液基细胞学与HPV联合检测在宫颈癌筛查中的临床价值探讨

目的 分析与探讨液基细胞学联合人乳头状瘤病毒（HPV）检测在宫颈癌筛查中的应用方法与临床价值.方法 收集接受子宫颈病变筛查的患者6 122例,对所有患者同时采取液基细胞学及HPV检测,并对液基细胞学异常的患者进行子宫颈组织病理学检查.结果 液基细胞学结果显示157例患者存在异常,其中不典型鳞状细胞、临床意义不明确（ASC-US）65例,非典型鳞状细胞、不除外高度鳞状上皮内病变（ASC-H）41例,低度鳞状上皮内病变（LSIL）26例,高度鳞状上皮内病变（HSIL）24例,鳞状细胞癌（SCC）1例.HPV检测阳性率7.54％（461/6122）,细胞学ASC-US以上患者的HPV阳性率为57.96％（91/157）.157例患者宫颈组织病理学检查结果显示炎性改变52例,湿疣及宫颈上皮内瘤变（CIN）1级54例,CIN2及CIN3级44例,浸润性鳞状细胞癌7例;符合率：LSIL为73.1％（19/26）,HSIL为66.7％（16/24）,SCC为100％（1/1）.结论 液基细胞学检测对宫颈癌有辅助诊断价值,与HPV检测联合,能明显提高诊断的准确性,并能及早发现癌前病变.     

HPV抗体检测联合细胞学诊断在宫颈病变筛查中的应用

目的：探讨人乳头状病毒（HPV）抗体检测联合细胞学诊断在宫颈病变筛查中的应用。方法：对疑为HPV感染或宫颈病变的妇科患者行HPV抗体检测和液基细胞学检查，根据细胞学诊断≥不典型鳞状细胞（ASCUS）及HPV抗体检测为阳性的病例进行阴道镜活检。结果：①HPV抗体检测阳性率为25.60％，液基细胞学诊断≥ASCUS为28.79％；在ASCUS、低度鳞状上皮内病变（LSIL）、高度鳞状上皮内病变（HSIL）、鳞状细胞癌（SCC）中HPV抗体的检出率分别为42.85％、63.15％、93.18％、100％；②细胞学诊断阳性≥LSIL18.37％与组织学诊断阳性宫颈上皮内瘤变（CINI）20.31％比较差异无统计学意义（P〉0.05），细胞学与组织学诊断符合率为SCC100％、HSIL92.68％、LSIL87.5％。组织学诊断CINI、CINⅡ、CINⅢ、SCC病变中HPV抗体检出率以62.5％、81.48％、85.71％、100％依次递增。结论：HPV抗体检测联合液基细胞学和组织学检查更能有效地筛查宫颈病变细胞。为临床防治宫颈癌变提供更可靠的科学依据。     

HPV亚型感染与宫颈病变的临床观察

目的探讨人乳头瘤病毒(HPV)亚型感染与宫颈病变的关系。方法对门诊就诊的450例宫颈糜烂患者进行HPV分型检测和液基细胞学检测;对细胞学诊断≥ASCUS(非典型鳞状细胞)的病例进行宫颈组织活检。结果 450例宫颈糜烂患者中HPV阳性者142例(31.6%),液基细胞学诊断≥ASCUS为80例(17.8%),在ASCUS、LSIL、HSIL、SCC中HPV的检出率分别为51.5%、69.2%、86.7%、100%;450例样本中共检出HPV亚型18种,高危型13种,组织学诊断CIN I、CIN II、CIN III、SCC病变中高危型HPV检出率分别为67.9%、71.4%、83.3%、100%,最常见的亚型为HPV 16、52、58型,以16型最多(40.7%)。结论 HPV分型检测联合液基细胞学和组织学能更有效地筛查宫颈病变细胞,为临床防治宫颈癌提供更可靠的科学依据。     

