Cervical Screening by Pap Test and Visual Inspection Enabling Same-Day Biopsy in Low-Resource, High-Risk Communities.

OBJECTIVE: To develop an effective, low-cost, single-visit cervical screening strategy incorporating a modified Pap test and visual inspection with acetic acid and Lugol's iodine for low-income settings. METHODS: We conducted a prospective cohort trial. Two low-income Muslim Uyghur communities in China's far western Kashi Prefecture served as pilot and validation study sites, respectively, and 4,049 women (aged 30-59 years) were screened. The conventional Pap test was modified using a cotton swab to collect cervical cells without scraping the cervix using an Ayre spatula, allowing visual inspection with acetic acid (and visual inspection with Lugol's iodine if visual inspection with acetic acid was negative) to be performed in a single visit. Results from both tests were available within 1-2 hours. Women positive for either or both underwent same-day biopsy that was shipped by a courier service to a central pathology laboratory. RESULTS: Single-visit screening incorporating both a modified Pap test and visual inspection achieved a sensitivity of 96.0% (95% CI 91.6-100), which was superior to Pap testing (76%, 95% CI 66.3-85.7; P<.001) or visual inspection with acetic acid-visual inspection with Lugol's iodine (48%, 95% CI 36.7-59.3; P<.001) alone in detecting cervical intraepithelial neoplasia (CIN) 2 or worse lesions. Rapid interpretation of both diagnostic procedures facilitated efficient same-day biopsy that achieved a negative predictive value of 98.2% in detecting CIN 2 or worse lesions. The increased sensitivity and minimized loss of follow-up allowed this approach to identify an extremely high prevalence of CIN 1 (2,741/100,000, 95% CI 2,238-3,245/100,000), CIN 2 or 3 (1,457/100,000, 95% CI 1,088-1,826/100,000), and cervical cancer (395/100,000, 95% CI 202-589/100,000) among these underscreened, at-risk women. CONCLUSION: Single-visit cervical screening with both a modified Pap test and visual inspection has greater sensitivity to detect high-grade CINs, reduces loss of follow-up, and could be an efficient low-cost strategy for low-resource settings.

[The establishment and application of the method with virus concentration and detection in drinking water].

OBJECTIVE: This study aimed to construct an effective method to concentrate and detect virus in drinking water, and human adenovirus pollution status in actual water samples was monitored by constructed method. METHODS: The concentration efficient of NanoCeram filter for the first concentration with source water and drinking water and the concentration efficient of the different concentrations of PEG 8000 for the second concentration were assessed by spiking f2 bacteriophage into water samples. The standard of human adenovirus for real-time PCR was constructed by T-A clone. The plasmid obtained was identified through sequence analyzing and consistency check comparing to target gene fragment was conducted by using blast algorithm. Then, real-time PCR was constructed to quantify the concentration of human adenovirus using the plasmid as standard. Water samples were concentrated by using NanoCeram filter on the spot and then concentrated for the second time by PEG/NaCl in 2011. The DNA of concentrated samples were extracted for the quantification of human adenovirus in real-time PCR subsequently to monitor the pollution of human adenovirus in water. RESULTS: For the first concentration by NanoCeram filter, the recovery rates were (51.63 ± 26.60)% in source water and (50.27 ± 14.35)% in treated water, respectively. For the second concentration, the highest recovery rate was reached to (90.09 ± 10.50)% at the concentration of 0.13 kg/L of PEG 8000. The sequence identity score of standard of adenovirus for real time PCR and adenovirus gene was 99%, implying that it can be successfully used to quantification with human adenovirus. The levels of human adenovirus in the water samples sampled in 2011 ranged from 4.13×10³ to 2.20×106 copies/L in source water, while range from 5.57×10² to 7.52×105 copies/L in treated water and the removal efficiency range was (75.49 ± 11.71)%. CONCLUSION: NanoCeram filers combined with PEG/NaCl was an effective method to concentrate virus in aquatic environment. There was a large number of human adenovirus in source water, and it is not sufficient to remove them thoroughly through conventional water treatment processes.

