HPV Genotyping and Clinical Studies of Women in Yan'an Area / 现代检验医学杂志

Objective To contrast HPV genotyping and clinical characteristics of women in Yan'an and provide data support for cervical cancer screening and prevention.Methods The genotyping of HPV infection was carried out by the method of PCR amplification and reverse hybridization.To statistical analysis clinical infection distribution data.Results Found 16.48％ (332 of 2014) were positive for HPV DNA in these women.HPV-16,52 and 53 were in the top three HPV high-risk types.HPV-81,6 and 44 were in the top three HPV low-risk types.There were 219 cases (65.96％) with pure high-risk type infection,74 cases (22.29％) with pure low-risk type infection and 39 cases (11.75％) with mixed infection in positive specimens.The HPV infection rate had showed first increasing then decreasing with age,and there were significant differences among the each groups (x2=34.238,P＜0.01).There were also differences in HPV positive detection rates in different occupations and there were significant differences among the each groups (x2=50.35,P＜0.01).There were also differences in HPV positive detection rates in different regions,and there were significant differences among the each groups (x2 =12.084,P＜0.05).Single infection was highest in HPV infection.Conclusion HPV infection was different in different populations,regions and ages,and it is of great significance to carry out HPV screening for early prevention and treatment of cervical cancer.

Clinical application of VerifyNow-P2Y12 assay in evaluation of platelet inhibition efficacy of clopidogrel / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the platelet inhibition efficacy in patients under regular maintenance dose of clopidogrel by VerifyNow-P2Y12 assay and explore the clinical characteristics of clopidogrel non-responders and related predicting factors.</p><p><b>METHODS</b>A total of 99 patients underwent percutaneous coronary intervention procedure and receiving clopidogrel in regular maintenance dose for at least 1 week were enrolled. Platelet reactivity, including baseline, P2Y12 reaction unit (PRU), and platelet inhibition rate were measured with VeifyNow-P2Y12 assay. The dosage of anti-platelet drugs, combination with any other drugs, clinical characters in baseline of all enrolled patients were analyzed. PRU ≤ 240 was used as cut-off to identify clopidogrel responder and clopidogrel non-responder. In the non-responder group, patients were further separated into 3 sub-groups (types) according to the baseline and platelet inhibition rate: type I with high baseline, high inhibition rate, representing false non-responder; type II with low inhibition rate, representing true non-responder and type III mixed type.</p><p><b>RESULTS</b>In this study, 48 of 99 patients were found to be clopidogrel non-responder (48.5%). The ratio of type I, type II and type III in the non-responder group was 9.1% (n = 9), 27.3% (n = 27), and 12.1% (n = 12), respectively. Baseline platelet value in female patients was significantly higher than in males (P < 0.01), number of females with high PRU also is higher than males (P < 0.01), female gender was a predict factor for type I non-responder (OR = 6.5, 95%CI 2.295 - 18.407, P < 0.01). BMI > 24 kg/m(2) was a risk factor for clopidogrel non-responder (P < 0.05), and may be regarded as a predict factor for type II non-responder (OR = 3.207, 95%CI 1.375 - 7.485, P < 0.01). Age, hypertension, diabetics, smoking, hyperlipidemia, CRP and pantoprazole use do not show significant correlation with baseline and platelet inhibition rate.</p><p><b>CONCLUSIONS</b>Clopidogrel responses could be reliably detected by VerifyNow-P2Y12 assay. Female gender and high body weight are independent risk factors for clopidogrel non-responses.</p>

Diagnostic value of 320-slice computed tomography coronary angiography to assess in-stent restenosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic accuracy of 320-slice CT coronary angiography (CTA) in the evaluation of in-stent restenosis (ISR, ≥50% luminal narrowing) in comparison with quantitative coronary angiography (CAG).</p><p><b>METHODS</b>A total of 69 patients with previous stent implantation who underwent both CTA and CAG were prospectively included. We assessed diagnostic valve for ISR with CTA in comparison with CAG.</p><p><b>RESULTS</b>A total of 110 stents were implanted in these patients.CAG identified 14 ISR. CTA correctly identified 13 ISR and misdiagnosed 5 ISR in stents without ISR. Besides, 6 stents could not be evaluated by CTA due to unsatisfied image quality. Accordingly, sensitivity, specificity, positive and negative predictive value of CTA for diagnosing ISR were 93%, 89%, 54% and 99%, respectively. The image quality of CTA was significantly better in larger stents (percentages of good and moderate stent image of ≥3.0 mm and <3.0 mm: 56% vs. 27%, 25% vs. 49%) and which was linked with better diagnostic coincidence rate (95% vs. 78%) for larger stents. The image quality of CTA was significantly better in stents with thinner stent strut thickness (percentages of poor CTA stent image quality of stent strut thickness<140 µm and ≥140 µm: 12% vs. 45%, P<0.01) and which was associated with better diagnostic coincidence rate for stents with thinner stent strut thickness (94% vs. 76%, P<0.05). The image quality of CTA was also significantly better in single stent (percentages of poor CTA stent image quality of single stent vs. overlap and dedicated stent: 17% vs. 36%, P<0.05). However, heart rate (≥65 beats/min vs. <65 beats/min) during CTA acquisition was not associated with image quality and the diagnostic coincidence rate (all P>0.05).</p><p><b>CONCLUSIONS</b>Our results indicate that 320-slice CTA allows accurate noninvasive assessment of significant in-stent restenosis in selected patients. Stents with a large diameter and thin struts are associated with better image quality and higher diagnostic accuracy.</p>