Human papillomaviruses and papillomatosis lesions of the female lower genital tract

Objective: The objective of this study was to determine whether human papillomavirus (HPV) infections are involved in the development of papillomatosis lesions of the lower female genital tract.Methods: A total of 616 biopsy specimens of genital papillomatous lesions (307 nodular and 309 papular types) from 598 patients were anaylyzed for the presence of HPV DNA sequences by polymerase chain reaction (PCR). These specimens were also examined by histopathological assessment for characteristic HPV-associated cytological changes, by immunohistochemical staining for HPV-associated antigen, and by electron microscopy for the presence of virions.Results: HPV DNA sequences were found in 97.9% (140 of 143 cases) and 1.1% (1 of 91 cases) of the nodular and papular papillomatosis cases tested, respectively. In 18 patients who had both types of papillomatosis lesions, HPV DNA was invariably found only in nodular tissues. HPV-associated antigen, koilocytosis, and virions were found in 53.6% (98 of 183 cases), 70.5% (129 of 183 cases), and 5.9% (5 of 85 cases) of nodular papillomatosis lesions tested, respectively.Conclusions: These data suggest that nodular papillomatosis was closely associated with HPV infection, but that papular papillomatosis of the lower female genital tract may have an etiology other than HPV infection.     

职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

目的 探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法 采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区（县）中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果 共纳入11 748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64（95%CI：1.34~2.00）上升至2.89（95%CI：2.39~3.50）。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论 多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。     

上海市50岁及以上人群维生素D水平与握力的关联研究

目的 探讨上海市≥50岁人群维生素D水平与握力的关系。方法 数据来源于WHO全球老龄化与成人健康研究我国上海市2018-2019年数据,采用logistic回归模型分析维生素D水平与握力的关系,进一步按照性别、年龄及乳制品摄入情况进行分层;采用限制性立方样条曲线绘制维生素D水平与低握力的剂量-反应曲线。结果 共4 391人纳入研究,其中男性2 054人（46.8%）;年龄（67.02±8.81）岁;低握力1 421人（32.4%）;维生素D不足及缺乏分别为1 533人（34.9%）和401人（9.1%）。在调整相关混杂因素后,logistic回归分析结果显示,维生素D缺乏的人群发生低握力的风险更高（OR=1.41,95%CI：1.09~1.83）;在男性中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.67,95%CI：1.12~2.50）,而女性中两者之间无关联（OR=1.30,95%CI：0.97~1.74）;在60~69岁及≥80岁年龄组中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.57,95%CI：1.05~2.35;OR=2.40,95%CI：1.08~5.31）,在乳制品摄入<250 ml/d的人群中,调整相关混杂因素后,二者之间呈显著正相关（OR=1.57,95%CI：1.17~2.09）,而在乳制品摄入≥250 ml/d的人群中无明显关联。限制性立方条样图显示,低握力的发生风险可能随维生素D含量的上升而降低,但差异无统计学意义（P>0.05）。结论 维生素D水平与握力存在一定的关系,维生素D缺乏人群出现低握力的风险更高。     

上海市儿童单纯性肥胖的调查

目的了解上海市学龄儿童肥胖发生率、肥胖对血压的影响以及肥胖影响因素,为预防儿童肥胖制订防制策略及措施提供基础资料。方法整群抽取１７５１名７～１１岁学龄儿童,测量身高、体重及血压等指标,并按统一编制的调查表进行问卷调查。结果肥胖检出率１４．０５％,其中男性高于女性,分别为１５．６７％和１２．２６％,差别有显著性（Ｐ＜０．０５）。肥胖儿童高血压检出率４．８８％,明显高于非肥胖儿童０．１９９％,差别有高度显著性（Ｐ＜０．０１）。喜食肥肉及油腻性食物、吃饭速度快者,肥胖检出率高。结论上海市儿童单纯性肥胖检出率似接近发达国家水平,肥胖儿童中高血压者明显增多。应指导家长对儿童进行合理饮食,平衡膳食,减少肥胖症发生。     

微电极导向同期双侧腹后苍白球 毁损术治疗帕金森病

目的介绍微电极导向同期双侧腹后苍白球毁损术治疗帕金森病的方法与效果。方法应用微电极电生理记录技术术对毁损靶点进行确认定位,对３１例难治性帕金森病患者行同期双侧腹后内侧苍白球毁损治疗,术前及术后于开状态、关状态分别行改良Ｗｅｂｓｔｅｒ记分,计算改善率,评价其疗效。结果经微电极确认后的电生理靶点与ＣＴ定位靶点存在明显差异,靶点调整率８０６％。３１例手术均有效,其中治愈７例,明显进步２４例。Ｗｅｂｓｔｅｒ计分术后１周开状态改善率为７４２％±９５％,关状态改善率为８９１％±８９％。无永久性并发症。结论微电极导向同期双侧腹后苍白球毁损术安全、有效,具有明显临床治疗优势,微电极记录技术可使术中定位精确度大大提高。     

