Human papillomavirus involvement in esophageal precancerous lesions and squamous cell carcinomas as evidenced by microscopy and different DNA techniques.

A series of 71 surgically resected esophageal squamous cell carcinomas, including 51 cases of formalin-fixed samples and 20 cases of fresh biopsy specimens derived from the high-incidence area of esophageal cancer in China, were systematically analyzed for the presence of human papillomavirus (HPV) infections by light microscopy, electron microscopy (TEM), in situ DNA hybridization, Southern blot hybridization, and polymerase chain reaction (PCR) techniques. On light microscopy, HPV-suggestive lesions were found in a total of 49.0% (25 of 51) of the specimens, including the flat type (22 of 51) and, less frequently, an inverted one (2 of 51). Of the 51 formalin-fixed, paraffin-embedded specimens, 43.1% (22 of 51) contained HPV DNA sequences by in situ hybridization. Of the positive cases, HPV 6 was present in three (5.9%), HPV 11 in three (5.9%), HPV 16 in eight (15.7%), HPV 18 in six (11.8%), double infections with HPV 11/18 in one (2.0%), and HPV 16/18 in one. In most cases the HPV-positive signals were localized in the hyperplastic and/or dysplastic epithelium adjacent to invasive carcinomas. In two specimens, however, HPV DNA sequences were found in the frankly invasive lesions, one being HPV 6 and the other HPV 18. On TEM, HPV-like particles located in the nuclei of koilocytotic cells were demonstrated in two of the five specimens previously shown to be HPV-positive by in situ hybridization. By means of the PCR technique, all specimens positive for HPV by in situ hybridization also contained amplified HPV sequences. Moreover, three additional samples negative by in situ hybridization were found to contain HPV 11 DNA sequences. Of the 20 DNA samples extracted from the fresh carcinoma samples (containing some surrounding tissues as well) 9 were shown to contain HPV DNA sequences by Southern blot hybridization under low-stringency conditions. Of these, eight samples remained positive when hybridized with the probe cocktail of HPV 11, 16, 18, and 30 DNA under high-stringency conditions. HPV DNA sequences in these carcinoma specimens appeared to be present mainly in an integrated form. The present results confirm the HPV involvement in esophageal squamous cell lesions and suggest that HPV infection might be an important etiologic factor in the pathogenesis of esophageal cancer, most probably acting synergistically with other carcinogenic factors.     

A case-control study of obstructive sleep apnea-hypopnea syndrome in obese and nonobese chinese children

BACKGROUND: Obesity is a risk factor for obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults. However, the prevalence of OSAHS in children is not clear, and the relationship between obesity and OSAHS remains controversial. METHODS: Obese children were recruited from the endocrinology, respiratory, and ear, nose, and throat clinics. Weight-matched, age-matched, and sex-matched children were recruited as control subjects. Standard questionnaires were administered, and a standardized physical examination was carried out. Lateral neck roentgenography, sleep polysomnography, full blood count, and arterial blood gas analysis were also performed. Children with body mass index z-scores of > 1.96 were considered to be obese. An adenoidal/nasopharygeal ratio of > 0.67 was considered to constitute adenotonsillar hypertrophy (ATH). OSAHS was defined as an apnea-hypopnea index (AHI) score of > 5 or obstructive apnea index (OAI) score of > 1. RESULTS: Ninety-nine obese children and 99 control subjects were recruited into the study. Obese patients had significantly higher AHI and OAI scores, and lower sleep efficiency and minimum arterial oxygen saturation (MinSao(2)) than control subjects. The prevalence of OSAHS was significantly higher in obese children with or without the ATH groups than their nonobese counterparts (odds ratio, 1.9 vs 108, respectively; 95% confidence interval, 1.21 to 4.7 vs 6.2 to 191, respectively). Obesity, tonsillar hypertrophy, and adenoid hypertrophy were independent risk factors for OSAHS (p < 0.001, p = 0.042, and p = 0.004, respectively). There was a positive correlation between the degree of obesity and AHI (r = 0.535; p < 0.001), and an inverse correlation between obesity and MinSao(2) (r = -0.507; p < 0.001). End-tidal CO(2), Paco(2), and bicarbonate levels were within the normal range. CONCLUSIONS: Obesity is a risk factor for OSAHS, and the degree of obesity is positively correlated with the severity of OSAHS.     

