Bioshock: Biotechnology and Bioterrorism

In the recent past, the threat of a global bioterrorist attack has increased dramatically. In addition to the already existing microorganisms and techniques, the recent explosion in biotechnology has considerably added to the arsenal of the bioterrorist. Molecular technologies are now available which can be used by committed bioterrorist groups to manipulate and modify microorganisms so as to make them increasingly infectious, virulent or treatment resistant for causing maximum casualties. Infectious diseases which are likely to be used as bioweapons are Anthrax, Botulism, Plague, Smallpox and Brucella. Molecular techniques like immunoassays and nucleic acid amplification are now available to detect bioattacks. This article discusses the threat of bioterrorism. It also evaluates the molecular diagnostic methods and the future of early containment of a bioterrorist attack using molecular techniques.Key Words: Bioterrorism, Molecular techniques     

Bioterrorism : A Public Health Perspective

The intentional release or threat of release of biologic agents (i.e. viruses, bacteria, fungi or their toxins) in order to cause disease or death among human population or food crops and livestock to terrorize a civilian population or manipulate the government in the present scenario of increased terrorist activity has become a real possibility. The most important step in the event of a bioterrorist attack is the identification of the event. This can be achieved by generating awareness, having high degree of suspicion and having a good surveillance system to assist quick detection.Bioterrorist attacks could be covert or announced and caused by virtually any pathogenic microorganism. Bioterrorist agents of major concern have been categorized as A, B and C based on the priority of the agents to pose a risk to the national security and the ease with which they can be disseminated. The five phases of activities in dealing with a bioterrorist attack are preparedness phase, early warning phase, notification phase, response phase and recovery phase.A bioterrorism attack in a public place is a public health emergency. Early detection and rapid investigation is the key to contain such attacks. The role of public health epidemiologist is critical not only in determining the scope and magnitude of the attack but also in effective implementation of interventions.Key Words: Bioterrorism, Anthrax, Botulism, Plague, Smallpox, Public health emergency, Category A, B and C agents     

Bioterrorism : A public health perspective

The intentional release or threat of release of biologic agents (i.e. viruses, bacteria, fungi or their toxins) in order to cause disease or death among human population or food crops and livestock to terrorize a civilian population or manipulate the government in the present scenario of increased terrorist activity has become a real possibility. The most important step in the event of a bioterrorist attack is the identification of the event. This can be achieved by generating awareness, having high degree of suspicion and having a good surveillance system to assist quick detection.     

Smallpox in the post-eradication era

Smallpox is a recently extinct human viral infection for which herd immunity has rapidly waned. The threat of smallpox during a bioterrorist event using caches of virus outside reference repositories would lead to epidemics of great and predictable mortality. The result would be short-term societal chaos. Control of smallpox requires vaccination and quarantine, the same measures that eliminated this disease in the 1970's. Extensive coordination and planning would be needed among the healthcare infrastructure, law enforcement agencies and political leadership for effective responses to this public health threat. Despite this challenge, we must remind ourselves that smallpox transmission and vaccinia effectiveness are well understood. Strategies that successfully eradicated smallpox 25 years ago, if appropriately implemented again, would undoubtedly lead to its elimination once again.     

Bioterrorism: a threat for which we are ill prepared

Of the weapons of mass destruction, the biological ones are the most feared and bioterrorism has become one of the most vicious threats to civilized society in recent times. Biological weapons have been sporadically used for centuries. Despite international regulations, there has been a global re-emergence of the threat of biological warfare. As many as 17 countries are suspected of either including or developing biological agents in their weapons programmes. In the past decade, a number of terrorist organizations with access to bioweapons technology have emerged. Current surveillance systems may be inadequate to detect biological attacks. The onset of illness is often delayed, thus the timing and location of such an event may be extremely difficult to identify. We are unfamiliar with most of the agents of biological warfare and are ill-equipped to handle the consequences of such an attack. In addition, there is no apparent coherent policy to handle a biological terrorist incident. Given the enormity of what is possible in the event of a biological attack, we must be prepared to detect, diagnose, epidemiologically characterize and respond appropriately to biological weapons. Of the potential biological weapons, smallpox and anthrax pose the greatest threats.     

流感病毒神经氨酸酶抑制剂的设计策略及研究进展

流感对人类的健康构成很大威胁,尤其在流感暴发期,能够造成大量人员死亡。神经氨酸酶（NA）为流感病毒表面蛋白,在病毒的生命过程中起着重要作用,是抗流感药物设计的重要靶点。自从1983年NA结构被解析出来后,基于结构的药物设计以及计算化学的运用极大地促进了NA抑制剂（NAI）的发展,到目前为止,已有两种抗流感药物上市——扎那米韦和奥司他韦。本文将以这两种药物的开发为例,简要介绍NAI的设计策略及最近几年的研究进展。     

Medical treatment of erectile dysfunction.

There has been a tremendous increase in demand for the treatment of erectile dysfunction in the last 10 years. This has occurred partly because of a greater understanding and awareness by both the general public and clinicians, and also because there now exists a range of effective treatments. The choice of treatments is increasing rapidly and novel delivery systems which may be more patient-friendly than intracavernosal injections are now becoming available. We review the published data on effectiveness and safety of the currently available treatments and discuss recent advances in oral therapy, as these drugs are likely to become available in the near future.     

