广州黄埔区内0～6岁儿童近五年健康状况分析

为了解最近5年广州医学院港湾医院辖区内0~6岁小儿的营养、健康状况变化趋势和明确今后儿童保健工作的重点,对该院管辖的7所幼儿园集体儿童及9个居委散居儿童,连续5年(2002—2006年)的体检资料进行了回顾性分析,人数达14485人,所有的体检资料均按照《WHO 0~6岁儿童身高体质量参考值及评价标准》以及贫血、视力异常、龋齿的国家卫生部标准进行评价。结果表明,总体的儿童营养不良率为0.86%,肥胖率为1.87%,生长迟缓患病率为1.26%,轻度贫血率1.35%;观察各年情况,肥胖率有逐年增长趋势,儿童营养不良率无逐年下降趋势;广州医学院港湾医院辖区内0~6岁小儿的营养不良、肥胖、生长迟缓、轻度贫血等患病率低于全国水平,但也有不容忽视之处,营养不良、轻度贫血等并没有因生活水平的提高而消失。加强对家长的科学育儿健康教育,以提高他们的育儿知识水平,是儿保工作的重点,应进一步降低儿童营养不良、贫血的发生率;对儿童肥胖应当切实采取措施,预防和控制肥胖症的发生。     

Femoral head avascular necrosis in sickle cell anemia: MR characteristics

Since considerable expansion of hematopoietic marrow occurs in patients with sickle cell anemia (SCA), magnetic resonance images of 20 hips in 10 patients with known homozygous SCA were reviewed to determine a) if low signal hematopoietic marrow extended into the femoral capital epiphysis and b) if the MR characteristics of avascular necrosis (AVN) differed depending on the type of epiphyseal marrow. Our results revealed variable epiphyseal marrow type; mixed (fatty and hematopoietic) marrow (42%), fatty marrow (32%), hematopoietic marrow (16%) and hemosiderotic marrow (10%). AVN occurred irrespective of the underlying marrow. Segmental areas of low signal intensity in variable shapes (ring, band, crescent or large homogeneous area) was the most consistent MR manifestation of AVN in SCA. A low signal intensity peripheral rim surrounding a central zone, isointense with epiphyseal marrow on T₁ and T₂ weighted images, was most frequently observed similar to that described in patients without hemoglobinopathy. The notable difference, however, was of segmental areas within the same femoral head that demonstrated variable central zone signal on T₂ weighted images. Further, while an increase in hip joint fluid is commonly seen with both early and advanced AVN in patients without hemoglobinopathy; it was increased in only one hip in patients with SCA. The observed differences in MR characteristics may be due to different pathophysiology of AVN in patients with SCA.     

泡利酚对缺铁性贫血成龄大鼠脾脏铁、铜、锌含量的影响

从微量元素角度对脾脏微量元素铁、铜、锌含量进行了研究,探讨了泡利酚对缺铁性贫血成龄大鼠免疫功能的影响。用Ｗｉｓｔａｒ大鼠,随机分为正常对照组（简称对照组）及缺铁性贫血（ＩＤＡ）模型组。ＩＤＡ模型组麻醉处死部分大鼠,再将剩余大鼠随机分为ＦｅＳＯ４治疗组（简称ＦｅＳＯ４组）、泡利酚治疗组（简称泡利酚组）进行治疗。分别于各阶段测定大鼠体重、脾重及脾脏微量元素含量。结果表明,当大鼠ＩＤＡ时,其体重、脾重及其微量元素铁、铜、锌含量均低于对照组,在给予ＦｅＳＯ４和泡利酚治疗后,其体重、脾重及其微量元素铁、铜、锌含量均显著升高,与给药前比较,有显著的差异,Ｐ＜００１。与对照组比较,ＦｅＳＯ４组无统计学意义;而泡利酚组则高于对照组,Ｐ＜００５。说明ＦｅＳＯ４及泡利酚均可使ＩＤＡ大鼠受损的免疫功能得到恢复,与其调节机体微量元素铁、铜、锌的含量有关。在对ＩＤＡ成龄大鼠免疫功能作用方面,泡利酚优于单纯补铁。     

Consumption of Sinlek Rice Drink Improved Red Cell Indices in Anemic Elderly Subjects

Iron fortifications are used for the treatment of iron-deficiency anemia; however, iron dosing may cause oxidative damage to the gut lumen. Thai Sinlek rice is abundant in iron and contains phytochemicals. We aimed at evaluating the effect of an iron-rice (IR) hydrolysate drink (100 mL/serving) on neurological function, red cell indices and iron status in elders. Healthy elderly subjects were divided into three non-anemic groups and one anemic group. The non-anemic groups consumed one WR (2 mg iron/serving) and two IR drinks (15 and 27 mg iron/serving) (groups A, B and D, respectively), while the anemic group consumed one IR drink (15 mg iron serving) (group C) every day for 30 days. There were no significant differences in the MMSE Thai 2002 and PHQ9 test scores for members of all groups, while the nutrition scores and body weight values of group D subjects were significantly increased. Hemoglobin (Hb) and mean corpuscular hemoglobin concentrations increased significantly only in group C. Serum iron and transferrin saturation levels tended to increase in group A, while these levels were decreased in members of group C. Serum antioxidant activity levels were increased in all groups, and were highest in group C. Thus, consumption of an IR drink for 15 days functioned to increase Hb and antioxidant capacity levels in anemic elders.     

