人乳头瘤病毒分型检测应用于宫颈癌筛查研究进展

宫颈癌是危害女性健康和生命安全的一种重症疾病,早期筛查和确诊是改善宫颈癌患者预后的关键。人乳头瘤病毒(HPV)感染是导致宫颈癌的一个重要因素。本文在阐明宫颈癌筛查现状,分析人乳头瘤病毒感染及其分型与宫颈癌关系的基础上,对人乳头瘤病毒分型检测在宫颈癌筛查中的应用进展进行综述,供大家参考。     

阴道微环境与人乳头瘤病毒感染相关性的研究进展

近年,宫颈癌的发病率不但无下降趋势,而且发病年纪日趋年轻化,所以对于宫颈癌的预防不可忽略,早期的筛查和对宫颈癌前病变的干预可以使宫颈癌的发生率降低。宫颈癌及癌前病变的致病因素有很多,主要的致病原因是人乳头瘤病毒(HPV)感染,尤其是高危型人乳头瘤病毒(HP-HPV)的持续感染。对于人乳头瘤病毒感染,阴道微环境的改变与其有一定的相关性,本文对阴道微环境与人乳头瘤病毒(HPV)感染相关性的研究进展进行综述。     

浅谈HPV检测在宫颈癌中的诊断意义

人乳头瘤病毒(human papill0mavirus,HPV)是一类具有严格宿主范围和组织特异性的病毒,主要感染人的皮肤或黏膜上皮细胞,引起感染部位发生病变.目前大量研究已证实HPV是感染宫颈癌的主要危险因素.宫颈癌是一个由癌前病变逐渐衍变为癌的连续性病理过程.高危型HPV持续感染及多重感染是导致宫颈癌变的重要原因之一.宫颈HPV早发现、早预防是阻断癌变的关键.建立简便、特异、快速的病原学诊断方法,在宫颈癌临床诊断中具有重要意义.目前还缺乏针对HPV公认的有效治疗手段.因此,应非常重视HPV感染.HPV DNA检测作为宫颈癌筛查的一种辅助手段是目前研究热点.现就近年来对HPV病毒的病原学诊断方法及其对宫颈癌诊断的意义进行了综述.     

液基细胞学与人乳头瘤病毒检查用于宫颈癌筛查的意义研究

目的探讨液基细胞学与人乳头瘤病毒检查在宫颈癌筛查中的应用价值.方法对2010年1月~2012年3月4570例妇科门诊受检者进行液基细胞学与人乳头瘤病毒检查与组织活检,对各项检查结果进行分析.结果4570例受检者中,412例(9.02%)患者结果异常,262例患者人乳头瘤病毒DNA检测阳性.HPV阳性患者中ASCUS以上病变患者比例显著高于HPV阴性患者,差异具有统计学意义(P<0.05).结论液基细胞学检测与人乳头瘤病毒检测结合可显著提高宫颈癌筛查的检出率,对宫颈癌的预防与治疗工作成功实施具有重要的临床应用价值.     

成都地区女性患者对宫颈癌筛查和HPV疫苗认知调查分析

目的 了解女性对宫颈癌筛查和预防性高危型人乳头瘤病毒(human papilloma virus,HPV)疫苗认知和接受度,分析相关影响因素.方法 选取695例门诊女性患者进行调查,对调查数据进行统计分析.结果 44.32％(308/695)女性知道宫颈癌筛查,43.73％(297/695)女性曾接受过宫颈癌筛查,17.70％(123/695)的女性知道HPV疫苗,48.00％(59/123)的女性愿意接种HPV疫苗.电视、网络是获取信息的主要途径,年龄、文化程度、对宫颈癌筛查的认知是影响HPV疫苗认知和接受度的重要因素.结论 女性对宫颈癌筛查的认知和接受度较高,对HPV疫苗认知率低,但接受度高,加强健康宣教和预防宫颈癌知识的宣传,推进宫颈癌防控工作的实施.     

