服用左炔诺孕酮滴丸和妈富隆1年对血压、血糖和血脂的影响

目的：观察第二、三代口服避孕药(COC)对育龄妇女体重指数、血压、血糖和血脂的影响。方法：将自愿服用COC避孕1年的妇女105例随机分为两组，其中54例给予第二代COC(EE／LNG组)，51例给予第三代COC(EE／DG组)。并对研究前后所有病例的体重指数(BMI)、血压、血糖和血脂代谢指标进行比较分析。结果：EE／LNG组：BMI、收缩压、舒张压、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)和载脂蛋白B(ApoB)水平均升高，高密度脂蛋白(HDL)水平下降，血糖、载脂蛋白AI(ApoAI)水平无明显改变。EE／DG组收缩压、TG、HDL水平升高，BMI、舒张压、血糖、TC、LDL、ApoAI和ApoB均未发生显著变化。以上所有测量指标均未超出正常范围。结论：使用1年第二、三代COC对妇女BMI、血压和血脂代谢都有微弱的影响，对空腹血糖无明显影响。第三代COC对妇女BMI、收缩压、舒张压、TG、TC、LDL、HDL水平和ApoB的不利影响小于第二代，更加安全可靠。     

Increased incidence of congenital hypothyroidism due to iodine deficiency

BACKGROUND: The incidence of congenital hypothyroidism (CH) is expected to be elevated in iodine-deficient areas. In this study, the authors aimed to determine the incidence of transient and permanent CH in a large city which is known to be in the zone of moderate iodine deficiency. METHODS: Newborn babies in Bursa, Turkey, were screened by measurement of serum thyroid-stimulating hormone (TSH) obtained by heel prick. The babies who had a serum TSH >20 mIU/L were recalled for measurement of T4 and TSH in venous serum. RESULTS: A total of 11 770 newborns were screened over a period of 9 years. The incidence of CH was found to be 1/840. However, after excluding the transient cases, permanent CH was diagnosed in 1/2354. It was impossible to distinguish transient patients from permanent CH by initial laboratory tests (P > 0.05). The estimated power of the study in determining the incidence of CH in the population was 90% (P < 0.05). CONCLUSION: The authors conclude that the incidence of CH is very high in their population which warrants a country-wide neonatal screening program. Since transient cases cannot be distinguished and untreated transient hypothyroidism may also cause mental retardation, treatment must be started as early as possible with frequent monitoring to optimize the outcome and identify the transient patients.     

Assessment of changes in 1-second forced expiratory volume in bronchial provocation testing

The question of whether functional residual capacity (FRC) falls in infants during active sleep has been clouded by studies using different subject groups and techniques for measurements of lung volume and determination of sleep state. Twenty healthy full-term infants within the first week of life participated in the present study. Neurophysiological and behavioral criteria were used to define sleep state, and measurements of FRC were made using a specially constructed closed-circuit helium dilution system. Regularity of respiration was recorded using magnetometers on the chest and a modified respirator monitor. Results showed that no significant changes in FRC occurred, related either to sleep state or to regularity of respiration. In addition, we failed to detect any differences in FRC between the sexes. Pediatr Pilmonol. 1989; 7:71–77 .     

MRI in subacute combined degeneration

We describe a patient with clear lesions in the spinal cord on MRI due to subacute combined degeneration. T2-weighted images clearly showed abnormal high signals in the posterior columns, which disappeared on recovery from the disease.     

