学龄前儿童血铅水平与体液免疫的关系

目的 探讨血铅水平对学龄前儿童体液免疫的影响.方法 采用石墨炉原子吸收光谱法对560名学龄前儿童进行血铅测定,根据血铅水平设高铅组和低铅组(对照组).分别对两组儿童用免疫比浊法测定免疫球蛋白(IgA、IgG、IgM)水平.高铅组及对照组均给予钙剂,2个月后两组儿童再次进行免疫球蛋白、血铅水平测定.结果 高铅组血铅水平由原来的142.8±11.9 μg/L下降到91.5±8.2 μg/L (P＜0.05),免疫球蛋白IgA、IgG水平分别由治疗前的0.63±0.16 g/L、6.20±1.37 g/L升高到0.96±0.29 g/L、9.47±2.05 g/L (P＜0.05);对照组免疫球蛋白IgA、IgG、IgM水平与补钙前比较,差异无统计学意义(P＞0.05).结论 高血铅对学龄前儿童体液免疫功能有一定的影响.补钙是一种安全有效的排铅方法之一.     

惠东县5141例儿童血铅检测的结果与分析

目的 调查本地区儿童血铅水平及其影响因素,为制定干预措施提供依据.方法 采用BH-2100钨舟原子吸收仪共检测5141份3～6岁儿童末梢血血铅含量,并对不同区域儿童的血铅水平、男女童血铅检测结果进行比较分析.结果 城区组血铅水平为(69.05±23.90) μg/L;鞋工业乡镇组血铅水平为(75.85±26.40) μg/L;海岛山区组血铅水平为(65.29±22.00) μg/L;受检儿童中血铅浓度≥100 μg /L有328例(6.38%);男童血铅水平高于女童,差异有显著性(P<0.01).结论 儿童的血铅水平存在明显的区域差异,鞋工业乡镇组较高;应加强对儿童血铅筛查,防止铅污染环境而影响儿童健康;在儿童保健中应科学合理地推行铅中毒的防治,改善儿童健康教育状况.     

南宁市学龄前儿童血铅水平对体格发育和心理行为影响的研究

目的:探讨南宁市学龄前儿童血铅水平(BPb)对体格发育和心理行为的影响.方法:对南宁市624名2～6岁学龄前儿童进行血铅、体格发育、血红蛋白以及心理行为的测定.结果:以美国国家疾病预防控制中心制定的铅中毒标准(血铅水平100μg/L)为界线,2～岁组、4～岁组和总体男童血铅水平显著高于女童(P＜0.05);男女童各年龄组间血铅水平差异无统计学意义(P＞0.05);2～岁组、3～岁组和总体男童的铅中毒检出率显著高于女童(P＜0.05);男女童各年龄组间铅中毒检出率差异无统计学意义(P＞0.05);学龄前儿童血铅水平对身高和体重达标率及贫血发生率的影响差异均无统计学意义(P＞0.05);血铅水平≥100 μg/L的学龄前儿童交往不良、躯体叙述攻击和多动违纪行为的发生率显著高于血铅水平＜100 μg/L的学龄前儿童(P＜0.05).结论:南宁市学龄前儿童血铅含量存在性别差异,而且血铅水平对学龄前儿童心理行为具有一定的影响.     

学龄前儿童血铅水平研究

目的　了解北京市推广使用无铅汽油后学龄前儿童血铅水平。方法　采用ASV方法对 136 0名 2～ 6岁保健门诊儿童血铅水平进行测定 ,同期检测 6 16名幼儿园儿童并比较。结果　检测 1976名儿童中 ,铅中毒 (血铅水平 >10 μg/dl,1μg/dl=0 .0 4 83μmol/L)儿童 2 5 8人 ,占 13.1% ,幼儿园和儿童保健门诊儿童平均血铅水平分别为 (4 .93± 3.3) μg/dl、(6 .6 2± 4 .5 7) μg/dl,两组间差异有显著性P <0 .0 0 1。 结论　北京市儿童血铅水平及流行率明显下降 ,幼儿园儿童低于保健门诊儿童。     

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。     

585名学龄儿童血铅水平测定分析

目的:探讨呼和浩特市学龄儿童血铅水平及铅中毒现状.方法:采用原子吸收光谱法对受测试儿童进行血铅测定.结果:受测试的585名7～12岁儿童血铅平均值为52.14 μg/L,其中47名儿童血铅≥100 μg/L,铅中毒率为8.03%;不同年龄组间血铅水平及铅中毒率差异无统计学意义;不同性别儿童血铅水平及铅中毒率比较差异有显著性意义.结论:呼和浩特市学龄儿童血铅水平不容忽视.     

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.     

抽动障碍患者血清多巴胺的测定及意义

[目的]了解抽动障碍(Tic Disorders)患者血清多巴胺的水平,探讨各亚型之间血清多巴胺的水平是否存在差别.[方法]应用德国DLD公司提供的多巴胺酶联免疫吸附试剂盒测定38例抽动障碍患者血清多巴胺并与22例正常儿童(对照组)进行比较.[结果]病例组血清多巴胺为(4.2±3.8)μg/L,对照组为(6.7±5.4)μg/L,两组各均值比较,差异有显著性(P＜0.05).病例组各亚型血清多巴胺中位数分别为3.5 μg/L,3.1 μg/L,1.8 μg/L,三者比较,差异无显著性(P＞0.05).[结论]抽动障碍患者存在多巴胺的水平异常,各亚型血清多巴胺水平无明显差别.     

淮南市1993名居民血清AFP及CEA水平放免测定

目的:了解淮南市居民的血清甲胎蛋白(AFP)及癌胚抗原(CEA)水平,以供临床检验参考和原发性肝癌的普查.方法:采用放射免疫法进行测定.结果:正常成人血清AFP男性为10.64±8.98 μg/L,女性为9.10±5.53 μg/L,差异有显著性(P＜0.01).血清CEA男性为7.23±4.13 μg/L,女性为7.52±5.63 μg/L,差异无显著性(P＞0.05),故正常参考范围为7.28±4.46 μg/L;并发现1名女性肝癌患者,其血清AFP异常升高,＞4 000 μg/L.CEA检测中未发现异常升高者.结论:该市人群血清AFP及CEA水平无异常变化,而放免法测定血清AFP可作为肝癌普查的有效指标.     

儿童多动症与血铅、锌水平关系的研究

目的:探讨儿童注意缺陷/多动障碍(ADHD)与血铅和血微量元素水平的关系。方法:采用整群抽样的方法,对禅城区托幼园所1～7岁儿童约5000人血液微量元素铅锌值进行测定及ADHD问卷调查健康体检普查的5000例儿童中筛查并确诊ADHD患儿90例,对其进行分析。结果:ADHD患儿血铅水平109.5±24.9μg/L高于对照组(99.2±13.4μg/L),两组比较差异有显著性(P<0.01);ADHD患儿血锌、钙水平分别为12.3±2.1μmol/L、2328.1±64.7μmol/L低于对照组(13.6±2.1μmol/L、2360.9±104.7μmol/L),两组比较差异有显著性(P<0.01,P<0.05);血铅与血锌呈负相关(P<0.05)。结论:轻度铅中毒、锌、钙缺乏可能是ADHD的病因之一,在诊治ADHD时,应采取相应的检测、治疗手段。     

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.