Treatment of Vitamin B12 Deficiency after Gastric Surgery for Severe Obesity

Background: Vitamin B₁₂ deficiency after gastric surgery for obesity is due to a failure of separation of vitamin B₁₂ from protein foodstuffs and to a failure of absorption of crystalline vitamin B₁₂ in the presence of intrinsic factor. The purpose of this study was to determine which of four oral doses of crystalline vitamin B₁₂ was most effective in treating vitamin B₁₂ deficiency in 102 patients. Methods and Results: At time of entry into the study, the patients had a serum vitamin B₁₂ < 100 pmol L ⁻¹, were 29.9 ± 21.7 months post-op, were 37 ± 8 years old and had a body mass index of 30 ± 6 kg m⁻². Eight (8%) had had a vertical banded gastroplasty and 94 (92%) a gastric bypass. For the first 3 months all patients received 350 μg per day of crystalline vitamin B₁₂ and all increased their serum vitamin B₁₂ levels to over 100 pmol L⁻¹. The patients were then assigned to receive for a further 3 month period one of four oral doses of crystalline vitamin B₁₂-100 μg, 250 μg, 350 μg and 600 μg. Serum vitamin B₁₂ levels were greater than 150 pmol L⁻¹ after 6 months in 83.3% of patients who received 100 μg; 92.3% of patients who received 250 μg; 94.7% after 350 μg and 95.2% after 600 μg (p%0.525). Conclusion: At least 350 μg per day is the appropriate oral dose of crystalline vitamin B₁₂ after gastric surgery for obesity to correct low serum vitamin B₁₂ levels in 95% of patients.     

贵州省1990～1997年麻疹流行病学分析

对贵州省1990～1997年麻疹的流行病学及接种率与发病率的关系进行了系统分析,结果显示：90年代本省麻疹发病率仍停留在较高水平上,下降幅度较慢,每隔4～5年出现一次流行;发病地区分布广泛（91．24％）,但主要流行区为山区和边远少数民族地区;发病季节高峰期延长,2-7月病例数占66．67％;发病年龄以14岁以下儿童为主（86．56％）,但7岁以下儿童占多数（59．02％）．麻疹流行的原因主要是因常规免疫工作不扎实,麻疹疫苗（MV）接种率偏低,免疫空白点较多,引起易感人群的快速积累．提示我省麻疹的预防工作仍处于控制阶段,必须狠抓MV免疫接种工作,确保MV的高接种率和免疫成功率,适时开展MV强化免疫,才能使麻疹发病率快速下降,保证我省麻疹监测工作的顺利开展．     

乙肝血清标记物阳性孕妇的胎盘组织和PBMC的HBVDNA检测及意义

为探讨乙型肝炎病毒（HBV）宫内感染的机理,本文采用原位分子杂交技术,测定了20份外周血HBsAg/HBeAg双阳孕妇胎盘组织和24份HBsAg阳性孕妇外周血单核细胞（PBMC）的HBV DNA,结果发现,胎盘组织HBV DNA均阳性;HBV DNA主要分布于胎盘蜕膜,而绒毛滋养层细胞未见阳性,提示HBV已侵袭胎盘蜕膜,且可能在蜕膜细胞中有复制,但未累及绒毛,PBM HBV DNA测定结果表明,HBV DNA阳性率为58．3％（14／24）,阳性的孕妇中,有2例其婴儿发生了宫内感染。     

儿童肥胖与高血压关系的研究

目的了解儿童肥胖与高血压的关系.方法运用病例对照研究的方法,在包头市小学生中对161对单纯性肥胖儿童及其相应对照进行了研究.结果单纯性肥胖儿童的收缩压、舒张压和高血压患病率均显著高于对照组.肥胖儿童中,肥胖程度越重,高血压患病率越高.结论在儿童时期,预防、控制肥胖是降低高血压及心血管疾病发生的重要措施.     

Systematic Differences in Validity of Self-Reported Mammography Behavior: A Problem for Intergroup Comparisons?

Background. Prior studies of recall accuracy for screening mammogram behavior have examined relatively homogeneous groups. Data are limited on possible systematic group differences, so we evaluated women's recall accuracy in two separate care systems in one city.Methods. Women 50 to 70 years old with and without screening mammograms 10 to 14 months prior were identified from fiscal, clinic, and radiology records at a military care system (MCS) and a county-funded system (CFS) for indigents. Mammogram status was verified through radiology records. Women were excluded if mammograms were diagnostic, done for other than annual screening, or had abnormal results. Interview ers blinded to mammogram status surveyed randomly selected eligible women.Results. For 62 screened/31 unscreened MCS women and 78 screened/61 unscreened CFS women, specificity was similar, at 65 and 62%, respectively. In contrast, sensitivity varied significantly: 95% versus 79% (P = 0.011). Primary ethonocultural groups were Euro-American (MCS—60%) and Mexican American (CFS—85%). Although not different in specificity of recall (67% versus 61%), these major subgroups significantly differed in sensitivity (97% versus 80%, P = 0.017), proportion of true negatives due to never having a mammogram (35% versus 57%, P = 0.003), and proportion with ≥high school education (78% versus 19%, P < 0.00001).Conclusion. Systematic differences in recall validity may exist and compromise the accuracy of intergroup comparisons.     

