成都市医务人员吸烟状况及控烟干预研究

目的 了解成都市医务人员的吸烟状况及其控烟态度和行为,并对其进行干预及其效果评价。方法 采用问卷形式对成都市3家医院的932名医务人员的吸烟危害知识、控烟态度和行为进行调查,并对一家医院进行干预,同时对干预结果进行评价。结果 男性吸烟率为49．7％,女性为0．2％,男性吸烟者主要集中在外科医生和医技人员中;知识方面,对吸烟与肺癌、缺血性心脏病的关系掌握较好,但对被动吸烟与儿童中耳炎和猝死综合症关系回答正确的仅41．5％和48．2％;86．2％的不吸烟者中反对“被动吸烟无害”,但吸烟者中仅为70．4％,两者的差异有统计学意义;态度方面,对于以经济手段来处罚违反吸烟规定者,不吸烟者和吸烟者赞成的比例分别是87．5％和68．1％,差异有统计学意义（P＜0．001）;行为方面,不吸烟者询问病人吸烟状况的比例高于吸烟者,同时不吸烟者鼓励家人或朋友戒烟的比例明显高于吸烟者,二者差异有统计学意义。通过综合干预,医务人员的吸烟率差异虽无统计学意义,但有好转趋势;控烟态度明显好于干预前,差异有统计学意义（P＜0．05）。结论 目前医务人员的吸烟率较高,控烟意识淡漠,吸烟者和不吸烟者在控烟态度和行为方面存在差异。在医院环境中采取综合干预的方法可以改变医务人员的吸烟行为,提高其控烟意识。     

ER和CD59在Buerger病变血管中表达的相关性

目的探讨血栓闭塞性脉管炎（Buerger病）患者病变血管中雌激素受体（ER）、补体调节蛋白（CD59）及IgG表达及其意义。方法采用免疫组织化学染色SP法检测30例男性Buerger病患者截肢肢体动脉血管和30例正常男性（对照组）外伤截肢肢体动脉血管内皮细胞膜ER、CD59和IgG抗体的表达水平,并采用直线相关分析方法分析其相关性。结果Buerger病患者动脉血管内皮细胞ER和CD59表达均强于对照组（P〈0．05）,动脉血管内皮细胞膜IgG表达弱于对照组（P〈0．05）,而动脉血管内皮细胞膜下IgG表达强于对照组（P〈0．05）。ER和CD59分别与IgG抗体的表达呈负相关。结论Buerger病患者体内血管内皮细胞中ER和CD59表达均上调,可能与Buerger病血管病变机制相关。     

下肢Buerger's 病患者腰交感神经节神经元中DBH的改变

目的:研究下肢Buerger's病患者腰交感神经节神经元中去甲肾上腺素合成酶--多巴胺-β-羟化酶(dopamine beta hydroxylase,DBH)的表达.方法:采用免疫组织化学SP法检测14例Buerger's病患者和11例非Buerger's病患者腰交感神经节神经元中DBH的表达水平.结果:Buerger's病患者神经元内DBH表达有高于正常人的总体趋势,差异具有统计学意义(P＜0.05).结论:DBH的表达增强可使血管更多的处于痉挛状态,促进了本病的发生发展.     

梭子蟹过敏原致敏组分的分析研究

目的应用免疫印迹(Western blotting)的方法分析梭子蟹[Portunus pelogicus(Linnaeus)]的致敏组分,为蟹过敏原的纯化和标准化变应原疫苗的研制提供理论依据。方法取常规方法制备的梭子蟹浸出液,经十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)分离,用考马斯亮蓝染色分析其抗原蛋白的组分,同时用对蟹过敏的病人血清进行免疫印迹。结果SDS- PAGE显示梭子蟹可辨有19条蛋白带,分子量在13kD-90kD之间,其中主带有9条,分子量是20.9kD、24.2kD、27.1kD、29.2kD、33.7kD、38.9kD、48.7kD、74.7kD、89.1kD。Western blotting结果表明,16例蟹过敏患者血清全部呈阳性反应,浸出液中共有5条致敏条带,其中分子量在74.4kD、48.7kD的是主要致敏组分,阳性反应率均为100%。结论梭子蟹74.4kD和48.7kD组分为主要过敏原。     

