PBX3在宫颈癌中的表达及与临床病理参数和预后关系

目的:探究宫颈癌组织中前B细胞白血病同源盒基因3(PBX3)的表达,以及与临床病理特征及预后的关系。方法:收集本院宫颈癌以及癌旁组织82例进行研究,Western blot法、免疫组化法检测标本组织中PBX3蛋白表达,分析二者与临床病理特征及预后的关系。对影响患者生存的临床因素进行COX回归分析,所有患者均进行30个月随访,统计患者生存率,采用Kaplan-Meier分析患者生存情况,Log-Rank法检测组间生存差异。结果:与癌旁组织相比,宫颈癌组织中PBX3蛋白、蛋白阳性表达率均升高(P0.05)。PBX3表达与年龄、病理类型、肿瘤浸润深度无关(P0.05),与肿瘤分期、肿瘤分化程度、肿瘤直径、浸润程度淋巴结转移有关(P0.05)。30个月随访,24人死亡,死亡率为29.3%。COX多因素分析显示,肿瘤分期、肿瘤分化程度、肿瘤直径、淋巴结转移、PBX3为影响患者预后的独立因素。PBX3阳性表达组58.1%死亡,阴性表达组23.5%死亡,两组患者Kaplan-Meier生存曲线存在差异(P0.05)。结论:PBX3在宫颈癌组织中表达上调,与肿瘤分期、分化程度、淋巴结转移等有关,可能为宫颈癌患者预后的生物学指标。     

宫颈癌中Plk1蛋白表达与疾病进展及患者远期生存率的关系

目的探讨宫颈癌组织中polo-like kinase 1(Plk 1)蛋白的表达与肿瘤发生发展、远期生存率的关系。方法选取80例宫颈癌组织标本(宫颈癌组)、宫颈上皮瘤组织作为CIN组(40例)、正常宫颈组织标本40例(对照组),收集时间2011年1月-2012年12月,采用免疫组化染色检测3组标本中的Plk1蛋白表达情况,分析Plk1蛋白与宫颈癌发生发展、远期生存率的关系。结果宫颈癌组的Plk1蛋白阳性表达率(73.75%)显著高于CIN组(45.00%)、对照组(12.50%),差异具有统计学意义(P0.05);宫颈癌组的Plk1蛋白阳性表达与分化程度、国际妇产联盟(FIGO)分期、是否发生淋巴结转移、间质浸润程度、是否发生脉管浸润具有显著的统计学意义(P0.05);宫颈癌组的Plk1蛋白阳性表达与患者肿瘤直径、年龄的关系无统计学意义(P0.05);宫颈癌组的Plk1蛋白阳性表达患者的3年生存率76.27%与阴性表达组的85.71%差异无统计学意义(P0.05);宫颈癌组的Plk1蛋白阳性表达患者的5年生存率40.68%显著低于阴性表达组的66.67%,差异有统计学意义(P0.05)。结论与CIN组织和正常宫颈组织相比,Plk1蛋白在宫颈癌中表达程度显著上调,并且与肿瘤的进展、患者远期生存密切相关。     

非小细胞肺癌患者腺苷A2A受体和TIM3的表达及其与患者预后的关系分析

目的探讨非小细胞肺癌(NSCLC)患者腺苷A2A受体(A2AR)和TIM3的表达及其与患者免疫功能的关系。方法采用免疫组织化学法检测65例NSCLC患者肺癌组织及其癌旁组织中的腺苷A2A受体和TIM3蛋白表达,并分析NSCLC组织腺苷A2A受体和TIM3蛋白表达与其预后的关系。结果肺癌组织腺苷A2A受体和TIM3蛋白表达率均高于癌旁组织(P0.05)。腺苷A2A受体和TIM3蛋白阳性表达患者的复发率、淋巴结转移率较高,5年生存率较低(P0.05)。Logistic多因素分析结果显示,NSCLC肺癌组织腺苷A2A受体和TIM3蛋白阳性表达率与其复发率、淋巴结转移率和5年生存率均相关。结论 NSCLC患者腺苷A2A受体和TIM3蛋白阳性表达率高且与其预后相关,可作为NSCLC患者预后评估的参考指标。     

