Environmental tobacco smoke exposure in school children: parent report and urine cotinine measures

BACKGROUND: Environmental tobacco smoke (ETS) in the home continues to be a major health risk for children around the world. Measuring ETS is a central feature of clinical and epidemiological studies, with children's exposure often assessed through parental estimates. The authors examined the relationship between parent-reported estimates of children's exposure to ETS and children's urinary cotinine levels and evaluated the ETS exposure and its effect on respiratory health in children. METHODS: A total of 188 school children were included in the study. Parents were asked to complete a questionnaire about their smoking habits, their children's respiratory morbidity status and housing conditions. Urinary cotinine levels were measured in children. RESULTS: According to the responses, 72.3% of the children came from households with smokers, and 34.6% had daily exposure to ETS. When urine cotinine levels of >10 ng/mL were used as the yardstick of exposure, 76% of the children were identified as ETS exposed. No relation was detected between the symptoms of respiratory tract diseases and ETS exposure. To determine the amount of ETS exposure, the contribution of parental reports was low. CONCLUSION: To evaluate the level of ETS exposure of children, the parents' reports were not reliable. The addition of a biological measure results in a more informative estimate of ETS exposure in children.     

The effects of caudal or intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine in children

Background: Clonidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine. Methods: Sixty ASA I and II children, aged 2–8 undergoing inguinal hernia repair or orchidopexy surgery received standardized premedication with midazolam and general anesthesia. The children were randomized in a double‐blind fashion to three groups. Group L (n = 20) patients received 0.75 ml·kg^?1 of caudal 0.25% levobupivacaine and i.v. 5 ml saline, Group L‐Ccau (n = 20) patients received 0.75 ml·kg^?1 of caudal 0.25% levobupivacaine + 2 μg·kg^?1 clonidine and i.v. 5 ml saline, Group L‐Civ (n = 20) patients received 0.75 ml·kg^?1 of caudal 0.25% levobupivacaine and i.v. 2 μg·kg^?1 clonidine in 5 ml of saline. Mean arterial blood pressure, heart rate, peripheral oxygen saturation, and end‐tidal carbon dioxide values were recorded. Postoperative pain [Children and Infants Postoperative Pain Scale (CHIPPS) score], sedation (Ramsay Sedation Scale) and motor blockade (Modified Bromage Scale) were assessed at predetermined time points during the first 24 h after surgery. Results: Caudal clonidine significantly delayed the time to first rescue analgesic and fewer patients required rescue analgesia in the 24 h after surgery. No motor block was observed in any of the three groups on awakening or during the study period. In Group L‐Ccau, the CHIPPS score was lower than in Group L at all times through 240 min (P < 0.05), while the pain scores were lower in Group L‐Civ only at extubation and at 240 min (P < 0.05). Conclusions: Caudal clonidine prolongs the duration of analgesia produced by caudal levobupivacaine without causing significant side effects and this is because of a spinal mode of action.     

维吾尔族妇女宫颈癌人乳头状瘤病毒感染与人类白细胞抗原Ⅰ类基因表达缺失的关系及其意义

目的 研究维吾尔族妇女宫颈癌中人乳头状瘤病毒(HPV)感染和人类白细胞抗原Ⅰ类(HLA-Ⅰ)家族基因HLA-A、B和C表达的关系,探讨HPV感染和HLA-Ⅰ类家族基因表达缺失在宫颈癌演进过程中的作用.方法 收集维吾尔族妇女宫颈炎、宫颈上皮内瘤样病变(CIN)Ⅰ/Ⅱ/Ⅲ和宫颈鳞癌患者的新鲜组织标本共78例,提取总RNA,采用半定量RT-PCR方法鉴定HLA-A、B和C基因的mRNA表达水平.提取组织DNA,采用HPV通用引物和HPV分型芯片确定HPV亚型.结果 HLA-A、B和C基因的总体mRNA表达缺失率随着宫颈病变的加重而增加,在宫颈炎组织内为1/12,在CIN及宫颈鳞癌分别占70.0%(14/20)和84.8%(39/46),在恶性程度高的低分化癌组织中高达90.6%(29/32),并与高危型HPV16感染呈正相关(r=0.803,P＜0.01).结论 HLA-Ⅰ类基因的表达缺失是维吾尔族妇女宫颈癌发生的重要标志,而HPV16感染可能是HLA-Ⅰ分子表达缺失的前提条件.     

基于磁共振的新疆汉族不同性别健康人群血清和尿液代谢组学差异分析

目的:寻找新疆汉族不同性别人群体液差异性代谢成分。方法:对92例不同性别汉族健康人血清和尿液样本进行研究。血清和尿液样本采用磁共振方法进行测试,并采用正交偏最小二乘判别分析(OPLS-DA)法进行模式识别分析,最后以R2X,R2Y,Q2等参数评价和分析结果。结果:男性血清极低密度脂蛋白、低密度脂蛋白、不饱和脂类、肌酸酐和丙酮等代谢物含量比女性高,而女性血清中柠檬酸、胆碱、葡萄糖及多种氨基酸(包括异亮氨酸、亮氨酸、缬氨酸、丙氨酸、瓜氨酸、赖氨酸、蛋氨酸、谷氨酸、苯丙氨酸、苏氨酸、酪氨酸、1-甲基组氨酸、甘氨酸等)含量高于男性;男性尿液中甲酸、丙二酸、牛磺酸、肌酸酐等代谢物含量比女性高,而女性尿液中马尿酸、γ-氨基丁酸、琥珀酸盐、柠檬酸和谷氨酸等代谢物含量高于男性。血清分析的模型参数为R2X=0.64,R2Y=0.70,Q2=0.67,尿液分析的模型参数为R2X=0.17,R2Y=0.70,Q2=0.44。结论:新疆健康人群血液和尿液中包含了多种与性别有关的代谢成分,这种差异性代谢产物的发现在临床代谢组学研究中具有积极的意义。     

