妇科恶性肿瘤血清及腹水层粘蛋白测定及临床意义

目的测定子宫内膜癌及卵巢癌患者血清层粘蛋白(1aminin,LN)含量及切除肿瘤对其影响.方法用放射免疫法测定14例子宫内膜癌,2例子宫内膜增殖症,8例卵巢癌,76例妇科良性疾病患者术前及部分内膜癌和卵巢癌术后血清LN含量,还测定了4例卵巢癌腹水中的含量.结果子宫内膜癌患者血清LN明显高于子宫内膜增殖症及其他各良性疾病组(P＜0.05)且与肌层浸润程度有关,卵巢癌血清LN也明显高于各良性疾病组但统计学分析无差异,其腹水LN明显高于血清(P＜0.05);手术切除肿瘤后,两种恶性肿瘤血清LN水平均显著下降(P＜0.05).结论血清及腹水LN水平与肿瘤的浸润过程密切相关;观察其变化对子宫内膜癌及卵巢癌的诊断、病情判断及监测可能有一定参考价值.     

神经系统及精神疾病

901144 影响控制小儿癫痫发作的因素分析/徐瑾…∥实用儿科杂志。-1990,5(1)。-18～19 作者分析55例抗癫痫治疗半年以上、癫痫发作未能控制的病例,男28例,女27例,【1岁30例(占55％),病程3天～8年。其中婴儿痉挛症3例,小运动型发作25例,大发作4例,精神运动型4例,部分运动型8例,植物神经型发作1例。每日、每周均有发作者占80％。病因可寻占80％,其中有热惊厥史者10例,病毒脑7例,脑发育不全6例,颅内出血4例。合并脑瘫13例,智力低下38例。免疫功能检查:IgG及IgM升高各5例,IgG和IgM同时升高1例。     

妊娠期及产褥期静脉血栓栓塞症风险评估及预防

目的:评估妊娠期及产褥期女性的静脉血栓栓塞症(VTE)发生风险,明确风险因素,并予以针对性预防,为探索妊娠相关VTE风险评估及预防策略提供依据.方法:根据2015年英国皇家妇产科医师学会(RCOG)妊娠期及产褥期静脉血栓栓塞疾病诊治指南推荐量表,对2018年11月1日至2019年12月31日在首都医科大学附属北京妇产医...     

神经系统及精神疾病

901467 高热惊厥550例临床分析及抽样随访/蒋宝娣…//云南医学.-1990,11(1).-39～41患儿男324例,女266例。年龄2个月～10岁10个月,6月～3岁患病率占80.3%。550例FC 患儿均伴随于各种感染性疾病。94.68%的患儿惊厥时体温在38.5℃以上,最高42℃。     

神经系统及精神疾病

900858 高热惊厥214例临床分析/关承稔∥新疆医学院学报.-1989,12(4).-260～261 214例占儿科住院总人数的4.35％(214/4910)。男132例,女82例。好发年龄为】6个月～6岁(占93.5％)。首发年龄多为6月～4岁(89.9％)。首次发作多见149例(70.3％)。惊厥发作时体温39℃以上(74.6％)。发热至惊厥发生时间在24小时之内占91.4％。热病过程中惊厥次数为1次者188例(87.9％)。     

化疗及放疗对卵巢的影响及预防

随治疗方法不断完善及新技术应用,肿瘤患者的生存率明显提高.但如何保持放化疗后各重要器官的生理功能,尤其是年轻患者的卵巢功能这个临床新问题日益引起临床医生的重视.详细综述有关放化疗后卵巢的损害及预防的最新研究动态.     

