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Objective:To investigate the incidence of high-risk human papillomavirus (hrHPV) negative cervical lesions in the screening population, and based on this, to preliminarily evaluate the potential harm (missed diagnosis) and benefits (reduced colposcopy referral) of HPV primary screening compared to combined screening so as to provide reference for the selection of cervical cancer primary screening methods.Methods:This study was a single center cross-sectional study. Women who underwent joint screening [hrHPV typing test combined with cervical liquid based cytology test (LCT)] at the Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to December 31, 2019 were included in the cervical cancer screening. The proportion of hrHPV negative cytological abnormalities and cervical lesions in the population was analyzed and the theoretical colposcopy referral rate of the combined screening and HPV initial screening protocol was calculated. In the population with cervical pathological results, the number of colposcopy examinations required for the diagnosis of cervical intraepithelial neoplasia grade 2 and above (CIN2+ ) was calculated.Results:A total of 35 321 screened women were included. The overall incidence of hrHPV infection, LCT abnormalities and severe LCT abnormalities in the population was 17.13%(6 051/35 321), 18.07%(6 384/35 321), and 3.97%(1 402/35 321), respectively. The negative rate of hrHPV in women with severe cervical cytology abnormalities was as high as 51.28%(719/1 402), and in CIN2+ lesions diagnosed by cervical biopsy, hrHPV negative accounted for 7.15% (49/685). The theoretical colposcopy referral rates for combined screening and initial HPV screening were 11.28%(3 985/35 321) and 8.33%(2 943/35 321), respectively, with an average diagnosis of CIN2+ requiring 3.51 and 2.81 colposcopy examinations, respectively.Conclusions:In the opportunistic screening population, the proportion of hrHPV negative CIN2+ lesions cannot be ignored, and the HPV initial screening strategy may cause missed diagnosis of these lesions. However, compared to combined screening, HPV initial screening has the potential to improve the efficiency of colposcopy. These results suggest that we should carefully choose the HPV initial screening plan.
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【Objective】 To explore a new approach to realize the informatization of blood donor satisfaction survey without cost input. 【Methods】 A new collection table i. e. satisfaction questionnaire, was created using Tencent Document, and the QuickMark(QR) code corresponding to the collection table was scanned by the respondents through WeChat to fill in the items on line after authorized login. Classification, summary and statistics of the survey results was conducted through background formula. 【Results】 The satisfaction survey in December 2020 showed that the satisfaction rate of blood donors in that month was 98.16%, with service attitude, appearance and blood donation publicity in top 3 rated at 98.26%(4 859/4 945), 98.14%(4 853/4 945) and 90.08%(4 850/4 945), respectively, and blood donation environment the lowest, rated at 97.82%(4 837/4 945). The survey does not involve personal privacy other than WeChat network name, and the reliability and security of the results are relatively high. 【Conclusion】 This online approach using Tencent Document is cost free, applicable and convenient, therefore worthes popularization.
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Objective:To analyze the clinical characteristics and treatment of patients with serious interstitial lung diseases (SILD).Methods:The clinical data of 43 patients with SILD hospitalized in the respiratory intensive care unit of the Characteristic Medical Center of The Chinese People's Armed Police Force from January 2010 to December 2020 were retrospectively reviewed. According to the prognosis, the patients were divided into the death group and non-death group.Results:The included 43 patients include 31 cases of acute exacerbation of idiopathic interstitial pneumonia (AE-IIP), 18 cases of usual interstitial pneumonia (UIP) and 16 cases of nonspecific interstitial pneumonia (NSIP), in which 40% were aggravated due to co-infection and 33 patients were dead. The results showed that there was no significant difference between death and non-death patients in age, gender, smoking, hospitalization time, duration, clinical symptoms and signs, blood T lymphocyte subsets, co-infection, mechanical ventilation and glucocorticoid dose (all P>0.05), and there were significant differences in arterial partial pressure of oxygen to the fraction of inspired oxygen (PaO 2/FiO 2) and arterial partial pressure of carbon dioxide (PaCO 2) (all P<0.05). The PaO 2/FiO 2 level in the dead patients was lower, who often accompanied by type Ⅱ respiratory failure. Conclusions:AE-IIP was more common in patients with SILD, and most of their chest images were consistent with UIP and NSIP. Pulmonary infection is a common cause of acute exacerbation of SILD, and type II respiratory failure in the progress of the disease is a sign of poor prognosis.
