Assessment and direction of Objective Structured Clinical Examination on clinical practice in Department of Obstetrics and Gynecology / 上海第二医科大学学报

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

Application of transitional problem-based learning in teaching of Department of Gynecology and Obstetrics / 上海第二医科大学学报

0.05).But transitional PBL had much priority in enhancing students' learning interests. Conclusion The applicational of transitional PBL requires to be further deepened and improved in the realm of medical education.

Prevalence of high-risk human papillomavirus infection in different cervical lesion among organized health-examination women in Shanghai, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cervical cancer is the second most common cause of death from cancer among women worldwide. Human papillomavirus (HPV) plays a central role in the etiology of cervical cancer. It is important to describe the prevalence of HPV infection in different types of cervical lesions and to explore the relation between HPV viral load and the severity of cervical lesions.</p><p><b>METHODS</b>To describe the HPV infection prevalence and viral load in different age groups, we retrospectively investigated 6405 cases of women who were organized by their units to take health-examination. They were given Hybrid Capture II tests between January 2005 and December 2006. The correlation between HPV viral load and pathology was assessed.</p><p><b>RESULTS</b>Overall HPV infection prevalence was 29.1% (1864/6405), while in women 18-20 years old it was 54.4% (31/57), the highest among all age groups. After declining rapidly, HPV prevalence stabilized at about 30.0% in women aged 30 and older. Of the 6405 women, 1483 women had a colposcopic biopsy and 33.2% (492/1483) were positive for HPV DNA. Twenty-one percent of women with a normal diagnosis (238/1095) had HPV infection, a statistically significantly lower prevalence than in women with cervical lesions, including those with cervical intraepithelial neoplasia (68.8% in CIN1, 66.7% in CIN2, and 76.5% in CIN3) or with cervical cancer (94.1%). The correlation coefficient between viral load and cervical lesion severity was 0.134, which was not statistically significant (P = 0.075). Viral load values in women with CINs and cervical cancer were calculated, and no significant differences were identified.</p><p><b>CONCLUSIONS</b>The prevalence of high-risk HPV infection among women attending hospitals for health-examination in Shanghai is similar to the worldwide rate. HPV viral load can distinguish cervical lesions from normal individuals but cannot adequately predict the severity of cervical lesions.</p>

Electrocolposcopic and thinprep cytologic test in diagnosis of subclinical human papillomavirus infection and cervical intraepithelial neoplasia / 上海第二医科大学学报

Objective To investigate the diagnostic value of thinprep cytologic test(TCT) and electronic colposcope(EC) examination in patients with subclinical human papillomavirus(HPV) infection(SPI) and cervical intraepithelial neoplasia(CIN),and explore its concordance with pathologic diagnosis. Methods A total of 1 125 females were examined with TCT,744 of whom diagnosed with abnormality by TCT or suspect of cervical lesions were examined with EC,and multiple punch biopsies were performed in 706 of those with abnomal EC images and suspected diseases. ResultsThe sensitivity of TCT,EC examination and the combined examination of TCT and EC for SPI and CIN were 88.74%,88.79% and 90.63%,respectively,the specificity 85.44%,80.38% and 96.41%,respectively,the positive predictive value 74.06%,68.90% and 91.10%,respectively,and the negative predictive value 94.19%,93.61% and 96.21%,respectively.By the combination of the two examinations,the specificity and positive predictive value were significantly increased(P

Correlation between high-risk human papillomavirus viral load and severity of cervical lesion / 上海第二医科大学学报

Objective To explore the correlation between high-risk human papillomavirus(hr-HPV) viral load and severity of cervical lesion. Methods One thousand eight hundred and six women undergoing both hr-HPV DNA test by hybrid capture Ⅱ(HCⅡ) and colposcopic biopsy for histologic results were enrolled in this study.Correlation between hr-HPV viral load and pathological findings was investigated. Results Of 1 806 cases,641(35.5%) patients were positive for HPV DNA.23.2%(301/1299) of women with normal diagnosis had HPV infection,significantly lower than cervical lesion including cervical intraepithelial neoplasia(CIN) and cervical cancer(P=0.000).Associations(odds ratio) among severity of cervical lesion and viral load were calculated.The significantly increased risk only existed between cervical cancer and CIN1 on high viral load(odds ratio,8.5;95% confidence interval,1.0-71.4;P=0.049).Furthermore,viral load values in CIN1,2,3 and cervical cancer were calculated and median analysis revealed non-significant difference(P=0.712). Conclusion The hr-HPV viral load can distinguish cervical lesion as CIN and cervical cancer from normal one,while the prediction of the severity of cervical lesion may be inadequate and need further investigations.

Cervical Regeneration Outcome after Loop Electrosurgical Excision Procedure for Management of Cervical Lesions / 上海第二医科大学学报

Objective To observe the cervical regeneration outcome after different loop electrosurgical excision procedures(LEEP) for the management of cervical lesions.Methods A total of 209 patients with cervical lesions including cervical epithelial neoplasia,cervical HPV infection,cervical polyp and condyloma,and severe cervicitis were performed LEEP in our hospital.The types of LEEP included shallow ring excision,deep ring excision,LEEP conization,and that similar to cold-knife conization.The width and depth of removed cervical tissues were recorded,and the cervical regeneration was observed during the follow-up. Results Among the 209 cases,179(85.6%) were satisfactory cervical regeneration,24(11.5%) were little satisfactory cervical regeneration,and 6(2.9%) were unsatisfactory cervical regeneration.Shallow ring excision,deep ring excision and cone excision had higher satisfactory situation.Extroversion of cervical columnar epithelium was observed in 15 cases(7.2%) in little satisfactory cervical regeneration.Severe extroversion of cervical columnar epithelium of 3 cases occurred in unsatisfactory cervical regeneration.Besides,there were 2 case of cervical shortening and 1 case of severe erythema in unsatisfactory cervical regenerations. Conclusion Although having such complications as extroversion of cervical columnar epithelium,cervical shortening and erythema,LEEP performs a high satisfactory cervical regeneration after management of cervical lesions.It is in great need to analyze the condition of different patients in managing cervical lesions by LEEP.