持续感染状态的HPV-16及HPV-58亚型在宫颈上皮内瘤变及宫颈癌中的分布及意义

目的:研究呈持续感染状态的高危型人乳头瘤病毒(HPV-16,HPV-58)在宫颈病变患者中的分布情况及意义。方法:应用分子导流杂交技术分别检测10 477例慢性宫颈炎,3 672例宫颈上皮内瘤变,1 108例宫颈癌患者中呈持续感染状态的HPV-16和HPV-58的分布情况。结果:HPV-16持续性感染在慢性宫颈炎,CINⅠ,CINⅡ/Ⅲ中的阳性率依次为0.41%(95%CI,0.29%～0.53%),3.00%(95%CI,2.26%～3.74%),15.40%(95%CI,13.63%～17.17%),感染率呈逐渐升高趋势,差异有统计学意义(P<0.05)。HPV-58持续性感染在慢性宫颈炎,CINⅠ,CINⅡ/Ⅲ中的阳性率依次为0.56%(95%CI,0.42%～0.70%),2.66%(95%CI,2.36%～3.46%),6.92%(95%CI,5.68%～8.16%),感染率呈逐渐升高趋势,差异有统计学意义(P<0.01)。HPV-16持续性感染与宫颈癌各临床病理参数无明显联系,差异无统计学意义(P>0.05)。HPV-58持续性感染的宫颈癌患者发病年龄高于HPV-58机会性感染或未感染者,差异有统计学意义(P<0.05)。结论:HPV-16及HPV-58持续性感染在宫颈癌前病变发生、发展过程中发挥重要作用,二者有望成为预测CIN进展的风险评估指标。高危型HPV亚型的定期检测对宫颈病变的预测和防治有重要的指导意义。     

Symptomatic hypogammaglobulinemia in infancy and childhood – clinical outcome and in vitro immune responses

Background  

Symptomatic hypogammaglobulinemia in infancy and childhood (SHIC), may be an early manifestation of a primary immunodeficiency or a maturational delay in the normal production of immunoglobulins (Ig). We aimed to evaluate the natural course of SHIC and correlate in vitro lymphoproliferative and secretory responses with recovery of immunoglobulin values and clinical resolution.     

DNA stability and lipid peroxidation in vitamin E–deficient rats in vivo and colon cells in vitro

Summary Background Fruit and vegetable consumption protects against cancer. This is attributed in part to antioxidants such as vitamin E combating oxidative DNA damage. Anthocyanins are found in significant concentrations in the human diet. However, it remains to be established whether they are bioactive in vivo. Aim To investigate the consequence both of vitamin E deficiency on oxidative damage to DNA and lipids and the cytoprotective effect of nutritionally relevant levels of cyanidin–3–glycoside both in vivo in rats and in vitro in human colonocytes. Methods Male Rowett Hooded Lister rats were fed a diet containing less than 0.5 mg/kg vitamin E or a vitamin E supplemented control diet containing 100 mg d–tocopherol acetate/kg. Half of the controls and vitamin E–deficient rats received cyanidin–3–glycoside (100 mg/kg). After 12 weeks endogenous DNA stability in rat lymphocytes (strand breaks and oxidised bases) and response to oxidative stress ex vivo (H₂O₂; 200 µM) was measured by single cell gel electrophoresis (SCGE). Tissue levels of 8–oxo–7,8–dihydro–2–deoxyguanosine (8–Oxo–dG) were measured by HPLC with EC detection. D–tocopherol and lipid peroxidation products (thiobarbituric acid reactive substances; TBARS) were measured by HPLC. Rat plasma pyruvate kinase and the production of reactive oxygen by phagocytes were detected spectrophotometrically and by flow cytometry respectively. Immortalised human colon epithelial cells (HCEC) were preincubated in vitro with the anthocyanins cyanidin and cyanidin–3–glycoside and the flavonol quercetin (all 50 µM) before exposure to H₂O₂ (200 µM). DNA damage was measured by SCGE as above. Results Plasma and liver d–tocopherol declined progressively over 12 weeks in rats made vitamin E deficient. Lipid peroxidation was increased significantly in plasma, liver and red cells. Reactive oxygen levels in phagocytes and plasma pyruvate kinase were increased. Vitamin E deficiency did not affect DNA stability in rat lymphocytes, liver or colon. Cyanidin–3–glycoside did not alter lipid peroxidation or DNA damage in rats. However, it was chemoprotective against DNA damage in human colonocytes.DNA strand breakage was decreased 38.8 ± 2.2 % after pretreatment with anthocyanin. Conclusion while it is accepted that vitamin E alters lipid oxidation in vivo, its role in maintaining DNA stability remains unclear. Moreover, whereas cyanidin–3–glycoside protects against oxidative DNA damage in vitro, at nutritionally relevant concentrations it is ineffective against oxidative stress in vivo.     

