为探讨丙烯腈(acrylonitrile,ACN)致大鼠肝细胞损伤中PI3K/AKT信号通路的作用,随机将60只雄性SD大鼠分为5组:对照组,ACN低、中、高剂量染毒组和干预组.分别给予玉米油,11.5 mg·kg-1、23.0 mg·kg-1、46.0 mg·kg-1 ACN和300 mg· kg-1 N-乙酰基半胱氨酸(NAC)+46.0 mg·kg-1 ACN灌胃染毒,灌胃容积为5.0 mL·kg-1,1次·d-1,6 d·周-1,共28 d.最后一次染毒1 d后,大鼠麻醉心脏采血后处死,取肝脏进行实验.(1)原位末端标记法(TUNEL)观察肝细胞凋亡水平;(2)定量逆转录聚合酶链反应法(qRT-PCR)检测pi3k、akt、bad、bcl-2、cyt c和caspase-3基因表达水平;(3)免疫印迹法(WB)检测PI3K/AKT信号通路和线粒体凋亡通路相关蛋白的表达水平.研究表明:(1)细胞凋亡方面.ACN低、中剂量组凋亡细胞较对照组显著增多(P＜0.05).(2)mRNA相对表达水平方面.与对照组相比,ACN低剂量组bad、caspase-3显著升高(P＜0.05),bcl-2显著降低(P＜0.05);ACN 中剂量组 pi3k、bcl-2 降低(P＜0.05),cytc升高(P＜0.05);ACN 高剂量组 pi3k、bcl-2 降低,bad升高(P＜0.05);ACN 各剂量组akt无显著差异(P＞0.05);NAC组bad较ACN高剂量组降低(P＜0.05).(3)蛋白相对表达水平方面.与对照组相比,ACN低剂量组 pro-Caspase-3 降低,cleaved-Caspase-3 升高(P＜0.05);ACN 中剂量组 PI3K、p-Bad 和 pro-Caspase-3 降低,Caspase-9、Bad、Bax和 Cyt c 升高,Bcl-2/Bax 值降低(P＜0.05);ACN 高剂量组 p-PI3K、p-AKT、Bcl-2、p-Bad 和 pro-Caspase-3 降低,Bad、Bax、Caspase-9、Cyt c和cleaved-Caspase-3升高,Bcl-2/Bax值降低(P＜0.05);ACN各剂量组AKT无显著差异(P＞0.05).与ACN高剂量组相比,NAC 组 PI3K、p-Bad 和 pro-Caspase-3 升高,Bax、Caspase-9 和 cleaved-Caspase-3 降低(P＜0.05).ACN 抑制 PI3K/AKT 信号通路及激活线粒体凋亡途径可能是大鼠肝细胞损伤的原因之一.

Accumulating evidence suggests that heavy metal exposure may have adverse effects on the fetal development. Furthermore, disruption of serum hormone homeostasis can result in the adverse pregnancy outcomes. Therefore, this study aimed to investigate the potential association between heavy metals and missed abortion, with a focus on whether serum hormones mediate this relationship. The concentrations of heavy metals and hormones in serum were measured in this case–control study. Statistical models including, logistic regression model, principal component analysis (PCA), and weighted quantile sum (WQS) regression model were employed to examine the relationship between heavy metals, serum hormones, and missed abortion. Furthermore, the mediation analysis was performed to assess the role of serum hormones as potential mediators in this relationship. This study revealed significant associations between heavy metal exposure and missed abortion. Notable, the WQS index weight, which was mainly influenced by copper (Cu) and zine (Zn), is associated with missed abortion. Moreover, heavy metals including manganese (Mn), nickel (Ni), Zn, arsenic (As), Cu, cadmium (Cd), and lead (Pb) were found to be associated with serum levels of β-human chorionic gonadotropin (β-hCG), progesterone (P), estradiol (E2), and lactogen (HPL). In addition, the mediation analysis indicated that β-hCG explained a portion of the association (ranging from 18.77 to 43.51