白芍总苷对原发性干燥综合征浆细胞样树突状细胞影响的研究

目的 探讨白芍总苷( TGP)治疗对原发性干燥综合征( pSS)患者外周血浆细胞样树突状细胞( pDC)的影响. 方法 收集新发pSS患者17例作为疾病组,每日予以TGP 1. 8 g治疗3个月,对照组17例. 采用流式细胞术检测疾病组治疗前、后及对照组pDC及其表面CD32、CD86、CXCR4和Blys表达;ELISA法检测血浆干扰素-α( IFN-α)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)水平;免疫组化法检测25例pSS患者唇腺pDC浸润. 结果 ① pSS患者外周血pDC比例较对照组下降,pDC表达CXCR4比例较对照组增加,血浆IL-6、TNF-α、IFN-α水平较对照组上升,25 例pSS患者唇腺中19例有pDC浸润;②TGP治疗后,pSS患者外周血pDC比例较治疗前上升;pDC表达CXCR4、Blys比例较治疗前下降;TGP治疗后血沉下降;血浆 IL-6、TNF-α 水平治疗后下降. 结论 新发pSS患者较正常者外周血pDC比例降低,表达CXCR4增加,唇腺组织中有pDC浸润;TGP可能抑制pSS患者pDC活化.     

下肢Buerger病患者腰交感神经节神经元TH和DBH的表达

目的:研究下肢Buerger病患者腰交感神经节神经元中去甲肾上腺素合成酶酪氨酸羟化酶(tyrosine hydroxylase, TH)和多巴胺-β-羟化酶(dopamine beta hydroxylase, DBH)的表达变化. 方法:采用免疫组织化学SP法检测14例Buerger病患者腰交感神经节内神经元中TH和DBH的表达水平,11例非Buerger病患者腰交感神经节作为对照. 结果:Buerger病患者腰交感神经节神经元内TH和DBH的表达有高于正常人的总体趋势,差异具有统计学意义(P<0.01和P<0.05).结论:Buerger病患者腰交感神经节神经元TH和DBH表达增强,可使血管更多的处于痉挛状态,促进了疾病的发生发展.     

Effect of 2-5 years of tobacco smoking on ventilatory function tests

Smoking is a pernicious scourge of the world today. There is paucity of literature on the effect of acute smoking on ventilatory functions. The present work is undertaken to study the effect of 2-5 years of tobacco smoking on ventilatory functions. The study group consisted of 30 male, young, healthy subjects, free from cardiopulmonary diseases and with history of smoking of 2-5 years duration, on an average of 10 cigarettes per day. The control group consisted of 30 age-and sex-matched healthy individuals who had naver smoked tobacco. The ventilatory function tests were carried out using electronic spriolyser. There was a significant lowering of the following parameters in smokers: Vital capacity (VC), inspiratory reserve volume (IRV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume at the end of first second (FEV1), maximum midexpiratory flow (MMEF), peak expiratory flow (PEF), midexpiratory flow75 (MEF75), maximum voluntary ventilation (MVV). This study shows that 2-5 years of tobacco smoking leads to a definite tendency to narrowing of both the large and the small airways.     

