原发性肝细胞癌与IL-2、IFN-γ基因多态性关系

目的探讨细胞因子IL-2基因-330T/G(rs2069762)位点和IFN-γ基因-1615C/T(rs2069705)、+5171A/G(rs2069727)位点单核苷酸多态性与原发性肝细胞癌(HCC)发生的关系。方法采用医院为基础的病例对照研究方法于2007年6月—2010年7月在广西医科大学第一附属医院和广西肿瘤医院收集784例HCC患者和同期在广西医科大学第一附属医院及广西区医院体检中心1 017名健康对照人群进行环境暴露调查;采用Taq-Man荧光定量PCR技术对上述位点进行分型,应用logistic回归模型分析组间基因-环境和基因-基因的交互作用。结果 IFN-γ的-1615C/T和+5171A/G位点存在连锁不平衡(D’=0.976,r2=0.549,P=2.22-16),单倍型CG在人群中发生频率<0.03,其他3种单倍型CA、TA、TG频率在病例组和对照组间分布差异均无统计学意义(P>0.05);IL-2-330T/G和IFN-γ-1615C/T、+5171A/G 3个位点的基因型在HCC患者和健康对照人群中分布差异均无统计学意义(P>0.05);吸烟、饮酒和携带HBV等环境暴露因素与-330T/G位点的突变基因G对HCC的发生有协同作用,交互作用指数S分别为1.38、1.50、1.03;吸烟、饮酒、有肝癌相关家族史和携带HBV等环境暴露因素与-1615C/T、+5171A/G位点的基因多态性在HCC患病风险中存在负交互作用;logistic回归分析结果表明,携带IL-2的-330T/G位点突变基因G并且同时携带IFN-γ的-1615C/T、+5171A/G位点的突变纯合子TT/GG能增加HCC患病风险(OR=1.84,95%CI=1.08～3.83)。结论 IL-2基因-330T/G和IFN-γ基因-1615C/T、+5171A/G位点多态性与环境暴露因素存在交互作用,基因-环境、基因-基因交互作用可能增加HCC发生风险。     

干扰素-γ、白介素-10单核苷酸多态性和环境因素联合作用与食管癌关系的研究

目的探讨干扰素-γ(IFN-γ)基因+874位点、白细胞介素-10(IL-10)基因-1082位点单核苷酸多态性(SNP)及其与环境危险因素交互作用以及基因-基因交互作用对食管癌发病的影响。方法采用病例-对照研究设计,以120例食管癌患者和122例对照为研究对象,应用PCR法检测IFN-γ+A874T及IL-10-A1082G单核苷酸多态性;运用叉生分析,计算IFN-γ+874位点基因型与部分环境因素以及两种基因间的交互作用定量分析指标。结果病例组IFN-γ+874位点T等位基因频率为37.92%,高于对照组的28.7%(χ2=4.6414,P=0.0312);IFN-γ+874AT基因型携带者患食管癌的风险是IFN-γ+874AA型者的1.729倍(95%CI:1.015~2.947),IFN-γ+874TT基因型携带者患食管癌的风险是IFN-γ+874AA型者的2.923倍(95%CI:1.227~5.214),而IFN-γ+874AT+TT患食管癌的风险是IFN-γ+874AA基因型的1.821倍(95%CI:1.081~3.069);IFN-γ+874AT+TT与饮酒指数、霉变食品摄入和三餐时间不规律存在正相加模型的协同作用,S值依次为1.909、4.154和5.026,人群归因危险度PAR%依次为51.10%、31.72%和25.37%;基因-基因交互作用分析显示,IFN-γ+874AT+TT与IL-10-1082AG+GG两者之间交互作用差异没有统计学意义。结论 IFN-γ+874AT和IFN-γ+874TT基因型可能增加食管癌患病易感性,T等位基因可能为食管癌发生的遗传危险因素。IFN-γ+874AT+TT基因型携带者如减少相应的环境危险因素暴露可有效降低食管癌的发病率。     

