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Objective:Analysis of subtype distribution characteristics of human papillomavirus (HPV) infection, pathological findings of HPV-positive patients operated colposcopy and cervical histopathological examination in Changsha from 2020 to 2022.Methods:Retrospective analysis of HPV infection status of 60 354 patients was treated in the First Affiliated Hospital of Hunan University of Chinese Medicine from Jan. 2020 to Oct. 2022. They were divided into<25 years old group (3 250 cases), 25-34 years old group (19 406 cases), 35-44 years old group (17 297 cases), 45-54 years old group (13 104 cases), 55-64 years old group (4 793 cases) and≥65 years old group (2 504 cases). Cervical exfoliated cells were collected from women and specimen of lesion site were collected from men. HPV genotyping detection used polymerase chain reaction (PCR) and flow fluorescence hybridization, which could detect 27 HPV genotypes. Analyze the distribution of HPV subtypes in patients of different age groups and different treatment departments. Analyze the relationship between the infection of HPV subtypes and the outcome of 224 patients with HPV positive who also underwent colposcopy and cervical histopathology. Pearson correlation test was used for correlation analysis, and two-tailed P<0.05 was statistically significant; Pearson chi-square test or continuous correction chi-square test was used to compare the rates between groups, and two-tailed P<0.05 was statistically significant; Chi-square split test was used to compare multiple sample rates. The standard test was corrected according to the number of groups and then compared. The difference was statistically significant when the two-tailed P value was less than the corrected standard test. Results:The overall positive rate of HPV was 16.4% (9 909/60 354). Among all HPV positive patients, affection of single type HPV accounted for 75.5% (7 479/9 909) and affection of multi-type HPV accounted for 24.5% (2 430/9 909). The top six HPV types with infection rates from high to low were: HPV52 22.8% (2 256/9 909), HPV58 11.1% (1 097/9 909), HPV53 10.5% (1 045/9 909), HPV16 9.0% (890/9 909), HPV61 7.8% (774/9 909) and HPV6 7.6% (750/9 909). The difference of overall infection rate between different age groups was statistically significant (χ 2=536.90, P<0.001). The HPV infection rate was the highest in the<25 years old group, 30.1% (978/3 250), and it is higher than the age groups of 25-34 years old, 15.6% (3 035/19 406), group of 35-44 years old, 14.2% (2 464/17 297), group of 45-54 years old, 16.1% (2 115/13 104), group of 55-64 years old, 19.1% (915/4 793) and group of≥65 years old, 16.1% (402/2 504), with statistical significance( P<0.001 respectively). The most common types of HPV infection were type 6, 16.7% (378/2 266) and type 11, 10.5% (239/2 266) in dermatology clinics. The positive rate of HPV16 accounted for 12/17 in cervical intraepithelial neoplasia (CIN) 3 and cervical cancer cases, it was significantly higher than that in the inflammatory cases, 25.0% (35/140) and CIN1 cases, 23.0% (11/48), the statistical values were χ 2=15.02, P<0.001 and χ 2=12.48, P<0.001, respectively, all of which were statistically significant. Conclusions:HPV infection rate is highest in young people under 25 years old. Low-risk HPV6 and 11 are the main types of skin and venereal diseases. Among the total cases, high-risk HPV52, 58 and 53 are the most common types of infection with women in Changsha. However, high-grade cervical intraepithelial neoplasia and cervical cancer are more closely related to HPV16 infection.