高州市宫颈癌早期筛查和预防

目的：筛检高州地区妇女宫颈癌情况,了解其患病率、HPV感染率和型别分布特征,预测高州地区宫颈癌发病趋势并指导宫颈癌的防治。方法以多级抽样的方法,抽取高州地区1650名妇女通过问卷调查和妇科检查的方式对宫颈癌进行早期筛查;妇科检查采用外生殖器检查、基因检测联合TCT检查、阴道镜下活检等方式,记录HPV（人乳头瘤病毒）感染、癌前病变以及宫颈癌发病情况;采用高危行为干预、HPV疫苗干预、LEEP刀治疗方式防治宫颈癌。结果人乳头瘤病毒感染率6.18%,宫颈癌癌前病变率5.54%,确诊为原位癌的为2.12%;人乳头瘤病毒感染的高发年龄段为30～40岁,占227例HPV阳性中的86.34%。结论通过宫颈癌的筛查以及对目标人群进行宫颈癌预防筛查、宣教,可以达到对宫颈癌早识别、早诊断和早防治,提高健康意识,积极治疗疾病,降低死亡率,减少经济负担。     

HPV相关性宫颈癌的研究现况

宫颈癌是世界范围内女性人群第二大常见的恶性肿瘤,宫颈癌患者中最主要的风险因素90%以上是早期有过人乳头瘤病毒(HPV)感染史。HPV疫苗接种是预防宫颈癌发病、降低病死率的有效方法。宫颈癌的危险因子包括生物学因素、行为因素、遗传易患性等。HPV筛查可选用宫颈巴氏涂片筛查、医师取样HPV检测等方法。该文就HPV相关宫颈癌的流行病学状况、基因分型、危险因子、疫苗研究进展及筛查方式等方面进行综述。     

宫颈人乳头瘤病毒基因分型检测在宫颈癌筛查中的临床价值

目的:评价人乳头瘤病毒(human papillomavirus,HPV)基因分型检测在宫颈癌筛查中的临床价值.方法:宫颈癌筛查的妇女1 380例,采用改良导流杂交法行宫颈HPV基因分型检测,分析HPV感染状况、多重感染和基因型别.结果:(1)HPV感染率为32.17％(444/1 380),高危型HPV(HR-HPV...     

兵团第四师妇女子宫颈癌筛查结果分析

目的:探讨人类乳头瘤病毒(HPV)感染与宫颈癌及癌前病变的关系,并提出相应的干预措施.方法:2013年1～12月选取兵团四师妇女为研究对象,对30 ～ 60岁妇女进行HPV检测及阴道镜检查筛查宫颈癌及癌前病变(子宫颈上皮内瘤变,CIN).结果:筛查兵团四师女性20 107例,HPV阳性者3 862例(19.21％),宫颈癌及癌前病变27例(0.13％).HPV阳性者中宫颈癌及癌前病变病变检出率明显高于HPV阴性者;以病理组织学诊断为金标准,评价HPV检测对预测宫颈癌及癌前病变的临床价值,其敏感度为81.48％,特异度为80.87％,阳性预测值为19.10％,阴性预测值为99.43％.结论:HPV感染与宫颈癌及癌前病变有着密切的相关性,把HPV感染者作为高危人群进行长期定期检查对预防和控制宫颈癌及癌前病变有着积极有效的作用;健康人群的普查对宫颈癌及癌前病变的早发现、早治疗起着至关重要的作用,应加强健康教育,促进健康人群自觉参与宫颈癌筛查.     

基于靶向扩增技术的HPV检测方法及其在宫颈癌预防性筛查中应用的研究进展

人乳头瘤病毒(HPV)感染与宫颈上皮内瘤变(CIN)及宫颈癌的发生密切相关,且HPV的致病性与其型别密切相关,所以检测和分型对宫颈癌的早期筛查、防治、预后判断等具有重要的临床意义.本文围绕基于靶向扩增技术的HPV检测方法学及其在宫颈癌预防性筛查中应用研究的近期进展进行综述.     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.