大骨节病患儿Ach和ChE的测定研究

关于大骨节病儿童是否存在神经递质方面的改变的报道甚少。为此我们研究了大骨节病区儿童的全血乙酰胆碱(Ach)含量及其相关酶—胆碱酯酶(ChE)活性的测定。 一、材料与方法 选择山西省目前大骨节病较活跃病区(病情活跃程度指数34.26)中,6～13岁儿童右手X光片干骺端或骨端有明显改变者18例,在非病区选同年龄段儿童X光手片正常者31例。两组生活条件,饮食习惯、居住环境类似。     

山西省2014年碘缺乏病实验室外质控考核结果评价

目的：评价山西省2014年省、市、县三级碘缺乏病实验室尿碘、盐碘、水碘检测能力,以促进检测水平不断提高,为碘缺乏病的流行病学监测和防治决策提供可靠的实验室质量保障。方法尿碘检测结果采用Z 比评分法、盐碘和水碘检测结果采用标准参考值±不确定度进行统计学评价,所有考核结果评价均来自国家碘缺乏病参照实验室的年度考核结果通报。结果省级和11个市级实验室均参加尿碘、盐碘、水碘考核,结果反馈率为100%,考核合格率为100%;全省119个县级实验室全部参加盐碘考核,反馈率和合格率均为100%。结论山西省各级碘缺乏病实验室的检测能力均通过了外质控考核,全部合格,应继续保持,并深入持久地开展质量控制工作。     

地方性砷中毒对机体氧化应激和免疫功能的远期影响

目的 观察地方性砷中毒(简称地砷病)对机体氧化应激及免疫功能的远期影响,为地砷病病区居民的预防和治疗提供科学依据.方法 2009年,在改水5年的地砷病病区(山西省山阴县古城镇四里庄村、大营村、古城村)选取轻、中、重度病例作为轻、中、重度病例组,在当地选择健康人群作为内对照组,另选取非病区(合盛堡乡杨庄村)健康人群作为外对照组.采集观察对象血样,检测氧化应激指标[采用黄嘌呤氧化酶法检测血清超氧化物歧化酶(SOD)活力,采用二硫代二硝基苯甲酸分光光度法检测谷胱甘肽过氧化物酶(GSH-Px)活力、采用硫代巴比妥酸分光光度法检测丙二醛(MDA)水平]和免疫功能指标[采用放射免疫(RIA)法检测免疫球蛋白G(IgG),采用比浊法检测血清溶菌酶].结果 本次共调查了252人,外对照组,内对照组,轻、中、重度病例组分别为56、57、49、44、46人.5组血清SOD活力分别为(72.19±11.75)、(66.96±12.02)、(49.79±11.07)、(48.54±10.56)、(47.68±10.68)kU/L,组间比较差异有统计学意义(F=52.42,P＜0.01),外对照组明显高于其他组别(P均＜0.05),内对照组高于3个病例组(P均＜0.05),病例组组间比较差异无统计学意义(P＞0.05);5组血清GSH-Px活力分别为(197.41±38.54)、(195.02±31.93)、(187.26±28.22)、(187.24±25.40)、(186.88±21.84)U/mg,组间比较差异无统计学意义(H=4.21,P＞0.05);5组血清MDA水平分别为(4.51±2.14)、(5.88±2.00)、(6.44±2.83)、(5.89±2.57)、(5.88±2.40)μmol/L,组间比较差异有统计学意义(F=3.36,P＜0.05),外对照组明显低于其他组别(P均＜0.05),其他组间比较差异无统计学意义(P均＞0.05);5组血清IgG水平分别为(11.16±2.08)、(8.15±1.44)、(8.77±2.54)、(9.19±1.97)、(8.44±2.52)g/L,组间比较差异有统计学意义(H=52.92,P＜0.01),外对照组明显高于其他组别(P均＜0.05),其他组间比较差异无统计学意义(P均＞0.05);5组血清溶菌酶水平分别为(13.57±5.16)、(10.05±3.96)、(8.78±3.35)、(8.72±3.76)、(9.38±4.26)mg/L,组间比较差异有统计学意义(H=35.00,P＜0.01),外对照组明显高于其他组别(P均＜0.05),其他组间比较差异无统计学意义(P均＞0.05).结论 地砷病患者饮用低砷水5年后,砷对机体的氧化应激反应及免疫功能影响仍然存在,地砷病病区在加大除砷改水力度的同时,应加强居民身体状况的监测.

