硒对慢性活动性肝炎的影响

５０例慢性活动性肝炎（慢活肝）随机分为治疗组和对照组。２５例治疗组接受１２周补硒治疗，结果显示，治疗组与对照组比较，血清ＡＬＴ显著下降，谷胱甘肽过氧化物酶活力明显升高，提示补硒能防治自由基引起的肝损伤，防止慢性肝病的发展。     

慢性支气管炎患者头发及血清微量元素的测定

用催化极谱法测定７２例慢性支气管炎患者及５０例健康者人发及血清中锌、铁、铜、锰四种微量元素的含量。结果表明，Ｚｎ、Ｆｅ元素的含量比对照组低，并表现有显著性差异（Ｐ〈０．０１），Ｃｕ、Ｍｎ元素的含量在两组之间无显著性差异（Ｐ〉０．０５）。     

重金属暴露与肾功能的关联性研究：基于代谢综合征人群的横断面研究证据

探索代谢综合征人群中重金属暴露与肾功能的相关性,为特定人群中慢性肾脏病的诊治提供新思路。基于2011—2018年美国健康与营养调查数据,纳入2 474名代谢综合征患者作为研究对象;探讨四种血液金属元素(包括镉、铅、硒、锰)对肾功能的影响。肾功能主要通过慢性肾病(CKD)、估计的肾小球滤过率(eGFR),尿微量白蛋白肌酐比(UACR)和尿酸(UA)评估。通过加权多因素Logistic回归模型及线性回归模型分析血液中金属元素水平与肾功能的关系。进一步按照年龄、性别、体质量指数(BMI)、是否患高血压、糖尿病及血脂异常进行亚组分析。研究发现血液中镉、铅水平与CKD的发生呈正相关,与eGFR呈现负相关。血硒与CKD的发生存在负向关联,而血锰与eGFR水平存在正相关(P<0.05)。而亚组分析结果显示,女性及老年代谢综合征患者对于金属暴露的效应更为敏感。代谢综合征人群中重金属暴露与肾功能存在关联,铅、镉暴露可能会导致肾功能受损,而硒、锰暴露则可能会起到一定的保护作用。     

ICP-AES法测定慢性乙肝患者头发中生命元素

建立了用ＩＣＰ－ＡＥＳ法同时分析头发中多种生命元素的方法,方法的相对标准偏差为１．４％￣４．９％,回收率介于９４％￣１２９％之间。测定了东莞地区１５９例在样大学生慢性乙肝患者头发样品中的Ａｌ、Ｂａ、Ｃａ、Ｃｏ、Ｃｒ、Ｃｕ、Ｆｅ、Ｍｇ、Ｍｎ、Ｎｉ、Ｐｂ、Ｓｒ、Ｚｎ等十三种生命元素的含量,并和健康人比较,初步分析了头发中生命元素含量和慢性乙型肝炎的相关性。     

The Relationship Between Dysphonia and Sinusitis: A Pilot Study

Though some clinicians believe chronic sinusitis is associated with dysphonia, studies confirming such a relationship are not available. This pilot study investigated vocal characteristics of chronic sinusitis patients compared to those of nonsinusitis patients. Nineteen male patients were evaluated in a single-blind, nonrandomized, prospective study at a Department of Veterans Affairs Medical Center. After candidates for the experimental and control groups were thoroughly screened [nasal and laryngology examinations, sinus computed tomography (CT) scan, history], 10 chronic sinusitis patients were assigned to the experimental group, nine patients without chronic sinusitis were assigned to the control group. Visi-Pitch analysis of their speech evaluated fundamental frequency, intensity, and perturbation. The evaluator described voice quality and vowel prolongation. Videostroboscopic examination evaluated glottic closure, supraglottic activity, vocal fold edge, amplitude, mucosal wave, and nonvibrating portion. Visi-Pitch analysis and vowel prolongation for each group was compared using an independent t-test. The average fundamental frequency mean was 113.43+/-32.75 Hz for the control group and 112.29+/-19.71 for the experimental group. This study established methods and parameters to determine if a relationship between chronic sinusitis and dysphonia actually exists. It did not establish a relationship between these entities, possibly due to the small sample size enrolled in the study, but determined that 126 subjects would be necessary to achieve significant results.     

