宫颈癌患者血清miR-329-3p和miR-34a-5p水平检测及临床意义

目的探讨宫颈癌患者血清miR-329-3p和miR-34a-5p水平检测及临床意义。方法选取2011年3月-2014年8月义乌市中心医院宫颈癌患者154例为观察组,分别于手术前以及术后3～4周采集全血,另选健康体检者123例为对照组,体检时采血,测定其血清miR-329-3p和miR-34a-5p及癌胚抗原(CEA)表达水平。结果术前观察组miR-329-3p、miR-34a-5p水平低于对照组,CEA水平高于对照组(P0. 05);术后观察组miR-329-3p、miR-34a-5p水平高于术前观察组,CEA水平低于术前观察组(P0. 05);不同年龄、肿瘤最大径、肿瘤数目特征组中血清miR-329-3p、miR-34a-5p水平相近(P0. 05);而病理学分级越高、TNM分期越高、有淋巴血管间隙浸、有淋巴结转移、有复发,血清miR-329-3p、miR-34a-5p表达水平越低(P0. 05); CEA与miR-329-3p、miR-34a-5p呈负相关(P0. 05); miR-329-3p、miR-34a-5p两者AUC相近(P0. 05),两者诊断结宫颈癌的灵敏度、特异度相近(P0. 05); miR-329-3p、miR-34a-5p阳性组3年生存率及生存期均明显高于miR-329-3p、miR-34a-5p阴性组(P0. 01)。结论 miR-329-3p、miR-34a-5p在宫颈癌患者血清的表达量降低,miR-329-3p、miR-34a-5p在宫颈癌的发生发展过程中起抑制作用,miR-329-3p、miR-34a-5p高表达可提高宫颈癌患者预后; miR-329-3p、miR-34a-5p具有较高的灵敏度、特异度,可作为诊断宫颈癌的生物学标志物。     

miR-425-5p在宫颈癌中的表达及临床意义

目的探究miR-425-5p在宫颈癌中的表达情况。方法选择在湖北省十堰市妇幼保健院妇产科就诊的38例宫颈癌患者为观察组,同时选取38例健康人为对照组。收集患者的病变和癌旁组织以及两组的血清,QRT-PCR检测miR-425-5p在各组织和血清中的表达情况,分析miR-425-5p与宫颈癌患者临床病理特征的关系。结果宫颈癌组织中的miR-425-5p表达水平明显高于癌旁组织,差异有统计学意义;观察组患者血清miR-425-5p表达水平显著高于对照组,差异有统计学意义;另外,临床Ⅱ、Ⅲ期或淋巴结转移阳性的宫颈癌患者,其病变组织和血清miRNA-425-5p表达水平显著高于临床Ⅰ期或淋巴结转移阴性患者,差异有统计学意义。结论宫颈癌患者病理组织和血清中miR-425-5p表达水平上升,与临床分期和淋巴结转移呈明显的相关性,可作为临床宫颈癌患者确诊的潜在生物学标志物之一。     

宫颈癌组织DcR3的表达与高危型人乳头状瘤病毒感染的相关性研究

  目的  观察宫颈癌组织诱捕受体3（decoy receptor 3，DcR3）表达与高危型人乳头状瘤病毒（high-risk human papilloma virus，HR-HPV）感染的相关性。  方法  分别采用免疫组织化学（streptavidin-perosidase，SP）法和第2代杂交捕获法检测35例正常宫颈组织（normal cervical tissues，NCE）、39例宫颈上皮内瘤变（cervical intraepithelial neoplasm，CIN）及44例宫颈癌组织（cervical squamous epithelial carcinoma，CSES）DcR3和HR-HPV的表达。设计并合成靶向HR-HPV16 E7基因的HR-HPV16 E7小干扰RNA（siRNA）和阴性对照HR-HPV16 E7 siRNA，脂质体法转染SiHa细胞，实时荧光定量聚合酶链式反应（real-time polymerase chain reaction，RT-PCR）法和蛋白质印迹（western blot，WB）法检测HR-HPV16 E7基因沉默对DcR3 mRNA和蛋白表达的影响，四甲基偶氮唑盐比色（methylthiazolyldiphenyl-tetrazolium bromide，MTT）法检测细胞增殖情况。  结果  NCE、CIN及CSES组DcR3蛋白阳性表达率分别为8.6%（3/35）、48.7%（19/39）、77.3%（34/44），表达呈逐渐增高趋势，差异具有统计学意义（χ2=36.942，P<0.001）。NCE、CIN及CSES组HR-HPV阳性检出率分别为5.7%（2/35）、56.4%（22/39）、93.2%（41/44），差异具有统计学意义（χ2=60.322，P<0.001）。DcR3表达与HR-HPV感染呈正相关（r=0.893，P=0.004）。HR-HPV基因沉默后DcR3在mRNA和蛋白水平的表达均明显降低，且细胞增殖受到抑制。  结论  DcR3在宫颈癌中异常高表达，其表达升高与HR-HPV感染密切相关，提示DcR3可能参与了宫颈癌的发生发展。siRNA技术成功诱导HR-HPV基因沉默可通过下调DcR3的表达抑制人宫颈癌SiHa细胞增殖。     