目的 通过建立体外胎盘滋养细胞(HTR-8/SVneocell)氧化应激模型,探讨在子痫前期(PE)氧化应激过程中核因子E2相关因子2(Nrf2)是否调控醌氧化还原酶1(NQO1).方法 分别采用Nrf2诱导剂(tBHQ)、Nrf2抑制剂(ML385)处理 HTR-8/SVneo cell 30 min 后用 250 μmol/L H2O2或空白处理 HTR-8/SVneo cell 4 h.继而 HTR-8/SVneo cell 各组中 Nrf2、NQO1蛋白水平及NQO1 mRNA相对表达水平用Western Blot和qRT-PCR法检测.结果 H2O2组、tBHQ组中Nrf2蛋白表达量[H2O2组(1.13±0.05)、tBHQ组(1.33±0.17)]较对照组(0.26±0.03)均增加,差异均有统计学意义(t=3.078、2.367,均P＜0.05);ML385组中Nrf2蛋白表达量(0.26±0.03)与对照组比较,差异无统计学意义(t=-0.427,P＞0.05);Nrf2蛋白表达量在H2O2+ML385组中(0.27±0.03)较单独使用H2O2处理组降低,差异有统计学意义(t=0.651,P＜0.05).同时随着Nrf2蛋白表达量的变化,NQO1和NQO1 mRNA也表现出同样的变化趋势.结论 在氧化应激状态下,Nrf2可激活HTR-8/SVneo cell中的NQO1.

To assess the pollution characteristics and health risks associated with street dust exposure among preschool children in typical industrial and mining areas, we analyzed heavy metal concentrations of 20 urban street dusts in commercial area (CA), residential area (RA), scientific and educational area (SEA) and industrial and mining area (IMA) from Baiyin, NW China. The average concentrations of Cr, Mn, Ni, Cu, Zn, Cd, Pb, As and Hg were 614.96, 484.25, 1757.74, 6868.86, 893.19, 77.62, 1473.99, 15.01 and 0.59 mg·kg−1, respectively. The ecological risk indexes for Cd, Cu and Hg were found as 20,075.20, 1425.07 and 1174.86, respectively, and the ecological risk was extremely high. The pollution load indexes (PLI) were > 1 for all four functional areas. The total hazard index (THI) for different functional areas were more than 1, and the main exposure pathway for children was ingestion route. Heavy metals in street dust of the IMA had the highest THI for children (43.88), and HI of Pb was being most significant (17.38). In addition, the carcinogenic risk to children via the respiratory route was acceptable. Furthermore, factor analysis and cluster analysis classified heavy metals into two groups, indicating common anthropogenic sources for Cr, Ni, Cu, Zn, Cd, Pb, As and Hg. In conclusion, urban street dusts from industrial and mining area of Baiyin, NW China were found polluted by heavy metals and the pollution would pose an obvious non-carcinogenic risk to preschool children.

The problems of environmental lead (Pb) pollution caused by mining activities have attracted global attention. Preschool children are vulnerable to exposure to Pb from the environment. To investigate the health risk of multiple exposures to Pb via oral ingestion (soil, water, rice, wheat, and vegetables) for preschool children in typical polluted areas, in this study, preschool children in Baiyin city were selected as the potential receptors, Pb concentrations in 28 soil samples and 33 vegetable samples were collected and measured. In addition, the Pb concentrations in local water, rice, and wheat were obtained by searching the literature. The Monte Carlo simulation was used in the uncertainty and sensitivity analysis of the parameters. Results showed that Pb concentrations in spinach, tomato, cushaw, lettuce, broad bean, pea, eggplant, and radish exceeded the standards (GB 2762-2017), and 42.86% of soil samples exceeded screening values (GB 15618-2018). The non-carcinogenic risk was as high as 3.58. Vegetables and wheat were the major contributors in the oral ingestion pathway. Furthermore, the carcinogenic risk of preschool children was 6.02E-06, which was acceptable. Monte Carlo simulations showed that health risk assessment results were most likely to be influenced by Pb concentrations in the media. In conclusion, the food safety of vegetables in soil-polluted areas deserves more attention, and certain measures should be taken to reduce the health risks to preschool children.