The Relationship Between Chronic Cough and Paradoxical Vocal Fold Movement: A Review of the Literature

SUMMARY: Chronic cough (CC) and paradoxical vocal fold movement (PVFM) are debilitating conditions. PVFM has been given many labels, including vocal cord dysfunction, Munchausen's stridor, functional inspiratory stridor, nonorganic functional or psychogenic upper airway obstruction, factitious asthma, psychogenic stridor, emotional laryngeal wheezing, and episodic laryngeal dyskinesia. Although CC and PVFM have been considered separate entities in many reports, there is preliminary support for the notion that there may be an underlying link between these two conditions. Speech pathologists have become increasingly involved in the treatment of these patients and therefore need to understand the theoretical background of these disorders, the pathophysiological links between the two, and the impact of voice disorders on these populations. The aim of this article is to review the current literature on CC and PVFM from a speech pathology perspective to provide a model for defining and conceptualizing the disorders and to provide a framework for management and future research.     

Hepatic sarcoidosis: MR appearances in patients with chronic liver disease

Purpose

To describe the MR appearances of hepatic sarcoidosis in patients with chronic liver disease and correlate the results with clinical stage of disease as measured with the Mayo end-stage liver disease (MELD) score.

Materials and methods

Twenty patients with chronic liver disease and histopathological diagnosis of hepatic sarcoidosis who underwent MR imaging were included in this study. Two abdominal radiologists retrospectively reviewed all images for the presence of cirrhosis, imaging pattern of the liver, intrahepatic biliary dilatation, presence of areas of parenchymal atrophy, presence of splenic nodules and lymphadenopathy. Imaging findings were correlated with the MELD score.

Results

Of the patients, 14/20 had imaging findings of cirrhosis, 9/20 had a large macronodular pattern of liver cirrhosis and 5/20 had a diffuse pattern of liver cirrhosis. Peripheral wedge-shaped areas of parenchymal atrophy were observed in 10 patients. The combination of a central macronodular pattern and peripheral atrophy was observed in 9/20 patients. The pattern of cirrhosis had statistically significant correlation with the presence of wedge-shaped areas of parenchymal atrophy (p < 0.005). No statistically significant difference was revealed between the clinical score of patients who had imaging findings consistent with cirrhosis and those who did not.

Conclusion

MR imaging appearances of chronic sarcoid liver disease are diverse and do not appear to correlate with severity of clinical disease. Large central regenerative nodules and wedge-shaped areas of peripheral parenchymal atrophy are frequent findings and may help to suggest the diagnosis.     

Geochemical and isotopic evidences from groundwater and surface water for understanding of natural contamination in chronic kidney disease of unknown etiology (CKDu) endemic zones in Sri Lanka

Chronic kidney disease of unknown etiology (CKDu) is the main health issue in the dry zone of Sri Lanka. Despite many studies carried out, causative factors have not been identified yet clearly. According to the multidisciplinary researches carried out so far, potable water is considered as the main causative factor for CKDu. Hence, the present study was carried out with combined isotopic and chemical methods to understand possible relationships between groundwater; the main drinking water source, and CKDu in four endemic areas in the dry zone. Different water sources were evaluated isotopically (²H, ³H and ¹⁸O) and chemically from 2013 to 2015. Results revealed that prevalence of CKDu is significantly low with the groundwater replenished by surface water inputs. It is significantly high with the groundwater stagnated as well as groundwater recharged from regional flow paths. Thus, the origin, recharge mechanism and flow pattern of groundwater, as well as geological conditions which would be responsible for natural contamination of groundwater appear as the main causative factors for CKDu. Therefore, detailed investigations should be made in order to identify the element(s) in groundwater contributing to CKDu. The study recommends providing drinking water to the affected zones using water sources associated with surface waters.     

Combination of medical and health care based on digital smartphone-powered photochemical dongle for renal function management

Currently, the global healthcare market is increasing at high speed with the impendent global aging issue. Healthcare Industry 4.0 has emerged as an efficient solution towards the aging issue since it was integrated with ubiquitous medical sensors, big health processing platform, high bandwidth, speed technologies, and medical services, etc. It is believed to fulfil the requirement of the tremendously growing health market. The acquisition of medical data acts as the dominant precondition to implement the Healthcare Industry 4.0. In the same way, the widely available smartphone could serve as the best biomedical information collect station. In this study, a smartphone-powered photochemical dongle is demonstrated to precisely estimate blood creatinine from the fingertip blood, which works as a highly compact reflectance spectral analyzer with an enzymatically dry chemical test strip. Comparing with conventional laboratory facility for the evaluation and treatment of chronic kidney disease (CKD), it implemented the platform of point care with agreed accuracy. In order to estimate the efficiency of treatment and recovery of the CKD, the proposed photochemical dongle would provide a flexible and rapid platform for point of care. Furthermore, the proposed measured technology is very promising method for remote CKD management.