Abstract：

Objective To explore the long-term effect of endemic arsenism on oxidative stress and immune function, and to provide scientific basis for prevention and treatment of the disease in the areas. Methods In 2009, Using cluster sampling and typical investigation, the cross-sectional study was completed. The patient groups and the internal control group were selected in the arsenism areas after 5 years quality improvement of drinking water(Silizhuang village, Daying village and Gucheng village in Shanyin county, Gucheng city, Shanxi province) and they were divided into mild, moderate, severe case and internal control groups, respectively. The external control group was selected in a non-arsenism area(Yangzhuang village in Heshengbu city). The Oxidative stress indicators were determined and analyzed [serum superoxide dismutase (SOD) activity was determined with xanthine oxidase method, glutathione peroxidase(GSH-Px) activity was determined with 2-thio-2-nitrobenzoic acid method, and mmuuity malondisldohyde(MDA) levels was determined with thiobarbituric acid method]. The immune function was determined and analyzed [immunoglobulin G (IgG) was determined with radioimmunoassay method, and serum lysozyme was determined with turbidimetric method]. Results A total of 252 people were surveyed, in which the external control group, the internal control group, mild, moderate and severe patient groups were 56, 57, 49,44 and 46, respectively. Serum SOD activities were (72.19 ± 11.75), (66.96 ± 12.02), (49.79±11.07), (48.54 ±10.56) and (47.68 ± 10.68)kU/L, respectively. The difference of serum SOD activities between the groups was statistically significant(F = 52.42, P ＜ 0.01 ). Serum SOD activities in the external control group were significantly higher than other groups (all P ＜ 0.05). The value in the internal control group was significantly higher than the 3patient groups (all P ＜ 0.05). There were no significant differences between the case groups (P ＞ 0.05). Serum GSH-Px activities of the five groups were (197.41 ± 38.54), (195.02 ± 31.93), (187.26 ± 28.22), (187.24 ± 25.40),(186.88 ± 21.84)U/mg, respectively, and the difference between the groups was not significant(H = 4.21, P ＞0.05). Serum MDA levels of the five groups were (4.51 ± 2.14), (5.88 ± 2.00), (6.44 ± 2.83), (5.89 ± 2.57),(5.88 ± 2.40)μ mol/L, respectively, and the difference between the groups was statistically significant(F = 3.36,P ＜ 0.05). The external control group was significantly lower than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum IgG levels were(11.16 ± 2.08), (8.15 ± 1.44), (8.77 ±2.54), (9.19 ± 1.97), (8.44 ± 2.52)g/L, respectively, and the difference between the groups was statistically significant(H = 52.92, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum lysozyme levels were (13.57 ± 5.16), (10.05 ± 3.96), (8.78 ± 3.35), (8.72 ± 3.76), (9.38 ± 4.26)mg/L, respectively, and the difference between the groups was statistically significant (H = 35.00, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Conclusions The effect of arsenic on the body's oxidative stress response and immune function persists after 5 years of drinking low arsenic water. In addition to intensify arsenic removal from drinking water, it should also strengthen the monitoring of population's health in the diseased areas.     

氢化物发生-原子荧光法分析尿中砷

目的寻找一种灵敏度高、准确可靠、实用性强的尿砷分析方法。方法应用氢化物发生-原子荧光法(HG鄄AFS)测定尿砷。样品处理选用过氧化氢(H2O2)为主、少量硝酸为辅的消解试剂,用控温消解仪消解。结果本方法线性范围为0～200μg/L,相关系数>0.9995,样品回收率91.00%～101.00%。如果取1ml尿样,最低检出限为0.6μg/L。结论本方法灵敏度高,取样量少,线性范围宽,准确可靠,操作简单快速,分析过程中对环境污染少,有利分析人员健康,是一种较好的尿砷分析方法。     