BACKGROUND:Mercury (Hg) is a highly toxic substance, and its harmful effects on maternal and infant health have been reported. Yet, the associations of Hg exposure with preeclampsia (PE) and adverse birth outcomes are not well understood.OBJECTIVE:The aim of this study was to investigate the potential effects of maternal Hg exposure on PE and birth outcomes.METHODS:We conducted a case-control study with 84 participants in China. Logistic models were used to estimate odds ratios for PE risk and birth outcomes according to maternal blood Hg levels, adjusting for potential confounding factors.RESULTS:Elevated blood Hg levels were associated with increased risks of mild PE (aOR, 7.03; 95% CI, 1.61, 30.62; P < 0.01) and severe PE (aOR, 47.55; 95% CI, 5.27, 429.05; P < 0.05). We also found that increased blood Hg levels were associated with low birth weight (aOR, 1.12; 95% CI, 1.00, 1.25; P < 0.05) and preterm birth (PTB) (aOR, 1.22; 95% CI, 1.08, 1.38; P < 0.05).CONCLUSIONS:Our study provided evidence that elevated blood Hg levels were significantly associated with an increased risk of PE. In addition, our findings support that increased blood Hg levels might be associated with low birth weight and PTB.

Mining activities exert a far-reaching impact on environmental quality, and health problems caused by lead (Pb) pollution have always attracted global attention. In this study, exposure pathways through various media in Baiyin city ( a typical heavy metal polluted area) and health risks of local preschool children to Pb were investigated. Results showed that Pb concentrations of Spinach, Tomato, Cushaw, Lettuce, Broad bean, Pea, Eggplant and Radish exceeded the standards (GB 2762 − 2017), and 42.86% of soil samples exceeded screening values (GB 15618 − 2018). The non-carcinogenic risk was as high as 3.78, and oral ingestion was the main exposure pathway which accounted for 94.60% of non-carcinogenic risk. Moreover, vegetables and wheat were the major contributors in oral ingestion pathway, and the younger preschoolers were, the more susceptible they were to Pb exposure. Furthermore, the carcinogenic risk of local preschoolers was 6.02E-06, which was acceptable. Monte Carlo simulation showed that concentration of medium was the most sensitive parameter on the health risk assessment results. In conclusion, Pb pollution in this area put preschoolers at a non-carcinogenic risk from eating vegetables and wheat.

OBJECTIVE:To explore whether the reduction of IGF-1 in missed abortion down-regulates PI3K/AKT signaling pathway, thereby causing trophoblast cell apoptosis and reducing the secretion of β-hCG and progesterone. DESIGN:12 pairs of serum and villous tissues were selected from missed abortion patients and normal early pregnant women who had terminated pregnancy by artificial abortion. The subjects in two groups had same age and gestational week. Wes Simple Western system and qRT-PCR were used to detect the expression of IGF-1, IGF-1R, PI3K/AKT signaling pathway and apoptosis-related factors in villous tissues. Radioimmunoassay and Enzyme-linked immunosorbent assay were used to detect β-hCG, progesterone and IGF-1 in serum. RESULTS:The serum levels of β-hCG, progesterone and IGF-1 were decreased in missed abortion group than those in normal early pregnant women. In addition, compared with normal early pregnant women, the genes and proteins levels of IGF-1 and PI3K/AKT signaling pathway and anti-apoptosis related factors were significantly decreased. CONCLUSIONS:Our results suggested that the reduction of IGF-1 in missed abortion patients could down-regulate the expression of PI3K/AKT signaling pathway, thereby increasing the apoptosis of trophoblast cells, leading to decreased secretion of β-hCG and progesterone, which may be one of the important mechanisms of missed abortion.

多样化的实验教学方式是公共卫生人才培养的重要内容,实验课独立设课是实验教学深化改革的关键,针对实验教学的现状和存在的弊端,初步构建多元实验考核体系,详细划分考核模块、考核内容和评分标准;并在本科生实验成绩评定中试运行,观察教学效果,收集带课教师和学生的反馈意见,进一步完善考核指标体系.公共卫生专业实验考核体系的改革更清晰地反映了学生的实际理解和操作能力,帮助教师及时发现教学中存在的问题,充分调动学生实验的主动性和创造性,提高实验教学质量,进而为实验教学改革提供参考,促进公共卫生人才专业技能的培养和发展.

