反式脂肪酸的高暴露食物以及高暴露人群。方法采用食物频率法调查过去3个月内被调查对象摄入各类含反式脂肪酸的食物的摄入频率以及平均每次的摄入量。结果两市的高暴露食物居第一位的均为植物油,其他食物顺位有所差异。共同的高暴露人群为13～17岁的年龄段人群和在校学生职业人群。结论两市反式脂肪酸高暴露食物与人群有所差异,其原因多样,有待进一步研究。     

动植物油脂中反式脂肪酸测定方法的建立

目的建立适合国内条件的动植物油脂中反式脂肪酸测定方法,为国标方法提供依据。方法选择普通植物油、动物油和氢化植物油三个大类共9种动植物油脂样品,参照国际标准经部分修改,建立了适合国内条件的反式脂肪酸气相色谱分析及用面积归一法定量的测定方法,并进行了重复性测定和实验室间的验证。结果在实验条件下,油脂中脂肪酸可以得到很好的分离;除个别含量极低的脂肪酸外,各脂肪酸组分10次分析结果的相对标准偏差均小于10%,其中反式脂肪酸总和的RSD值在豆油和氢化豆油中分别是2.0%和0.3%;实验室间验证结果也表明,该方法在不同实验室间的结果有很好的一致性,豆油、氢化豆油、猪油三种样品的反式脂肪酸总和的RSD值分别是5.0%、1.1%和4.6%,均远小于10%。结论该检测方法实验室内和实验室间的精密度均较高,且所需仪器比较普及,操作步骤简单易行,分析时间短,适合国内开展,可作为我国动植物油脂反式脂肪酸的测定方法之一。     

TRANS FATTY ACIDS IN FOODS

The trans fatty acid contents of foods as determined by capillary gas-liquid chromatography are presented. Mayonnaise had the least amount and margarine the most.     

Formation of trans fatty acids during the frying of chicken fillet in corn oil

To assess effects of heated edible oils on intake of trans fatty acids (TFAs); the formation of TFAs in cooking conditions was investigated by a frying system model, in which chicken fillet was fried in a commercial corn oil at 170?°C, for 12 frying cycles. The main TFAs detected in chicken fillet were trans C18:2 fatty acids (FAs) and trans C18:3 FAs, which exhibited no significant differences among the frying cycles. Besides, the content of trans C18:1 FAs were very low in all samples on different frying cycles. The intake of TFAs was estimated to be 0.06?g/100?g when chicken fillet fried in this process was consumed. These results suggest that an ordinary frying process upon a commercial corn oil has little impact on the daily TFAs intake.