Tobacco smoking and pulmonary tuberculosis: a case-control study

A case-control study was carried out to assess if the tobacco smoking is associated with development of active pulmonary tuberculosis in 153 cases with active pulmonary tuberculosis and 160 control subjects. Detailed information on smoking habits was collected from cases and controls using questionnaire. It was seen that tobacco smoking was associated with pulmonary tuberculosis. The estimated crude odd's ratio (OR) of the association was 1.66 (95% confidence interval: 1.01-2.73) . The age adjusted OR was 1.70 (95% CI: 1.01-2.88), p < 0.05. The increased risk for pulmonary tuberculosis was significant in men who had smoked for over 20 years (OR 3.07; 95% CI: 1.37-6.86). The adjusted OR for heavy smokers (more than 20 bidis per day) was 2.72 (95% CI: 1.19-6.20). There was a dose-response relationship between the number of bidis smoked daily and the risk of development of pulmonary tuberculosis. The study showed that tobacco smoking is associated with pulmonary tuberculosis, with a dose-response relationship with the number of bidis consumed daily.     

Tobacco habit in northern India

To study tobacco consumption practices in north-Indian population, a community-based, stratified sampling survey using validated interview schedule was performed in rural/urban areas of Lucknow, Uttar Pradesh. There were 432 tobacco users (385 men, 47 women; 276 urban, 156 rural) taken as subjects. Tobacco use practices ie, chewing/smoking/rubbing/snuffing, frequency, starting age, supply, place/context of use, quid habit, affect, facilitating conditions/barriers, tobacco users' opinion on control measures were all taken into consideration. Single mode of tobacco use was reported by 277 subjects (64.1%) and the rest had a plethora of tobacco practices. Chewing was prevalent in 322(74.5%), smoking in 256(59.3%), rubbing in 32(7.4%) and snuffing in 4 subjects (0.9%). Of the 10 preparations in the questionnaire, the "top 5" preferences ranked as tobacco-betel, gutka, cigarette, bidi and khaini that remained unchanged between sexes, rural/urban people and age groups. Women significantly (p<0.00001) preferred smokeless tobacco and perceived social barrier for smoking. Gutka consumption was significantly higher in youngsters (<25 yeans; p<0.0001). Most subjects (235; 54.3%) used tobacco 7-24 times/day. Majority (259; 60%) users started consuming tobacco before 21 years of age and about a fifth 95(22%) before 15 years. Majority users (232; 53.6%) did not procure tobacco from a fixed shop. The commonest context of tobacco use was with any refreshment (337; 78.0%). Of the 322 tobacco chewers, about half the subjects (178; 52.2%) rotated the quid in their mouth, 313(97.2%) later spat it out, 9(2.1%) swallowed it and 15(4.7%) admitted to sleep with the quid in mouth. Tobacco along with alcohol was consumed by 82(19%) and with opium by 33 subjects (7.6%). Social barrier to tobacco use was perceived by 231 subjects (53.5%), especially by smokers. Majority users (355; 82.2%) did not have negative feelings or embarrassment in using tobacco. Most users (351; 81.4%) said they would welcome legislative control on tobacco use.     

河南省居民吸烟现状调查

目的:了解河南省居民的吸烟状况,为开展针对性的控烟工作提供依据。方法:采用多阶段分层整群抽样的方法,调查河南省15～69岁居民2056人的吸烟情况。结果:河南省居民的吸烟率为21.11%;男性吸烟率为44.49%(420/944),女性为1.26%(14/1112),男性高于女性(χ2=573.034,P<0.001);现在吸烟率为20.09%(413/2056)。不同年龄、职业和收入水平居民的吸烟率差异有统计学意义(χ2=24.672,69.101和54.166,P<0.001)。吸烟者中有25.35%的人尝试过戒烟,戒烟成功率仅为4.84%,而且仅有13.32%的人打算在1a内戒烟。现在吸烟者开始吸烟时的年龄平均为21.92岁(95%CI为21.25～22.58岁),超过83.82%的现在吸烟者开始吸烟时的年龄不到25周岁。男性开始吸烟年龄早于女性(Z=2.219,P=0.027),烟龄长于女性(Z=2.219,P=0.027),但吸烟量差异无统计学意义(Z=1.746,P=0.081)。79.18%的调查对象知晓吸烟危害健康;现在吸烟者、戒烟者和从不吸烟者知晓率差异无统计学意义(χ2=2.208,P=0.332)。结论:河南省居民吸烟率仍然较高,控烟工作仍面临巨大的挑战。     

