Increasing prevalence rates of HPV attributable oropharyngeal squamous cell carcinomas in the Netherlands as assessed by a validated test algorithm

Human papillomavirus (HPV) infection has been etiologically linked to oropharyngeal squamous cell carcinoma (OPSCC). The prevalence of HPV‐positive OPSCC varies between studies, ranging from 20 to 90%. This may be related to the lack of a standardized HPV detection assay as well as to the time period in which HPV prevalence is investigated, as rising incidence rates are reported over the last decades. Here, we validated our previously defined test algorithm for HPV detection in formalin‐fixed paraffin‐embedded (FFPE) tumor specimen consisting of p16^INK4A immunostaining followed by high‐risk HPV DNA detection by GP5+/6+ PCR on the positive cases (Smeets et al., Int J Cancer 2007;121:2465–72). In addition, we analyzed HPV prevalence rates in OPSCCs in the years 1990–2010. The test algorithm was validated on a consecutive series of 86 OPSCCs collected during 2008–2011, of which both fresh frozen and FFPE samples were available. We performed HPV‐E6 RT‐PCR on the frozen samples as gold standard and applied the algorithm to the corresponding FFPE samples. The test algorithm showed an accuracy of 98%. Using the validated algorithm, we determined the presence of an oncogenic HPV infection in 240 OPSCCs of patients diagnosed in the years 1990–2010 at our center. A significant increase in the proportion of HPV‐positive samples was observed, from 5.1% in 1990 to 29.0% in 2010 (p = 0.001). In conclusion, we confirmed the accuracy of the test algorithm for HPV detection in FFPE tumor specimen and we found a significant increase in the prevalence of HPV in OPSCC over the last two decades at our center.     

有抗肿瘤活性的青蒿B衍生物

从菊科值物黄花蒿(Artemisia annua L.)中分离得到的青蒿B(arteannuin B)是一个有α-次甲基五元环倍半萜内酯化合物。文献报道一些α-次甲基环内酯萜类化合物具有抗肿瘤活性,如模地胆宁(molephantinin)。     

Ki-67、 PI3K、 Beclin1在口腔鳞癌组织中的表达及意义

目的：检测Ki-67、磷酸肌醇-3-激酶（PI3K）、Beclin1在口腔鳞癌组织中的表达及意义。方法：选取2017年1月—2018年12月南京市口腔医院收治的口腔鳞癌患者30例,取所有手术切除癌组织及癌旁组织标本,进行免疫组织化学染色处理,并检测Ki-67、PI3K、Beclin1的表达,采用Pearson分析TMSG-1、Ki-67、Pgp1之间的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果：口腔鳞癌癌组织中Ki-67、PI3K阳性表达率显著高于癌旁组织,Beclin1阳性表达率显著低于癌旁组织（P<0.05）。Ki-67、PI3K、Beclin1在高分化口腔鳞癌中的阳性表达率显著高于中分化、低分化口腔鳞癌（P<0.05）。Ki-67、PI3K在有淋巴结转移的口腔鳞癌中的阳性表达率显著高于无淋巴结转移的口腔鳞癌,Beclin1在有淋巴结转移的口腔鳞癌中的阳性表达率显著低于无淋巴结转移的口腔鳞癌（P<0.05）。Ki-67、PI3K、Beclin1在Ⅰ+Ⅱ期、Ⅲ+Ⅳ期口腔鳞癌中的阳性表达率无统计学差异（P>0.05）。Ki-67与PI3K的表达呈正相关（r=0.391,P=0.032）,Ki-67与Beclin1的表达呈负相关（r=-0.525,P=0.02）,Beclin1与PI3K的表达呈负相关（r=-0.367,P=0.045）。结论：Ki-67、PI3K、Beclin1的表达具有相关性,与患者有无淋巴结转移、病理分期有关,可能参与口腔鳞癌发生与发展。     

Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test

Background:

We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology.

Methods:

We used data of 25 871 women (aged 30–60 years) from the intervention group of the VUSA-Screen study (VU University Medical Center and Saltro laboratory population-based cervical screening study), who were screened by cytology and hrHPV. Primary outcome measure was the number of cervical intraepithelial neoplasia grade 3 or higher (CIN3+), detected within 3 years. We compared baseline cytology testing with three possible hrHPV screening strategies at different relative light unit/cutoff (RLU/CO) thresholds.

Results:

Compared with baseline cytology testing, hrHPV DNA testing as a sole primary screening instrument did not yield a superior sensitivity, as well as lower colposcopy referral rate and lower false positivity rate at any RLU/CO threshold. The hrHPV screening at 1 RLU/CO threshold with cytology triage at baseline and at 12 months revealed the highest sensitivity for CIN3+ (relative sensitivity of 1.32), although still displaying a lower colposcopy referral rate than cytology testing (relative colposcopy rate of 0.94). Higher thresholds (>1RLU/CO) yielded lower colposcopy rates, but resulted in substantial loss in sensitivity.

Conclusions:

The hrHPV testing at the commonly used threshold of 1 RLU/CO with cytology triage at baseline and at 12 months showed a much higher sensitivity with a lower colposcopy referral rate compared with cytology testing.     

