p16/Ki-67联合检测对TCT阴性高危型HPV感染者子宫颈病变的诊断价值

目的探讨p16/Ki-67联合检测对TCT阴性的高危型HPV感染者子宫颈病变筛查的应用价值。方法收集2020年5月～2021年1月合肥市第一人民医院妇科收治的高危型HPV且TCT检测阴性的患者150例,经阴道镜取子宫颈组织行病理活检和p16/Ki-67联合检测,以病理活检结果为金标准,分析p16/Ki-67联合检测对筛查子宫颈病变的诊断价值。结果 150例TCT阴性高危型HPV感染患者中,子宫颈阳性病变者62例(41.3%),其中CINⅠ级36例(24%),CINⅡ级20例(13.3%),CINⅢ级5例(3.3%),子宫颈癌1例(0.7%),而达到CINⅡ级以上病变者共26例(17.3%)。p16/Ki-67联合检测阳性率在于子宫颈阴性病变组为12.5%,在子宫颈阳性病变组为69.4%,其中在CINⅠ、Ⅱ、Ⅲ级及子宫颈癌中双阳率分别为:55.6%、85.0%、100%、100%。p16/Ki-67联合检测在CINⅡ级以上病变的敏感度为88.5%,特异度为96.6%,阳性预测值为67.6%,阴性预测值为96.3%。结论 p16/Ki-67联合检测对于子宫颈病变检出具有较高的敏感性和特异性,临床上可提高对TCT阴性高危型HPV感染的子宫颈病变检出率,可用于子宫颈病变的早期筛查,具有一定预警作用。     

TCT联合细胞DNA定量分析在桂西壮族妇女宫颈病变诊断中的应用

目的探讨宫颈液基薄层细胞学检查(TCT)联合DNA定量分析在桂西壮族妇女宫颈病变筛查中的价值。方法选取同时行TCT、细胞DNA定量分析和活组织病理学检查的430例资料进行分析。宫颈脱落细胞液基薄层制片,1张巴氏染色做TCT诊断,1张Feulgen染色,应用全自动细胞图像分析系统扫描诊断。结果以活检结果作为诊断的金标准,TCT、DNA定量分析和联合检测的检出率分别为64.2%、90.6%和96.2%。联合检测与单独DNA定量分析检出率比较,差异不显著(P>0.05),联合检测与单独TCT的检出率比较,TCT与DNA定量分析的检出率比较,差异均显著(P<0.01)。结论 DNA定量分析检出率高于TCT,二者联合应用并不能有效地提高宫颈病变的检出率。     

高危人乳头瘤病毒在宫颈癌筛查中的应用及卫生经济学评价

据2002年数据统计,全球估计有49万的子宫颈癌新发病例,超过27万妇女死于该病。目前高危人乳头瘤病毒（high risk-human pappiloma virus,HR-HPV）联合细胞学检测是大多数发达国家和发展中国家经济发达地区妇女首选的子宫颈癌筛查方案。研究显示,HPV检测可明显提高宫颈高度病变的检出率,提高细胞学检查的敏感性,从卫生经济学角度来看,两者联合检测是一个低本高效的方案,HR-HPV与细胞联合检测是目前宫颈癌筛查的最佳选择,但仍存在一定的局限性。     

HPV E6/E7 mRNA联合HPV L1衣壳蛋白在子宫颈癌前病变诊断中的价值

目的探讨HPV E6/E7 mRNA联合HPV L1衣壳蛋白检测在子宫颈癌前病变诊断中的价值。方法采用分支链DNA信号放大技术检测156例子宫颈活检不同病变组织中HPV E6/E7 mRNA的表达,并应用免疫组化En Vision法检测HPV L1衣壳蛋白的表达。结果与正常组织相比,子宫颈低级别上皮内病变(low-grade squamous intraepithelial lesion,LSIL)、子宫颈高级别上皮内病变(high-grade squamous intraepithelial lesion,HSIL)和子宫颈鳞癌组织中HPV E6/E7mRNA的阳性率增高(P 0. 05),且HSIL和子宫颈癌中HPV E6/E7 mRNA的阳性率高于LSIL(P 0. 05),但HSIL和子宫颈癌组织中HPV E6/E7 mRNA的阳性率差异无显著性(P 0. 05); HPV L1衣壳蛋白在LSIL中的阳性率明显高于HSIL(P 0. 05)。结论通过对子宫颈不同病变标本进行HPV E6/E7 mRNA和HPV L1衣壳蛋白联合检测,了解不同病变子宫颈组织中HPV E6/E7 mRNA和HPV L1衣壳蛋白的表达趋势,可预测子宫颈上皮内病变的发展趋势,指导临床医师进行合理治疗。     

TCT技术与HPV分型技术在子宫颈病变筛查中的应用价值

为探讨液基薄层细胞检测法（TCT）与人乳头状瘤病毒（HPV）分型检测在子宫颈病变筛查中的应用价值,对18534例妇科宫颈刷检标本进行TCT检测,其中257例标本采用导流杂交技术（FTH）检测HPV分型。结果表明,257例标本中,108例HPV病毒检测结果为阳性（阳性率42.1%）,包括93例高危亚型感染,15例低危亚型感染,20例感染两种以上HPV亚型,149例HPV为阴性（57.9%）。HPV是诱发女性宫颈癌及生殖器病变的主要病源。TCT检测技术联合HPV分型应用于宫颈癌早期防治以及确诊子宫颈病变具有着重要意义。     

子宫颈病变组织中低分子量蛋白酶体表达与HPV16感染的关系

目的观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系。方法以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况。结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致。在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%。临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05)。(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05)。在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05)。结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一。     