HPV-DNA检测和液基细胞学检查与宫颈病变的相关性分析

目的 评估HPV检测与液基细胞学在宫颈病变筛查中的作用及意义.方法 对573例怀疑宫颈病变患者行HPV-DNA检测、TCT检查及阴道镜指导下活检.结果 573例宫颈病变患者HPV-DNA检出率分别为:鳞状上皮轻度非典型增生(CINⅠ)10.0%(42/418例),鳞状上皮中度非典型增生(CINⅡ)46.0%(23/50例),鳞状上皮重度非典型增生(CINⅢ)88.9%(24/27例),鳞状细胞癌(SCC)100%(5/5例).HPV感染率CINⅠ、CINⅡ、CINⅢ组间比较有显著性差异(P<0.01).SCC组与CINⅠ、CINⅡ组比较有显著性差异(P<0.01),CINⅢ与SCC组间比较差异无显著性(P>0.05).结论 TCT联合HPV-DNA检测对于及时发现和确定宫颈癌高危人群、研究宫颈癌的发病机制,以及预防和早期发现宫颈癌及癌前病变都有重要意义.     

宫颈病变的液基细胞学和组织学诊断分析

目的评价ThinPrep液基细胞学检查诊断宫颈上皮病变的准确性。方法对64例宫颈病变受检者均行液基细胞学薄片检查，并采用双盲法与宫颈活检进行比较，细胞学诊断采用描述性诊断系统(11BS)。结果64例液基细胞学检查与宫颈活检比较，液基细胞学检查对不同病变的检出率分别为：鳞状细胞癌(SCC)3／3；鳞状上皮内高度病变(HSIL)17/18，其中宫颈上皮内瘤变Ⅲ(CINⅢ)11/11，宫颈上皮内瘤变Ⅱ(CINⅡ)6／7；鳞状上皮内低度病变(LSIL)15/18。结论ThinPrep液基细胞学检查准确性高，尤其对鳞状上皮内高度病变其检出率达100％。     

液基细胞学联合阴道镜下活检在子宫颈病变诊断中的临床应用

目的:评价液基细胞学检测技术(简称TCT)及阴道镜下活检在宫颈病变诊断中的作用.方法:对1466例受检者的宫颈细胞采用TCT技术检测,将诊断意义不明的不典型鳞状细胞(ASCUS)以上病变均列为细胞阳性病例,对其中90例行阴道镜下多点取材活检.结果:TCT检查1466例,细胞学阳性127例,占8.66%,其中ASCUS 47例(3.20%)、低度鳞状上皮内病变(LSIL)77例(5.25%)、高度鳞状上皮内病变(HSIL)2例(0.14%).对细胞学阳性中90例进行阴道镜下活检,与病理组织学对照,ASCUS(CIN Ⅰ～Ⅱ7例、CINⅢ2例、SCC1例);LSIL(CIN Ⅰ-Ⅱ19例、CINⅢ7例、SCC1例);HSIL(SCC1例).结论:TCT筛查联合阴道镜下活组织病理检查,能早期发现子宫颈病变.     

液基细胞学联合阴道镜检查在诊断宫颈病变中的作用

目的:探讨液基细胞学联合阴道镜检查在诊断宫颈疾病的中价值.方法:对854例宫颈疾病患者进行液基细胞学检查,异常患者行阴道镜下定点活检病理组织学检查.结果:液基细胞学检查阳性患者246例(28.8%),其中不典型鳞状细胞(ASCUS)131例,占15.4%;低度鳞状上皮内病变(LSIL)78例,占9.1%;高度鳞状上皮内病变(HSIL)35例,占4.1%;鳞状细胞癌(SCC)2例,占0.2%.阴道镜下定点活检病理组织学检查:炎症95例,上皮内瘤样病变(CIN)Ⅰ 94例,CINⅡ 20例,CINⅢ 35例,SCC 2例.细胞学检查与阴道镜下活组织病理检查结果符合率分别为:LSIL 82.98%(78/94),HSIL 63.64%(35/55),SCC 100%(2/2).结论:液基细胞学联合阴道镜检查可提高宫颈疾病的阳性检出率,对于宫颈癌前病变及宫颈癌的早期诊断具有重要的临床诊断价值.     

