清肺化痰利咽汤治疗“吸烟肺”临床疗效及中药戒烟疗法

目的:观察清肺化痰利咽汤治疗"吸烟肺"临床疗效及戒烟方治疗效果。方法:80例"吸烟肺"患者,随机分为治疗组和对照组,各40例。对照组采用头孢曲松钠治疗,治疗组采用清肺化痰利咽汤配合头孢曲松钠治疗。比较两组疗效。结果:治疗后,治疗组治疗总有效率为95.0%,显著高于对照组的82.5%,差异有统计学意义(P<0.05);两组患者治愈者和显效者54例,经戒烟方治疗后,戒烟率85.19%,半年后复吸率为13.04%。结论:清肺化痰利咽汤、戒烟方治疗"吸烟肺"安全有效,值得临床推广应用。

吸烟有害健康

活动目的 用实验来验证香烟中的有毒物质，了解香烟中含有哪些有害物质，吸烟给人体、给环境带来哪些危害。

Effects of Plant Growth Regulator on Absorption,Circulation and Contents of Potassium in Flue-cured Tobacco

[Objective] This study was to investigate the effects of plant growth regulator on accumulation and circulation of potassium in flue-cured tobacco.[Methods] Hydroponics experiment was adopted to study the effects of plant growth regulator（NAA,GA3,BR） on accumulation and circulation of potassium in flue-cured tobacco.[Results] The BR treatment increased the absorption of potassium,calcium and magnesium in flue-cured tobacco,reduced the potassium emission from the root,enhanced the accumulation and contents and promoted the circulation of potassium in the tobacco plants.There was no statistical difference between the NAA and GA3 treatment.And BR treatment was 0.52%,0.30%,0.28% higher than NAA treatment in enhancing potassium content in tobacco plants at 2,7,12 d after topping.In a word,the results showed that BR treatment was the most.[Conclusion] BR treatment could effectively enhance potassium content in tobacco plants after topping.

Glutathione S-transferase M1 and T1 Gene Deletion Associated with Increased Susceptibility to Nasopharyngeal Carcinoma

Objective： To evaluate the association of Glutathione S-transferase （GST） M1 and T1 genetic polymorphisms and susceptibility to nasopharyngeal carcinoma （NPC） in a high risk area of Guangxi Zhuang Autonomous Region （province）, Southwest of China. Methods： A case-control study was conducted to investigate the genetic polymorphisms of these enzymes （GSTM1 and GSTT1 null genotypes）. A total of 127 NPC cases and 207 controls were recruited. Results： GSTM1 and GSTT1 null genotype frequencies were higher among NPC patients at a level of statistical significance （P〈0.005; P〈0.001 respectively）, and both GSTM1 and GSTT1 null genotype were even more significant （P〈0.001）. Conclusion： NPC is the most common cancer in Guangxi. GST enzymes are involved in the detoxification of many environmental carcinogens. Homozygous deletions of GSTM1 and GSTT1 have been associated with several types of cancer. The risk to develop NPC has been associated with environmental factors such as cigarette smoking and EB virus infection. The present results indicate that the GSTM1 and GSTT1 deletion polymorphisms are associated with an increase risk of susceptibility to NPC, and both detoxific enzyme genes deletion is more important than a single gene deletion for the susceptibility to NPC.

Effects of Foliar Spraying of Magnesiumpotassium Sulfate Fertilizer on Absorption of Magnesium, Potassium and Calcium in Differentposition Tobacco Leaves

[Objective] ln the Mg-deficient （exchangeable Ca/Mg ratio ＆gt; 20） tobacco-growing areas in Qujing City of Yunnan Province, the ratio of Ca/Mg was adjusted by applying Mg fertilizer in soil and spraying Mg fertilizer on tobacco leaves. ln ad-dition, the effects of Mg fertilization on the absorption of K, Ca and Mg in flue-cured tobacco leaves were investigated, providing theoretical basis and production guidance for the balanced fertilization technology in the Mg-deficient flue-cured to-bacco-growing areas in Qujing City of Yunnan Province. [Method] The field plot test and randomized complete block design were adopted in this research. The group without Mg fertilization was treated as control. There were 3 treatment groups for foliar spraying of magnesium-potassium sulfate fertilizer and 2 treatment groups for soil application ＋ foliar spraying of magnesium-potassium sulfate fertilizer. The tobac-co roots, stems, lower leaves, middle leaves and upper leaves were dried and weighed. They were grinded for the determination of K, Ca and Mg content. The total K, Ca and Mg content in upper （B2F）, middle （C3F） and lower （X2F） flue-cured tobacco leaves in each plot was measured. [Result] The foliar spraying and soil application ＋ foliar spraying al increased the absorption of Mg and K in middle and lower tobacco leaves and the absorption of Ca in lower tobacco leaves, but de-creased the absorption of Mg, K and Ca in upper leaves and the absorption of Ca in middle leaves. Among the positions, the accumulated distribution of Mg, K and Ca ranked as middle leaves ＆gt; lower leaves ＆gt; upper leaves. With the application of Mg fertilizer, the Ca/Mg ratio and K/Mg ratio al decreased in middle and upper to-bacco leaves; while the Ca/Mg ratio increased in the lower tobacco leaves, and the K/Mg ratio showed no significant difference among treatment groups. [Conclusion] The foliar spraying and soil application ＋ foliar spraying of magnesium-potassium sulfate fertilizer affected the Ca/Mg ratio and K/Mg ratio in tobacco leaves mainly through affecting the absorption of Mg.

