Effects of Environmental Lead Pollution on Blood Lead and Sex Hormone Levels among Occupationally Exposed Group in An E-waste Dismantling Area

Objective To study the effects of environmental multi-media lead pollution on blood lead and sex hormone levels among lead exposed males engaged in E-waste dismantling, and the correlation between confounding factors and sex hormone levels. Methods An E-waste dismantling area in Taizhou of Zhejiang Province was selected as the research site. One hundred and fifty two samples were collected from the groundwater, soil, rice, corn, chicken, and pork in the dismantling area. The effects of the multi-media lead pollution on the male blood lead and sex hormone levels of FSH, LH, and T, as well as the correlation with confounding factors, were studied. Results The blood lead concentrations in the males aged under 31, from 31 to 45 and from 46 to 60 were 98.55, 100.23, and 101.45 I~/L, respectively. Of all the environmental media lead exposures, the groundwater, rice and soil were main contributing factors to the lead accumulation in humans. FSH and LH levels increased with the age while the T levels decreased with the age instead. There was a significant correlation between the FSH and LH levels and wearing masks. Conclusion There was correlation between the FSH, LH, and T levels, and the mean values of lead concentrations in environmental media, and the sex hormone levels were correlated with the confounding factor of wearing masks.

Umbilical Cord Blood Lead Levels in Shanghai, China

This study was designed to determine the cord blood lead (BPb) levels of babies born in one urban area of Shanghai, and to preliminarily identify the demographic, social environment and prenatal factors which have an effect on the cord BPb concentrations. From August to November 1993, umbilical cord blood samples were obtained from 605 live newborns in the Yangpu Maternal and Child Hospital. 257 samples were excluded from measurement because of clotting. In 348 cord samples, the geometric mean of cord BPb levels was 9. 2μg/dl, with a 95 % confidence interval of the mean 8. 86-9. 54 (μg/dl). 142 babies (40. 8 % ) had cord BPb levels of 10μg/dl or greater. As a result of this high percentage of newborns with BPb levels equal to or greater than 10 μg/dl, we estimate that each year in the Shanghal City about 60,000 newborns are at risk for developing neuropsychological deficiencies caused by maternal lead exposure during pregnancy. To investigate the factors affecting cord blood levels, the subjects with levels greater than the 70th percentile (10. 7μg/dl) (n = 104) and less than the 3oth percentile (7. 4μg/dl) (n = 104) were selected to compare the demographic, environ ment and prenatal medical history. Increased BPb levels at birth were associated with maternal passive smoking, a family member being occupationally exposed to lead, proximity to major traffic way, household coal combustion, neighborhood coal combustion, low level of meternal occupations, and the increasing occurrence of having the high lead foodstuff pidan (preserved duck egg) during pregnancy. We conclude that prenatal lead exposure has become an impor tant health issue for young children in Shanghai

A Systematic Assessment of Blood Lead Level in Children and Associated Risk Factors in China

In this study, we searched multiple databases for all relevant original articles (1996-2013). To investigate blood lead levels (BLL) and possible risk factors for lead exposure among children in China A total of 388 articles met our inclusion criteria. The overall geometric mean (GM) BLL was 71 μg/L, and the prevalence of elevated BLL (EBLL, defined as BLL ≥100 μg/L) was 18.48% among children. The prevalence of EBLL remained significantly higher among boys. In children less than 6 years of age, there were significantly increasing trends in both BLL and prevalence of EBLL in an age-dependent manner. The ban on leaded gasoline significantly reduced the BLL as well as EBLL prevalence; however, children whose parents had lower educational levels or were exposed to lead in the workplace had a higher EBLL prevalence. Despite its decline over time, the average BLL among children in China remains higher than the average level most recently reported in the United States. Childhood lead poisoning remains a public health problem in China.

Blood Lead Dynamics of Lead-Exposed Pregnant Women and Its Effects on Fetus Development

The dynamics of blood lead (Pb-B) and blood zinc protoporphyrin (ZPP-B) of women in early pregnancy and parturient women with lead exposure and the effects on fetus development were investigated. Pb-B of lead-exposed women was high: 0.984 μmol/L (20.38 μg/dl) and ZPP was 84.52μg/dl. Cord blood Pb-B was 0.896 μmol/L(18.56μg/dl)and cord blood ZPP was 69.24μg/dl. In the control group, Pb-B was 0.261μmol/L(5.41μg/dl), ZPP-B, 37.59 μg/dl, cord blood, Pb-B 0.34 μmol/L (7.93 μg/dl), and cord ZPP-B 49.0μg/dl. There was a significant correlation between blood lead and blood ZPP, maternal Pb-B and cord Pb-B, maternal Pb-B and cord ZPP-B. The significance of the consistency of high level Pb-B and the effects on fetus development is discussed.