白芍总苷对糖尿病大鼠肝脏内质网应激的调节作用

目的 探讨白芍总苷( TGP)对糖尿病大鼠肝脏损害的保护作用是否与抑制内质网应激( ERS)有关. 方法 建立链脲佐菌素( STZ)诱导的糖尿病模型,随机分为对照组、模型组、TGP ( 50、100、200 mg/kg )给药组. 应用油红 O与Masson染色对肝组织行病理检查;采用免疫组化法检测肝组织ED-1表达;采用Western blot法检测GRP78、p-Perk及p-Eif2α的表达. 结果 TGP给药可降低糖尿病大鼠肝重增加及肝组织总胆固醇( TC)、三酰甘油( TG)及游离脂肪酸( FFA)水平. 模型组肝细胞油红O染色评分明显高于对照组( P <0. 01 );TGP 各给药组评分明显低于模型组( P <0. 01). Masson染色模型组肝纤维化评分明显高于对照组(P<0. 01);TGP 50、100、200 mg/kg给药组评分明显低于模型组( P<0. 01 ). 免疫组化显示模型组肝组织巨噬细胞浸润明显增加,各给药组均能抑制糖尿病肝组织巨噬细胞浸润的增加. Western blot显示糖尿病模型组肝组织GRP78、p-Perk及p-Eif2α表达明显高于对照组, TGP 给药组肝组织GRP78、p-Perk及p-Eif2α表达明显低于模型组. 结论 TGP对糖尿病肝损害有明显保护作用,其机制可能与其抗炎、抑制ERS有关.     

自身抗体谱在原发性胆汁性肝硬化诊断中的作用

目的分析原发性胆汁化肝硬化（PBC）患者的自身抗体谱和免疫功能,探讨其对PBC的诊断价值。方法用免疫印迹法检测107例PBC、100例疾病对照组和30例健康体检者血清中的抗线粒体抗体（AMA）M2亚型、AMAM2—3E（BPO）、抗Spl00抗体、抗gp210抗体、抗肝肾微粒体1型（LKM一1）抗体、抗早幼粒细胞性白血病（PML）抗体、抗肝特异性胞质抗体-1（LC-1）、抗可溶性肝抗原,肝胰抗原抗体（SLA／LP）。结果1．AMA—M2、AMAM2—3E（BPO）、抗Spl00抗体、抗PML抗体、抗gp210抗体对PBC诊断的敏感性、特异性分别为74．7％、90．2％,86．9％、95．1％,32．7％、97．1％。27．1％、97．5％,39．3％,98．3％。未检测到抗LKM-1抗体、抗LC～1抗体、抗SLA几P抗体。2．在118例疾病对照组中AMA—M2、AMAM2—3E（BPO）、抗Sp100抗体、抗PML抗体、抗gp210抗体检出率分别为16％、11％、3％、1％、3％,未检测到抗LKM-1抗体、抗LC-1抗体、抗SLA／LP抗体。在正常对照组上述8种抗体的检出率均为0。3．AMA—M2呈阳性的患者（n=97）比呈阴性的患者（n=lO）有更加严重的疾病。这可通过更加严重的组织学变化和更高的IgG,IgM和ALP平均值看出;抗gp210抗体呈阳性的患者肝功能衰竭发生率明显高于呈阴性的患者（P〈0．05）。结论PBC患者血清中可检测到多种自身抗体,其中抗Spl00抗体、抗PML抗体、抗gp210抗体在PBC诊断中特异性高,可协助诊断PBC。     

Effects of strong government measures against tobacco in Hong Kong

The government of Hong Kong grasped the political nettle of control of tobacco in the early 1980s, since when a comprehensive policy of legislation, education, and publicity, together with large increases in taxation on tobacco products, has been introduced. This has led to almost all of the population of Hong Kong having knowledge of the harmful effects of tobacco and of antismoking measures taken by the government. From 1982 to 1984 the number of people who smoked daily fell appreciably from 888 300 to 744 500, a reduction of 16%, while the number of teenage smokers was halved (from 22 600 to 11 200). Government commitment is crucial in programmes against tobacco in developing countries; without it antismoking efforts are unlikely to be successful.     