Cloning of Glutamate Dehydrogenase cDNA from Chlorella sorokiniana and Analysis of Transgenic Tobacco Plants

A full_length cDNA has been cloned encoding nicotinamide adenine dinucleotide phosphate_specific glutamate dehydrogenase (NADP_GDH) from Chlorella sorokiniana with the RT_PCR method. The complete nucleotide sequence of NADP_GDH gene had 94% homology to the previously reported one . The NADP_GDH gene was constructed into a vector highly expressed in plants. The specific activity of NADP_GDH in transformants was detected, but not in the control plants. All transformed shoots on MS medium containing lower concentration of nitrogen and the transformed seedlings grown in lower concentration of nitrogen vermiculite had higher growth rate and more leaves than the control plants. Transformed leaf discs cultured on MS medium containing different nitrogen concentrations had more chlorophyll contents compared to the controls. These results suggested that exogenous NADP_GDH may enhance the absorption and utilization to ammonium in plants. The increased weight of transformed leaf discs cultured on medium supplemented with different concentrations of phosphinothricin (PPT) was more than that of control discs. 0.5 μg/mL PPT could be used as a selecting drug instead of kanamycin to develop the transformants. These results suggested that the NADP_GDH gene might be used as a new selecting gene in the future research of plant gene engineering.

F=F

国外有人给“吸烟”下了个定义：F=F。这里，倘若把“=”稍作“整容”，“=”就可变成一支香烟。两个F则是把Fire(火)和Fool(傻瓜)缩写而成的，放在香烟的两端，就得到F=F的等式及含义：“Two ends on cigarette．one is fire，the other is fool．”

Association of smoking, alcohol drinking and dietary factors with esophageal cancer in high- and low-risk areas of Jiangsu Province, China

AIM： To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer （EC） risk in low- and high-risk areas of Jiangsu Province, China. METHODS： Since 2003, a population-based casecontrol study has been conducted simultaneously in lowrisk （Ganyu County） and high-risk （Dafeng County） areas of Jiangsu Province, China. Using identical protocols and pre-tested standardized questionnaire, following written informed consent, eligible subjects were inquired about their detail information on potential determinants of EC, including demographic information, socio-economic status, living conditions, disease history, family cancer history, smoking, alcohol drinking, dietary habits, frequency, amount of food intake, etc. Conditional logistic regression with maximum likelihood estimation was used to obtain Odds ratio （OR） and 95 % confidence interval （95% CI）, after adjustment for potential confounders. RESULTS： In the preliminary analysis of the ongoing study, we recruited 291 pairs of cases and controls in Dafeng and 240 pairs of cases and controls in Ganyu, respectively. In both low-risk and high-risk areas, EC was inversely associated with socio-economic status, such as level of education, past economic status and body mass index. However, this disease was more frequent among those who had a family history of cancer or encountered misfortune in the past 10 years. EC was also more frequent among smokers, alcohol drinkers and fast eaters. Furthermore, there was a geographic variation of the associations between smoking, alcohol drinking and EC risk despite the similar prevalence of these risk factors in both low-risk and high-risk areas. The dose-response relationship of smoking and smoking related variables, such as age of the first smoking, duration and amount were apparent only in high-risk areas. On the contrary, a dose-response relationship on the effect of alcohol drinking on EC was observed only in low-risk areas. CONCLUSION： The environmental risk factors, together with genetic factors and gene-environmental interactions might be the main reason for this high-risk gradient in .liangsu Province, China.

