Monitoring and analysis of disinfection quality in clinical institutions in Yangpu District， Shanghai in 2018‒2020 / 上海预防医学

Objective To determine the current disinfection quality and understand existing problems in clinical institutions in Yangpu District， and provide scientific evidence for improving hospital infection control. Methods From 2018 to 2020， the specimens were collected from medical instruments， disinfectant in use， dialysis water in hemodialysis rooms， air， surface of objects， sterilization equipment， hands of medical staff， dental therapy water and sewage in clinical institutions in Yangpu District， and then examined for disinfection quality. Results A total of 1 420 samples were collected consecutively in 3 years， in which the total qualified rate was determined to be 88.52%. The qualified rates in secondary and tertiary hospitals， primary health centers， and private clinics were 94.86%， 90.22% and 75.74%， respectively， with a significant difference （χ2=95.01， P<0.01）. The qualified rates in sterilization equipment， air， and dialysis water were all 100.00%； in contrast， the rates in medical instruments， surface of objects， hands of medical staff， disinfectants in use， dental therapy water， and sewage were 98.28%， 97.63%， 95.05%， 93.39%， 54.71% and 50.00%， respectively. Conclusion Overall disinfection quality remains good in clinical institutions in Yangpu District of Shanghai， whereas the quality in private clinics is low. In addition， dental therapy water and hospital sewage might be susceptible to contamination， which warrants further improvement in the disinfection and monitoring.

Insecticide resistance tendency and prevention strategies of Aedes albopictus in Yangpu District， Shanghai， China / 上海预防医学

Objective To investigate the resistance development of Aedes albopictus to commonly used insecticides in Yangpu District of Shanghai， China， and to provide scientific bases for the control of A. albopictus and the emergency treatment of dengue fever. Methods The larva immersion method recommended by WHO was used to assay the median lethal concentration （LC50） of A. albopictus larva. SPSS 25.0 was used to calculate the toxicity baselines of insecticides. Results A. albopictus kept a medium resistance to beta-cypermethrin， and the resistance ratios were 14.44， 10.00， 17.78， respectively， in 2015， 2017， 2019. The mosquitos kept a high resistance to permethrin， and the resistance ratios were 54.00， 140.00， 52.00 respectively， in 2015， 2017， 2019. Besides， A. albopictus also kept a medium resistance to propoxur， and the resistance ratios were 15.34， 13.06， 10.83 respectively， in 2015， 2017， 2019. To deltamethrin， A. albopictus showed high resistance in 2015 and medium resistance in 2017， the resistance ratios were 40.00 and 35.00. To temephos， A. albopictus showed low resistance in 2015， with the resistance ratio of 9.38. Conclusion A. albopictus has developed high resistance to permethrin in Yangpu District of Shanghai， and cautious and reduced use of permethrin is suggested. It is necessary to implement and adopt the strategy of comprehensive management， in order to establish the long-term mechanism for mosquito control and prevention.

Efficacy of the plastic repair for over-wide eyelid fold after double eyelid plasty / 中华医学美学美容杂志

Objective:To investigate the key points of reparation and clinical effects of the over-wide eyelid fold after double eyelid plasty.Methods:The widths of double eyelids were measured for 28 patients who were unsatisfied with their over-wide double eyelids even after surgery. The maximum width was 12 mm, the minimum width was 6.5 mm, with average of 8.59 mm. The major repair methods of simply over-wide double eyelids were used to release adhesion and reduce the width. The repair methods of complexly over-double eyelids were to release adhesion, and to reduce the width; at the same time, fat transplantation and filling, orbital septal fat transfer, shortening of levator palpebrae superioris muscle, anterior fixation of levator palpebrae superioris muscle aponeurosis or correction of upper eyelid retraction should be also performed.Results:After the over-wide double eyelids were repaired, the width of double eyelids was obviously reduced; the double eyelids were more natural and asymmetrical. The upper eyelid was no longer sunk and the cornea exposure rate was greatly improved. 26 patients were satisfied with their surgical results. One patient was dissatisfied with the surgical result affected by the skin which was thin and not elastic. One patient required doctors to get the eyelids slight wider.Conclusions:It is of referential significance to define the clinical characteristics and major shortcomings of over-wide double eyelid for determining surgical plan, surgical items, consultation and preoperative communication with patients.

