The Tobacco Pack Surveillance System: A Protocol for Assessing Health Warning Compliance,Design Features,and Appeals of Tobacco Packs Sold in Low- and Middle-Income Countries

Background

Tobacco remains the world’s leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack.

Objective

The objective of this study was to establish a surveillance system for tobacco packs in the 14 low- and middle-income countries with the greatest number of smokers. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended, and identifies pack designs and appeals that might violate or detract from the communication of harm-related information and undermine the impact of a country’s tobacco packaging laws. The protocol outlined is intended to be applicable or adaptable for surveillance efforts in other countries.

Methods

Tobacco packs were collected in 14 countries during 2013. The intention was, to the extent possible, to construct a census of “unique” pack presentations available for purchase in each country. The TPackSS team partnered with in-country field staff to implement a standardized protocol for acquiring packs from 36 diverse neighborhoods across three cities in each country. At the time of purchase, data on price and place of acquisition of each pack was recorded. The field staff, according to a standardized protocol, then photographed packs before they were shipped to the United States for coding and archiving.

Results

Each pack was coded for compliance with the country-specific health warning label laws, as well as for key design features of the pack and appeals of the branding elements. The coding protocols were developed based upon prior research, expert opinion, and communication theories. Each pack was coded by two independent coders, with consistency of personnel across the project. We routinely measured intercoder reliability, and only retained variables for which a good level of reliability was achieved. Variables where reliability was too low were not included in final analyses, and any inconsistencies in coding were resolved on a daily basis.

Conclusions

Across the 14 countries, the TPackSS team collected 3307 tobacco packs. We have established a publicly accessible, Internet archive of these packs that is intended for use by the tobacco control policy advocacy and research community.     

皮肤晚期糖基化终末产物与2型糖尿病周围神经病变的相关性研究

目的分析2型糖尿病（T2DM）伴周围神经病变（DPN）患者皮肤晚期糖基化终末产物（AGEs）水平变化及其临床意义。方法选择99例 T2DM 患者,依据神经缺陷评分（NDS）将其分为 DPN 组和非 DPN 组,同时选取正常对照组（NC 组）35例,测定各组皮肤 AGEs 和糖化血红蛋白（HbA1c）水平并进行比较。结果与 NC 组相比,T2DM 患者皮肤 AGEs 水平明显升高（P ＜0.05）;与非 DPN 组相比,DPN 组患者皮肤 AGEs 水平明显增（P ＜0.05）,两组 HbA1c 水平差异无统计学意义（P ＞0.05）。结论T2DM 患者皮肤 AGEs 水平升高可能参与糖尿病周围神经病变的发生。     

重型颅脑外伤术后颅内感染患者脑脊液高迁移率族蛋白-1和RAGE水平的变化及意义

目的:观察重型颅脑外伤(sever traumatic brain injury,s TBI)术后发生颅内感染的患者高迁移率族蛋白-1(High mobility group box 1,HMGB-1)和晚期糖基化终产物受体(receptor for advanced glycosylation end products,RAGE)的脑脊液(cerebrospinal fluid,CSF)水平,探讨其对诊断颅内感染的价值。方法:54例s TBI术后拟诊发生颅内感染的患者根据最后诊断分为颅内感染组(n=12)和非颅内感染组(n=42)。酶联免疫法吸附法(enzyme-linked immunosorbent assay,ELISA)检测拟诊颅内感染时CSF中的HMGB-1和RAGE蛋白水平。受试者工作曲线(receiver operating characteristic,ROC)分析其对颅内感染的诊断意义。结果:脑脊液的HMGB-1和RAGE水平在颅内染组和非颅内感染组之间比较差异具有统计学意义(t=6.711,P=0.000;t=2.683,P=0.008)。脑脊液HMGB-1和RAGE水平诊断颅内感染的ROC的曲线下面积分别为:0.899(95%CI:0.822~0.975)、0.682(95%CI:0.555~0.809)。HMGB-1的cut-off值分别为209.50 ng/m L(敏感度:0.75,特异性:0.93);RAGE的cut-off值为108.50 ng/m L(敏感度:1.00,特异性:0.43)。结论:联合检测脑脊液HMGB-1和RAGE水平对s TBI术后是否发生颅内感染具有重要的诊断价值。     

糖耐量异常患者骨密度水平测定及其与血糖代谢指标的关系探究

目的 研究糖耐量异常(IGT)患者的骨密度水平及其与血糖代谢指标的关系.方法 将河北医科大学第一医院门诊体检发现的IGT患者290例纳入研究的观察组,同期体检的健康者290例纳入研究的对照组,检测两组受试者的血糖代谢指标空腹血糖、空腹血浆胰岛素、胰岛素样生长因子、糖基化终末产物、糖化血红蛋白水平以及L3、L4椎体、股骨颈、大转子、Ward's区的骨密度,分析骨密度水平与血糖代谢指标的关系.结果 两组受试者空腹血糖水平无明显差异(P＞0.05).观察组患者的晚期糖基化终末产物、糖化血红蛋白水平高于对照组,胰岛素、胰岛素样生长因子水平以及L3、L4腰椎、股骨颈、Ward's三角区、大转子的骨密度水平均低于对照组.糖基化终末产物、糖化血红蛋白水平与骨密度水平呈负相关,胰岛素、胰岛素样生长因子水平与骨密度水平呈正相关.结论 IGT患者的骨密度显著下降,且骨密度与血糖代谢指标胰岛素、胰岛素样生长因子、糖基化终末产物、糖化血红蛋白水平密切相关.     