Ulcerative colitis in smokers,non-smokers and ex-smokers

Smoking is a major environmental factor that interferes in the establishment and clinical course of ulcerative colitis (UC). Firstly, the risk of smoking status impact in the development of UC is reviewed, showing that current smoking has a protective association with UC. Similarly, being a former smoker is associated with an increased risk of UC. The concept that smoking could have a role in determining the inflammatory bowel disease phenotype is also discussed. Gender may also be considered, as current smoking delays disease onset in men but not in women. No clear conclusions can be driven from the studies trying to clarify whether childhood passive smoking or prenatal smoke exposure have an influence on the development of UC, mainly due to methodology flaws. The influence of smoking on disease course is the second aspect analysed. Some studies show a disease course more benign in smokers that in non-smokers, with lower hospitalizations rates, less flare-ups, lower use of oral steroids and even less risk of proximal extension. This is not verified by some other studies. Similarly, the rate of colectomy does not seem to be determined by the smoking status of the patient. The third issue reviewed is the use of nicotine as a therapeutic agent. The place of nicotine in the treatment of UC is unclear, although it could be useful in selected cases, particularly in recent ex-smokers with moderate but refractory attacks of UC. Finally, the effect of smoking cessation in UC patients is summarised. Given that smoking represents a major worldwide cause of death, for inpatients with UC the risks of smoking far outweigh any possible benefit. Thus, physicians should advise, encourage and assist UC patients who smoke to quit.

Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

AIMTo compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)-based therapies to treat Helicobacter pylori (H. pylori).METHODSWe retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori -positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan. The primary endpoint was the eradication rate, which was assessed with a full analysis set. The secondary endpoints were adverse events and related factors.RESULTSAfter the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%), 71.6% (95%CI: 67.5%-75.5%), 62.9% (95%CI: 52.0%-72.9%), and 57.3% (95%CI: 50.4%-64.1%), respectively. The vonoprazan eradication rate was significantly higher than that of the PPIs (P &#x0003c; 0.01). Interestingly, smoking did not affect the H. pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013). The incidence of adverse events in the vonoprazan group was not different from the PPI group (P = 0.054), although the vonoprazan group exhibited a wider range of adverse events. Vonoprazan-based triple therapy was highly effective as a second-line treatment, with an eradication rate similar to that of PPI-based therapy.CONCLUSIONVonoprazan might be superior to PPIs in first-line H. pylori therapy, particularly for smokers. However, caution is required due to possible adverse events.

Perianal disease,small bowel disease,smoking,prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn's disease

AIM:To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine(AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn's disease(CD).METHODS:Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed(M/F:155/185, duration:9.4 ± 7.5 years) with a complete clinical follow-up.Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively.Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits.RESULTS:A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean diseaseduration of 9.0 ± 7.2 years.In a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/ biological therapy use were independent predictors of disease behavior change.In a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location(P = 0.001), presence of perianal disease(P < 0.001), prior steroid use(P = 0.006), early AZA(P = 0.005) or AZA/biological therapy(P = 0.002), or smoking(P = 0.032) were independent predictors of disease behavior change.CONCLUSION:Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients.

Synergistic effect of fatty liver and smoking on metabolic syndrome

AIM:To investigate the association of fatty liver and smoking on metabolic syndrome and its components.METHODS:This cross-sectional study enrolled participants who attended annual health screening at Shin Kong Wu Ho-Su Memorial Hospital from January to December 2005.A total of 3455(1981 men and 1474 women) subjects were included in final analyses.Fatty liver was diagnosed using abdominal ultrasonography by trained gastroenterologists.The modified National Cholesterol Education Program Adult Treatment Panel Ⅲ was used to define metabolic syndrome.The associations between smoking,fatty liver and metabolic syndrome were analyzed using multiple logistic regression.RESULTS:Subjects with fatty liver,and who smoked tobacco,had the highest odds ratios(ORs) for high waist circumference [OR,4.5(95% CI:3.3-6.1) ,P < 0.05],hypertriglyceridemia [OR,8.1(95% CI:6.0-10.9) ,P < 0.05],low serum high-density lipoprotein cholesterol(HDL-C) [OR,8.3(95% CI:6.1-11.3) ,P < 0.05],and metabolic syndrome [OR,9.5(95% CI:6.7-13.4) ,P < 0.05] compared to subjects without fatty liver who did not smoke tobacco.We also found that the ORs for hypertriglyceridemia,low serum HDL-C,and metabolic syndrome for subjects with fatty liver who smoked tobacco had greater than the sum of the ORs for subjects with fatty liver who did not smokeplus those who did not have fatty liver and who did smoke.CONCLUSION:Fatty liver and smoking had a synergistic effect on metabolic syndrome and its components,especially for hypertriglyceridemia and low serum HDL-C.

