上海市某区一级医院门诊病人吸烟现况调查与分析

目的　了解上海市某区一级医院门诊病人吸烟现状及其影响因素。方法　对 5 4 0名门诊病人进行问卷调查。结果　烟民占调查对象的 38 8% ,吸烟率 35 9% (男性吸烟率 6 1 6 % ,女性吸烟率 2 1% ) ,现在吸烟率2 6 3%。城镇患者吸烟率为 33 0 % ,农村患者吸烟率为 37 6 %。开始吸烟的平均年龄为 (2 1 6± 5 6 )岁 ,吸烟主要原因为社交需要 ,5 2 2 %的吸烟者近 6个月内没有戒烟打算 ,35 1%从未考虑戒烟的原因是烟瘾 ,37 5 %的烟民从医生处得到简单的劝告 ,仅 15 0 %的烟民从医生处得到详细的吸烟危害健康的说明。结论　吸烟与性别、对被动吸烟危害性的认识情况有关。大部分调查对象对吸烟和被动吸烟危害健康的认识较好 ,但是医务人员帮助病人戒烟的建议和劝告明显不够     

基于Toll样受体4/核因子κB通路观察香烟烟雾溶液刺激对人支气管上皮样细胞相关基因表达的影响

目的 观察Toll样受体4(TLR4)基因沉默或过表达后香烟烟雾溶液（CSE）对人支气管上皮样细胞（16HBE）相关基因表达的影响。方法 2020年8—12月,用常规培养的人支气管上皮样细胞16HBE作为空白对照组,实验设干扰小RNA(siRNA)TLR4-1组（hs-TLR4-si-1+16HBE）、siRNA TLR4-2组（hs-TLR4-si-2+16HBE）、siRNA TLR4-3组（hs-TLR4-si-3+16HBE）,另设阴性对照组（NC+16HBE）,实时荧光定量逆转录聚合酶链反应（qRT-PCR）筛选TLR4基因最佳沉默效果;自制CSE作用于16HBE,实验设常规培养的16HBE作为空白对照组、CSE组（CSE+16HBE）、siRNA TLR4组（CSE+hs-TLR4-si-2+16HBE）、siRNA TLR4-NC组（CSE+NC+16HBE）、Lv-TLR4组（CSE+Lv-TLR4+16HBE）、Lv-TLR4-NC组（CSE+Lv-TLR4-NC+16HBE）,qRT-PCR检测TLR4、核因子κB(NF-κB)以及黏蛋白MUC5AC、MUC7、MU...     

Volatile constituents detected in smoke condensates from the combination of the smoking ingredients sucrose,black tea leaves,and bread flour

Smoke condensates from three major smoking ingredients used for traditional Chinese smoked large yellow croaker and chicken—black tea leaves, bread flour, and cane sugar—were obtained in a laboratory. The aim of this study was to assess the influence of the three smoking ingredients in the volatile compounds of smoke condensates. Seven main peaks were detected using chemical standards and 73 compounds were identified by gas chromatography and mass spectrometry (GC-MS) for smoke condensates. The smoke condensate from three mixed ingredients contains a high percentage of furfural (46.08% area), 5-methyl-2-furancarboxaldehyde (16.92% area), 5-hydroxymethyl-2-furaldehyde (4.17% area), and caffeine (11.86% area) in the volatile profile. Phenolic derivatives (phenol, 2-methylphenol, 3-methylphenol), furan compounds (furfural, 5-methyl-2-furancarboxaldehyde, 5-hydroxymethyl-2-furaldehyde), and caffeine are the major volatile constituents found in the smoke condensates. Each smoking ingredient contributed some major volatile constituents. Caffeine mainly derived from black tea leaves was found in the smoke condensate for the first time. Nitrogen-containing pyrazines were mainly found in the smoke condensate of black tea leaves and bread flour.     