HR-HPV DNA检测与TCT检查的相关性研究及其在宫颈早期病变筛查中的应用

目的探讨TCT与HPV DNA检测结果的相关性,并评价该两种方法在宫颈早期病变筛查中的应用价值。方法对439名妇科门诊就诊者同时进行TCT检查和HPV DNA荧光定量PCR检测,并将两者的检测结果进行对比分析。结果439例样本中HPV DNA检测阳性者154例（35.1%）,TCT结果阳性者163例（37.1%）;两者均为阳性者65例（14.8%）;经统计学分析,两种方法的检测结果不相关（P〉0.05）,TCT结果的异常程度与HR-HPV的感染数量亦无相关性（P〉0.05）。结论该两种方法在宫颈早期病变的筛查中不能相互替代或相互验证;两种方法联合应用可使阳性检出率明显提高。     

HPV联合TCT检查在宫颈癌筛查中的应用分析

目的:了解武汉地区妇女人乳头瘤病毒(HPV)的感染状况及其分布特点,探讨HPV与宫颈液基薄层细胞学(TCT)联合检测在宫颈癌前病变筛查中的临床价值。方法:选取2018-08-2020-07在武汉科技大学附属天佑医院妇产科进行宫颈癌前病变筛查的5 996例患者,分别进行HPV和TCT检测,其中HPV16/18检测(至少一个为阳性)或/和TCT检测异常的507例患者,进一步做宫颈组织病理学检查,对照分析TCT、HPV及组织病理学检查结果。结果:此次纳入对象HPV感染率为17.53%,感染率最高的为HPV33型(5.95%),单一型感染率最高(14.33%),二重及以上感染逐渐减少(3.20%))。61-65岁受检者HPV检出率最高(20.34%);HPV16/18检出率随着TCT检查严重程度的加重呈增高趋势(P0.05);HPV16/18检测阳性检出率为5.89%,TCT检测异常检出率为6.84%,HPV16/18联合TCT检测异常检出率为8.46%,联合检测优于单独检测。结论:本地区HPV感染以33型和16型为主;高危型HPV感染与宫颈细胞学异常的严重程度有关;HPV联合TCT检测能提高宫颈癌前病变筛查能力。     

Association of the expression of the low molecular-weight protein with HPV16 infection in cervical lesions

目的 观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系.方法 以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7 mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况.结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致.在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%.临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05).(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05).在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05).结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一.     

细胞DNA定量分析及高危型HPV-DNA检测在宫颈病变筛查中的应用

目的:分析细胞DNA定量和高危型人乳头状瘤病毒(human papillomavirus,HPV)DNA检测在宫颈病变筛查中的作用.方法:选取2015年5月至2016年9月间在江苏省中医院同时行DNA倍体分析及薄层液基细胞学检查(thin-cytologic test,TCT)的5 042例妇女,其中1 573例行HPV检测,146例行病理活检.结果:宫颈病变筛查病例中DNA倍体异常390例,阳性率7.74％,TCT异常病例408例,阳性率8.10％,两者相比差异无统计学意义(P＞0.05).其中＜3个细胞且2.5≤DI＜4.5者TCT阳性率为33.74％;≥3个细胞且2.5≤DI＜4.5者,TCT阳性率为94.74％;DI≥4.5者,其TCT阳性率为98.5％,差异具有统计学意义(P＜0.01).不能明确意义的非典型鳞状上皮细胞,低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)及高度鳞状上皮内病变(high-grade squamousintraepithelial lesion,HSIL)病例DNA倍体定量分析阳性率分别为45.42％,97.14％和100％,差异具有统计学意义(p＜0.01).高危型HPV总体感染率为24.5％,并且随着DI指数的升高,高危型HPV感染率也随之升高,具有统计学意义(P＜0.01),DNA倍体异常病例及DNA倍体异常且TCT异常病例高危型HPV感染率分别为56.8％和60.4％,差异无统计学意义(P＞0.05).DNA倍体异常病例阴道镜活检组织病理学阳性率为70.5％,TCT异常病例阳性率为65.9％,两者差异无统计学意义(P＞0.05),总体检出率为74.6％.结论:细胞DNA定量分析是一种有效的宫颈病变筛查方法.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Cerebellar noradrenergic systems in aging: studies in situ and in in oculo grafts

Age-related changes in noradrenergic function in the rat cerebellum were examined using electrophysiological and electrochemical techniques. Sprague-Dawley and Fischer 344 rats showed subsensitivity to norepinephrine (NE) locally applied onto cerebellar Purkinje neurons. The modulatory actions of NE on Purkinje cell-evoked activity was also examined. In young rats NE preferentially inhibits spontaneous activity more than evoked excitations when compared to control. These modulatory actions of NE are not seen in senescent Fischer 344 rats. The intrinsic vs. extrinsic influences determining the loss of efficacy to NE were examined using three groups of rats with in oculo cerebellar grafts. The first group had young grafts grown in young hosts and these grafts showed a potent response to perfused NE. The second group, old grafts in old hosts, showed a diminished responsiveness to NE with respect to the first group. The third group consisted of young grafts in old hosts. These grafts demonstrated a responsiveness to NE that was indistinguishable from those in the first group. The integrity of the presynaptic NE fibers was examined in the grafts using electrochemical techniques. No difference in the release of NE was observed in the old grafts. Taken together, these results suggest a loss of postsynaptic NE function that is intrinsically determined. The change in NE modulation could influence information processing within the aged cerebellar cortex. This deficit could underlie behavioral changes seen in senescence.