白介素10基因多态性与肝细胞癌关系

目的 探讨细胞因子白介素10(IL-10)基因启动子区单核苷酸多态性和环境因素的交互作用与肝细胞癌(HCC)遗传易感性关系.方法 采用以医院为基础的病例对照研究方法,选择589例HCC患者为病例组,同期在相同医院住院的597例无肿瘤患者为对照组;应用TaqMan MGB实时荧光定量PCR技术对IL-10基因-819位点和-592位点进行基因分型,采用非条件Logistic回归模型分析比较携带不同基因型者罹患HCC风险,以及基因多态性和环境因素的交互作用.结果 IL-10-819位点CC、CT、TT基因型在2组中分布差异无统计学意义(P＞0.05),3种基因型与HCC患病风险无统计学关联(P＞0.05);IL-10基因-592位点CC、AC、AA基因型在2组中分布差异无统计学意义(P＞0.05),3种基因型与HCC患病风险无统计学关联(P＞0.05);交互作用分析结果表明,IL-10基因-819和-592位点单核苷酸多态性与吸烟、饮酒、食鱼生及乙型肝炎表面抗原(HBsAg)阳性等环境因素在HCC发生中存在交互作用.结论 IL-10基因多态性在HCC发生过程中,可能无独立的危险作用,但与吸烟、饮酒、食鱼生及HBsAg阳性等环境因素的交互作用能增加HCC的患病风险.     

白介素-1O、干扰素-γ基因多态性与肺结核病易感性的关系

目的 探讨白介素-10(IL-10)基因-1082G/A位点和干扰素-γ(IFN-γ)基因+874A/T位点单核苷酸多态性(SNP)与肺结核病易感性的关系.方法 采用序列特异性引物PCR(PCR-SSP)及测序技术检测深圳地区汉族人群肺结核病例组及对照组各200例IL-10启动子区-1082G/A、IFN-γ+874A/T位点基因多态性.结果 病例组IL-10(-1082)位点A/A纯合子、A/G杂合子、G/G纯合子基因型频率分别为85.4%、13.1%、1.5%,对照组分别为77.5%、22.0%、0.5%;病例组A、G等位基因频率分别为91.9%、8.1%,对照组分别为88.5%、11.5%.两组间基因型分布差异有统计学意义(P＜0.05).病例组A/A基因型高于对照组,G/A基冈型低于对照组(P＜0.05).但两组的A、G等位基冈频率分布差异没有统计学意义.IFN-γ(+874)位点基因型频率及等位基因频率在病例组和对照组中分布无明显差异(P＞0.05).结论 中国汉族人群中细胞因子IL-10(-1082)基因SNP与肺结核易感性相关.A/A基因型可能是一个肺结核易感的风险因素.细胞因子IFN-γ(+874)基因位点SNP与肺结核易感性无关.     

Th1和Th2细胞因子的基因多态性与新生儿乙型肝炎疫苗低免疫应答的关联性研究

目的探讨Th1和Th2细胞因子基因多态性与新生儿乙型肝炎(乙肝)疫苗(Hep B)低免疫应答的关系。方法在广西两家医院招募已完成Hep B全程免疫的8-9月龄汉族儿童,采用微粒子酶联免疫测定法测定血清乙肝表面抗体(HBs Ab),抗体浓度≥10m IU/L且100m IU/L为低应答,≥1 000m IU/L为高应答。采用SNPscanTM多重单核苷酸多态性(SNP)分型技术检测细胞因子,分析基因位点、基因型、等位基因与Hep B免疫应答水平的关联性。结果本研究纳入Hep B低应答儿童88名、高应答儿童132名;共筛选出Th1和Th2细胞因子12个基因52个位点。Logistic回归分析显示,IL18基因rs3882891位点T/T基因型、IL12A基因rs583911位点A等位基因、IFN-γ基因rs2069728位点C等位基因的低应答比例高[OR(95%CI):2.72(1.33-5.57);1.81(1.15-2.85);2.01(1.07-3.79)],IL1B基因rs16944位点A等位基因的低应答比例低[OR(95%C I):0.64(0.43-0.95)]。结论 IL18基因rs3882891位点T/T基因型、IL12A基因rs583911位点A等位基因、IFN-γ基因rs2069728位点C等位基因可能与汉族儿童Hep B初次免疫低应答有关,而IL1B基因rs16944位点A等位基因可能是其保护因素。     