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Objective To evaluate the value of non-invasive coronary flow reserve ( CFR ) for investigating the relationship between myocardial ischemia and coronary stenosis ,and the result after percutaneous coronary intervention ( PCI) in patients with unstable angina pectoris . Methods The rest blood flow spectrum and the maximum coronary diastolic blood flow spectrum were obtained respectively for 131 coronary artery lesions including the left anterior descending coronary artery ,the left circumflex coronary artery and the right coronary artery in 86 patients from the coronary artery flow imaging of transthoracic Doppler echocardiography ,then CFR was calculated . All patients were performed by coronary angiography . Patients with the rate of coronary stenosis > 70％ and CFR ≤ 2 .0 were treated by PCI . CFR was measured again at different intervals after PCI . Results ① As the degree of stenosis increased ,CFR decreased gradually .The coronary stenosis was negatively correlated with CFR ( r = - 0 .803 , P < 0 .001) . The sensitivity of CFR ≤ 2 .0 predicting coronary stenosis rate of more than 70％ was 82 .7％ ,the specificity was 87 .7％ . ② CFR of post-PCI was higher than that of per-PCI . With a follow-up of half a year ,CFR of all coronary arteries was greater than 2 .0(44/44) ,but restenosis occurred at one year after PCI in two left anterior descending coronary arteries . Conclusions Non-invasive CFR can evaluate the relationship between myocardial ischemia and coronary stenosis ,select indications for PCI and evaluate postoperative outcome for patients with unstable angina pectoris .
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Acute ischemic stroke (AIS), as the third leading cause of death worldwide, is characterized by its high incidence, mortality rate, high incurred disability rate, and frequent reoccurrence. The neuroprotective effects of Ginkgo biloba extract (GBE) against several cerebral diseases have been reported in previous studies, but the underlying mechanisms of action are still unclear. Using a novel in vitro rat cortical capillary endothelial cell-astrocyte-neuron network model, we investigated the neuroprotective effects of GBE and one of its important constituents, Ginkgolide B (GB), against oxygen-glucose deprivation/reoxygenation and glucose (OGD/R) injury. In this model, rat cortical capillary endothelial cells, astrocytes, and neurons were cocultured so that they could be synchronously observed in the same system. Pretreatment with GBE or GB increased the neuron cell viability, ameliorated cell injury, and inhibited the cell apoptotic rate through Bax and Bcl-2 expression regulation after OGD/R injury. Furthermore, GBE or GB pretreatment enhanced the transendothelial electrical resistance of capillary endothelial monolayers, reduced the endothelial permeability coefficients for sodium fluorescein (Na-F), and increased the expression levels of tight junction proteins, namely, ZO-1 and occludin, in endothelial cells. Results demonstrated the preventive effects of GBE on neuronal cell death and enhancement of the function of brain capillary endothelial monolayers after OGD/R injury in vitro; thus, GBE could be used as an effective neuroprotective agent for AIS/reperfusion, with GB as one of its significant constituents.
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Animals , Rats , Apoptosis , Brain Ischemia , Drug Therapy , Cell Survival , Cells, Cultured , Disease Models, Animal , Endothelial Cells , Ginkgolides , Pharmacology , Glucose , Lactones , Pharmacology , Neurons , Neuroprotective Agents , Pharmacology , Oxygen , Plant Extracts , Pharmacology , Stroke , Drug TherapyABSTRACT
Background:Pancreatitis is the main complication of ERCP,and a variety of risk factors will increase its risk. Studies showed that temporary pancreatic duct stent can reduce the incidence of post-ERCP pancreatitis (PEP). Aims:To study the efficacy and safety of prophylactic pancreatic duct stenting on preventing PEP in patients with risk factors. Methods:Patients undergone ERCP and accompanied with one or more PEP-associated risk factors from November 2013 to November 2016 at Huaibei People's Hospital were enrolled,and were divided randomly into pancreatic duct stenting group (observation group)and non-stenting group (control group). Serum levels of amylase at 4,24 and 48 hours after the procedure and incidence of PEP were compared between the two groups. Results:A total of 297 patients were enrolled, and 147 patients were in observation group,and 150 patients in control group. No significant differences in gender,age and ERCP disease spectrum were found between the two groups (P > 0. 05). Incidence of PEP was significantly decreased in observation group than in control group (6. 1％ vs. 16. 0％,P 0. 05). Conclusions:Prophylactic pancreatic duct stenting may decrease the incidence of PEP in patients accompanied with PEP-associated risk factors, especially could decrease the severity of PEP. However, the incidence of hyperamylasemia is not decreased.