维吾尔族妇女宫颈病变组织中HPV感染与低相对分子质量蛋白酶体2和7基因启动子甲基化的关系

目的 探讨维吾尔族妇女宫颈病变及其人乳头状瘤病毒( human papillomavirus,HPV)感染与低相对分子质量蛋白酶体(low molecular-weight protein,LMP)基因启动子区甲基化水平的关系和意义.方法 利用专业软件设计LMP2和LMP7基因启动子区含CpG岛特异性PCR引物,对SiHa宫颈癌细胞DNA进行亚硫酸氢盐修饰、目的片段扩增、质粒载体克隆和测序,确定该区域所含CpG序列甲基化情况;收集维吾尔族妇女正常宫颈上皮、宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者新鲜组织和石蜡组织标本78例,并提取DNA,采用Sequenom MassARRAY DNA技术平台(质谱分析),定量分析LMP2和LMP7基因启动子甲基化水平,同时以HPV分型芯片鉴定HPV亚型,分析基因甲基化与HPV感染的关系;应用RT-PCR和免疫组织化学方法检测LMP2、LMP7mRNA和蛋白的表达,并分析蛋白表达与基因甲基化的关系.结果 LMP2和LMP7基因相应目的片段各含有22个CpG位点,在SiHa宫颈癌细胞基因组DNA中,只有LMP7有2个位点发生甲基化.宫颈病变病理过程伴随着LMP7基因CpG片段甲基化水平改变,其在CSCC和CIN组织的甲基化率(0.1864±0.0893和0.0728±0.0548)高于正常宫颈上皮组织(0.0652±0.0488),差异有统计学意义(P＜0.05).随着宫颈病变的加重LMP7 mRNA和蛋白表达逐渐下调,各组间表达差异具有统计学意义(P＜0.05),LMP7蛋白表达随着该基因甲基化率增高而降低(F=8.69,P=0.035).而LMP2蛋白表达在3组间差异无统计学意义(P＞0.05).HPV分型芯片检出12种HPV基因型,其中HPV16感染率构成比为52/78(66.7％),HPV16亚型阳性与宫颈病变进程及LMP7基因甲基化率升高趋势正相关(t=1.996,P=0.049).结论 LMP7基因启动子区CpG岛甲基化是一种宫颈癌病变特异性改变,与HPV16感染可能存在密切关系.     

宫颈病变中抗原呈递元件成员蛋白和人类白细胞共同抗原Ⅰ类分子表达的关系

抗原呈递元件(APM)成员蛋白作为一组抗原呈递相关功能蛋白,在协助人类白细胞共同抗原(HLA)Ⅰ类分子组装、负载和提呈内源性抗原肽,介导抗病毒T细胞免疫中发挥着重要作用[1].其成员蛋白抗原处理相关转运体(TAP)负责将内源性抗原肽向内质网腔转运.TAP相关蛋白对HLA-Ⅰ类分子在内质网中的装配发挥关键作用[2].分子伴侣钙连接蛋白和钙网蛋白以及疏基二硫键氧化还原酶Erp57协助新合成的HLA-Ⅰ蛋白正确折叠和组装[3].人乳头状瘤病毒(HPV)是宫颈癌发生的始动因素,也可能通过协助肿瘤细胞影响HLA-Ⅰ基因表达调控.因此,探讨HPV感染引起宿主HLA-Ⅰ类分子表达缺失与APM成员表达情况有无关联,是揭示肿瘤的分子机制、疫苗治疗、建立肿瘤生物标志谱体系的关键.我们通过检测宫颈上皮内瘤变(CIN)和宫颈癌组织中APM成员蛋白及HLA-Ⅰ类分子的表达情况,分析其与HPV16感染的相关性,从而探讨宫颈病变中HLA-Ⅰ类分子表达下调的机制.     

标准化方法对大鼠尿液 1H磁共振谱 代谢物分析结果的影响

目的：采用磁共振（magnetic resonance, MR）波谱技术测试不同性别大鼠尿液代谢物并用不同标准化方法进行预处理,探讨不同标准化方法对分析结果的影响。方法：大鼠尿液MR 图谱数据经过中心化（mean-centering and not scaling,Ctr）和自动规格化（unit variance scaling,UV）两种不同标准化方法处理后用正交偏最小二乘判别分析（orthogonal to partial least squares discriminant analysis, OPLS-DA）法分析,通过相关系数的计算确定不同性别大鼠尿液中含量有差异的代谢物。结果：数据进行中心化处理后判别出两组大鼠尿液中缬氨酸、乙酸、鸟氨酸、氨基马尿酸、苯乙胺、氧氨嘧啶、甲胺、二甲胺、尿囊素、延胡索酸、丙氨酸、柠檬酸和化学位移在δ4.14的一种未知代谢物等13种代谢物含量有差异。进行自动规格化处理后,判别出以上除柠檬酸外的12种代谢物以及硫胺、肌酸酐、甲酸和化学位移在δ2.92的一种未知代谢物等4种代谢物含量有差异。结论：自动规格化处理是代谢组学研究中比较灵敏的数据预处理手段。