用于筛选天然产物中脲酶抑制剂的脲酶活性测试方法的建立

抑制幽门螺杆菌产生的脲酶具有治疗胃炎和消化性溃疡的作用。用酚红指示剂和Ｂｅｒｔｈｅｌｏｔ试剂在９６孔培养板上检测重组脲酶活性，其灵敏度指标酚红法每ｍｇ酶蛋白引起的每分钟吸光度变化。△Ａ为６．９，而Ｂｅｒｔｈｅｌｏｔ法每ｍｇ酶蛋白引起的每分钟吸光度比值变化△Ａ为３１３。结果表明用Ｂｅｒｔｈｅｌｏｔ试剂检测重组脲酶活性适宜在９６孔培养板上大规模筛选天然产物中的脲酶抑制剂。     

Antibody-dependent neutrophil-mediated parasite killing in non-lethal rodent malaria

The effects of administrating recombinant human granulocyte colony-stimulating factor (rhG-CSF) and passively transferring immune serum on infection with an attenuated variant of Plasmodium berghei XAT (Pb XAT), in severe combined immunodeficiency (SCID) mice were examined. In immune competent (C.B-17) mice, the attenuated parasite infection was inevitably self-resolving and degenerating forms inside erythrocytes appeared, coinciding with the drop in parasitaemia, whereas SCID mice were unable to control parasite growth and all the mice died. Continuous administration with rhG-CSF caused neutrophilic granulocytosis in both SCID and C.B-17 mice. The effect of rhG-CSF on the infection in C.B-17 mice was to suppress the course of the parasitaemia at an early phase whereas it had no effect in SCID mice. When immune serum was transferred on the day of infection, the prepatent period was prolonged two days in both SCID and C.B-17 mice. When administration with rhG-CSF was combined with transfer of immune serum, SCID mice showed four days delay in patency and degenerating parasites were seen during the course of parasitaemia, although the infection was ultimately fatal. C.B-17 mice similarly treated showed a seven day delay in the onset of the patent parasitaemia which was of a lesser magnitude and shorter in duration compared with control mice. On the other hand, when C.B-17 mice were splenectomized three weeks before infection and then treated with rhG-CSF and immune serum, no degenerating parasites were seen during the infection and all mice died with high parasitaemias. These results show that antibody-dependent neutrophil-mediated parasite killing may occur in the spleen of mice infected with P. berghei XAT.     

Poor co-ordination in 5 year olds: A screening test for use in schools

A simple standardized screening test (South Australian Motor Co-ordination Screening Test, SAM Test) was developed to screen for poor co-ordination in 5 year olds; This SAM Test, which can be used by teachers, nurses and doctors, has explicit pass/fail criteria and has classified correctly 90% of children. The McCarthy Motor Scales, which are time consuming and limited to use by psychologists, were used to categorize 60 poorly co-ordinated and 60 normal children. The 120 children thus selected were tested on 19 items covering gross and fine motor skills. Statistical analysis to determine which items best discriminated between the two groups found the following five gross motor items to be most effective: one leg balancing, hopping, heel-toe walking on line, jumping Over ribbon and dropping ball and catching.     

The pros and cons of fecal occult blood testing for colorectal neoplasms

Testing feces for occult blood is widely recommended as a means of detecting subclinical colorectal tumors. Guaiac tests such as Hemoccult^® are the most widely used, but chemical sensitivity is relatively low and the tests are affected by dietary peroxidases, the state of fecal hydration, and certain drugs. The newly devised HemoQuant^® and immunologic techniques appear more sensitive and specific, but they require further evaluation before widespread clinical usage can be recommended.Occult blood screening has both merits and weaknesses. Testing does uncover subclinical colorectal cancer, often at a relatively early stage, but whether this actually improves the prognosis remains to be proven. Benign neoplastic polyps are also detected, although it is debatable whether this is a valid rationale for screening. Test sensitivity for malignancy varies from good to moderate, but is poor for benign polyps. Specificity is usually around 97%–98%, yet the predictive value of a positive test for cancer is only about 10%: hence most test-positive individuals are needlessly subjected to invasive colonic investigations. Reported figures on public compliance with occult blood testing vary widely from excellent to poor. Published costs of screening are usually quite low, but these overlook important indirect and hidden expenses and are therefore misleading.On balance, the problems of occult blood testing currently appear to outweight the merits. This could change, however, with the newer testing techniques and with awaited mortality data from controlled clinical trials now underway.