Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Muscle Contraction ; Muscle, Skeletal ; physiopathology ; Muscular Diseases ; physiopathology ; therapy

Objectives To investigate the epidemiology of high-risk human papillomavirus (HPV) infection and the common genotypes in Liaocheng city, Shandong province, China, and to evaluate the application value of high risk HPV detection in cervical cytology with different pathological conditions.Methods A total of 19 707 permanent female residents in Liaocheng were recruited who were married or had sexual life, aged from 18 to 70 years old.They were screened for cervical cancer by thinprep liquid-based cytology test (TCT) from January 2013 to January 2014.The screen positive rate was 4.24 ％ (837/19 707), and 785 volunteers aged from 21 to 65 years old were recalled.The xMAP bead-based hybridization and flowcytometry analysis were used for genotyping.The data were analyzed by comparison and description.Results According to TCT, among 785 cases, there were 478 cases of atypical squamous epithelium of unknown significance (ASCUS) and atypical glandular epithelium of unknown significance (AGCUS), 175 cases of low-grade squamous intraepithelial lesion (LISL), 127 cases of high-grade squamous intraepithelial lesion (HSIL), 5 cases of squamous cell carcinoma (SCC) and adenocarcinoma (ACC).The positive rate of high-risk HPV was 62.8 ％ (493/785).The risk age of infection was 26-30 years old (87.7 ％, 71/81) and 51-55 years old (79.7 ％, 51/64), while a low risk one was found in patients older than 55 years old (28.6 ％, 14/54).The top five high-risk subtypes of HPV were HPV16 (21.5 ％, 169/785), HPV52 (12.2 ％, 96/785), HPV58 (9.8 ％, 77/785), HPV33 (9.7 ％, 76/785), HPV18 (7.5 ％, 59/785).Single infection accounted for 45.0 ％ (353/785), while multi-infection for 17.8 ％ (140/785).98 cases were infected by two subtypes, 37 cases by three subtypes, 2 cases by four subtypes, 2 cases by five subtypes and 1 case by six subtypes.Conclusions Compared with pure cervical TCT screening, high-risk HPV infection detection is an effective method for cervical cancer screening, which can improve the specificity of cervical cancer screening and reduce the omission diagnostic rate.In Liaocheng, HPV subtypes 16, 52, 58, 33, 18 and multi-infection are more prevalent.Women belonging to 26-30 or 51-55 years old are identified as high-risk population.Screening is important for this group to discover early cervical lesions.

Objective To evaluate the diagnostic value of MRI for the mammographic sign of focal asymmetry of the breast (FAB) .Methods The morphological features of MRI and Time‐signal intensity curve (TIC) types of 46 cases of mammographic signs of FAB were analyzed retrospectively .Results In all 46 patients ,MRI detected 46 lesions in the corresponding areas of FAB on mammography ,in which 35 cases of benign lesions and 11 cases of malignant lesions were confirmed by pathology .The accuracy , positive predictive value and negative predictive value of the sub‐leaf shape and edge burr of the breast lesions were 82 .61% ,66 .67% , 86 .49% and 86 .96% ,85 .71% ,87 .18% respectively .TIC showed:in type Ⅰ ,all 17 cases were benign;In type Ⅱ ,4 cases were be‐nign and 2 cases were malignant ;In type Ⅲ ,9 cases were all malignant .The diagnostic accuracy of MRI for the benign and malignant breast lesions was 86 .96% .The positive predictive value and negative predictive values were 81 .82% and 96 .88% respectively .Con‐clusion MRI can definitely estimate the potential character of lesion in FAB ,and more accurately discriminate malignant and benign breast lesions .

ObjectiveTo evaluate the effect on lung injury of gefitinib or/and radiation.Methods Totally 160 mice were divided into five groups:control (C) ;gefitinib (G) ;radiation (R) ;gefitinib followed by irradiation ( G + R) ;and R + G.12 Gy irradiation was delivered.Geiitinib fed by 200 mg/kg once daily for 3 weeks.Mice were sacrificed on 1,2,4 or 6 months after radiation.Macrophage count of lung lavage fluid and hydroxyproline assessed,lung fibrosis scored.and plasma TGF-β1 concentration assayed.One-way ANOVA was used to test the significance. Results The lung lavage macrophage cell number were significantly higher in group R,R + G and G + R than group C ( q =2.95 - 8.61,all P ＜ 0.05 ) on 4 and 6months,yet no significant difference between the three groups ( q =0.37 -3.49,all P ＜ 0.05 ) ; The macrophage was significantly lower in month 1,4 and 6 in group G than R,R + G and G + R ( q =3.37- 6.25,all P ＜ 0.05 ).The hydroxyproline content and the fibrosis score of G,R,R + G and G + R were significantly higher than C ( q =3.14 - 4.76,all P ＜ 0.05 ),but no significant difference between the four groups ( q =0.70 - 4.19,all P ＞ 0.05 ).The TGF-β1 concentration of R,G + R,R + G at all time points and TGF-β1 concentration of G at 1 st and 2nd months were significantly higher than C ( q =3.76 -8.09,all P ＜ 0.05).ConclusionsGefitinib could cause lung fibrosis in vivo in BalB/C mouse.The combination of gefitinib and radiation did not significantly exacerbate lung injury caused byeither alone.The mechanism of lung fibrosis caused by gefitinib might be different from that by radiation which needs further research.