CTLA4基因多态性与不明原因习惯性流产发生风险关系

目的:探究细胞毒性T淋巴细胞相关性抗原-4(CTLA4)与不明原因习惯性流产(UHA)发生风险关系。方法:选取本院治疗的98例UHA患者,另选107例正常妊娠者为对照组,提取血液DNA,聚合酶链式反应-限制性片段多态性法检测CTLA-4基因rs5742909、rs4553808、rs231775位点基因分型,酶联免疫吸附法检测血清Th1型、Th2型细胞因子表达;分析CTLA4基因型与UHA发生风险、各位点基因型与炎症因子水平关系。结果:与对照组相比,UHA组血清干扰素γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白介素-2(IL-2)水平均升高,IL-4、IL-6、IL-10水平均降低(P<0.05)。两组CTLA4基因rs5742909、rs4553808、rs231775位点实际基因频率与理论值无差异(P>0.05),符合Hardy-Weinberg遗传平衡定律;s5742909位点T等位基因频率、rs231775位点G等位基因频率均高于对照组(P<0.05)。rs5742909、rs231775不同基因型者血清IFN-γ、TNF-α、IL-2、IL-4、IL-6、IL-10水平有差异(P<0.05)。logistic多因素回归分析显示rs5742909 T等位基因携带者发生UHA相对危险度为C等位基因的1.984倍,rs231775 T等位基因携带者发生UHA相对危险度为C等位基因的1.837倍。结论:CTLA4基因rs5742909、rs231775位点多态性与UHA发生相关,rs5742909位点C→T突变、rs231775位点A→G突变可增加UHA的发病风险。     

Th1和Th2细胞因子的基因多态性与新生儿乙型肝炎疫苗低免疫应答的关联性研究北大核心

目的探讨Th1和Th2细胞因子基因多态性与新生儿乙型肝炎(乙肝)疫苗(HepB)低免疫应答的关系。方法在广西两家医院招募已完成HepB全程免疫的8-9月龄汉族儿童,采用微粒子酶联免疫测定法测定血清乙肝表面抗体(HBsAb),抗体浓度≥10mIU/L且<100mIU/L为低应答,≥1000mIU/L为高应答。采用SNPscanTM多重单核苷酸多态性(SNP)分型技术检测细胞因子,分析基因位点、基因型、等位基因与HepB免疫应答水平的关联性。结果本研究纳入HepB低应答儿童88名、高应答儿童132名;共筛选出Th1和Th2细胞因子12个基因52个位点。Logistic回归分析显示,IL18基因rs3882891位点T/T基因型、IL12A基因rs583911位点A等位基因、IFN-γ基因rs2069728位点C等位基因的低应答比例高[OR(95%CI):2.72(1.33-5.57);1.81(1.15-2.85);2.01(1.07-3.79)],IL1B基因rs16944位点A等位基因的低应答比例低[OR(95%CI):0.64(0.43-0.95)]。结论IL18基因rs3882891位点T/T基因型、IL12A基因rs583911位点A等位基因、IFN-γ基因rs2069728位点C等位基因可能与汉族儿童HepB初次免疫低应答有关,而IL1B基因rs16944位点A等位基因可能是其保护因素。     