The Contributions of Biomedical Informatics to the Fight Against Bioterrorism

A comprehensive and timely response to current and future bioterrorist attacks requires a data acquisition, threat detection, and response infrastructure with unprecedented scope in time and space. Fortunately, biomedical informaticians have developed and implemented architectures, methodologies, and tools at the local and the regional levels that can be immediately pressed into service for the protection of our populations from these attacks. These unique contributions of the discipline of biomedical informatics are reviewed here.Current outbreaks of anthrax exposure and cases test our health care delivery and public health systems with threats of large spatial scope—the entire nation—that demand a very short temporal latency in our responses. Other potential bioterrorist attacks only increase the dimensions of this unprecedented challenge. The dimensions, however, are not unprecedented; rather, they are quite familiar to many researchers in biomedical informatics over the last 40 years. The task of comprehensive real-time monitoring on the regional and national scale has been the subject of full-fledged design and large-scale implementations led by biomedical informaticians.Nonetheless, we run the risk that the knowledge gained in the decades of informatics research will not, in the appropriate haste to safeguard the population of the United States from the threats of bioterrorism, be reflected in the national public health information infrastructure. And that may result not only in wasteful expenditures but also in ineffective measures to prevent future attacks on the health of the U.S. population. This is, therefore, a timely juncture to review some of the most germane contributions from the biomedical informatics armamentarium to the tasks at hand, particularly data acquisition, threat detection, and response.     

人乳头瘤病毒感染与子宫颈上皮内瘤变的关系

近年来,我国宫颈癌的发病率逐年上升,且呈年轻化的趋势,宫颈癌已经成为威胁女性健康的＂第二杀手＂,早在80年代于子宫颈癌监测出人乳头瘤病毒（HPV）以后,有关宫颈上皮内瘤变（CIN）的基础和临床研究取得了很大进展,建立了阴道细胞学系统（TBS）,监测HPV感染的计算机辅助细胞监测（CCT）及聚合酶链反应（PCR）技术的广泛应用,改变了传统的CIN诊断和治疗方法,现将HPV感染与CIN的关系作一综述。     

The effect on academic health centers of tertiary care in community hospitals

Increased competition among hospitals is a potential threat to teaching hospitals. The growing cost of medical education and the provision of care to the indigent can be endangered by the dilution of revenue sources which traditionally have been available to the academic health centers but which now are being taken over by suburban hospitals. As an example of such a threat, the authors in this paper relate a case study regarding the expansion of open heart surgery programs in St. Louis, Missouri.     

Ⅱ型糖尿病相关基因研究进展

随着人们生活水平的日益增长,约占糖尿病90％的Ⅱ型糖尿病正严重地危害着我们的身心健康。胰岛素分泌缺陷和胰岛素抵抗（Insulinresistance,IR）作为Ⅱ型糖尿病的重要发病机制已为医学界所认识和接受。文章将从胰岛素分泌缺陷和胰岛素抵抗两个方面对Ⅱ型糖尿病相关基因研究进展进行综述。     

Large-scale quarantine following biological terrorism in the United States: scientific examination, logistic and legal limits, and possible consequences.

Concern for potential bioterrorist attacks causing mass casualties has increased recently. Particular attention has been paid to scenarios in which a biological agent capable of person-to-person transmission, such as smallpox, is intentionally released among civilians. Multiple public health interventions are possible to effect disease containment in this context. One disease control measure that has been regularly proposed in various settings is the imposition of large-scale or geographic quarantine on the potentially exposed population. Although large-scale quarantine has not been implemented in recent US history, it has been used on a small scale in biological hoaxes, and it has been invoked in federally sponsored bioterrorism exercises. This article reviews the scientific principles that are relevant to the likely effectiveness of quarantine, the logistic barriers to its implementation, legal issues that a large-scale quarantine raises, and possible adverse consequences that might result from quarantine action. Imposition of large-scale quarantine-compulsory sequestration of groups of possibly exposed persons or human confinement within certain geographic areas to prevent spread of contagious disease-should not be considered a primary public health strategy in most imaginable circumstances. In the majority of contexts, other less extreme public health actions are likely to be more effective and create fewer unintended adverse consequences than quarantine. Actions and areas for future research, policy development, and response planning efforts are provided.     

分子免疫技术在中西医结合研究中的应用

分子免疫技术近年来得到了突飞猛进的发展,特别是标记免疫技术的迅速发展更奠定了其在现代医学研究中不可或缺的地位.随着中医药学现代化研究的进展,医学免疫学亦成为沟通现代医学和祖国传统医学无可替代的桥梁学科之一,人们不仅可从机体整体、细胞水平,而且可深入至分子水平、基因水平探讨中医药的理论本质及对疾病的防治机制,因而掌握该技术的特点并合理地选用将对中西医结合研究工作发挥重要作用.     