Objective To evaluate the clinical value and efficacy of prophylactic pancreatic duct stenting for biliary-type stenosis of Oddi sphincter with difficulty cannulation.Methods The present study was a retrospective study of 63 patients with biliary-type stenosis of Oddi sphincter and difficult cannulation.The stent group consisted 30 patients who underwent prophylactic pancreatic duct stenting from February 2010 to February 2011 and the control group included 33 patients who underwent only ERCP without prophylactic pancreatic duct stenting from January 2009 to January 2010.The incidence of postoperative pancreatitis were compared between the two groups.Results The incidence of postoperative pancreatitis of the control group was significantly higher than that of the stent group (P ＜ 0.05).Conclusion For patients with definite diagnosis of biliary-type stenosis of Oddi sphincter and difficult cannulation,prophylactic pancreatic duct stent placement is safe and effective.

PurposeTo study the patterns of the expression of MMP-2 and MMP-9 in human salivary adenoid cystic carcinoma and evaluate the relationship between the expression and nerve invasion and lymph node metastasis. MethodsThe immunohistochemical location of MMP-2 and MMP-9 was evaluated by using Envision immunoperoxidase technique. Studies were performed in 53 surgical excised specimens. The immunohistochemical staining results were densitometrically semiquantitatived. ResultsThe expressions of MMP-2 and MMP-9 in salivary adenoid cystic carcinoma were 67.92 % and 79.25 % respectively. The MMP-2 and MMP-9 levels in salivary adenoid cystic carcinoma with nerve invasion were much higher than those without invasion(P＜ 0.05, P＜ 0.05 respectively), and the percentage of lymph node metastasis rose with the change of MMP-2 and MMP-9 (P ＜ 0.05, P ＜ 0.05 respectively). ConclusionsThe results indicate that the rise of MMP-2 and MMP-9 correlate with the nerve invasion and lymph node metastasis.

ObjectiveTo evaluate whether oral administration of Chinese tradiational medicine,Qing-Xue granula,can prevent mouse lung injury caused by thoracic radiation.Methods128 BalB/C mice were divided into 4 groups:control (C) group; radiation (R) group; radiation plus high dose Qing-Xue granula (H) group and radiation plus median dose Qing-Xue granula ( M ) group.The H and M groups were fed 0.64 g and 0.32 g of Qing-Xue granula dissolved in 0.5 nl anline once daily for two months,which were 4 and 2 times of human dosage,respectively.Whole thorax radiation of 12 Gy was delivered with a single ventral-dorsal field with 6 MV X-ray.Group C and group R received 21 days of 0.5 ml saline feeding.Mice were sacrificed at 1,2,4 or 6 months after radiation. Macrophage cell count of lung lavage fluid and hydroxyproline content of left lung were assayed,and the lung fibrosis was scorred according to the Ashcroft's criteria.The plasma interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) concentration were assayed with ELISA method.The One-way ANOVA was used to test the significance of any differences between groups at each time point. Results The macrophage cell number of lung lavage fluid was significantly lower in the 1st month in group M than in group R (2∶4,q =3.92,P ＜ 0.05 ),but had no significant difference between group M and C ( 1 ∶ 4,q =2.13,P＞0.05 ).The hydroxyproline content of group H was significantly lower than group R in the 1st and 6th months (q =3.62,3.54,all P ＜ 0.05 ),but still higher than group C ( q =4.09,3.72,all P ＜ 0.05 ).The fibrosis score of group H was significantly lower than group R in the 2nd,4th and 6th months (q=3.38 -4.16,all P＜0.05).The IL-6 concentration of group H was significantly lower than group R in the 1st month ( q=3.53,P＜0.05 ),but not significantly higher than group C (q =1.41,P＞0.05).The VEGF concentration was significantly higher in group R than group C since the 2nd month ( q =3.12 - 3.78,P ＜ 0.05 ).The VEGF concentration was significantly higher in group H and M than group R in the 2nd and 6th months ( q =3.08 - 3.92,all P ＜ 0.0 5 ).Conclusions Oral Chinese traditional medicine,Qing-Xue granula,could prevent radiation induced lung fibrosis in mice,especially at high dosage.The degree of elevation of VEGF in plasma was not parallel with that of lung fibrosis.