山西省高砷水源筛查和砷中毒病情调查报告

目的掌握山西省高砷区和地方性砷中毒（简称地砷病）病区的流行范围和危害程度，为今后的防治工作提供科学依据。方法根据《全国地方病防治项目方案》，在山西省选择了200个村作为调查村；水砷筛查采用半定量试剂盒法，水砷定量测定采用氢化物发生一原子荧光法（HG—AFS）进行，地砷病诊断按国家地方性砷中毒诊断标准进行，数据处理采用SPsS13．0forwindows软件进行。结果共筛查了234个村，其中有28个村（分布在4个县）水含砷量超过了国家标准（O．05mg／L），水样超标率3．98％，高砷暴露人口21197人。高砷水源普查发现，有19个村水含砷量超过了0．15mg／L。病情普查显示，19个村中除1个村为重病区外，其余18个村均为轻病区。患者病情以中度以下为主，患病人群主要集中于中老年，不同性别患病率比较差异无统计学意义（x^2=3．14，P〉0．05），病情程度与饮用水含砷量高低有关（H=40．31，P〈0．01）。结论山西省发现了新的高砷区和地砷病病区，大部分为轻病区。今后仍应继续进行高砷水源筛查。     

饮水砷暴露居民死因的调查与分析

目的调查饮水砷暴露地区居民的死亡情况。方法运用横断面调查方法，对20个砷中毒病区常住居民1999—2001年的死亡情况进行调查，调查结果按照国际疾病分类（ICD-10）编码分类登记，标化死亡率采用2000年全国标准人口构成进行标化。结果20个砷中毒病区3年累计调查人口33473人，死亡人口256人．粗死亡率764．79／10万．标化死亡率812．59／10万，砷中毒病区居民死亡率明显高于一般人群（u=3．82，P〈0．01）。其中．男性死亡率高于女性（u=2．14，P〈0．05）。各年龄组中儿童、中老年死亡率明显高于一般人群，砷中毒病区居民全死因标化死亡比（SMR）为1．43（95％CI：1．26～1．61，P〈0．05），砷中毒病区居民的前5位死因是呼吸系统疾病、恶性肿瘤、脑血管病、心脏病、内分泌系统疾病。结论饮水砷暴露地区居民的死亡率明显高于一般人群．尤以儿童和中老年明显，死因主要是呼吸系统疾病、恶性肿瘤等慢性疾病为主。     

氟对大鼠脑髓鞘碱性蛋白及髓鞘磷脂质损伤的研究

目的：研究氟对大鼠脑有髓神经髓鞘形态及化学组份的影响，进一步探讨氟对大脑髓鞘碱性蛋白（MBP）及髓鞘磷脂质损伤机理。方法：取饮用含F^－150mg/L水7个月大鼠的脑组织，应用Anti-MBP-HRP免疫组化法标记大脑髓鞘碱性蛋白分布，用组织化学法观察大脑髓鞘脂质改变,MBP－ELISA法分析血清中MBP含量。结果：免疫组化显示，氟中毒大鼠大脑髓鞘染色变浅，髓鞘结构解紊乱和均质化，证明髓鞘MPB缺失或溶解，组化法显示，氟组大鼠大脑髓鞘磷脂溶解，成空泡状或状样变，且染色变浅，说明高氟对髓鞘磷脂产生了破坏作用，实验组动物血清中MBP含量显著升高与对照组比较差异有显著意义，个体间MBP含量高低与免疫组化结果呈相关关系。结论：氟中毒可造成大鼠大脑中枢有髓神经鞘直接损伤，髓鞘MBP缺失，髓鞘脂质解，髓鞘结构被破坏。     

钼与地方性氟中毒关系的探讨

钼与地方性氟中毒的关系,有过不少研究,并存在分歧。为此,作者对饮水型氟中毒病区村的水氟、水钼和主食粮、人发、土壤样品的钼含量与其相邻的非病区村进行了比较分析。1 材料与方法 在全省范围内选择饮水型地方性氟中毒病区村76个,其相邻非病区村73个。每个点采水样1份,土样1份;根据情况采当地产主食粮2种,每种1份;采3名健康儿童枕部头发,混合成1份发样。     

