大骨节病和克山病老病区粮食中T-2毒素和黄绿青霉素污染状况调查

目的观察大骨节病与克山病老病区丰田村和林茂村地产粮食中T鄄2毒素和黄绿青霉素(CIT)的污染状况。方法选40岁以上自愿者作右手X线拍片检查,评估大骨节病历史患病情况;收集文献数据评估克山病历史病情;用ELISA法和高效液相色谱(HPLC)法检测病区地产粮食T鄄2毒素和CIT。结果丰田村和林茂村成人大骨节病患病率很高,是历史上的严重病区。地产面粉中T鄄2毒素阳性检出率为77.78%,T鄄2毒素平均水平为120.64 μg/kg;地产玉米面中CIT阳性检出率为42.31%,CIT毒素平均水平为12.33 μg/kg,均明显地高出本省市场同类粮食。结论丰田村和林茂村是大骨节病、克山病历史上的严重病区,地产粮食中T鄄2毒素、CIT 水平仍然相当高,如果不是当地粮食占居民主食中的比例已经很小(< 20%),这两种病的当前检出率也许达不到现在程度的低水平。     

黑龙江省市售粮食T-2毒素检测与分析

目的 了解黑龙江省市售粮食中T-2毒素水平。方法从黑龙江省64个县中按方位选出生产、生活水平有代表性的13个县,从每个县的粮食市场采集大米、玉米和面粉各10份样品,用ELISA法检验T-2毒素。结果大米130份,阳性样品检出9份,阳性样品中T-2毒素检出量均<50ng／g,均值17.2ng／g。按标准评价,大米显然没有受到污染。玉米130份,43份阳性,阳性率偏高,但检出量没有超过100 ng/g的样品。面粉130份样,检出阳性80份,其中超过100 ng/g的8份,超过200 ng/g的2份,超过250 ng／g的1份,均值58.74 ng／g。按粮食中T-2毒素容许量100 ng／g的国外标准,只有面粉超标,超标率为6.1％。结论 黑龙江省市售粮食中面粉受T-2毒素污染较为严重,认为有出现散发大     

一种人体衰老生物学标志的"可干预性"分析

衰老生物学标志是根据日历年龄来测定一定功能年龄的手段,是确定衰老速度的方法,是延缓衰老药物疗效的标准,是论证健在型衰老的依据[1]。增龄变化、多元组合以及流行病学意义并不能说明指标系作为衰老生物标志的成立,它还必须具有可变性。1　材料与方法1.1　受试者自愿受?..     

中老年人手指骨骨膜增生的观察和分析

目的：观察中老年人手指骨骨膜增生的形态、性质和特点。方法：在我国中东部13个省的18个点区对35岁以上自愿受检者1477例拍右手X线片，观察指骨骨膜增生的形态，部位及发生频率。结果：判认有骨膜增生者379例，检出率25．6％；常见有4种形态多发于食、中、环、小各指近节；男性多于女性；检出率随年龄增加而增高；地区间检出率差异明显；大骨节（KBD）病区检出率62．9％，东南沿海地区接近或低于15．0％；骨关节病（OA）者检出率达81．1％。结论：指骨的骨膜增生可视为OA（含成人KBD）的X线基本表现之一，但不宜单独使用，需注意鉴别。     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

2009年黑龙江省大骨节病历史病区成人颈动脉粥样硬化调查

Objective To assess the prevalence of carotid atherosclerosis in adult patients with KaschinBeck disease(KBD) in endemic area, and to investigate the association between KBD and atherosclerosis. Methods B-mode ultrasound was used to investigate carotid atherosclerosis in patients with KBD over 40 years old in Shanhe farm and Shangzhi city and residents in Shuangcheng county in 2009. Ultrasonography images were saved and graded according to intima media morphology. Results The prevalence rates of carotid atherosclerosis in patients with KBD from the 5 villages affiliated to Shanhe farm were 50.0%(26/52),37.3%( 19/51 ),42.5%(30/71 ),58.2% (39/67) and 44.0% (22/50) , respectively. The prevalence rates of carotid atherosclerosis in patients with KBD from the 5 villages affiliated to Shangzhi city were 63.0% (34/54), 45.3% (24/53), 47.2% (25/53), 60.0% (30/50)and 51.9% (28/54), respectively. The prevalence rates of carotid atherosclerosis in people without KBD in the 5 control villages affiliated to Shuangcheng county were 63.9% (46/72),43.1% (31/72),57.1% (40/70),46.9% (30/64) and 53.0%(35/66), respectively. Ten villages in KBD endemic area and 5 villages in control area were investigated. The prevalence rates of carotid atherosclerosis in the 15 villages were standardized and compared by Wilcoxon test. The differences were not significant between two KBD endemic areas and one control( T = 25.0,24.5,all P ＞ 0.05). There was no significant difference in prevalence of atherosclerosis in the 3 areas(x2 = 0.36, P＞0.05). Comparing the severity of carotid atherosclerosis in 3 locations, the difference was statistically significant (x2 = 15.28, P ＜ 0.05) and there was significant difference statistically between the subjects in Shangzhi city and that in the control group(x2 = 8.92, P ＜ 0.05). There was no significant difference between the detection rate of atherosclerosis and the severity of KBD, and similar results in the grade of atherosclerosis and the severity of KBD were found (x2 = 1.88,5.07, all P ＞ 0.05). Conclusions The prevalence rate of carotid atherosclerosis in historical endemic area in Heilongjiang province is not higher than that in the control area.     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