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Objective:To determine bacteriostatic abilities ofArtemisia argyi extracts,and to explore the effect ofArtemisia argyi extracts on oral ulcer in rats.Methods:We extracted the mixture ofArtemisia argyi volatile oils and water-extraction by leaching method and evaluated the anti-microbial effect ofArtemisia argyi extracts on common oral floras in vitro.The rat cheeks were burnt by NaOH to establish the models of oral ulcer.The curative effects of crude drug of Artemisia argyi extracts at 2.0,1.0,0.5 g/mL on oral ulcer in rats were evaluated by measuring the oral ulcer healing time.Serum TNF-α level and expression of proliferating cell nuclear antigen (PCNA) were analyzed by ELASA and immunohistochemical staining.Results:Artemisia argyi extracts obviously inhibited the Staphylococcus aureus and Streptococcus.NaOH-made oral ulcer in rats were successfully established.The crude drug at 2.0 and 1.0 g/mL obviously reduced healing time,significantly inhibited the release of TNF-α,and improved the PCNA level in the ulcer tissues (All P＜0.01).The extracts obviously reduced the local inflammatory reaction and promoted tissue repair of oral ulcer.Conclusion:Artemisia argyi extracts promote tissue repair of oral ulcer via inhibiting bacterial growth,reducing the release of TNF-α and improving the PCNA level.
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BACKGROUND:Previous studies have demonstrated that normal rat liver homogenate supernatant can induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels with partial hepatocyte functions. However, whether fibrotic liver homogenate supernatant can work or how the inducing effect is remains unclear. OBJECTIVE:To investigate the differentiation potential of human umbilical cord mesenchymal stem cels into hepatocytes under the normal liver and fibrotic liver microenvironment in vitro. METHODS:Liver fibrosis was induced in the SD rats by repeated intraperitoneal injections of 3% thioacetamide at a dose of 200 mg/kg body mass, twice a week for 4 weeks, and then fibrotic liver tissues and normal liver tissues were used to prepare liver homogenate supernatants. Passage 3 human umbilical cord mesenchymal stem cels were used and divided into standard control group (cels were cultured in DMEM/F12 with 10% fetal bovine serum), fibrotic liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 50 g/L fibrotic liver homogenate supernatants), normal liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 100 g/L normal liver homogenate supernatants). The morphological changes of the cels in each group were recorded under inverted microscope; the protein levels of CK18, AFP, CYP3A4, CYP2E1, CYP2D6 and TPH2 were evaluated using western blot assay. Furthermore, the concentration of albumin in the cels was measured. RESULTS AND CONCLUSION:After a 7-day inducement, the stem cels in liver homogenate supernatants groups lost their fusiform shape and changed into hepatocyte-like cels with the morphous of round shape. Compared with the standard control group, the hepatocyte-like cels in the two liver homogenate supernatants groups exhibited human hepatocyte biomarkers, CK18 and AFP. The standard control group cels could express a little amount of CYP2E1, while cels in the two liver homogenate supernatants groups could express CYP3A4, CYP2E1, CYP2D6, TPH2. Compared with the standard control group, the expression level of CYP2E1 in the two liver homogenate supernatants groups increased significantly (P 0.05). At the same time, compared with the standard control group, the concentration of albumin in the two liver homogenate supernatants groups markedly increased (P 0.05). Experimental findings demonstrated that both of normal liver tissue and fibrotic liver tissue microenvironments could induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels. To achieve the same effect, compared with normal liver tissue, fibrotic liver tissue required lower concentrations, suggesting that fibrotic liver tissue microenvironment may be more conducive to differentiation of umbilical cord mesenchymal stem cels into hepatocytes.