阴道分娩及剖宫产产后出血预警及防范

产后出血是产科常见且严重的并发症之一,是产妇死亡的首要原因。产后出血患者通常在产前即存在一种或多种高危因素,引起产后出血主要包括子宫收缩乏力、胎盘因素、软产道损伤、凝血功能异常四大因素。因此,所有产科工作者都应当重视防治产后出血,及早发现高危因素,及时处理,从而降低产后出血的发生率。     

神经系统及精神疾病

惊厥后脑内神经细胞黏附分子的表达及川芎嗪干预作用；新生儿惊厥的临床分析；单纯性热性惊厥患儿血清神经元特异性烯醇化酶、促乳素水平检测及意义；小儿热性惊厥对HLA-Ⅱ类基因的遗传易感性     

神经系统及精神疾病

小儿异丙酚靶控输注镇静的临床研究，儿童中枢神经系统感染的影像学诊断，FC患儿发病年龄、发作次数及脑电图与预后的关系，轻度胃肠炎伴良性婴幼儿惊厥临床分析及远期随访观察，基层医院新生儿惊厥128例临床分析     

神经系统及精神疾病

儿童暴发抑制型脑电图的病因分析及预后；一氧化氮和内皮型一氧化氮合成酶与血管迷走性晕厥发病的关系；仪征市儿童感觉统合失调的调查研究；长程录像脑电图监测儿童发作性疾病262例;奥卡西平与卡马西平单药治疗新诊断的儿童部分性癫痫对照研究.     

贵州省三都水族自取样HPV检测宫颈癌筛查及分流模式#br#

Objective?To explore a cervical cancer screening strategy suitable for remote minority areas in China. Methods?A total of 1 874 cases of shui minority women aged 21~65 years in Sandu were randomly sampled self-sampling HPV test, TCT test and P16 cytological immunohistochemical test. The patients with HPV positive, TCT abnormality (ASC-US) and P16+underwent colposcopy and biopsy, and squamous intraepithelial lesion (SIL) was detected. Results?The positive rate of HR-HPV was 15.69% in 1 874 women. HPV52 was the most common type, followed by HPV16, HPV39, HPV58 and HPV56. Among 249 patients with colposcopy biopsy, 23 cases (9.24%) were detected with HSIL or above lesions.The positive rates of p16 in HSIL and above cervical lesions, LSIL and cervicitis were 73.91%, 34.57% and 10.34% (P<0.001).The sensitivity of self-sampled HPV test to HSIL+ was 100%, and the area under ROC curve for HSIL+ detected by HPV-positive test and p16 test was 0.577 (P>0.05) and 0.774 (P<0.05), respectively. Conclusion?Self-sampled HPV was highly sensitive to HSIL. Using self-sampling HPV detection as primary screening, combined with p16 staining triage, can be used as a screening strategy in remote areas of Guizhou province to improve the coverage of screening.     

宫颈高危型HPV感染程度与阴道菌群、宫颈局部调节性T细胞的关系分析

目的 探讨宫颈高危型人乳头瘤病毒(human papilloma viruses,HPV)感染感染是否转阴与阴道菌群及宫颈局部调节性T细胞关系.方法 选择2018年9月至2019年12月南通市妇幼保健院收治的230例高危HPV感染患者为研究对象,所有患者随访6个月,观察两组阴道菌群和宫颈局部CD4+CD25+Foxp3...     

宫颈癌患者外周血TSCM与Treg的分布特征及临床意义

目的:探讨宫颈癌患者外周血中干细胞样记忆性T细胞(TSCM)与调节性T细胞(Treg)的分布特点及临床价值.方法:选取2019年10月至2020年3月在徐州医科大学附属医院住院的宫颈癌、高级别上皮内瘤变、低级别上皮内瘤变各30例为观察组,同期15例宫颈炎患者作为对照组.采集外周静脉血2ml,流式细胞学方法检测TSCM与...     

Fas gene promoter -670 polymorphism (A/G) is associated with cervical carcinogenesis

OBJECTIVE: To investigate the biological significance of single nucleotide polymorphism (SNP) at Fas gene promoter in cervical carcinogenesis. METHODS: SNP at -670 of Fas gene promoter (A/G) together with human papillomavirus (HPV) types were examined in a total of 279 cervical smear samples and 8 human cervical squamous carcinoma cell lines using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) techniques. RESULTS: 49 patients with high-grade squamous intraepithelial lesion (HSIL) had higher frequency of high-risk HPV and GA + GG genotype than 167 with low-grade SIL (LSIL) and 63 controls. G allele frequency was also higher in HSIL than in LSIL and controls. There was an increased OR (6.00; CI, 1.32-27.37; P = 0.021) for GA + GG genotype in HSIL cases compared to controls among 96 patients with high-risk HPV. 7 of 8 cervical carcinoma cell lines also showed GA or GG genotype. CONCLUSION: Fas gene promoter -670 polymorphism (A/G) may be closely associated with cervical carcinogenesis in a Japanese population.     