目的 调查2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化患病情况,探讨水源性高碘与颈动脉粥样硬化发生的关系.方法选择山东省郓城县和巨野县作为高碘病区和对照区,以郓城县的大陈楼村、魏垓村、刘一村和二十里铺村为高碘病村,以巨野县的章西村、毕海南村、夏官屯和祁集村为对照村.利用彩超对40岁以上的高碘病区居民299人和对照区居民323人进行颈动脉粥样硬化检查、诊断和记分.结果大陈楼村、魏垓村、刘一村和二十里铺村4个高碘病村成人颈动脉粥样硬化检出率分别为47.1%(33/70)、62.2%(51/82)、67.5%(52/77)和58.6%(41/70);章西村、毕海南村、夏官屯和祁集村4个对照村成人颈动脉粥样硬化检出率分别为40.7%(35/86)、40.8%(31/76)、38.2%(34/89)和37.5%(27/72).高碘病村和对照村成人颈动脉粥样硬化检出率按年龄标准化后分别为45.81%、58.18%、61.63%、55.34%和34.66%、36.25%、43.01%、41.30%,高碘病村的检出率高于对照村(T=26,P＜0.05).高碘病区299人中,检出阳性163人、阴性136人,0分136人、1～3分120人、4～7分43人;对照区323人中,检出阳性122人、阴性201人,0分201人、1～3分87人、4～7分35人.高碘病区与对照区成人颈动脉粥样硬化阳性检出情况及病变严重程度比较,差异有统计学意义(x2值分别为17.54、18.42,P均＜0.01).结论高碘病区成人动脉粥样硬化检出率增高、病变严重程度增大.

Abstract：

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

成人大骨节病膝关节间隙的X线观察

目的 观察成年大骨节病患者膝关节间隙改变情况,为进一步进行的干预试验做基础准备.方法 2007年在黑龙江省尚志市光辉村对40岁以上的成人进行大骨节病临床检查,典型病例拍摄双侧膝关节X线片,测量关节间隙.每个膝关节内、外上髁关节面各取外、中、内3个点,记录测量结果.结果 病村40岁以上人口307人,本次检查282人,检查率为91.9%,检出Ⅰ度以上病例80人,占28.4%.外上髁外、中、内3个部位测量值随着病情的加重明显降低[Ⅰ度分别为(5.85±0.17)、(4.84±0.17)、(4.36±0.18)mm,Ⅱ度分别为(5.11±0.43)、(4.24±0.34)、(3.48±0.28)mm,Ⅲ度分别为(3.59±0.78)、(3.10±0.56)、(2.14±0.62)mm;F外=6.547,F中=5.372,F内=10.302,P均<0.05];而内上髁内、中、外3个部位的测量值并没有出现相同的趋势[Ⅰ度分别为(3.66±0.17)、(3.47±0.17)、(3.73±0.18)mm,Ⅱ度分别为(3.55±0.34)、(3.54±0.29)、(4.35±0.35)mm.Ⅲ度分别为(3.19±0.72)、(3.92±0.66)、(4.51±0.72)mm;F内=0.351,F中=0.356,F外=1.883,P均>0.05].关节间隙<5.00 mm的测量点共618个,内上髁关节面测量点(363个)明显多于外上髁关节面(255个),二者比较差异有统计学意义(χ2=9.59,P<0.05).结论 光辉村成年大骨节病病例较多;伴随病情加重患者膝关节间隙呈变窄趋势,尤以外上髁表现明显;但患者以内上髁狭窄病变为多见.     

主食中T─2毒素含量与手骨关节病检出率关系的观察

对食用3种不同T-2毒素含量主食类型农民的手骨关节病发病水平进行了调查,并按Kellgren/Lawrence的诊断标准作出统计。结果以含T-2毒素较多的当地产面粉（平均278.4ng/g）为主食的农村人群,典型病例检出率51.2%,男性为43.5%,女性为60.0%;以主食来源多样且含T-2毒素相对较低的农村,男性为33.3%,女性为19.4%;以主食大米含T-2毒素最少（平均6.7ng/g）的农村,病情最轻,男性为11.8%的,女性为12.1%。     

腹腔镜与改良Kugel手术在成人腹股沟疝修补术中疗效比较的Meta分析

目的 系统评价腹腔镜腹股沟疝修补术(LIHR)与改良Kugel手术用于腹股沟疝治疗方面的差异。方法 通过检索PubMed、Cochrane Library、Embase、Web Science、CNKI、VIP、CBM和Wanfang数据库,收集LIHR与改良Kugel手术治疗腹股沟疝的中英文对照研究,查找时间为建库至2022年9月。2名独立研究者对检索出的所有中英文文献进行文献筛选和纳入文献质量评估后,再采用RevMan 5.3进行Meta分析。结果 最终共纳入12项研究,4197例患者,其中LIHR组2415例,改良Kugel手术组1782例。与改良Kugel手术组相比,LIHR组术中出血量少(P=0.0004),24 h VAS评分低(P=0.007),术后下床活动时间短(P=0.003),切口感染(P=0.0003)及慢性疼痛发生率低(P<0.00001),长期并发症少(P<0.0001);两组在手术时间、术后复发和短期并发症中差异无统计学意义(P>0.05)。结论 LIHR是一种安全有效的手术方式,与改良Kugel手术相比更具临床优势。