Clinical efficacy of five-flap method in epicanthus correction / 中华医学美学美容杂志

Objective:To explore the clinical application of five flaps method in epicanthus correction.Methods:From May 2009 to July 2016, 39 surgical cases were collected, including 2 males and 37 females, aged 18-55 years, with an average age of 32 years. Patients with single eyelid accompanied by epicanthus and epicanthus alone were treated with the five-flap method to correct epicanthus combined with double eyelid plasty or the five-flap method to correct epicanthus. Postoperative follow-up was conducted for 2 weeks to 10 years.Results:All incisions healed in one stage without triangular flap necrosis. From 2 weeks to 3 months after operation, the medial canthus had slight scar hyperplasia reaction. Three months after operation, the scar hyperplasia reaction subsided without complications, no obvious scar, epicanthus correction, natural shape of the inner canthus angle, obvious narrowing of the distance between the inner canthus, and increased length of bilateral eyelid fissure. The eyelid shape was natural, and the inner canthus connected smoothly and naturally.Conclusions:Five-flap method for correction of epicanthus can effectively alleviate the tension of epicanthus skin by lengthening the main axis of epicanthus, relax the tension-free cross-joint of local tissues, relieve epicanthus, fully expose the angle of epicanthus, enlarge the transverse diameter of palpebral fissure, and avoid contracture of arc scar of epicanthus.

Association of the H770H of PR gene polymorphism with susceptibility to endometriosis / 中华妇产科杂志

Objective To investigate the association of PR gene exon 5 region H770H (rs1042839) single nucleotide polymorphism (SNP) with the genetic susceptibility to endometriosis (EM) in southern Han Chinese women. Methods Totally 431 EM patients and 499 non-EM women were collected and separated into EM group and control group, that all cases were confirmed by operation and pathology. A case-control study was performed in EM and control groups to evaluate the association of these SNP with the susceptibility to EM by using a fluorescent quantitative PCR-based high resolution melting (HRM) method. Results The C and T of PR H770H allele frequencies among the EM and control groups were 97.9%(844/862), 2.1% (18/862) and 99.4% (992/998), 0.6% (6/998), respectively. The CC, CT and TT of PR H770H genotype frequencies among the EM and control groups were 95.8%(413/431), 4.2%(18/431), 0 and 98.8%(493/499), 1.2%(6/499), 0, respectively. There were statistical significances in the PR H770H alleles and genotypes distributions between the two groups (χ2=7.386, P=0.007;χ2=8.135, P=0.004). Carrying allele C reduced the risk of EM (OR=0.986, 95%CI: 0.976-0.996), while carrying allele T enhanced the risk of EM (OR=3.319, 95%CI: 1.323-8.325); carrying genotype CC reduced the risk of EM 0.970 time (OR=0.970, 95%CI: 0.949-0.991), whereas carrying genotype CT enhanced the risk of EM 3.473 times (OR=3.473, 95%CI:1.391-8.671). Conclusion There is significant association between the polymorphism of PR H770H and genetic susceptibility to EM in southern Han Chinese women.

Illumina sequencing 16S rRNA tagging reveals diverse vaginal microbiomes associated with bacterial vaginosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze and compare vaginal microbiomes in healthy women at child-bearing ages and patients with bacterial vaginosis (BV).</p><p><b>METHODS</b>A total of 74 vaginal swabs of the vaginal fornix were collected from 37 BV patients and 37 healthy women. BV status was assessed according to Amsels clinical criteria for all the subjects and confirmed using Gram-stain criteria (Nugent scores). Genomic DNA of the samples was extracted for amplifying the 16S rRNA V6 hypervariable region by PCR and pyrosequencing by Illumina. BIPES, UCHIME, TSC and GAST were employed to analyze the information of the species from the samples.</p><p><b>RESULTS</b>Lactobacillus was the predominant species in healthy women (more than 95%), including mainly L. iners and L. crispatus, with a small quantity of Gardnerella, Granulicatella, Streptococcus, Prevotella, Escherichia and other genus. The α diversity was significantly increased in 30 BV patients (P<0.001), and β diversity also changed obviously shown by decreased Lactobacillus (varying from 45% to 1%, consisting mainly of L. iners) or even absence Lactobacillus in 6 cases, with increased relative abundance of Gardnerella, Prevotella, Granulicatella, Anaerococcus, Parvimonas, Peptoniphilus.harei, Peptostreptococcus, and Dialister. Different from previous data, 7 BV cases showed a predominance of the rare species L.gasseri and L.acidophilus (75% to 50%).</p><p><b>CONCLUSION</b>Lactobacillus is the predominant vaginal species in healthy women (mainly L. iners and L. crispatus) co-existing with many other bacteria and a variety of microorganisms. Lactobacillus is significantly decreased and even absent in most of BV patients, and some cases show the predominance of the rare species L.gasseri and L.acidophilus.</p>

