老龄患者的营养调查与分析

对象与方法：１９９８年对我院１０６例老年患者进行了营养调查，其中高血压５７例、糖尿病２５例、冠心病６２例，脑动脉供血不足２３例、心肌梗塞４０例。将患者分为两组，第一组（５０～５９岁）男２６例，女１２例，第二组（６０～７９岁）男６０例，女８例。膳食调查采取询问法，连续记录三天的饮食情况，计算出每人每日摄入的营养素。体格检查及生化检查，包括身高（ｃｍ）、体重（ｋｇ）、上臂围（ＡＣ）、肱三头肌皮褶厚度（ＴＳＦ），臂肌围（ＡＭＣ）、血红蛋白（Ｈｂ）、血胆固醇（ＴＣ）、血甘油三酯（ＴＧ）、血糖（ＧＬＵ）、血低密度脂蛋白（ＬＤＬ）。结果：膳食调查显示两组热能平均摄入量分别为７．７６ＭＪ（１８５４ｋｃａｌ），７．３０ＭＪ（１７４４ｋｃａｌ），均低于中国营养学会ＲＤＡ；蛋白质平均摄入量分别为６４．８ｇ与６０．２ｇ，略低于ＲＤＡ；其中动物蛋白、豆类蛋白与植物蛋白所占比例分别为７８．２％、６．４８％、１５％；与８２．７％、１０．１％、７．１４％，豆类与植物蛋白摄入偏低。动物脂肪摄入量分别为３１．２ｇ，３０．１ｇ，占脂肪摄入量的７２．２％与７４％，摄入偏高。其他两组分别为：钙仅占ＲＤＡ的６２．９％与６４．３％；铁仅占ＲＤＡ的７６?     

An evaluation of the mode of action framework for mutagenic carcinogens case study II: Chromium (VI)

In response to the 2005 revised U.S Environmental Protection Agency's (EPA) Cancer Guidelines, a strategy is being developed to include all mutagenicity and other genotoxicity data with additional information to determine whether the initiating step in carcinogenesis is through a mutagenic mode of action (MOA). This information is necessary to decide if age‐dependent adjustment factors (ADAFs) should be applied to the risk assessment. Chromium (VI) [Cr (VI)], a carcinogen in animals and humans via inhalation, was reassessed by the National Toxicology Program (NTP) in 2‐year drinking water studies in rodents. From these data, NTP concluded that the results with Cr (VI) showed clear evidence of carcinogenicity in male and female mice and rats. Cr (VI) is also mutagenic, in numerous in vitro assays, in animals (mice and rats) and in humans. Accordingly, Cr (VI) was processed through the MOA framework; postulated key steps in tumor formation were interaction of DNA with Cr (VI) and reduction to Cr (III), mutagenesis, cell proliferation, and tumor formation. Within the timeframe and tumorigenic dose range for early events, genetic changes in mice (single/double‐stranded DNA breaks) commence within 24 hr. Mechanistic evidence was also found for oxidative damage and DNA adduct formation contributing to the tumor response. The weight of evidence supports the plausibility that Cr (VI) may act through a mutagenic MOA. Therefore, the Cancer Guidelines recommend a linear extrapolation for the oral risk assessment. Cr (VI) also induces germ cell mutagenicity and causes DNA deletions in developing embryos; thus, it is recommended that the ADAFs be applied. Environ. Mol. Mutagen., 2010. Published 2009 Wiley‐Liss, Inc.     