Association between Polymorphisms of MALAT1 and Blood Lead Levels in Lead-exposed Workers

Lead,a heavy metal,which is nonessential but may be harmful to the human body,has been widely used to manufacture many products for use in the modern world.Lead-acid batteries have the advantages of low price,high safety,and advanced technology.

Blood Lead Levels During Pregnancy and Its Influencing Factors in Nanjing,China

Objective To investigate the blood lead levels （BLLs） in the duration of pregnancy and 6-12 weeks after delivery, and analyze the influencing factors of BLLs in healthy pregnant women. Methods Pregnant women were recruited from September 2009 to February 2010 at the prenatal clinic in Nanjing Maternity and Child Health Care Hospital. Altogether 174 healthy pregnant women without pregnant or obstetric complications or abnormal pregnancy outcomes were enrolled as the gravida group, and 120 healthy non-pregnant women as the control group. BLLs during pregnancy were determined by flame atomic absorption spectroscopy. Results BLLs in all the three pregnancy trimesters and postpartum were 59.8±24.3, 55.4±20.1, 55.9±19.7, and 67.6±17.4 μ/L, respectively, and the mean BLL in control group was 67.5±21.3 μg/L. BLLs during all the three trimesters were lower in the gravida group than in the control group （P=0.043, 0.021, and 0.028）. Furthermore, occupations, nutrients supplementation, and time of house/apartment painted were associated with BLLs in pregnant women. Lead-related occupations, cosmetics use, and living in a house painted less than 1 year before are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors. Conclusion Supplementing calcium, iron, zinc, and milk, or avoiding contact with risk factors may help people, especially pregnant women, to reduce lead exposure.

Low Blood Lead Concentrations and Cognitive Development of Primary School Children from Three Areas in Malaysia

A study on to identify the relationship between blood lead and cognitive development was conducted on primary school children in Malaysia. About 413 children aged 62^/1 - 82^/1 years from urban （236）, rural （80） and industrial areas （97） were studied. Blood lead was analyzed using the Atomic Absorption Spectrophotometer （GFAAS）. Cognitive development was measured by the ＇McCarthy Scales of Children＇s Abilities Test＇ （MSCA）. Significant differences found in the mean cognitive scores between the urban （94.40）, industrial （102.90） and suburban children （101.24） （p 〈 0.001）, with the blood lead between the urban （3.66 p.g/dL）, industrial （3.54 μg/dL） and suburban children （3.04μg/dL） （p = 0.022）. Significant inverse correlations between blood lead and cognitive scores found for all groups （p 〈 0.001）, urban （p 〈 0.001） and suburban children （p 〈 0.001）. Low blood lead significantly influenced the cognitive development for all children after adjusting for confounders （p _〈 0.001）. The urban children＇s cognitive scores were significantly influenced by blood lead levels and household income （p 〈 0.001）. However, for the suburban children, the cognitive score were significantly influenced by the blood lead levels, the mothers＇ education, number of siblings, sequence in the family and the household income （p 〈 0.001 ）. Blood lead below 10μg/dL influenced the cognitive development. Urban children had higher blood lead but suburban children with lower blood lead were also vulnerable to the effect of lead on their cognitive development.

The Blood Lead, Blood Pressure Connection: An Evaluation of Apparently Healthy Lead Exposed Workers in Nigeria

Objective: There is a paucity of evidence on the lead exposure and blood pressure association in Nigeria where lead exposure is still prevalent and poorly regulated. The objective of this study was to evaluate the association between lead exposure using blood lead level and blood pressure in Port Harcourt Nigeria. Methodology: A prospective cross sectional comparative study of adult subjects with occupational lead exposure and controls, performed in Port Harcourt, South-south Nigeria. Blood lead measured by atomic absorption spectrophotometry was used as the biomarker of lead exposure while systolic and diastolic blood pressures and other relevant variables were measured and analysed. Results: The mean systolic blood pressure was significantly higher in lead exposed subjects 118.49 (14.67) mmHg compared to controls 113.62 (11.31) mmHg (p = 0.008). No difference was observed in the mean diastolic blood pressure. A higher proportion of subjects had systolic and diastolic pressure > 140 mmHg and >90 mmHg compared to controls 9.47% vs. 1.25% and 10.51% vs. 2.54%, with (p = 0.016), OR = 8.27 , RR = 1.38 and (p = 0.028), OR = 4.59 , RR = 1.33 respectively. There was no significant statistical correlation between blood lead and blood pressure. Conclusion: The results of this study indicate a significant systolic blood pressure elevation and prevalence of hypertension among lead exposed workers in Port Harcourt Nigeria. Lager longitudinal research is needed to evaluate lead exposure and elevated blood pressure association in Nigeria. The findings call for better regulation of occupational lead exposure in Nigeria.

