台州市健康体检人群MTHFR C677T基因和MTHFR A1298C基因多态性研究

目的了解台州市健康体检人群亚甲基四氢叶酸还原酶(MTHFR)C677T基因和MTHFR A1298C基因多态性的分布。方法以2016年9月—2017年9月在台州市中心医院进行健康体检者为研究对象,采集血液应用荧光定量PCR法检测MTHFR C677T以及MTHFR A1298C基因型,比较不同性别和地域人群MTHFR C677T和MTHFR A1298C等位基因和基因型频率分布差异。结果体检人群MTHFR 677CC、677CT、677TT基因型频率分别为40.09%、44.53%和15.39%,677T等位基因频率为37.65%;MTHFR 1298AA、1298AC、1298CC基因型频率分别为65.69%、30.47%和3.83%,1298C等位基因频率为19.07%。男女性体检者的MTHFR C677T基因型分布差异有统计学意义(P=0.036),但MTHFR A1298C基因型分布差异无统计学意义(P=0.278)。台州市健康体检人群MTHFR C677T等位基因和基因型频率分布情况与河南、乌鲁木齐和北京比较,差异均有统计学意义(P0.05);与武汉比较,差异均无统计学意义(P0.05)。结论台州市健康体检人群MTHFR C677T基因多态性分布受性别影响,且具有一定的地域特点。     

胃癌亚甲基四氢叶酸还原酶基因多态性及其与微卫星不稳的关系

目的探讨胃癌亚甲基四氢叶酸还原酶（MTHFR）基因多态性与微卫星不稳的关系。方法采用聚合酶链反应一限制性片段长度多态性技术检测122例胃癌和101名正常对照的MTHFR基因C677T和A1298C多态性；采用PCR为基础的方法检测微卫星不稳定性（MSI）。结果MTHFR C677T多态性可分为677CC、677CT和677TT三种类型。胃癌组3种基因型频率分别为47．5％、39．3％和13．1％；对照组分别为48．5％、42．6％和8．9％，两组相比差异无统计学意义（P〉0．05）。以677CC基因型做为参考，胃贲门癌677CT基因型OR值为0．38，95％CI：0．15～0．98；TT基因型OR值为0．26，95％CI：0．03～2．18；677CT＋TT基因型OR值为0．36，95％CI：0．07～0．98。胃体癌677TT基因型OR值为3．03，95％CI：1．07～8．65。MTHFR A1298C多态性可分为1298AA、1298AC和1298CC3种类型。胃癌组3种基因型频率分别为59．8％、36．1％和4．1％；对照组分别为57．4％，37．6％和5．0％，两组相比差异无统计学意义（P〉0．05）。以1298AA基因型的OR值为1．00，胃窦癌AC基因型的OR值为0．87，95％CI：0．42～1．82，CC基因型的OR值为0．41，95％CI：0．05～3．72。MTHFR 677TT基因型胃癌与微卫星不稳显著相关（P〈0．05），而MTHFR A1298C多态性与微卫星不稳无关（P〉0．05）。结论重庆地区人群中MTHFR C677T多态性是胃贲门癌的保护因素，是胃体癌的危险因素；MTHFR A1298C多态性可能是胃窦癌的保护因素；677TT基因型胃癌的发生可能涉及到MSI途径。     

亚甲基四氢叶酸还原酶基因多态性、饮酒与结直肠癌关系的病例对照研究

目的 研究亚甲基四氢叶酸还原酶(MTHFR)基因多态与结直肠癌(包括结肠癌、直肠癌)易感性的关系。方法 应用聚合酶链反应(PCR)和限制性片段长度多态性方法(RFLP),检测了126例结直肠癌患者和343名正常对照的MTHFR C677T和A1298C两个位点基因多态,并比较不同基因型单独、联合时与结直肠癌风险的关系,以及两个多态位点与饮酒的联合作用。结果MTHFR677T和1298C突变基因在对照组中的频率分别为39.7％和17.1％。1298C突变基因携带者与野生型相比,患结直肠癌的风险均降低;在携带677C和1298C等位基因组合个体中,结直肠癌的风险略有降低(OR=0.718,95％CI:0.367～1.407),同时含677T和1298A等位基因者,结直肠癌的风险降低1倍;同时含有677T和1298C等位基因者,结直肠癌的风险降低4倍,直肠癌的风险降低7倍(OR=0.304,95％CI:0.108～0.852)。在过去饮酒者中,1298A等位基因携带者结直肠癌风险性增加2倍(OR=3.307,95％CI:0.521～17.698)。结论 MTHFR C667T和A1298C位点多态性在结直肠癌发生过程中起着一定作用,携带MTHFR 1298AC基因多态型者过去饮酒是结直肠癌的危险因素。     