神经外科病房多重耐药菌感染的临床特点和护理对策

[目的]分析神经外科病房多重耐药菌(MDRO)感染的特点,探讨相应的护理对策。[方法]将2012年1月—2014年8月神经外科病房的56例培养标本作为研究对象,分析 MDRO 的数量、种类和感染部位。[结果]56份培养标本细菌耐甲氧西林金黄色葡萄球菌占37.50%、铜绿假单胞菌占25.00%、肺炎克雷伯菌占17.86%、大肠埃希菌占12.50%、鲍曼不动杆菌占7.14%,主要感染部位呼吸道占50.00%、泌尿道占25.00%、血液占1 9.64%、切口占5.36%。[结论]加强对各类人员的培训和宣教,积极实施护理干预可降低神经外科病房 MDRO 发生几率。     

青少年心理问题影响因素分析

青少年群体存在不同程度的心理问题,严重影响其心身健康发展。青少年心理问题的发生与心理社会多种因素有关,本文对青少年心理健康的影响因素进行了分析,旨在为促进青少年的心身健康发展提供依据。     

免疫分型在单株丙球蛋白血症中的应用评估

目的探讨免疫分型、血清免疫球蛋白的定量检测在单株丙球蛋白血症诊断中的价值。方法收集118例单株丙球蛋白血症患者进行血清蛋白电泳(SPE)、免疫固定电泳(IF)、免疫球蛋白(Ig)定量及血清轻链(κ、λ)检测。针对免疫分型阳性、Ig定量阴性患者进行分析。结果免疫分型阳性、Ig定量阴性患者56例,其中游离轻链型6例(κ轻链型2例,λ轻链型4例),未分泌型1例;免疫分型阳性、Ig定量阳性的患者62例。结论 IF技术对单株丙球蛋白血症的诊断及分型具有重要意义,可以结合血清Ig及轻链的定量检测等其他实验室诊断。     

血清降钙素原在烧伤患者细菌性感染诊断中的价值

目的探讨血清降钙素原(PCT)在烧伤患者细菌性感染诊断中的临床价值。方法 169例烧伤患者经血培养、分泌物和穿刺液培养等病原学检查确认细菌性感染96例,非细菌性感染73例,2组患者同时进行PCT、WBC和超敏C反应蛋白(hsCRP)检查,比较这3项指标在细菌性感染诊断中的价值,并进一步研究PCT浓度水平与烧伤程度的关系。结果细菌性感染组烧伤患者血清PCT、WBC和hs-CRP浓度水平明显高于非细菌性感染组(P0.05)。PCT诊断细菌性感染敏感性为90.63%,特异性为89.04%,阳性预测值为91.58%,阴性预测值为87.84%,PCT对细菌性感染的诊断效能明显高于其他两项炎症指标,PCT的浓度水平与烧伤患者的烧伤程度成正相关。结论细菌性感染的烧伤患者血清PCT、WBC和hs-CRP水平明显升高,PCT作为诊断细菌性感染标志物具有更好的敏感性及特异性,优于WBC和hs-CRP两项炎症指标。     

冠心病患者B型脑钠肽水平与肾功能损伤的关系

目的探讨冠心病患者B型脑钠肽(BNP)水平与其肾功能损伤的关系。方法 2013年1~8月该院收治的冠心病患者435例,按照《2008中西方BNP专家共识》诊断心力衰竭的标准分为A、B、C 3组,A组118例排除心力衰竭,B组141例存在心力衰竭,C组176例介于灰区。检测所有患者BNP、尿素氮(Urea)、肌酐(Cr)水平,比较3组患者Urea、Cr水平及3组患者肾功能损伤的发生率,并对3组患者的BNP水平与Urea、Cr水平做相关分析。结果血清Urea、Cr水平及肾功能损伤的发生率随着BNP水平升高逐渐升高,3组患者Urea、Cr水平及肾功能损伤的发生率比较差异均有统计学意义(P<0.05)。结论冠心病患者BNP水平的变化与肾功能损伤关切密切。