长春市某医院儿童铅暴露现状及影响因素调查

目的了解长春市儿童铅暴露现状及影响因素,为本地区儿童铅中毒防治工作提供科学依据。方法以长春市某儿童医院儿童保健科在2017年5月—2018年9月收治的804例就诊儿童作为研究对象,进行血铅检测和问卷调查,分析儿童铅暴露的特点。结果长春市儿童血铅水平为32.30(25.40,41.00)μg/L,男童和女童的血铅水平分别为33.00μg/L、32.00μg/L。其中53例血铅水平≥100μg/L,高血铅检出率为6.59%(高铅血症34例、轻度铅中毒7例、中度铅中毒11例、无重度铅中毒例数)。血铅正常组与异常组儿童在性别、父亲文化水平、啃指甲方面比较,差异无统计学意义(P>0.05);但在年龄、母亲文化水平、居住楼层、饭前洗手、吮吸手指、异食癖方面比较,差异有统计学意义(P<0.05)。儿童血铅异常的多因素分析显示:居住楼房较高、饭前洗手等是儿童血铅异常的保护因素(P<0.05);儿童年龄低、吮吸手指、异食癖是儿童血铅异常的危险因素(P<0.05)。结论长春市儿童的血铅水平及高铅血症不容忽视,尤其是3岁及以下婴幼儿、不良行为习惯和异食癖与血铅水平有密切关系。

四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响

目的观察四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响。方法将92例受试者随机分为对照组与治疗组各46例。在常规治疗基础上,对照组加用四逆升降散安慰剂,治疗组加用四逆升降散,治疗7d。比较两组受试者治疗前、治疗第3天、治疗第7天血栓弹力图、血小板计数(PLT)、凝血功能四项、纤维蛋白原降解产物(FDP)、D二聚体(D-Di)。结果治疗后治疗组PLT、血小板强度(MA)、血栓形成动力学(Angle)凝血综合指数(CI)、D-Di数值均下降,反应时间(R)、动力学时间(K)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)数值均上升,与对照组治疗第7天比较差异有统计学意义(P<0.05),纤维蛋白原(FIB)、FDP差异无统计学意义(P>0.05)。结论四逆升降散能够改善脓毒症毛细血管渗漏综合征患者的高凝状态,但是不会造成低凝或出血表现。

郭志华教授从“血不利则为水”论治心力衰竭水肿经验

郭志华教授基于“血不利则为水”理论,结合心、肺、脾的生理和病理特点,将“治病必求于本”与“五脏一体观”的辨证论治思想贯穿于心力衰竭合并顽固性水肿临床治疗过程。郭志华教授认为心衰水肿的核心病机为脏气亏虚、气血失和、血水互结,治疗当以补气活血行水为基,补益脏腑为本,主张扶正养心温阳、补肺健脾、益气养血以固本,活血行瘀利水祛其邪。

多动障碍儿童的血铅水平与其社会功能的关系

目的分析多动障碍患儿的血铅水平与其社会功能的关系。方法选取126例多动障碍患儿为观察组,126例非多动障碍儿童为对照组,比较两组的血铅水平、社会功能。比较不同亚型多动障碍患儿的血铅水平,分析多动障碍患儿的血铅水平与其社会功能的相关性。结果观察组的血铅水平高于对照组,WFIRS-P各维度评分及总分均高于对照组(P<0.05)。Pearson相关分析显示,多动障碍患儿的血铅水平与学习和学校、生活技能、社会活动呈正相关(P<0.05)。结论多动障碍患儿的血铅水平较高,其血铅水平与部分社会功能存在相关性,临床应重视铅暴露对儿童社会功能的影响。

智杞颗粒联合氟哌啶醇片治疗肝肾阴虚型儿童多发性抽动症临床研究

目的:观察智杞颗粒联合氟哌啶醇片治疗肝肾阴虚型儿童多发性抽动症的临床疗效。方法:回顾性分析110例肝肾阴虚型多发性抽动症患儿的临床资料,根据治疗方法分为2组各55例。观察组予智杞颗粒联合氟哌啶醇片治疗,对照组予氟哌啶醇片治疗。2组均以4周为1个疗程,连续治疗3个疗程。治疗前后评定中医证候评分、耶鲁综合抽动严重程度量表(YGTSS)评分,检测血清铅水平,比较2组的临床疗效,观察2组不良反应的发生情况。结果:治疗3个疗程后,观察组总有效率高于对照组(P<0.05)。2组摇头耸肩、挤眉弄眼、肢体震颤、形体消瘦、两颧潮红评分均较治疗前降低(P<0.05),观察组以上5项中医证候评分均低于对照组(P<0.05)。2组血清铅水平均较治疗前下降(P<0.05),观察组血清铅水平低于对照组(P<0.05)。2组抽动次数、抽动频率、抽动强度评分均较治疗前下降(P<0.05),观察组以上3项评分均低于对照组(P<0.05)。结论:智杞颗粒联合氟哌啶醇片治疗肝肾阴虚型儿童多发性抽动症,可提高临床疗效,有效缓解症状和促进患儿体内铅的排出,改善肌肉功能,不良反应少,安全性好。