性与生殖健康是国家首批线下一流课程,对2020年选课的477名学生进行课程思政内容满意度问卷调查,结果显示,通识课性与生殖健康思政教育学生满意度高,基本达到思政育人的效果.

目的 探讨白银市2000-2019年新生儿死亡率变化趋势,创建时间序列模型预测2020年白银市新生儿死亡率,为医疗卫生行政部门制定相关措施提供参考依据.方法 收集2000-2019年白银市妇幼卫生年报数据,通过SPSS 26.0软件进行时间序列分析,根据筛选的最优模型对2000-2019年新生儿死亡率进行回代拟合,并预测2020年新生儿死亡率.结果 白银市新生儿死亡率从2000年的22.40‰下降至2019年的2.39‰(降幅89.33％),城区郊县新生儿死亡率差距逐年缩小.Holt线性趋势模型为最优模型,2020年白银市新生儿死亡率的预测值为1.66‰,95％CI(-0.76‰～4.07‰).结论 白银市新生儿死亡率总体呈下降趋势.

目的 评价典型重金属污染地区学龄前儿童镉(Cadmium,Cd)暴露健康风险.方法 采集某典型重金属污染地区土壤样本和蔬菜可食用部位并检测其Cd浓度,查阅当地空气、小麦、水稻和水的Cd浓度,通过美国国家环境保护局推荐的健康风险评价模型评价当地学龄前儿童的Cd暴露健康风险,分别采用危险系数(hazard quotient,HQ)和终生增量致癌风险(incremental lifetime canc-er risk,ILCR)评估非致癌风险和致癌风险.结果 该地区学龄前儿童总的非致癌风险HQ总为4.14,HQ经口为4.10,HQ小麦为2.77,其他途径和介质HQ均＜1.00.该地区学龄前儿童总的致癌风险ILCR总为1.54×10-3.各途径中ILCR经口为1.53×10-3,各媒介中ILCR小麦 ＞ILCR蔬菜＞ILCR水稻＞ 1.00× 10-4.结论 该典型重金属污染地区学龄前儿童存在Cd暴露的非致癌风险和致癌风险.经口是Cd暴露的主要途径,小麦是非致癌风险的主要贡献者,小麦、蔬菜和水稻是致癌风险的主要贡献者.

目的 分析兰州市2011-2020年孕产妇死亡情况,为降低兰州市孕产妇死亡率提供科学依据.方法 收集兰州市2011-2020年孕产妇死亡报告卡进行总结分析.结果 兰州市2011-2020年共死亡孕产妇72例,年平均死亡率为24.18/10万.2011-2020年孕产妇死亡率呈下降趋势(x2趋势=0.049,P＜0.05).兰州市孕产妇死因前三位为产科出血、羊水栓塞、内科合并症;死亡的孕产妇中,初中及以下学历者占47.22％,家庭人均年收入在4000元以下者占44.45％,产检次数少于5次者占31.95％.死亡评审70.00％为可避免死亡.结论 兰州市2011-2020年孕产妇年平均死亡率为24.18/10万,孕产妇死亡多为可避免死亡.应继续加大对妇幼卫生事业的投入,加强孕期保健知识的宣传,提升医务人员的专业技能.

目的:了解甘肃省永靖县妇女常见乳腺疾病类型及发生情况,为进一步深入研究和实施干预提供依据.方法:收集2009—2018年在永靖县妇幼保健院进行乳腺检查妇女的相关信息进行回顾性分析.结果:2009—2018年在永靖县妇幼保健院进行乳腺检查者6265例,共检出乳腺疾病患者2010例,其中乳腺炎218例,主要集中在40岁以下妇女;积乳269例,多为40岁以下妇女;乳腺导管扩张235例,主要见于25～54岁女性;有乳腺肿块者1239例,多见于25～54岁妇女;乳腺淋巴炎30例,多为25～54岁女性;乳腺早期发育者19例,主要见于29岁以下女性.检出肿块并确诊为乳腺癌的患者共有75例,确诊率为6.05％,乳腺癌患者主要集中于刘家峡镇、太极镇和盐锅峡镇女性居民中.结论:永靖县妇女的各类乳腺疾病呈现年龄和区域的聚集性,应根据年龄变化和区域特点,确定高危人群和重点区域,做好乳腺相关知识的宣传教育工作,降低各类乳腺疾病的发生率,提高妇女的生活质量.