芦丁铬对正常和高血脂大鼠血脂的调节作用

目的：研究芦丁与三价铬离子生成的芦丁铬络合物（芦丁铬）调节血脂作用。方法：采用大鼠高血脂模型，观察芦丁铬对正常和高血脂大鼠的甘油三酯、胆固醇、HDL－胆固醇和LDL－胆固醇浓度的影响。结果：芦丁铬能有效地升高正常和高血脂大鼠血铬水平，降低血清甘油三酯浓度；升高高血脂大鼠血清高密度脂蛋白水平；对高血脂大鼠血清总胆固醇和低密度脂蛋白也有降低趋势。结论：芦丁铬对正体和高血脂大鼠的血脂均有调节作用。     

Urinary excretion of chromium in chromeplaters after discontinued exposure

In a previous study [Lindberg and Vesterberg, 1983a], excretion of chromium in urine (U-Cr) in chromeplaters was proposed for biological monitoring of ongoing exposure. Published reports were found about the decline of U-Cr after discontinued exposure in welders working in chromium-alloyed stainless steel, but not in chromeplaters. In this study, half-times (t1/2) were calculated for ten chromeplaters over a weekend, and for 23 chromeplaters over 31 days vacation. The results suggest that the excretion of chromium can be approximated to a two-compartment model. Estimated from the median values, an initial rapid phase with an assumed t1/2 of 2-3 days is followed by a phase with a t1/2 of approximately a month. Differences between the decline of U-Cr in chromeplaters and welders are discussed.     

城区100名老年人的营养状况调查分析

对象与方法：采用分层整群抽样的方法，随机抽取济南市区６０岁以上老年人１００名。其中男性４３名，平均年龄６６．５±５．６岁，平均ＢＭＩ指数２４．７±３．７，女性５７名，平均年龄６８．７±６．６岁，平均ＢＭＩ指数２４．６±３．８。用食物频数问卷和２４ｈ回忆法对其进行了膳食营养状况及一般情况调查。结果：各组膳食中能量、蛋白质、铁、维生素Ｅ、烟酸的摄入量能满足需要。，钙的摄入量普遍不足，以女性为突出，分别低于ＲＤＡ的６７％和４２％，各年龄女性组锌、硒的摄入量，低于ＲＤＡ的７０％。７０岁组维生素Ａ摄入量不能满足需要，尤以男性为甚，分别低于ＲＤＡ的５７％和４９％。，各年龄女性组维生素Ｂ１、Ｂ２的摄入量低于ＲＤＡ的６１％。膳食构成的调查结果：蛋白质供热比达到或超过１３％～１５％，优质蛋白质占４０％以上，碳水化物的供热比低于５４％，脂肪供热比超过３０％。调查中还发现，肥胖者（ＢＭＩ指数＞２５）占４０％，冠心病，占调查人数的２１％，高血压１５％、糖尿病７％。提示，城区老年人的膳食构成已发生明显变化。肉、蛋类摄取量增加，蔬菜、水果及奶类摄取量偏低；这种不平衡的膳食构成对健康极为不利。故应重视老年人的营养教育，并加以指导。另外，?     

Comparison of long-term clinical outcomes after the second-generation cobalt–chromium sirolimus-eluting stents implantation in diabetic versus non-diabetic patients: a subgroup analysis from the prospective FOCUS registry

Background: Diabetes mellitus (DM) was broadly acknowledged as a risk factor for adverse events after coronary stent implantation. However, the role of DM in patients treated with second-generation cobalt–chromium sirolimus-eluting stents (CoCr-SES) was less known. Methods: A total of 4720 patients available for 3-year follow-up in the prospective FOCUS registry were subdivided into the DM group and the non-DM group to assess the effect of DM on the clinical outcomes after CoCr-SES implantation both before and after propensity score matching. Results: The rates of major adverse cardiovascular event was low (<10%) in both DM and non-DM groups but significantly greater in the DM group after matching (9.6% versus 6.1%; p?=?0.005). Although the soft endpoints including target vessel revascularization (2.3% versus 2.3%; p?=?0.938) and target lesion revascularization (1.2% versus 1.1%; p?=?0.828) was not significantly different between two groups, the hard endpoints represented by cardiovascular death or myocardial infarction (7.3% versus 5.3%; p?=?0.012) demonstrated a significant increase in the DM group. Conclusions: This subgroup analysis demonstrated that DM significantly increased the risk of adverse events after implantation of CoCr-SES, but the general safety and efficacy performance of CoCr-SES in both diabetic and non-diabetic patients was satisfying and comparable with other types of new-generation drug-eluting stents.

