人乳头瘤病毒致宫颈癌变机制研究进展

宫颈癌是一种常见的妇科恶性肿瘤,严重威胁女性的生命健康。高危型人乳头瘤病毒(HR-HPV)持续感染是导致宫颈癌的主要原因。已知从HPV感染进展到宫颈癌历时较长,这为宫颈癌的癌前筛查提供了可能。因此,了解HPV自身及其致癌机制十分重要,本文就不同HPV分子的致癌潜能、HPV的生命周期、HPV致宫颈癌变的中心环节及其导致的宿主细胞基因组不稳定性和体细胞基因突变作如下综述。     

宫颈癌易感基因多态性的研究进展

<正>宫颈癌是妇科最常见的恶性肿瘤之一,严重威胁女性的健康和生命。研究发现宫颈癌是由多种因素长期相互作用引起的疾病,其中高危型人乳头瘤病毒(HPV)的持续感染是宫颈癌发生的必要条件。持续的高危型HPV感染会导致HPV-DNA整合到宿主基因组中并破坏开放阅读框,导致病毒癌基因E6和E7表达增加,并分别与P53和PRb结合,导致宫颈细胞恶变,进而引起宫颈癌的发生^[1]。然而仅高危型HPV感染不足以诱发宫颈细胞恶性转化,研究显示宿主基因多态性可能是影响个体对宫颈癌易感性最不可忽略的因素^[2]。     

广州市HPV的基因分型特点及其与宫颈病变的关系研究

目的分析广州市人乳头瘤病毒(Human papillomavirus,HPV)的基因分型特点及其与宫颈病变的关系。方法选取2015年6月-2018年3月南方医科大学第三附属医院经HPV基因芯片技术检测和病理活检检测的女性816例,根据病理学诊断将受试者分为宫颈癌组(n=48)、癌前病变组(n=213)、宫颈炎症组(n=421)、正常宫颈组(n=134),分析各组HPV感染的基因分型特点及其与宫颈癌的关系。结果 816例受检女性共有337例HPV阳性,479例HPV阴性,阳性率为41.30%;共检测出506个HPV基因型,其中高危型HPV 245例,占48.42%,低危型HPV 261例,占51.58%,高危型常见基因型主要为HPV16,占13.44%;正常宫颈组、宫颈炎症组、癌前病变组、宫颈癌组HPV阳性率呈逐渐升高趋势(P<0.05);癌前病变组、宫颈癌组高危型HPV阳性率高于正常宫颈组、宫颈炎症组,且宫颈癌组高于癌前病变组(P<0.05);Logistic回归分析结果显示HPV、高危型HPV与宫颈癌的发生呈正相关(P<0.05)。结论广州市女性高危型HPV感染常见基因型为HPV16、52、58、53、18、33、31,HPV感染、高危型HPV感染与宫颈癌的发生呈正相关。临床上应根据HPV基因分型特点开展防治工作,减少广州市女性宫颈癌发生的风险。     

中国HPV感染面临的问题与挑战

人乳头状瘤病毒（HPV）感染已成为全球女性最严重的疾病负担之一,其不仅可以引起常见的性传播疾病,还与生殖道肿瘤密切相关。尤其是高危型HPV,是导致宫颈癌的最主要因素。虽然HPV感染与宫颈癌的临床研究已成为近十余年的研究热点,但我国有关HPV感染的流行病学、高危型HPV检测在我国宫颈癌筛查中的作用和地位、如何阻断高危型HPV的持续性感染以及HPV疫苗在中国的应用等方面还存在诸多问题与挑战。     

血清25-羟-维生素D及雌二醇水平与宫颈癌发生的关系研究

<正>宫颈癌是在全球范围内发病率居于第3位的女性常见恶性肿瘤。高危型人乳头瘤状病毒(HPV)是宫颈癌发生的主要原因[1]。虽然HPV在已育女性中的感染率较高,但感染人群中只有一小部分会发展成宫颈癌。说明高危HPV感染并不足以引起恶性病变,那么寻找其他相关致癌因子就十分重要。目前针对雌激素与宫颈癌发生关系的探讨多有报道[2-3]。近年来更是有不少研究报道了维生素D水平与恶性肿     