叶酸、蛋氨酸摄入量,MTHFR多态性与结直肠癌关系的病例对照研究

目的:研究亚甲基四氢叶酸还原酶(MTHFR)基因多态,叶酸、蛋氨酸摄入量与结直肠癌易感性的关系。方法:应用PCR-RFLP法,检测126例结直肠癌患者和343例正常对照者的MTHFRC 677T和A1298C两个位点基因多态,比较不同基因型与结直肠癌风险的关系,以及两个多态位点与叶酸、蛋氨酸的联合作用。结果: MTHFR C677T和A1298C突变基因在对照组中的频率分别为39.7%和17.1%。MTHFR A1298C突变基因携带者与野生型相比,患结直肠癌的风险显著降低(OR=0.51,95% CI:0.27～0.95);在叶酸个别摄入量组,MTHFR C677T多态使结直肠癌的风险显著降低(OR=0.23,95% CI:0.06～0.93)。结论: MTHFR A1298C位点多态性是直肠癌的保护因素 ,在叶酸摄入充足的条件下,MTHFR C677T多态是结肠癌的保护因素。     

亚甲基四氢叶酸还原酶基因多态性与胃癌化疗的敏感性关系的研究

目的 研究亚甲基四氢叶酸还原酶(MTHFR) 因C677T、A1298C多态与胃癌患者对5-FU为基础的化疗敏感性和毒性的关系。方法 收集经病理学确诊的晚期胃癌患者75例,病例化疗前均抽静脉血,提取白细胞DNA,用聚合酶链反应-限定性片段长度多态性技术检测MTHFR基因型。所有患者经5-FU为基础的化疗方案治疗。结果 (1)在75例晚期胃癌患者中,MTHFR C677TC／C、C／T、T／T基因型者分别为24例(32.0％)、33例(44.0％)和18例(24.0％);MTHFR A1298CA／A、A／C、C／C基因型者分别为52例(69.3％)、22例(29.3％)和1例(1.3％);经化疗后22例患者有效,总有效率29.3％。(2)MTHFR C677T T／T基因型者化疗的有效率为83.3％,显著高于T／C基因型者(15.2％,x2=22.27,P=0.000)和C／C基因型者(8 3％,x2=23.44,P=0.000)。C677T T／T基因型患者化疗敏感性是携带C677T C等位基因者的7.64倍(调整了性别、年龄、以往辅助化疗史及化疗方案,95％CI:3.14-18.62)。MTHFR A1298C A／A基因型者的有效率(36.5％),显著高于携带A1298C C(13.0％)等位基因者(x2=4 19,P=0.041;调整OR=3 75,95％CI:0.94-14.87)。同时携带MTHFR C677T T／T基因型和A1298C A／A基因型者化疗的有效率(86.7％)显著高于其他基因型者(15.0％,Fisher's exact:P=0.000,调整OR=6.57.95     

探讨亚甲基四氢叶酸还原酶C677T和A1298C基因多态性与乳腺癌的易感性研究

目的探讨亚甲基四氢叶酸还原酶(MTHFR)基因C677T和A1298C位点多态性与乳腺癌易感性的关系。方法选取96例乳腺癌患者为疾病组,107例健康体检女性为对照组,用聚合酶链反应技术检测MTHFR基因C677T和A1298C位点的多态性,基因型分别为野生型(677CC)、杂合型(677CT)、纯合型(677TT)和野生型(1298AA)、杂合型(1298AC)、纯合型(1298CC)。结果乳腺癌组677位点3种基因型频率分别为39.58%、50.00%和10.42%,与对照组相比,差异无统计学意义(P0.05);乳腺癌组1 298位点3种基因型频率分别为66.66%、22.92%和10.42%,其中野生型(1298AA)和杂合型(1298AC)与对照组比较,差异无统计学意义(P0.05),而纯合型(C1298C)与对照组相比较差异有统计学意义(P0.05)(OR=4.03,95%CI:1.08~15.11)。结论 MTHFR基因1 298位点A-C变异可能是台州地区乳腺癌的易感因素之一,但仅在CC纯合型时有统计学意义,677位点多态性与乳腺癌的发生无明显相关性。     