Association of P53 gene polymorphisms with susceptibility to endometriosis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of a single nucleotide polymorphism(SNP) in tumor suppressor gene P53 with the risk of endometriosis (EM) in Han Chinese women.</p><p><b>METHODS</b>For 460 EM patients, 113 patients with endometrial carcinoma and 530 matched unrelated controls, a rs1042522(C/G) SNP of the P53 gene was genotyped by polymerase chain reaction-single strand polymorphism (PCR-SSP) and DNA sequencing.</p><p><b>RESULTS</b>A significant difference has been detected in the distribution of rs1042522 alleles and genotypes between the EM patients and controls (P< 0.01). Allele G has increased the risk of EM by 1.209 times, while allele C has reduced this risk by 0.837 times. Compared with GG genotype, GC and CC genotypes have both increased the risk for EM (OR=2.073, 95%CI: 1.521-2.820, and OR=1.930, 95%CI: 1.363-2.733, respectively). Significant differences were also detected in the distribution of rs1042522 alleles and genotypes between endometrial carcinoma patients and controls (P< 0.01). Allele G has increased the risk to endometrial carcinoma by 1.311 times, while allele C has reduced this risk by 0.757 times. Compared with GG genotypes, individuals with GC and CC genotypes are more likely to be affected with endometrial carcinoma (OR=2.778, 95%CI: 1.585-4.870, and OR=2.864, 95%CI: 1.557-5.263, respectively).</p><p><b>CONCLUSION</b>Our study has suggested a significant association between the rs1042522(G/C) polymorphism and susceptibility to EM in Han Chinese women. The mechanism of EM is similar to carcinoma from genetics point of view.</p>

Relationship of polymorphisms of AhR - 1661G/A with GSTP1 - 313A/G and susceptibility to endometriosis / 中华妇产科杂志

Objective To investigate the association of polymorphisms of arylhydrocarbon receptor (AhR) - 1661G/A with glutathione S-transferase pi ( GSTP1 ) - 313A/G and the susceptibility to endometriosis in southern Han Chinese.Methods Total of 432 endometriosis patients undergoing laparoscopic or laparotomy surgery matched with 493 patients with fallopian tube ligation,tubal recanalization,laparoscopic hydrotubation,benign ovarian tumor and teratoma surgeries without endometriosis as control group were enrolled in this study.The single nucleotide polymorphism (SNP) of AhR -1661G/A and GSTP1 -313A/G were detected by using a fluorescent quantitative PCR-based high resolution melting (HRM).Results The numbers of combined genotypes AhR - 1661G/A and GSTP1 -313A/G were 120 patients with AG + AA,64 patients with AG + AG,8 patients with AG + GG,109 patients with GG +AA,84 patients with GG + AG,4 patients with GG + GG,31 patients with AA + AA,10 patients with AA + AG,1 patient with AA + GG at endometriosis group and 131 patients with AG + AA,68 patients with AG + AG,6 patients with AG + GG,157 patients with GG + AA,66 patients with GG + AG,4 patients with GG + GG,35 patients with AA + AA,20 patients with AA + AG,3 patients with AA + GG at endometriosis group.There was no statistically different frequencies of genotypes between endometriosis group and control group (x2 = 12.558,P = 0.128 ).Compared with genotype GG + AA,the risk of endometriosis with genotype GG + AG was increased 1.833 time (95％CI:1.233-2.274).Conclusion The combined genotype GG + AG [ from AhR - 1661G/A (GG) and GSTP1 - 313A/G (AG) ] might be related with susceptibility to endometriosis.

Association of the tumor necrosis factor-alpha - 1031T/C and its combination with interleukin-6 -634C/G gene polymorphisms with susceptihility to endometriosis / 中华妇产科杂志

Objective To investigate the association of tumor necrosis factor-alpha (TNF-α) gene promoter region - 1031T/C and its combination with interleukin-6 (IL-6 ) gene promoter region -634C/G single nucleotide polymorphisms (SNP) with the genetic susceptibility to endometriosis.Methods Total of 432 endometriosis patients and 499 non-endometriosis women who had received an operation due to tubal ligation,tubal recanalization,laparoscopic hydrotubation,ovarian simple cyst and teratoma were collected and separated into endometriosis group and control group,that all cases were confirmed by operation and pathology.A case-control study was performed in endometriosis and control group to evaluate the association of these SNP with the susceptibility to endometriosis by using a fluorescent quantitative PCR-based high resolution melting ( HRM ) method.Results ( 1 ) TNF-α - 1031T/C genotype:the T and C of TNF-α - 1031T/C allele frequencies in the endometriosis group and control group were 79.2％ (684/864),20.8％ (180/864) and 81.8％ (816/998),18.2％ (182/998),respectively.The TT,TC and CC of TNF-α - 1031T/C genotype frequencies in the two groups were 63.7％ (275/432),31.0％ ( 134/432 ),5.3％ (23/432) and 66.5％ (332/499),30.5％ (152/499),3.0％ ( 15/499),respectively.There were no statistical significances in the TNF-α - 1031T/C alleles and genotypes distributions between the two groups ( P =0.158,P =0.186 ).( 2 ) TNF-α - 1031T/C and IL-6 - 634C/G conjoint genotypes:to research on the TNF-α - 1031T/C and IL-6 -634C/G genotypes for conjoint analysis,the TT + CC,TC + CC,CC +CC,TT + CG,TC + CG,CC + CG,TT + GG,TC + GG and CC + GG combination genotype frequencies in the two groups were 39.4％ ( 170/432 ),19.4％ ( 84/432 ),4.6％ ( 20/432 ),20.6％ ( 89/432 ),8.8％ (38/432),0.9％ (4/432),3.5％ (15/432),2.3％ (10/432),0.5％ (2/432) and 36.7％ ( 183/499),17.4％(87/499),1.4％ (7/499),26.1％ (130/499),10.4％ (52/499),1.2％ (6/499),3.8％ (19/499),2.6％ ( 13/499),0.4％ (2/499),respectively.There were no statistical significances in the combination genotypes distributions between the two groups ( P =0.107 ).As compared with carriers of TT + CC combination genotype,the endometriosis risk of carriers of CC + CC combination genotype enhanced 3.076 times ( 95％ CI:1.268 - 7.457,P =0.009 ),and the endometriosis risk of carriers of other combination genotypes were no statistical significances (all P ＞ 0.05 ).ConclusionsThe study demonstrates that there are no significant association between the SNP of TNF-α - 1031T/C and genetic susceptibility to endometriosis.However the results indicate that there are significant association betweengenetic susceptibility to endometriosis and the combination polymorphisms of TNF-α -1031T/C and IL-6- 634C/G.