Objective:To investigate the feasibility and safety of perimembranous ventricular septal defects (PmVSD) closure solely by femoral vein approach under transesophageal echocardiography (TEE) guidance.Methods:From January 1,2014 to May 31,2016,26 patients with PmVSD in Second Xiangya Hospital were selected,with age at 3.2-6.0 (4.3±0.7) years old and body weight at 15.0-19.5 (16.7±1.4) kg.The diameter of VSD was 3.5-4.8 (4.1±0.3) mm.All patients were treated by percutaneous PmVSD closure solely by femoral vein approach under TEE guidance.The effect of the procedure was evaluated by TEE and transthoracic echocardiography (TTE).The clinical follow-up study was conducted by TTE at 1,3,6 and 12 month (s) after the procedure.Results:Twenty cases were successfully treated with percutaneous PmVSD closure solely by femoral vein approach under TEE guidance,and the success rate was 76.9％.Six patients were converted to perventricular closure under TEE guidance because the guide wire in two cases or catheter in other cases could not pass through PmVSD.The diameter of symmetrical VSD occluder was 6.0-7.0 (6.2±0.4) mm.The procedural time was 12.0-64.0 (26.8±6.3) min.The residence time at ICU was 1.8-2.4 (26.8±6.3) h.The in-hospital time was 4.0-5.0 (4.4±0.5) d.There were 3 patients with immediate post-operative trivial residual shunt and incomplete right bundle branch block (IRBBB).All patients survived with no peripheral vascular injury or complications such as tricuspid regurgitation,pericardial tamponade and pulmonary infection.The residual shunt disappeared in 3 patients and IRBBB became normal rhythm in 3 patients at 1 month follow-up time point.No patients suffered from occluder malposition,residual shunt,pericardial effusion,arrhythmia (atrio-ventricular block),aortic valve regurgitation and tricuspid regurgitation.Conclusion:TEE-guided percutaneous PmVSD closureby femoral vein approach is safe and effective.

Objective To explore the effect of 20°trendelenburg position on hemodynamics during induction of general anesthesia of patients under gastrectomy.Methods One hundred and eighteen patients (77 males and 41 females,aged 50-60 years,ASA physical status Ⅰ or Ⅱ),scheduled for elective radical gastrectomy,were randomly divided into group A (n=40),group B (n=38) and group C (n=40).In group A,patients were placed in the supine position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In group B,patients were placed in the supine position during induction of anesthesia and was placed in the 20°trendelenburg position when hypotension occurred,and vasopressor would be administered if blood pressure was not restored.In group C,patients were placed in the 20°trendelenburg position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In all groups Lactated Ringer′s was infused at 15 ml·kg-1·h-1in 30 min before induction.Anesthesia was induced with propofol 2 mg/kg,sufentanil 0.5 μg/kg,rocuronium 0.9 mg/kg.The occurrence of hypotension and the total amounts of drug administrations were doccumented.Results Nineteen patients (47.5%) in group A,fourteen patients (36.8%) in group B and six patients (15.0%) in group C developed hypotention.The incidence of hypotension in group A and B was significantly higher than that in group C (P<0.05).In all groups the total dosage of ephedrine was used.Phenylephine was only used in the group A at a dose of 26.5±0.14 μg.The amounts of drug administrations in group B and C were significantly lower than that in group A (P<0.05).Two patients in group A went into a refractory hypotensive state.However,no patients in all groups fell into a serious arrhythmia state,so atropine was not used.Conclusion The 20°trendelenburg position during induction of general anesthesia of patients during gastrectomy can prevent hypotension during induction.This position is effective in the management of hypotension after the induction of general anesthesia and can decrease the amounts of drug administrations during induction of general anesthesia.

OBJECTIVE: To evaluate the impact of Down syndrome (DS) on surgical management in patients with congenital heart defects (CHD). METHODS: We retrospectively analyzed the clinical data from 35 children with DS and CHD, who underwent cardiac surgery between 2004 and 2009. The data on surgical mortality, complications and follow-up results are emphasized. RESULTS: All of the patients underwent primary repair. One child (2.9%) with DS and complete atrioventricular septal defect (CAVSD) died early postoperatively because of pulmonary hypertension. Two patients (5.7%) had low cardiac output syndrome, and 15 (42.9%) suffered pulmonary complications. III degree atrioventricular block (AVB) occurred in 4 patients (11.5%). Thirty children who were followed up 10 months to 6 years [(3.8±1.1) years] are in NYHA class I or II. There were no reoperations or later death. CONCLUSION CHD in DS children can be repaired with a low risk of mortality, although a high incidence of severe infections and III degree AVB can result in a complicated postoperative course. The results of mid-term follow up are satisfactory.
Child ; Child, Preschool ; Down Syndrome ; complications ; Female ; Heart Defects, Congenital ; complications ; mortality ; surgery ; Heart Septal Defects, Ventricular ; complications ; mortality ; surgery ; Humans ; Infant ; Male ; Postoperative Complications ; etiology ; Retrospective Studies ; Survival Analysis ; Treatment Outcome