CK2β和p53蛋白在宫颈癌组织中的表达及对患者预后的预测价值

目的探讨CK2β和p53蛋白在宫颈癌组织中的表达及对患者预后的预测价值。方法选取2012年7月-2014年12月该院收治的宫颈癌患者95例(研究组)和慢性宫颈炎患者50例(对照组),采用免疫组化法检测两组中宫颈组织标本中CK2β和p53蛋白表达情况,分析CK2β和p53阳性表达与宫颈癌患者临床病理参数的关系及与宫颈癌患者预后的相关性。结果研究组宫颈癌组织中CK2β、p53蛋白免疫组化评分分别为(6.89±1.46)分、(5.74±1.87)分,阳性率分别为67.37%、50.53%,均高于对照组(P<0.01)。宫颈癌组织中CK2β和p53蛋白阳性表达与患者年龄、病理分型无关(P>0.05),与FIGO分期、分化程度及淋巴结转移显著相关(P<0.05)。95例宫颈癌患者随访时间为18~53个月,中位随访时间38个月,随访结束时82例(86.32%)存活,13例(13.68%)死亡。FIGO分期(OR=16.837,P=0.000)、分化程度(OR=12.254,P=0.031)、淋巴结转移(OR=5.432,P=0.037)、CK2β蛋白阳性表达(OR=3.476,P=0.038)、p53蛋白阳性表达(OR=18.384,P=0.000)均可影响宫颈癌患者预后;而FIGO分期(OR=2.648,P=0.021)、p53蛋白阳性表达(OR=5.598,P=0.012)是影响宫颈癌患者预后的独立危险因素。结论宫颈癌组织中CK2β和p53蛋白均呈高表达,p53蛋白阳性表达对宫颈癌患者预后预测具有一定的价值。     

联合检测血管内皮生长因子与内皮因子在宫颈癌组织中的表达及其临床意义

目的探讨血管内皮生长因子(VEGF)与内皮因子(CD105)在宫颈癌组织中的表达及其临床意义,为临床诊治提供参考依据。方法应用免疫组织化学方法 (S-P法)对宫颈癌组织(72例)和正常宫颈癌组织(48例)的VEGF表达情况进行检测,其中新生血管的内皮细胞标记采用CD105,肿瘤内微血管的密度计算方法为Weidner法。同时对宫颈癌组织中的VEGF、CD105和分化程度、临床分期情况之间的关系进行分析。结果宫颈癌组患者VEGF阳性表达率(76. 39%)显著高于宫颈正常组(10. 42%),差异有统计学意义(P0. 05);Ⅰ～Ⅱ期宫颈癌患者组织中VEGF的表达较Ⅲ～Ⅳ期患者弱,差异有统计学意义(P0. 05),宫颈癌中淋巴结转移者VEGF的表达显著高于淋巴结未转移者,差异有统计学意义(P0. 05),宫颈癌组织中VEGF的表达水平与患者年龄、组织类型及分化程度等无关,差异无统计学意义(均P 0. 05);宫颈癌组CD105-MVD(31. 51±2. 702)显著高于正常宫颈组(1. 76±2. 113),差异有统计学意义(P0. 05);Ⅰ～Ⅱ期宫颈癌患者CD105-MVD显著低于Ⅲ～Ⅳ期患者,差异有统计学意义(P0. 05),宫颈癌淋巴结转移患者CD105-MVD显著高于宫颈癌淋巴结未转移者,差异有统计学意义(P0. 05),宫颈癌组织CD105的表达与患者年龄、分化程度、类型之间无相关性,差异无统计学意义(均P0. 05);宫颈癌组VEGF阳性患者中位生存时间(22. 5个月)明显短于VEGF阴性患者中位生存时间(31. 5个月),差异有统计学意义(P0. 05)。结论 VEGF与CD105在宫颈癌组织中高表达,临床FIGO病理分期增加以及淋巴结发生转移的宫颈癌患者中VEGF与CD105的阳性表达率均高于FIGO分期低与淋巴结未转移者,证实在宫颈癌疾病的发展、淋巴结转移过程中VEGF与CD105的联合检测对于患者的预后评估具有重要应用价值。     