宫颈癌患者血清miR-329-3p和miR-34 a-5p水平检测及临床意义

目的探讨宫颈癌患者血清miR-329-3 p和miR-34 a-5 p水平检测及其临床意义。方法选取2017年2月至2018年2月在鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)手术切除的39例宫颈癌组织标本为研究对象。根据癌旁黏膜组织有无癌前病变将其分组。利用免疫组化对39例标本中的p 53、c-erbB-2、bax表达进行检测。结果 miR-329-3 p和miR-34 a-5 p在宫颈癌组织中表达水平明显低于正常组织,差异有统计学意义(P<0.05)。宫颈癌低分化标本miR-329-3 p和miR-34 a-5 p表达水平明显低于分化较好组,差异有统计学意义(P<0.05)。有高危人乳头瘤病毒感染或淋巴转移的宫颈癌标本中miR-329-3 p和miR-34 a-5 p表达水平更低,差异有统计学意义(P<0.05)。结论 miR-329-3 p和miR-34 a-5 p可作为宫颈癌患者预后判断的重要参数指标,其对判断宫颈癌的发展有重要意义。     

PI3K p110α在宫颈病变中的表达研究

目的研究PI3K p110α蛋白在宫颈上皮内瘤变和宫颈癌中的表达及其与临床病理特征的关系。方法应用ElivisionTMSuper免疫组化法检测40例正常宫颈、31例CINⅠ、33例CINⅡ、35例CINⅢ和41例宫颈癌石蜡标本中PI3K p110α的表达,比较各组间的差别及与患者临床病理特征的关系。结果①PI3K p110α在正常宫颈、CINⅠ、CINⅡ、CINⅢ及宫颈癌中的阳性率依次为0.0%、19.4%、57.6%、65.7%、80.5%。②比较正常宫颈与CINⅠ之间（χ2=8.451,P=0.004）及CINⅠ与CINⅡ之间（χ2=9.810,P=0.002）,PI3K p110α阳性率差异有统计学意义;CINⅡ组与CINⅢ组之间（χ2=0.476,P=0.490）及CINⅢ与宫颈癌之间（χ2=2.125,P=0.145）比较,随着分期的增加呈上升趋势,但差异无统计学意义。③PI3K p110α在LSIL和HSIL中的阳性率分别是19.4%和61.8%,差异有统计学意义（χ2=15.333,P=0.000）,可将其视为宫颈LSIL与HSIL间的辅助鉴别指标。④PI3K p110α蛋白表达与宫颈癌临床分期、组织分化程度及有无淋巴结转移有关（P〈0.05）。结论 PI3K p110α在除正常宫颈组织外的各级宫颈病变组织中均呈阳性表达,抑制其活性可能为宫颈癌的治疗提供新靶点。     

子宫内膜异位症患者血清中miR-199a-5p和基质金属蛋白酶-9的表达及意义

目的 探讨miR-199a-5p和基质金属蛋白酶-9(MMP-9)在子宫内膜异位症(EMS)患者血清中的表达及临床意义. 方法 分别采用SYBR GreenⅠ实时荧光定量PCR方法及ELISA法检测40例EMS患者(EMS组)与20例输卵管积水患者(对照组)血清中miR-199a-5p和MMP-9的表达,分析miR-199a-Sp和MMP-9的相关性及其与子宫内膜异位症临床特征的关系. 结果 两组血清中均检测出miR-199a-5p和MMP-9的表达,EMS组血清中miRNA-199a-5p表达少于对照组,MMP-9含量高于对照组,差异均有统计学意义.EMS组血清miR-199a-5p相对表达量随r-AFS分期增加而减少,MMP-9表达量随r-AFS分期增加而增加,差异均有统计学意义;EMS组血清中miR-199a-5p和MMP-9的表达量与VAS评分无关.EMS组血清中miR-199a-5p相对表达量与MMP-9呈负相关(r=-0.501). 结论 miR-199a-5p和MMP-9可能参与EMS的发病,且发病机制可能与miRNA调控异常相关.     