三种类型蚊香烟雾对室内空气污染的研究

目的 了解不同类型蚊香烟雾对室内空气污染的状况.方法 在关窗条件下,对3种蚊香使用后不同时间室内一氧化碳(CO)、二氧化碳(CO2)、可吸入颗粒物(IP)和总挥发性有机物(TVOC)的浓度进行测定.结果 有烟蚊香使用后不同时间室内CO、IP浓度均超过室内空气质量标准,TVOC浓度在使用5和6h后超标,CO2浓度未超标;无烟蚊香使用后不同时间室内CO和TVOC浓度均超标,CO2和IP浓度均未超标;电蚊香片使用后不同时间室内CO、IP、CO2和TVOC浓度均未超标.有烟蚊香产生的CO、CO2、IP和TVOC均与时间呈正相关关系(P＜0.01);无烟蚊香产生的CO、CO2和TVOC与时间呈正相关关系(P＜0.01),但IP与时间无相关性(P＞0.05);电蚊香片产生的TVOC与时间呈负相关关系(P＜0.01),但CO、CO2和IP与时间无相关性(P＞0.05).蚊香使用3及6h后,CO、CO2污染情况:有烟蚊香显著高于无烟蚊香,无烟蚊香显著高于电蚊香片;TVOC污染情况:无烟蚊香显著高于有烟蚊香,有烟蚊香显著高于电蚊香片;IP污染情况:有烟蚊香显著高于无烟蚊香和电蚊香片,而无烟蚊香和电蚊香片间差异无统计学意义.结论 有烟蚊香主要造成室内IP、CO和TOVC污染,无烟蚊香主要造成室内CO和TVOC污染,电蚊香片主要产生TVOC污染.     

去除尼古丁和焦油的香烟烟雾提取物与尼古丁对大鼠睾丸氧化应激损伤及睾酮影响的比较

目的:探讨去除尼古丁和焦油的香烟烟雾提取物(CSE)与尼古丁对大鼠睾丸氧化应激损伤及睾酮影响的差异及其机制。方法:30只SD雄性大鼠随机分为3组:对照组(PBS组)、CSE组及尼古丁组。8周后放射免疫法检测血清睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)水平;用黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性、硫代巴比妥酸法测定丙二醛(MDA)活性;HE染色观察睾丸组织形态学变化,并用电镜观察睾丸间质细胞和精子细胞的超微结构变化。结果:HE染色显示尼古丁组生精小管萎缩,生精细胞排列紊乱,数量减少。电镜下尼古丁组精子细胞出现异型性、凋亡,CSE组睾丸间质细胞中出现线粒体水肿,线粒体嵴消失及溶酶体增多。CSE、尼古丁组T值[(2.58±0.81)ng/ml,(1.74±0.51)ng/ml]、SOD值[(28.28±1.27)U/mg prot,(26.42±2.02)U/mg prot]较PBS组[T(6.02±0.75)ng/ml,SOD(38.07±1.39)]显著降低(P<0.05),MDA值[(0.65±0.070)U/mg prot,(0.76±0.073)U/mg prot]较PBS组[(0.50±0.066)U/mg prot]显著升高(P<0.05),两组之间比较有显著性差异(P<0.05),且T值与MDA呈负相关,与SOD呈正相关。对照组和CSE组FSH[(1.97±0.25),(1.92±0.29)mIU/ml]、LH[(8.49±0.42),(8.14±0.46)mIU/ml]显著高于尼古丁组[FSH(1.54±0.28)mIU/ml,LH(7.01±0.61)mIU/ml](P<0.05),但两组之间比较差异无统计学意义(P>0.05)。结论:CSE与尼古丁对睾丸的损伤及血清睾酮的影响与氧化应激有关,但是两者对睾丸损伤部位、性激素及氧化应激水平影响不一。     

Firefighters' multiple exposure assessments in practice

During the past decade, more research has focused on firefighters' multiple exposures via multi-route exposure. Multi-route exposure can alter the kinetics of chemicals; this has brought changes to the recommendations on biomonitoring. In addition, the possibility that the chemicals in smoke have additive and synergistic effects has not been consistently taken into account. In this study, biomonitoring and occupational hygienic measurements were used to determine smoke diving trainers' exposure to smoke in conventional and modern simulators. Biological action limit values (BALs) for 1-hydroxypyrene, linked with the ratio of pyrene to benzo[a]pyrene, were established for conventional and modern simulator types. The additive and synergistic effects for the main compounds detected in the air during the suppression of a fire were also calculated. According to the biomonitoring results, dermal exposure played a role in exposure to polycyclic aromatic hydrocarbons (PAHs), and it seemed to delay the excretion of 1-hydroxypyrene and 1-naphthol. The calculated BALs for 1-hydroxypyrene were 6 nmol/L and 53 nmol/L for the conventional and modern simulators, respectively. The combined cancer and eye disorders or upper respiratory tract irritation effects of volatile organic compounds (VOCs) in the conventional simulator were from 6.5 to 7.0-fold higher than in the modern simulator.     