人表皮生长因子受体-2的表达与大肠癌患者预后的相关性分析

目的探究人表皮生长因子受体-2(HER-2)的表达与大肠癌患者预后的相关性,为临床上评估大肠癌患者预后提供理论依据。方法研究对象选取在2012年2月-2014年2月间于我院就诊的大肠癌患者118例,采用免疫组化法检测患者大肠癌组织中HER-2表达水平,将HER-2表达结果分为两组,分别为阳性组(29例)和阴性组(89例)。分析患者一般资料、TNM分期、淋巴结转移与患者HER-2表达的相关性;并对其中术后在我院治疗资料完整的29例进行了预后及生存的评估,比较两组患者5年内生存率的差异。结果相关性分析结果显示,患者年龄、性别等一般资料与HER-2表达无显著相关性;患者TNM分期以及淋巴结转移情况与HER-2表达存在显著相关性(P0.05);两组患者术后5年内生存率比较结果显示,阳性组患者生存率低于阴性组,且差异存在统计学意义(P0.05)。结论 HER-2的表达与大肠癌患者预后存在显著相关性,可作为临床上评估大肠癌患者预后的重要指标。     

上皮间质转化相关因子E-钙黏蛋白和波形蛋白在浸润性乳腺癌中的表达及临床意义

目的探讨上皮间质转化相关因子E-钙黏蛋白(E-cadherin)和波形蛋白(Vimentin)在浸润性乳腺癌中的表达情况及两者的相关性,并分析其与临床病理特征及预后的关系,为临床治疗和干预浸润性乳腺癌提供理论依据。方法采用免疫组织化学方法检测150例浸润性乳腺癌和50例癌旁正常组织中上皮间质转化相关因子E-cadherin和Vimentin的表达情况,统计分析E-cadherin和Vimentin的相关性,并分析其与临床病理特征及预后的关系。结果 150例浸润性乳腺癌组织中Vimentin蛋白阳性表达64例,阳性率为42. 67%,E-cadherin蛋白阳性表达71例,阳性率为47. 33%; 50例癌旁正常乳腺组织中Vimentin蛋白阳性表达4例,阳性率为8. 00%,E-cadherin蛋白阳性表达45例,阳性率为90. 00%。浸润性乳腺癌组织中Vimentin蛋白阳性表达率显著低于癌旁正常乳腺组织,E-cadherin蛋白阳性表达率显著高于癌旁正常乳腺组织,差异有统计学意义(P<0. 05)。Vimentin蛋白在浸润性乳腺癌组织中的阳性表达与患者临床分期、淋巴结转移有关(P<0. 05),与患者年龄、肿瘤大小、组织学分级无关(P>0. 05)。E-cadherin蛋白在浸润性乳腺癌组织中的阳性表达与患者临床分期、淋巴结转移、组织学分级有关(P<0. 05),与患者年龄、肿瘤大小无关(P>0. 05)。随访5年,失访22例,随访到128例,死亡46例,其中44例死于浸润性乳腺癌,2例死于其他原因,1年、3年、5年总生存率分别为96. 88 (124/128)、84. 38 (108/128)、64. 06 (82/128)。Vimentin蛋白的阳性表达越强,无瘤生存时间越短,E-cadherin蛋白阳性表达越强,无瘤生存时间越长,差异有统计学意义(P<0. 05)。结论上皮间质转化相关因子E-cadherin和Vimentin表达的联合检测可预测浸润性乳腺癌的临床分期、组织学分级,对预后的判断具有重要的临床意义。     