Paeoniflorin protects HUVECs from AGE-BSA-induced injury via an autophagic pathway by acting on the RAGE

The aim of our study was to investigate the protective effects of Paeoniflorin (PF) against injury induced by AGE-modified bovine serum albumin (AGE-BSA) in human umbilical vein endothelial cells (HUVECs), and to examine the underlying mechanisms of these effects. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to determine cell viability. Protein expression levels were determined by western blotting. For function-blocking experiments, we used small interfering RNA molecules (siRNA) for function-blocking experiments. At 6 h, we found that 100 μg/mL AGE-BSA reduced the viability of HUVECs. However, pretreatment with PF restored cell viability in a dose-dependent manner. AGE-BSA increased the levels of microtubule-associated protein light chain 3-II (LC3-II) and the receptor for advanced glycation end products (RAGE). Expression of p62 protein was also increased, but not at a statistically significant level. Pretreatment with PF further increased levels of LC3-II and RAGE, but reduced the expression of p62. In cells transfected with Atg5 and RAGE siRNA, cell viability and expression of LC3-II decreased in both the AGE-BSA and PF + AGE-BSA treatments. PF can protect HUVECs from AGE-BSA-induced injury by upregulating autophagy and promoting the completion of autophagy flux. RAGE plays an important role in this autophagic protection effect.     

MADPH氧化酶抑制剂对晚期氧化蛋白产物诱导内皮细胞高通透性的影响及机制

目的:探讨NADPH氧化酶(Nox)抑制剂对晚期氧化蛋白产物(AOPP)刺激下血管内皮的保护作用。方法:体外培养人脐静脉内皮细胞进行实验,人血清白蛋白(HSA)作为阴性对照,用不同浓度(50、100和200mg/L)AOPP-HSA共同孵育8 h后,利用5-氯甲基二乙酸荧光素标记人急性单核细胞白血病细胞株THP-1的细胞渗出数量反映内皮细胞的通透性,研究不同浓度AOPP-HSA对单层细胞通透性的影响。此外,另将细胞分为HSA组、AOPP-HSA组和AOPP-HSA+二联苯碘(DPI)组,进而探讨AOPP-HSA对Nox活化水平的影响以及DPI对内皮细胞骨架重构和细胞通透性改变的作用。结果:AOPP-HSA可使血管内皮细胞通透性明显增加(P0.05)。AOPP-HSA可导致Nox磷酸化水平上升,并呈剂量依赖性。Nox抑制剂DPI预处理组可抑制AOPP-HSA刺激下Nox磷酸化水平的上升,从而抑制血管内皮细胞通透性增加及细胞骨架重构。结论:AOPP-HSA可通过激活Nox导致血管内皮细胞通透性受损,Nox抑制剂DPI可以降低其通透性及细胞骨架重构,起到一定的保护作用。     

宁夏回族自治区消毒产品监管现状调查

目的了解宁夏回族自治区消毒产品经营和使用单位管理现状,为规范消毒产品监管提供依据。方法通过抽检方式,对辖区内涉消毒产品经营单位和使用单位进行抽样检查。结果共调查167家消毒产品经营单位,337种消毒产品。经营单位索证率为58.68%,标签说明书符合率为84.27%。调查169家消毒产品使用单位,151种消毒产品,使用单位索证率为63.31%,标签说明书符合率为83.43%。结论该区消毒产品经营和使用单位索证率均比较低,市场消毒产品存在标签说明书管理不规范情况,必须加强消毒产品市场监管和涉消毒产品单位监督监测力度。     

Plasma for fractionation: safety and quality issues.

Plasma may be procured for use as a therapeutic product or as a raw material for manufacture of other products, and may be collected as a by-product of whole blood, or as a plasma donation from aphaeresis. When collected for fractionation, the quality and safety of the plasma are intimately linked to the quality and safety of the manufactured plasma derivatives. High quality plasma can be obtained either from whole blood or from plasmapheresis; quality can, however, be adversely affected by poor storage conditions after collection. Quality standards for plasma for fractionation are necessarily different than for plasma for transfusion and, with modern fractionation methods, certain quality aspects become less relevant. Similarly, the relevance of certain recent technological advances, such as nucleic acid testing (NAT), for maximizing the safety of plasma for fractionation are questionable, although their introduction through the linkage of recovered plasma to whole blood collection can improve the safety of fresh blood components. Viruses that are not screened for at blood banks may also be excluded from the plasma pool they are more clinically relevant when multiple products made from a pool may infect a large number of recipients, in contrast to components given to one or a small number of patients.     

双水相萃取在中药活性成分提取分离中的应用进展

双水相萃取是一种易于放大、可连续化操作、易于集成技术、绿色环保的新型液/液萃取分离技术,在分离纯化蛋白质、基因、生物纳米分子、细胞和天然产物等领域有着广泛应用。系统综述近5年该技术在中药活性成分提取分离中的应用进展,以期抛砖引玉,推动中药活性成分分离纯化研究的进步和发展。