2005-2009年山西省改水降氟工程调查分析

目的 了解山西省改水降氟工程运行及使用现状,为加快地方性氟中毒防治工作提供科学依据.方法 2005-2009年,根据国家<地方病防治项目技术方案>,在山西省实施改水降氟措施的县(市、区),对降氟改水工程运行现状进行调查,并采用氟离子选择电极法检测水氟.结果 本次共调查了51个县(市、区)1658处降氟改水工程,改水工程类型中打井占93.12%(1544/1658),以打井为主.正常运行的改水工程为1405个(占84.74%),间歇运转工程为190个(占11.46%);报废工程为63个(占3.80%),其中大同盆地改水工程报废率达到36.36%(12/33).在1595处可运行工程中水氟＞1.0 mg/L为874个(占54.80%),不同盆地的降氟改水工程超标情况不同(H=33.22,P＜0.01),其中大同盆地超标率达88.37%(38/43),大同盆地改水任务艰巨..结论 全省改水降氟工程运行情况较好,但改水工程水氟合格率较低,各地区改水工程超标情况差异较大,防治形势依然严峻,今后应进一步加大改水工作力度.

Abstract：

Objective To learn the present status of defluoridation water improvement project in Shanxi province in order to provide scientific basis for speeding up the prevention and control of endemic fluorosis.Methods According to "The National Technical Scheme for Endemic Disease Control" from 2005 to 2009, the investigation points were selected in the counties that implemented the measures of water improvement and defluoridation,the status of drinking water defluoridation Project was investigated, and the water fluoride levels were determined by fluoride selective ion electrode. Results The primary status was surveyed in 1658 water improvement and defluoridation projects in 51 counties. The resource of drinking water for water improvement and defluoridation projects was mostly ground water[accounting for 93.12% (1544/1658)]. Among 1658 water improvement and defluoridation projects 1405 projects worked well(accounting for 84.74%) and 190 projects intermittently worked (accounting for 11.46%). Sixty three projects abandoned (accounting for 3.80%), in Datong basin the abandoned projects accounted for 36.36% (12/33). Water fluoride content of 1595 water improvement and defluoridation projects had been determined, among them water fluoride content of 874 projects were above 1.0 mg/L (accounting for 54.80%). The situations of exceeded national standard in the five basins was different(H = 33.22,P ＜ 0.01). The rate of over national standard of fluoride levels in drinking water was 88.37%(38/43) in Datong basin. Therefore, in Datong basin water improvement should be strengthened. Conclusions In Shanxi province the water improvement and defluoridation projects are basically running normally. However, the qualified rate is lower for the water improvement and defluoridation projects. The water improvement status varies dramatically among areas.The situation is still grim in Shanxi province. Water improvement and defluoridation needs to be strengthened to improve the effect of prevention and control of the disease.     

地方性砷中毒对居民免疫功能远期影响

目的 探讨地方性砷中毒对机体免疫功能的远期影响,为砷中毒病区居民的预防和治疗提供科学依据.方法采用整群抽样和典型调查相结合的方法进行现场调查,将改水5年后的砷中毒病区调查者分为轻、中、重度病例组和内对照组,非病区调查者为外对照组；对调查者的免疫功能指标免疫球蛋白G(IgG)和溶菌酶(LSZ)进行测定,采用SPSS 13.0软件对数据进行统计分析.结果调查5个组共252人,所选择的病区村5年前已实施改水,水砷含量符合国家标准(≤0.05 mg/L),各组尿砷含量差异无统计学意义(H=2.698,P＞0.05)；各组IgG含量差异有统计学意义(H=52.923,P＜0.01),外对照组IgG均数为11.16g/L,含量明显高于其他组(P＜0.05),其他组间比较差异无统计学意义(P＞0.05)；各组溶菌酶水平差异有统计学意义(H= 34.998,P＜0.01),外对照组溶菌酶水平为13.57 μ g/ml,明显高于其他组(P＜0.05),其他组间比较差异无统计学意义(P＞0.05).结论地方性砷中毒患者饮用低砷水5年后砷对机体免疫功能的影响仍然存在,砷中毒病区在加大除砷改水力度的同时,应加强居民身体状况的监测.