MTHFR基因多态性与先兆流产和复发性流产的关系

目的探讨5,10-亚甲基四氢叶酸还原酶(MTHFR)基因C677T和A1298C位点多态性与先兆流产和复发性流产的关系。方法选取2016年7月-2017年7月在台州市中心医院就诊的135例先兆流产患者和108例复发性流产患者分别为先兆流产组和复发性流产组,选取于同院接受健康查体的140例育龄期健康女性为对照组。采用荧光定量PCR技术检测3组MTHFR基因C677T和A1298C位点的多态性。结果先兆流产组与对照组MTHFR基因C677T位点CC、CT、TT基因型频率比较差异无统计学意义(P0. 05); TT基因型频率在复发性流产组中显著升高,而CC基因型频率在复发性流产组中显著降低(P0. 05)。复发性流产组MTHFR基因C677T位点T等位基因频率显著高于对照组(P0. 05),相对于纯合未突变等位基因C的相对危险度OR=1. 816,95%CI为1. 258～2. 622;先兆流产组与对照组T等位基因频率比较差异无统计学意义(P0. 05)。与对照组比较,先兆流产组、复发性流产组MTHFR基因A1298C位点AA、AC、CC基因型频率比较差异均无统计学意义(均P0. 05);先兆流产组及复发性流产组C等位基因频率与对照组相比差异均无统计学意义(均P 0. 05)。结论 MTHFR基因C677T位点C/T变异可能是台州地区复发性流产的因素之一,MTHFR基因A1298C位点多态性与先兆流产和复发性流产的发生无明显相关性。     

不良妊娠结局患者和正常人群亚甲基四氢叶酸还原酶基因多态性的比较

目的研究台州地区不良妊娠结局育龄妇女与正常人群育龄妇女亚甲基四氢叶酸还原酶(methylenetrahydrofolate reductase,MTHFR)基因C677T和A1298C基因型的分布情况,探讨MTHFR C677T和A1298C基因位点多态性与不良妊娠结局的相关性。方法应用实时荧光定量PCR仪检测MTHFR C677T和A1298C位点基因多态性,并进行基因分型。结果观察组和对照组MTHFR C677T位点TT基因型频率为23.39%和12.68%,差异有统计学意义(χ2=6.595,P0.05)。T等位基因频率在观察组和对照组分别为43.15%和31.69%,差异有统计学意义(χ2=7.450,P0.01)。MTHFR A1298C位点CC基因型在观察组和对照组差异无统计学意义(χ2=1.639,P0.05)。C等位基因在观察组和对照组相比差异无统计学意义(χ2=1.334,P0.05)。结论 MTHFR C677T位点的多态性和不良妊娠结局密切相关。台州地区育龄妇女人群MTHFR基因的分布特点与群体遗传学特征具有地域特异性。     

叶酸基因检测对于不明原因复发性自然流产的应用价值

目的探讨叶酸基因检测对于不明原因复发性自然流产的应用价值。方法选择2016年1月-2019年1月温州市中心医院截止不明原因复发性自然流产患者200例纳入研究,依据叶酸基因检测与否分为研究组、对照组,各100例。采用荧光定量PCR技术对叶酸MTHFR基因(C677T、A1298C)多态性实施检测,探究叶酸MTHFR基因型和不明原因复发性自然流产发生相对风险性。结果研究组血浆叶酸、红细胞叶酸表达水平均高于对照组(P0.05);研究组MTHFR基因C677T位点CC基因型频率高于对照组,但TT基因型频率低于对照组,(P0.05);两组MTHFR基因A1298C位点AA、AC、CC基因型的频率分布差异无统计学意义(P0.05);研究组MTHFR基因C677T位点C等位基因的频率高于对照组,但T等位基因频率低于对照组(P0.05);相较于MTHFR基因C677T位点CC纯合子,TT纯合子基因型患者出现不明原因复发性自然流产风险高3.29倍,OR值为3.288,95%CI为1.340～8.065。结论不明原因复发性自然流产患者体内叶酸水平降低,叶酸MTHFR C677T位点基因多态性和不明原因复发性自然流产发生存在相关性,且MTHFR基因C677T位点TT基因型可导致患病风险增加。     

MTHFRC677T基因多态性与胎儿神经管畸形关系

目的:探讨亚甲基四氢叶酸还原酶(MTHFR)C677T位点基因多态性与胎儿神经管畸形的相关性。方法:分别选择52例既往孕有神经畸形胎儿的女性(观察组)和50例正常孕育史女性(对照组),取肘静脉血采用TaqMan探针SNP基因分型技术检测MTHFR C677T位点基因多态性,循环酶法检测血清同型半胱氨酸Hcy水平。分析MTHFR C677T位点基因多态性与血清Hcy水平以及胎儿神经管畸形易感的相关性。结果:观察组MTHFR C677T位点TT基因型、等位T基因频率高于对照组(P0.05)。观察组MTHFR C677T位点TT基因型受试者血清Hcy水平高于CC、CT基因型者(P0.05);对照组MTHFR C677T位点3种基因型之间差距没有统计学意义(P0.05)。二元logistic回归分析MTHFR C677T位点TT基因型[OR=2.003(95%CI:1.245～5.235)]携带者是胎儿神经管畸形易感的危险因素(P0.05)。结论:MTHFR C677T位点携带TT基因型人群血清Hcy水平偏高,是胎儿神经管畸形易感的高危人群。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.