脆性组氨酸三联体基因在宫颈癌组织中的表达及其与放疗疗效的关系

目的探究宫颈癌组织中脆性组氨酸三联体(FHIT)基因的表达情况,并分析其与放疗疗效的关系,为临床治疗提供参考依据。方法选取2010年1月-2013年12月张家口市崇礼区中医院肿瘤科收治的53例宫颈癌患者为研究对象,所有患者均经放疗治疗并定期随访3年,放疗2个月后评价其近期临床疗效,统计随访期间患者生存情况。另采用免疫组化检测各患者放疗前、放疗中及放疗后宫颈癌组织FHIT基因表达情况,分析其与患者临床病理特征及近远期临床疗效的关系。结果放疗2个月后,53例患者中完全缓解(CR)19例,部分缓解(PR)18例,疾病稳定(SD)9例,疾病进展(PD)7例,临床有效率为69.81%;随访期间,53例患者1、2、3年生存率分别为73.58%、64.15%、50.94%。放疗中及放疗后患者宫颈癌组织FHIT阳性表达率显著高于放疗前,差异有统计学意义(P0.05),且随放疗进展逐渐升高。宫颈癌患者FHIT表达率与年龄无显著相关性(P0.05),而与肿瘤大小及临床分级相关(P0.05)。FHIT阳性组RR显著高于FHIT阴性组,差异有统计学意义(P0.05);FHIT阳性组患者1年生存率显著高于FHIT阴性组,差异有统计学意义(P0.05),而两组间2、3年生存率比较,差异无统计学意义(P0.05)。结论放疗可有效上调宫颈癌组织中FHIT基因表达,且FHIT基因表达与宫颈癌患者近远期疗效明显相关,有助于判定宫颈癌患者放疗敏感性。     

子宫内膜癌组织MFG-E8蛋白表达与临床病理特征和患者生存率的关系

目的探讨乳脂肪球表皮生长因子8(MFG-E8)在子宫内膜癌(EC)组织的表达情况及其临床意义,并判断其是否可以作为肿瘤进展或预后生物标志物。方法采用anti-MFG-E8抗体进行免疫组织化学法检测EC组织、子宫内膜不典型增生组织及正常子宫内膜组织中MFG-E8蛋白表达,统计分析各组MFG-E8蛋白表达的相关性及其与患者临床病理特征和预后的关系。结果EC组织MFG-E8的阳性表达率(82.4%)明显高于子宫内膜不典型增生(40%)及正常子宫内膜组织(4%),差异有统计学意义(P<0.05);肿瘤组织MFG-E8表达水平与浸润深度≥1/2肌层、肿瘤大小及淋巴结转移相关;EC组织MFG-E8强阳性表达组5年生存率明显低于MFG-E8阴性组;单因素和多因素Cox回归发现,子宫内膜癌组织MFG-E8强阳性表达是患者预后的独立危险因素。结论MFG-E8强阳性表达可以作为肿瘤进展的标志物,预测EC的不良预后。     

CD47在宫颈病变组织中的表达及临床意义

目的 探讨CD47 mRNA及CD47蛋白在宫颈病变组织中的表达及临床意义。方法 采用qRT-PCR技术检测40例宫颈癌组织、40例HSIL和40例正常宫颈组织中CD47 mRNA的表达水平。采用IHC检测60例宫颈癌、30例HSIL和30例正常宫颈组织中CD47蛋白表达;并分析其表达水平与宫颈癌临床分期、分化程度等临床病理特征的相关性;绘制Kaplan-Meier曲线并采用LogRank检验比较不同CD47蛋白表达患者术后的生存情况,Cox比例风险模型分析宫颈癌患者预后的影响因素。结果 与正常宫颈组织相比,CD47 mRNA在宫颈癌和HSIL中高表达(P<0.05),宫颈癌组和HSIL组间差异无统计学意义(P>0.05)。与正常宫颈组织相比,CD47在宫颈癌和HSIL组织中的蛋白表达水平升高(P<0.05),宫颈癌和HSIL组间差异无统计学意义(P>0.05);且CD47蛋白的表达水平与宫颈癌分化程度、HPV感染、淋巴结转移和脉管浸润相关(P<0.05);Kaplan-Meier生存分析：CD47蛋白高表达组患者无进展生存率和总生存率均明显低于CD47低...     

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.     

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.     

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.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.