Real-time PCR detection of enteric viruses in source water and treated drinking water in Wuhan, China.

A total of 48 water samples were collected from six water treatment plants in Wuhan and analyzed by real-time PCR assay for viral identification of enterovirus (EV), rotavirus group A (RVA), human adenovirus (HAdV) as well as human adenovirus subgroup F (HAdVF) during the period from December 2010 to October 2011. HAdV, HAdVF, and RVA were all positively detected in the samples of source water and treated drinking water. EV could be found in 46 % (11/24) of all the source water samples, but only 21 % (5/24) positive in treated drinking water. The concentrations of these three kinds of enteric viruses detected were as follows: HAdV > RVA > EV. The highest removal rate was EV (97 %), followed by RVA (82 %), HAdV (73 %), and HAdVF (72 %). HAdV and RVA have been abundant in untreated river water and finished water after conventional processes of water treatment plants, while bacterial indicators could not be detected in tap water, which met the standard of China for drinking water bacterial quality. Some factors that could affect the accuracy of qPCR detection are also discussed in this study.

[The relationship between the potential years of life lost of lung cancer and air pollution in Wuhan].

OBJECTIVE: To study the present situations of lung cancer in Wuhan and to explore the relationship between the potential years of life lost of lung cancer and air pollution, especially vehicle emissions. METHODS: Data gathered between 1986 and 1995 in Wuhan city, including air pollution and tobacco production and data on lung cancer between 1991 and 2000 were collected extensively. Simple Correlation and Grey Relational Analysis were used to analyze the relationship of them. RESULTS: There was a ascending tendency in variance of oxides of nitrogen (NOx). The degree of grey incidence (DGI) between the concentration of air pollutants and the male's or female's potential years of life lost of lung cancer (PYLL) were calculated respectively. In males, the values of DGI were 0.6702, 0.7071, 0.6199 on sulfur dioxide (SO2), NOx, total suspensions (TSP) respectively. In females,the values of DGI were 0.6188, 0.8555, 0.5842 according to the same order as listed above. Significant positive correlation was found between the concentration of NOx and with lung cancer in both males and females by spearman correlation test (rmale = 0.63523, P = 0.0484; rfemale = 0.76396, P = 0.0101). CONCLUSION: With the fast growing speed of the quantity of vehicles, pollution of vehicle emission-caused air pollution posed an important risk factor for lung cancer, despite the fact that tobacco smoking still played the leading role.

[Protective effects of total flavonoids of Broussonetia papyrifera on oxidative injury of ultraviolet A to human keratinocytes].

OBJECTIVE: To investigate the oxidative damage of ultraviolet A (UVA) to human immortalized keratinocytes line HaCaT and the protective effects of total flavonoids of Broussonetia papyrifera (TFBP) gotten from the leaves of broussonetia papyifera. METHODS: Based on the culture of the human keratinocytes, the experiment group added with different dosages of TFBP before exposure to the radiation, received the UVA radiation together with the treatment group. The levels of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were determined in cultured HaCaT cells as well as the cell activity with MTT reduction assay. Human immortalized keratinocytes HaCaT cells received ultraviolet A with the different dosages between 0.46 and 2.76 J/cm(2) respectively. The protective effects of TFBP at different concentrations were also evaluated. RESULTS: The cell activity decreased gradually from 96.3% to 37.5% with the increase of UVA dosage from 0.46 J/cm(2) to 2.76 J/cm(2). After 10 mg/L up to 200 mg/L of TFBP were added the cell activity increased, the levels of MDA decreased from (5.14 +/- 0.58) nmol/mg pro to (2.98 +/- 0.14) nmol/mg pro, the levels of SOD increased from (23.09 +/- 3.91) U/mg pro to (34.50 +/- 1.59) U/mg pro and the activity of GSH-Px increased somewhat. CONCLUSION: Ultraviolet A causes significant oxidative injury to HaCaT cells under the conditions of this study. TFBP gotten from the leaves of broussonetia papyrifera has certain protective effect on HaCaT epithelial cells.