Impact of human papillomavirus coinfections on the risk of high-grade squamous intraepithelial lesion and cervical cancer

Objective

The molecular and epidemiologic effect of human papillomavirus (HPV) coinfections in the risk of developing cervical cancer is yet unclear. The aim of this study was to determine the frequency HPV coinfections at different stages of cervical lesions in the development of cervical cancer and the impact of HPV specific type interactions on high-grade squamous intraepithelial lesions (HSIL) and invasive cervical cancer (ICC) risk.

Methods

HPV testing was performed in 931 cervical samples diagnosed as: negative for intraepithelial lesion or malignancy (NILM); low-grade squamous intraepithelial lesion (LSIL); HSIL; and ICC. For HPV detection and typing two sets of primers from the L1 region were used in the polymerase chain reaction method (PCR) (MY09/MY11/HMB01 and L1C1/L1C2.1/L1C2.2) and HPV type was determined by PCR product sequence. To look for multiple HPV infections, the E6 nested multiplex PCR method was performed in all DNA samples. Odds ratios were calculated as indexes of the strength of the association between the sample category (LSIL/NILM or ICC/HSIL) and the presence of a given viral combination.

Results

In HPV positive samples, coinfections are as common in ICC/HSIL as in LSIL/NILM (47.12% and 40.17%, respectively). There is an increased risk to ICC/HSIL when multiple high-risk HPV types are present. The coinfection of HPV68 with HPV16 increases the risk of ICC/HSIL (OR = 14.54, P = 0.012, after multivariate adjustment), related to the presence of HPV16 or HPV68 alone.

Conclusions

These results sustain that specific HPV coinfections confer an increased risk to develop ICC/HSIL.     

Hypermethylation of two consecutive tumor suppressor genes, BLU and RASSF1A, located at 3p21.3 in cervical neoplasias

OBJECTIVES: Although initiated by human papillomavirus (HPV), cervical carcinogenesis demands other cofactors to shape its natural course. Epigenetic effects such as DNA methylation, are considered to contribute to carcinogenesis process. METHODS: The methylation status of BLU and RASSF1A, as well as the HPV infection status, were assessed in a full spectrum of cervical neoplasia, including 45 low-grade squamous intraepithelial lesions (LSIL), 63 high-grade squamous intraepithelial lesions (HSIL), 107 squamous cell carcinomas (SCC), 23 adenocarcinomas (AC), and 44 normal control tissues. RESULTS: The BLU was methylated in 76.9% of SCC, 57.4% of HSIL, 20.0% of LSIL and 12.5% of normal tissues (P<0.001). The RASSF1A was methylated in 15% of SCC, 17.5% of HSIL, but not in LSIL or normal tissues (P<0.001). In AC, 43.5% of patients showed BLU methylation and 26.1% RASSF1A methylation, significantly higher than the corresponding control frequencies of 12.5% (P=0.005) and 0% (P=0.001), respectively. There was an insignificant trend toward loss of BLU methylation with advancing clinical stages of SCC (84.8%, 67.7%, and 63.6% in stages I, II, and III/IV, respectively; P=0.08). Patients with LSIL infected with high-risk HPV showed a higher rate of BLU methylation than those without HPV (38.8% vs 9.1%, respectively; P=0.057). The methylation of RASSF1A was inversely related to HPV infection in patients with HSIL/SCC (P=0.003). CONCLUSIONS: These results suggest that the methylation of BLU and RASSF1A genes is associated with cervical carcinogenesis, which could be clinically important in the future molecular screening of cervical neoplasia.     