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OBJECTIVE: To explore the role of N~6-methyladenosine(m~6A) catalytic enzymes(methyltransferases and demethylases) in cadmium-induced oxidative damage in human renal epithelial cells(HK-2 cells), and to analyze the correlation between nuclear factor-erythroid 2-related factor 2(NRF2) and m~6A catalytic enzymes. METHODS: i) HK-2 cells in logarithmic growth phase were randomly divided into control group and 6 cadmium sulfate treatment groups, then treated with 0, 2, 4, 8, 16, 32 and 64 μmol/L cadmium sulfate solution for 24 hours. The cell survival rates were detected by CCK-8 assay, and the appropriate doses of cadmium sulfate were selected for subsequent experiments. ii) HK-2 cells in logarithmic growth phase were randomly divided into control group and low-, medium-, and high-dose groups, and treated with 0, 4, 8, and 16 μmol/L cadmium sulfate solution respectively for 24 hours. Subsequently, the levels of reactive oxygen species(ROS) were detected by fluorescence probe. The mRNA expression of NRF2, the m~6A methyltransferases such as methyltransferase like proteins(METTL) 3, METTL14, METTL16 and the m~6A demethylases such as fat mass and obesity associated protein(FTO), AlkB family of nonheme Fe(Ⅱ)/α-ketoglutarate(α-KG)-dependent dioxygenases 5(ALKBH5) were determined by real-time polymerase chain reaction. RESULTS: i) The survival rate of HK-2 cells was more than 60.00% and lower than that of the control group(P<0.05) after the cells were stimulated with 16 μmol/L of cadmium sulfate. Therefore, 4, 8 and 16 μmol/L of cadmium sulfate were selected as the stimulation concentrations in the follow-up experiments. ii) The relative expression of NRF2, METTL3, METTL14 and METTL16 in HK-2 cells in low-dose group increased(all P<0.05), while the levels of ROS and the relative mRNA expression of NRF2, METTL3, METTL14, METTL16 and FTO in HK-2 cells in medium and high-dose groups increased(all P<0.05) when compared with the control group. There was no significant difference in the expression of ALKBH5 mRNA among these 4 groups(P>0.05). In the correlation analysis, NRF2 mRNA expression was positively correlated with the mRNA expression of METTL3 and METTL16 [Pearson correlation coefficient(r) = 0.61 and 0.66, respectively, all P<0.05]. There was no correlation between NRF2 mRNA expression and METTL14, FTO and ALKBH5(r=0.53, 0.48, and 0.01 respectively, all P>0.05). CONCLUSION: Cadmium sulfate may increase intracellular ROS level, up-regulate NRF2 expression and activate NRF2 signaling pathway as well as enhance the expression of METTL3 and METTL16 in HK-2 cells, thus increasing intracellular oxidative damage and decreasing the cell survival rate.
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Objective:To investigate the clinical application and efficacy of microsurgical peripheral nerve decompression in the treatment of painful diabetic peripheral neuropathy (PDPN) .Methods:From Sep. 2017 to Jun. 2018, 33 PDPN patients of our department were treated with DELLON microsurgical peripheral nerve decompression. All surgeries were assisted with neuroelectrophysiological monitoring during the operation and were followed up for 0.5 to 1 years. Electromyography and VAS pain scores were performed 0.5 years before and after surgery, and the preoperative and postoperative results were compared.Results:Postoperative electromyography showed that sensory nerve conduction velocity (SNCV) was significantly improved compared with preoperative ( P<0.05) , while the postoperative VAS score (4.6±1.8) was significantly lower than that (8.3±2.6) of before ( P<0.05) . Conclusions:Microsurgical peripheral nerve decompression is an effective therapeutic method for PDPN. Intraoperative electrophysiological monitoring can effectively avoid iatrogenic nerve injury. Neurophysiological examination can be used as an objective evidence for definitive diagnosis and evaluation of surgical outcomes.
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Objective To investigate the clinical characteristics of DCD donor-derived CRKP infection and bleeding in kidney transplantation,and to summarize the experience of diagnosis,treatment and prevention.Methods A retrospective analysis was carried out from July 2016 to December 2017 in hospital,containing clinical data of 4 cases of CRKP-infected DCD donors and 7 cases of kidney transplantation recipients.Results In the CRKP culture of 4 cases of DCD donors,1 case was positive for blood culture,1 case was positive for urine culture,1 case was positive for sputum culture,and 1 case was negative for blood,urine and sputum culture.The corresponding 7 recipients were all positive for blood culture after renal transplantation,4 cases were positive for urine culture,3 cases were positive for sputum culture,and 5 cases were positive for perirenal drainage.Of the 7 patients,4 cases had renal artery hemorrhage,1 of them was died.The average bleeding time was 17.75 days after operation (14-19 days).In 7 patients with renal transplantation,CRP increasd.And in 3 cases of deaths,CRP was stably higher than normal.Meanwhile,CRP in 4 surviving patients gradually decreased to the normal range after effective anti-infection treatment.All 7 patients were treated with carbapenems;2 patients were dead without avibactam therapy;and 5 cases were treated with avibactam and carbapenems and survived,1 case died and 1 case had good renal function recovery.Conclusion Positive CRKP in blood,urine and sputum of DCD donors can lead to CRKP infection in kidney transplant recipients.Even if the body fluids of donors are all negative,the false negative results could not be excluded.Persistent or increased high-level CRP after operation is an early warning on CRKP infection.And CRP can be used as an indicator for evaluating the effectiveness of anti CRKP therapy.The combination of avibactam and carbapenem antibiotics is an effective regimen in the treatment of DCD donor-derived CRKP.