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Objective To explore the value of coronary flow reserve(CFR) evaluating myocardial ischemia measured by adenosine triphosphate (ATP) stress transthoracic Doppler echocardiography (TTDE),and the feasibility of CFR to predict coronary stenosis.Methods Fifty-four patients suffering chest pain with known or suspected coronary artery disease were performed ATP stress TTDE to measure resting and maximum expansion coronary blood flow velocity and calculate CFR.all patients were performed by coronary angiography (CAG) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging.Results ① To evaluate myocardial ischemia,there was not statistical significant difference between non-invasive CFR and SPECT myocardial perfusion imaging(P ＞0.05).CFR≤2.0 was the best cutoff value for evaluating myocardial ischemia which yielded a sensitivity of 93.3 ％ and specificity of 89.7％.②Coronary artery stenosis was negatively correlated with CFR (P ＜0.001).ROC curve analysis demonstrated that CFR≤ 1.60 yielded a sensitivity of 92.3％ and specificity of 73.3％ to predict coronary stenosis significantly.Conclusions CFR measured by ATP stress TTDE can evaluate myocardial ischemia of coronary artery disease and predict LAD significant stenosis before CAG.Using CFR and CAG has important clinical value for choosing treatment of stable coronary artery disease.
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ObjectiveStudy the effects of mitral valve replacement using video-assisted thorascoscopy compared with median sternotomy mitral valve replacement.MethodsBetween October 2003 and October 2011,72 cases suffer from mitral valve disease underwent video-assisted thorascoscopic mitral valve replacement,74 cases underwent median sternotomy procedure.CPB time,cross clamp time,ventilation time,drainage,ICU stay time and hospital stay time of the two groups were compared.Results It was longer that CPB time and cross clamp time in video-assisted thoracospic group than those of median sternotomy group.There was statistically significant difference.However there was no statistically significant differentce in ventilation time and ICU stay time between two groups.Drainage of video-assisted thoracospic group was less than median sternotomy group.And there was statistically significant difference.ConclusionAs long as strictly a good indication,mitral valve surgery can routinely be performed with video-assisted thoracospic.
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Objective To explore how to apply SWOT analysis method for analysis in nursing management in special wards,to develop individualized measures,and to evaluate the clinical quality of care. Methods Using SWOT analysis method to investigate the internal strengths factors,internal weaknesses factors,external opportunities factors,and external threats factors and arranged as a matrix in accordance with a certain order,and used systems analysis methods to analyze the factors matching each other,to dr aw the appropriate conclusions,and to develop appropriate countermeasures.30 patients before and 40 patients after the application of SWOT analysis method were selected for effect comparison. Results After the implementation of SWOT analysis method primary care,I-level care,health education quality,satisfaction degree of patients and ward management score were better than those before the implementation. Conclusions SWOT analysis method was intuitive and simple to use.It possesses balance and systematieness,which is suitable for clinical care management.
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To investigate the effects of Losartan,an angiotensinⅡ(AngⅡ)receptor(AT_1) antagonist,on pancreatic stellate cells(PSCs)and its possible mechanisms.Methods (1)PSCs were isolated from pancreatic cancerous samples to test the expressions of AT_1 and collagenⅠafter incubated with AngⅡor/and Losartan.(2)Ninety S-D rats were divided into normal group,control group and treatment group,with 30 rats in each.The rats in control and treatment groups were induced pancreatic fibrosis by injection of 2% trinitrobenenze sulfonic acid(TNBS)into biliopancreatic duct.Rats in treat- ment group were then treated with Losartan by garage daily and rats in control group were only given distilled water.The rats were sacrificed on day 3,7,14,21 and 28,respectively,and pancreas were removed.The histological abnormalities were observed by electron microscope.The mRNAs of trans- forming growth factor?_1(TGF?_1)and procollagenⅠwere detected by reverse transcription-polymerase chain reaction(RT-PCR).The expression of TGF?_1 and?-smooth muscle actin(?-SMA)proteins was assessed by immunohistochemistry and the level of?-SMA protein was quantified by Western blot. Results In vitro,there existed AT_1 expression in PSCs,and Losartan reduced expression of collagenⅠ.Losartan treatment reversed the histological abnormalities observed by electron microscope,com- pared to treatment with distill water.The expression of?-SMA,TGF?_1 and procollagenⅠwere signifi- cantly higher in the control group than those in normal group and were reduced by Losartan to different extent in treatment group.Conclusion AT_1 antagonist can inhibit the activation and the profibrogenic action of PSCs by blocking AT_1 receptor-mediated pathways.