结核分枝杆菌检测技术研究进展

结核是由结核分枝杆菌引起的一种世界性疾病,为最受关注的公共卫生问题之一。虽然近年来结核病的发病率呈下降趋势,但其对人类健康造成的危害仍十分严峻。患者的及时上报是结核病防控的重要环节之一,报告率的上升有助于提高结核的治愈率以及卫生机构对结核患者的管理强度。快速、准确的诊断方法直接影响结核病的报告率,影响疾病传播和患者管理,是控制结核发病的基础。近年来,分子诊断技术发展迅速,为结核病的快速诊断提供了新的思路。分子诊断技术检测速度快,灵敏度、特异度、准确率高,绝大多数技术成本低廉,可同时对多个样本进行检测,实用性较强,具有较好的发展前景。本文对现阶段临床上实际应用的结核诊断技术与近年来出现的新型分子诊断技术进行简要概述。     

分子生物学实验多媒体教程的构建与应用

分子生物学是一门实践性很强的学科,其实验教学对该学科的学习具有非常重要的意义。采用多媒体技术制作由多媒体课件、Flash动画、实验技术视频三大模块相结合的分子生物学实验多媒体教程,经多年的应用,获得了显著的教学效果。     

原发灶不明肿瘤的诊断与治疗

原发灶不明肿瘤(CUP)是一类异质性肿瘤,具有独特的生物学特性,最常见的病理类型是腺癌。在世界范围内,CUP占所有肿瘤的2.3%~5.0%,不仅是第6~8位常见的癌症,也是导致癌症患者死亡的第3~4位常见原因。CUP原发灶检出困难,主要诊断方法有全面的病史采集、详细的体格检查、实验室及影像学检查、内窥镜、免疫组化和基因表达谱分析技术等,其中病理和免疫组化仍是诊断的金标准。近年来随着诊断技术的发展,CUP发病率已有所下降。CUP患者的预后受多种因素影响,如肿瘤原发部位、转移灶及数目、病理类型、治疗方式、体力状况、乳酸脱氢酶水平等。因其独特的生物学特性,相关临床试验开展困难,CUP患者整体预后不佳,其中15%~20%的CUP患者预后较好,80%~85%的患者预后差,中位生存期不足1年。传统经验性治疗包括以铂类或紫杉醇为基础的化疗、放疗和手术治疗,并不能有效改善患者预后。基因表达谱分析等分子诊断技术可识别CUP患者的分子特征,为组织形态学提供了实用而有效的补充,并使靶向治疗成为可能,开辟了CUP患者治疗的新途径。分子诊断指导下的位点特异性治疗,靶向及免疫治疗有望使CUP的治疗个体化、精准化,利于提高患者的生活质量和生存期。      

血流感染的分子诊断研究进展

血流感染是指病原微生物进入血液循环并生长繁殖,产生毒素、代谢产物,导致全身炎症反应的感染性疾病,是当前全世界临床医生面临的重大挑战之一。早期诊断并使用有效的抗感染方案能缩短抗生素使用时长、降低患者死亡率。血培养及药物敏感试验是目前临床诊断血流感染的金标准,但其存在病原学检测结果时间长、阳性率低等缺点,不能满足血流感染危重患者快速及精准治疗的需求。近年来随着分子检测技术的发展,涌现出DNA 微阵列、质谱分析、数字PCR、二代高通量测序等分子诊断技术,较血培养能更快速地识别病原菌及耐药基因、提高检测的阳性率,指导临床医师早期进行目标抗生素干预,对改善血流感染患者临床预后具有潜在价值,并可降低病原菌耐药性。     

检验本科《分子生物学检验技术》双语教学的体会

分子生物学是近年来生命科学中迅速发展的一门前沿学科,其新知识、新技能不断涌现,故在教学中应用双语授课不仅能提高学生的综合素质,更有利于学生及时掌握、跟踪国外分子生物学界的最新动态。     

PARP抑制剂与合成致死

随着人们对恶性肿瘤生物学认识的加深,一些新的抗肿瘤策略不断出现。例如之前已有基于肿瘤中的癌基因依赖现象的分子靶向疗法成功用于临床,而合成致死成为当下抗肿瘤药物发展的又一新的方向。研究表明,PARP-1与BRCA1/2之间为合成致死的关系。本文对PARP-1抑制与BRCA1/2缺陷如何构成其合成致死作用以及此作用在抗肿瘤中的潜在应用价值进行综述。     

PET凋亡细胞显像探针的研究进展

细胞凋亡是生命体的一种基本生理机制。活体检测肿瘤组织的凋亡细胞将来可能应用于临床实践,尤其是对肿瘤治疗和预后的预测,对指导肿瘤个体化治疗具有重要的意义。PET作为分子影像显像手段,在凋亡显像研究中具有很大优势。基于凋亡显像的重要性,许多有潜力的PET探针被开发出来,包括正电子核素标记的膜联蛋白Annexin-V,靛红衍生物类Caspase-3抑制剂、疏水性阳离子和Apo-sense化合物,上述探针针对凋亡过程中的不同靶点,能够不同程度地反映出活体组织细胞凋亡状态。