FAM19A4/miR124-2 methylation in invasive cervical cancer: A retrospective cross-sectional worldwide study

Widespread adoption of primary human papillomavirus (HPV)-based screening has encouraged the search for a triage test which retains high sensitivity for the detection of cervical cancer and precancer, but increases specificity to avoid overtreatment. Methylation analysis of FAM19A4 and miR124-2 genes has shown promise for the triage of high-risk (hr) HPV-positive women. In our study, we assessed the consistency of FAM19A4/miR124-2 methylation analysis in the detection of cervical cancer in a series of 519 invasive cervical carcinomas (n = 314 cervical scrapes, n = 205 tissue specimens) from over 25 countries, using a quantitative methylation-specific PCR (qMSP)-based assay (QIAsure Methylation Test®). Positivity rates stratified per histotype, FIGO stage, hrHPV status, hrHPV genotype, sample type and geographical region were calculated. In total, 510 of the 519 cervical carcinomas (98.3%; 95% CI: 96.7–99.2) tested FAM19A4/miR124-2 methylation-positive. Test positivity was consistent across the different subgroups based on cervical cancer histotype, FIGO stage, hrHPV status, hrHPV genotype, sample type and geographical region. In conclusion, FAM19A4/miR124-2 methylation analysis detects nearly all cervical carcinomas, including rare histotypes and hrHPV-negative carcinomas. These results indicate that a negative FAM19A4/miR124-2 methylation assay result is likely to rule out the presence of cervical cancer.     

代谢综合征与胃癌发病风险的Meta分析

目的 采用Meta法评价代谢综合征(MetS)与胃癌(GC)发病风险的关系.方法 计算机检索CNKI、WanFang Data、VIP、CBM、Web of Science、The Cochrane Library及PubMed数据库,搜集国内外关于MetS与GC相关的病例—对照研究,检索时限均为建库至2020年6月....     

PMH2 Assessment of Health-Related Quality of Life During Treatment of Opiate Dependence using the Short Form-36

In the U.S., acute general hospitals increasingly provide treatment for patients with schizophrenia.
OBJECTIVE: To estimate the average annual cost of inpatient schizophrenia care per patient in an acute general hospital setting.
METHODS: Using ICD9 codes to identify disease and procedure-level data in five state (CA, FL, MA, MD, NC) acute care, all payer, discharge databases, an average cost per admission was estimated and combined with the frequency of admission calculated from the MA database to derive a mean annual acute care inpatient cost. Physician costs were calculated by applying 1997 Medicare fees to a resource use profile derived from the databases and published treatment recommendations. All costs are reported in 1997 US$, appropriately adjusted for medical inflation and cost-to-charge ratios.
RESULTS: Of 7.5 millions discharges, 73,000 were identified as having been admitted primarily due to schizophrenia. The average length of stay was 13.5 days, with 90% of time spent in a designated psychiatric bed. Over 90% were discharged within one month, most (∼80%) to home without documentation of further services. The mean cost per stay (including physician fees) was $8,963. Most (68%) patients had only one admission, and 96% had less than five in one year, leading to annual hospitalization cost per schizophrenic patient of $13,854.
CONCLUSIONS: Of schizophrenic patients admitted to an acute general hospital, the majority are admitted only once per year, spend their stay in a designated psychiatric unit bed, and are discharged within two weeks. Although these patients may have subsequent admissions to another type of inpatient facility, the majority are not transferred to such a facility at the time of discharge.     

医院全面预算管理体系的实施与效果

随着我国医改工作的逐渐深入,新《医院财务制度》对医院预算管理的要求也更加显著,而医院面临着财政补偿不足、医疗市场竞争激烈的严峻挑战,这就要求医院要,加强预算管理,合理配置医疗卫生资源,保证资金流安全顺畅.文章从预算编制与审批、预算执行与调整及预算分析与考核3个方面对医院预算管理体系的实施进行阐述,并结合实施效果作进一步的分析.     

两种方法治疗慢性分泌性中耳炎的疗效比较

目的 探讨鼻内镜下行咽鼓管置管术治疗慢性分泌性中耳炎的疗效,并观察和分析咽鼓管咽口形态与分泌性中耳炎的关系.方法 将慢性分泌性中耳炎患者73例(88耳)随机分成置管组和对照组,分别行鼻内镜下的咽鼓管置管术和传统的咽鼓管吹张术,术后随访3个月,比较两组疗效.结果 置管组38例(45耳):治愈17耳,占37.8%,好转21耳,占46.6%,总有效率84.4%;对照组35例(43耳):治愈8耳,占18.6%,好转22耳,占51.2%,总有效率69.8%.治疗后两组治愈率差异有显著性意义(P＜0.05).结论 鼻内镜下咽鼓管置管术具有微创、安全、简单、疗效好等特点,是治疗慢性分泌性中耳炎的一个良好方法;咽鼓管咽口形态可分五种类型,与分泌性中耳炎有着密切的联系.     

肾移植病房耐甲氧西林金黄色葡萄球菌随机扩增多态DNA分型研究

目的 研究医院肾移植病房耐甲氧西林金黄色葡萄球菌(MRSA)的分子流行病学特征,以确定病房内是否存在MRSA流行.方法 用头孢西丁纸片扩散法检测MRSA,用双重PCR方法检测金黄色葡萄球菌的femA,mecA基因,采用随机扩增多态DNA技术(RAPD),对肾移植病房一段时间内临床患者感染部位及环境和医务人员分离的MRSA作同源性分析.结果 16例患者中有5例感染MRSA;从57份医护人员鼻腔、手部、环境分离出1株MRSA;5株患者MRSA的RAPD分型具有较高的同源性;医护人员分离的MRSA与患者分型结果无同源性.结论我们医院肾移植病房存在严重的MRSA局部流行,应及时检测MRSA,防止医院感染菌株的播散.