CYP2E1 RsaⅠpolymorphism impacts on risk of colorectal cancer association with smoking and alcohol drinking

AIM： To investigate associations between the Rsa I polymorphism of CYP2E1 and risk of colorectal cancer. METHODS： A case-control study was conducted with 315 colorectal cancer cases （105 colon, 210 rectal） and 439 population-based controls in Jiangsu Province of China. Genomic DNA samples were assayed for restriction fragment length polymorphisms in CYP2E1 by PCR amplification followed by digestion with Rsa I. Information on smoking and alcohol drinking was collected using a questionnaire. Odds ratios （ORs） were estimated with an unconditional logistic model. RESULTS： The proportional distribution of the CYP2E1 Rsa I c1/c1, c1/c2 and c2/c2 genotypes were 61.4%, 35.6% and 3.0% in controls, 60.6%, 33.7% and 5.8% in colon cancer cases, and 58.4%, 34.0% and 7.7% in rectal cancer cases, respectively. A significant differencewas noted between controls and rectal cancer cases （P = 0.029）, the c2/c2 genotype being associated with elevated OR （adjusted age, sex and status of the smoking and alcohol drinking） for rectal cancer （1.64, 95% CI, 1.12-2.41, vs cl allele carriers）, but not for colon cancer. In interaction analysis between the CYP2E1 Rsa I genotype and smoking and drinking habits, we found a significant cooperative action between the c2/c2 genotype and alcohol drinking in the sex-, age-adjusted ORs for both colon （4.74, 95% CI, 1.10-20.40） and rectal （5.75, 95% CI, 1.65-20.05） cancers. Among nonsmokers, the CYP2E1 Rsa I c2/c2 genotype was also associated with elevated ORs in the two sites （1.95, 95% CI, 0.99-3.86 and 2.30, 95% CI, 1.32-3.99）. CONCLUSION： The results of the present study suggest that the CYP2E1 c2/c2 genotype increases susceptibility to rectal cancer and the gene-environmental interactions between the CYP2E1 polymorphism and smoking or alcohol drinking exist for colorectal neoplasia in general.

Smoking in inflammatory bowel diseases:Good,bad or ugly?

Smoking is an important environmental factor in inflammatory bowel disease （IBD）, having different effects in ulcerative colitis （UC） and Crohn＇s disease （CD）. A recent meta-analysis partially confirmed previous findings that smoking was found to be protective against ulcerative colitis and, after onset of the disease, might improve its course, decreasing the need for colectomy. However, smoking increases the risk of developing Crohn＇s disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn＇s disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

Heavy smoking and liver

Smoking causes a variety of adverse effects on organs that have no direct contact with the smoke itself such as the liver. It induces three major adverse effects on the liver: direct or indirect toxic effects, immunological effects and oncogenic effects. Smoking yields chemical substances with cytotoxic potential which increase necroinflammation and fibrosis. In addition, smoking increases the production of pro-inflammatory cytokines (IL-1, IL-6 and TNF-α) that would be involved in liver cell injury. It contributes to the development of secondary polycythemia and in turn to increased red cell mass and turnover which might be a contributing factor to secondary iron overload disease promoting oxidative stress of hepatocytes. Increased red cell mass and turnover are associated with increased purine catabolism which promotes excessive production of uric acid. Smoking affects both cell-mediated and humoral immune responses by blocking lymphocyte proliferation and inducing apoptosis of lymphocytes. Smoking also increases serum and hepatic iron which induce oxidative stress and lipid peroxidation that lead to activation of stellate cells and development of fibrosis. Smoking yields chemicals with oncogenic potential that increase the risk of hepatocellular carcinoma (HCC) in patients with viral hepatitis and are independent of viral infection as well. Tobacco smoking has been associated with supression of p53 (tumour suppressor gene). In addition, smoking causes suppression of T-cell responses and is associated with decreased surveillance for tumour cells. Moreover, it has been reported that heavy smoking affects the sustained virological response to interferon (IFN) therapy in hepatitis C patients which can be improved by repeated phlebotomy. Smoker’s syndrome is a clinico-pathological condition where patients complain of episodes of facial flushing, warmth of the palms and soles of feet, throbbing headache, fullness in the head, dizziness, lethargy, prickling sensation, pruritus and arthralgia.

Effect of smoking on inflammatory bowel disease: Is it disease or organ specific?

Smoking is an important environmental factor in inflammatory bowel disease （IBD） with differing effects in ulcerative colitis （UC） and Crohn＇s disease （CD）. Never smoking and formerly smoking increase the risk of UC, whereas smoking exacerbates the course of CD. The potential mechanisms involved in this dual relationship are yet unknown. A reasonable assumption is that smoking has different effects on the small and large intestine. This assumption is based on animal and human studies that show that the effects of smoking/nicotine on CD and UC depend on the site of inflammation and not on the type of disease.

