2007年青海省碘缺乏病高危地区育龄妇女尿碘调查

Objective To investigate the iodine nourishment in women of child-beating age in high risk region of iodine deficiency disorders (IDD) in Qinghai Province. Methods According to The Notice to Launch a Reinforced Survey on IDD in High Risk Region issued by The Ministry of Public Health, 17 counties in 6 districts were selected as investigated area in Qinghai Province in 2007, using two stage cluster sampling and combining The National IDD Preliminary Surveillance Scheme, 30 women aged from 18 to 40 years were selected in each village, 1 or 2 villages in each town, 3 to 5 towns in each county, who were divided into newly wedding, pregnant, lactation and other women of child-bearing age. Iodine concentration in urine was detected by the method of As3+-Ce4+catalytic spectrophotometry. Results One thousand six hundreds and four urine iodine samples were analyzed. The median was 93.3 μg/L,52.1%(836/1604),31.8%(510/1604) and 12.4%(199/1604) was lower than 100,50 and 20 μg/L, respectively. It was 70.5%(527/747) and 43.0%(128/298) of women in Yushu and Haixi that had urinary iodine lower than 100 μg/L, respectively, while it was 50% of women in the 6 districts, to be specific, 88.3%(91/103) in Nangqian, 83.8% (62/74) in Zaduo and 70.7%(118/167) in Zhiduo Counties respectively. The median of urinary iodine in women who were not lactating and not pregnant was only 88.6 μg/L, of whom 53.9% (763/1415) lower than 100 μg/L. Conclusions The women of reproductive age in high risk region of IDD are deficient of iodine in Qinghai Province.     

Value of radiopaque markers in identifying partial small bowel obstruction

Confirming partial small bowel obstruction is often a diagnostic challenge. In this case report, 4-mm solid radiopaque markers were used in 4 patients to show partial small bowel obstruction. Results of enteroclysis were normal in 2 of the 4 patients, and the markers were used to challenge suspected partial obstruction. The markers coalesced in the region of the partial obstruction, which was confirmed at surgery. Enteroclysis is the examination of choice in the diagnosis of partial small bowel obstruction. However, examinations with false- negative results can occur, particularly with adhesive and/or intermittent obstructions. The use of radiopaque markers in these cases proved an effective and useful method of establishing the diagnosis of partial small bowel obstruction, particularly in the 2 cases in which enteroclysis results were normal. Prospective studies are needed to establish the feasibility of this novel technique. (Gastroenterology 1996 Jun;110(6):1958-63)     

Cell elastimetry in the detection of antineutrophil antibodies

Cell elastimetry has been applied to the measurement of antineutrophil antibodies. This technique measures, under direct visualization, the negative pressure required of aspirate PMNs into small-pored pipettes. Two groups of studies were carried out: (A) In the first group of studies, normal PMNs were incubated with 1 of 8 known antineutrophil serums. Each serum significantly decreased membrane deformability-- i.e., cells became more rigid. The study was conducted in an entirely blind fashion. Randomly coded serums from patients and controls were studied for deformability by observers unaware of the code. (B) In the second group of studies, sera containing immune complexes were incubated with normal PMNs. No significant effects were noted upon deformability. As a single cell assay that partially reflects membrane rigidity, elastimetry may, therefore, have potential in the further characterization of mechanisms by which such antineutrophil antibodies compromise neutrophil functions.     

Viability and functional integrity of washed platelets

The viability and functional integrity of saline- and ACD-saline-washed platelets were compared with those of unwashed platelets. After template bleeding time (TBT) was measured, 15 healthy volunteers underwent plateletpheresis and ingested 600 mg of aspirin. Autologous 111In-labeled platelets were transfused: unwashed (n = 5), washed with 0.9 percent saline solution (SS) (n = 5), and washed with a buffered 12.6 percent solution of ACD-A in 0.9 percent saline solution (n = 5). After transfusion, we measured TBT at 1, 4, and 24 hours; platelet survival at 10 minutes and 1, 4, and 24 hours and daily for 6 days; and the percentage of uptake in liver and spleen by quantitative whole-body radionuclide scintigraphy at 24 and 190 hours. We found that saline washing affected platelet recovery, 23.47 +/- 12 percent (p less than 0.001) as compared to 52.43 +/- 17 percent (p less than 0.002) for ACD-saline and 73.17 +/- 8 percent for control; that saline washing resulted in a greater liver uptake than control and ACD-saline-washed platelets (31.9 +/- 8% [p less than 0.001] vs 17.7 +/- 4.1 and 19.3 +/- 2.1% [p greater than 0.1], respectively); that, unlike control and ACD-saline-washed platelets, saline-washed platelets did not shorten bleeding time; and that neither type of washing affected survival. Although ACD-saline washing affects recovery, it also results in intact function, normal survival, higher recovery than SS platelets, and no significant liver uptake.     