婴儿维生素A慢性中毒一例

患儿男,１０个月。因双眼凝视２天于１９９８年３月２９日来我院就诊。追问病史,患儿自２个半月前开始服用浓鱼肝油滴剂,每日３次,每次维生素Ａ３．５万ＩＵ,服用２个月后,患儿逐渐出现食纳减退、精神萎靡、烦躁、易激惹、口唇皲裂、前囟隆起等症状。既往体健,无感染及高热惊厥史。体检：体温３７．６℃,发育正常,营养中等。精神差,表情淡漠,头发稀少,口唇皲裂、结痂,前囟隆起,心肺腹正常,神经系统正常。眼部检查：双眼向内凝视,视乳头边缘模糊。Ｂ超、ＣＴ提示脑积水,颅内压增高。诊断：维生素Ａ慢性中毒。立即停用维生素…     

女性睡眠呼吸暂停低通气综合征临床特点

OBJECTIVE: To realize the characteristics of symptoms and polysomnography in women with sleep apnea-hypopnea syndrome (SAHS) compared with that of male patients. METHODS: The symptoms and polysomnography were compared between men and women with SAHS and among mild (5 to 19 events/h), moderate (20 to 39 events/h), severe (> or = 40 events/h) of female patients. RESULTS: Female patients were older than that of male(51.1 +/- 11.2 yr versus 43.9 +/- 10.1 yr). The mean body mass index(BMI) for women was (27.8 +/- 3.9) kg/m2 and (28.1 +/- 3.8) kg/m2 for men. Women with higher AHI snored more severely, and female had a lower apnea hypopnea index (AHI) and apnea index (AI) but higher hypopnea index (HI) than did male. In addition, the respiratory events during non-rapid eye movement for men were significantly higher than that for women. CONCLUSION: Female patients are older than male but not more adipose. SAHS and respiratory events during NREM sleep are less severe in women.     

Expression of constitutively active Notch4 (Int-3) modulates myeloid proliferation and differentiation and promotes expansion of hematopoietic progenitors.

The Notch family of transmembrane receptors has been implicated in the regulation of many developmental processes. In this study, we evaluated the role of Notch4 in immature hematopoietic progenitors by inducing, with retroviral transduction, enforced expression of Int-3, the oncogenic and constitutively active form of mouse Notch4. Int-3-transduced human myeloid leukemia (HL-60) cells demonstrated significantly delayed expression of differentiation markers following retinoic acid and 12-0-tetradecanoylphorbol 13-acetate treatment. Furthermore, HL-60 cells expressing Int-3 displayed a slower growth rate than cells infected with void virus, and accumulation in the G0/G1 phases of cell cycle. Transduction with deletion mutants of Int-3 defined the importance of individual domains of the protein (in particular, the ANK domain and the C-terminal domain) in the inhibition of differentiation and growth arrest of HL-60 cells. When mouse bone marrow enriched for stem cells (5-fluorouracil-resistant, lineage negative) was transduced and cultured for two weeks, the Int-3-transduced population displayed a lower expression of differentiation markers and a three- to five-fold higher frequency of colony-forming cells (CFU-GM/BFU-E) than control cultures. These results strongly support the notion that Notch signaling inhibits differentiation and promotes expansion of hematopoietic stem/progenitor cells.     

Tongue reconstruction with a combined brachioradialis-radial forearm flap

Total glossectomy adversely affects speech and swallowing, and subsequent reconstruction results in limited functional return. The radial forearm flap has been reliably used to resurface glossectomy defects, but has limited bulk with which to aid in palatoglossal contact for speech. The authors have modified the forearm flap by incorporating a segment of brachioradialis muscle, to increase bulk posteriorly and to aid in speech. Sufficient muscle perforators arise from the proximal brachial artery and enter the brachioradialis to permit transfer of the muscle with the fasciocutaneous forearm flap as a single free-flap unit. The muscle is folded onto itself and enclosed within the forearm flap skin to create a neotongue. Coaptation of the antebrachial cutaneous nerves can provide a senate flap. Successful transfer of the combined brachioradialis/forearm flap in a patient who had undergone total glossectomy resulted in a neotongue good shape. Speech was rated good by a speech pathologist, and palatoglossal contact was observed on cineoradiograph. No functional loss at the donor site occurred. Inclusion of the brachioradialis muscle with the radial forearm flap as a combined unit results in a neotongue with good form and increased bulk posteriorly at the base, compared to a standard fasciocutaneous flap alone. This is a useful variation of the forearm flap. Sensory return is possible if the medial and/or lateral antebrachial cutaneous nerves of the flap are coapted to the lingual nerve.