强直性脊柱炎患者的食管运动功能

研究诱导型一氧化氮合酶 （ｉｎｄｕｃｉｂｌｅ ｎｉｔｒｉｃ 　ｏｘｉｄｅ ｓｙｎｔｈａｓｅ, ｉＮＯＳ）在电离辐射导致的神经细胞凋亡中的作用。 方法：以单剂量２．０ Ｇｙ γ射线照射出生后 ０ ｄ的 Ｗｉｓｔａｒ大鼠,用 ＡＢＣ法检测照射后第 ０．５、１、２、４、６、８、１２、２４、４８小时大脑皮质内ｉＮＯＳ的表达。结果：照射组各时间点均有不同程度的ｉＮＯＳ表达,第６小时达峰值。各对照组未见ｉＮＯＳ表达。结论：ｉＮＯＳ所具有的神经毒作用可能是电离辐射导致的发育中脑神经细胞凋亡的重要因素。     

心肌梗死患者左室舒张功能评价方法的研究

探讨心肌梗死（ＭＩ）患者左室舒张功能的评价方法及临床应用。方法：采用脉冲多普勒超声心动 图技术检测５０例正常人和５０例ＭＩ患者的左房收缩时间间期（ＬＡＳＴＩ）。包括左房射血前期（ＡＰＥＰ）、校正心房射血 前期（ＡＰＥＰＣ）和左房射血期（ＡＥＴ）;肺静脉Ｓ峰、Ｄ峰、Ａ峰;二尖瓣血流Ｅ峰、Ａ峰及Ｅ／Ａ比值。ＭＩ组给予抗舒张 障碍治疗３周后再测量各项指标。结果：ＭＩ组的ＡＰＥＰ、ＡＰＥＰＣ缩短,ＡＥＴ延长;肺静脉Ｓ峰、Ａ峰增大,Ｄ峰减小; 二尖瓣Ｅ峰减小,Ａ峰增大（Ｐ＜０．０１）。ＭＩ组治疗３周后各项指标明显改善（Ｐ＜０．０１）。结论：综合多指标分析能 提高左室舒张功能评价的准确性。     

血清TGA、TMA、T3、T4、TSH鉴别甲亢型桥本甲状腺炎和Graves病

目的：鉴别甲亢型桥本甲状腺炎（ Ｈ Ｔ）和 Ｇｒａｖｅｓ 病（ Ｇ Ｄ）,提高 Ｈ Ｔ 的诊断率,减少 Ｈ Ｔ 手术和不必要的抗甲状腺治疗。方法：以经甲状腺细针穿刺活检或术后病理证实为 Ｈ Ｔ 和 Ｇ Ｄ 的临床表现为甲状腺功能亢进的病人为研究对象,以活检前或术前清晨空腹血清 Ｔ Ｇ Ａ, Ｔ Ｍ Ａ, Ｔ３, Ｔ４ 和 Ｔ Ｓ Ｈ 为检测指标。结果：甲亢型 Ｈ Ｔ 和 Ｇ Ｄ 病人的 Ｔ Ｇ Ａ, Ｔ３ 有明显差异（ Ｐ＜ ００１）; Ｔ３／ Ｔ４, Ｔ Ｍ Ａ, Ｔ Ｓ Ｈ 有显著差异（ Ｐ＜ ０００１）; Ｔ４ 无差异（ Ｐ＞ ００５）。结论：血清 Ｔ３, Ｔ３／ Ｔ４ , Ｔ Ｓ Ｈ, Ｔ Ｇ Ａ 和 Ｔ Ｍ Ａ 可以作为鉴别甲亢型 Ｈ Ｔ 和 Ｇ Ｄ 的重要检测指标。     

人抑制素α亚基单克隆抗体的制备和鉴定

目的：建立分泌抗人抑制素α亚基３７ － ６５ 片段单克隆抗体（ 单抗） 细胞株,并对单抗进行免疫学鉴定。方法：以猪卵泡液粗提物为免疫原,免疫ＢＡＬＢ／ｃ 小鼠,取其脾细胞与ＮＳ１ 小鼠骨髓瘤细胞融合。杂交瘤细胞用人工合成的人抑制素α亚基３７ －６５ 片段包被,间接ＥＬＩＳＡ法筛选。结果：获得稳定分泌抗人抑制素α亚基３７ － ６５ 片段单抗细胞３ 株,ＥＬＩＳＡ 检测腹水效价为１×１０－ ５～１×１０ －３ ,与α亚基１ －３２ 及其他多肽激素无交叉反应,３ 株识别同一抗原位点。相对亲和力为ⅠＡ５ ＞ Ⅳ３Ｃ＞ Ⅴ５Ｇ。腹水中的抗体能明显地被人卵泡液和猪卵泡液和α（３７ － ６４）中和。结论：３ 株细胞有特异性、敏感性和实用性。抗体可用于人的正常组织及部分肿瘤组织免疫组化研究     

风轮菜的化学成分研究

从止血中药风轮菜中分得５个化合物,经光谱及化学方法鉴定了它们的结构,分别为香蜂草苷、柚皮素－７－芸香糖苷、江户樱花苷、异樱花素和β－谷雷醇,其中Ⅱ、Ⅲ和Ⅴ为首次从该植物中分得。