Body mass index does not affect the survival of pancreatic cancer patients

AIM to evaluate the association of body mass index(b MI) with the overall survival of pancreatic ductal adenocarcinoma(PDAC) patients.METHODS A retrospective analysis of PDAC patients diagnosed in the National Cancer Center of China between January 1999 and December 2014 was performed. these patients were categorized into four b MI groups(< 18.5, 18.5-22.9, 23-27.4 and ≥ 27.5 kg/m2). χ2 tests for comparison of the proportions of categorical variables, and Student's t-test or Mann-Whitney test for continuous variables were employed. Survival analysis was performed with the Kaplan-Meyer method. their HRs of mortality and 95%CIs were estimated using the Cox proportional hazards model.RESULTS With a median age of 59.6 years(range: 22.5-84.6 years), in total 1783 PDAC patients were enrolled in this study. their mean usual b MI was 24.19 ± 3.53 for the whole cohort. More than half of the patients(59.3%) experienced weight loss during the disease onset and progression. Compared with healthy-weight individuals, newly diagnosed patients who were overweight or obese had more severe weight loss during their disease onset and progression(P < 0.001). Individuals who were overweight or obese were associated with positive smoking history(P < 0.001). A significant difference in comorbidity of diabetes(P = 0.044) and coronary artery disease(P < 0.001) was identified between high b MI and normal-weight patients. After a median follow-up of 8 mo, the survival analysis showed no association between b MI and the overall survival(P = 0.90, n = 1783). When we stratified the whole cohort by pancreatic cancer stage, no statistically significant association between b MI and overall survival was found for resectable(P = 0.99, n = 217), unresectable locally advanced(P = 0.90, n = 316) and metastatic patients(P = 0.88, n = 1250), respectively. the results did not change when we used the b MI at diagnosis.CONCLUSION Our results showed no significance of b MI for the overall survival of PDAC patients.

Management of Crohn’s disease in smokers:Is an alternative approach necessary?

Inflammatory bowel disease(IBD) is a chronic condition with a pathogenic background that involves both genetic and environmental factors.Although important progress has been made regarding the former in the last decade,scarce knowledge is available for the latter.In this sense,smoking remains the most important environmental factor in IBD.Active smoking increases the risk of developing Crohn's disease(CD).Moreover,CD patients who start or continue smoking after disease diagnosis are at risk for poorer outcomes such as higher therapeutic requirements and disease-related complications,as compared to those patients who quit smoking or who never smoked.However,the harmful effect of active smoking is not uniform in all patients or in all clinical scenarios.Interventions designed to facilitate smoking cessation may impact the course of the disease.In this article,the available evidence of the deleterious effects of smoking on CD is reviewed in detail,and alternative therapeutic approaches to CD in smokers are proposed.

Effects of Regulation of C/N Ratio Wheat Straw Application on Nitrogen,Phosphorus and Potassium Uptake in Tobacco

[Objective]The aim was to study the effects of regulation of C/N ratio wheat straw application on tobacco nitrogen,phosphorus and potassium uptake. [Method]Effects of regulation C/N ratio wheat straw application on the flue-cured tobacco yield,output value,nitrogen,phosphorus and potassium content and cumulative uptake of the upper,middle and bottom leaf were studied by using the field plot experiments at Banqiao town,Qujing city,Yunnan Province during the 2008-2009 summer growing seasons. [Result]The results showed that the application of wheat straw alone or after C/N regulation,could significantly increase tobacco production,potassium content,the potassium and nitrogen accumulation amount of leaf,and was more conducive to the potassium uptake of tobacco leaf with wheat straw application after C/N regulation. Compared with non-straw application,the yield of tobacco increased by 6.59%,3.58%,5.98%,8.80% with application of wheat straw alone,wheat straw and vetch,wheat straw and oilseed cake,wheat straw and urea nitrogen,the potassium content in tobacco leaf increased by 3.85%,7.76%,8.82%,11.21%,respectively,the total potassium cumulative amount of leaf increased by 10.71%,11.62%,15.32% ,21.01% and the total nitrogen cumulative amount increased by 9.76%,1.22%,8.14%,14.00%. However,the differences of tobacco leaf nitrogen content among the different treatments were not significant,the phosphorus uptake of tobacco leaf decreased. [Conclusion]application of high C/N ratio wheat straw in flue-cured tobacco production,which should be concerned not only to adjust C/N ratio by adding nitrogen,but also considering additional phosphorus application.