基质金属蛋白酶-9在COPD合并肺间质纤维化大鼠中的表达

目的观察慢性阻塞性肺疾病(COPD)合并肺间质纤维化模型大鼠肺组织中基质金属蛋白酶-9(MMP-9)的表达随时间的变化,评价其与COPD合并肺间质纤维化发病机制的关系。方法雄性SD大鼠24只,随机分为正常对照组(A组),28 d(B组)和42 d(C组)模型组。以吸烟联合脂多糖建立大鼠PIF-COPD模型。模型组每日吸烟,B组于第1天,第15天气管内注入0.2 ml含200μg的脂多糖,C组于第1天,第15天,第28天气管内注入0.2 ml含200μg的脂多糖。免疫组织化学法检测肺组织中MMP-9水平。结果 MMP-9在正常肺组织中有少量表达,为0.1 208±0.0 021;PIF-COPD肺组织中B组和C组分别为0.1 970±0.0 017和0.2 414±0.0 017,与A组相比(P﹤0.05)水平明显增高且与疾病的严重程度呈正相关。结论 PIF-COPD肺组织中MMP-9水平与发病机制有关,检测肺组织中MMP-9水平可以辅助推测PIF-COPD的严重程度。     

戒烟对慢性收缩性心力衰竭的影响

目的探讨戒烟对慢性收缩性心力衰竭的影响。方法将慢性收缩性心力衰竭且有吸烟史患者120例随机分为治疗组和对照组各60例。2组患者均给予常规治疗,治疗组患者另给予戒烟干预。治疗后比较2组疗效。结果治疗组总有效率为93.3%高于对照组的78.3%,差异有统计学意义(P<0.05)。结论吸烟可导致患者的肺功能下降,加重心力衰竭患者的临床症状,戒烟则有利于改善患者的生活质量,值得临床推广。     

Vaccination against nicotine alters the distribution of nicotine delivered via cigarette smoke inhalation to rats

Preclinical models of nicotine vaccine pharmacology have relied on i.v. or s.c. administration of nicotine. Models using cigarette smoke inhalation might more accurately simulate nicotine exposure in smokers. Nicotine vaccine effects were examined in rats using two cigarette smoke exposure models: a 10 min nose-only exposure (NSE) producing serum nicotine levels equivalent to the nicotine boost from 1 cigarette in a smoker, and a 2 h whole-body exposure (WBE) producing serum nicotine levels similar to those associated with regular mid-day smoking. Vaccination prior to 10 min smoke NSE reduced nicotine distribution to brain by 90%, comparable to its effect on nicotine administered i.v. Vaccination prior to 2 h smoke WBE reduced nicotine distribution to brain by 35%. The nicotine concentration in broncheoalveolar lavage (BAL) fluid obtained after 2 h WBE was increased by 230% in vaccinated rats but was also increased in rats passively immunized with a nicotine-specific monoclonal antibody, and so was likely due to transfer of antibody from serum rather than local production at the pulmonary mucosa. Nicotine-specific IgA was not detectable in BAL fluid, but titers in serum were appreciable at 21–25% of the IgG titer and could contribute to vaccine efficacy. Both vaccination and passive immunization are effective in reducing nicotine distribution to brain in rats when nicotine is delivered via inhaled cigarette smoke. These data validate results previously obtained in rodents for nicotine vaccines using i.v. or s.c. nicotine dosing and provide a quantitative method for studying aspects of nicotine exposure which are unique to cigarette smoke inhalation.     

Sclerosis therapy of bronchial artery attenuates acute lung injury induced by burn and smoke inhalation injury in ovine model

Introduction

In burned sheep, we showed more than a 10-fold increase in bronchial blood flow following smoke inhalation. It was previously reported that sclerosis of the bronchial artery prior to smoke exposure reduces the pathophysiology of the inhalation insult. We hypothesized that sclerosis of the bronchial artery after insult attenuates smoke/burn-induced acute lung injury.

Methods

Through an incision at the 4th intercostal space, a catheter was placed via the esophageal artery into the bronchial artery such that the bronchial blood flow remained intact. Acute lung injury was induced by a 40% total body surface area, 3rd degree cutaneous burn and smoke inhalation. Adult female sheep (n = 18, 35.6 ± 1.0 kg) were divided into three groups following the injury: (1) sclerosis group: 1 h after injury, 4 mL of 70% ethanol was injected into bronchial artery via bronchial catheter, n = 6; (2) control group: 1 h after injury, an equal dose of saline was injected into bronchial artery via the bronchial catheter, n = 6; (3) sham group: no injury and no treatment, n = 6. The experiment was conducted in awake animals for 24 h.

Results

Bronchial blood flow, measured by microspheres, was significantly reduced after ethanol injection in the sclerosis group. Pulmonary function, evaluated by measurement of blood gas analysis, pulmonary mechanics, and pulmonary transvascular fluid flux, was severely impaired in the control group. However, pulmonary function was significantly improved by bronchial artery sclerosis.

Conclusion

The results of our study clearly demonstrate a crucial role of enhanced bronchial circulation in thermal injury-related morbidity. Decreasing bronchial circulation using pharmacological agents may be an effective strategy in management of burn patients with concomitant smoke inhalation injury.