吸烟与血液流变学及心脑血管疾病的关系

按是否吸烟将健康男性124例分为两组,同样按是否吸烟将单纯高粘血症、TIA,冠心病及急性脑梗塞患者共246例分为两组,用NX-5型血粘度计细胞电泳仪测定10项血流变学指标。结果:1.病人组血流变学各项主要指标均显著高于健康人组。表明缺血性心脑血管疾病患者血粘滞因素显著升高;2.健康人中吸烟者的红细胞压积、低切全血粘度、还原粘度和血粘度系数(yss)显著升高,脑血流量显著降低;3.病人组中吸烟者除与健康人吸烟者具有同样的结果外,高切全血粘度、血浆粘度亦显著升高,表明吸烟的病人血粘滞因素升高更甚;4.正常人与缺血性心脑血管疾病患者中,吸烟人数的构成比差异显著,病人组中70.33%是吸烟者。     

棉尘及吸烟对肺功能影响的观察

对８３名接触棉尘的健康者作肺功能测定，并与３９名不接触棉尘的健康者对照。其中男性均为吸烟者；女性均为不吸烟者。结果表明，ＭＭＥＦ、ＰＥＦＲ、Ｖ２５％～７５％均明显低于对照组（分别为Ｐ＜０．０１和Ｐ＜０．０５）．在男性吸烟组，ＶＣ，ＭＢＣ，ＦＥＶ１％也有明显下降（Ｐ＜０．０１），作者认为棉尘对人体的危害主要部位在小气道，吸烟者因损害严重可累及大气道。以往对棉尘反应的肺功能评估仅以ＦＥＶ１％为指标，不能反映早期的变化，有必要进一步完善。     

Efficacy of group intervention on tobacco cessation among male employees in health-care setting: A randomized controlled trial

BackgroundThe tobacco epidemic is one of the biggest public health threats the world has ever faced. World Health Organization has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about 7 million people across the world each year. The objective of the study was not only to find the effect of group intervention on tobacco cessation but also to describe certain epidemiological factors associated with tobacco cessation and make suitable recommendations to tackle this epidemic.MethodsA randomized controlled trial was carried out among male employees who were tobacco users in health-care setting in Western Maharashtra. In the study, 60 subjects each in intervention and control arm were taken. Pretested validated questionnaires were used for the study. The intervention comprised of two sessions delivered 5 weeks apart. Control arm received self-help material (Booklet) immediately after baseline data collection. The outcomes were measured using structured interview schedule. The data were analyzed using SPSS, version 20.ResultsOverall, 13.3% of the study subjects had quit tobacco use post intervention. In the intervention group 21.7% of the participants had quit tobacco since past one month and 5% in the control group (relative risk (RR) = 4.33). Low to moderate nicotine dependence (p = 0.023, RR = 6.46) and stage of contemplation (p = 0.018) were found to be important predictors of abstinence.ConclusionCommunity-based group intervention for tobacco cessation is the way forward to tackle the tobacco epidemic.     