Measuring and mapping disparities in access to fresh fruits and vegetables in Montréal

OBJECTIVE: This study was conducted to evaluate disparities in access to healthy food in Montreal, focusing on the availability of fresh fruits and vegetables (F/V) as an indicator. METHOD: F/V selling area was measured in all food retail stores and public markets offering more than 75 square feet of fresh fruits and vegetables. An accessibility index was elaborated, taking into account motorization rates and the total surface of these fresh foods for sale within an easily accessible zone. The extent of that zone was determined differently for motorized (3 km) and non-motorized (500 m) consumers. Measures were calculated and georeferenced at the level of "Dissemination Areas" according to the 2001 Census. RESULTS: In general, access to healthy foods is quite good for consumers who shop by car. But 40% of the population have poor access to fruits and vegetables within a walkable distance from home. No relationship is observed between median income in dissemination areas and food supply. CONCLUSION: Improved access to healthy food by non-motorized consumers is needed in many areas of Montreal. Implications of differential access to fresh fruits and vegetables for health and environmental sustainability are discussed.     

In fitness and health? A prospective study of changes in marital status and fitness in men and women

The authors examined the prospective associations between marital status transitions and changes in fitness in men and women. Between 1987 and 2005, a total of 8,871 adults (6,900 men) aged 45.6 (standard deviation, 9.1) years were examined at the Cooper Clinic, Dallas, Texas; the median follow-up was ～3 years. Marital transition categories (from single to married, married to divorced, divorced to remarried) were derived from self-reported marital status at baseline and follow-up. Fitness (maximal oxygen consumption) was assessed by a maximal treadmill test. Analyses were adjusted for baseline levels and changes in body mass index, physical activity, smoking, alcohol consumption, and major chronic diseases. Compared with the corresponding "control" groups (remaining single, married, or divorced), transitioning from being single to married was associated with a reduction in fitness in women (P = 0.03); divorce was associated with an increase in fitness in men (P = 0.04); and remarriage was associated with a reduction in fitness in men (P = 0.05). The authors conclude that the transitions to being married (from single to married or from divorced to remarried) are associated with a modest reduction, while divorce is associated with a modest increase in fitness levels in men. Study results suggest that these patterns may be different in women, but further research is required to confirm this.     

New horizons in genetics and nutrition

From the emergence of the genus “homo” over 2 million years age,until the agricultrural revolution of roughly 10. 000 years age our ancestors were hunter-gatherers, so the adaptive pressures inherent in that environmental niche have exerted defining influence on human genetic make up. The portion of our genome that determines basic anatomy and physiology has remained relatively unchanged over the past 40. 000 years.     