Top-down控制图法评定石墨炉原子吸收光谱法测定血中铅含量的不确定度

采用Top-down控制图法评定石墨炉原子吸收光谱法测定血中铅含量的不确定度。依据GBZ/T 316.1—2018《血中铅的测定第1部分:石墨炉原子吸收光谱法》,不同人员每周测定铅质量浓度为(104±15)μg/L的冻干牛血质控样品1次,连续测定35次。对检测的35组数据进行离群值、正态性、独立性验证,并用Top-down控制图法评定铅含量的不确定度。血中铅质量浓度质控测试结果为(105.97±12.04)μg/L(95%包含概率)。Top-down控制图法评定血中铅含量的不确定度,简单、易操作,可以作为血铅含量检测的质量控制手段,对实验室检测结果进行趋势性分析,发现潜在的影响检测结果的因素,规避实验室风险。

基于“不通则痛”探讨中医药治疗子宫内膜异位症痛经机制的研究进展

子宫内膜异位症(EMT)是一种慢性雌激素依赖性疾病,痛经作为其最典型的临床症状,近年来发病率逐年升高,严重影响女性的生命质量。中医学认为不通则痛是EMT痛经的主要发病机制。现代医学发现,EMT发生与血管新生、上皮间质转化和免疫炎症等相关。最新研究文献发现,中医药可以从调节细胞自噬,发挥免疫、抗炎、抑制子宫平滑肌的收缩、改善子宫血液流变学、降低患者疼痛敏感性,抑制异位组织细胞的植入、粘连、黏附与侵袭而改善EMT痛经。在中医理论指导下,从中西医结合出发,总结现代医学理论中中医药治疗EMT痛经的作用机制,开拓中医药治疗EMT痛经的新思路与新方法。

Lead Pollution Research of Resident Children around Some Industrial Park

Lead is an important toxic heavy metal among environment pollution. Some industrial parks were founded in 2005 including non-ferrous metal processing and smelting plants. In order to identify the consequence of lead pollution on children around the industry park, blood samples of neighboring children were collected and analyzed in laboratory. The results showed that the involved children have suffered serious harms from Pb pollution. Almost 75% of the children＇s blood lead levels （BLLs） exceeded the limit of normal blood lead. Worse still, 26.17% of them were at the level of Moderate lead poisoning. The group aged 0-7 showed more susceptibility to Pb than that aged 8-14. Only 19.05% of the children aged 0-7 were at the level of normal blood lead, compared with 45.45% in the group aged 8-14. There was no significant difference between the values of blood lead concentration for male and female or among different age groups. Some approaches, which include controlling the Pb pollution from the industry park and safeguarding the residents, esp. the children were suggested.

Lead poisoning due to geophagia: The consumption of miniature pottery

Geophagia (the pica of pottery, clay, earth, or dirt) is practiced before and during pregnancy in several countries, including Mexico, Turkey, Australia, and some African countries, and has been linked with cultural fertility beliefs and the satisfaction of cravings. Unfortunately, consumption of contaminated pottery can represent a source of lead exposure. Concerns regarding ingested pottery are two-fold;first, that people consuming these pots might be exposed to high concentrations of lead, and, second, that ingestion of these pots by pregnant women could result in elevated in utero lead exposure for the fetus. Very few published articles exist on this topic. In an effort to investigate “pot eating”, this study aims to summarize published case studies on lead poisonings resulting from consumption of contaminated pottery. Additionally, several pottery items that are sold for the purpose of consumption were located and analyzed. This paper investigates the risk that “pot eating” poses by reviewing the literature, examining case studies, and analyzing the availability and lead concentration of edible pottery. Preliminary research indicates that although it is not common, “pot eating” can represent a high-risk lead exposure for pregnant women and their fetuses.

刍议慢性心力衰竭的气血津液辨治

气血津液皆中焦脾胃所化生,功能上互生互济,故而气虚、气滞、血虚、血瘀、水饮等气血津液的病理过程也常相继发生。“血不利则为水”阐明了气分、血分、水分的病理因果关系,可用以解释慢性心力衰竭(慢性心衰)的病变过程,认为慢性心衰常见病因皆可导致气的化生及气的功能障碍,进而引起“血不利”,所化之水饮停聚肌肤、脏腑组织间隙导致“水不利”,水饮、瘀血互结日久化热酿毒,则蚀脉伤肌,变证丛生。治疗应补气兼顾理气,活血利水不忘养血,恰当配伍清热解毒药,希冀在减少慢性心衰心血管事件方面获得较好的疗效。