中国大学生吸烟行为和吸烟态度研究

目的:对我国大学生的吸烟现状进行调查;并检验“吸烟态度与吸烟行为具有一致性”的假设。方法:用问卷法对805名中国大学生进行了研究。结果:大学生中有19.1％的人为当前吸烟者;男生吸烟普遍性显著高于女生;吸烟的普遍性随着年级的增高而增高;大学生对尼古丁没有依赖性;不吸烟者抗烟态度强,吸烟者抗烟态度弱。结论:吸烟态度与吸烟行为具有一致性。     

白芍总苷对系统性红斑狼疮CD4+ T细胞ITGAL基因表达和启动子甲基化修饰的影响

目的: 探讨白芍总苷(total glucosides of peony, TGP)对系统性红斑狼疮(SLE)患者外周血CD⁴⁺ T细胞甲基化敏感基因ITGAL(CD11a)表达及启动子甲基化修饰的影响。方法: 利用磁珠分选获得外周血CD⁴⁺ T细胞,用不同浓度TGP(0,62.5,312.5和1562.5 mg/L)处理SLE患者CD⁴⁺ T细胞,48 h后收集细胞。MTT法检测处理后CD⁴⁺ T细胞的活力。定量PCR检测ITGAL基因mRNA表达水平。流式细胞术检测CD⁴⁺ T细胞表面CD11a分子表达水平。亚硫酸盐测序法分析ITGAL基因启动子甲基化水平。结果: TGP处理48 h后,各浓度组CD⁴⁺ T细胞活力无明显差异。与对照组相比,高浓度组(1562.5 mg/L)ITGAL基因mRNA表达水平显著降低(P<0.01),CD⁴⁺ T细胞表面CD11a表达水平亦显著降低(P<0.01)。进一步DNA甲基化水平检测显示高浓度TGP处理组ITGAL基因启动子甲基化水平较对照组显著升高(P<0.01)。结论: TGP可通过升高ITGAL基因启动子甲基化水平降低SLE患者外周血CD⁴⁺ T细胞中CD11a表达水平,初步揭示了TGP抑制SLE自身免疫反应的分子机制。     

采用Western blotting的方法分析蚕蛹致敏原成份

目的应用Western blotting的方法检测蚕蛹(silkworm chrysalis)浸出液中致敏原的成份,为蚕蛹致敏原的研究和临床诊断提供依据.方法取蚕蛹浸出液,经SDS-聚丙烯酰胺凝胶分离,再转印到PVDF膜上,封闭后将血清与膜条共同孵育,后与辣根过氧化物酶标记的羊抗人IgE抗体反应,显色底物用对氨基联苯胺.结果SDS-PAGE显示蚕蛹可辨条带有12条,分子量在14～94 kD之间,其中主带有8条,分子量依次为80 kD、68 kD、62kD、50 kD、29 kD、28 kD、18 kD、16 kD.Western blotting结果表明,22例蚕蛹过敏患者血清全部呈阳性反应,浸出液中共有6条致敏条带,其中分子量68 kD和29 kD是主要致敏组份,阳性反应率均为100%.结论蚕蛹分子量68 kD和29 kD的组份为主要致敏组份,结果可为开发适合我国特色的蚕蛹变应原提供依据.     

刺苋花粉特异性变应原成分的分析研究

目的：分析刺苋花粉的抗原成分以及刺苋花粉特异性变应原组分,为刺苋花粉变应原的纯化和标准化变应原疫苗的研制提供理论依据.方法：取刺苋花粉浸出液,经十二烷基硫酸钠-聚丙烯酰胺凝胶电泳（SDSPAGE）分离,以16例刺苋花粉过敏的病人血清为探针,进行免疫印迹（Western blotting）,检测刺苋花粉浸出液的致敏组分.结果：SDS-PAGE显示可辨蛋白条带有11条,分子量在15～80 kD之间,其中主带有9条,分子量依次为18 kD、24 kD、29 kD、35 kD、39 kD、40 kD、42 kD、62 kD、78kD.Western blotting结果表明,16份刺苋花粉过敏患者的血清全部呈阳性反应,浸出液中共有4条致敏条带,其中主要致敏蛋白的分子量是78 kD和40 kD.结论：刺苋花粉78 kD和40 kD的变应原为主要特异性变应原.