A generation apart? Gender-related experiences and health in women in early and late mid-life

There have been a number of critiques in the last few years of the prevailing paradigm of research on gender and health, which dominated in the latter part of the 20th century. One such criticism has centred on the a historic and decontextualised way in which much evidence for gender differences has been used. In this paper we aim to show that, even within a relatively confined geographical locale over a relatively short period of time, there have been substantial changes in gender relations which are likely to have affected the experience, opportunities, and attitudes of women born in the early 1930s and early 1950s. We illustrate this using data from a study of inequalities in health in Scotland, which includes unusually rich longitudinal data on gender, including occupancy and experience of gender-related roles, attitudinal data on gender equality, and measures of gender role orientation (GRO). These are related to various dimensions of health and health behaviour. The data show substantial differences in the experiences of two generations of women, who are just 20 years apart in age, and a lack of consistency between measures of GRO and health. Whilst on the one hand these data suggest the importance of taking more account of the broader (social, historical or political) context, the analysis also highlights the methodological problems posed.     

Vulnerability and sexual risks: Vagos and vaguitas in a low income town in Perú

Young people constitute a priority for sexual health research, policy and planning. Many studies, however, regard youth as a homogeneous group defined by developmental stages and their problems as inherent rather than factors resulting from structural vulnerability. Ethnographic data from this study provided strong evidence of the inappropriateness, in prevention interventions, of the concept of 'young people' as a group defined only by age and gender. When incorporating social resources and support into the analysis, specific segments of youth with diverse sexual practices and health seeking behaviours emerge. Thus, although most young people in urban areas show a similar level of HIV/STI knowledge, their exposure to risk varies according to their living conditions. Two population segments - "street guys" and "fast girls" - identified as vulnerable for sexual risk, are characterized. Both groups hang out on the streets, and most are involved in using alcohol and drugs, and/or practicing transactional sex. This study provided evidence for the need of various approaches according to level of poverty and social vulnerability in order to develop more effective HIV/AIDS and STI prevention programs to meet the needs of young men and women in low-income areas.     

Do Probiotics in Pregnancy Reduce Allergies and Asthma in Infancy and Childhood? A Systematic Review

The maternal immune system is very important in the development of the foetal immune system. Probiotics have been shown to help regulate immune responses. Therefore, it is possible that the administration of probiotics to pregnant women could influence the development of the foetal immune system, reducing the likelihood of infants and children developing an allergic condition. The aim of this research was to conduct a systematic review to determine whether administering probiotics to pregnant women can reduce the incidence of allergic disease in their children. Medline, CINAHL and Embase databases were searched for randomised controlled trials (RCTs) that compared supplementation of probiotics to pregnant women to a placebo control and recorded the presentation of allergic conditions in their children. Data extracted from the study reports included their characteristics and findings. Study quality and risk of bias were assessed. From a total of 850 articles identified in the search, 6 were eligible for inclusion in this review. Two studies found no effect of maternal probiotics on the outcomes measured, two studies found that the incidence of eczema or atopic dermatitis (AD) was reduced by maternal probiotics, one study found no effect on the overall incidence of atopic sensitisation, but a reduction in a subgroup of children at high hereditary risk of allergic disease, and one study found no effect in an intention to treat analysis, but a reduction in AD in complete case analysis. The results of these studies are inconsistent but demonstrate that probiotics may have the potential to reduce infant allergies when administered prenatally, particularly in children at high risk of allergy development. There is a need for further larger-scale studies to be performed in order to provide a more definitive answer. Such studies should focus on at-risk groups.     

Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002

Background  

Over the last decade, significant downward linear time trends in suicide mortality were observed in most Western countries. To date, it is not established whether those favourable time trends developed homogeneously for sex and age groups and how they were affected by the number of undetermined deaths.     

HPV-16,-18型致宫颈癌机制及其疫苗研究

宫颈癌病例中,人乳头瘤病毒16(HPV-16),-18型的检出率可高达50%～70%.HPV-16,-18型诱发宫颈癌的主要机制是其E6和E7基因在宫颈细胞中表达增加,其基因产物E6和E7两个癌蛋白分别与抑癌蛋白P53和pRb结合,进而诱导P53和PRb蛋白降解.HPV疫苗包括预防性和治疗性疫苗.国际上预防性疫苗只有GSK的Cervarix疫苗和Merke公司的Gardsil疫苗,主要预防HPV-16,-18型感染以及HPV-16,-18型相关性宫颈肿瘤和生殖器疣的发生.预防性疫苗是通过细胞免疫和体液免疫以去除或减少已经被感染的细胞或肿瘤细胞,其靶蛋白主要为E6或E7.到目前为止治疗性疫苗的类型虽然很多,主要包括肽类疫苗、病毒载体疫苗及DNA疫苗等.因为治疗性疫苗的机制比较复杂,目前还在实验阶段.     