不同HPV亚型的多重感染和年龄因素与宫颈病变的关系

目的:探讨不同亚型人乳头状瘤病毒(human papillomavious,HPV)多重感染及年龄等因素与宫颈不同程度病变的关系。方法:采用核酸分子快速导流杂交基因微阵列分型检测技术对418例女性HPV感染者进行HPV分型检测,同时检测宫颈病变程度。结果:仅感染高危型HPV病毒(包括混合感染多种高危HPV病毒)的女性患者其宫颈癌、尖锐湿疣构成比与仅感染低危型HPV病毒(包括混合感染多种低危HPV病毒)组的相应构成比存在较大差异(χ2=41.81,P<0.001);感染多种高危(低危)HPV与感染单一高危(低危)HPV相比,不同宫颈疾病的构成比并无差别;在不同的年龄段,高危型、低危型以及高低危HPV混合感染类型的构成比有显著性差异(χ2=17.25,P<0.05)。多元logitic回归分析年龄因素及不同类型高危型HPV感染与宫颈癌的关系显示年龄超过40岁(OR=1.63,P<0.05),16型HPV感染(OR=2.78,P<0.01),58型HPV感染(OR=1.69,P<0.05)宫颈癌患病风险大大增加。结论:感染高危型HPV引起宫颈癌的患病风险增加,而低危型HPV则更易引起尖锐湿疣的发生;多重感染并不会促进宫颈疾病的进展;年龄、16型和58型HPV的感染是影响宫颈癌发生的重要因素。     

女性健康体检者HPV基因型及高危因素分析

目的探讨女性健康体检者人乳头瘤病毒(HPV)基因型与高危影响因素。方法对2016年7月-2018年1月在江门市五邑中医院接受健康体检的522例女性受检人员进行PCR-反向斑点杂交法检测,了解受检者中HPV阳性情况、HPV分型及HPV感染相关高危因素。结果 522例受检人员中HPV阳性率为14. 56%,共检出6种高危基因型别,其中HPV16基因检出率(8. 05%)最高;饮酒、性伴侣1个、伴宫颈糜烂是HPV感染的高危因素(P0. 05)。结论 HPV基因型别检测可以为宫颈癌早期筛查及高危因素判别提供重要信息,有助于促进女性健康体检工作的合理开展,全面了解HPV的基因类型与高危风险因素,为宫颈癌预防、诊断及治疗提供依据。     

HPV E2蛋白及其在宫颈癌演变中的作用机制

宫颈癌及其癌前病变的发生是多种因素协同作用的结果,高危型人乳头瘤病毒(HPV)感染是宫颈癌演变的始动因素,而HPV与宿主染色体的整合则是推动宫颈癌变进展的重要事件.病毒基因组的整合破坏了E2基因完整性,E2蛋白断裂使宫颈细胞更易于永生化,促进癌变发展.下面就E2基因的功能及病毒基因组整合后癌变发生的机制进行阐述.E2蛋白是一种序列特异性DNA结合蛋白,可调节DNA复制、转录,在HPV感染及感染后病毒生活周期的正常维持中具有关键作用.宫颈癌的演变与高危型别HPV感染不可分割,以HPV16、HPV18两型感染最常见.HPV16 E2蛋白编码基因序列位于基因组第2 755～3 852位;HPV18 E2蛋白编码基因序列位于基因组第2 817～3 914位.     

宫颈癌可以预防吗

<正>宫颈癌是一种常见的恶性肿瘤，严重威胁女性生殖健康，其“元凶”是人乳头状瘤病毒(Human Papilloma Virus，简称HPV)。国际癌症研究署公布，HPV亚型有200余种，可致癌的有12种，可能致癌的有12种。在我国，约98%的患者因感染高危型HPV导致宫颈癌。值得庆幸的是，宫颈癌是目前唯一一个病因明确的恶性肿瘤，可通过三级预防措施降低患病率。     

宫颈病变中p27、p16表达情况的相关研究

宫颈癌是女性最常见的恶性肿瘤之一,发病率仅次于乳腺癌,死亡率较高。宫颈癌与HPV感染密切相关,高危型人乳头瘤病毒(HR-HPV)的持续感染是宫颈癌的主要致病原因。但是,较高的HPV感染率与较低的宫颈癌发病率又说明宫颈癌的发生还需要其他因素的参与〔1〕。分子病理学表明:宫颈癌的发生及发展与细胞周期调节紊乱关系非常密切〔2〕。真核细胞最重要的细胞周期调控系统是Cyclin-     

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.