Rhesus Model-based Immunological Insights into Endometriosis / 医学研究杂志

Objective To Investigate the dynamics of the parameters in the immune system,including T cell,NK cell sub-populations and cytokines,on the experimental endometriosis model in rhesus,in order to study the immunity-related profile in endometriosis.Materials Six female healthy rhesuses with regular menstrual cycle were selected,among them,five for experiment and one as control.During day 8-15 of menstruation,or day 3-5 after the midcycle estrogen peak,the endometrium and the greater omentum were implanted into the extra-uterine pelvic cavity in the experimental group and the control group,respectively.Samples of sera were collected at the time of 8th and 16th day of every menstruation after the implantation.An exploratory laparotomy or laparoscopy was undertaken during the period from day 8 to day 15 of the menstruation in the 2nd month and the 4th month after the implantation for observation of the occurrence of endometriosis.Methods Flow cytometer(FCM),radioimmuno-assay(RIA),electrochemiluminescence(ECL) and enzyme-linked immunosorbent assay(ELISA) were used to detect the dynamics of the expression levels of CD3,CD4,CD8,CD16 and activity of NK cells,the dynamics of the IgG、IgM,of cytokines,including TNF-a、IL-6、IL-8、CA125、HGF and ICAM-1 in peripheral blood of rhesus pre-operation and during the three months of post operation.Results Cellular immune function declined in the rhesus endometriosis model,showing from the changes of the CD3、CD4、NK(CD16) ratios,CD4/CD8 ratio and decrease of the NK cell activity;For the humoral immunity,no significant changes occurred in the levels of IgG、IgM,with little decline.5 During the 4-month period post-operation,the levels of CA125 rised gradually,ICAM-1 and HGF increased significantly,IL-8 increased slightly,TNF and IL-6 increased markedly in rhesuses that formed endometriosis.Conclusion This experiment shows what we observed in human patients for the immunological system changes could also be reproduced in the rhesus model.Therefore such a model can be used in the future to test the interference of the immune system to tackle his medical problem.Finally we found the oncogenis marker CA125 shows a gradual increase during the disease course therefore it can be used for prognosis of the disease.

Comparative study of HLA-DQA1 and HLA-DRB1 allele in patients with endometriosis and adenomyosis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To make a comparative study of HLA-DQA1 and HLA-DRB1 allele frequencies in the cases of endometriosis and adeonmyosis.</p><p><b>METHODS</b>The allelic types of HLA-DQA1 and HLA-DRB1 were detected by polymerase chain reaction-sequence specific primers (PCR-SSP) technique in 51 cases of endometriosis, 45 cases of adenomyosis, and 44 normal individuals as the control.</p><p><b>RESULTS</b>The frequencies of HLA-DQA1*0401(7.8%, 10.0%) were significantly increased in the endometriosis group and the adenomyosis group (Pc=0.03, Pc=0.01), and the frequencies of HLA-DQA1*0301(8.8%, 5.6%) were significantly decreased in these two groups (Pc=0.00, Pc=0.00).There was no significant difference between the frequencies of HLA-DQA1 and HLA-DRB1 of endometriosis and adenomyosis.</p><p><b>CONCLUSION</b>The results indicate that HLA-DQA1*0301 and *0401 alleles are associated with both endometriosis and adenomyosis, and there is perhaps common mechanism involved in both endometriosis and adenomyosis based on HLA-DQA1 and HLA-DRB1 allele frequencies.</p>