目的 分析兰州市2003-2018年孕产妇死亡率变化和孕产妇保健状况,为兰州市妇女保健工作提供依据.方法 采用动态数列和Mann-Kendall趋势检验分析兰州市2003-2018年孕产妇死亡率变化趋势和孕产妇保健状况,运用主成分分析综合评价2003-2018年孕产妇保健状况.结果 兰州市2003-2018年孕产妇死亡率总体呈下降趋势,平均增长速度为-3.46％,但趋势变化无统计学意义(Z=-0.855,P=0.392),且期间波动明显;2003-2018年兰州市孕产妇产检率、早检率、产后访视率、系统管理率、住院分娩率总体呈上升趋势,平均增长速度分别为0.76％、1.97％、0.61％、2.06％、1.65％;高危孕产妇比重呈下降趋势,年均下降2.86％.主成分分析显示兰州市2003-2008年孕产妇保健水平低于2003-2018年平均水平,2011-2013年产检率、早检率、产后访视率、系统管理率、住院分娩率等孕产妇基本保健服务利用较好,2014-2018年较2011-2013年高危孕产妇比重减少,但基本保健服务利用率降低.结论 2003-2018年兰州市孕产妇保健工作取得了良好进展,但2016-2018年孕产妇死亡率仍高于全国平均水平,仍应继续加强孕产妇保健服务,提高妇女保健服务的利用度.

This study aims to clarify if apigenin (AP) could play a pivotal role in attenuating acrylonitrile (ACN)-induced sperm and testis injury by inhibiting ASK1-JNK/p38 signaling pathway. Male Sprague-Dawley rats were randomly divided into five groups: a control group (corn oil), an ACN group (ACN 46 mg kg-1), an ACN + AP1 group (ACN + AP 117 mg kg-1), an ACN + AP2 group (ACN + AP 234 mg kg-1) and an ACN + AP3 group (ACN + AP 351 mg kg-1). The ACN + AP groups were given ACN by gavage after a pretreatment with different dosages of AP for 30 min, whereas the rats in the control group received an equivalent volume of corn oil. The gavage was conducted for 6 days per week in 4 weeks. The results showed that AP reduced sperm deformity rate and DNA fragment index and attenuated the testicular injury induced by ACN. AP could also alleviate oxidative stress, downregulate ASK1-JNK/p38 signaling pathway and eventually inhibit mitochondria-mediated testicular apoptosis. In brief, AP could dampen oxidative stress thereby inhibiting testicular apoptosis mediated by ASK1-JNK/p38 signaling pathway, alleviating ACN-induced sperm and testis injury and exerting a protective effect on male reproductive system.

目的 分析兰州市2000-2018年5岁以下儿童营养性疾病患病情况,探讨可能影响因素,对未来制定儿童保健政策提供依据.方法 收集2000-2018年兰州市妇幼卫生年报资料,通过SPSS 20.0软件经x2检验、趋势x2检验、Spearman相关检验对数据进行分析,运用动态数列描述结果.结果 2000-2018年兰州市5岁以下儿童中重度营养不良平均患病率为2.57％,且呈下降趋势(x2趋势=159.200,P＜0.05),城区县区差异无统计学意义(x2=0.205,P＞0.05).2014-2018年兰州市5岁以下儿童平均低体重率(1.65％)、生长迟缓率(0.69％)、超重率(2.21％)和肥胖率(0.05％)均呈下降趋势(P＜0.05).新生儿访视、7岁以下儿童保健覆盖、3岁以下儿童系统管理、6个月以内母乳喂养以及6个月以内纯母乳喂养都与5岁以下儿童中重度营养不良的发生呈负相关(r=-0.712,-0.663,-0.784,-0.750,-0.909,P＜0.05).结论 兰州市5岁以下儿童中重度营养不良率呈下降趋势,城区县区间的差距逐渐缩小.目前兰州市出现城区儿童以超重肥胖为主、县区儿童以低体重、生长迟缓的营养性疾病的双重负担,但其患病率在全国范围处于较低水平,应继续加强儿童保健工作,积极开展健康教育,促进儿童健康成长.