• Key messages

• The overall rate of adverse clinical events in both diabetic and non-diabetic patients was <10%, indicating a satisfying long-term safety and efficacy performance of CoCr-SES, even in high–risk diabetic patients.

• DM significantly increased the risk of MACE (HR 1.3; 95% CI: 1.0–1.6) in patients undergoing CoCr-SES implantation.

     

动脉粥样硬化性脑梗死患者血清铬与胰岛素抵抗的关系

目的 探讨脑梗死患者体内血清铬与胰岛素抵抗的关系.方法 受试对象分为两组,动脉粥样硬化性脑梗死(ACI)组和正常对照组,每组30例;分别检测空腹和早餐后2 h血糖和血清胰岛素水平,并计算胰岛素抵抗指标(IRI);采用二苯碳酰二肼比色法测定血清铬含量.结果 两组患者体内铬含量、IRI均存在着显著性差异(P＜0.05,P＜0.001),这两指标呈负相关(r=-0.576),结论 ACI患者体内存在着胰岛素抵抗,微量元素铬的缺乏可引起ACI患者体内IR的发生.     

The Effect of Anticoagulants on the Distribution of Chromium VI in Blood Fractions

Metal-on-metal resurfacing arthroplasty is associated with elevated circulating levels of cobalt and chromium ions. To establish the long-term safety of metal-on-metal resurfacing arthroplasty, it has been recommended that during clinical follow-up of these patients, the levels of these metal ions in blood be monitored. In this article, we provide information on the distribution of chromium VI ions (the predominant form of chromium released by cobalt-chrome alloys in vivo and in vitro) in blood fractions. Chromium VI is predominantly partitioned into red blood cells compared with plasma (analysis of variance, P < .05). The extent of accumulation in red blood cells is influenced by the anticoagulant used to collect the blood, with EDTA giving a lower partitioning into red cells compared with sodium citrate and sodium heparin.     

The expression of RKIP, RhoGDI, galectin, c-Myc and p53 in gastrointestinal system of Cr(VI)-exposed rats

Hexavalent chromium (CrVI) is considered to be a risk factor in the formation of human cancer. Raf kinase inhibitor protein (RKIP), Rho‐GDIα, galectin, c‐Myc and p53 play important roles in cancer formation. The purpose of this study was to determine if Cr(VI) induces the formation of gastrointestinal cancer. We explored the expression of RKIP, Rho‐GDIα, galectin, c‐Myc and p53 in the colon and stomach in rats exposed to chromium (CrVI). Thirty Wistar rats were divided into six groups which were chronically fed with 250, 500, 750, 1000 and 1250 ppm Na₂Cr₂O₇ and water for 60 days. The level of Cr(VI) was determined by electrothermal atomic absorption spectrometry. The expression of RKIP, Rho‐GDIα, galectin, c‐Myc and p53 of stomach and colon was measured by western blot. The gene expression of RKIP, Rho‐GDIα, galectin, c‐Myc and p53 of the stomach and colon was determined by RT‐PCR. The results showed that the expression of p53 and Rho‐GDIα was decreased in the stomach and colon of rats with Cr(VI) treatment. The expression of RKIP was decreased in the stomach and colon of rats treated with high‐dose Cr(VI). The expression of c‐Myc and gelectin‐1 was increased in the stomach and colon of rats with Cr(VI) treatment. We concluded that the anomalous expression of RKIP, Rho‐GDIα, galectin, c‐Myc and p53 might be a dangerous index of cancer formation in the stomach and colon of rats with Cr(VI) exposure. Copyright © 2011 John Wiley & Sons, Ltd.