HPV-16，-18型致宫颈癌机制及其疫苗研究

宫颈癌病例中,人乳头瘤病毒16(HPV-16),-18型的检出率可高达50%～70%。HPV-16,-18型诱发宫颈癌的主要机制是其E6和E7基因在宫颈细胞中表达增加,其基因产物E6和E7两个癌蛋白分别与抑癌蛋白P53和pRb结合,进而诱导P53和PRb蛋白降解。HPV疫苗包括预防性和治疗性疫苗。国际上预防性疫苗只有GSK的Cervarix疫苗和Merke公司的Gardsil疫苗,主要预防HPV-16,-18型感染以及HPV-16,-18型相关性宫颈肿瘤和生殖器疣的发生。预防性疫苗是通过细胞免疫和体液免疫以去除或减少已经被感染的细胞或肿瘤细胞,其靶蛋白主要为E6或E7。到目前为止治疗性疫苗的类型虽然很多,主要包括肽类疫苗、病毒载体疫苗及DNA疫苗等。因为治疗性疫苗的机制比较复杂,目前还在实验阶段。     

Bigger and better? Scaling up and innovation in health aid

As the volume of health aid to developing countries increases and allocations shift toward specific disease burdens, issues of allocation efficiency become more important to the achievement of better health outcomes. This paper examines (1) whether health aid--traditional and innovative--corresponds to recipients' needs and priorities and (2) how the terms of aid affect its efficiency. We find that there is considerable scope for improvement through consolidation, improvement of terms, and increased attention to the efficient allocation of the marginal dollar of aid.     

Residues of organochlorines in mallards and blue-winged teal collected in Colombia and Wisconsin, 1984–1989

We compared the seasonal concentrations of 12 organochlorine (OC) compounds in samples of breast muscle, associated skin, and subcutaneous fat of blue-winged teal (Anas discors) collected in Ciénaga Grande de Santa Marta, Colombia (1987–1988), and of mallards (Anas platyrhynchos) and blue-winged teal collected in Wisconsin (1984–1989). Although these species have similar feeding habits and overlapping breeding distributions, their winter ranges differ markedly. Most blue-winged teal winter in the Neotropics, whereas most mallards remain in the temperate regions of North America. A seasonal comparison of OC exposure in these species may help determine the geographic origins of contamination. All examined OCs were found to be below concentrations known to affect reproduction in waterfowl. DDE was most often detected in blue-winged teal and PCBs, in mallards. DDE exposure may have predominantly occurred outside of Wisconsin. The DDE concentration in blue-winged teal samples collected in Wisconsin in the spring (GM=0.406 g/g) were greater (P<0.001) than in the fall (GM=0.033 g/g) and greater than the concentrations in mallard samples from the spring (GM=0.058 g/g; P<0.001). Ciénaga Grande, however, was not a source of DDE contamination. The DDE concentrations in blue-winged teal samples from Ciénaga Grande did not differ between the spring (GM=0.037 g/g) and the fall (GM=0.039 g/g) and were lower (P<0.001) than the concentration in blue-winged teal samples from Wisconsin in the spring. In contrast, PCB contamination seemed to have occurred in Wisconsin and affected mostly mallards. PCBs were not detected in the samples from Colombia and were detected in only five (8.3%) of the blue-winged teal samples from Wisconsin (GM=0.025 g/g), however, those compounds were detected in 47% of the mallard samples collected in Wisconsin (GM=0.272 g/g). DDE and PCB concentrations were greater (P=0.0) in mallard samples collected from wetlands adjacent to Lake Michigan than in samples from inland wetlands.