目的:比较CT引导下半月神经节射频热凝术与三氧注射治疗三叉神经痛的疗效.方法:收集2014至2020年因三叉神经痛接受治疗的病人诊疗信息,按手术方法分为经皮射频热凝术(percutaneous radiofrequency thermocoagulation,PRT)组14例和三氧注射治疗(ozone therapy,OT)组13例;并进行随访.采用视觉模拟评分法(visual analogue scale,VAS)评分及巴罗神经学研究所(Barrow neurological institute,BNI)疼痛评分,评估病人疼痛(pain)和麻木(numbness)程度.结果:两组治疗前VAS,BNI(P)和BNI(N)评分差异均无统计学意义.治疗后1周VAS和BNI(P)评分均降低;但OT组高于PRT组.治疗后BNI(N)评分OT组均低于PRT组.随访期间PRT组2例疼痛复发,病人均有麻木症状;OT组5例病人偶发轻微疼痛,均无麻木症状.结论:OT和PRT均可缓解三叉神经痛,OT缓解疼痛的效果略低于PRT,但OT组的病人术后麻木程度低于PRT组.

目的 评价2010—2018年兰州市妇幼保健机构卫生资源配置的变化趋势,为兰州市妇幼卫生事业的可持续发展提供依据.方法 对2010—2018年兰州市妇幼保健院上报的行政报表进行整理分析,计算其增长速度.结果 兰州市妇幼保健机构各类资源总体呈增长趋势.床位数、卫生技术人员数和卫生总费用的定基比增长速度分别为218.10％、169.71％和524.07％,年平均增长速度分别为15.56％、13.20％和25.72％;卫技人员学历以本科及以上为主,职称以初级为主;门诊人次、住院人次、每名医生的门诊诊疗人次和承担的入院病人数的定基比增长速度分别为156.37％、242.68％、23.80％和65.47％,年均增速分别为12.49％、16.64％、2.70％和6.50％;每万人口床位数和卫技人员数9年间增长了149.26％、124.41％,年均增长12.96％、10.63％.结论 2010—2018年兰州市妇幼保健工作成绩显著,但仍需增加保健部技术人员,培养和引进高学历和高级职称人才.

目的 分析2009-2018年甘肃省永靖县5岁以下儿童死亡状况,为做好儿童保健工作提供科学依据.方法 收集2009-2018年永靖县全部《围生儿、儿童死亡报告卡》,使用Epidata 3.0建立数据库,录入信息,采用SPSS 20.0软件分析.结果 新生儿、婴儿及5岁以下儿童死亡率均呈降低趋势(x2 =46.068,P＜0.01;x2=37.762,P＜0.01;x2 =45.124,P＜0.01),平均死亡率为5.90‰,8.55‰,9.79‰,其中新生儿死亡占5岁以下儿童死亡的60.28％.近十年造成永靖县5岁以下儿童死亡的死因中,前五位死因依次为出生窒息、早产/低体质量、先天性心脏病、其他出生缺陷及肺炎.2009-2018年婴儿死亡中,出生窒息及早产/低体质量的死亡率呈降低趋势(x2=12.003,P＜0.01;x2=10.862,P＜0.01).结论 2009-2018年,永靖县新生儿、婴儿及5岁以下儿童死亡率显著降低,且已低于全国水平.出生窒息、早产/低体质量、先天性心脏病、其他出生缺陷及肺炎是永靖县5岁以下儿童的主要死因.婴儿死亡中,出生窒息及早产/低体质量的死亡率明显降低.