1260例育龄妇女宫颈病变筛查临床分析

目的:为宫颈癌的早期诊断积累临床资料。方法:通过查阅文献,并于2009年1月至2011年10月对1 260例育龄妇女进行宫颈病变筛查,包括妇科检查、宫颈涂片、液基细胞学检查、高危型HPV分型检测、阴道镜检查及宫颈组织多点活检病理学检查。结果:行传统宫颈刮片检查656例,TCT检查604例。细胞学异常者32例(2.54%),其中巴氏Ⅲ级2例,高度鳞状上皮内病变(HSIL)5例(0.56%),低度鳞状上皮内病变(LSIL)4例(0.32%),意义不明的非典型鳞状上皮细胞(ASCUS)21例(1.67%);细胞学异常者中行高危型HPV检测21例,阳性13例(61.90%);细胞学异常者均行阴道镜检查+宫颈活检,病理学结果 HSIL 6例(0.48%),LSIL 3例(0.24%);而细胞学NILM/炎症,高危型HPV检测阳性者102例(8.11%),均行阴道镜检查+宫颈活检,病理结果湿疣4例(0.32%),LSIL 3例(0.24%)。结论:宫颈病变的筛查应遵循规范化诊治流程,细胞学检查结合高危型HPV检测为宫颈癌的一线筛查,高危型HPV检测可减少单纯依据细胞学检查造成的宫颈病变漏诊,敏感度高。高危型HPV检测作为初筛具有其可行性。     

液基细胞学结合高危型HPV检测在宫颈病变筛查中的应用

目的 探讨超薄液基细胞学(LCT)结合高危型人乳头状瘤病毒(HR-HPV)检测在宫颈病变筛查中的作用.方法 回顾性分析4264例行LCT检查的患者,其中621例结果为意义不明的不典型鳞形细胞(ASCUS)及以上患者同时行HR-HPVDNA检测和阴道镜检查并活检,分析2种方法对诊断宫颈病变的临床意义.结果 将细胞学结果与组织学结果作对比分析,细胞学异常的621例样本中ASCUS 388例,低度鳞状上皮内瘤变(LSIL)147例,高度鳞状上皮内瘤变(HSIL)75例,鳞状上皮细胞癌(SSC)11例.细胞学与病理诊断符合率分别为LSIL 72.41%(147/203),HSIL 92.60%(75/81),SCC 100%(11/11).621例ASCUS异常患者中HPV感染率43.32%(269/621),HPV在不同宫颈病变中的阳性率分别是:宫颈癌100.00%(11/11),宫颈上皮瘤样增生(CIN)Ⅲ 84.85%(28/33),CIN Ⅱ 70.83%(34/48),CIN Ⅰ 84.073(172/203),正常或炎症7.32%(24/326),高危型HPV感染阳性率随宫颈病变程度加重而明显升高.LCT检查的敏感性为81.04%,特异性为91.64%;HR-HPV检测的敏感性为90.47%,特异性为93.14%.结论 液基细胞学(LCT)结合高危型人乳头状瘤病毒(HPV)检测提高了宫颈病变诊断的敏感度和特异度,是防治宫颈癌的关键.     

液基细胞学配合阴道镜检查对宫颈病变的诊断价值

目的探讨宫颈细胞学检查配合阴道镜检查及宫颈活检在宫颈病变中的诊断价值。方法行液基细胞学检查(LPT),对异常者进一步行阴道镜下活检。结果1872例LPT检查细胞异常者173例,其中不典型鳞状上皮(ASCUS)120例(6.41%),轻度鳞状上皮内病变(LSIL)38例(2.03%),重度鳞状上皮内病变(HSIL)8例(0.43%),不典型腺细胞(AGC)7例(0.37%)。细胞学检查异常者173例,行阴道镜下活检有炎症60例(34.68%),宫颈上皮内瘤变(CIN)I58例(33.52%),CINII33例(19.08%),CINIII14例(8.09%),鳞癌SCC8例(4.62%)。结论液基细胞学检查配合阴道镜检查能早期发现宫颈癌前病变,是宫颈癌筛查方便可靠的检查方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.