Rate-Responsive Pacing: Clinical Experience

Single chamber, rate-responsive pacing is emerging as a new modality in cardiac pacing and in ihe near future, dual chamber rule-responsive pacing may be the optimal solution for most pacemaker patients. In this report we describe our short- and long-term clinical experience with two different rate-responsive pacemakers: the RS4, an asynchronous atrial sensing ventricular pacemaker, and the TX-pacemaker, which senses the evoked QT after a ventricular paced beat, as an indicator of metoholic demand. Both systems use a single ventricular lead. Nine palients received RS4 and 10 palients received TX units. All of these patients had AV block and good ventricular function except for three patients with sinas node disease in the TX group. Between 1 and 3 months after implantation, a 24-hour Holter monitoring was performed, durifig which two maximal symptom-limited treadmill exercise tests (Bruce protocol) were conducted in VVI (70 bpm) and rate-responsive modes, in a random fashion. The mean follow-up was 25 months in RS4 group and 10 months in TX group. Significant improvements in patient exercise tolerance were found in the rate-responsive mode (9.0 vs. 6.6 METs in VVI) with similar results in both groups (RS4 and TX) despite higher ventricular pacing rates in the TX group (721 bpm vs. 102 bpm in RS4). An autolimited rate-responsive pacemaker-mediated tachycardia, induced by retrograde ventriculoatrial conduction, was observed in a patient with an RS4. There are still many problems with these units; at the end of follow-up, only 4 out of 9 with the RS4 unit and 9 out of 10 with the TX unit have pacers that are functioning properly. Single chamber rate-responsive pacing should be considered as a step forward in cardiac pacing.     

Composition of peripheral blood progenitor cell components collected from healthy donors

BACKGROUND: Peripheral blood progenitor cell (PBPC) components are being collected from healthy donors for allogeneic transplantation, but the quantity, quality, composition, and variability of PBPCs collected from healthy people given granulocyte-colony-stimulating factor (G-CSF) have not been evaluated. STUDY DESIGN AND METHODS: PBPC components were collected from 150 healthy people who were given G-CSF (5, 7.5, or 10 microg/kg/day) for 5 days. The components were evaluated for white cell (WBC), mononuclear cell, CD34+ cell, neutrophil, platelet, and red cell (RBC) composition. RESULTS: The quantities collected were: WBCs, 35.0 +/? 16.4 × 10(9) (range, 11.9–163.3 × 10(9)); mononuclear cells, 33.3 +/? 14.4 × 10(9) (range, 11.9–139.6 × 10(9)); CD34+ cells, 412 +/? 287 × 10(6) (range, 70–1658 × 10(6)); neutrophils, 1.71 +/? 3.59 × 10(9) (range, 0–27.6 × 10(9)); RBCs, 7.2 +/? 4.0 mL (range, 0–22.1 mL); and platelets, 480 +/? 110 × 10(9) (range, 250–920 × 10(9)). PBPC components collected from people given G-CSF at 7.5 or 10 microg per kg per day contained significantly more CD34+ cells (respectively, 428 +/? 300 × 10(6); range, 70–1658 × 10(6) and 452 +/? 294 × 10(6); range, 78- 1380 × 10(6)) than those from people given G-CSF at 5 microg per kg per day (276 +/? 186 × 10(6); range, 91–767 × 10(6)) (p = 0.007 and p = 0.002). When 10 microg per kg per day of G-CSF was given, 50 percent of the components contained enough CD34+ cells for transplantation to a 75- kg recipient (375 × 10(6) CD34+ cells), but 10.6 percent of the components contained less than 150 × 10(6) CD34+ cells and thus would provide a transplantable dose only for a 30-kg patient. CONCLUSION: One PBPC component collected from a healthy donor given 7.5 or 10 microg per kg per day of G-CSF should contain 70 to 1660 × 10(6) CD34+ cells, with 0 to 22 mL of RBCs. Because of the great variability in the number of CD34+ cells collected, the quantity of CD34+ cells in each component should be measured after each procedure to ensure that sufficient quantities of cells are present for a successful transplant.     

In vivo viability and functional integrity of filtered platelets

The in vivo viability and functional integrity of filtered platelets were compared with those of nonfiltered platelets in a controlled study. On two occasions, after template bleeding time, 14 healthy volunteers underwent plateletpheresis and received 600 mg of aspirin. Autologous 111In-labeled platelets were transfused without further manipulation (control) on one occasion and after filtration on a second occasion. The filter was primed and flushed with a buffered 12.6-percent solution of ACD-A in 0.9-percent normal saline (pH 6.5). After transfusion, the bleeding time was measured at 1, 4, and 24 hours and platelet survival at 10 minutes; 1, 4, and 24 hours; and daily for 6 days. The decrease in the bleeding time was not significantly different from that after transfusion of nonfiltered platelets (p greater than 0.2). Filtering of platelets did not affect 1-hour in vivo recovery (filtered, 69.5%; nonfiltered, 66%: p = 0.56) or the platelet survival (filtered platelet t1/2 = 83.0 hours, nonfiltered platelet t1/2 = 82.9 hours: p = 0.96). It can be concluded that filtration does not adversely affect in vivo recovery, survival, or functional integrity of platelets.     

Role of arginase in killing of schistosomula of schistosoma mansoni

Nonspecific resistance to the multicellular organism Schistosoma mansoni can be induced in mice by several infectious agents. We utilized the observed genetic restriction of such acquired resistance to study the mediators of killing of the larval stage of S. mansoni in vitro. Adherent peritoneal cell monolayers from Corynebacterium parvum-treated C57BL/6J but not from C. parvum-treated BALB/cJ mice killed an increased proportion of schistosomula in 24 h. Activated macrophages (M) from both strains exhibited enhanced H(2)0(2) production after incubation with the parasites or phorbol myristate acetate. Thus H(2)0(2) production was not associated with schistosomula killing. Moreover, schistosomula killing was unaffected by catalase or superoxide dismutase. In contrast, activated C57BL/6J (but not BALB/cJ) M released fourfold more arginase into supernates than control M. Schistosomula killing by these M correlated with arginase content of the supernates, was exaggerated in arginine-poor medium, and could be blocked by the addition of arginine. Exogenous bovine arginase added to Fischer's medium without macrophages produced comparable parasite mortality. Our data suggest that arginase is a critical mediator of in vitro killing of this multicellular organism by activated macrophages.