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AIM:To investigate the protective effects of adenosine on cultured rat hippocampal neurons after oxygen-glucose deprivation. METHODS:The control and adenosine-treated hippocampal neurons cultured for 12 d were exposed to oxygen-glucose deprivation environment for 0.5-4 h and then cultured with original medium in normoxia for 24 h . The soma area,survival rate, effluxes of lactate dehydrogenase (LDH)and apoptosis of neurons were observed. RESULTS:The soma area, effluxes of lactate dehydrogenase from neurons and apoptosis were increased while survival rate of neurons was decreased after oxygen-glucose deprivation compared with those pre-oxygen-glucose deprivation. Compared with the control, after oxygen-glucose deprivation the soma area, effluxes of lactate dehydrogenase from neurons and apoptosis were decreased, however, the survival rate of neurons was increased in the adenosine group.CONCLUSION: Oxygen-glucose deprivation can lead to the severe damage of cultured hippocampal neurons, and adenosine can reduce neuronal injury induced by oxygen-glucose deprivation.
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AIM: To determine the effects of NF-?B on the development of rat pancreatic fibrosis mediated by angiotensin II. METHODS: Spraque-Dawley rats (200-300g) were randomly divided into normal group, control group and losartan-treatment group. Pancreatic fibrosis was induced by injection of 2% TNBS into biliopancreatic duct. Rats in losartan-treatment group and control group were respectively treated with losartan (10 mg?kg~(-1)?d~(-1)) by gavage and the same volume of saline vehicle. The expression, distribution, and activation of NF-?B were studied by Western blot, immunohistochemistry and TransAM~(TM). Toluidine blue staining and transmission electron microscopy were also used to observe the number, distribution and degranulation of mast cells. In addition, RT-PCR was performed to detect the intrapancreatic ICAM-1 mRNA expression. RESULTS: The expression and activity of intrapancreatic NF-?B p65 protein were significantly increased on day 3 after operation, reaching peak on day 7 [(0.406?0.086) mg/g total protein]. Mast cell activation was observed and ICAM-1 mRNA levels on day 3 and 7 were up-regulated in control group. Losartan treatment inhibited NF-?B expression and activation, reduced mast cell infiltration and degranulation and decreased ICAM-1 mRNA expression compared with control rats. CONCLUSION: It might be associated with the expression and activation of NF-?B that angiotensin II mediates inflammation and fibrosis in the early stage of pancreatic fibrosis. [
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AIM: To examine the effects of PPAR? activation on the growth of human pancreatic carcinoma in vitro and to explore the role of NF-?B and activator protein-1 (AP-1) in this process. METHODS: SW-1990 pancreatic cancer cells were treated with ligand of RXR?, 9-cis-RA, ligand of PPAR?, 15d-PGJ_2, and both. Antiproliferative effect was evaluated by using MTT assay; the expression of NF-?B p65 active protein was assayed by using TransAM~TM technique. Expression of c-jun and c-fos by SW1990 cells, which were treated with 15d-PGJ_2, 9-cis-RA and both at varying concentrations, were detected by RT-PCR. RESULTS: MTT assay demonstrated that 15d-PGJ_2, 9-cis-RA and the combination of both had a potent inhibitory effect on the growth of SW1990 cells in a dose-dependent manner. 9-cis-RA had a synergic action with 15d-PGJ_2 on the growth inhibition of pancreatic carcinoma. TransAM~TM showed a down-regulation trend of P65 active protein in SW1990 cells treated with 15d-PGJ_2, 9-cis-RA and both. RT-PCR demonstrated that the expression of c-jun mRNA in 15d-PGJ_2, 9-cis-RA and the combination of both-treated cells were firstly increased and then decreased, the expression of c-fos was decreased in 15d-PGJ_2 or 9-cis-RA treated SW1990 cells, but increased in cells treated with both 15d-PGJ_2 and 9-cis-RA. CONCLUSION: Activation of PPAR? exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro. Activation of RXR? has a synergic action with PPAR? agonist. The mechanism is probably associated with down-regulating the expression of NF-?B and AP-1. [
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Objective To explore the diagnostic value of human telomerase reverse transcriptase (hTERT) and proliferating cell nuclear antigen (PCNA) in pleural and peritoneal effusion. Methods The expressions of hTERT and PCNA were detected by immunocytochemistry in 46 malignant and 21 benign serous specimens. Results hTERT and PCNA were detected respectively in 39 and 29 of 46 malignant specimens, but no expressions in reactive mesothelial cells in all serous specimens. hTERT correlated with PCNA (r=0.30, P