人乳头瘤病毒L1壳蛋白在筛查宫颈鳞状上皮内病变中的应用

目的:探讨人乳头瘤病毒(HPV)L1壳蛋白筛查HPV阳性妇女宫颈脱落细胞中宫颈鳞状上皮内病变的应用价值。方法:选取2012年5月至2014年12月就诊于温州市人民医院的妇女212例,收集宫颈脱落细胞并行HPV L1壳蛋白检测、HPV DNA分型、TCT(液基细胞学)及阴道镜下活检,比较HPV阳性妇女的宫颈脱落细胞中HPV L1壳蛋白的表达情况。结果:212例细胞学标本中HPV L1壳蛋白阳性率为33.9%,其中未见上皮内病变/恶性细胞组(NILM)、无明确诊断意义的鳞状上皮细胞病变组(ASCUS)、低度鳞状上皮内病变组(LSIL)、不能排除高度鳞状上皮内病变组(ASC-H)、高度鳞状上皮内病变组(HSIL)中阳性率分别为47.1%、35.1%、54.2%、29.2%、16.1%,各组比较差异有统计学意义(P0.05);两两比较,HSIL组与LSIL组和NILM组比较,差异均有统计学意义(P均0.005);进行数据合并后,LSIL/ASCUS组与ASC-H/HSIL组比较差异有统计学意义(P=0.001)。178例宫颈细胞学异常患者中,宫颈低级别病变和宫颈高级别病变的HPV L1壳蛋白阳性率比较,在ASCUS组(P=0.000)、LSIL组(P=0.004)中均有差异,在ASC-H组(P=0.127)、HSIL组(P=0.515)中均无差异。HPV 16/18感染患者的HPV L1壳缺失同宫颈高级别病变有更紧密的关系(P=0.003)。结论:子宫颈脱落细胞HPV L1壳蛋白检测在HPV阳性妇女的子宫颈病变筛查中具有一定的价值,可能成为一种合适的分流方法。     

Glutathione-S-transferase and p53 polymorphisms in cervical carcinogenesis

OBJECTIVE: To investigate the clinical significance of glutathione-S-transferase GSTM1, GSTT1 and p53 codon 72 polymorphisms in cervical carcinogenesis. METHODS: GSTM1, GSTT1 and p53 codon 72 polymorphisms together with human papillomavirus (HPV) types were examined in a total of 198 cervical smear samples using multiplex polymerase chain reaction (PCR) and PCR restriction fragment length polymorphism (RFLP) techniques. RESULTS: Forty-two patients with high-grade squamous intraepithelial lesion (HSIL) had higher frequency of high-risk HPV and null GSTT1 genotype than 102 with low-grade SIL (LSIL) and 54 controls. Thirty-one patients with HSIL had also statistically higher frequency of null GSTT1 genotype than 28 with LSIL among 69 patients with high-risk HPV. There was no statistical difference in p53 Arg, Arg/Pro and Pro genotypes between SILs and controls with or without high-risk HPV. CONCLUSION: GSTT1 null genotype in cervical cell samples may be associated with more severe precancerous lesions of the cervix in a Japanese population. The p53 codon 72 polymorphism is unlikely to be related to HPV status and the onset of cervical cancer.     

阴道微生态异常与宫颈上皮内病变的相关性研究

Objective?To analyze the characteristics of vaginal microecology in patients with cervical lesions, and to explore the correlation between vaginal microecology disorder and cervical lesions. Methods?From January 2015 to August 2019, a total of 888 cases of patients were enrolled ,who have underwent the histopathological examination guided by colposcopy and vaginal microecology test in the meantime. The clinical data of age, HPV infection, vaginal microecology test, pregnancy and childbirth history, contraceptive method, and histopathology result were collected to analyze the correlation between them and cervical lesions. Results?In 888 patients, the top 6 types of high grade squamous intraepithelial lesion(HSIL) were HPV16, 58, 33, 52, 31, 18, and the top 5 types of cervical cancer were HPV16, 18, 33, 45, 58, respectively. The risk of HSIL+ was increased by vaginitis and HR HPV infection, OR value was1.631 (95%CI: 1.122~2.373) and 4.865 (95%CI: 1.918~12.341) respectively. The risk of HSIL+ increased by HPV16 and 18 was 7.456 (95%CI: 2.938~18.921), other 13 high-risk HPV types had an increased risk OR of 3.956 (95%CI: 1.546~10.122). The differences were statistically significant (P<0.05). Conclusion?Both HR HPV infection and vaginitis can increase the risk of HSIL+.