梅毒血清固定患者外周血Th17/Treg平衡改变及IL-17A与IL-17F多态性的关系

目的探讨梅毒血清固定患者外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)平衡改变及白细胞介素-17A(IL-17A)、白细胞介素-17F(IL-17F)多态性分析。方法选择安徽省宣城市人民医院皮肤病性病科2019年1月-2020年5月收治的梅毒患者90例作为研究对象,根据梅毒血清状态分为血清固定组(n=37)和血清转阴组(n=53)。采用酶联免疫吸附法(ELISA)检测血清中Th17型细胞因子白细胞介素-17(IL-17)和Treg型细胞因子干扰素-γ(IFN-γ)水平;采用聚合酶链式扩增反应(PCR)对IL-17A基因rs2275913位点和IL-17F基因rs763780位点进行扩增,通过测序确定分型结果。结果血清固定组患者血清IL-17、IL-17/IFN-γ水平低于血清转阴组,IFN-γ水平高于血清转阴组,差异均具有统计学意义(P0.05);两组IL-17A rs2275913基因型分布差异具有统计学意义(P0.05);IL-17A基因rs2275913位点不同基因型患者IL-17、IFN-γ、IL-17/IFN-γ差异具有统计学意义(P0.05),AA型患者IL-17、IL-17/IFN-γ水平低于GG型和GA型,IFN-γ水平高于GG型和GA型,差异具有统计学意义(P0.05)。结论梅毒血清固定患者存在明显的Th17/Treg失衡,其机制可能与IL-17A rs2275913位点突变有关,但与IL-17F rs763780位点无关。     

广西肝细胞癌与TGF-β1及IL-12B基因多态性关系

目的 探讨广西地区肝细胞癌遗传易感性与人群转化生长因子β1( TGF-β1)基因和白细胞介素12B(IL-12B)基因单核苷酸多态性关系.方法 采用以医院为基础的病例对照研究,选取广西户籍的新发肝细胞癌患者608例,选取相同户籍地、年龄、性别和民族频数匹配的非肿瘤患者612例作为对照,采用TaqMan MGB实时荧光定量PCR方法检测TGF-β1 rs1800469(-509 C＞T)位点和IL-12B rs3212227(3' UTR+ 1188A＞ C)位点基因单核苷酸多态性,比较不同基因型与肝细胞癌患病风险的关系.结果 对照组IL-12B基因rs3212227位点的C突变等位基因频率为43.5％,病例组为48.9％,差异有统计学意义(P＜0.05);与IL-12B基因rs3212227位点AA基因型相比,携带rs3212227AC杂合子及携带rs3212227 CC突变基因型的个体发生原发性肝细胞癌的风险明显升高(分别校正OR=1.271,95％ CI =0.976～1.655;校正0R=1.515,95％CI=1.092～2.102);IL-12B基因rs3212227位点AC+ CC基因型可增加女性和＜55岁者罹患肝细胞癌的风险(分别校正OR =2.036,95％ CI=1.169 -3.548;校正OR=1.529,95％ CI=1.129 ～2.071);肝细胞癌患病风险与TGF-β1基因rs 1800469位点多态性无明显关联.结论IL-12B基因rs3212227位点与广西地区人群原发性肝细胞肝癌发病风险明显关联.     

张家口地区白细胞介素-28B基因单核苷酸多态性与肝细胞癌的相关性研究

目的 探讨白细胞介素-28B（IL-28B）基因rs12979860位点单核苷酸多态性与张家口居民肝细胞癌遗传易感性的关联及与环境因素间的交互作用。方法 采用以医院为基础1[DK]∶1配比病例对照研究方法,选取肝细胞癌患者218例作为观察组,同期健康体检者218例作为对照组,应用改良多重高温连接酶检测反应技术检测两组IL-28B基因rs12979860位点单核苷酸多态性。采用二分类logistic回归模型分析IL-28B基因rs12979860位点单核苷酸多态性与肝细胞癌遗传易感性的关系,并探究rs12979860位点单核苷酸多态性与环境因素的交互作用对肝细胞癌发病影响。结果 对照组与观察组间IL-28B基因rs12979860位点基因型分布差异无统计学意义（P>0.05）。IL-28B基因rs12979860位点T等位基因可增加肝细胞癌发病风险（P<0.05）。分层分析发现,在饮酒、乙型肝炎病毒（HBV）及丙型肝炎病毒（HCV）感染人群中rs12979860位点TT基因型相比TC+CC基因型,肝细胞癌发病风险升高,差异具有统计学意义（P<0.05）。交互作用分析示,IL-28B基因rs12979860位点单核苷酸多态性与饮酒、HBV及HCV感染均存在正交互作用。结论 在张家口地区,IL-28B基因rs12979860位点单核苷酸多态性与肝细胞癌遗传易感性明显相关,并与饮酒、HBV及HCV感染存在正交互作用,可增加肝细胞癌发病风险。     

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.     

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.     

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.     

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.     

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.