Objective To investigate the prevalence of human papilloma virus (HPV) infections among gynecological patients and to identify the risk factors associated with high-risk HPV (HR-HPV)infection.Methods HPV DNA genotyping was performed in 391 HPV infected gynecological patients admitted in Weifang People's Hospital during January 2010 and December 2012.HPV negative patients (controls,n =356) were matched to HR-HPV positive patients (cases,n =356) with a 1 ∶ 1 ratio.All the participants took part in a questionnaire survey with 50 items,including demographic characteristics,pregnancy and reproductive history,living conditions,sexual behavior,family history,etc.Stepwise Logistic regression analysis was used to determine the risk factors of HR-HPV infection.Results Among 391 HPV positive patients,318 (81.3％) were infected with one type of HR-HPV,35 (9.0％) were infected with one type of low-risk HPV,and 38 (9.7％) were infected with mixed types.Logistic regression analysis showed that married women,age of sexual debut ＜ 20,multiple sexual partners,oral sex,commercial sexual activity,and vaginal douching more than once a week were risk factors of HR-HPV infection (OR =4.053,1.861,1.587,2.420,5.125 and 1.943,respectively,all P ＜ 0.01).Conclusions Unprotected sex may be associated with HR-HPV infection.Healthy sexual behavior should be encouraged,and the detection,prevention and control of HR-HPV infection should be strengthened.

BACKGROUND: There is nearly no muscle tissue with satisfactory function and appearance applying in clinical repair and construction of injured muscles to date. OBJECTIVE: To investigate the feasibility of applying autologous fascia as a scaffold to construct muscle in vivo. DESIGN, TIME AND SETTING: The randomized, self-matched control experiment was carried out between January 2004and June 2006 at Department of Burns & Plastic Surgery, Second Hospital of Shenzhen, Shenzhen, Guangdong Province, China MATERIALS: Twenty-eight healthy New Zealand rabbits, weighing (1.7±0.5) kg, without sex restriction, establishing middle part defect model of anterior tibial muscle of rabbit hind legs. METHODS: One hind leg of each rabbit was randomized to the experimental group (n=28), the other hind leg was assigned to one of 3 control groups, scaffold-connected group (n=10), muscle particle implant group (n=10) and blank control group(n=8). In experimental group, the defect was connected with an autologous fascial scaffold and filled with the mutilated muscle particles, and subcutaneous tissue and skin were sutured in situ. In scaffold-connected group, the treatments were same to the experimental group only except muscle particle implantation. In muscle particle implant group, the defect was filled with muscle particles but without fascial scaffold and other treatments were same to the experimental group. The defect in blank control group received no treatment. MAIN OUTCOME MEASURES: The success rate of muscle transplantation, histological and ultra structural observation,and immunohistochemical identification of desmin were observed at 2, 3, 4, 6 and 9 weeks after operation. The middle parts of samples were also harvested for relative quantitative analysis of α-actin cDNA using reverse transcription-polymerase chain reaction in the experimental group and scaffold-connected group.RESULTS: In experimental group, 1 muscle broke near the proximal junction, the other 27 succeeded and the appearance of healed defects became near normal gradually. In scaffold-connected group, 4 muscles broke, 6 muscles still depressed in defect area; in muscle particle implant group and blank control group, the defects had no change. In experimental group, a large quantity of skeletal muscle satellite cells proliferated, which reached peak at 2-3 weeks, cells attached to the ends of fibrous connective tissue; in scaffold-connected group only fibrous connective tissue was seen. lmmunohistochemistry showed that 85% cells in experimental group were desmin-positive, while the positive rate in scaffold-connected group was < 25%. The relative quantitative analysis of α -actin cDNA showed that there were significant differences between the experimental group and scaffold-connected group at different time points(P < 0.05).CONCLUSION: The success rate of repairing muscle defect with autologous fascial scaffold reached 93.33%, which indicates that it is feasible to promote muscle regeneration with autologous fascial scaffold.

Objective To study the etiology and drug resistance of escherichia coli isolated from clinic in chengde from 2016 to 2018, and to provide an objective basis for the epidemiological study and clinical rational use of antimicrobial agents. Methods The feces of 702 diarrhea patients in an outpatient clinic in chengde district from 2016 to 2018 were collected, isolated and prepared by conventional pathogen testing procedures, and the specimens suspected of escherichia coli were identified by multiple PCR and single PCR experiments. DEC was sensitized to 15 antibiotic drugs in vitro by automatic microbiological identification and drug sensitivity analyzer Vitke-2 compact. Results A total of 189 DEC strains was isolated from the feces of 702 diarrhea patients, and the detection rate was 26.92%. Among 189 DEC strains, EAEC had the highest detection rate (57.67%), followed by ETEC (32.80%), then EPEC (6.35%) and mixed (3.17%). EIEC and EHEC were not detected. The virulence genes were mainly ast A 、est Ib and esc V. All types of DEC were detected throughout the year, with the highest detection rate (29.19%) between June and August. The patients were mainly aged between 20 and 45 years old, and the detection rate was 25.86% and 27.97% for men and women. The detection of EPEC was not affected by season, sex or age, except by season and age. DEC had the highest resistance to ampicillin at 62.96%, 51.32%, 49.74% and 30.16% to cotrimoxazole, ciprofloxacin and gentamicin, and less than 20% to the other 11 drugs, all of which were sensitive to meropenem but not resistant. Among 189 DEC strains, esbl-producing strains accounted for 1.59%. Multiple resistant strains accounted for 32.80%. Conclusion DEC for chengde area of the most common bacterial pathogens in gastrointestinal tract infection, clinical laboratory should strengthen the monitoring of the region DEC, especially to carry on a variety of virulence genes, ESBL producing and multiple drug resistance strains, timely grasp the dynamics of bacterial drug resistance, and to guide clinical rational drug use, delay and reduce the generation of bacterial drug resistance.

Objective:To evaluate the day-surgery unit-based training of laparoscopic cholecystectomy (LC).Methods:Perioperative data of 438 patients (187 males and 251 females) with a median age of 54 (aged 17 to 91) years undergoing LC during January 2019 to April 2021 in the day-surgery unit of Chinese PLA General Hospital were retrospectively collected and subdivided according to the training methods of surgeons [Group A( n=260): conventional training vs. Group B ( n=178): protocoled stepwise training]. The protocoled stepwise training consists of the rotation in open biliary surgery unit, the stimulator-based laparoscopic training, and the stepwise procedural tutoring. The conventional training features the traditional surgical practice following senior surgeons. The technical data involving operation time, blood loss, the percentages of intraoperative decision-making by senior surgeons and the handing-over of procedure to senior surgeons, etc. were statistically analyzed. Results:The operation time was shortened in Group B [(55±30) min vs. (61±33) min], with significantly decreased percentages of intraoperative decision-making by senior surgeons [7.9% (14/178)vs. 16.9%(44/260), P<0.05] and the handing-over of procedure to senior surgeons [3.4%(6/178) vs. 11.2%(29/260), P<0.05]. Conclusion:Based on the protocoled stepwise training and the consecutive, high-volumed and standardized procedures, the laparoscopic technical proficiency and competency of the trainee surgeons have been improved.