Smac和Livin的表达与宫颈癌的发生发展相关性分析

目的 探讨凋亡相关蛋白Smac、Livin在宫颈癌组织中的表达及临床意义.方法 选取2014年3月至2015年3月汕头市中心医院妇产科宫颈鳞状细胞癌24例(宫颈癌组),宫颈上皮内瘤变(CIN)Ⅰ 15例(CIN Ⅰ组),CIN Ⅱ13例(CIN Ⅱ组),CIN Ⅲ13例(CIN Ⅲ组),正常宫颈组织15例作为正常对照(对照组),采用免疫组化法检测各组的Smac和Livin表达情况.结果 宫颈癌组Smac阳性比例为83.33％,明显高于对照组,差异比较有统计学意义(x2=25.658,P＜0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Smac阳性比例比较差异无统计学意义(x2=2.204,P＞0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Livin阳性比例分别为79.17％、76.92％和84.62％,明显高于对照组(x2值分别为19.420、17.279、14.412,均P＜0.05);CIN Ⅰ组与对照组Smac和Livin阳性比例比较差异无统计学意义(x2值分别为0.536、0.000,均P＞0.05);CIN Ⅰ组Smac和Livin阳性比例明显低于CINⅡ组、CINⅢ组和宫颈癌组(x2值分别为20.843、22.611,均P＜0.05);低分化患者Smac阳性比例为42.86％,明显低于高中分化患者(x2=11.657,P＜0.05);宫颈鳞状细胞癌中Smac和Livin的表达呈正相关(r=0.872,P＜0.05).结论 Smac和Livin在宫颈鳞状细胞癌的发生发展中起协同作用.     

凋亡抑制基因Survivin与高危型-人乳头瘤病毒在宫颈癌及癌前病变中的表达及其临床意义

目的 研究宫颈癌及癌前病变中凋亡抑制基因Survivin的表达及高危型-人乳头瘤病毒(HR-HPV)的感染情况,探讨两者在宫颈癌发病机制中的作用.方法 入选宫颈上皮内瘤变(CIN)Ⅰ 25例、CINⅡ～Ⅲ23例及宫颈癌34例,另取20例正常宫颈作为对照.采用免疫组织化学SP法检测Survivin的表达,以聚合酶链反应技术检测HR-HPV感染情况.结果 Survivin阳性表达率和HR-HPV感染率均为宫颈癌[85.3％(29/34)和88.2％ (30/34)]高于CIN [52.1％(25/48)和54.2％(26/48) ](P＜ 0.05),CIN高于正常宫颈[0和10.0％(2/20)](P＜0.05),CINⅡ～Ⅲ[65.2％(15/23)和73.9％(17/23)]高于CIN I[32.0％(8/25)和28.0％(7/25)](P＜ 0.05).在宫颈癌中Survivin阳性表达与组织学分级相关(P＜0.05),而与年龄、临床分期及病理分型无关(P＞0.05).HR-HPV感染与年龄、临床分期、组织学分级及病理分型均无关(P＞0.05).在宫颈癌中Survivin阳性表达与HR-HPV感染呈正相关(r=0.403,P＜ 0.05).结论 Survivin阳性表达及HR-HPV感染可能与宫颈癌的发生、发展密切相关.两者在宫颈癌的发病机制中可能起着协同作用.     

宫颈癌组织中Hpa与DEK基因表达的相关性研究

目的研究DEK与Hpa基因在宫颈癌组织中的表达及二者的相关性。方法采用免疫组织化学方法对宫颈癌石蜡标本45例、宫颈上皮内瘤样病变（CIN）45例、正常宫颈组织10例进行Hpa及DEK基因检测。结果（1）DEK在宫颈癌组织、CIN、正常宫颈组织中阳性表达率分别为88．9％、24．4％、10．0％。宫颈癌组织中DEK阳性表达率高于CIN组织和正常组织（X2=38．05,P〈0．01;）（2=5．77,P〈0．05）;Hpa基因在宫颈癌组织、CIN及正常宫颈组织中的阳性表达率分别为75．6％、24．4％和10．0％,宫颈癌组织中Hpa阳性表达率高于CIN组织和正常组织（x2=31．69,12．94,P〈0．01）。（2）在宫颈癌组织中DEK基因表达与Hpa基因表达呈正相关（r=0．617,P=0．001）。结论宫颈癌组织及CIN组织中DEK、Hpa的表达共同影响CIN的发展及宫颈癌的发生和发展。     

血浆miR-18a-5p表达对宫颈癌的诊断及预后价值研究

目的探讨血浆miR-18a-5p对宫颈癌诊断及预后的预测价值。方法采用qRT-PCR法检测60例宫颈癌患者血浆miR-18a-5p表达量,并分析其对宫颈癌的临床病理特征、诊断及预后的关系。结果宫颈癌患者血浆miR-18a-5p表达水平明显高于术后组及对照组,差异均有统计学意义(P 0. 001)。ROC曲线显示血浆miR-18a-5p诊断宫颈癌的曲线下面积为0. 928,95%置信区间为0. 876～0. 979;诊断灵敏度为76. 7%,特异度为96. 7%。血浆miR-18a-5p表达水平与宫颈癌患者肿瘤分化程度(P=0. 032)、临床分期(P=0. 001)及淋巴结转移(P=0. 001)相关,而与其他临床特征无关。Kaplan-Meier分析表明miR-18a-5p高表达患者的总体生存率显著低于低表达患者(P 0. 05)。结论血浆miR-18a-5p表达水平可作为宫颈癌潜在标志物用于临床诊断及预后评估。     

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.     

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.     

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.     

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.     

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.