缺铁性贫血患儿发锌测定

采用示波极谱法测定了86例缺铁性贫血患儿的发锌,并与78例健康体检儿发锌进行比较。结果表明,缺铁性贫血患儿缺锌率高于健康儿。     

轻型地中海贫血血清锌铜的测定

测定了轻型地中海贫血病人体内锌、 铜含量。结果表明,轻型β－地中海贫血及α－地中海贫血特征患者清锌、铜与正常对照组比较无差异。     

锌原卟啉与儿童铅中毒和贫血关系的研究

[目的 ]探讨锌原卟啉测定诊断儿童铅中毒与贫血可能性。 [方法 ]测定了 2 3 5名儿童血ZPP、Hb、BPb。 [结果 ]ZPP值 2 3 9± 1 0 2 μg/gHb ,增高率 1 3 61 % ;血铅水平 8 94± 4 62 μg/dL ,铅中毒率 41 0 7%。Hb平均浓度 1 1 2 5 0± 1 0 5 5g/L ,贫血患病率 3 1 48%。ZPP与Hb呈高度负相关 (P <0 0 1 ) ,与BPb无相关性 (P >0 0 5 )。血铅水平正常组与铅中毒组ZPP值差异无显著意义(P >0 0 5 )。Hb正常组与贫血组ZPP值差异有显著意义 (P <0 0 1 )。 [结论 ]ZPP升高可作为缺铁性贫血的诊断指标 ,但在血铅水平较低的地区 ,则不宜用ZPP作为儿童铅中毒的筛查指标。     

贫血儿童血铅含量的变化及意义

测定了78例贫血患儿及30例健康儿血铅含量。结果显示，贫血患儿血铅水平明显升高。提示铅中毒影响造血系统。     

Human Respiration Under the Condition of Severe Anemia Investigated with the Aid of Fractionation Effects of Oxygen Isotopes

Abstract

The dependence of overall fractionation effect of respiration between ¹⁶O₂ and ¹⁶O¹⁸O (δ_IU) on varying levels of hemoglobin concentration within blood is investigated. Experiments are carried out on 6 healthy humans and 6 patients suffering from various degrees of chronic anemia.

δ_IU-values of anemic patients are decreased towards 0‰ meaning that within anemia rates of ¹⁶O_2? and ¹⁶O¹⁸O-transport are aligned together more than they are under healthy conditions.

On the basis of a resistance model of respiration, it is concluded that within anemia the entire oxygen transport system is more limited by blood flow than it is in healthy humans. This limitation starts to influence respiration far above a hemoglobin concentration of 8 g/100 ml.     

Ribosomal protein mutations in Korean patients with Diamond-Blackfan anemia

Diamond-Blackfan anemia (DBA) is a congenital bone marrow failure syndrome characterized by hypoproliferative anemia, associated physical malformations and a predisposition to cancer. DBA has been associated with mutations and deletions in the large and small ribosomal protein genes, and genetic aberrations have been detected in ∼50–60% of patients. In this study, nine Korean DBA patients were screened for mutations in eight known DBA genes (RPS19, RPS24, RPS17, RPS10, RPS26, RPL35A, RPL5 and RPL11) using the direct sequencing method. Mutations in RPS19, RPS26 and RPS17 were detected in four, two and one patient, respectively. Among the mutations detected in RPS19, two mutations were novel (c.26T>A, c.357-2A>G). For the mutation-negative cases, array-CGH analysis was performed to identify copy-number variations, and no deletions involving the known DBA gene regions were identified. The relative mRNA expression of RPS19 estimated using real-time quantitative PCR analysis revealed two- to fourfold reductions in RPS19 mRNA expression in three patients with RPS19 mutations, and p53 protein expression analysis by immunohistochemistry showed variable but significant nuclear staining in the DBA patients. In conclusion, heterozygous mutations in the known DBA genes RPS19, RPS26 and RPS17 were detected in seven out of nine Korean DBA patients. Among these patients, RPS19 was the most frequently mutated gene. In addition, decreased RPS19 mRNA expression and p53 overexpression were observed in the Korean DBA patients, which supports the hypothesis that haploinsufficiency and p53 hyperactivation represent a central pathway underlying the pathogenesis of DBA.